Predictors of SCD include CM phenotype, family history of CM (DCM), severity of systolic dysfunction (DCM), and extent of LV hypertrophy (HCM). Continuing follow-up of this cohort into adulthood is likely to reveal an ongoing risk of SCD.
Whereas many researchers have developed sophisticated instruments to assess quality of care in nursing facilities (NFs), the concept of quality, its measurement, and its relationship to organizational characteristics remain important issues that are characterized by inconsistent findings across studies. The conceptualization and methodologies used in twenty-four NF quality studies are compared. The review identifies four main sources of variation hypothesized to be important bases of inconsistency in the NF quality literature: (1) differences in conceptualization and operationalization, (2) differences in the unit of analysis (resident vs. facility), (3) differences in sampling method and sample constitution, and (4) differences in the main method of analysis. As an empirical test of three of these sources of variation, the authors investigated relationships between primary organizational characteristics and various measures of quality using a sample of 104 Wisconsin NFs. From both the comparative and Wisconsin analyses, implications for research are drawn.
The prevalence of college students' tobacco use is widely recognized, but successful cessation and relapse-prevention programs for these smokers have drawn little attention. The authors, who explored the feasibility of training peers to lead cessation and relapse-prevention programs for undergraduates, found a quit rate of 88.2%, suggesting that peers were effective facilitators. Relapse-prevention interventions, which began immediately after participants quit smoking, included 6 monthly group programs and individual meetings. Each session provided education and training in stress management, nutrition and exercise habits, managing environmental smoking triggers, and coping in social situations. After participating in the relapse-prevention programs, 63.3% of the initial quitters remained smoke free, another indication that peers were effective facilitators. The success of the program, combined with the dearth of population-specific cessation and relapse-prevention tools, suggests that college administrators and health educators should develop integrated tobacco management strategies on college campuses.
This study distinguishes between organizational characteristics, regarded as exogenous structural indicators of quality, and those identified as endogenous indicators of structural care (SC), and investigates the degree to which measures of SC vary by ownership mode (defined by four combinations of chain affiliation and profit status) for 142 certified and licensed nursing facilities (NFs) in a southern state. Structural care measures include: licensed and unlicensed staffing, licensed therapists, and case mix-adjusted direct care expenditures. In addition, seven (four process and three outcome) facility-level, risk-adjusted process, and outcome quality scales are developed from 39 resident-level quality indicators. A causal mode of NF quality arranged according to the structure, process and outcome paradigm is specified and estimated using path analysis. Organizational data derive from the 1991 Medicaid Cost Report; process and outcome quality measures were developed from the Minimum Data Set Plus Resident Assessment Instrument. Using the percentage of Medicaid and private pay residents as covariates, there was a significant overall multivariate effect due to ownership mode on the SC measures. Although there were several significant direct effects, the overall path model was unconfirmed. The multivariate results suggest that some organizational characteristics of structure quality may be more appropriately considered exogenous to causal quality models and therefore have indirect (versus direct) effects on process or outcome quality indicators. The path analysis implies that the structure-process-outcome paradigm may not accurately capture the way NF health care is delivered. Research which considers alternate NF quality paradigms needs to be done with samples that are more representative of national proportions of each ownership mode.
Homeland Security (HS) is a growing field of study in the U.S. today, generally covering risk management, terrorism studies, policy development, and other topics related to the broad field. Information security threats to both the public and private sectors are growing in intensity, frequency, and severity, and are a very real threat to the security of the nation. While there are many models for information security education at all levels of higher education, these programs are invariably offered as a technical course of study; these curricula are generally not well suited to HS students. As a result, information systems and cybersecurity principles are underrepresented in the typical HS program. The authors propose a course of study in cybersecurity designed to capitalize on the intellectual strengths of students in this discipline and that are consistent with the broad suite of professional needs in this discipline.
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