scholarly journals Incomplete Early Childhood Immunization Series and Missing Fourth DTaP Immunizations; Missed Opportunities or Missed Visits?

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Steve G. Robison
Keyword(s):  
Early Childhood ◽  
Early Care ◽  
Childhood Immunization ◽  
Missed Opportunities ◽  
Childhood Immunizations ◽  
The Us ◽  
Oregon Health Plan ◽  
Missed Visits ◽  
To Receive

The successful completion of early childhood immunizations is a proxy for overall quality of early care. Immunization statuses are usually assessed by up-to-date (UTD) rates covering combined series of different immunizations. However, series UTD rates often only bear on which single immunization is missing, rather than the success of all immunizations. In the US, most series UTD rates are limited by missing fourth DTaP-containing immunizations (diphtheria/tetanus/pertussis) due at 15 to 18 months of age. Missing 4th DTaP immunizations are associated either with a lack of visits at 15 to 18 months of age, or to visits without immunizations. Typical immunization data however cannot distinguish between these two reasons. This study compared immunization records from the Oregon ALERT IIS with medical encounter records for two-year olds in the Oregon Health Plan. Among those with 3 valid DTaPs by 9 months of age, 31.6% failed to receive a timely 4th DTaP; of those without a 4th DTaP, 42.1% did not have any provider visits from 15 through 18 months of age, while 57.9% had at least one provider visit. Those with a 4th DTaP averaged 2.45 encounters, while those with encounters but without 4th DTaPs averaged 2.23 encounters.

Aseptic Ingredient Addition: Meeting the Demand for Better-Tasting Orange Juice

2006 ◽  
Author(s):  
Paul P. Brocker
Keyword(s):  
Orange Juice ◽  
Juice Quality ◽  
Storage Tanks ◽  
Bulk Storage ◽  
Naturally Occurring ◽  
The Us ◽  
Enhancement Method ◽  
Market Perception ◽  
To Receive

Since the late 1970’s, Aseptic Not-From-Concentrate Orange Juice (NFCOJ) has been successfully stored in large refrigerated aseptic storage tanks. Aseptic tanks have evolved from 280,000 gallons in volume to now in excess of 1.8 million gallons each. The total bulk storage capacity in Florida has grown to approximately 280 millions of gallons and continues to grow with new installations occurring each year at some facilities. Worldwide, the market is expanding into Brazil, Spain, and markets that are beginning to receive juice shipped in bulk on snips. The aseptic storage methods have been accepted in Brazil and Europe, and aseptic transfer of the juice is occurring via specially outfitted aseptic tanker vessels from Brazil to the US and Europe. The consumer’s demand for NFCOJ has grown steadily throughout these years, and the suppliers of consumer packaged orange juice have developed special processes and methods to maximize the quality and flavor of the juices sent to the market. Fresh juice, light pasteurization, and flavor enhanced products are just some of these methods resulting in very high quality juice availability. Also, cost and price are always under assault, and the juice suppliers are always looking for an edge. Recently, the flavor enhancement method has come under scrutiny by the FDA, and the industry is being reminded that all added flavors must be made from naturally occurring orange derivatives or must be labeled appropriately: such as “with natural (other fruit) flavors” or “with artificial flavors,” both of which may have an undesirable impact on the market perception of the juice quality. At this same time, as the bulk storage technology of NFCOJ has matured in the past 25 years, some processors who package their own juice are investing in special aseptic transfer methods from the aseptic bulk storage tanks without the need to re-pasteurize the juice prior to packaging. Their goal is to provide the highest quality juice to the consumer, and to minimize or eliminate the need to add expensive and special flavor packs to the juice. This is being done commercially in Florida and Spain. This paper explores these methods of aseptic juice transfer direct to packaging and the aseptic addition of natural or otherwise desired and labeled ingredients, and their potential impact on the quality of the juice. Paper published with permission.

scholarly journals Strengthening the Quality of Preschool, Childcare, and Parenting

2020 ◽  
pp. 204-223
Author(s):  
Soo-Young Hong ◽  
Holly Hatton-Bowers ◽  
Lisa Knoche
Keyword(s):  
Early Childhood ◽  
Emotional Competence ◽  
Well Being ◽  
Early Childhood Educators ◽  
Early Care And Education ◽  
Positive Behavior ◽  
Collaborative Partnerships ◽  
Early Care ◽  
Preschool Childcare

Early childhood is a critical period during which children learn to regulate and manage emotions and behaviors, develop and maintain social relationships, and interact effectively with others. In this chapter, the authors describe research-based supports for young children’s emotional well-being and positive behavior, promising strategies and interventions used in early care and education settings, the well-being of early childhood educators that impacts children’s emotional competence, and the importance of engaging families in promoting children’s emotional well-being and positive behavior. This chapter uses a systemic lens and emphasizes the importance of collaborative partnerships between parents and early childhood educators in supporting young children’s emotional well-being and positive behavior.

scholarly journals 40 Across the Pond: Why Are Junior Doctors Seeking Surgical Training Abroad?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Irfan ◽  
I Ahmed
Keyword(s):  
Surgical Training ◽  
Training Programme ◽  
Junior Doctors ◽  
Common Time ◽  
Surgical Trainees ◽  
Surgical Workforce ◽  
The Us ◽  
To Receive ◽  
Career Uncertainty

Abstract Introduction The loss of junior doctors from the NHS has been an ongoing issue. A subset are now seeking surgical training in other systems, such as the US. This is a costly and difficult process and many enter into undesignated positions with no guarantee of a job. With so much career uncertainty, why are trainees willing to take the risk? Method We performed a survey of trainees who graduated from British medical schools; all are currently enrolled in a US surgical training programme. They were asked about their experiences and perceptions of Results Nine trainees completed the survey. The most common time for trainees to move was during or after foundation training and the majority initially matched into preliminary positions. The most common reason cited to move was to receive better quality training. Many perceived the US training to be better and felt that they had a reasonable work-life balance. Conclusions The potential loss of the future NHS surgical workforce is worrying. Our survey highlights that surgical trainees place a high value on the quality of their training and were willing to enter an intense and uncertain process to achieve it. This needs to be addressed to retain potential trainees.

