Agency Program Research Articles

Perspective of Water-Use Programs in Agriculture in Guanajuato

Integrated agricultural water management (IAWM) encompasses multiple factors, necessitating the evaluation of performance across programs and involved entities and local consideration in different regions. This study analyzes the relation of allocation budgets and government agency programs in relation to the average annual availability of groundwater in Guanajuato State. Documentary investigation was conducted on public programs, aquifer availability, and agricultural land types over the period from 2017 to 2023. In the last six years, the amounts allocated to government programs from subsidies and donations have increased by 40%, leading to enhanced agricultural productivity in the state. Considering the agricultural types (rain-fed, irrigated, and protected) as separate variables, simple linear regression explains 97.8% of the variability in the DMA, indicating a decrease of 78.2 million m3 and an increase in irrigated agriculture. The estimator for the budget allocated to public programs is −2.21 × 10−7, indicating that even if the resources allocated to government programs related to the use and exploitation of water in the agricultural sector increase, the DMA will continue to decrease. Regarding the agriculture area type, the estimator has a value of −0.00237, indicating that each rain-fed or irrigated agriculture unit established would result in an approximate reduction of 2370 m3 of water in the DMA. Taking this into account, it is imperative to formulate strategies that consider intersectoral links, with a focus on prioritizing essential actions in rain-fed areas for water capture and/or irrigated agricultural areas for food production, which comprise 52% of the total land dedicated to the agricultural sector, and specifically targeting actions that promote groundwater management.

Filling the blindspots: Assessing distributive equity in fund allocation of Florida's local housing program for disaster recovery

Despite the role of local assistance in addressing households' disaster recovery needs, few studies have examined the role of localized programs in filling the gaps that might exist in federal programs. To address the question of whether local recovery funds distribute resources to socially vulnerable neighborhoods and how local assistance fits into the broader federal disaster assistance landscape, we take Florida's State Housing Initiatives Partnership (SHIP) program as a case study. The SHIP program can help fill neighborhood-level gaps left by the Federal Emergency Management Agency's (FEMA) Individual Assistance program by aiding neighborhoods with the higher proportions of 1) those who did not receive federal assistance or 2) those who had residual damages not fully covered by federal assistance. The study finds that SHIP funds typically flow into socially vulnerable neighborhoods with a higher proportion of Black and Hispanic residents, even without specific social or racial equity measures built into program regulations. The study highlights the importance of balancing the consistency of fundamental rules and having flexibility in distributing funds.

Predictors of length of time in service: Characteristics of people in intensive case management for longer than 5 years.

The purpose of this study was to examine the characteristics of people who stay in intensive case management (ICM) for longer than 5 years. We conducted a secondary analysis of client data collected by a community mental health organization from 2012 to 2022. Using the Gelberg-Andersen Model for Access to Health Services, we conducted a logistic regression with 22 predictor variables, predicting clients in ICM for 5 years or less (N = 531) and those in ICM for longer than 5 years (N = 289). People who were older and those with psychotic disorder, co-occurring substance use disorder, dual diagnosis (with developmental disability), chronic medical condition, and also in another program in the same agency were more likely to be in ICM for longer than 5 years. People who were returning ICM clients and those who completed the ICM program (rather than withdrawing or disengaging) were more likely to be in ICM for 5 years or less. Higher dose of ICM (in contacts) predicted a shorter time in ICM. People with serious mental illness, dual diagnosis, concurrent substance use, and chronic medical conditions and those who are older may need additional supports within ICM and when transitioning out of ICM. People in ICM for a longer time have lower numbers of contacts, indicating that a less intense service may meet their needs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Analisis Program Badan Layanan Umum Daerah (BLUD) Sekolah Menegah Kejuruan (SMK) Dalam Mewujudkan Layanan Pemerintah Daerah Yang Good Corporate Governance (GCG)

