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This study is an exploratory comparison of 69 Hispanic students enrolled in first-semester general chemistry (Chem I) who attended either a Hispanic-Serving or emerging Hispanic-Serving Institution and were not successful in Chem I. Students ’ automaticity skills (what can be done without the aid of a calculator) in arithmetic and quantitative reasoning were analyzed based on students ’personal characteristics such as gender, prior knowledge in chemistry and mathematics, entry college (i.e., STEM or not), and parents ’ academic background. Findings indicate that without basic automaticity skills, students enter Chem I at a deficit, but these at-risk students can be identified early in the semester to help them succeed. Results also indicate that arithmetic automaticity is more influential than quantitative reasoning in predicting academic success. A suggested high-impact practice is presented as a possible correction for these deficits.

This contribution reports the process and outcomes of a multiyear effort that supported institutions in reforming general chemistry using multidimensional learning approaches in the form of performance expectations. Performance expectations are based on evidence-centered assessment design principles and describe what learners should be able to do with their knowledge, a subtle (but profound) shift from traditional course learning goals. The effort grew from the recommendations of a task force appointed in 2015 by the American Chemical Society’s Division of Chemical Education and Society Committee on Education. This task force recommended a participatory process for creating general chemistry performance expectations that was distributed over, and also coordinated across, multiple institutions. With support from the ACS Education Division, this recommendation was enacted through workshops which supported faculty in developing activities and assessments that integrated content, science and engineering practices, and cross-cutting concepts—a three-dimensional structure based on the National Research Council report A Framework for K-12 Education.From these workshops, a group of faculty committed to implementing three-dimensional performance expectations in their courses evolved. In practice, these faculty found that their institutional work resulted in designing learning performances that, while also three-dimensional, were of narrower content focus than is typical of performance expectations. This development process also led faculty to use the structures of evidence-centered design and multidimensional learning to document learning activity designs in new ways, generating a consensus activity structure. As examples of how faculty used this consensus activity structure as a new way to examine student learning and performances, development artifacts from four of the participating institutions is presented.

First-semester general chemistry is a known “gatekeeper” course due to its high failure rate. These higher education courses are taken by students who for the most part are regularly admitted freshmen, yet many struggle to succeed. In this investigation researchers from six higher-education institutions of varied sizes with student bodies of different ethnic composition teamed up to investigate the Math-Up Skills Test (MUST) as a potential tool to identify at-risk students in first-semester general chemistry (Chem I). A large population (N= 1073) was given the MUST at the beginning of the semester. The MUST had good internal consistency with the sample (Cronbach's alpha = 0.856). The MUST offers a quick 15 minute assessment of basic mathematics ability without a calculator. Instructors may find it easier than other documented predictors, which may take more time or involve obtaining student records (e.g., Math SAT). Results from the MUST support prior findings that mathematics skills correlate with course grades in chemistry. Poor arithmetic automaticity may be an underlying factor in lower performance by many students. With statistical modeling, the MUST, along with other demographic variables, was able to identify students who would go on to make a 69.5% or better in Chem I with a high percent of accuracy. The MUST, in tandem with other demographic variables, should be considered a potential tool for early identification of students at-risk for failing the class.

Completion of a first-semester chemistry (Chem I) course lays the foundation for understanding second-semester chemistry (Chem II) topics. The purpose of this study is to evaluate the influence of basic arithmetic skills on students’ Chem II success in understanding mathematics-grounded concepts (e.g., solutions and aqueous reactions, kinetics, equilibrium, acids and bases, solubility and equilibria, thermodynamics, electrochemistry, and nuclear chemistry). Previous studies suggest a strong correlation between arithmetic preparation and performance in general chemistry courses, though few have focused on the second-semester course. In this investigation, researchers from six higher-education institutions in Texas, USA of different sizes and with student bodies of different diversities have collaborated to determine whether the Math-Up Skills Test (MUST) is able to reliably identify at-risk students from a population of n= 1599 at the beginning of a Chem II course.

Weigh-in-motion (WIM) technology is a traffic monitoring technology that highway agencies use to obtain information about the weight, axle loading, and configuration of heavy vehicles moving at operational speed. To ensure high-quality WIM data, the Federal Highway Administration (FHWA) recommends regular calibration of WIM equipment. This study addresses the need to optimize the allocation of the limited resources that agencies have for WIM equipment calibration by developing a procedure for data-driven calibration scheduling. This was accomplished through an analysis of WIM measurement errors from test truck data collected during field performance validation and calibration events and an analysis of monthly changes in truck weight and axle loading characteristics, based on WIM data collected between calibration events. The analysis results were used to draw conclusions on the functional performance of different WIM sites. The study also demonstrates how the newly developed National Cooperative Highway Research Program (NCHRP) WIM Data Quality Assurance Analysis Tool can be used to compute truck weight and axle loading parameters and visualize data analysis results using four case studies: two WIM sites with piezo quartz sensors in asphalt pavements and two WIM sites with bending plate sensors in concrete pavements. This paper provides a practical procedure and recommendations that highway agencies can use to develop data-driven WIM calibration schedules that will ensure consistent high-quality WIM data for sites managed by an agency with the aid of the NCHRP WIM Data Quality Assurance Analysis Tool.

