Attendant Benefits Research Articles

Gender Differences in Uptake, Adherence and Experiences: A Longitudinal, Mixed-Methods Study of a Physical Activity Referral Scheme in Scotland, UK.

Physical activity referral schemes (PARS) are implemented internationally to increase physical activity (PA), but evidence of effectiveness for population subgroups is equivocal. We examined gender differences for a Scottish PARS. This mixed-methods, concurrent longitudinal study had equal status quantitative and qualitative components. We conducted 348 telephone interviews across three time points (pre-scheme, 12 and 52 weeks). These included validated self-reported PA and exercise self-efficacy measures and open-ended questions about experiences. We recruited 136 participants, of whom 120 completed 12-week and 92 completed 52-week interviews. PARS uptake was 83.8% (114/136), and 12-week adherence for those who started was 43.0% (49/114). Living in less deprived areas was associated with better uptake (p = 0.021) and 12-week adherence (p = 0.020), and with male uptake (p = 0.024) in gender-stratified analysis. Female adherers significantly increased self-reported PA at 12 weeks (p = 0.005) but not 52 weeks. Males significantly increased exercise self-efficacy between baseline and 52 weeks (p = 0.009). Three qualitative themes and eight subthemes developed; gender perspectives, personal factors (health, social circumstances, transport and attendance benefits) and scheme factors (communication, social/staff support, individualisation and age appropriateness). Both genders valued the PARS. To increase uptake, adherence and PA, PARS should ensure timely, personalised communication, individualised, affordable PA and include mechanisms to re-engage those who disengage temporarily.

Students and Africa’s Democratization Process: From Colonial to Post-Independence Eras

Enough historical evidence abound which dispel the fast-held notion that suggests, pre-colonial African societies never practiced any form of democracy, until the advent of colonialism. Simplistic as the African democratic experiences might have been, these forms nonetheless, bore semblance to other known practices in the western world and did, indeed, conform to the basic principles of modern democracy. This research paper has briefly reviewed these pre-colonial practices; however, the focus is on Africa’s post-colonial democratic experiences and in particular, the role of students in this whole process. In the given milieu, the main objective of this work is an evaluation of students’ contributions in this entire democratic process---their achievement and also, the price they have/had to pay for. The study which adapted an analytical approach, obtained primary, secondary and tertiary data on the subject matter, having used Ghana as case study. Consequently, findings have revealed that, throughout both colonial and post-colonial eras, the activities and interventions (including peaceful demonstrations, non-violent advocacy and sometimes violent protests) of African students, have immensely contributed to the enhancement of democracy within the continent. The attendant benefits having aided the following: socio-politico-economic development of the continent; peaceful co-existence of people of varied political opinions; and the observance of fundamental human rights; inter alia. That said, lapses still persist within the context of democratic governance among African states, which students’ activism are constantly striving to address with a resulting resistance from the corridors of power. Indeed, it is also significant to mention that, one major recommendation put forth by the study is that: students’ activism should approach issues non-violently while at the same time authorities should acknowledge and uphold the potent contributions of students in that regard. Finally, the implications of this study are multifaceted as they do not only complement scholarly literature but are also relevant in respect of policy-direction and the enhancement of good democratic governance among the community of states, as spearheaded by the United Nations.

Building upon the foundational science curriculum with physiology-based grand rounds: a multi-institutional program evaluation