The Regional Government, in supporting education reform for better quality and optimality within its units of authority, established the Regional Public Service Agency Program (BLUD) which can be understood as a system implemented by a technical implementation unit of regional agencies/agencies in providing services to the community, and has flexibility in financial management as an exception to regional financial management provisions in general. In line with the Directorate of Vocational High School Development (SMK) in seeking SMK as a school with BLUD status, this can support the management of goods and services whose superior products can manage the production process in the Teaching Factory Program (TEFA) more flexibly without violating regulations (Fazli, 2022). Implementing the Teaching Factory (TEFA) in the form of goods and services for vocational school students is expected to align with the objectives of Good Corporate Governance (GCG) Regional Government Services, namely good management to support the BLUD Vocational School Program in schools. In conducting this research the author used a descriptive qualitative research method approach.

Islamic Social Financing of The National Zakat Amil Agency Program for Support Ensures the Availability and Sustainable Management of Water and Sanitation for All (Case Study of Islamic Boarding Schools Riyadul Awamil Indonesia)

Islamic Social Financing of The National Zakat Amil Agency Program for Support Ensures the Availability and Sustainable Management of Water and Sanitation for All (Case Study of Islamic Boarding Schools Riyadul Awamil Indonesia)

Comparative outcomes of arterial bypass using the human acellular vessel and great saphenous vein in patients with chronic limb ischemia

ObjectiveThe Human Acellular Vessel (HAV) is a novel, off-the-shelf biologic conduit being evaluated for arterial reconstructions. Regulatory studies in peripheral arterial disease (PAD) to date have consisted of single-arm cohorts with no comparator groups to contrast performance against established standards. This study aimed to compare outcomes of the HAV with autologous great saphenous vein (GSV) in patients with advanced PAD undergoing infrageniculate bypass. MethodsPatients with advanced PAD and no autologous conduit who underwent bypass with the 6-mm diameter HAV (Group 1; n = 34) (March 2021-February 2024) were compared with a multicenter historical cohort who had bypass with single-segment GSV (group 2; n = 88) (January 2017-December 2022). The HAV was used under an Investigational New Drug protocol issued by the Food and Drug Administration (FDA) under the agency's Expanded Access Program. ResultsDemographics were comparable between groups (mean age 69 ± 10 years; 71% male). Group 1 had higher rates of tobacco use (37 pack-years vs 28 pack-years; P = .059), coronary artery disease (71% vs 43%; P = .007), and prior coronary artery bypass grafting (38% vs 14%; P = .003). Group 1 had more patients classified as wound, ischemia, and foot infection clinical stage 4 (56% vs 33%; P = .018) and with previous index leg revascularizations (97% vs 53%; P < .001). Both groups had a similar number of patients with chronic limb-threatening ischemia (Rutherford class 4-6) (88% vs 86%; P = .693) and Global Anatomic Staging System stage III (91% vs 96%; P = .346). Group 1 required a composite conduit (two HAV sewn together) in 85% of bypasses. The tibial vessels were the target in 79% of group 1 and 100% of group 2 (P < .001). Group 1 had a lower mean operative time (364 minutes vs 464 minutes; P < .001). At a median of 12 months, major amputation-free survival (73% vs 81%; P = .55) and overall survival (84% vs 88%; P = .20) were comparable. Group 1 had lower rates of primary patency (36% vs 50%; P = .044), primary-assisted patency (45% vs 72%; P = .002), and secondary patency (64% vs 72%; P = .003) compared with group 2. ConclusionsImplanted under Food and Drug Administration Expanded Access provisions, the HAV was more likely to be used in redo operations and cases with more advanced limb ischemia than GSV. Despite modest primary patency, the HAV demonstrated resilience in a complex cohort with no autologous conduit options, achieving good secondary patency and providing major amputation-free survival comparable with GSV at 12 months.

Optimizing androgen receptor prioritization using high-throughput assay-based activity models.

