Vanglerche0323

nerable population.This RCT was registered (2012-00071) with ClinicalTrials.com on 6/28/2013.

Cross-jurisdictional sharing is gaining traction as an option for increasing the effectiveness and efficiency of public health services in local health departments.

Assess whether breastfeeding initiation among participants in the

changed with the addition of a trained breastfeeding specialist funded by cross-jurisdictional integration.

A longitudinal retrospective comparative difference in difference design using state-based program data, pre- and post-integration was undertaken. Three local county health departments (

= 5) that fully integrated into one Community Health Board during January 2015, and four neighboring Community Health Boards (

= 4) that did not integrate, were included.

Controlling for confounders and interactions, the relative rate of change over time in breastfeeding initiation rates was greater in the integrated jurisdiction than neighboring Community Health Boards, but not statistically significant. When the integrated Community Health Board's original three local health dositive change was seen in this local health department where the specialist staff was physically located. Public health staff specialization can lead to increases in economic efficiency and in improved delivery of public health services.Fractal and polarization analysis of diffusively scattered light is applied to determine the complex relationship between fractal dimension of structural morphology and concentration of chemically active ingredients in two pharmaceutical mixture systems including a series of binary mixtures of acetaminophen in lactose and three multicomponent blends with a proprietary active ingredient. A robust approach is proposed to identify and filter out multiple- and single-scattering components of scattering indicatrix. The fractal dimension extracted from scattering field reveals complex structural details of the sample, showing strong dependence on low-dose drug concentration in the blend. Low-angle diffraction shows optical "halo" patterns near the angle of specular reflection caused by light refraction in microcrystalline aggregates. Angular measurements of diffuse reflection demonstrate noticeable dependence of Brewster's angle on drug concentration. It is shown that the acetaminophen microcrystals produce scattered light depolarization due to their optical birefringence. The light scattering measurement protocol developed for diffusively scattered light by microcrystalline pharmaceutical compositions provides a novel approach for the pattern recognition, analysis and classification of materials with a low concentration of active chemical ingredients.Background Although the increases in overweight and obesity observed for several decades have appeared to have leveled off, the prevalence of overweight and obesity remains exceptionally high among children of color. This article estimates the effect of Healthy Harlem's Get Fit-a 12-week after-school program aimed at helping students improve physical activity and eating habits-on BMI and weight status of adolescents. Methods Participants were 436 students who had overweight or obesity in 12 Harlem Children's Zone after-school programs in New York. The evaluation was a randomized controlled trial where students were assigned to an intervention group that received Get Fit plus Prevention services or a control group that only received Prevention services in 2013 or 2014. Impacts were assessed on BMI z-score, percentage with overweight or obesity, and percentage with obesity using regression analysis. Results Relative to the control group, students randomized to Get Fit experienced a decrease in BMI z-score (mean difference = -0.04; p = 0.02). The percentage of students with overweight or obesity was also lower (mean difference = -5.3; p = 0.02), but there was no effect on the percentage of students with obesity. Get Fit had an impact on BMI for girls, but not boys. Conclusions Get Fit improved middle- and high-school students' BMI outcomes and weight status. Schools continue to face pressure to allocate time for physical education and activity while meeting their academic demands, underscoring the importance of after-school student-level interventions like Get Fit.Modified battery-powered ride-on toy cars represent novel rehabilitation tools for children with disabilities. However, safety concerns exist with the use of these battery-power toys and pose a barrier for the growth of adaptive ride-on toy programs due to the lack of evidence demonstrating that modifications made to these cars are safe. Within this context, the purpose of this study was to investigate whether modifications to ride-on toys are sufficient to prevent common injuries and determine how these modifications influence injury metrics. Specifically, we evaluated the effects of common modifications such as various seatbelt configurations and determined how increased seat back height effects neck forces. Results indicated that occupant displacement can be reduced using a lap belt, and further reductions in displacement are achieved with a 5-point harness. Although some injury metrics increased with restraints, none of the collected injury metrics even came close to approaching known tolerance thresholds, and most were well within the range that is experienced by a child in daily life. As the greatest concerns for these ride-on toys are related to displacement, findings from this study support the use of a 5-point harness system to minimize displacement-related injuries with little-to-no added risk.Purpose To systematically describe and analyze the tracking systems, the variables, and the statistical methods used to evaluate the players and teams' tactical behavior in small-sided and conditioned games (SSCGs). Methods A search was done in Web of Science, PubMed, Science Direct, and Scielo databases to identify manuscripts published between 2008 and 2019 that manipulated small-sided and conditioned games (SSCGs) and analyzed tactical behaviors of players and teams. Results From 349 articles identified, 31 were selected for review. To collect positional data, the global positioning system (GPS), the local position measurement (LPM) system, and TACTO were identified as reliable tracking systems. Twenty-one positional variables were identified to evaluate tactical behaviors, grouped into five main categories team balance, playing space, width and length of playing space, and interpersonal distance. Tactical behavior patterns were analyzed using approximate entropy, sample entropy, Shannon entropy, and patterns of coordination between players and teams were analyzed using relative phase and running correlation. Discussion The tracking systems analyzed were reliable but revealed different advantages and disadvantages of their use. Authors should define the use of each tracking system based on their purpose and level of precision required for analysis. CD38inhibitor1 A great duplication was observed on the variables used with similar purposes of tactical analysis. The identification of the variables according to their purpose of analysis will allow a better understanding of their use in the future.Background Telepharmacy services are expected to have an important role in increasing access of patients to pharmaceutical care and reducing potential dispensing errors in community pharmacies. Objective To assess the predictors for effective telepharmacy services on increasing access of patients to care and reducing dispensing errors in community pharmacies. Method This is a prospective study carried out for 4 months in 52 community pharmacies across the United Arab Emirates (UAE) using disguised direct observation. Multivariable logistic regression was used as a tool to predict factors associated with effective telepharmacy services in improving dispensing safety and increasing access of patients to pharmaceutical care. Data were entered and analyzed using the Statistical Package for Social Science (SPSS) software version 26. Results Pharmacist recommendations related to COVID-19 at pharmacies with telepharmacy (n = 63,714) versus those without remote services (n = 15,539) were significantly more likely to be (1) contact the nearest testing center (adjusted odds ratio [AOR] = 7.93), (2) maintain home quarantine (AOR = 5.64), and (3) take paracetamol for fever (AOR = 3.53), all were significant results (p 0.05), respectively. However, pharmacies with telepharmacy were more likely to include wrong patient errors (AOR = 5.38, p less then 0.05). Conclusions Telepharmacy can be used as a tool to reduce the burden on the health care system and improve drug dispensing safety in community pharmacies.Background The authors draw upon their experience with a successful, enterprise-level, telemedicine program implementation to present a "How To" paradigm for other academic health centers that wish to rapidly deploy such a program in the setting of the COVID-19 pandemic. The advent of social distancing as essential for decreasing viral transmission has made it challenging to provide medical care. Telemedicine has the potential to medically undistance health care providers while maintaining the quality of care delivered and fulfilling the goal of social distancing. Methods Rather than simply reporting enterprise telemedicine successes, the authors detail key telemedicine elements essential for rapid deployment of both an ambulatory and inpatient telemedicine solution. Such a deployment requires a multifaceted strategy (1) determining the appropriateness of telemedicine use, (2) understanding the interface with the electronic health record, (3) knowing the equipment and resources needed, (4) developing a rapid rollout plan, (5) establishing a command center for post go-live support, (6) creating and disseminating reference materials and educational guides, (7) training clinicians, patients, and clinic schedulers, (8) considering billing and credentialing implications, (9) building a robust communications strategy, and (10) measuring key outcomes. Results Initial results are reported, showing a telemedicine rate increase to 45.8% (58.6% video and telephone) in just the first week of rollout. Over a 5-month period, the enterprise has since conducted over 119,500 ambulatory telemedicine evaluations (a 1,000-fold rate increase from the pre-COVID-19 time period). Conclusion This article is designed to offer a "How To" potential best practice approach for others wishing to quickly implement a telemedicine program during the COVID-19 pandemic.Purpose To quantify the peak post-pitch-entry physical responses of soccer substitutes while assessing contextual influences. Peak responses may be important performance indicators for substitutes introduced to provide a physical impact. Method Thirty-three professional substitutes wore Microelectromechanical Systems during 44 matches (4 ± 3 observations·player-1). Post-pitch-entry relative peak values for total and high-speed (> 5.5 m·s-1) distances, average acceleration, and PlayerLoad™ were calculated using rolling averages over 60-s to 600-s. Linear mixed models assessed contextual influences (position, substitution timing, scoreline, and location). Results Substitutes introduced during the final ~15 min of match-play covered less high-speed distance than first-half substitutes (~2.8-3.1 m·min-1) over 480-s to 600-s epochs, and less than 6000-7459 min substitutes (~1.7-1.8 m·min-1) during 540-s and 600-s epochs. Average acceleration during all except 180-s epochs was lower for 7500+ min substitutes compared with first-half replacements (~0.