This small single-center study suggests that in selected patients with severe hypoglycemia and large glycemic variability, islet transplantation provides superior glycemic control and reduction in hypoglycemia compared to continuous subcutaneous insulin infusion or multiple daily insulin injections.

The article offers information on approach of painter Deborah Walker of capturing different moods of water and light including concerning effect on landscape paintings, use of large watercolors, and impact of crimson colors.

The article profiles 43-year-old actor John Cusack. In his 26 years in the movie industry, Cusack has worked on 60 movies including "2012," "Serendipity," and "Con Air." He has played character roles in "Cradle Will Rock" and "Being John Malkovich," a war widower in "Grace Is Gone," and an assassin in "Grosse Pointe Blank." His role as Lloyd Dobler in 1989's "Say Anything" has been parodied by teens even decades later. His company New Crime Productions has produced the studio comedy "Hot Tub Time Machine" with partner Steve Pink.

AbstractWe describe multidrug-resistant (MDR) SalmonellaHeidelberg infections associated with mechanically separated chicken (MSC) served at a county correctional facility. Twenty-three inmates met the case definition. All reported diarrhea, 19 (83%) reported fever, 16 (70%) reported vomiting, 4 (17%) had fever ≥103°F, and 3 (13%) were hospitalized. A case–control study found no single food item significantly associated with illness. SalmonellaHeidelberg with an indistinguishable pulsed-field gel electrophoresis pattern was isolated from nine stool specimens; two isolates displayed resistance to a total of five drug classes, including the third-generation cephalosporin, ceftriaxone. MDR SalmonellaHeidelberg might have contributed to the severity of illness. SalmonellaHeidelberg indistinguishable from the outbreak subtype was isolated from unopened MSC. The environmental health assessment identified cross-contamination through poor food-handling practices as a possible contributing factor. Proper hand-washing techniques and safe food-handling practices were reviewed with the kitchen supervisor.

CenteringPregnancy® group prenatal care is growing in popularity and has commonalities with childbirth education classes. In order for leaders of childbirth education classes to best serve their clients’ needs, it is important to be aware of new, emerging models of prenatal care such as CenteringPregnancy. This article provides an overview of CenteringPregnancy and similarities and differences between CenteringPregnancy and childbirth education classes. Providers of prenatal education, whether it is within CenteringPregnancy group prenatal care or in childbirth education classes, have a common important aim: promoting positive perinatal outcomes.

This article provides a comprehensive overview of the first decade of the Massachusetts Tobacco Control Program (MTCP). Born after Massachusetts passed a 1992 ballot initiative raising cigarette excise taxes to fund the program, MTCP greatly reduced statewide cigarette consumption before being reduced to a skeletal state by funding cuts. The article describes the program's components and goals, details outcomes, presents a summary of policy accomplishments, and reviews the present status of MTCP in the current climate of national and state fiscal crises. The first decade of the MTCP offers many lessons learned for the future of tobacco control.

The treatment of depression in an older person with Alzheimer's dementia using cognitive behavioural therapy (CBT) is described. Treatment focused on identifying beliefs associated with dementia, behavioural experimenting to test the validity of these beliefs, and increasing pleasurable activities. Results were promising, suggesting that it may be possible to treat depression in people with cognitive impairment.

Fetal monitoring is a routine procedure overseen by labor and delivery nurses and upon which they exert considerable influence. There is a discrepancy, however, between the type of fetal monitoring routinely used and the evidence provided by current research and professional organization recommendations. This study provides the first look at labor and delivery nurses' attitudes toward fetal monitoring in more than 20 years. A descriptive, correlational study was conducted at five southeastern Michigan hospitals to evaluate attitudes toward intermittent fetal monitoring and the effect of selected demographic variables on their attitudes. Of the labor and delivery nurses who participated (N= 145), 72.4% agreed that intermittent fetal monitoring should be the standard of care. Although 87% of the respondents stated that they were willing to provide intermittent monitoring, 53.9% indicated that nurse/patient ratios were a problem in providing this service. Nurses' attitudes were significantly influenced by education level (P= .004), and 48% were unsure about current research findings related to intermittent auscultation. Nurses have a positive attitude toward intermittent monitoring, although safe nurse/patient ratios and clear policies need to be addressed. Lack of knowledge regarding the current evidence and other barriers may contribute to intermittent auscultation not being used routinely, despite the fact that its use for women of low obstetrical risk is supported by current research and professional organizations.