Introduction: Computational models using data from high-throughput screening assays have promise for prioritizing and screening chemicals for testing under the U.S. Environmental Protection Agency's Endocrine Disruptor Screening Program (EDSP). The purpose of this work was to demonstrate a data processing method for the determination of optimal minimal assay batteries from a larger comprehensive model, to provide a uniform method of evaluating the performance of future minimal assay batteries compared with the androgen receptor (AR) pathway model, and to incorporate chemical cluster analysis into this evaluation. Although several of the assays in the AR pathway model are no longer available through the original vendor, this approach could be used for future evaluations of minimal assay models for prioritization and screening. Methods: We compared two previously published models and found that an expanded 14-assay model had higher sensitivity for antagonists, whereas the original 11-assay model had slightly higher sensitivity for agonists. We then investigated subsets of assays in the original AR pathway model to optimize overall testing strategies that minimize cost while maintaining sensitivity across a broad chemical space. Results and Discussion: Evaluation of the critical assays across subset models derived from the 14-assay model identified three critical assays for predicting antagonism and two critical assays for predicting agonism. A minimum of nine assays is required for predicting agonism and antagonism with high sensitivity (95%). However, testing workflows guided by chemical structure-based clusters can reduce the average number of assays needed per chemical by basing the assays selected for testing on the likelihood of a chemical being an AR agonist, according to its structure. Our results show that a multi-stage testing workflow can provide 95% sensitivity while requiring only 48% of the resources required for running all assays from the original full models. The resources can be reduced further by incorporating in silico activity predictions. Conclusion: This work illustrates a data-driven approach that incorporates chemical clustering and simultaneous consideration of antagonism and agonism mechanisms to more efficiently screen chemicals. This case study provides a proof of concept for prioritization and screening strategies that can be utilized in future analyses to minimize the overall number of assays needed for predicting AR activity, which will maximize the number of chemicals that can be tested and allow data-driven prioritization of chemicals for further screening under the EDSP.

Kualitas Pelayanan Pasien Peserta BPJS di RSUD Lembang Kabupaten Bandung Barat (KBB)

One of the public services that is highly considered by the wider community is health services because health services in Indonesia are still not of good quality. The health service problems that are occurring in Indonesia today are caused by the uneven distribution of quality health services for all Indonesian people in the process of providing services, for example regarding service discrimination with the service itself. Health services were not optimal, therefore the Indonesian government made a health program to deal with service problems, namely the BPJS (Health Insurance Organizing Agency) program. This study aims to determine the quality of service for BPJS participant patients in Lembang Hospital. The method used in this study is a qualitative method in a way that describes synergistic problems when the research is carried out. Data collection techniques are carried out by observation, interviews and documents. The instruments used in this study were observation sheets, interview sheets, and structured documentation made by the researchers themselves. The results of this study show that service to patients participating in BPJS at the Lembang Hospital is in the requirements are clear, but there are still some obstacles in terms of the quantity, quality of human resources and infrastructure in the Lembang Hospital and the attitude of employees when serving patients.

Enhancing client engagement and alleviating period product insecurity: A cross-sectional study of community-based period supply banks' distribution of free period products through intermediary partner agencies in the United States.

Period products like pads, tampons, and a variety of disposable and reusable hygiene supplies constitute just one facet essential for effectively managing menstruation in a way that allows an individual to feel comfortable carrying out their daily routine. Given the absence of comprehensive public policies ensuring access to period products for economically disadvantaged menstruating individuals, community-based basic needs banks, particularly period supply banks, were established to alleviate the challenges faced by those experiencing period product insecurity. These initiatives specifically aim to furnish essential menstrual products to individuals in need. This study aimed to assess any organizational benefits experienced by community-based organizations distributing period products on behalf of period supply banks. This cross-sectional study is a formative evaluation of the distribution of free period products by period supply banks, which provide access to essential menstrual hygiene products for individuals in need through partnership with community-based partner agencies. Staff members at agencies distributing period products were invited to complete an anonymous web-based survey at two different time points about their agency's experiences distributing free period products. All participants provided informed consent via the web-based survey. Agency staff reported that since they started providing period products, clients were more likely to: start a conversation about other needs (66.7%), extend the length of their relationship with the agency (60.0%), keep scheduled appointments (62.1%), ask for assistance with another need (75.0%), communicate between visits (42.4%), participate in other agency programming (55.9%), and seek other agency services (73.5%). Due to a shortage of period products, 41% of agencies have had to turn away clients needing period supplies. Period supply banks, in collaboration with community-based partner agencies, enhance access to both menstrual products and the associated support, fostering engagement with diverse resources and opportunities among recipients. However, addressing unmet needs necessitates policies and additional funding to ensure universal access to essential hygiene supplies for everyone to thrive and actively participate in society.

