These results suggest that shielded syringes and related technology may offer potential for reducing the risk of needlestick injuries among hospital and other healthcare employees. This study should be viewed as a preliminary effort to assess the potential of shielded-syringe technology for reducing the risk of needlestick injuries among healthcare workers. The results are encouraging, but more clinical experience with this new device and longer follow up are essential to provide the data necessary for a definitive assessment of efficacy.
Background and Objectives: Family physicians are increasingly making or contemplating various methods of practice transformation, but most report significant barriers to making that transition. Given strong interest in practice transformation, and perceived barriers to doing so, it is important to examine how some practices are implementing changes and overcoming barriers. In this project, Family Medicine for America’s Health Practice Team learned from practices across the United States that are transforming and experiencing the benefits of working in a comprehensive, value-based practice. The objectives of the project were to identify drivers of transformation to value-based care and ways of working with drivers to mitigate potential barriers, and to determine relationships between practice transformation and joy of practice. Methods: Fifteen practices of varying size and type from 11 states participated in this project. Practices were sent a short-answer survey about their practice, transformation, and payment structure. Next, practices participated in a 45-60-minute deep-dive interview. All surveys and interviews were iteratively coded to identify themes using Thomas Bodenheimer, MD, et al’s building blocks of high performing primary care framework. Results: Engaged leadership, data-driven improvement, team-based care, and comprehensiveness and care coordination were primary drivers of transformation, with payment as a needed foundation. Practice transformation helped meet the triple aim and was correlated to joy of practice. Conclusions: Practices are transforming to comprehensive value-based care delivery and experiencing greater joy in practice; but payment reform is required to spread and sustain practice transformation.
Check, Connect, and Expect (CCE) is a secondary tier behavioral intervention that provides students with levels of support including a dedicated “coach” for check-in and check-out procedures, and social skills instruction. Elementary students ( n = 22) in an alternative education school setting received CCE for 13 weeks following 4 weeks of baseline data collection. Measures included (a) daily progress reports (DPR), (b) direct observation of academic engagement, and (c) curriculum-based measures of academic growth (math calculation and oral reading fluency). These measures were used to examine the relationship between CCE and student outcomes using an interrupted time series design and multilevel growth curve modeling. This quasi-experimental within-subjects design compared the slopes and intercepts of baseline student data with intervention student data. Results demonstrate that students displayed statistically significant improvement on DPRs at the onset of CCE and demonstrated positive behavioral growth during CCE. There was also a statistically significant improvement of academic engagement at the onset of CCE. There was no statistically significant change in academic performance. A description of potential moderating variables, future research directions, and practical significance is presented.
This paper considers how one teacher educator, Dr. Gomez, took up revisionist history and inquiry in her social studies methods classroom. The concepts of figured worlds (Holland et al.. Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press; Vygotsky, L. S. (1986). Thought and language. Boston: The MIT Press] are used to present a case study. The study focuses on the artifacts that made up the figured world of history learning in Dr. Gomez's social studies methods class and the learner identities aorded by this context. The purpose of this study is two-fold: (a) explore how teacher education classes can recruit primarily white, middle class students into a figured world of history learning that is culturally congruent with urban settings, and (b) demonstrate the application of the figured worlds framework to the study of learning in a teacher preparation program.
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