Suchergebnisse

Objective: Using a theory of change framework, this study examines outcome measures of a home visitation program that provided services to first-born children and their parents living in southwestern New Mexico. Method: Home visitation workers conducted pretest and posttest assessments for prenatal and postpartum periods for 109 families receiving services in the First-Born Program. Families were assessed using the Revised North Carolina Family Assessment Scale. Paired sample t tests were used to assess effect. Results: Clients participating in the First-Born Program displayed significantly higher posttest scores on measures of family resiliency. Specifically, clients demonstrated improved scores in operationalized measures of resilience: social support, caregiver characteristics, family interaction measures, and a reduction in personal problems affecting parenting. Conclusion: The results are promising as participants were observed to make positive improvements in specific areas related to family resiliency.

Categorical funding mechanisms traditionally used to fund public health programs are a challenge to providers serving individuals with complex needs that often span multiple service areas. Integration--a formalized, collaborative process among service systems--responds to the challenge by decreasing fragmentation of care and improving coordination. In 2000, the Massachusetts Department of Public Health (MDPH) received a one-year planning grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to evaluate opportunities for integrating HIV/AIDS programs and substance abuse treatment programs. The project was later expanded to include viral hepatitis programming. Outcomes include the development of a strategic plan, joint procurement initiatives, and an ongoing commitment to sustain inter-bureau integration efforts, even in the face of substantial budget reductions. Integrated approaches can promote greater efficiency, improving communication and coordination among clients, providers, and government funding agencies.

Traumatic brain injury (TBI) induces the rapid formation of Alzheimer's disease (AD)-like amyloid-β (AB) plaques in about 30% of patients. However, the mechanisms behind this selective plaque formation are unclear. We investigated a potential association between amyloid deposition acutely after TBI and a genetic polymorphism of the AB-degrading enzyme, neprilysin (n = 81). We found that the length of the GT repeats in AB-accumulators was longer than in non-accumulators. Specifically, there was an increased risk of AB plaques for patients with more than 41 total repeats (p < 0.0001; OR: 10.1). In addition, the presence of 22 repeats in at least one allele was independently associated with plaque deposition (p = 0.03; OR: 5.2). In contrast, the presence of 20 GT repeats in one allele was independently associated with a reduced incidence of AB deposition (p = 0.003). These data suggest a genetically linked mechanism that determines which TBI patients will rapidly form AB plaques. Moreover, these findings provide a potential genetic screening test for individuals at high risk of TBI, such as participants in contact sports and military personnel.

BACKGROUND: Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, various strategies have been taken worldwide to reduce the risk of infection. As part of the amendment to the Infection Protection Act, elective medical interventions were restricted, leading to a change in patient care. However, the consequences of the lockdown on the treatment of rhythmological patients in Germany remains unclear. OBJECTIVES: The aim of this study was to analyze the reduction in rhythmological interventions and the patient care situation using a nationwide survey during the first lockdown period. METHODS: A survey was sent to all electrophysiological centers certified by the German Society of Cardiology. Here, the treatment volume of tachycardia and bradycardia and their invasive therapy were surveyed before and during the lockdown period. Furthermore, the number of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) treated at these centers and the incidence of cardiac arrhythmias was also recorded. RESULTS: Participating centers performed a total of 24,648 ablation procedures/year and represent approximately 34% (24,648/72,548) of the estimated German ablation treatments. The majority of these centers (33/40; 82.5%) were so-called primary COVID-19 hospitals (level-1). Overall, the number of ablations and pacemaker implantations were reduced by 41% and 18% respectively. Due to postponed ablation procedures and pacemaker implantations, 22/40 (55%) centers reported a worsening of clinical symptoms or early re-hospitalization of their patients. CONCLUSION: These results demonstrate a significant decline in elective rhythmological procedures during the lockdown, as required by the German Federal Government. At the same time, however, more than half of the participating centers reported an increase in patient re-hospitalizations due to postponed procedures.

Modern developed nations are rich and politically stable in part because their citizens are free to form organizations and have access to the relevant legal resources. Yet in spite of the advantages of open access to civil organizations, it is estimated that eighty percent of people live in countries that do not allow unfettered access. Why have some countries disallow the formation of organizations as part of their economic and political system? The contributions to Organizations, Civil Society, and the Roots of Development seek to answer this question through an exploration of how developing nations throughout the eighteenth and nineteenth centuries, including the United States, United Kingdom, France, and Germany, made the transition to allowing their citizens the right to form organizations. The transition, contributors show, was not an easy one. Neither political changes brought about by revolution nor subsequent economic growth led directly to open access. In fact, initial patterns of change were in the opposite direction, as political coalitions restricted access to specific organizations for the purpose of maintaining political control. Ultimately, however, it became clear that these restrictions threatened the foundation of social and political order. Tracing the path of these modern civil societies, Organizations, Civil Society, and the Roots of Development is an invaluable contribution to all interested in today's developing countries and the challenges they face in developing this organizational capacity