Chemistry domain of applicability evaluation against existing estrogen receptor high-throughput assay-based activity models.

The U. S. Environmental Protection Agency's Endocrine Disruptor Screening Program (EDSP) Tier 1 assays are used to screen for potential endocrine system-disrupting chemicals. A model integrating data from 16 high-throughput screening assays to predict estrogen receptor (ER) agonism has been proposed as an alternative to some low-throughput Tier 1 assays. Later work demonstrated that as few as four assays could replicate the ER agonism predictions from the full model with 98% sensitivity and 92% specificity. The current study utilized chemical clustering to illustrate the coverage of the EDSP Universe of Chemicals (UoC) tested in the existing ER pathway models and to investigate the utility of chemical clustering to evaluate the screening approach using an existing 4-assay model as a test case. Although the full original assay battery is no longer available, the demonstrated contribution of chemical clustering is broadly applicable to assay sets, chemical inventories, and models, and the data analysis used can also be applied to future evaluation of minimal assay models for consideration in screening. Chemical structures were collected for 6,947 substances via the CompTox Chemicals Dashboard from the over 10,000 UoC and grouped based on structural similarity, generating 826 chemical clusters. Of the 1,812 substances run in the original ER model, 1,730 substances had a single, clearly defined structure. The ER model chemicals with a clearly defined structure that were not present in the EDSP UoC were assigned to chemical clusters using a k-nearest neighbors approach, resulting in 557 EDSP UoC clusters containing at least one ER model chemical. Performance of an existing 4-assay model in comparison with the existing full ER agonist model was analyzed as related to chemical clustering. This was a case study, and a similar analysis can be performed with any subset model in which the same chemicals (or subset of chemicals) are screened. Of the 365 clusters containing >1ER model chemical, 321 did not have any chemicals predicted to be agonists by the full ER agonist model. The best 4-assay subset ER agonist model disagreed with the full ER agonist model by predicting agonist activity for 122 chemicals from 91 of the 321 clusters. There were 44 clusters with at least two chemicals and at least one agonist based upon the full ER agonist model, which allowed accuracy predictions on a per-cluster basis. The accuracy of the best 4-assay subset ER agonist model ranged from 50% to 100% across these 44 clusters, with 32 clusters having accuracy ≥90%. Overall, the best 4-assay subset ER agonist model resulted in 122 false-positive and only 2 false-negative predictions compared with the full ER agonist model. Most false positives (89) were active in only two of the four assays, whereas all but 11 true positive chemicals were active in at least three assays. False positive chemicals also tended to have lower area under the curve (AUC) values, with 110 out of 122 false positives having an AUC value below 0.214, which is lower than 75% of the positives as predicted by the full ER agonist model. Many false positives demonstrated borderline activity. The median AUC value for the 122 false positives from the best 4-assay subset ER agonist model was 0.138, whereas the threshold for an active prediction is 0.1. Our results show that the existing 4-assay model performs well across a range of structurally diverse chemicals. Although this is a descriptive analysis of previous results, several concepts can be applied to any screening model used in the future. First, the clustering of the chemicals provides a means of ensuring that future screening evaluations consider the broad chemical space represented by the EDSP UoC. The clusters can also assist in prioritizing future chemicals for screening in specific clusters based on the activity of known chemicals in those clusters. The clustering approach can be useful in providing a framework to evaluate which portions of the EDSP UoC chemical space are reliably covered by in silico and in vitro approaches and where predictions from either method alone or both methods combined are most reliable. The lessons learned from this case study can be easily applied to future evaluations of model applicability and screening to evaluate future datasets.