Traditionally, low‐risk pregnant women in the United States who participate in prenatal care have been scheduled for approximately 14–16 prenatal visits, which is the schedule recommended by the American College of Obstetricians and Gynecologists. In 1989, an expert panel convened by the United States Department of Health and Human Services proposed a reduced frequency prenatal visit schedule for low‐risk, healthy women based on the timing of specific tests or events that occur in pregnancy. Available evidence shows no adverse effect on maternal or neonatal outcomes for low‐risk pregnant women who follow a reduced visit schedule, making it a highly important consideration for pregnant women and their health care providers. Other important aspects of prenatal care, especially related to adequacy and content, will be explored in‐depth in a future segment of this series on evidence‐based prenatal care.

Results obtained with the rut bar were compared with those obtained with other devices, and it was determined why the rut-bar measurements are different from field observations. Also, because it would be beneficial if the cause of the rutting could be identified from the shapes of the profiles collected by next-generation rut-bar vehicles, it was determined whether this is possible. Trenching data were collected for 10 different pavements located in Texas. Rut depths were measured with several devices before a trench was cut across the traffic lane. Careful measurement of each pavement layer was done to determine the amount of rutting in each layer. Although there may be 50 mm of rutting as measured with a straightedge, the rut bar sometimes measured no rutting. The rut bar yielded zero rut depth in 10 percent of cases in which ruts were deeper than 16 mm. This is mainly due to limitations of the current rut-bar setup, specifically, the sensor spacing and rut-bar length. A profile alone is still not adequate to determine the layer in which rutting occurred. Material-related problems such as bleeding yielded wide-basin rutting that appears to be base or sub-grade rutting, as observed from the profile alone. The profile has been found to be inadequate for determination of the major source of rutting except when there is a clear dual-wheel rut. This is a good indication that rutting is isolated to the asphalt concrete surface layer. The sensor spacing recommended for routine data collection is 100 mm. Analysis of the data shows that this spacing is 95 percent accurate and capable of capturing dual-tire ruts.

Results obtained with the rut bar were compared with those obtained with other devices, and it was determined why the rut-bar measurements are different from field observations. Also, because it would be beneficial if the cause of the rutting could be identified from the shapes of the profiles collected by next-generation rut-bar vehicles, it was determined whether this is possible. Trenching data were collected for 10 different pavements located in Texas. Rut depths were measured with several devices before a trench was cut across the traffic lane. Careful measurement of each pavement layer was done to determine the amount of rutting in each layer. Although there may be 50 mm of rutting as measured with a straightedge, the rut bar sometimes measured no rutting. The rut bar yielded zero rut depth in 10 percent of cases in which ruts were deeper than 16 mm. This is mainly due to limitations of the current rut-bar setup, specifically, the sensor spacing and rut-bar length. A profile alone is still not adequate to determine the layer in which rutting occurred. Material-related problems such as bleeding yielded wide-basin rutting that appears to be base or sub-grade rutting, as observed from the profile alone. The profile has been found to be inadequate for determination of the major source of rutting except when there is a clear dual-wheel rut. This is a good indication that rutting is isolated to the asphalt concrete surface layer. The sensor spacing recommended for routine data collection is 100 mm. Analysis of the data shows that this spacing is 95 percent accurate and capable of capturing dual-tire ruts.

A sample of 117 Massachusetts adults with predominately high-level spinal cord injuries (SCIs) report a mean of 6.5 (&#453.0) of 17 secondary conditions in the previous year. Hierarchical multiple regression based on a conceptual framework to examine possible contributing factors shows two independent predictors (P&#104 .05) of a greater number of secondary conditions: These predictors are more difficulty with instrumental activities of daily living (IADLs) and more difficulty with accessing medical care. In addition, three variables marginally predicted (P&#104 0.10) more secondary conditions: inadequate access to transportation, tobacco-smoking, and race (white). The findings highlight the importance of IADL difficulty and access to medical care in relation to secondary conditions among adults with SCI.

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A comprehensive birth-to-kindergarten program was evaluated by classroom observa tions and teacher ratings of 132 participant children and 366 comparison children during fall and spring of the kindergarten year. The observations revealed significant advantages for the participants in both fall and spring on a majority of indices, particularly for behaviors categorized as social and use of time. The teacher ratings indicated few overall differences, with advantages for participants only in the fall on a prereading scale. A logistic regression model was used to adjust for possible effects of children's background characteristics; advantages for participants over comparison children were consistent across background characteristics. On the teacher ratings, the adjustments revealed significant interactions: advantages of participants over comparison children were found for subgroups traditionally associated with having difficulties in kindergarten.

