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2015

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Articles 2701 - 2730 of 11981

Full-Text Articles in Medicine and Health Sciences

Long-Term Effects Of Childhood Risk Factors On Cardiovascular Health During Adulthood, Roman Shrestha, Michael Copenhaver Aug 2015

Long-Term Effects Of Childhood Risk Factors On Cardiovascular Health During Adulthood, Roman Shrestha, Michael Copenhaver

UCHC Articles - Research

The primary purpose of this article is to provide a broad overview of the research on the long-term effects of childhood risk factors on cardiovascular diseases (CVDs) during adulthood and to outline recommendations for prevention of CVDs based on evidence-based interventions (EBIs). CVDs are the leading cause of death and a major cause of disability in the United States and globally. Risk factors for CVDs are already identifiable in children and youth, and include both modifiable factors (e.g., unhealthy diet, physical inactivity, tobacco smoking), and factors that cannot be changed (e.g., age, heredity, sex). A fundamental issue has been the …


An Intervention To Increase Identification And Referral Of Families At High Risk For Child Maltreatment In A Military Community, Tavia M. Wilkinson Aug 2015

An Intervention To Increase Identification And Referral Of Families At High Risk For Child Maltreatment In A Military Community, Tavia M. Wilkinson

Regis University Student Publications (comprehensive collection)

Summary
An Intervention to Increase Identification of Families at High Risk for Child Maltreatment in a Military Community
Problem
According to Gibbs, Martin, Clinton-Sherrod, Walters, and Johnson (2011), child maltreatment in the military community has become a significant issue. Initial interaction and assessment of expectant and post-partum mothers takes place in the labor and delivery and mother-baby units at a hospital in a western state where families at high risk for child maltreatment are initially identified. Current methods of recognizing high risk families include visual assessment of parent-child bonding, family dynamics, and involvement of the father. However, these methods have …


Disordered Speech Disrupts Conversational Entrainment: A Study Of Acoustic-Prosodic Entrainment And Communicative Success In Populations With Communication Challenges, Stephanie A. Borrie, Nichola Lubold, Heather Pon-Barry Aug 2015

Disordered Speech Disrupts Conversational Entrainment: A Study Of Acoustic-Prosodic Entrainment And Communicative Success In Populations With Communication Challenges, Stephanie A. Borrie, Nichola Lubold, Heather Pon-Barry

Communicative Disorders and Deaf Education Faculty Publications

Conversational entrainment, a pervasive communication phenomenon in which dialogue partners adapt their behaviors to align more closely with one another, is considered essential for successful spoken interaction. While well-established in other disciplines, this phenomenon has received limited attention in the field of speech pathology and the study of communication breakdowns in clinical populations. The current study examined acoustic-prosodic entrainment, as well as a measure of communicative success, in three distinctly different dialogue groups: (i) healthy native vs. healthy native speakers (Control), (ii) healthy native vs. foreign-accented speakers (Accented), and (iii) healthy native vs. dysarthric speakers (Disordered). Dialogue group comparisons revealed …


The Effect Of Workload, Job Satisfaction, And Role Conflict On The Timing Of Leaving Of Nursing Faculty From Their Current Faculty Position, Sherri Henry Suozzo Aug 2015

The Effect Of Workload, Job Satisfaction, And Role Conflict On The Timing Of Leaving Of Nursing Faculty From Their Current Faculty Position, Sherri Henry Suozzo

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Due to the significant nursing faculty shortage and the probable impact on healthcare, it is imperative to expand the available literature on the nursing faculty shortage. The descriptive data in this study highlight the critical nature of the aging and retiring nursing faculty body. The statistics available in this study regarding this are quite alarming. The Northeast may be looking at a mass exodus of nursing faculty in the next 5 years with up to 70 percent of the faculty leaving their current position. Another alarming factor is the significant level of inexperience the remaining faculty may have and …


Foundational Public Health Services And Health System Reform, Glen P. Mays Aug 2015

Foundational Public Health Services And Health System Reform, Glen P. Mays

Health Management and Policy Presentations

The Institute of Medicine's 2012 report on public health financing recommended a national initiative to identify the components and costs of a "minimum package" of public health programs and infrastructure that should be available in every U.S. community. In response, efforts are now underway to reach consensus on a set of "Foundational Public Health Services" for the nation, and to identify resource requirements for implementing these services. This presentation reviews existing research on the current availability of Foundational Public Health Services across the U.S. and the health and economic effects attributable to these services. We also review progress on ongoing …


Ca2+ Diffusion Through Endoplasmic Reticulum Supports Elevated Intraterminal Ca2+ Levels Needed To Sustain Synaptic Release From Rods In Darkness., Minghui Chen, Matthew J. Van Hook, Wallace B. Thoreson Aug 2015

