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Shwu-Jiuan Sheu,1,2 Cheng-Kuo Cheng,3,4 Hsi-Kung Kuo,5 Ching-Yao Tsai,2,6 Tai-Chi Lin,2,7 Jonathan Tan,8 Hitesh Chandwani,8 Michael Adena,9 Shih-Jen Chen2,7 1Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 2Department of Ophthalmology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 3Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; 4Department of Medicine, School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan; 5Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; 6Department of Ophthalmology, Taipei City Hospital Zhongxing Branch, Taipei, Taiwan; 7Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan; 8Global Health Economics and Outcomes Research, Allergan Singapore Pte. Ltd., Singapore, Singapore; 9Datalytics Pty Ltd, Kingston, ACT, Australia Objectives: To characterize diabetic macular edema (DME) treatment patterns in Taiwan and examine their impact on health care resource utilization and visual and anatomic outcomes. Methods: Retrospective, observational cohort study of longitudinal data from medical records of five hospital ophthalmology clinics. Patients with type 2 diabetes and DME who received ≥1 laser treatment or pharmacotherapy (intravitreal/subtenon corticosteroids and/or intravitreal anti-vascular endothelial growth factor [VEGF] agents) between January 2012 and December 2013 (index period) and attended ≥1 follow-up visit after the first treatment during that period were identified (prevalent population, N=431). In addition, a subset that received no anti-VEGFs before 2012 (anti-VEGF-naïve population, N=77) was analyzed. Outcome measures were change in DME treatment distribution between January 2009 and December 2014 and health care resource utilization over up to 3 years from the first DME treatment received in the index period (prevalent population), mean number of anti-VEGF injections and change from baseline in visual acuity and central macular thickness over 12 months (anti-VEGF-naïve population).Results: Between 2009 and 2014, laser treatment use declined, overall use of anti-VEGFs increased, and bevacizumab use decreased proportionately as ranibizumab use increased. Patients receiving corticosteroids and anti-VEGFs in the first 6 months post-index had greater health care resource utilization than those treated with laser, corticosteroids, or anti-VEGF alone (P

Objectives. Community processes are key determinants of older adults’ ability to age in place, but existing scales measuring these constructs may not provide accurate, unbiased measurements among older adults because they were designed with the concerns of child-rearing respondents in mind. This study examines the properties of a new theory-based measure of collective efficacy (CE) that accounts for the perspectives of older residents. Methods. Data come from the population-based Chicago Neighborhood Organization, Aging and Health study (N = 1,151), which surveyed adults aged 65 to 95. Using descriptive statistics, correlations, and factor analysis, we explored the acceptability, reliability, and validity of the new measure. Results. Principal component analysis indicated that the new scale measures a single latent factor. It had good internal consistency reliability, was highly correlated with the original scale, and was similarly associated with neighborhood exchange and disorder, self-rated health, mobility, and loneliness. The new scale also showed less age-differentiated nonresponse compared to the original scale. Discussion. The older adult CE scale has reliability and validity equivalent to that of the existing measure but benefits from a more developed theoretical grounding and reduced likelihood of age-related differential nonresponse.

The Institute for Research and Reform in Education (IRRE) is dedicated to helping schools raise the academic performance of all students to levels required for postsecondary education and high-quality employment. To accomplish this, IRRE developed First Things First (FTF), a reform framework grounded in research about how young people develop and how schools promote students' engagement and learning in the process. The FTF framework identifies student and school outcomes, critical features essential to improve those outcomes, specific strategies for putting the critical features in place, and structured and timed processes for planning, capacity building, and continuous improvement. Within the FTF framework are seven critical features of school reform essential for achieving improved outcomes for students and schools. This article explores the first four critical features, which focus on students. The authors also introduce the three specific strategies for achieving these features. (Contains 1 figure, 1 exhibit, and 26 notes.)

An emerging consensus exists in the school reform literature about what conditions contribute to student success. Conditions include high standards for academic learning and conduct, meaningful and engaging pedagogy and curriculum, professional learning communities among staff, and personalized learning environments. Schools providing such supports are more likely to have students who are engaged in and connected to school. Studies show students with caring and supporting interpersonal relationships in school report more positive academic attitudes and values, and more satisfaction with school. These students also are more engaged academically. The study reported in this paper was guided by a reduced version of the Self-System Process Model developed by Connell. In this paper, optimal and risk thresholds for the Student Performance and Commitment Index (SPCI) and engagement are reported, and then data on how much engagement matters for later success in school are presented. Thresholds associated with teacher support also are presented with estimates of how much teacher support matters for engagement in school. (Contains 4 tables and 9 figures.)

This study reports on four patients who underwent a Modified Boyd Fusion, which consists of a Chopart amputation with a subtalar and ankle joint arthrodesis utilizing an intramedullary nail. This technique affords the patient a rigid platform for ambulation by controlling the rearfoot and provides maximal limb length preservation. This technique also helps prevent the complications associated with a Chopart amputation alone, which consist of an equinovarus deformity and associated increased plantar pressures of the distal stump with high risk of subsequent wound development and failure.

