Jamison D. Fargo

Urban School Reform Enabled by Transformative Professional Development: Impact on Teacher Change and Student Learning of Science

This longitudinal study of middle school science teachers explored if a teacher participation in the TPD program resulted in change in instructional practice as well as a significant increase in student learning. Four participating schools were matched and randomly assigned to intervention and control groups. Teacher and student outcomes were compared. Eight teachers from Bryce and Zion Middle Schools participated in the 2-week summer institute, followed by monthly release day professional development sessions focused on implementing instruction outlined in the National Science Education Standards. Student achievement was assessed using the pre- or postinstruments. Students of teachers at treatment schools experienced significantly larger gains than students at the control schools.TPD intervention teachers experienced increase in teaching effectiveness. Findings in this study revealed the positive impact that whole-school, sustained, collaborative, professional development programs have on improving teacher practice and student achievement at the school level.

Variables contributing to acute mountain sickness on the summit of Mt Whitney.

Abstract Objective.—The interaction of 15 variables representing physical characteristics, previous altitude exposure, and ascent data was analyzed to determine their contribution to acute mountain sickness (AMS). Methods.—Questionnaires were obtained from 359 volunteers upon reaching the summit of Mt Whitney (4419 m). Heart rate and arterial oxygen saturation were measured with a pulse oximeter, and AMS was identified by Lake Louise Self-Assessment scoring. Multiple logistic regression analysis was used to identify significant protective and risk factors for AMS. Results.—Thirty-three percent of the sample met the criteria for AMS. The odds of experiencing AMS were greater for those who reported a previous altitude illness (adjusted odds ratio [OR] = 2.00, P < .01) or who were taking analgesics during the ascent (adjusted OR = 2.09, P < .01). Odds for AMS decreased with increasing age (adjusted OR = 0.82, P < .0001), a greater number of climbs above 3000 m in the past month (adjusted OR = 0.92, P < .05), and use of acetazolamide during the ascent (adjusted OR = 0.33, P < .05). Conclusions.—The significant determinants of AMS on the summit of Mt Whitney were age, a history of altitude illness, number of climbs above 3000 m in the past month, and use of acetazolamide and analgesics during ascent.

NEW PERSPECTIVES ON COMMUNITY-LEVEL DETERMINANTS OF HOMELESSNESS

ABSTRACT: Understanding the root causes of homelessness is important for developing effective solutions to the problem. This fact has not gone unnoticed by researchers, who have made numerous attempts to identify the underlying structural determinants of homelessness by modeling inter-community variation in the rate of homelessness as a function of community-level variables. Yet, prior studies in this area have a number of serious limitations, principally their reliance on methodologically flawed estimates of the size of the homeless population. The present study addresses this and other limitations by using newly available and more reliable estimates from the U.S. Department of Housing and Urban Development to model variation in the rate of homelessness across a large and diverse sample of communities throughout the United States. In doing so, this study builds on the analysis conducted by Lee, Price-Spratlen, and Kanan (), and its findings have implications for policy and future research.

Emergency Department-Based Brief Intervention to Reduce Risky Driving and Hazardous/Harmful Drinking in Young Adults: A Randomized Controlled Trial

BACKGROUND Risky driving and hazardous drinking are associated with significant human and economic costs. Brief interventions for more than one risky behavior have the potential to reduce health-compromising behaviors in populations with multiple risk-taking behaviors such as young adults. Emergency department (ED) visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking. METHODS We determined the efficacy of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol addressing risky driving and hazardous drinking. We used a randomized controlled trial design with follow-ups through 12 months. ED patients aged 18 to 44 who screened positive for both behaviors (n = 476) were randomized to brief intervention (BIG), contact control (CCG), or no-contact control (NCG) groups. The BIG (n = 150) received a 20-minute assessment and two 20-minute interventions. The CCG (n = 162) received a 20-minute assessment at baseline and no intervention. The NCG (n = 164) were asked for contact information at baseline and had no assessment or intervention. Outcomes at 3, 6, 9, and 12 months were self-reported driving behaviors and alcohol consumption. RESULTS Outcomes were significantly lower in BIG compared with CCG through 6 or 9 months, but not at 12 months: Safety belt use at 3 months (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08 to 0.65); 6 months (AOR, 0.13; 95% CI, 0.04 to 0.42); and 9 months (AOR, 0.18; 95% CI, 0.06 to 0.56); binge drinking at 3 months (adjusted rate ratio [ARR] 0.84; 95% CI, 0.74 to 0.97) and 6 months (ARR, 0.81; 95% CI, 0.67 to 0.97); and ≥5 standard drinks/d at 3 months (AOR, 0.43; 95% CI, 0.20 to 0.91) and 6 months (AOR, 0.41; 95% CI, 0.17 to 0.98). No substantial differences were observed between BIG and NCG at 12 months. CONCLUSIONS Our findings indicate that SBIRT reduced risky driving and hazardous drinking in young adults, but its effects did not persist after 9 months. Future research should explore methods for extending the intervention effect.