Feasibility and Clinical Implications of Remotely Guided Ultrasound Examinations

2020 ◽  
Vol 91 (7) ◽  
pp. 592-596
Author(s):  
Quinn Dufurrena ◽  
Kazi Imran Ullah ◽  
Erin Taub ◽  
Connor Leszczuk ◽  
Sahar Ahmad
Keyword(s):  
Clinical Utility ◽  
Regional Wall Motion ◽  
Subjective Assessment ◽  
Clinical Implications ◽  
Pilot Studies ◽  
Objective Quality ◽  
The Us ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities

BACKGROUND: Remotely guided ultrasound (US) examinations carried out by nonmedical personnel (novices) have been shown to produce clinically useful examinations, at least in small pilot studies. Comparison of the quality of such exams to those carried out by trained medical professionals is lacking in the literature. This study compared the objective quality and clinical utility of cardiac and pulmonary US examinations carried out by novices and trained physicians.METHODS: Cardiac and pulmonary US examinations were carried out by novices under remote guidance by an US expert and independently by US trained physicians. Exams were blindly evaluated by US experts for both a task-based objective score as well as a subjective assessment of clinical utility.RESULTS: Participating in the study were 16 novices and 9 physicians. Novices took longer to complete the US exams (median 641.5 s vs. 256 s). For the objective component, novices scored higher in exams evaluating for pneumothorax (100% vs. 87.5%). For the subjective component, novices more often obtained clinically useful exams in the assessment of cardiac regional wall motion abnormalities (56.3% vs. 11.1%). No other comparisons yielded statistically significant differences between the two groups. Both groups had generally higher scores for pulmonary examinations compared to cardiac. There was variability in the quality of exams carried out by novices depending on their expert guide.CONCLUSION: Remotely guided novices are able to carry out cardiac and pulmonary US examinations with similar, if not better, technical proficiency and clinical utility as US trained physicians, though they take longer to do so.Dufurrena Q, Ullah KI, Taub E, Leszczuk C, Ahmad S. Feasibility and clinical implications of remotely guided ultrasound examinations. Aerosp Med Hum Perform. 2020; 91(7):592–596.

Lesson Study dan Implikasinya Terhadap Pembelajaran Berbasis Kurikulum Tingkat Satuan Pendidikan

2016 ◽  
Vol 1 ◽  
pp. 189-196
Author(s):  
Vian Harsution
Keyword(s):  
Learning Environment ◽  
Learning Process ◽  
Lesson Study ◽  
Learning Difficulties ◽  
Learning Needs ◽  
Democratic Leadership ◽  
Entrepreneurial Spirit ◽  
To Receive

Lesson study is a systematic, collaborative, and sustainable method of improving the quality of learning. Lesson study emphasizes the exploration of students’ learning needs; teacher openness towards learning difficulties encountered; the willingness of teachers to receive and provide advice and solutions to the difficulties encountered; and the consistency of the various parties to follow up the suggestions and solutions. Implementation of lesson study involving teachers, principals, and experts in the field of education. Kurikulum tingkat satuan pendidikan or abbreviated KTSP is operational curriculum formulated and implemented by each educational unit. KTSP has the characteristics, namely: giving broad autonomy to the educational unit, involving the community and parent participation, involving the democratic leadership of the principal, and require the support of a working team that is synergistic and transparent. KTSP based on the learning process, needs to be supported by a conducive learning environment and fun to be created by teachers.Teachers and principals in a professional, systematic and collaborative create an atmosphere that fosters independence, tenacity, entrepreneurial spirit, adaptive and proactive nature of the learning process. Thus, the learning needs of students who fulfilled optimally and professional ability of teacher who have increased on an ongoing basis, may usher in success – based learning KTSP. It means that the lesson study provides positive implications for the KTSP – based learning.

Prevention and Treatment of Early Childhood Caries (ECC)

2016 ◽  
Vol 1 (3) ◽  
Author(s):  
Jeffrey .
Keyword(s):  
Early Childhood ◽  
Health Problem ◽  
Early Childhood Caries ◽  
Health Providers ◽  
Missing Teeth ◽  
Optimal Basis ◽  
Major Health Problem ◽  
Major Health ◽  
Childhood Caries

Early Childhood Caries (ECC) is a chronic disease that can be prevented. It commonlyaffects children involving in one or more decayed (with lesions or not) teeth, missing teeth (dueto caries), or teeth with fillings in children aged under 71 months. The disease is sometimesoverlooked, but this condition usually affects the general health of children. Early detection ofEarly Childhood Caries (ECC) can prevent problems which are harmful to children. Therefore,the ECC must be prevented and for teeth that have had dental caries they should be givenproper treatment so as not to worsen and affect the quality of life in children. Prevention of thisdisease is a significant component in any health program to prepare for the optimal basis forthe oral health of children. This condition will become a serious health problem if not handledproperly, and it is a major health problem for health providers throughout the world.Primarypreventive must be initiated since a woman getting pregnant.Keywords: Early Childhood Caries (ECC), prevention, treatment

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