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While family engagement at the individual level of health care, such as families partnering with providers in decision-making about health care for an individual child has been well studied, family engagement in systems-level activities (e.g., participation in advisory and other decision-making groups, or creation and revision of policies) that impact the health services families and children receive has not. This note from the field presents a framework that describes the information and supports that help families partner with professionals and contribute to systems-level activities. Without attention to these components of family engagement, family presence and participation may be only token. We engaged an expert Family/Professional Workgroup whose members represented key constituencies and diverse geography, race/ethnicity, and areas of expertise; conducted a review of peer-reviewed publications and grey literature; and conducted a series of key informant interviews to identify best practices for supporting meaningful family engagement at the systems level. Based on an analysis of the findings, the authors identified four action-oriented domains of family engagement and key criteria that support and strengthen meaningful family engagement in systems-level initiatives. Child- and family-serving serving organizations can use this Family Engagement in Systems framework to support meaningful family engagement in the design of policies, practices, services, supports, quality improvement projects, research, and other systems-level activities., Author(s): Beth Dworetzky [sup.1] , Clarissa G. Hoover [sup.1] , Deborah Klein Walker [sup.2] Author Affiliations: (1) Family Voices, , 561 Virginia Rd, Bldg. 4, Suite 300, 01742, Concord, MA, [...]

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.

The Math-Up Skills Tests (MUST) has been used in multiple research projects conducted by the Networking for Science Advancement (NSA) team to determine how automaticity skills (what can be done without a calculator) in arithmetic can be used to predict if students will be successful (course average = 69.5%+) in general chemistry. This study expands our investigations to include how students' quantitative literacy/quantitative reasoning (QL/QR) abilities influence their success. The NSA team studied multiple classes at eight universities (n = 1,915) within a broad geographic setting in one large, majority-minority southwestern US state. In a short amount of required classroom time, it is possible to identify students at the beginning of the semester who will struggle in first- and second-semester general chemistry (Chem I and Chem II). Results show a strong correlation between students' automaticity MUST skills and their QL/QR ability (r = 0.60) and indicate that when taking both diagnostic assessments into consideration, convincing signals appear allowing for the identification of almost 50% of the Chem I students and about 45% of the Chem II students who will not succeed. With the addition of the QL/QR to the first-week assessments, about 9% more students who enter the courses underprepared were identified than when only the MUST was administered. Outcomes indicate that students with at least average arithmetic and QL/QR automaticity abilities are those who are better prepared for these courses. For on-sequence students with at least one average or above diagnostic score, 88.3% Chem I and 90.5% Chem II were successful.

Omaveloxolone is a nuclear factor (erythroid‐derived 2)‐like 2 activator approved in the United States and the European Union for the treatment of patients with Friedreich ataxia aged ≥16 years, with a recommended dosage of 150 mg orally once daily on an empty stomach. The effect of the US Food and Drug Administration (FDA) high‐fat breakfast on the pharmacokinetic profile of omaveloxolone observed in study 408‐C‐1703 (NCT03664453) deviated from the usual linear correlation between fed/fasted maximum plasma concentration (Cmax) and area under the concentration–time curve (AUC) ratios reported for various oral drugs across 323 food effect studies. Here, physiologically based biopharmaceutics modeling (PBBM) was implemented to predict and explain the effect of the FDA high‐fat breakfast on a 150‐mg dose of omaveloxolone. The model was developed and validated based on dissolution and pharmacokinetic data available across dose‐ranging, food effect, and drug–drug interaction clinical studies. PBBM predictions support clinical observations of the unique effect of a high‐fat meal on omaveloxolone pharmacokinetic profile, in which the Cmax increased by 350% with only a 15% increase in the AUC. Key parameters influencing omaveloxolone pharmacokinetics in the fasted state based on a parameter sensitivity analysis included bile salt solubilization, CYP3A4 activity, drug substance particle size distribution, and permeability. Mechanistically, in vivo omaveloxolone absorption was solubility and dissolution rate limited. However, in the fed state, higher bile salt solubilization led to more rapid dissolution with predominant absorption in the upper gastrointestinal tract, resulting in increased susceptibility to first‐pass gut extraction; this accounts for the lack of correlation between Cmax and AUC for omaveloxolone. [ABSTRACT FROM AUTHOR]

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.

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.