ABSTRACT Introduction: Vertically integrating physiology into patient care has the potential to improve clinical reasoning. Clinical Physiology Grand Rounds (CPGR) is a case-based teaching method that brings together students from all years of medical school to focus on linking clinical presentations to core basic science concepts including anatomy, physiology, and pathophysiology. In this study, we describe the implementation of CPGR at two different institutions in the United States and assess student-reported outcomes. Methods: We survey students who participated in CPGR at Columbia University College of Physicians & Surgeons (P&S) and Medical University of South Carolina (MUSC). Subjects were queried across three domains: the benefits of attending, the impact of concept maps, and the impact of the mixed-learner environment. Results: Despite differences in session leadership and the underlying medical school curricula, conference attendees reported similar benefits at the two schools included in this study. Students overwhelmingly (92.9%) reported that remembering clinical presentations was easier when they understood the underlying physiology. They also reported gaining a true understanding of concepts that were previously memorized (87.5%). Both clinical (92.5%) and preclinical students (93.1%) valued the mixed-learner environment as a component of the conference. Discussion: By assuring a mixed-learner environment with near-peer interactions, using concept maps as a teaching tool, and rigorously linking clinical presentation and management to physiological concepts, we found that the key benefits of CPGR were replicable across different institutions, despite several local differences in how CPGR was implemented, led, and conducted.

Context-Aware Blockchain-Based Sustainable Supply Chain Visibility Management

Abstract Supply chain visibility allows a state of being able to see end to end in a supply chain. Sustainable supply chain visibility is premised on sharing of mutually benefiting information, to achieve associated sustainability objectives including those related to economic, environmental and social goals. Sustainable supply chains strive for distinctive visibility with its attendant benefits that include improving and strengthening the supply chain for competitive advantage. Advances in technology such as blockchain technology can help facilitate effective management of sustainable supply chain visibility and in delivering associated benefits. The relational characteristics of blockchain and sustainable supply chain visibility has recently been reported in the literature with some emphasis on the capacity, capability and context of sustainable supply chain visibility. This paper explores a notion of context-awareness and blockchain in relation to sustainable supply chain visibility. A landscape for an architecture of a blockchain-based sustainable supply chain visibility management platform centred on context-awareness is suggested. The main thrust of the considerations is provisioning of secure, auditable and mutually benefiting sustainable supply chain information sharing, for distinctive visibility, in heterogeneous context-aware scenarios whilst recognising the underlying characteristics of sustainable supply chain visibility.

Church Attendance and Mobility Limitation Among Black and White Men With Prostate Cancer

Prostate cancer is a significant impediment that can reduce physical functional status. Mobility is fundamental for quality of life and church attendance to be associated with improved physical functioning. Few studies have examined how religious participation have implications for mobility limitation among men in general and among prostate cancer survivors in particular. The purpose of this study was to assess the association between church attendance and mobility limitation among Black and White prostate cancer patients and survivors. Data for this investigation were drawn from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 804 Black and White men with complete information on the primary outcome and predictor variables. Mobility limitation was the primary outcome variable, and church attendance was the main independent variable. The analytic sample was almost equally divided between Black (N = 382) and White men (N = 422). The proportion of Black men reporting mobility limitation (30.09%) more than doubled the corresponding percentage for White men (14.7%). Black men had a higher proportion of individuals who reported weekly church attendance (49.2% vs. 45.0%). Fully adjusted modified Poisson regression models produced results indicating that respondents attending church weekly had a lower mobility limitation prevalence (PR = 0.56, 95% CI [0.39, 0.81]) than those never attending church. Results from this study contribute to the body of evidence asserting the health benefits of church attendance. These findings suggest that health providers should consider how religion and spirituality can present opportunities for improved outcomes in prostate cancer patients and survivors.

The Benefits of Alternatives to Conventional College: Comparing the Labor-Market Returns to For-Profit Schools and Community Colleges

This paper provides novel evidence on the labor-market returns to for-profit postsecondary school and community college attendance using a two-step model to avoid recent concerns with singlestage fixed effects methods. Specifically, we link administrative records on for-profit school and community college attendance with quarterly earnings data for over 400,000 students in one state. Five years after enrollment, quarterly earnings conditional on employment exceed earnings in the absence of schooling by 20-29 percent for students attending for-profit schools and 16-27 percent for students attending community colleges. Despite differences in costs, in aggregate the benefits of attendance generally exceed the costs in both for-profit schools and community colleges. Finally, we present evidence showing that students in for-profit schools and community colleges pursue different degrees and focus on different areas of study.

