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Diabetes Self-Management in a Community Health Center: Improving Health Behaviors and Clinical Outcomes for Underserved Patients

Daren Anderson
Jan 1, 2008; 26:22-27
Bridges to Excellence




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Improving Patient Adherence

Alan M. Delamater
Apr 1, 2006; 24:71-77
Feature Articles




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How Technology Is Improving Safety On the Roads and Reducing Driving Anxiety

Technology has changed a number of aspects of our everyday lives and has led to increased efficiency. But when it comes to driving, has it helped or hindered the process? In this article, we will be looking into some of the ways that technology has improved safety on our roads in the last 10 years. […]




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New Study Shows 1-to-1 Technology Improves Student Achievement in Math Over Time

A new study published in the Educational Evaluation and Policy Analysis journal found that there is potential for 1-to-1 technology programs to increase achievement in the short term, but more so in the medium term.




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North Carolina Awards $12 Million Dollar Grant to Improve Literacy Instruction

A $12.2 million dollar grant from the state Department of Public Instruction will go to a program based at North Carolina State University to provide additional training literacy training to teachers in 16 high-needs districts across the state.




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Staff Email Addresses Removed From District Websites to Improve Cybersecurity

Some district technology leaders say having staff email addresses publicly available opens the door for phishing scams and potential hacks.




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Eligibility for Federal School Improvement Grants Helped Ohio Students, Study Says

Academic achievement at Ohio schools eligible for School Improvement Grants during the Obama administration increased for a few years, a new study says, but SIG's legacy remains complicated.




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A Look at Teacher Improvement in Tennessee

A state department leader outlines what Tennessee is learning about teacher improvement and where the state still needs to learn more.




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Improvement under new coaches is wide-ranging

In 2018, the programs with new coaches had a combined .433 winning percentage (120-157), up from .416 (117-164) a year earlier. Four schools won or shared conference titles and made the postseason - ETSU (under Randy Sanders), UIW (Eric Morris), North Carolina A&T (Sam Washington) and Wofford (Josh Conklin). The winning percentage at schools with new coaches was .448 (137-169), up from .444 (123-154) in 2018, with a decline in record at 13 schools and a better one at the other 12.




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Forum 2019 : 3D The keys to profit and cash flow improvement : slides / presented by Mathew Schlyder, Director, FWO Chartered Accountants.




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Forum 2019 : 4A Transform your business culture with a 'meta' skill... : one that improves all other skills : slides / presented by Tomas Jajesnica, Mr Meditate.




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National return to work strategy 2020-2030 : a national strategy to drive and leverage national action to improve return to work outcomes for workers with a work-related injury or illness / Safe Work Australia.




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Rewording the brain : how cryptic crosswords can improve your memory and boost the power and agility of your brain / David Astle.

Memory.




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The DASH diet Mediterranean solution : the best eating plan to control your weight and improve your health for life / Marla Heller, MS, RD.

Hypertension -- Diet therapy -- Recipes.




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Description of an improved apparatus for inhalation of vapour in the cure of diseases / by John Gairdner.

[Edinburgh] : [publisher not identified], [1823]




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Descriptive catalogue of the anatomical museum of the Boston society for medical improvement / by J.B.S. Jackson.

Boston : W.D. Ticknor, 1847.




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Directions for preparing aerated medicinal waters, by means of the improved glass machines made at Leith Glass-Works.

Edinburgh : printed for William Creech, 1787.




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Directions for using the improved sliding scale of chemical equivalents : with a short explanation of the doctrine of definite proportions / by David Boswell Reid.

Edinburgh : J. Dunn, 1826.




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Dissertation on scientific nomenclature, medical and general : exhibiting the defects, anomalies, errors, and discrepancies of its present condition : with suggestions for its improvement / by R.G. Mayne.

London : J. Churchill, 1849.




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The Edinburgh medical and physical dictionary : containing an explanation of the terms of art in anatomy, physiology, pathology ... as employed in the present improved state of medical science ... : to which is added, a copious glossary of obsolete terms

Edinburgh : Bell & Bradfute, 1807.




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The Edinburgh new dispensatory : ... Being an improvement upon the new dispensatory of Dr Lewis.

Edinburgh : And for C. Elliot and T. Kay, London, 1789.




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Eruptions of the face, head, and hands : with the latest improvements in the treatment of diseases of the skin / by T.H. Burgess.

London : H. Renshaw, 1849.