Privacy, achieved through self-administered modes of interviewing, has long been assumed to be a necessary prerequisite for obtaining unbiased responses to sexual identity questions due to their potentially sensitive nature. This study uses data collected as part of a split-ballot field test embedded in the National Health Interview Survey (NHIS) to examine the association between survey mode (computer-assisted personal interviewing (CAPI) versus audio computer-assisted self-interviewing (ACASI)) and sexual minority identity reporting. Bivariate and multivariate quantitative analyses tested for differences in sexual minority identity reporting and non-response by survey mode, as well as for moderation of such differences by sociodemographic characteristics and interviewing environment. No significant main effects of interview mode on sexual minority identity reporting or nonresponse were found. Two significant mode effects emerged in subgroup analyses of sexual minority status out of 35 comparisons, and one significant mode effect emerged in subgroup analyses of item nonresponse. We conclude that asking the NHIS sexual identity question using CAPI does not result in estimates that differ systematically and meaningfully from those produced using ACASI. [ABSTRACT FROM AUTHOR]

Calls for remedies for the persistent scarcity of accurate, reliable, national, disaggregated health statistics on hard-to-survey populations are common, but solutions are rare. Survey strategies used in community and clinical studies of hard-to-survey populations often cannot be, and generally are not, implemented at the national level. This essay presents a set of approaches, for use in combination with traditional survey methods in large-scale surveys of these populations, to overcome challenges in 2 domains: sampling and motivating respondents to participate. The first approach consists of using the American Community Survey as a frame, and the second consists of implementing a multifaceted community engagement effort. We offer lessons learned from implementing these strategies in a national survey, some of which are relevant to all survey planners. We then present evidence of the quality of the resulting data set. If these approaches were used more widely, hard-to-survey populations could become more visible and accurately represented to those responsible for setting national priorities for health research and services. [ABSTRACT FROM AUTHOR]

Limited access to health care has produced rural communities whose residents are older, poorer, sicker, and have a life expectancy that is two years shorter than their urban counterparts. The REACH Healthcare Foundation created its Rural Health Initiative to encourage the development of innovative strategies to improve access to health care and reduce health inequities in three rural counties in Missouri and Kansas. This article discusses the foundation’s original approach to the initiative and how it adjusted that approach in response to its rural partners’ experiences. It reflects on the challenges encountered in rooting the four conditions and capacities of community change and innovation – supports for implementation; foundational structures; skills and processes; and community engagement – into the work of community health improvement. [ABSTRACT FROM AUTHOR]

Objectives. Community processes are key determinants of older adults' ability to age in place, but existing scales measuring these constructs may not provide accurate, unbiased measurements among older adults because they were designed with the concerns of child-rearing respondents in mind. This study examines the properties of a new theory-based measure of collective efficacy (CE) that accounts for the perspectives of older residents. Methods. Data come from the population-based Chicago Neighborhood Organization, Aging and Health study (N = 1,151), which surveyed adults aged 65 to 95. Using descriptive statistics, correlations, and factor analysis, we explored the acceptability, reliability, and validity of the new measure. Results. Principal component analysis indicated that the new scale measures a single latent factor. It had good internal consistency reliability, was highly correlated with the original scale, and was similarly associated with neighborhood exchange and disorder, self-rated health, mobility, and loneliness. The new scale also showed less age-differentiated nonresponse compared to the original scale. Discussion. The older adult CE scale has reliability and validity equivalent to that of the existing measure but benefits from a more developed theoretical grounding and reduced likelihood of age-related differential nonresponse. [ABSTRACT FROM AUTHOR]

Randomised trials have established the importance of oxaliplatin (O) and irinotecan (I) in advanced colorectal cancer (CRC). However, patients enrolled in clinical studies represent a restricted population and little is known about the use of O and I in the general population and the subsequent outcomes outside clinical studies. We used the Australian Health Insurance Commission (HIC) database to describe prescribing patterns of O and I and their impact on survival in all patients with 5-fluorouracil (5-FU) refractory CRC in Australia in 2002 and 2003. In 2999 patients, there was a marked increase in initial treatment with O rather than I; 48% of patients received O first in 2002 vs 66% in 2003 (P<0.001). Overall 40-45% of patients received both O and I; however, younger patients were more likely to receive both drugs (P<0.001). After 5-FU failure and treatment with O or I, the proportion of patients surviving 6 or 12 months was estimated to be 0.67 (95% CI, 0.66-0.69) and 0.42 (95% CI, 0.40-0.44), respectively. Survival was superior for patients who received both O and I; however, the sequence of agents had no impact. Older patients (> or =70 years) had inferior survival no matter which drug was used as initial treatment. Analysis of the Australian HIC database provides a valuable means of assessing patterns of use and outcomes of new therapies. [ABSTRACT FROM AUTHOR]

This article presents a theory of change approach to planning educational reform initiatives with a focus on district level efforts. Using examples from ongoing consulting work with urban school districts, we walk through steps in a planning process that can yield a theory of change that meets 4 criteria: plausible, doable, testable, and meaningful. The benefits of this planning approach for evaluation and implementation of district level educational reform are also discussed. We conclude with implications of this approach for educational and psychological consultants working with educational reform initiatives. [ABSTRACT FROM AUTHOR]