The unmet needs of childhood cancer survivors in long-term follow-up care: A qualitative study.

ObjectiveEvidence suggests benefits of long‐term follow‐up care attendance for childhood cancer survivors, but studies show poor inclusion of survivorship issues and needs. While information needs of childhood cancer survivors have been addressed previously, few studies specifically investigated the supportive care needs of survivors beyond the domain of information and communication. Therefore, this qualitative study aimed to assess the unmet needs of childhood cancer survivors with regards to their long‐term survivorship.MethodsChildhood Cancer Switzerland invited survivors of childhood cancer to participate in our study. We used semistructured interviews to assess survivors' experiences regarding the impact of their disease and the (un)met needs during their survivorship. Data analysis followed the principles of qualitative content analysis.ResultsInterviews were conducted with 28 childhood cancer survivors (mean age 31 years, age at diagnosis 9 years, time since end of treatment 19 years). Key themes in relation to unmet needs of survivors were (1) lacking psychosocial support, (2) lacking collaboration and decentralization of care, (3) starting from zero, and (4) need for centralized, specialized, and individualized services.ConclusionsOur findings revealed a demand for integrating psychosocial support in long‐term follow‐up care and a strong need for personalized, centralized, and interdisciplinary long‐term follow‐up care. Current established interdisciplinary clinics should be further extended to provide centralized, personalized, and evidence‐based long‐term follow‐up care including adequate psychosocial support for all childhood cancer survivors.

Dimensionality and reliability of a screening instrument for students at-risk of dropping out from Higher Education

Dropout stems from a complex, gradual process of decision-making in which the demands and benefits of university attendance are weighed. Early identification of at-risk students benefits from quick and large-scale screening instruments. This study presents the dimensionality of a screening instrument for students at risk of dropping out of Higher Education, integrating three scales: Academic Exhaustion, Satisfaction with Education and Dropout Intention. A sample of 611 first-year university students was considered in the statistical analysis. The results demonstrate evidence of internal and external validity as well as the reliability of the screening instrument scores. The differences in correlation coefficients between these three scales and the students’ intentions of completing the course and completing their education at their university, evaluated at two different points during the first semester, suggest that dropout analysis requires collecting information throughout the process of adjustment to higher education.

Quality Improvement: Arterial Grafting Redux, 2010:2019

The evidence base favoring utilization of multiple arterial conduits in coronary artery bypass grafting has strengthened in recent years. Nevertheless, utilization of arterial conduits in the US lags behind that of many European peers. We describe a statewide collaborative based approach to improving utilization. Four metrics of arterial revascularization were devised. These were displayed and discussed at quarterly statewide quality collaborative meetings from January 2016 onwards, integrated with an educational program regarding attendant benefits. We undertook retrospective review of isolated coronary artery bypass grafting statewide from 2012-2019 to assess impact. A total of 38,523 cases met inclusion/exclusion criteria. Statewide incidence of multiple arterial grafting increased from 7.4% at baseline to 21.7% in 2019 (P < .001), implementation across hospitals varied widely, ranging from 67.6% to 0.0%. Utilization of total arterial revascularization increased 1.9% to 4.4% (P < .001) between time frames. Utilization of both radial artery and bilateral internal thoracic artery conduit increased significantly from 5.3% to 13.2% (P < .001) and 2.1% to 8.5% (P < .001), respectively; radial artery utilization was significantly higher than bilateral internal thoracic artery for each year (P < .001 for all comparisons). Our statewide quality improvement initiative improved rates of utilization of multiple arterial grafting by all metrics. Barriers to current utilization were identified to guide future quality improvement efforts. This reproducible approach is readily transferable to improve quality of care in other domains and geographical areas.

Anaesthetists' attitudes towards attending the funerals of their patients: A cross-sectional study among Australian and New Zealand anaesthetists.