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Finding Common Ground Through Data to Improve Idaho's Teacher Pipeline

A superintendent outlines the importance of various groups coming together to address teacher recruitment and retention challenges in Idaho.




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Unsupervised Pre-trained Models from Healthy ADLs Improve Parkinson's Disease Classification of Gait Patterns. (arXiv:2005.02589v2 [cs.LG] UPDATED)

Application and use of deep learning algorithms for different healthcare applications is gaining interest at a steady pace. However, use of such algorithms can prove to be challenging as they require large amounts of training data that capture different possible variations. This makes it difficult to use them in a clinical setting since in most health applications researchers often have to work with limited data. Less data can cause the deep learning model to over-fit. In this paper, we ask how can we use data from a different environment, different use-case, with widely differing data distributions. We exemplify this use case by using single-sensor accelerometer data from healthy subjects performing activities of daily living - ADLs (source dataset), to extract features relevant to multi-sensor accelerometer gait data (target dataset) for Parkinson's disease classification. We train the pre-trained model using the source dataset and use it as a feature extractor. We show that the features extracted for the target dataset can be used to train an effective classification model. Our pre-trained source model consists of a convolutional autoencoder, and the target classification model is a simple multi-layer perceptron model. We explore two different pre-trained source models, trained using different activity groups, and analyze the influence the choice of pre-trained model has over the task of Parkinson's disease classification.




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Deep transfer learning for improving single-EEG arousal detection. (arXiv:2004.05111v2 [cs.CV] UPDATED)

Datasets in sleep science present challenges for machine learning algorithms due to differences in recording setups across clinics. We investigate two deep transfer learning strategies for overcoming the channel mismatch problem for cases where two datasets do not contain exactly the same setup leading to degraded performance in single-EEG models. Specifically, we train a baseline model on multivariate polysomnography data and subsequently replace the first two layers to prepare the architecture for single-channel electroencephalography data. Using a fine-tuning strategy, our model yields similar performance to the baseline model (F1=0.682 and F1=0.694, respectively), and was significantly better than a comparable single-channel model. Our results are promising for researchers working with small databases who wish to use deep learning models pre-trained on larger databases.




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Genetic and metabolic engineering for improved biofuel production from lignocellulosic biomass

9780128179543 (electronic bk.)




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Brassica improvement : molecular, genetics and genomic perspectives

9783030346942 (electronic bk.)





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Hierarchical infinite factor models for improving the prediction of surgical complications for geriatric patients

Elizabeth Lorenzi, Ricardo Henao, Katherine Heller.

Source: The Annals of Applied Statistics, Volume 13, Number 4, 2637--2661.

Abstract:
Nearly a third of all surgeries performed in the United States occur for patients over the age of 65; these older adults experience a higher rate of postoperative morbidity and mortality. To improve the care for these patients, we aim to identify and characterize high risk geriatric patients to send to a specialized perioperative clinic while leveraging the overall surgical population to improve learning. To this end, we develop a hierarchical infinite latent factor model (HIFM) to appropriately account for the covariance structure across subpopulations in data. We propose a novel Hierarchical Dirichlet Process shrinkage prior on the loadings matrix that flexibly captures the underlying structure of our data while sharing information across subpopulations to improve inference and prediction. The stick-breaking construction of the prior assumes an infinite number of factors and allows for each subpopulation to utilize different subsets of the factor space and select the number of factors needed to best explain the variation. We develop the model into a latent factor regression method that excels at prediction and inference of regression coefficients. Simulations validate this strong performance compared to baseline methods. We apply this work to the problem of predicting surgical complications using electronic health record data for geriatric patients and all surgical patients at Duke University Health System (DUHS). The motivating application demonstrates the improved predictive performance when using HIFM in both area under the ROC curve and area under the PR Curve while providing interpretable coefficients that may lead to actionable interventions.




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3 Improvements the COVID-19 Pandemic May Force

The pandemic may force certain improvements but I'm not sure that it will, because political distractions are doing a rather good job of drawing our focus away from fixing things now. For instance, we should be ramping domestic manufacturing of PPEs and ventilators permanently to prepare for a likely huge fall spike in COVID-19 infections. Still, we aren't.




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How AI Can Improve Customer Retention

Customer attrition and churn are not new problems. Anyone who has spent time in the sales world has heard statistics around the cost of acquiring a new customer. It can be five to 25 times more expensive to acquire a new customer than to retain an existing one. Improving customer retention by just 5 percent can increase profits by 25-95 percent, depending on your industry and company size.




