Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

Program evaluation and its application to equipment based on super-efficiency DEA and gray relation projection method

For the gray attributes of the equipment program and its difficulty to carry out the quantitative assessment of the equipment program information, the gray relation projection method is simply reviewed. Combining the super-data envelopment analysis（DEA） model and the gray system theory, a new super-DEA for measuring the weight is proposed, and a gray relation projection model is established to rank the equipment programs. Finally, this approach is used to evaluate the equipment program. The results are verified valid and can provide a new way for evaluating the equipment program.

Implementation and Evaluation of a Postpartum Care Program for Mothers Raising Infants: A Pilot Study

Background: The aims of this pilot study were to implement and evaluate a postpartum care program for mothers raising children younger than one year to provide physical relaxation, and to reduce mothers’ parenting problems. Methods: A day-service and group-type postpartum care program was implemented with the aim of interacting with peers, promoting local communication, and relaxing mothers. Results: Forty-five pairs of mothers and infants participated in the study. Most of the mothers experienced relaxation, communicated with each other, resolved physical problems, reduced childcare concerns, and developed parenting friends. Conclusions: In addition, feasibility was assured as they were very satisfied with the content of programs such as baby massage and aroma treatment.

Program & faculty evaluation

Graduate medical education(GME)has shifted its curricula from process-oriented approach to outcomes-oriented models.Program and faculty evaluation are methods by which educational curricula may adjust the teaching and learning environment to meet the needs and fills the gaps in GME.The measurement of educational outcomes is an essential for assessing teaching effectiveness in a shifting health care environment.In addition to trainee,program,and faculty evaluations,annual program review(APR)and evaluation and navigational changes made by the program education committee are essential to maintain effectiveness of an educational curriculum in a contemporary graduate medical training program.

Critical Review of Literature on Radiologic Technology Education Program Evaluation

Curriculum has achieved a varied record of success in influencing health based practices and developing professional skills. Designing and implementing an effective radiologic technology educational program curriculum requires a disciplined pedagogical approach where the instructor performs a thorough situational analysis, develops a theory based and pragmatic learning plan, and implements a course of study in accordance with the established educational guidelines and requirements. Diligent efforts are needed to enhance the relationship amongst curriculum developers and evaluators. The collection of information at the formative stage: followed by process evaluation to assess implementation as the curriculum progresses, and summative evaluation to assess impact is required for accreditation of program in the United States by the Joint Review Committee for Education in Radiologic Technology. Formative evaluation research is used to enhance effectiveness of the curriculum, guide development of teaching and learning strategies, and reveal promising and ineffective components of curriculum. This review of literature provides evidence as to what is considered to be the best practice in the program evaluation/accreditation process.

Helping Nurses Cope with COVID-19 Pandemic: Evaluating Support Programs

During the height of the Coronavirus Disease (COVID-19) Pandemic, nurses all over the world, including members of the National Association of Nigerian Nurses in North America (NANNNA) experienced a heightened and unprecedented level of stress, anxiety, fear, uncertainty, concern for their safety and that of their loved ones. This prompted NANNNA leadership to initiate and conduct support programs for nurses especially those on the frontline of care. This project evaluates the effectiveness of the support programs conducted by NANNNA during the early surge of COVID-19. The Centers for Disease Control’s (CDC’s) Framework for Evaluation in Public Health guided this evaluation. Focus group discussion and online survey was utilized to gather data. While 19% of respondents reported being diagnosed with COVID-19, the majority (81%) were not. About 44% of respondents had family members who were diagnosed with COVID-19, while 18% reported loss of a close family member due to COVID-19 complications. Most respondents reported that the program was impactful in information sharing as well as significant in helping them feel connected with other nurses. Hence, this subsequently enhanced their support networks, provided emotional and spiritual support. Survey results revealed that NANNNA support programs had positive effects in helping members mitigate the fear, anxiety and uncertainty experienced during the surge of the COVID-19.

