The USDA's Supplemental Nutrition Assistance Program's (SNAP) strives to connect SNAP recipients to local and healthful food sold at Farmers' markets. These efforts are an attempt to provide families, struggling to make ends meet, access to healthy foods and food purchasing power via the Federal Food Stamp program. However, of the 288 listed farmers' markets in Illinois only 25 are listed as SNAP/EBT accepting markets (2010 National Farmers Market Directory). The first part of this study uses the 61st Street Farmers Market as a case study, investigating the practical market operations and interpreting their method of EBT implementation to provide an established model of an existing and thriving farmers' market. Next, I will investigate the socio-economic characteristics (population, race, employment, income, poverty, education, age, and SNAP recipients) of Illinois farmers' markets accepting EBT. I will compare this data to other Illinois Farmers' markets that do not accept EBT and assess which non-accepting market locations would be most suitable for implementing EBT usage in the future. Finally, based on my case study and statistical analysis, I will discuss recommendations for farmers' markets to accept EBT into their markets. Findings indicate that there is no significant difference between the mean ranks of the socio-economic characteristics for the EBT and non-EBT accepting farmers' markets. Of the 8 socio-economic characteristics tested, the populations of SNAP recipients were analogous for each group: EBT and Non-EBT accepting farmers' markets.

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No. of bitstreams: 1 Dissertação Ariadne.pdf: 1881547 bytes, checksum: 5eda55be3197c20bcbcf2d5e6b1a9f63 (MD5) Previous issue date: 2014-12-17 / O trabalho como coordenadora pedagógica da Comissão Permanente de Avaliação (CPA) do Centro Estadual de Educação Magalhães Neto – CEA, onde exames supletivos são desenvolvidos, estimulou a realização da presente dissertação de mestrado que tem por objetivo conhecer as motivações que levam pais, mães e seus filhos, de contextos socioeconômicos diversos, a optarem pelos exames supletivos. O estudo caracterizou-se por ser descritivo exploratório e teve 80 participantes. Estes foram subdivididos em Grupo 1, composto por 20 candidatos aos exames supletivos e seus respectivos pais/mães pertencentes às classes sociais A e B, e o Grupo 2 abarcou 20 candidatos das classes sociais C e D e seus pais/mães. Os critérios de classe foram os estabelecidos pelo IBGE, no Censo 2010, e a idade dos candidatos variou de 15 a 20 anos. Para a coleta de dados foram construídos dois questionários semiestruturados: um para os candidatos e outro para os seus pais. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da UCSal. Houve convite aos participantes no Centro Estadual de Educação Magalhães Neto – CEA e os que aceitaram, assinaram o Termo de Consentimento/Assentimento Livre e Esclarecido e, em seguida, preencheram o questionário na sala da Coordenação Pedagógica da referida instituição. Os dados foram analisados construindo categorias a partir das respostas obtidas e calculando-se as respectivas porcentagens. Além disso, houve análise da quantidade de inscritos, dos presentes e dos aprovados nas avaliações dos exames supletivos da referida escola no período de 2010 a 2013. Os principais resultados foram: na unidade escolar estudada, havia uma maior procura pelos exames supletivos referentes ao ensino médio do que ao ensino fundamental II. Foi crescente a procura por tais exames, mas o percentual de reprovação mostrou-se elevado. Para os/as pais/mães das classes A e B (Grupo 1), a principal motivação para que o(a) filho(a) realizasse os exames supletivos foi a antecipação do ingresso dele(a) na universidade. Por outro lado, os pais das classes C e D (Grupo 2) queriam que o(a) filho(a) concluísse o ensino médio com maior rapidez por estar em defasagem idade/série. Os jovens do Grupo 1 estavam motivados principalmente pelo fato de terem sido aprovados em faculdade/ENEM. Por sua vez, para os jovens do Grupo 2, as motivações estavam voltadas para obter a certificação em decorrência da defasagem idade/série e para poder inserir-se mais facilmente no mercado de trabalho. Nos diversos contextos, há expectativas dos pais para que os filhos tornem-se bons profissionais e sejam independentes economicamente. A educação é valorizada por todos os entrevistados, mas há a necessidade de políticas públicas eficazes que garantam educação formal de qualidade para todos, numa sociedade que a cada dia exige mais capacitação dos seus cidadãos. / Working as educational coordinator of the Standing Committee Assessment (CPA) the State Center for Education Magalhães Neto – CEA, where suppletive exams are developed, led to the development of this dissertation which aims to understand the motivations that lead parents and their children, representing different social contexts, opt for supplementary course exams. The study was characterized by being descriptive exploratory and had 80 participants. These were divided into Group 1 comprised 20 candidates for supplementary course examinations and their fathers/mothers belonged to A and B social classes, and Group 2 encompassed 20 candidates of C and D social classes and their fathers/mothers. The class criteria were established by the IBGE in the 2010 Census, and the age of the candidates ranged from 15 to 20 years. For data collections were built two semi-structured questionnaires: one for the candidates and one for their parents. The study was approved by UCSal Research Ethics Committee. There was invitation to participants in the State Center for Education Magalhães Neto – CEA and who agreed, signed the Consent/Free and Clear Assent and then completed the questionnaire in the Pedagogical Coordination room of the mentioned institution. Data were analyzed building categories from the responses obtained and calculating the respective percentages. Furthermore, there was analysis of the subscribers’ amount, current and approved on reviews from suppletives tests of that school in the period 2010 t0 2013. The main results were: in the studied school, there was a greater demand for supplementary course examinations related to high school than the elementary school II. The demand for such tests increased, but the failure percentage was high. For the fathers/mothers of classes A and B (Group 1), the main motivation for the son performs the tests suppletives was the anticipation of his access at the university. On the other hand, parents of Class C and D (Group 2) wanted the son conclude the high school faster by being overdue in age/grade. Young people from Group 1 were mainly motivated by the fact that they were approved in college/ENEM. In turn, for young people in Group 2, the motivations were aimed to obtain certification as a result of age/grade and to be able to enter more easily into the labor market. In many contexts, there are parents’ expectations for their children to become good professionals and economically independent. Education is valued by all respondents, but there is the need for effective public policies that guarantee formal quality education for all, a society that every day requires more training of its citizens.

