Outreach Center Research Articles

Telegenetics: a systematic review of telemedicine in genetics services

Telemedicine is being increasingly used in many areas of health care, particularly to reduce the barriers that rural populations face in accessing health-care services. Telemedicine may also be effectively utilized in clinical genetics services—an application that has been termed “telegenetics.” A systematic review of the literature was conducted to identify studies of genetic consultations carried out through video conferencing so as to determine whether conclusions can be drawn about the value of telegenetics. A total of 14 articles reporting data from 12 separate studies met the inclusion criteria. In a majority of these studies, patients received their telegenetics consultation at a local clinic or outreach center, from where they communicated via a synchronous video link with a genetic spractitioner. All the studies reported high levels of patient satisfaction with telegenetics,and patients were generally more receptive to telegenetics than the genetics practitioners were. The studies had limitations of small sample sizes and lack of statistical analyses. This review suggests that telegenetics may be a useful tool for providing routine counseling and has the potential to evaluate pediatric patients with suspected genetic conditions. Prospective,fully powered studies of telegenetics that explore the accuracy of diagnoses and patient outcomes are needed to allow informed decisions to be made about the appropriate use of telemedicine in genetics service delivery.

Mooren′s corneal ulceration in a pseudophakic eye: A case report and literature review

Surgery (ECCE+ PCIOL) is an unusual possible aetiology of Mooren's corneal ulceration. A clinical and laboratory evaluation of a case of a 60-year-old male Nigerian who in the immediate postoperative period developed Mooren's corneal ulceration after an uneventful extracapsular cataract extraction and a posterior chamber intraocular lens (ECCE+PCIOL) implantation at an outreach center is presented. Healing occurred within 2 weeks of medical and surgical intervention, but no remarkable visual improvement. A review of literature from relevant sources with emphasis on management options is also incorporated. Many cases of Mooren's corneal ulceration remain refractory to treatment even in advanced countries. However, early case finding and prompt referral by trained primary eye care personnel may help to reduce severe visual morbidity in this environment.

Organizational Use of a Media Campaign Booklet to Encourage Parent–Child Communication about Waiting to Have Sex

Promoting parent—child communication through the use of print materials may be an important health communication approach for preventing teen sexual activity in the United States. Although prior work has suggested successful methods of disseminating print materials, research has not examined dissemination approaches across organization types. Understanding the use and dissemination of print materials among different organizations is crucial to guiding materials development in a way that maximizes uptake and effectiveness among consumers. Accordingly, this study examined the use of a booklet for parents that encouraged parent–child communication about waiting to have sex as collateral material for a national media campaign. We interviewed staff at 9 community organizations, 9 health care facilities, 5 school-based organizations, and 3 campaign outreach centers. Results suggested variability within and across organization types regarding use of the booklet. Community and outreach center staff tended to walk through the booklet content with parents; health care facilities and education-oriented organizations usually reported both direct and indirect distribution approaches. Staff identified useful elements of the booklet and made suggestions for dissemination in line with prior research. A better understanding of how print materials are utilized to supplement media campaigns can improve their usefulness and potential influence on health behaviors.

The Mathematics Outreach Center—Saving Dreams

The Amarillo College Mathematics Outreach Center (ORC) uses innovative funding and cross-discipline cooperation to make a cost-effective difference in the lives of thousands of students. Using limited resources, tutoring sessions have increased in four years and students' test grades have been proven to increase up to two letter grades.

An Ecological Model of STEM Education: Operationalizing STEM for All

This article describes a framework for how to provide more accessible, relevant, and effective instruction in science, technology, engineering, and mathematics (STEM) education to all students. The STEM FOR ALL initiative asserts that all students, including those with disabilities and other diverse learning needs, should be included in meaningful STEM education and develop expertise in STEM areas as well as 21st century skills associated with STEM learning. This framework is described through the lens of Bronfrenbrenner's (1977, 1994) ecological model, which provides a mechanism for understanding the interconnected and complex interactions that occur across multiple systems (e.g., policy makers, curriculum developers, teachers, and students) within the current STEM education infrastructures. Examples and lessons learned from the Furthering Urban STEM Innovation, Outreach, & New Research(UC|FUSION) research and outreach STEM center illustrate how the model is currently applied in Ohio schools and how it could be adapted to other local, regional, and national STEM FOR ALL initiatives.