Implementation of programs for the development of operational processes of the HR management system of government agencies in Western countries

Today, the problem of digitalization of HR management system operational processes is the lack of automated HR management programs for government agencies, lack of resources, staff reduction, data management, and change management. Many countries have faced problems with the digitalization of HR processes in government agencies. To a greater or lesser extent, such structural problems of the labor market can be found in all Western countries. The development of technologies and information systems creates new opportunities for managing and improving the processes of government agencies. The specifics of public administration require effective personnel management on a country or city scale, which makes it necessary to implement effective technological solutions. With this in mind, today's workforce data from many sources provides an opportunity to manage civil servants with an evidence-based HR policy. Thus, governments are increasingly able to recruit, deploy, train, motivate, and retain their employees scientifically and analytically based on objective HR data. As a result of the analysis, the authors found that most Western countries collect HR data to analyze, interpret and actively use it to make better management decisions, as well as to develop and implement HR policies. The purpose of the article is to highlight the problem of digitalization of HR processes in government agencies and to demonstrate the analysis of HR data from Western countries in tabular forms. The article demonstrates the results of implementing information collection of HR data for effective HR management on a country or city scale. The authors analyze and demonstrate in infographics the growing possibility of collecting human resources data as a basis for improving public services, service delivery and continuous performance management. The authors analyze and present in the infographic data from surveys of civil service employees in Western countries, information on employee engagement and satisfaction with work and the working environment in government agencies.

Outcomes of lower extremity arterial bypass using the Human Acellular Vessel in patients with chronic limb-threatening ischemia

ObjectivePatients with chronic limb-threatening ischemia (CLTI) and no great saphenous vein to use as a conduit for arterial bypass have a high risk for amputation despite advances in medical and endovascular therapies. This report presents findings from a U.S. Food and Drug Administration (FDA) supported study of the Human Acellular Vessel (HAV) (Humacyte Inc.) used as a conduit for arterial bypass in patients with CLTI and inadequate or absent autologous conduit. MethodsThe HAV is a 6-mm, 40-cm vessel created from human vascular smooth muscle cells seeded onto a polyglycolic acid scaffold pulsed in a bioreactor for 8 weeks as cells proliferate and the scaffold dissolves. The resultant vessel is decellularized, creating a nonimmunogenic conduit composed of collagen, elastin, and extracellular matrix. The FDA issued an Investigational New Drug for an intermediate-sized, single-center study of the HAV under the agency's Expanded Access Program in patients with advanced CLTI and inadequate or absent autologous conduit. Technical results and clinical outcomes were analyzed and reported. ResultsBetween March 2021 and July 2023, 29 patients (20 males; mean age, 71 ± 11 years) underwent limb salvage operation using the HAV as a bypass conduit. Most patients had advanced CLTI (Rutherford class 5/6 in 72%; wound, ischemia, and foot infection stage 3/4 in 83%), and 97% had previously failed revascularization(s) of the extremity. Two HAVs were sewn together to attain the needed bypass length in 24 patients (83%). Bypasses were to tibial arteries in 23 patients (79%) and to the popliteal artery in 6 (21%). Technical success was 100%, and the 30-day mortality rate was 7% (2 patients). With 100% follow-up (median, 9.3 months), the limb salvage rate was 86% (25/29 patients). There were 16 reinterventions to restore secondary patency, of which 15 (94%) were successful. Primary and secondary patency of the HAV at 9 months were 59% and 71%, respectively. ConclusionsThe HAV has demonstrated short- to intermediate-term safety and efficacy as an arterial bypass conduit in a complex cohort of patients with limb-threatening ischemia and no autologous options. This experience using the FDA’s Expanded Access Program provides real-world data to inform regulatory deliberations and future trials of the HAV, including the study of the vessel as a first-line bypass conduit in less severe cases of chronic limb ischemia.