Background: The buprenorphine transdermal system (BTDS) is approved in the US for the management of chronic pain. Due to its high affinity for mu-opioid receptors with a slow dissociation profile, buprenorphine may potentially displace or prevent the binding of competing mu-opioid-receptor agonists, including immediate-release (IR) opioids, in a dose-dependent manner. Health care professionals may assume that the use of IR opioids for supplemental analgesia during BTDS therapy is not acceptable. Materials and methods: This post hoc analysis evaluated the use of IR opioids as supplemental analgesia during the management of moderate-severe chronic pain with BTDS at 52 US sites (BUP3015S, NCT01125917). Patients were categorized into IR-opioid and no-IR-opioid groups. At each visit of the extension phase, adverse events, concomitant medications, and information from the Brief Pain Inventory (BPI) were recorded. Results: The most common supplemental IR opioids prescribed during BTDS treatment (n=354) were hydrocodone-acetaminophen and oxycodone-acetaminophen. The mean daily dose of IR opioids (morphine equivalents) for supplemental analgesia was 22 mg. At baseline, BPI pain intensity and BPI - interference scores were higher for patients in the IR-opioid group. In both treatment groups, scores improved by week 4, and then were maintained throughout 6 months of the open-label extension trial. The incidence of treatment-emergent adverse events was similar in both groups. Conclusion: Patients who were prescribed IR opioids reported lower scores for BPI pain intensity and pain interference to levels similar to patients receiving BTDS without IR opioids, without increasing the rate or severity of treatment-emergent adverse events. Patients prescribed concomitant use of IR opioids with BTDS had greater treatment persistence. The results of this post hoc analysis provide support for the concomitant use of IR opioids for supplemental analgesia during the management of moderate-severe chronic pain with BTDS.

Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.