Developing Brokered Community Transportation for Seniors and People With Disabilities

Communities are exploring ways to increase transportation coordination to improve access for seniors. One such effort is a brokered transportation system in which one agency serves as the central point of contact for ride information or actually arranging transportation for clients of multiple programs by use of a combination of transportation services. A team of social work faculty and students from the University of New Hampshire (UNH) Social Work Outreach Center, a center that provides service learning opportunities to students, collaborated with a local coalition to investigate the specific transportation needs of the region's senior citizens. A total of 641 people participated in the survey. Results indicate that the study population experiences problems reliably meeting daily living needs due to inconsistent or unavailable private and public transportation options. Study findings also indicate the promising potential of brokered transportation systems, particularly for isolated seniors in rural and suburban areas with relatively limited public and private transportation options.

Living in the Buckle: Promoting LGBT Outreach Services in Conservative Urban/Rural Centers

LGBT Outreach Center (LOC) faces the difficult task of marketing outreach services to lesbian, gay, bisexual, and transgender (LGBT) individuals in a conservative rural/urban center. Creating internal messages that support the LGBT identity is critical to organizational member support. However, presenting external messages to a community-at-large that tends to be unsupportive of LGBT individuals is daunting. Focus groups identified obstacles to outreach and fundraising. Recommendations are provided for LGBT outreach centers in conservative areas.

Bedding Options for an Alternative Housing System for Dairy Cows: A Descriptive Study

Availability of bedding material for compost bedded pack barns is a concern for dairy producers who use this type of alternative housing system. The material most commonly used in these barns is dry sawdust. The objective of this descriptive study was to evaluate different types of bedding material that could potentially substitute or partially substitute for sawdust in these housing systems. The study was conducted at the West Central Research & Outreach Center in Morris, Minnesota, from November 2006 to March 2007. Materials included: pine sawdust (control) (SD), corn cobs (CC), pine woodchip fines (WC), and soybean straw (SS). Some of these materials were evaluated as mixtures on a 2:1 volume-to-volume ratio. These mixtures included: woodchips/sawdust (WC/SD), woodchips/soybean straw (WC/SS), and soybean straw/sawdust (SS/SD). Experimental bedded packs were used, each with one of the bedding materials, and 16 cows were placed on each pack. Replicated samples of the bedded pack material were collected twice a month and analyzed for dry matter. C:N ratios and pH were analyzed monthly. Temperatures of each pack were measured weekly at various depths (15.2, 30.5, 45.7, and 61.0 cm). Cows were scored for hygiene (1=clean, 5=dirty) twice a month. Moisture content of SD was 59.7; CC, 44.5; WC/SD, 60.6; SS/SD, 58.2; WC/SS, 60.7; and SS, 60.6. SD pH was 8.7; CC, 7.7; WC/SD, 8.6; SS/SD, 8.6; WC/SS, 8.3; and SS, 8.6. C:N ratio of SD was 37.3; CC, 29.2; WC/SD, 47.5; SS/SD, 25.6; WC/SS, 31.0; and SS, 22.8. Hygiene score of cows on SD was 2.4; CC, 2.7; WC/SD, 2.5; SS/SD, 2.9; WC/SS, 2.6; and SS, 2.8. Based on these results and our observations, it appears that any of the bedding materials evaluated in this study would work in this type of housing system if proper bedding management is applied on a consistent basis. It was concluded that ideal bedding material for compost barns should be dry, processed to less than 2.5 cm long, offer structural integrity, and have good water absorption and holding capacity.

Buying local organic food: a pathway to transformative learning

Food is a powerful symbol in the struggle to transition to a more sustainable pathway since the food choices citizens make have deep environmental and social impacts within their communities and around the world. Using transformative learning theory, this research explored the learning that took place among individual adults who consumed goods directly from local organic producers, and how this behavior affected their worldview. Learning was classified as instrumental, communicative, or transformative. Ultimately, we considered if the learning created lasting change, directed toward a more sustainable society, among learners. Three different models of producer/consumer interfaces located in Atlantic Canada were considered: a market-garden operation, an education and outreach center, and a community shared agriculture project. It was found that all participants experienced some form of learning, either instrumental or communicative, through their participation in organic agriculture. Closing the gap between producer and consumer through direct contact with the farmer at a market, visiting the farm, or participating in food production oneself is both a desirable step in reaching a more sustainable lifestyle and a powerful learning tool in linking the consumer to a host of other environmental and social issues.