A patient's death can pose significant stress on the family and the treating anaesthetist. Anaesthetists' attitudes about the benefits of and barriers to attending a patient's funeral are unknown. Therefore, we performed a prospective, cross-sectional study to ascertain the frequency of anaesthetists' attendance at a patient's funeral and their perceptions about the benefits and barriers. The primary aim was to investigate the attitudes of anaesthetists towards attending the funeral of a patient. The secondary aims were to examine the perceived benefits of and barriers to attending the funeral and to explore the rate of bonds being formed between anaesthetists, patients and families. Of the 424 anaesthetists who completed the survey (response rate 21.2%), 25 (5.9%) had attended a patient's funeral. Of the participants, 364 (85.9%) rarely formed special bonds with patients or their families; 233 (55%) believed that forming a special bond would increase the likelihood of their attendance. Showing respect to patients or their families was the most commonly perceived benefit of attending a funeral. Participants found expression of personal grief and caring for the patient at the end-of-life and beyond beneficial to themselves and the family. Fear of their attendance being misinterpreted or perceived as not warranted by the family as well as time restraints were barriers for their attendance. Most anaesthetists had never attended a patient's funeral. Few anaesthetists form close relationships with patients or their families. Respect, expression of grief and caring beyond life were perceived benefits of attendance. Families misinterpreting the purpose of attendance or not expecting their attendance and time restraints were commonly perceived barriers. Trial registration: ACTRN 12618000503224.

Church attendance buffers against longer-term mental distress

ABSTRACT It has been argued that church attendance benefits mental health by buffering against stress. However, underlying mechanisms are debated and longitudinal evidence is scarce. We use eight years of longitudinal population-representative data from New Zealand to test whether consistent church attendance translates into sustained reductions in distress. We also investigate whether church attendance disrupts dynamic bi-directional relationships between the personality trait of Neuroticism and distress: relationships such as at least temporary increases in Neuroticism following escalations in distress. We compare mental distress trajectories and dynamic effects across three groups of religious people (3,535 non-attenders at church, 1,656 sporadic attenders, and 2,393 consistent attenders), controlling for the effects of gender, age, relative deprivation, and perceived physical health. We observe a more adaptive (downward) mental distress trajectory among consistent attenders as compared to non-attenders, although consistent attenders were also found to have higher baseline levels of mental distress. Among sporadic attenders, we observe elevated baseline distress levels without a decrease in mental distress over time, suggesting that the differences in the trajectories of consistent attenders and non-attenders cannot be explained solely by regression to the mean. Church attendance consistency did not modulate dynamic effects. The findings point to a role for church attendance in buffering stress specifically among people in difficult (distressing) circumstances.

Postpartum Contraceptive Use and Other Reproductive Health Outcomes Among CenteringPregnancy Group Prenatal Care Participants

Background: CenteringPregnancy® is a model of group prenatal care (PNC) that reduces preterm birth and increases patient satisfaction. Less is known about postpartum outcomes. Methods: This study aimed to evaluate whether CenteringPregnancy participants have more favorable postpartum reproductive health outcomes compared with traditional PNC participants. Our primary outcome was utilization of long-acting reversible contraception (LARC). As secondary outcomes, we examined breastfeeding at the postpartum visit, follow-up at the postpartum visit, and rapid repeat pregnancy. We conducted a retrospective cohort study of 422 women who received PNC and delivered at tertiary care hospital in Atlanta, Georgia between 2011 and 2015. Participants were eligible to participate if they were enrolled in Medicaid and received at least three PNC visits with a Certified Nurse Midwife in either CenteringPregnancy (n = 248) or traditional PNC (n = 174). Demographic and clinical data were abstracted from the electronic medical record. Multivariable log binomial regression was used to compare CenteringPregnancy participants and women who received traditional PNC. Results: One quarter of women (26%) chose LARC for postpartum contraception. There was no difference in overall contraceptive uptake between CenteringPregnancy and traditional PNC groups. CenteringPregnancy participants were 70% more likely to use LARC postpartum compared with women receiving traditional PNC (adjusted relative risk [aRR] 1.76; p < 0.01). CenteringPregnancy participants were significantly more likely to initiate breastfeeding before hospital discharge (aRR 1.14, p = 0.01) and to report exclusive breastfeeding at the postpartum visit (relative risk [RR] 2.54; p < 0.01). Women in the CenteringPregnancy group were marginally more likely to report any breastfeeding at the postpartum visit and to attend the postpartum visit (RR 1.31, p = 0.05 and RR 1.17, p = 0.05 respectively), but were no less likely to have a rapid repeat pregnancy (RR 0.90, p = 0.57). Conclusion: Women in CenteringPregnancy groups had increased uptake of LARC compared with a similar cohort of women in traditional PNC. Other potential benefits of CenteringPregnancy, including breastfeeding and attendance at the postpartum visit require further study.