Deep radiomics-based fusion model for prediction of bevacizumab treatment response and outcome in patients with colorectal cancer liver metastases: a multicentre cohort study

Accurate tumour response prediction to targeted therapy allows for personalised conversion therapy for patients with unresectable colorectal cancer liver metastases (CRLM). In this study, we aimed to develop and validate a multi-modal deep learning model to predict the efficacy of bevacizumab in patients with initially unresectable CRLM using baseline PET/CT, clinical data, and colonoscopy biopsy specimens. In this multicentre cohort study, we retrospectively collected data of 307 patients with CRLM from the BECOME study (NCT01972490) (Zhongshan Hospital of Fudan University, Shanghai) and two independent Chinese cohorts (internal validation cohort from January 1, 2018 to December 31, 2018at Zhongshan Hospital of Fudan University; external validation cohort from January 1, 2020 to December 31, 2020at Zhongshan Hospital-Xiamen, Shanghai, and the First Hospital of Wenzhou Medical University, Wenzhou). The main inclusion criteria were that patients with CRLM had pre-treatment PET/CT images as well as colonoscopy specimens. After extracting PET/CT features with deep neural networks (DNN) and selecting related clinical factors using LASSO analysis, a random forest classifier was built as the Deep Radiomics Bevacizumab efficacy predicting model (DERBY). Furthermore, by combining histopathological biomarkers into DERBY, we established DERBY+. The performance of model was evaluated using area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predictive value. DERBY achieved promising performance in predicting bevacizumab sensitivity with an AUC of 0.77 and 95% confidence interval (CI) [0.67-0.87]. After combining histopathological features, we developed DERBY+, which had more robust accuracy for predicting tumour response in external validation cohort (AUC 0.83 and 95% CI [0.75-0.92], sensitivity 80.4%, specificity 76.8%). DERBY+ also had prognostic value: the responders had longer progression-free survival (median progression-free survival: 9.6 vs 6.3 months, p=0.002) and overall survival (median overall survival: 27.6 vs 18.5 months, p=0.010) than non-responders. This multi-modal deep radiomics model, using PET/CT, clinical data and histopathological data, was able to identify patients with bevacizumab-sensitive CRLM, providing a favourable approach for precise patient treatment. To further validate and explore the clinical impact of this work, future prospective studies with larger patient cohorts are warranted. The National Natural Science Foundation of China; Fujian Provincial Health Commission Project; Xiamen Science and Technology Agency Program; Clinical Research Plan of SHDC; Shanghai Science and Technology Committee Project; Clinical Research Plan of SHDC; Zhejiang Provincial Natural Science Foundation of China; and National Science Foundation of Xiamen.

Hippocampal and amygdala volumes vary with residential proximity to toxicants at Birmingham, Alabama's 35th Avenue Superfund site.

Exposure to environmental toxicants have serious implications for the general health and well-being of children, particularly during pivotal neurodevelopmental stages. The Environmental Protection Agency's (EPA) Superfund program has identified several areas (Superfund sites) across the United States with high levels of environmental toxicants, which affect the health of many residents in nearby communities. Exposure to these environmental toxicants has been linked to changes in the structure and function of the brain. However, limited research has investigated the relationship between the proximity of childhood homes to a Superfund site and the development of subcortical structures like the hippocampus and amygdala. The present study investigated the hippocampal and amygdala volumes of young adults in relation to the proximity of their childhood homes to Birmingham, Alabama's 35th Avenue Superfund site. Forty participants who either lived within or adjacent to the Superfund site (Proximal group; n = 20) or who lived elsewhere in the greater Birmingham metropolitan area (Distal group; n = 20) were included in this study. Both groups were matched on age, sex, race, and years of education. Magnetic resonance imaging (MRI) was used to compare the gray matter volume of the hippocampus and amygdala between groups. Differences in bilateral hippocampal and left amygdala volumes were observed. Specifically, hippocampal and amygdala volumes were greater in the Proximal than Distal group. These findings suggest that the proximity of children's homes to environmental toxicants may impact the development of the hippocampus and amygdala. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Badan Penyelenggara Jaminan Sosial Ketenagakerajaan Berdasarkan Undang-undang Nomor 40 Tahun 2004 Tentang Sistem Jaminan Sosial Nasional