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Task Errors Drive Memories That Improve Sensorimotor Adaptation

Traditional views of sensorimotor adaptation (i.e., adaptation of movements to perturbed sensory feedback) emphasize the role of automatic, implicit correction of sensory prediction errors. However, latent memories formed during sensorimotor adaptation, manifest as improved relearning (e.g., savings), have recently been attributed to strategic corrections of task errors (failures to achieve task goals). To dissociate contributions of task errors and sensory prediction errors to latent sensorimotor memories, we perturbed target locations to remove or enforce task errors during learning and/or test, with male/female human participants. Adaptation improved after learning in all conditions where participants were permitted to correct task errors, and did not improve whenever we prevented correction of task errors. Thus, previous correction of task errors was both necessary and sufficient to improve adaptation. In contrast, a history of sensory prediction errors was neither sufficient nor obligatory for improved adaptation. Limiting movement preparation time showed that the latent memories driven by learning to correct task errors take at least two forms: a time-consuming but flexible component, and a rapidly expressible, inflexible component. The results provide strong support for the idea that movement corrections driven by a failure to successfully achieve movement goals underpin motor memories that manifest as savings. Such persistent memories are not exclusively mediated by time-consuming strategic processes but also comprise a rapidly expressible but inflexible component. The distinct characteristics of these putative processes suggest dissociable underlying mechanisms, and imply that identification of the neural basis for adaptation and savings will require methods that allow such dissociations.

SIGNIFICANCE STATEMENT Latent motor memories formed during sensorimotor adaptation manifest as improved adaptation when sensorimotor perturbations are reencountered. Conflicting theories suggest that this "savings" is underpinned by different mechanisms, including a memory of successful actions, a memory of errors, or an aiming strategy to correct task errors. Here we show that learning to correct task errors is sufficient to show improved subsequent adaptation with respect to naive performance, even when tested in the absence of task errors. In contrast, a history of sensory prediction errors is neither sufficient nor obligatory for improved adaptation. Finally, we show that latent sensorimotor memories driven by task errors comprise at least two distinct components: a time-consuming, flexible component, and a rapidly expressible, inflexible component.




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Reward-Based Improvements in Motor Control Are Driven by Multiple Error-Reducing Mechanisms

Reward has a remarkable ability to invigorate motor behavior, enabling individuals to select and execute actions with greater precision and speed. However, if reward is to be exploited in applied settings, such as rehabilitation, a thorough understanding of its underlying mechanisms is required. In a series of experiments, we first demonstrate that reward simultaneously improves the selection and execution components of a reaching movement. Specifically, reward promoted the selection of the correct action in the presence of distractors, while also improving execution through increased speed and maintenance of accuracy. These results led to a shift in the speed-accuracy functions for both selection and execution. In addition, punishment had a similar impact on action selection and execution, although it enhanced execution performance across all trials within a block, that is, its impact was noncontingent to trial value. Although the reward-driven enhancement of movement execution has been proposed to occur through enhanced feedback control, an untested possibility is that it is also driven by increased arm stiffness, an energy-consuming process that enhances limb stability. Computational analysis revealed that reward led to both an increase in feedback correction in the middle of the movement and a reduction in motor noise near the target. In line with our hypothesis, we provide novel evidence that this noise reduction is driven by a reward-dependent increase in arm stiffness. Therefore, reward drives multiple error-reduction mechanisms which enable individuals to invigorate motor performance without compromising accuracy.

SIGNIFICANCE STATEMENT While reward is well-known for enhancing motor performance, how the nervous system generates these improvements is unclear. Despite recent work indicating that reward leads to enhanced feedback control, an untested possibility is that it also increases arm stiffness. We demonstrate that reward simultaneously improves the selection and execution components of a reaching movement. Furthermore, we show that punishment has a similar positive impact on performance. Importantly, by combining computational and biomechanical approaches, we show that reward leads to both improved feedback correction and an increase in stiffness. Therefore, reward drives multiple error-reduction mechanisms which enable individuals to invigorate performance without compromising accuracy. This work suggests that stiffness control plays a vital, and underappreciated, role in the reward-based imporvemenets in motor control.




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Learn how cash transfer programmes improve lives in sub-Saharan Africa and share the infographics

Did you know that cash transfer (CT) programmes in countries of the sub-Saharan Africa actually have a significant impact? In Malawi, these programmes helped families invest in agricultural equipment and livestock to produce their own food and reduce levels of negative coping strategies, like begging and school drop-outs. In Kenya, secondary school attendance rose by 9 percent and access to [...]