Implementation and Evaluation of Infertility Reflection in Early Pregnancy after the Use of Assisted Reproductive Technology: A Feasibility Study

Background: This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of infertility reflection) and 2) outcome evaluation (satisfaction of care needs, anticipatory anxiety towards the loss of a pregnancy or fetus, cognition of infertility experience, and depression and anxiety). Methods: This program evaluation study used a one-group pre-post-test design. The participants were 50 primiparas who had undergone ART at two fertility treatment facilities in a metropolitan area in Japan. For the infertility reflection, they conducted an online reflection. Data were collected three times: at the 5th week of pregnancy (Time 1), the 8th week of pregnancy as the final consultation at the clinic (Time 2), and the 16th week of pregnancy as the final point of early pregnancy (Time 3). Results: The data from 40 participants were analyzed. More than 80% of the users of the online reflection positively evaluated the appropriateness and usefulness of the methods and contents. Organized thoughts and feelings by reflection were shown as the reasons for the usefulness. The evaluation of the online reflection showed a relatively strong correlation with the Care Need Satisfaction Scale (CNSS) for both Time 2 and Time 3, but the online reflection did not show a significant correlation with the other outcome variables. There were no significant differences in outcome variables between users and non-users of online reflection between Time 2 and Time 3. Conclusions: Attempts at the reflection in early pregnancy require modified methods that do not have a negative impact and lead to the fulfillment of needs.

A New Talent Cultivation Model Under Open-source Environment:A Case Study at Zhejiang University

The open-source movement profoundly impacts the development of computer education.The current requirements for postgraduate cultivation in Chinese universities mainly include publishing papers,applying for patents,winning awards,and conducting research projects,which demonstrate the capabilities of students when they graduate from university.However,in today’s prevalent open-source culture,these types of assessments are still not comprehensive enough for postgraduate cultivation,especially for professional postgraduate degrees.For this reason,Zhejiang University takes the lead in proposing educational reforms for postgraduate cultivation based on the open-source ecosystem.It has implemented a new“trinity”mechanism(i.e.,open-source course,open-source training,and open-source capability evaluation)for graduate training centered on open source,serving as a novel supplement to the traditional methods of postgraduate cultivation.After a year of pilot operation,this new approach,deeply loved by teachers and students,has achieved good results and positive feedback.

Life-Cycle Impact Assessment of Air Emissions from a Cement Production Plant in Cambodia

Cement industrial emissions account for 32% of air pollution in Cambodia. With that in mind, we examined the environmental impact of Cambodia’s cement industry and identified ways that it could reduce air pollution. The study focused on raw material extraction and preparation, calcination, and cement preparation. Data for the life-cycle inventory were provided by the Kampot Cement Plant. Air emissions were assessed using EMEP/EEA and IPCC criteria, and the impact assessment used ReCiPe (2016). The baseline analysis revealed that calcination contributed the most air pollutants, so mitigation scenarios focused on alternative fuels only during the calcination stage of cement production: 1) 100% coal (S1);2) 93% coal and 7% biomass (S2);3) 85% coal and 15% biomass (S3);4) 70% coal and 30% biomass (S4);and 5) 50% coal and 50% biomass (S5). The results demonstrated that certain mitigation measures reduced major emissions and environmental damage. S5 had the best results, reducing CO2 by 49.97, NOx by 2.233, and SO2 by 49.333%;however, it increased PM2.5 by 19.60% and total heavy metal (Pb, Cd, Hg, As, Cr, Cu, Ni, Se, Zn) output by 28.113%. The results of the study showed reductions in serious health and environmental effects associated with climate change of 48.83%, ozone generation of 9.62%, and particulate matter formation of 28.80%. However, carcinogenic and non-carcinogenic human toxicity increased by 35.66%. Therefore, such mitigation effect would be benefit to carbon reduction target in Cambodia.

Development and application of a two-dimensional water quality model for the Daqinghe River Mouth of the Dianchi Lake

Water quality models are important tools to support the optimization of aquatic ecosystem rehabilitation programs and assess their efficiency. Basing on the flow conditions of the Daqinghe River Mouth of the Dianchi Lake, China, a two-dimensional water quality model was developed in the research. The hydrodynamics module was numerically solved by the alternating direction iteration （ADI） method. The parameters of the water quality module were obtained through the in situ experiments and the laboratory analyses that were conducted from 2006 to 2007. The model was calibrated and verified by the observation data in 2007. Among the four modelled key variables, i.e., water level, COD （in CODcr）, NH4＋-N and PO43-P the minimum value of the coefficient of determination （COD） was 0.69, indicating the model performed reasonably well. The developed model was then applied to simulate the water quality changes at a downstream cross-section assuming that the designed restoration programs were implemented. According to the simulated results, the restoration programs could cut down the loads of COD and PO43-P about 15%. Such a load reduction, unfortunately, would have very little effect on the NH4^＋-N removal. Moreover, the water quality at the outlet cross-section would be still in class V （3838-02）, indicating more measures should be taken to further reduce the loads. The study demonstrated the capability of water quality models to support aquatic ecosystem restorations.

Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service:A pilot study

Objectives:Little is known about the differences between urban and rural gamblers in Australia,in terms of comorbidity and treatment outcome.Health disparities exist between urban and rural areas in terms of accessibility,availability,and acceptability of treatment programs for problem gamblers.However,evidence supporting cognitivebehaviour therapy as the main treatment for problem gamblers is strong.This pilot study aimed to assess the outcome of a Cognitive-Behavioural Therapy(CBT)treatment program offered to urban and rural treatment-seeking gamblers.Methods:People who presented for treatment at a nurse-led Cognitive-Behavioural Therapy(CBT)gambling treatment service were invited to take part in this study.A standardised clinical assessment and treatment service was provided to all participants.A series of validated questionnaires were given to all participants at(a)assessment,(b)discharge,(c)at a one-month,and(d)at a 3-month follow-up visit.Results:Differences emerged between urban and rural treatment-seeking gamblers.While overall treatment outcomes were much the same at three months after treatment,rural gamblers appeared to respond more rapidly and to have sustained improvements over time.Conclusion:This study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts,but once in treatment appear to respond quicker.ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained.Ensuring better availability and access to such treatment in rural areas is important.Nurses are in a position as the majority health professional in rural areas to provide such help.

Effectiveness of an employment-based smoking cessation assistance program in China

Objective:The objective of this study was to adapt an evidence-based smoking cessation intervention initially developed in the United States to the Chinese context and evaluate the ef-fectiveness of this intervention in China.Method:A smoking cessation program from United States was adapted and implemented through an Employee Assistance Program(EAP)in China.The intervention consisted of recom-mending medication and psychological counseling.Local EAP counselors received training on the program and delivered the intervention to clients.Program evaluation examined the intervention's effectiveness in helping clients quit or reduce the amount of smoking and nicotine dependence.Results:Ninety-day follow-up showed that those who had completed the program were more likely to remain abstinent,or stop smoking daily and have lower levels of nicotine dependence(p<0.05)than those who had dropped out.Conclusions:The evidence-based cessation program is effective in helping Chinese smok-ers quit or reduce the amount of smoking.Moreover,implementing such programs in an EAP setting is a practical approach to providing a wider spectrum of smokers with access to cessation assistance in China.

Impact of a Senior High School Tuition Relief Program on Poor Junior High School Students in Rural China

A significant gap remains between rural and urban students in the rate of admission to senior high school. One reason for this gap might be the high levels of tuition and fees for senior high school By reducing students＇ expectations of attending high school, high levels of tuition and fees could be reducing student aeademic performance in junior high schools. In this paper we evaluate the impacts of a senior high tuition relief program on the test scores of poor rural seventh grade students in China. We surveyed three counties in Shaanxi Province and exploited the fact that, while the counties are adjacent to one another and share similar characteristics, only one of the three implemented a tuition relief program. Using several alternative estimation strategies, including difference-in-differences, propensity score matching and difference-in-differences matching, we find that the tuition program has a statistically significant and positive impact on the mathematics scores of seventh grade students. More importantly, this program is shown to have a statistically significant and positive effect on the poorest students in the treatment group compared to their wealthier peers.

KNOWLEDGE-SCIENTIFIC EVALUATION OF COMMUNITY SERVICE SYSTEMS

This paper proposes a knowledge-scientific approach to evaluation of community service systems from the viewpoints of knowledge creation, consciousness reform, and value co-creation. A concrete example of the commtmity service system treated here is an education program for old men to find their reason for living after the retirement. After introducing this program and the traditional evaluation methods for such a program, the paper emphasizes the necessity of developing new evaluation methods for such a community service system based on knowledge science. The paper proposes a new evaluation framework and reports an actual evaluation result using the interview data from participants in that program.

Competing Theories for Improving Teacher Preparation Programs:The Case of North Carolina

Purpose:Written from the prospective of a school of education dean,the article describes how deans worked with researchers and university system staff to develop multiple measures of teacher preparation program(TPP)quality.Design/Approach/Methods:As a key participant in the development of a multi-methods approach to evaluating(TPP)quality,the author frequently interacted with the university system oversight staff,the researchers tasked with measuring TPP quality,and the school of education deans.The article draws on his experience in collaborating with individuals in these three groups over an 8-year period.The article also reviews the controversial history of hierarchical linear models as tools for evaluating TPPs.Findings:The author argues that over time and as a result of frequent conversations and discussions,the three groups collaborated in creating a data dashboard that provides TPP faculty with evidence that enables them to make data-informed improvements to their programs and satisfies policymakers’interest in informing the public of TPP quality.Originality/Value:Few,if any,articles have been published that describe a collaborative process for creating a data repository that can inform the continuous improvement of TPPs and address policymakers’concerns about teacher quality.Educators,researchers,and policymakers elsewhere may learn about how to develop a partnership focused on generating and using data in program improvement as well as the value of multiple measures in evaluating TPPs and informing policymakers.