The purpose of the study was to determine what nutritional, demographic, and behavioral differences existed between children one year of age from two similar WIC clinics with different prevalences of anemia. Children from the higher-prevalence site were found to consume significantly (p < .05) more B12, C, copper, fiber, folate, total kilocalories, and riboflavin than did children from the lower-prevalence site. Family income and maternal weight gain were significantly (p < .05) higher in the lower-prevalence group as compared to the higher-prevalence group. In addition, children from the higher-prevalence site were enrolled in the WIC program at a significantly (p < .05) younger age than were children from the lower-prevalence site.

Supplemental instruction (SI), a peer assisted learning model, improves course performance, retention, and graduation rates of post-secondary education students. Researchers have questioned if the success of SI is due to students becoming more aware of assessment demands or if SI also promotes construction of new knowledge. The purposes of this case study were to describe techniques utilized by SI peer leaders, explore how sociocognitive learning techniques are implemented, and explore the perceptions of supplemental instruction program stakeholders regarding sociocognitive learning techniques. The research questions focused on what techniques peer leaders are trained to implement and what peer leaders' perceptions of sociocognitive learning techniques are. Piaget's theories on cognitive conflict and construction of knowledge, Vygotsky's theories on zone of proximal development and sociocognitive learning, and Chi's framework on interactive learning provided the conceptual framework for the study. The case study was conducted at a Northeast United States community college, using interviews with SI administrators and peer leaders (n = 8), voice recordings of SI sessions, and review of training material. The constant comparative method analysis of findings suggest that peer leaders trained in traditional tutoring and sociocognitive learning techniques promote construction of knowledge, and while programmatic and peer leader goals align with sociocognitive learning techniques, student goals do not. One recommendation is to clarify the distinction of SI versus traditional tutoring. This study could lead to positive social change by contributing to expanded goals of SI resulting in enhanced quality of learning for student participants at higher education institutions.

Food insecurity (not having continuing access to nutritious food to maintain health) is common in the United States, especially in working poor households. The Supplemental Nutrition Assistance Program (SNAP) is a well-documented safety net for individuals and families struggling with food insecurity. Little is known about the effect of SNAP policy on food insecurity in working poor military households. The purpose of this qualitative phenomenological study was to investigate the lived experiences of food-insecure Army families and the perceived influence of SNAP policy on their food-insecurity. The theoretical framework was policy feedback theory. Data were collected from semistructured interviews with 13 Army heads of households. Data were coded and categorized to identify 3 themes: impact of Army culture, federal programs as stabilization, and limiting SNAP policy. Participants struggle with food insecurity due to unique aspects of military culture, such as transition, and the limitations of current SNAP policy. Findings may be used to inform policymakers of the influence of SNAP policy on food insecurity in the U.S. Army.

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No description available.

Background In July 2014, the Institute of Medicine released a review of the governance of Graduate Medical Education (GME), concluding that changes to GME financing were needed to reward desired performance and to reshape the workforce to meet the nation's needs. In light of the rapid emergence of alternative payment systems, we evaluated the financial value of resident participation in operative surgical care. Methods The Department of Surgery provided Current Procedural Terminology (CPT) codes for procedures performed by the general surgical service at our institution for the 2011 academic year. For each code, the charge and total instances were provided. CPTs allowing an assistant fee were identified using the Searchable Medicare Physician Fee Schedule. This approach enabled calculation of the potential resident contribution to GME funding. Results A total of 515 unique CPTs were potentially billable for a total of 6,578 procedures, of which 2,552 (39%) were reimbursable. These CPTs would have generated $1,882,854 in assistant charges. The top 50 most frequent CPTs resulted in 4,247 procedures. Within the top 50, 1362 procedures (32% of the top 50, 21% of the total) were reimbursable. Of the total assistant charges, $963,227 (51%) occurred in the top 50 most frequent CPTs. Conclusions Credit for resident participation in operative care as co-surgeon would average $67,244 per resident, compared to our current funding of $142,635 per resident. This type of alternative funding could provide 47% of current educational support. The skew in distribution of procedures also suggests that such a system could provide guidance to a more balanced operative experience. Such performance-based credentialing could be used to ensure appropriate housestaff for a given case; these reimbursements could also be adjusted based on quality metrics to provide for transformational change in patient outcomes.