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Learn how good food can improve your health

Have you ever wondered if you are getting adequate nutrients from the food you eat? It is a common misconception that malnutrition means not getting enough food. This is, however, incorrect! People who take in insufficient food can be malnourished, but also those who consume too much face the same risks. Malnutrition is defined as “An abnormal physiological condition caused by [...]




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Seven examples of nuclear technology improving food and agriculture

Some of the most innovative ways being used to improve agricultural practices involve nuclear technology. Nuclear applications in agriculture rely on the use of isotopes and radiation techniques to combat pests and diseases, increase crop production, protect land and water resources, ensure food safety and authenticity, and increase livestock production. FAO and the International Atomic Energy Agency (IAEA) have been expanding [...]




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Winnipeg to start testing technology to improve cellular reception, support 5G service

Winnipeg will soon test "small cell" technology to improve cellular reception in parts of Winnipeg, ahead of a possible future transition to 5G service. 



  • News/Canada/Manitoba

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Childhood Well-Being In Flint Improving After Water Crisis

The Flint Water Crisis captured national attention about the dangers of lead contamination in public water supplies. Now, nearly six years after the problem was first detected, health officials are reporting on the well-being of children in Flint.




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Hands on: Brydge Pro+ firmware updated improves iPadOS user experience



Brydge on Wednesday launched a new update to improve its Brydge Pro+ keyboard with trackpad that recently starting shipping for iPad Pro. AppleInsider goes hands-on with the latest firmware to see how Brydge's improvements have strengthened the user experience of its flagship product.




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Improve your COVID-19 stay at home with these free apps and resources



As the COVID-19 pandemic continues around the world, countries are extending periods of national lockdown and increasing the need for people to stay home. AppleInsider has compiled a list of free resources, apps, tools, and services that are still available to use while social distancing.



  • iOS/macOS/iPadOS

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Qualcomm CEO touts improved relationship with Apple after bitter legal dispute



Qualcomm CEO Steve Mollenkopf in an interview on Thursday said the chipmaker's relationship with Apple has greatly improved since the two companies ended a bitter legal battle over patent licensing and royalties in 2019.




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Learn How to Improve Productivity with Simulation

Learn more about this simulation-focused webinar series on Improving Productivity, which will cover topics like 2D Simplification in detail, FEA vs CFD, Static vs Dynamics, Large Assembly analysis and simulation for 3D-printed parts.

Author information

Dassault Systèmes SolidWorks Corp. offers complete 3D software tools that let you create, simulate, publish, and manage your data. SolidWorks products are easy to learn and use, and work together to help you design products better, faster, and more cost-effectively. The SolidWorks focus on ease-of-use allows more engineers, designers and other technology professionals than ever before to take advantage of 3D in bringing their designs to life.

The post Learn How to Improve Productivity with Simulation appeared first on The SOLIDWORKS Blog.




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Improving Behavior Challenges and Quality of Life in the Autism Learning Health Network

OBJECTIVES:

To summarize baseline data and lessons learned from the Autism Learning Health Network, designed to improve care and outcomes for children with autism spectrum disorder (ASD). We describe challenging behaviors, co-occurring medical conditions, quality of life (QoL), receipt of recommended health services, and next steps.

METHODS:

A cross-sectional study of children 3 to 12 years old with ASD receiving care at 13 sites. Parent-reported characteristics of children with ASD were collected as outcome measures aligned with our network’s aims of reducing rates of challenging behaviors, improving QoL, and ensuring receipt of recommended health services. Parents completed a survey about behavioral challenges, co-occurring conditions, health services, and the Patient-Reported Outcomes Measurement Information System Global Health Measure and the Aberrant Behavior Checklist to assess QoL and behavior symptoms, respectively.

RESULTS:

Analysis included 530 children. Challenging behaviors were reported by the majority of parents (93%), frequently noting attention-deficit/hyperactivity disorder symptoms, irritability, and anxiety. Mean (SD) scores on the Aberrant Behavior Checklist hyperactivity and irritability subscales were 17.9 (10.5) and 13.5 (9.2), respectively. The Patient-Reported Outcomes Measurement Information System Global Health Measure total score of 23.6 (3.7) was lower than scores reported in a general pediatric population. Most children had received recommended well-child (94%) and dental (85%) care in the past 12 months.