Ethics of Codes and Codes of Ethics: When Is It Ethical to Provide Cardiopulmonary Resuscitation During the COVID-19 Pandemic?

Objective:Our study aims to provide a paradigm when it is ethical to perform cardiopulmonary resuscitation (CPR) on patients during the COVID-19 pandemic.Summary Background Data:Hospitals around the nation are enacting systems to limit CPR in caring for COVID+ patients for a variety of legitimate reasons and based on concepts of medical futility and allocation of scarce resources. No ethical framework, however, has been proposed as a standard to guide care in this crucial matter.Methods:Our analysis begins with definitions of ethically relevant terms. We then cycle an illustrative clinical vignette through the mathematically permissible possibilities to account for all conceivable scenarios. Scenarios with ethical tension are examined.Results:Patients have the negative right to refuse care including CPR, but they do not have the positive right to demand it. Our detailed ethical analysis and recommendations support CPR if and only if 1) CPR is judged medically beneficial, and in line with the patient's and values and goals, 2) allocations or scarce resources follow a just and transparent triage system, and 3) providers are protected from contracting the disease.Conclusions:CPR is an intervention like any other, with attendant risks and benefits and with responsibility for the utilization of limited resources. Our ethical analysis advocates for a systematic approach to codes that respects the important ethical considerations in caring for the critically ill and facilitates patient-centered, evidence-based, and fair treatment to all.

S0480 Portable Hydrogen Breath Testing and Microbiome Analysis Identifies Prebiotic-Induced Increases in Colonic Fermentation and Bifidobacterium