Background/Objectives: Lipid metabolism plays an important role in maternal health and fetal development. There is a gap in the knowledge of how lipid metabolism changes during pregnancy for Black women who are at a higher risk of adverse outcomes. We hypothesized that the comprehensive lipidome profiles would show variation across pregnancy indicative of requirements during gestation and fetal development. Methods: Black women were recruited at prenatal clinics. Plasma samples were collected at 8–18 weeks (T1), 22–29 weeks (T2), and 30–36 weeks (T3) of pregnancy. Samples from 64 women who had term births (≥37 weeks gestation) were subjected to "shotgun" Orbitrap mass spectrometry. Mixed-effects models were used to quantify systematic changes and dimensionality reduction models were used to visualize patterns and identify reliable lipid signatures. Results: Total lipids and major lipid classes showed significant increases with the progression of pregnancy. Phospholipids and glycerolipids exhibited a gradual increase from T1 to T2 to T3, while sphingolipids and total sterol lipids displayed a more pronounced increase from T2 to T3. Acylcarnitines, hydroxy acylcarnitines, and Lyso phospholipid levels significantly decreased from T1 to T3. A deviation was that non-esterified fatty acids decreased from T1 to T2 and increased again from T2 to T3, suggestive of a potential role for these lipids during the later stages of pregnancy. The fatty acids showing this trend included key fatty acids—non-esterified Linoleic acid, Arachidonic acid, Alpha-linolenic acid, Eicosapentaenoic acid, Docosapentaenoic acid, and Docosahexaenoic acid. Conclusions: Mapping lipid patterns and identifying lipid signatures would help develop intervention strategies to reduce perinatal health disparities among pregnant Black women. [ABSTRACT FROM AUTHOR]

Objectives Infant mortality remains a significant public health problem in the U.S. The Collaborative Improvement & Innovation Network (CoIIN) model is an innovative approach, using the science of quality improvement and collaborative learning, which was applied across 13 Southern states in Public Health Regions IV and VI to reduce infant mortality and improve birth outcomes. We provide an in-depth discussion of the history, development, implementation, and adaptation of the model based on the experience of the original CoIIN organizers and participants. In addition to the political genesis and functional components of the initiative, 8 key lessons related to staffing, planning, and implementing future CoIINs are described in detail. Methods This paper reports the findings from a process evaluation of the model. Data on the states' progress toward reducing infant mortality and improving birth outcomes were collected through a survey in the final months of a 24-month implementation period, as well as through ongoing team communications. Results The peer-to-peer exchange and platform for collaborative learning, as well as the sharing of data across the states, were major strengths and form the foundation for future CoIIN efforts. A lasting legacy of the initiative is the unique application and sharing of provisional 'real time' data to inform 'real time' decision-making. Conclusion The CoIIN model of collaborative learning, QI, and innovation offers a promising approach to strengthening partnerships within and across states, bolstering data systems to inform and track progress more rapidly, and ultimately accelerating improvement toward healthier communities, States, and the Nation as a whole., Author(s): Reem M. Ghandour [sup.1] [sup.4] , Katherine Flaherty [sup.2] [sup.3] , Ashley Hirai [sup.1] , Vanessa Lee [sup.1] , Deborah Klein Walker [sup.3] , Michael C. Lu [sup.1] Author [...]

This is a large-scale, multi-author collaborative autoethnographic study exploring the concept of building a tangible teaching commons on the example of the Scholarship of Teaching and Learning (SoTL) Commons Conference. The project organizers sought to provide a big tent and extended an invitation to attendees to respond to a series of writing prompts about their conference experience. Collaborative writing took place asynchronously over an approximately 60-day period following the close of the conference and generated ≈ 20,000 words. This corpus became the basis for a three-stage emergent coding process, conducted by the four-member steering commit-tee, which led to the identification of three primary themes from the collective experiences of the 2023 SoTL Commons Conference attendees: SoTL as pedagogy, SoTL as a community of scholars, and SoTL as scholarship. Despite some limitations to what the sense of commons represents, the project highlighted the respondents' spirit of appreciative inquiry, a signature mindset of SoTL and engaged participants who were new to the field. We argue that it acted as a form of academic hospitality itself; enabling the sharing of practice, deepening of reflection, strengthening of research skills, fostering of social connections, and, by extension, the advancement of the field as a community of scholars. [ABSTRACT FROM AUTHOR]