Ca2+ Diffusion Through Endoplasmic Reticulum Supports Elevated Intraterminal Ca2+ Levels Needed To Sustain Synaptic Release From Rods In Darkness., Minghui Chen, Matthew J. Van Hook, Wallace B. Thoreson

Journal Articles: Ophthalmology

UNLABELLED: In addition to vesicle release at synaptic ribbons, rod photoreceptors are capable of substantial slow release at non-ribbon release sites triggered by Ca(2+)-induced Ca(2+) release (CICR) from intracellular stores. To maintain CICR as rods remain depolarized in darkness, we hypothesized that Ca(2+) released into the cytoplasm from terminal endoplasmic reticulum (ER) can be replenished continuously by ions diffusing within the ER from the soma. We measured [Ca(2+)] changes in cytoplasm and ER of rods from Ambystoma tigrinum retina using various dyes. ER [Ca(2+)] changes were measured by loading ER with fluo-5N and then washing dye from the cytoplasm with …


Prediction Of The Gene Expression In Normal Lung Tissue By The Gene Expression In Blood, Justin W. Halloran, Dakai Zhu, David C. Qian, Jinyoung Byun, Olga Y. Gorlova, Christopher I. I. Amos, Ivan P. Gorlov Aug 2015

Prediction Of The Gene Expression In Normal Lung Tissue By The Gene Expression In Blood, Justin W. Halloran, Dakai Zhu, David C. Qian, Jinyoung Byun, Olga Y. Gorlova, Christopher I. I. Amos, Ivan P. Gorlov

Dartmouth Scholarship

Background:

Comparative analysis of gene expression in human tissues is important for understanding the molecular mechanisms underlying tissue-specific control of gene expression. It can also open an avenue for using gene expression in blood (which is the most easily accessible human tissue) to predict gene expression in other (less accessible) tissues, which would facilitate the development of novel gene expression based models for assessing disease risk and progression. Until recently, direct comparative analysis across different tissues was not possible due to the scarcity of paired tissue samples from the same individuals.

Methods:

In this study we used paired whole blood/lung …


Use Of A Blog In An Undergraduate Nursing Leadership Course, Shelly Jensen Reed, Debra Edmunds Aug 2015

Use Of A Blog In An Undergraduate Nursing Leadership Course, Shelly Jensen Reed, Debra Edmunds

Faculty Publications

In this study, the use of a blog in a senior leadership clinical nursing course was analyzed qualitatively through two means; focus group interviews of those using the blog, and analysis of blog content. Initial feelings expressed by students were annoyance and intimidation concerning the blogging assignment. These feelings quickly dissipated, with students verbalizing many positive aspects related to the blog, including having a place to reflect, feeling connected as a group, valuing feedback provided by their peers, and learning from theirs and others' experiences. The mechanics of having to synthesize their thoughts in written form, in a shared venue …


Investigation In To The Effect Of Spin Locking On Contrast Agent Relaxivity, Julian Saunders Haigh Aug 2015

Investigation In To The Effect Of Spin Locking On Contrast Agent Relaxivity, Julian Saunders Haigh

Dissertations and Theses

The current trend in magnetic resonance imaging (MRI) is towards higher external magnetic field strengths (B0) to take advantage of increased sensitivity and signal to noise ratio (SNR). Unfortunately, as (B0) increases the effectiveness (relaxivity) of clinical gadolinium (Gd3+)-based contrast agents (CAs) administered to enhance image contrast is significantly reduced. Excellent soft tissue contrast can be generated with current agents despite their non-optimum relaxivities but necessitates large doses. The limits of detection of a CA at high B0 fields can be lowered by recovering the lost relaxivity and is a pre-requisite to the …


Vitamin D Deficiency And Infertility: A Systematic Review, Susanne Stoddard Sollis Aug 2015

Vitamin D Deficiency And Infertility: A Systematic Review, Susanne Stoddard Sollis

Student Works

Vitamin D regulates calcium and phosphorus homeostasis in the body. In recent years, studies have been conducted examining the role vitamin D plays in reproduction. Vitamin D deficiency is associated with infertility, decreased pregnancy rates, and hormonal changes. Asians appear to have a reverse correlation with pregnancy rates and vitamin D levels. There are some conflicting studies regarding vitamin D levels in relationship to infertility. This paper reviews the most recent literature focusing on the relationship between vitamin D status and infertility. This review evidences vitamin D levels >30 ng/mL result in improved fertility outcomes.