INTRODUCTION: Changes in gut microbiome composition and the attendant health benefits associated with prebiotic intake, vary from person-to-person, implying the need for personalisation. As the primary metabolite of colonic fermentation that can be detected on exhaled breath, hydrogen could be used to indicate when a prebiotic is being metabolized by the host microbiota. METHODS: Volunteers (n = 20) were studied in a double-blind, crossover design (1-week baseline, 2-weeks 1st prebiotic, 2-week wash-out, 2-weeks 2nd prebiotic, 1-week washout) using two different prebiotic fibres, a galacto-oligosaccharide (GOS) and a wheat dextrin (WD). Breath hydrogen scores were recorded using a portable breath analyser, while 6 faecal samples per individual were acquired during the study (2 baseline samples and 4 intervention samples) (Figure 1). Bacterial DNA was extracted and submitted to 16S rRNA sequencing on an iSeq platform (Carbiotix) to characterise the gut microbiota. RESULTS: Five faecal samples were excluded due to low quality DNA. A mean number of 388 breath hydrogen levels were recorded per individual (SD 59). A high degree of interpersonal variation was apparent in both breath hydrogen and microbiome composition. We noted a consistent trend for increased abundance of the genus Bifidobacterium on administration of GOS (group 1, 1% (range 0–2.1) - 3.6% (0.4–14.2), P = 0.004; group 2, 2.4% (0.03–11.6) - 10.2% (0.04–22), P = 0.04) and in one of two groups following WD (group 1, 0.09% (0–10) - 1.1% (0–19), P = 0.04). On an individual level, we saw greater changes in breath hydrogen on administration of GOS, which was less apparent if WD was taken first in sequence. We used repeated-measures-correlation to correlate the relative abundance of bacterial genera with weekly breath hydrogen. Following correction for multiple comparisons, only Bifidobacterium was significantly positively correlated with weekly breath hydrogen (r = 0.35, adjusted P-value = 0.016) (Figure 2). CONCLUSION: These results reflect the known Bifidogenic effects of these prebiotics. Interestingly, Bifidobacterium are unable to produce hydrogen, as they do not possess hydrogenases. However, a possible mechanism is that the fermentation of these prebiotics resulted in an initial increase in hydrogen and other important products, and via cross-feeding, the growth of Bifidobacterium was supported, to varying degrees in all individuals. Future studies are needed to understand the processes at play.Figure 1.: Overview of study. A baseline was established for each user (week one). A prebiotic fibre was taken for a two week period (week two and three), followed by a two week wash-out period (week four and five), before switching to the other prebiotic intervention (week six and seven). No prebiotic was taken during week eight.Figure 2.: Breath hydrogen simple moving average (SMA) and Bifidobacterium abundance levels for one of the study participants for the duration of the study period.

Shared Decision-making in Orthopaedic Surgery.

Shared decision-making (SDM) is the process by which the physician and the patient collaborate to arrive at the evidence-based treatment that best aligns with the patient's individual goals of care. The implementation of SDM practices is especially important when an invasive surgical procedure is among the treatment options. Ideally, the variation in the patient treatment choice would mirror the variability in patient goals rather than variation in a physician's ability to communicate effectively. Potentially aiding in these communication efforts, decision aids are tools gaining popularity for their ability to help physicians facilitate the SDM process with patients. This article is intended to give the practicing orthopaedic surgeon an understanding of the concept of SDM and how it can improve physician-patient communication. We will explore the key elements of SDM, attendant benefits, indications, and barriers to implementation and propose steps to begin the incorporation of SDM into practice.

Religiosity and veteran mental health compared with non-veterans.

While the potential buffering effects of spirituality are well established in the general population, how spirituality affects those in extremely high-stress occupations like the military and law enforcement is less clear. This paper explores the possibility that spiritual influences may operate differently among military veterans than other people. It specifically proposes that attendance at religious services is an especially important buffer for combat veterans. This study engaged in a secondary analysis of 74 480 respondents from the National Survey on Drug Use and Health for the years 2013-17. The respondents were split into four groups; veterans with combat experience before September 2001, veterans with combat experience since September 2001, veterans with no combat experience and non-veterans. The likelihood of mental illness decreased in the general population along three different measures of religion; the importance of religion, friendships that shared religious beliefs and attendance at religious services. The relationship was weak and disappeared when controls for non-religion variables were included. A major exception was combat veterans, for whom the religious effects were limited to attendance at services, and the effect survived with the addition of non-religion control variables. Mental health professionals, chaplains, pastoral counsellors and clergy need to recognize that among the therapeutic benefits of religious attendance and recognize the value of the religious rituals as ends in themselves.