Forensic sexual assault examination and genital injury: is skin color a source of health disparity?

PURPOSE The study objectives were to (1) estimate the frequency, prevalence, type, and location of anogenital injury in black and white women after consensual sex and (2) investigate the role of skin color in the detection of injury during the forensic sexual assault examination. METHODS A cross-sectional descriptive design was used with 120 healthy volunteers who underwent a well-controlled forensic examination after consensual sexual intercourse. RESULTS Fifty-five percent of the sample had at least 1 anogenital injury after consensual intercourse; percentages significantly differed between white (68%) and black (43%) participants (P = .02). Race/ethnicity was a significant predictor of injury prevalence and frequency in the external genitalia but not in the internal genitalia or anus. However, skin color variables--lightness/darkness-, redness/greenness-, and yellowness/blueness-confounded the original relationship between race/ethnicity and injury occurrence and frequency in the external genitalia, and 1 skin color variable--redness/greenness--was significantly associated with injury occurrence and frequency in the internal genitalia. CONCLUSIONS Although differences exist in anogenital injury frequency and prevalence between black and white women, such differences can be more fully explained by variations in skin color rather than race/ethnicity. Clinical recommendations and criminal justice implications are discussed.

Universal Screening for Homelessness and Risk for Homelessness in the Veterans Health Administration

We examined data for all veterans who completed the Veterans Health Administrations national homelessness screening instrument between October 1, 2012, and January 10, 2013. Among veterans who were not engaged with the US Department of Veterans Affairs homeless system and presented for primary care services, the prevalence of recent housing instability or homelessness was 0.9% and homelessness risk was 1.2%. Future research will refine outreach strategies, targeting of prevention resources, and development of novel interventions.

The Relationship between Community Investment in Permanent Supportive Housing and Chronic Homelessness

In recent years, permanent supportive housing (PSH) has emerged as the preferred intervention for addressing chronic homelessness in the United States. However, almost all prior studies examining the effectiveness of PSH have been conducted at the individual level, with only minimal attempts to empirically test the relationship between PSH and chronic homelessness at the community level. This study uses longitudinal data collected by the US Department of Housing and Urban Development (HUD) and several other sources to model the relationship between measures of community investment in PSH and rates of chronic homelessness. The results show modest negative associations between increased investment in PSH and rates of chronic homelessness over time. We discuss the implications of these findings for ongoing efforts to address chronic homelessness and future research.

The Use of Self-Generation Procedures Facilitates Verbal Memory in Individuals with Seizure Disorders

The efficacy of a self-generation encoding procedure in facilitating the encoding and retrieval of verbal memories was compared with the didactic presentation of information in individuals with seizure disorders. Through a within-subject design, 87 patients (25 left temporal seizure onset, 29 right temporal, 8 frontal, and 25 psychogenic nonepileptic seizures) received a self-generation learning condition and a didactic learning condition and were subsequently tested for verbal paired associate free recall, cued recall, and recognition memory. All patient groups benefited from the use of the self-generation condition relative to the didactic condition. Better performance occurred with the self-generation procedure for cued recall and recognition memory test performance, but not free recall. Individuals with a left temporal seizure onset (patients with the poorest memory performance on the didactic condition) benefited the most from the self-generation condition. A memory encoding strategy that actively involves patient participation enhances memory performance.

Classroom-Based Narrative and Vocabulary Instruction: Results of an Early-Stage, Nonrandomized Comparison Study

PURPOSE This nonrandomized feasibility study was designed to provide a preliminary assessment of the impact of a narrative and vocabulary instruction program provided by a speech-language pathologist (SLP) in a regular classroom setting. METHOD Forty-three children attending 2 first-grade classrooms participated in the study. Children in each classroom were divided into high- and low-risk subgroups on the basis of their performance on a narrative test. Narrative and vocabulary instruction was provided by an SLP in 1 classroom for three 30-min periods per week for 6 weeks. RESULTS The children in the experimental classroom made clinically significant improvements on narrative and vocabulary measures; children in the comparison classroom did not. Within the experimental classroom, children in the high-risk subgroup demonstrated greater gains in narration and fewer gains in vocabulary than children in the low-risk subgroup. There were no subgroup differences in the comparison classroom. CONCLUSION These preliminary results provide early evidence of the feasibility of implementing a narrative instruction program in a classroom setting. Children at a high risk for language difficulties appeared to profit more from the narrative instruction than from the embedded vocabulary instruction. More extensive research on this instructional program is warranted.

Identifying homelessness among veterans using VA administrative data: Opportunities to expand detection criteria

Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.