Initiated in 1991, the Federal Healthy Start Program includes 105 community-based projects in 39 states, the District of Columbia and Puerto Rico. Healthy Start projects work collaboratively with stakeholders to ensure participants' continuity of care during pregnancy through 2 years postpartum. This evaluation of Healthy Start projects examined relationships between implementation of nine core service and system program components and improvements in birth and project outcomes. Program components and outcomes were examined using data from a 2010 Healthy Start project director (PD) survey (N = 104 projects) and 2009 performance measure data from the Maternal and Child Health Bureau Discretionary Grant Information System (N = 98 projects). We explored bivariate relationships between the nine core program components and (a) intermediate and long-term project outcomes and (b) birth outcomes. We assessed independent associations of implementation of all core program components with birth outcomes, adjusting for project characteristics and activities. In 2010, 57 projects implemented all nine core program components: 104 implemented all five core service components and 69 implemented all four core systems components. Implementation of all core program components was significantly associated with several PD-reported intermediate and long-term project outcomes, but was not associated with singleton low birth weight or infant mortality among participants' infants. This evaluation revealed a mixed set of relationships between Healthy Start projects' implementation of the core program components and achievement of project outcomes. Although the findings demonstrated a positive impact of Healthy Start projects on birth outcomes, only a few associations were statistically significant., Author(s): Vonna Lou Caleb Drayton[sup.1] , Deborah Klein Walker[sup.2] , Sarah W. Ball[sup.2] , Sara M. A. Donahue[sup.2] , Rebecca V. Fink[sup.2] Author Affiliations: (1) Booz Allen Hamilton, One Preserve [...]

Family members can become leaders who are a voice not only for their own family, but also as part of a collective voice to advocate for changes in services, programs, [...]

Background: People with type 1 diabetes (T1D) aged <21 years are eligible for subsidised continuous glucose monitoring (CGM) products under the Australian National Diabetes Services Scheme. There are few real‐world published studies to evaluate the benefits of CGM in young adults. Aims: To perform a real‐world observation study among youth with T1D to evaluate CGM use and benefits of CGM. Methods: Patients at the Westmead Hospital Young Adult Diabetes Clinic aged 15–21 years who commenced CGM before July 2018 were followed for 6 months post commencement of CGM. Differences in HbA1c and glucose metrics at baseline and follow up are compared between those commencing CGM and those that did not. Results: Forty‐four (38%) of 115 eligible patients commenced CGM. Demographic characteristics and baseline HbA1c did not differ significantly between those started on CGM and those that did not. At 6 months, 18 (41%) of 44 patients still used CGM, with discomfort and inconvenience the most common reasons for dropout. In CGM continuers, at 6 months compared with baseline, there was no change in HbA1c (8.2% vs 8.0%; P = 0.8), coefficient of variation of glucose (38% vs 39%; P = 0.5) or percentage time in range (52% vs 58%; P = 0.3). Six‐month follow‐up HbA1c in CGM non‐users deteriorated significantly compared with users. Mean hypoglycaemia fear scores (worry scale) were significantly decreased from baseline at 6 months (33 vs 18; P < 0.01). Conclusion: There are high rates of discontinuation in CGM use among youth with T1D. At 6 months of CGM use, there was no significant change in glycaemic control, although HbA1c in non‐users deteriorated significantly. Worry of hypoglycaemia was significantly decreased among those who continued CGM. [ABSTRACT FROM AUTHOR]

Background: Limited studies have compared outcomes between emerging adults with type 1 diabetes mellitus (T1D) attending a diabetes transition support programme using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Aims: To assess glycaemic control and service utilisation in emerging adults with T1D on MDI or CSII attending a young adult diabetes clinic (YAC). Methods: A retrospective cohort analysis was conducted from January 2013 to December 2015. Data collected included clinic visits per year, after‐hours mobile telephone use, diabetic ketoacidosis (DKA) admissions and all HbA1c levels. Independent t‐test was used to compare continuous variables whilst Pearson's Chi‐squared test was used for categorical variables. Linear mixed effects models explored mean changes in HbA1c levels over time. Results: Over 3 years, 318 youth with T1D (176 MDI, 121 CSII, 21 switched from MDI to CSII) attended our YAC. Aggregated mean HbA1c levels remained similar between modalities (CSII 9.1% vs MDI 9.3%; P = 0.23); however, mean change in HbA1c at 3 years was significantly increased in CSII users at 0.55% (95% CI 0.15–0.95; P < 0.01) compared with no significant change in MDI users. Clinic visits per year were improved in CSII users (CSII 2.8 vs MDI 2.5; P = 0.02), while DKA admissions remained similar between MDI and CSII users (3.6 admissions per 100 patient‐years). Conclusion: In our YAC cohort, glycaemic control in CSII and MDI users was similar but well below recommended international glycaemic targets (HbA1c level < 7.0%). Despite increased clinical engagement occurring in CSII users, glycaemic deterioration was observed over the 3 years. [ABSTRACT FROM AUTHOR]