The purpose of this study is to determine and analyze the Implementation of Policies Towards the Implementation of the Employment Social Security Program Based on Law Number 40 of 2004 concerning the National Social Security System and to determine and analyze the Form of Application of Administrative Sanctions Against Business Entities or Non-Governmental Institutions That Do Not Run the Employment Social Security Organizing Agency Program. In this study the authors used normative research methods, namely legal research conducted by means of literature review and study of legislation. In this research what is studied is legal events, legal relationships and objects of law. Implementation of Policies on the Implementation of the Employment Social Security Program Based on Law Number 40 of 2004 concerning the National Social Security System, namely the Government, among others, has made implementing regulations of the Act, has also continuously carried out all orders of the legislation. From the implementation of the Law, the labor social security program is a basic protection for workers and their families and can provide legal certainty. However, the practice of charging routine contributions by the BPJS as well as the imposition of sanctions on citizens is what actually denies the main principle of the social security system which should be borne by the state as the principle of the welfare state which is then transferred to the burden of citizens as well as accompanied by sanctions if citizens do not want to register as / participate in insurance organized by BPJS. Thus, it can be said that the Government has not succeeded in implementing the national social security system in realizing community welfare.

Reconnecting Hope: The Treatment of Eating Disorders in Rural America

Eating disorders (EDs), a significant public health concern, impact millions of Americans every year. Many people with EDs are often overlooked for multiple reasons, including the stereotype that EDs predominantly affect thin, White, affluent young women and girls. One historically overlooked group is impoverished individuals in rural areas of the United States (U.S.), who may, in fact, be at an increased risk for EDs. The Reconnect Eating Disorders treatment program (REDTP) at Ozark Center is the first comprehensive, evidence-based, multidisciplinary ED treatment program to be developed in a Certified Community Behavioral Health Organization (CCBHO) in the U.S. CCBHOs are a unique model of financially sustainable integrated care well-suited to the treatment of biopsychosocial illnesses such as EDs because CCBHOs offer a full range of services to treat both physical and mental health. This paper details the development of REDTP, including its team, barriers, and successes. The role of Community Support Specialists/Reconnect Coaches and Healthcare Home/Medical Support is reviewed, which includes providing outpatient care and intensifying treatment for the most acute clients. Key domains of growth for REDTP included selecting core evidence-based treatments, building a team and defining team roles, and intensive training to develop evidence-based ED expertise. Persistent barriers included staffing limitations for providing intensive treatment to a small number of clients. Adult case studies of REDTP clients are presented. Recommendations for future ED and other specialized treatment programs in low resource agencies are provided.

High Temperature Superconductivity Application Readiness Map - Energy Delivery - Transmission, Substation and Distribution

The International Energy Agency's High Temperature Superconductivity Technology Collaboration Program (IEA HTS TCP) analyzed energy delivery applications for HTS. The product was a Readiness Map that illustrates the Technology Readiness Levels (TRL) over time of HTS applications. Assessing these TRL levels is important since the electric power system that supplies our residential, commercial and industrial sectors is experiencing a transition to safer, more efficient and cleaner power supply. The international experts assessed the present degree of technological development of the main transmission, substation and distribution HTS applications in the energy delivery sector and estimated the pathway to commercialization phase. Instead of using a specific TRL number 1-9 for each of the applications, they are categorized into low, medium and high TRL levels. Superconducting fault current limiters and medium voltage AC cables to interconnect substations at the low side of the transformer are currently at a high TRL as they can be purchased in the market. High voltage AC and DC cables are at a medium TRL and could reach a high level TRL level in 2030-2035. Superconducting transformers are at a low TRL and they could reach a high TRL level by 2030-2035.