• A group of 169 children was followed up from birth to second grade in a community-based early identification and early intervention project. Periodic assessments of health and function yielded profiles of concerns. Over the first five years of life, 39% of the children had health concerns, 20% had cognitive concerns, 25% had motor concerns, 15% had social adjustment problems, and 12% had early attentional problems. Children at the highest risk of having reading and behavioral problems in second grade were those with early attentional disability. At the second-grade level, 31% of the children with early attention concerns were one full grade behind in reading and 38% had behavioral problems; among the youngsters without early attentional concerns, 6% demonstrated a reading delay and 8% had behavioral problems. In addition, children of highly educated mothers were more likely to benefit from the multidisciplinary program than were children of less educated mothers, for whom the intervention effected only a modest improvement when contrasted with randomly selected comparison children. For instance, among children with early cognitive problems and whose mothers had little education, 31% of these children had reading problems in second grade as opposed to 10% of those whose mothers had high educational attainment. Similarly, 39% of children with the combined risks of low maternal education and early attentional problems had reading problems in second grade compared with none of the attention-problem children of highly educated mothers. This study shows that while early identification of health and developmental problems can be carried out in a community-based project, strategies for the early intervention of developmental concerns among children of low socioeconomic status remain less than completely effective.(AJDC 1987;141:55-59)

Objective: to evaluate the effectiveness of a reduced-frequency prenatal visit schedule by comparing perinatal outcomes, anxiety and maternal satisfaction with prenatal care. Methods: pregnancy outcomes of infant and maternal morbidity and mortality, anxiety and satisfaction for 81 women receiving prenatal care at a free-standing birthing center according to either an alternative prenatal care visit schedule (APCVS) (n= 43) or the traditional prenatal care visit schedule (TPCVS) (n= 38) were examined in this prospective randomized study. Upon entry into prenatal care, all women were of low obstetrical risk status. Results: major findings revealed no significant differences in selected perinatal outcomes between the two study groups. Women in the APCVS group reported significantly higher levels of satisfaction than women in the TPCVS group on both the satisfaction with provider subscale (F = 5.74, P= .02) and the satisfaction with the prenatal care system subscale (F = 2.01, P= .04). There were no statistically significant differences found in anxiety scores between women in the two study groups. Conclusions: low-risk women who followed the reduced-frequency visit schedule experienced no difference in perinatal outcomes or anxiety. Women in the reduced-frequency (APCVS) group reported an increased level of satisfaction with both provider and the prenatal care system.

Review of evaluation and care of the child with arthritis in the school setting is provided in this article. Suggested herein are strategies that may help the child, the parent, and the school, and areas for improvement and change are discussed.

Children with chronic illnesses and handicapping conditions spend more time outside the family in school than in any other institution. This article addresses the major issues that need to be addressed by schools and gives guidelines for appropriate school care. The topics discussed are educational placement of chronically ill children, related school services, school-health services, and the pediatrician’s role in schools.

Chronically ill children are currently being served in every state in a number of early childhood education programs, including special education programs, Head Start, early intervention programs, and a variety of other center-based day care and preschool education programs. Although there are some mandates for serving some chronically ill young children in early education programs—the Education for All Handicapped Children Act (P.L. 94–142) and Head Start—only a small percentage of all chronically ill children under 6 years of age are currently enrolled in these programs. Care of chronically ill children in educational settings often entails the delivery of a variety of related services, for example, transportation; education-based health services; speech, physical, and occupational therapies; child and family counseling; and building and schedule modifications. Who should provide and pay for these related services is the focus of heated policy debates at local, state, and federal levels of government.

A 2-year follow-up study assessed the stability of special education students' mobility, status, and classification labels. A total of 1,184 students were selected in fall 1982 from the elementary special education programs of three cities. Two years later, 92% remained in their school district. Of these, 71% stayed in special education with the same classification, 12% remained with a different classification, and 17% were no longer receiving special education services. The child's original primary classification was the strongest predictor of reclassification and termination. Family background contributed most to mobility. Implications for practice and research are discussed.

Objective:Children with chronic health conditions face special issues in their interactions with managed care. These children often require additional and more varied services than do other children. Managed care plans increasingly include these children, especially with the growth of Medicaid managed care. This article examines the special issues facing children with chronic conditions and develops strategies for monitoring their care in managed care settings. Methods:The project staff conducted an extensive review of the research and policy literature related to managed care and the special needs of families with children with chronic conditions. The project also reviewed current and proposed plans of federal, state, and private groups for monitoring and, working with parents and other outside groups, identified key issues to consider in developing monitoring plans. Results:The relative rarity of many childhood conditions and the complex interactions among child, family, and community over time make assessment of their care difficult. We describe these child and family characteristics, outline essential features and domains for monitoring systems, and describe population-based and plan-based monitoring systems to assess managed care for these children and their families. Conclusions:Monitoring for children with chronic conditions in managed care arrangements will require public health agencies and health providers to define populations systematically, assess across a variety of conditions, and monitor several domains central to the health of these families.