Maternal Education, Family Formation, and Child Development: The Continuing Significance of Race

AbstractObjectiveFamily formation patterns and their attendant benefits for children have diverged by maternal education in recent decades, but has there been racial variation in these trends?BackgroundTheories of intersectionality and structural racism suggest that relationships between women's educational attainment, family formation, and benefits for children may differ between Black, Hispanic, and White women who have completed the same amount of schooling.MethodUsing longitudinal data on mothers and children from the Early Childhood Longitudinal Study, Kindergarten Class of 2010–11 ( https://nces.ed.gov/ecls/kindergarten2011.asp), descriptive statistics examine racial variation within maternal education groups on a number of family formation characteristics. A series of regression analyses, stratified by maternal education, assess racial differences (by mother's race) in reading scores at school entry among children of same‐education mothers and reveal the extent to which variation in family patterns accounts for such differences.ResultsBlack and, to a lesser extent, Hispanic mothers often (although not always) have significantly different family formation patterns compared with same‐education White mothers. Controlling for these family characteristics largely attenuates and sometimes fully reverses significant Black–White gaps in children's school‐entry reading achievement within maternal education groups but does less to account for Hispanic–White gaps.ConclusionRace continues to have a structural influence on many family and child outcomes, over and above maternal education, particularly for Black mothers relative to same‐education White mothers.

‘I shall miss the company’: participants’ reflections on time-limited day centre programming

AbstractThe social needs of frail or isolated older people are sometimes aided by referrals to day centres in the United Kingdom. Since the late 1940s, day centres have had a role to play promoting socialisation in later life. Additionally, attendance at day centres is often open ended, with participants only leaving due to moving to a nursing home or dying. In this study, the views of those attending time-limited day centre programmes in seven day centres in Northern Ireland have been sought in relation to their thoughts about the service as well as how they feel when it ends. Seventeen participants completed diaries for the programme duration and/or engaged in an interview process. Participants reflected on the social and educational benefits of attending but also recognised impositions in the centres that impinged upon individual choices and also the length of time they could remain. This study reveals that, in order to maintain socialisation, time-limited programmes must have clear follow-on strategies for participants. Additionally, respondents’ experiences reflect that a paternalistic model of care delivery remains in place that, whilst restrictive, reveals that access to the service is more specialised and not universal. Nevertheless, should day centres wish to remain relevant, it is important that service users are fully consulted about their desires and choices within the setting.

The Importance of Community Colleges in Students’ Choice to Major in STEM

ABSTRACT This article investigates whether attending a community college is related to an increase in the number of students majoring and graduating with degrees in science, technology, engineering and mathematics (STEM) at four‐year colleges. We follow a longitudinal sample of students in North Carolina from middle school through college graduation, including some who attended a community college. Our multilevel models indicate that for our sample of students, who attended a four‐year institution and declared a major within 6 years of high school graduation, ever attending a community college and/or starting post‐secondary education at a community college have a significant positive relationship with their likelihood of declaring and graduating with a STEM major. Results hold true even after controlling for sample self‐selection through propensity score matching techniques. Our findings also show that the benefits of community college attendance on students’ likelihood of declaring and graduating with a STEM major are not restricted to only low‐SES students. Overall, this study supports the notion that two‐year colleges could work as means of helping push students from diverse socioeconomic backgrounds into STEM.

Leadership in Collaborative Governance: The Case of HIV/AIDS Health Services Planning Council in South Florida

ABSTRACT This study uses the case of Broward County’s HIV/AIDS Health Services Planning Council to highlight the likely leadership contributions in collaborative governance for core medical and support services to target populations as a conduit to care and treatment. The study relies on an in-depth interview of Council members including leaders to generate relevant data for interpretation purposes. The data are subjected to thematic analysis to help derive insights from participants’ experiences relative to leadership efforts in collaborative governance. The results accentuate formal and informal leadership contributions in shared understanding, trust building, commitment to process, institutional design, communication, conflict resolution, empowerment, system context, and allocation priorities with attendant facilitation benefits and challenges. The findings point to the irreplaceable role of leadership in collaborative governance in areas such as antecedent/initial conditions, collaborative process, and the consequential outputs and/or outcomes for the benefits of target populations and society at large. It appears the tragedy of HIV/AIDS epidemic unexpectedly fosters alternative leadership approaches which is usually facilitative in nature as part of a governance regime and enables collective multi-stakeholder engagements for viable and sustainable solutions while embracing associated challenges.