Multi personal computer storage system: solution of sea capacity PACS storage

Objective According to the characteristics of digital medicine and the demands of digitalized management in hospitals, we established a storage system that is affordable, highly expandable, and reliable. Methods The multi personal computer storage system (MPCSS) was constructed using hardware and software. The image data were archived from major servers to storage personal computers (PCs) by using Neusoft-picture archiving and communication system (PACS) and backed up on storage PCs. We simulated data loss on storage PCs and then restored the data. We also expanded the storage system to enlarge its capacity. Results The average transfer rate from MPCSS was 27.7 MB/s, and the average cost for this system was $74/GB. In the testing stage, only 6 of 187 instances of data retrieval (from 100 patients) failed. Conclusion The MPCSS is much less expensive than other high capacity systems or devices. It is feasible and suitable for digital image storage.

The effectiveness of E-learning in continuing medical education for tuberculosis health workers: a quasi-experiment from China

Background:Given the context of rapid technological cha nge and COIVD-19 pan demies,E-lear ning may provide a unique opportunity for addressing the challenges in traditional face-to-face continuing medical education(CME).However,the effectiveness of E-learning in CME interventions remains unclear.This study aims to evaluate whether E-learning training program can improve TB health personnel's knowledge and behaviour in China.

Achieving Better Educational Practices Through Research Evidence:A Critical Analysis and Case Illustration of Benefits and Challenges

Purpose:We examine considerations regarding the positive contributions of evidence accountability and challenges that frustrate educators in gaining access to the needed product information.Design/Approach/Methods:We review the research literature on the multiple characteristics of evidence relative to consumer(practitioner)interests.We then examine,through a"case illustration"of an initiative in a large school district,a second challenge for evidence usage-conducting viable studies and interpreting outcomes from comprehensive interventions in complex educational systems.Findings:Despite attention being given to rigorous evidence,consumers report preferring peer recommendations and local pilot studies as sources.In our case illustration,we found that the availability of evidence from comprehensive formative evaluation studies was viewed by stakeholders as positively contributing to program implementation quality and sustainability over time.Originality/Value:We use a real-world"case illustration"of a complex initiative in a large,diverse school district to illustrate how current policies and expectations regarding evidence support for educational programs is filtered through multiple agendas and personal needs of key stakeholders.Consequently,evaluators acquire nontraditional roles that go beyond routine execution of rigorous studies.Given these factors,we offer recommendations for fostering more meaningful and objective interpretations and usage of evidence by local stakeholders.

The causes of chronic and transient poverty and the implications for poverty reduction policy in rural China

The study focuses on two components of total poverty:chronic and transient poverty,and investigates their relative importance in total observed poverty,as well as the determinants of each component.We find that transient poverty accounts for a large proportion of total poverty observed in the poor rural areas of China.By analyzing the determinants of the two types of poverty,we find that household demographic characteristics,such as age of the head of households,family sizes,labour participation ratio,and educational level of the head of the households,are very important to the poverty status of households.These factors matter more to chronic poverty than transient poverty,and have greater impacts on the poverty measured by consumption than that measured by income.Besides the demographic factors of households,other household factors like physical stocks,the composition of income,and the amount of cultivated lands also have significant effects on both chronic and transient poverty.It is also confirmed that change in cash holding and saving and borrowing grain are used by rural households to cope with income variation and smooth their consumption.Attributes of community where the households reside are also important to poverty.With very few exceptions,we do not find that poverty programs have significant impact on poverty reduction at the households’level.We interpret this as the poverty programs benefiting the wealthy more than the poor in a given poor area.The main reason for this could be that the implementation design of these programs fails to target the poor.

Returns to Lying？ Identifying the Effects of MisreporUng When the Truth Is Unobserved

Consider an observed binary regressor D and an unobserved binary vari- able D＊, both of which affect some other variable Y. This paper considers nonpara- metric identification and estimation of the effect of D on Y, conditioning on D＊ = 0. For example, suppose Y is a person＇s wage, the unobserved D＊ indicates if the person has been to college, and the observed D indicates whether the individual claims to have been to college. This paper then identifies and estimates the difference in av- erage wages between those who falsely claim college experience versus those who tell the truth about not having college. We estimate this average effect of lying to be about 6% to 20%. Nonparametric identification without observing D＊ is obtained ei- ther by observing a variable V that is roughly analogous to an instrument for ordinary measurement error, or by imposing restrictions on model error moments.