ALCOHOL/DRUG DEPENDENCY IN HOMELESS YOUTH

Purpose: By age 16, half of all adolescents use alcohol and about one‐quarter use marijuana. The pervasiveness of substance abuse is remarkably higher among homeless youth as compared to the general youth population. A significant need exists to develop appropriate drug and alcohol treatment that takes into account the unique perspectives of drug use in the culture of homelessness. While predictors, such as criminal involvement, academic failure, victimization, and “street” involvement are useful in understanding substance use among homeless youth, further research on alcohol/drug dependency is needed to develop effective interventions for this population.Methods: A convenience sample of 153 homeless youth accessing services at a street outreach center participated. Those 18‐23 years of age, whose case managers had identified them as drug or alcohol users, were recruited. Following informed consent, youth completed a quantitative questionnaire.Results: The sample averaged 21 years of age, were predominantly white (67.3%) and male (65.4%). Results indicated that 98.7% of these youth reported drinking alcohol, using amphetamines (39.2%), heroin (46.4%), and/or marijuana (91.5%); 57.8% of youth interviewed were identified as dependent on substances and 61.0% were dependent on alcohol. Logistic regression analyses indicated that participants who received support from substance‐using street friends (OR=2.1) and were dependent on substances (OR=4.9) increased the likelihood of alcohol dependency, while the more positive youth felt about drug use (OR=.88), the more confident they were in their ability to decrease their drug use (OR=.65), or earned money by selling blood/plasma (OR=.06) decreased the likelihood of alcohol dependence (model χ2 = 63.8, p<.001). Similar analyses of drug dependence showed that those who felt changing drug use behavior was important (OR=1.3), carried a weapon (OR=3.1), or were alcohol dependent (OR=2.7) were more likely to be drug dependent (model chi‐square = 49.1, p<.001).Conclusions: This study confirms the magnitude of alcohol/drug dependence among homeless youth and demonstrates the varying predictors for alcohol and drug dependency. While school‐based substance use prevention programs are available for adolescents, effective programs for homeless youth are nearly non‐existent and needed. This study highlights the need for service agencies proving care for these youth to assess their alcohol and drug use. Although typical drug treatment is not feasible for these agencies, developing assessment and referral mechanisms and brief interventions that target alcohol/drug issues are needed.

Black Tuesday (review)

Reviewed by: Black Tuesday Deborah Stevenson Colebank, Susan Black Tuesday. Dutton, 2007264p ISBN 0-525-47766-7$16.99 M Gr. 7-10 Black Tuesday is the day Jayne's life changes: she starts out as an overburdened workhorse focusing on Harvard, but that all comes to a screeching halt along with her car—which she drives through a red light and into another vehicle, resulting in the hospitalization and eventual death of the six-year-old girl riding in the passenger seat. Jayne's controlling and polished anchorwoman mother sets Jayne up with a great attorney, so her punishment is limited to loss of driver's license and performance of community service (she also perfunctorily attends counseling with a family friend). In the aftermath, she begins to ease up on her long-term habit of diligent striving and attention to rules, doing the rebellious piercing and edgy-hairstyle thing and reveling in the attentions of a sexy guy she meets at the youth outreach center where she's performing community service. While the story has some thematic commonality with Cooney's Driver's Ed (BCCB 9/94), the superficial writing and muddled emotional exploration preclude the book's effectiveness as either emotional drama or ethical investigation. Jayne is largely unsympathetic, starting out as a sour and complaining martyr and then acting out her pain in preteen-styled brattiness, and characterization overall is handed out rather than established. What's more, the actual consequence of Jayne's action, the death of the little girl, is only peripherally touched upon as something that has repercussions for Jayne, and the people around the victim are oddly villainized (there's a whiff of homophobia in the book's approach to the girl's sister, who is Jayne's classmate, and her friend, though it's never actually clear if they're lesbians). Ultimately, it seems [End Page 458] less like Jayne worked through her personal and family issues than she got off easy because of that very good-girl history she's trying to reject, and cynical readers will wonder if they, too, can increase their chances of Harvard admission by screwing up as catastrophically and with as little consequence as Jayne. Copyright © 2007 The Board of Trustees of the University of Illinois

Open the Door Whenever Opportunity Knocks

The Community Environmental Health Program/Community Outreach and Education Program (CEHP/COEP) New Mexico Center for Environmental Health Sciences has learned that listening and responding to opportunities that arise in local communities can be a more effective means of reaching health care providers, lay health workers, and community members than structured plans of action. While specific opportunities that have occurred in New Mexico may be unique, they are presented here with the hope that they might suggest new strategies to the reader and help to identify parallel opportunities in other communities. The paper is organized around three major opportunities to which CEHP/COEP has responded: (1) the need for more informed health care in communities with unique and complex environmental and occupational exposures due to their proximity to National Laboratories; (2) the need for resources on environmental health within local provider networks and issue-specific groups; and (3) the need for community environmental health projects within the College of Nursing. CEHP/COEP's responses, observations, and lessons learned through these experiences are discussed. In the end, the major lesson is that the ability to respond to opportunities requires flexibility and creativity; by sticking doggedly to plans, valuable-and sometimes more profitable and productive-opportunities may be missed.