The Degree of Using Infographics in Presenting &amp; Presenting data in Public Education Agency Programs from General Supervisors’ Perspective in the Ministry of Education in The Kingdom of Saudi Arabia

هدفت الدراسة إلى التعرف على درجة استخدام الإنفوجرافيك في عرض وتقديم البيانات ببرامج وكالة التعليم العام وأهم معوقات استخدامه وتقديم مقترحات تطويرية من وجهة نظر مشرفي العموم بوزارة التعليم بالمملكة العربية السعودية، واستخدمت الدراسة المنهج الوصفي، واعتمدت على الاستبانة كأداة لجمع المعلومات اللازمة لهذه الدراسة، استخدمت الباحثة أسلوب الحصر الشامل وقامت بتطبيق أداة الدراسة على كامل المجتمع والبالغ عددهم (230) مشرفا ومشرفة عموم، توصلت نتائج الدراسة إلى أن أفراد عينة الدراسة يقيمون استخدام الإنفوجرافيك في عرض البيانات ببرامج الوكالة، بمتوسط حسابي (3.70 من5)، كما أن معوقات استخدام الإنفوجرافيك في الوكالة، بمتوسط حسابي (4.08)، وكلاهما بتقدير (كبير)، وتمثلت أبرز هذه المعوقات في قلة البرامج التدريبية المقدمة لمنسوبي الوكالة في مجال انتاج الإنفوجرافيك بأنواعه، عدم القدرة على تحميل برامج التصميم لوجود برامج أمن وحماية المعلومات على أجهزة الحاسوب المكتبي والمحمول لمنسوبي الوكالة، كما أشارت النتائج إلى أن أهم المقترحات التي يمكن أن تسهم في تطوير استخدام الإنفوجرافيك في الوكالة هي: عقد دورات تدريبية لمشرفي العموم لتطوير مهارتهم في استخدام وتفعيل الإنفوجرافيك، إعداد دليل إرشادي يُساعد منسوبي التعليم على استخدام الإنفوجرافيك.

Racial disparities in farm loan application processing: Are Black farmers disadvantaged?

AbstractBlack farmers have historically been discriminated against in services from the federal government, including access to credit. Discrimination can take the form of delayed loan processing requests, which can affect timely planting, harvesting, feeding of livestock, and farm performance. This study uses nationwide, farm‐level data from 2009 to 2021 from the Farm Service Agency's direct farm loan program to investigate racial discrimination in the farm loan program. Findings reveal loan processing times average longer for Black borrowers on operating loans, though with a substantial state‐level variation. Specifically, it takes an average of more than two additional days for Black farmers' operating loan applications to be completed and another two additional days to be processed. However, there was no significant difference in time for farm ownership loans suggesting a more nuanced cause than outright racial discrimination. Other factors that increased loan processing time for borrowers included larger loan amounts, more complex loan types, a mix of collateral, and being a new borrower.

LEADERSHIP ESSENTIALS FOR COMPLICATED TIMES

AbstractThe author, who has a long consulting history of creating programs for corporations, government agencies, and other organizations, notes that today’s world is complex and nuanced, and creates dilemmas for leaders. For instance, “They want leaders to provide high‐level vision and be strategic, yet they also want them to be intensely operational and tactical. They want leaders to be decisive and work with urgency, yet they also want them to be inclusive and involve the voices of everyone.” But the search for the new and novel can blind us to ideas and concepts that are well‐tested and can be applicable in today’s highly uncertain world: “Rather than look for novel approaches to leading during turbulent times, leaders would do well to get back to the timeless essentials of leadership.” This requires focusing on two first principles that may seem obvious, but are often less so in practice: 1. Leading yourself and 2. Leading others. In category one he further describes concepts such as, in his words: Know thyself, value values, sunshine and shadows, practice self‐care, and “cultivate composure.” In #2, in his words, are Earn trust, create safety, team building, and create inclusion. “Leadership is hard,” he writes, “but it doesn’t have to be complicated.”