CONCLUSIONS:

This baseline data (1) affirmed the focus on addressing challenging behaviors; (2) prioritized 3 behavior domains, that of attention-deficit/hyperactivity disorder, irritability, and anxiety; and (3) identified targets for reducing severity of behaviors and strategies to improve data collection.




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Improving Antibiotic Prescribing for Pediatric Urinary Tract Infections in Outpatient Settings

OBJECTIVES:

To determine if a multicomponent intervention was associated with increased use of first-line antibiotics (cephalexin or sulfamethoxazole and trimethoprim) among children with uncomplicated urinary tract infections (UTIs) in outpatient settings.

METHODS:

The study was conducted at Kaiser Permanente Colorado, a large health care organization with ~127 000 members <18 years of age. After conducting a gap analysis, an intervention was developed to target key drivers of antibiotic prescribing for pediatric UTIs. Intervention activities included development of new local clinical guidelines, a live case-based educational session, pre- and postsession e-mailed knowledge assessments, and a new UTI-specific order set within the electronic health record. Most activities were implemented on April 26, 2017. The study design was an interrupted time series comparing antibiotic prescribing for UTIs before versus after the implementation date. Infants <60 days old and children with complex urologic or neurologic conditions were excluded.

RESULTS:

During January 2014 to September 2018, 2142 incident outpatient UTIs were identified (1636 preintervention and 506 postintervention). Pyelonephritis was diagnosed for 7.6% of cases. Adjusted for clustering of UTIs within clinicians, the proportion of UTIs treated with first-line antibiotics increased from 43.4% preintervention to 62.4% postintervention (P < .0001). The use of cephalexin (first-line, narrow spectrum) increased from 28.9% preintervention to 53.0% postintervention (P < .0001). The use of cefixime (second-line, broad spectrum) decreased from 17.3% preintervention to 2.6% postintervention (P < .0001). Changes in prescribing practices persisted through the end of the study period.

CONCLUSIONS:

A multicomponent intervention with educational and process-improvement elements was associated with a sustained change in antibiotic prescribing for uncomplicated pediatric UTIs.




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Fin24.com | MONEY CLINIC: Which debt should I pay off first in order to improve my credit score?

A Fin24 user wants to know whether paying off a car loan or credit card will make her credit score 'look better.'




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A Primer on Continuous School Improvement

What is continuous improvement and why are schools and districts jumping on that bandwagon?




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Current Referral Patterns and Means to Improve Accuracy in Diagnosis of Undescended Testis

Primary care providers (PCPs) identify patients with undescended testis (UDT) and refer them to surgical specialists. Referral beyond the recommended times for orchiopexy has been reported, and PCPs' accuracy in identifying and distinguishing UDTs from retractile testes has been questioned.

We describe 3 observations that are strongly correlated with UDT, that is, birth history of UDT, prematurity, and visible scrotal asymmetry. UDT diagnoses are best made by 8 months of age, to reduce confusion with testicular retraction and to facilitate timely orchiopexy. (Read the full article)




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Early Intervention Improves Behavioral Outcomes for Preterm Infants: Randomized Controlled Trial

Prematurely born children have an increased prevalence of behavioral problems in the long term. Knowledge regarding the effects of early intervention programs is sparse, and more randomized controlled trials are warranted.

A modified version of the Mother-Infant Transaction Program showed beneficial effects on behavioral outcomes reported by both parents of preterm infants with birth weights of <2000 g at a corrected age of 5 years. (Read the full article)




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Community Asthma Initiative: Evaluation of a Quality Improvement Program for Comprehensive Asthma Care

Comprehensive home visits conducted by Community Health Workers including environmental remediation and office-based nurse case management improve asthma outcomes.

Implementation of a comprehensive quality improvement program as part of enhanced care of pediatric asthma patients with a history of hospitalizations or emergency department visits can improve health outcomes and be cost-effective as well as reduce health disparities. (Read the full article)




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Triage Nurse Initiation of Corticosteroids in Pediatric Asthma Is Associated With Improved Emergency Department Efficiency

Early administration of oral corticosteroids is essential for children presenting to emergency departments with moderate to severe acute asthma exacerbations, because subsequent admission need is directly related to time to receipt of systemic steroids, yet delays to administration remain long.

A medical directive allowing nurse initiation of oral corticosteroids before physician assessment was associated with improved quality and efficiency of care provided in the pediatric emergency department by ensuring implementation of evidence-based practice. (Read the full article)