Quality-of-life in children and adolescents with cystic fibrosis managed in both regional outreach and cystic fibrosis center settings in queensland

To assess the health-related quality-of-life (HRQOL) of children/adolescents with cystic fibrosis (CF) and compare HRQOL in children managed by cystic fibrosis outreach service (CFOS) with those treated in a cystic fibrosis center (CFC). To compare HRQOL of children with CF in Queensland with previously published HRQOL data from the United States and examine the relationship between HRQOL scores and pulmonary function. Participants were children/adolescents with CF and their parents managed by the Royal Children's Hospital Queensland at a CFC or CFOS. Two HRQOL surveys were used: PedsQL and Cystic Fibrosis Questionnaire (CFQ). There were 91 CFC and 71 CFOS participants with similar demographics. PedsQL total summary score was statistically higher in CFOS, P=.05. There was no significant difference in CFQ scores between groups. Queensland parents reported lower HRQOL for their children compared with US parents (P<.01) despite similar pulmonary function. Declining pulmonary function correlated with worse CFQ scores in adolescents, P<.05. Children living in regional Queensland reported as good as or slightly better HRQOL compared with children attending a CFC. Parent proxy HRQOL scores were generally low suggesting a reduced perception of HRQOL by parents for their children.

Weed Control in Organic Vegetable Production: The Use of Sweet Corn Transplants and Vinegar

Weed control in organic vegetable production is a major challenge. During Summer 2004, we conducted field trials to manage weeds in organic sweet corn, carrots and onions. In sweet corn, we evaluated the efficacy of transplanting greenhouse-grown sweet corn seedlings. In carrots and onions, we tested vinegar and several concentrations of acetic acid. Studies were conducted in southwestern Minnesota at the Lamberton Research and Outreach Center and in eastern Minnesota at Foxtail Farm in Shaefer. Ten-day-old corn transplants were effective at both locations. Stand establishment was greater, less tillage was needed, and yield was greater than in the seeded plots. Straight vinegar was not very effective in controlling weed populations. Although there was greater damage to broadleaf weeds than grasses, straight vinegar did not reduce the need for tillage. Although 10% to 20% acetic acid did provide better weed control, it significantly damaged carrot and onion seedlings. These results suggest that using sweet corn transplants is time and cost effective for small acreage sweet corn production such as CSAs. Vinegar and acetic acid are problematic. Nonselectivity, potential danger in handling, and poor control at low concentrations were all considered significant disadvantages.

Predictive Value of Photoscreening and Traditional Screening of Preschool Children

To compare the usefulness of traditional vision screening and photoscreening of 3- and 4-year-old children in the pediatrician's office. Following training of pediatricians and office staff, six pediatric clinics used both the MTI PhotoScreener (Medical Technology Industries, LLC, Riviera Beach, FL) and traditional acuity and stereopsis screening materials (HOTV charts/Random Dot E tests as recommended by established AAP-MCHB-PUPVS guidelines) during well-child exams. Clinics used one testing method for a 6-month period and switched to the other for the following 6 months, in a randomized manner. Referred children received a complete eye examination with cycloplegic refraction by local ophthalmologists or optometrists who forwarded the results to Vanderbilt Ophthalmology Outreach Center. Amblyogenic factors were defined using standardized published criteria. Six hundred five children were screened with the photoscreener and 447 were screened with traditional techniques. Mean time for screening was less with the photoscreener: 2.5 versus 5.9 minutes ( P < 0.01). Untestable rates were similar (18% vs 10%, respectively P = NS), but higher with the photoscreener due to one clinic's 70% unreadable rate. Referral rates were also similar: 3.8% versus 4.5%. The positive predictive value (PPV) rate differed greatly. With follow-up results obtained from 56% of referred children, 73% of photoscreening referred children (8/11 examined) had amblyogenic factors confirmed on formal eye exams, whereas all children referred using traditional screening methods (10/10 examined) were normal. Photoscreening is more time efficient than traditional screening and has a significantly higher PPV in 3- and 4-year-old children. This study was unable to validate traditional screening techniques in this preschool age group. If these results can be replicated, support for traditional vision screening must undergo intense scrutiny, and attention should be turned toward making photoscreening feasible for widespread implementation.

Validation of the Alcohol Use Disorders Identification Test (AUDIT) in urban community outreach and de-addiction center samples in north India.

The Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization for screening disorders related to alcohol use has been shown to have robust psychometric properties. This study compared the performance of AUDIT with that of the Short Michigan Alcoholism Screening Test (SMAST) in a region of North India. A total of 297 consecutive subjects who had used alcohol in the past year were recruited from a de-addiction center (DAC) (n = 97) and a community outreach setting (n = 200) in West Delhi. Using International Classification of Diseases, Tenth Edition (ICD-10) criteria, the relative effectiveness of the AUDIT and the SMAST in identifying alcohol-use-related disorders was assessed and compared. Internal consistency and interscale correlations were evaluated, along with sensitivity, specificity and ROC curve analyses. The AUDIT had very high internal reliability (alpha 0.92) in this Indian sample. There was, in general, good correlation between the total and factor scores of the AUDIT and SMAST (ranging from 0.28 to 0.97), which were higher in the community than in the DAC sample. The AUDIT (area under the curve [AUC] = 0.883) and SMAST (AUC = 0.870) were similar in detecting harmful use of alcohol. The AUDIT optimal cutoff score was 16 (sensitivity 85.3, specificity 89.4) for ICD-10 harmful use and 24 (sensitivity 69.4, specificity 87.5) for ICD-10 alcohol dependence. The AUDIT and SMAST seem to be comparable in their ability to screen subjects with alcohol use disorders. The AUDIT score for screening harmful use in the sample appears to be higher than previously reported. The utility of such high cutoff for screening subjects for intervention is obvious, but it is quite likely that some positive cases might be missed.

Risk-Efficiency Criteria for Evaluating Economics of Herbicide-Based Weed Management Systems in Corn

Evaluation of economic outcome associated with a given weed management system is an important component in the decision-making process within crop production systems. The objective of this research was to investigate how risk-efficiency criteria could be used to improve herbicide-based weed management decision making, assuming different risk preferences among growers. Data were obtained from existing weed management trials in corn conducted at the University of Minnesota Southern Research and Outreach Center at Waseca. Weed control treatments represented a range of practices including one-pass soil-applied, one-pass postemergence, and sequential combinations of soil and postemergence herbicide application systems. Analysis of risk efficiency across 23 herbicide-based weed control treatments was determined with the mean variance and stochastic dominance techniques. We show how these techniques can result in different outcomes for the decision maker, depending on risk attitudes. For example, mean variance and stochastic dominance techniques are used to evaluate risk associated with one- vs. two-pass herbicide treatments with and without cultivation. Based on these analyses, it appears that a one-pass system is preferred by a risk-averse grower. However, we argue that this may not be the best option considering potential changes in weed emergence patterns, application timing concerns, etc. The techniques for economic analysis of weed control data outlined in this article will help growers match herbicide-based weed management systems to their own production philosophies based on economic risk.

Thinking Like A Scientist About Real-World Problems: The Cornell Institute for Research on Children Science Education Program

We describe a new educational program developed by the Cornell Institute for Research on Children (CIRC), a research and outreach center funded by the National Science Foundation. Thinking Life A Scientist targets students from groups historically underrepresented in science (i.e., girls, people of color, and people from disadvantaged backgrounds), and trains these individuals to reason scientifically about everyday problems. In contrast to programs that are content based and which rely on disciplinary concepts and vocabulary within a specific domain of science (e.g., biology), Thinking Like A Scientist is domain-general and attempts to promote the transfer of scientific reasoning. Although the full evaluation of Thinking Like A Scientist must await more data, this article introduces the conceptual basis for the program and provides descriptions of its core themes and implementation.

Post-Release Substance Abuse Treatment for Criminal Offenders: A Cost-Effectiveness Analysis

This study conducted a cost-effectiveness analysis of Delaware's CREST Outreach Center, a work release therapeutic community (TC) and aftercare program for criminal offenders. Treatment effectiveness was assessed using the number of days reincarcerated during an 18-month, post-release follow-up period. The 6-month CREST program cost $1937 for the average participant, and led to ∼30 fewer days incarcerated (29% less) than the average participant in a standard work release program. This implies that the CREST program reduced incarceration for criminal offenders at an average cost of $65 per day. The additional investment of $935 per client to provide aftercare services led to 49 fewer days incarcerated (43% less) than CREST work release-only participants. This suggests that by adding an aftercare component to the CREST work release program, a day of incarceration is avoided at an average cost of $19 per day. These findings have implications for future investments in post-release substance abuse treatment for criminal offenders. However, the results must be interpreted with caution given potential selection bias in the groups that participated in the CREST work release and aftercare programs. Selection bias and the policy implications of this research are noted and discussed.

Psychiatrists Plan Strategy to Reduce MH Care Disparities

Psychiatrists Plan Strategy to Reduce MH Care Disparities