Two Novel Genetic Variants In The Mineralocorticoid Receptor Gene Associated With Spontaneous Preterm Birth, Inge Christiaens, Q. Wei Ang, Lindsay N. Gordon, Xin Fang, Scott Williams Aug 2015

Two Novel Genetic Variants In The Mineralocorticoid Receptor Gene Associated With Spontaneous Preterm Birth, Inge Christiaens, Q. Wei Ang, Lindsay N. Gordon, Xin Fang, Scott Williams

Dartmouth Scholarship

Background: Preterm birth is the leading cause of mortality and morbidity in newborn infants. Its etiology is multifactorial with genes and environmental factors, including chronic maternal stress, contributing to its risk. Our objective was to investigate whether single nucleotide polymorphisms (SNPs) in genes involved in the stress response are associated with spontaneous preterm birth using a candidate gene approach.

Methods: A total of 210 cases (singleton spontaneous preterm birth at <37 >weeks) and 412 controls (singleton term birth at 38–42 weeks without a history of preterm birth) were studied. High quality maternal DNA was available from saliva samples of 190 cases …


Food Insecurity Reported By Children, But Not By Mothers, Is Associated With Lower Quality Of Diet And Shifts In Foods Consumed, Jennifer Bernal, Edward A. Frongillo Jr., Juan A. Rivera Aug 2015

Food Insecurity Reported By Children, But Not By Mothers, Is Associated With Lower Quality Of Diet And Shifts In Foods Consumed, Jennifer Bernal, Edward A. Frongillo Jr., Juan A. Rivera

Faculty Publications

Household food security shows little indication of nutrient inadequacy among children, according to reports made by parents. We examined the associations of food insecurity as reported by children and mothers with children’s consumption of energy, macronutrients such as vitamin A, calcium, iron and zinc, and selected foods, and whether these associations differed by child’s gender. This cross-sectional study had non-probabilistic 128 Venezuelan mother–child pairs. We assessed food insecurity and management strategies in children using 10- and nine-item instruments, respectively. Mothers’ report of food insecurity came from a previously validated 12-item instrument. Nutrient intake of children was assessed with a 67-item …


Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging., Shubhika Srivastava, Beth F. Printz, Tal Geva, Girish S. Shirali, Paul M. Weinberg, Pierre C. Wong, Peter Lang Aug 2015

Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging., Shubhika Srivastava, Beth F. Printz, Tal Geva, Girish S. Shirali, Paul M. Weinberg, Pierre C. Wong, Peter Lang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.


An Insight Into The Role Of Vitamins Other Than Vitamin D On Bone, Robert E. Salazar, Jameela Banu Aug 2015

An Insight Into The Role Of Vitamins Other Than Vitamin D On Bone, Robert E. Salazar, Jameela Banu

Health & Biomedical Sciences Faculty Publications

Vitamins are essential micronutrients for normal development. Great emphasis has been placed on vitamin D for bone development and maintenance. However, other vitamins also influence bone health. While some of them are more beneficial to bone and increase bone mass by increasing bone formation, calcium deposition and stimulate osteoblastogenesis, higher concentrations of others have deleterious effects causing fragile bones and increasing the risk of fractures. Knowledge about the effects of these vitamins will help in better maintenance of bone. This review focuses on the information available on vitamins A,B,C,E and K on bone health. Existing information supports vitamin C and …


Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging. Spctpd/Acc/Aap/Aha., Shubhika Srivastava, Beth F Printz, Tal Geva, Girish S. Shirali, Paul M Weinberg, Pierre C Wong, Peter Lang, Society Of Pediatric Cardiology Training Program Directors, American College Of Cardiology, American Academy Of Pediatrics, American Heart Association Aug 2015

Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging. Spctpd/Acc/Aap/Aha., Shubhika Srivastava, Beth F Printz, Tal Geva, Girish S. Shirali, Paul M Weinberg, Pierre C Wong, Peter Lang, Society Of Pediatric Cardiology Training Program Directors, American College Of Cardiology, American Academy Of Pediatrics, American Heart Association

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.


Improving Hand Off Communication To Enhance Patient Outcomes And Staff Satisfaction, Karin Weinstock Aug 2015

Improving Hand Off Communication To Enhance Patient Outcomes And Staff Satisfaction, Karin Weinstock

Master's Projects and Capstones

Abstract

The specific aim statement is: Improving hand off communication to enhance patient outcomes and staff satisfaction 50% by August 6. Staff had 100% participation. Reduction in unnecessary appointments occurred and a structured standardized hand off form with situation, background, assessment, and recommendation (SBAR) was implemented at the start date. The clinic has 2 exam rooms, 1 lab, a reception area, and two small offices. The majority of the clients are Hispanic females ages 15-25. The non-profit clinic provides free medical services to the community. Evaluation methods yielded quantitative and qualitative results through chart audits and direct observations.

In-services, one-to-one …


How Fear And Anxiety In Response To Countertransference And Somatic Countertransference Impacted The Clinical Decision-Making Of A Dance/Movement Therapy Intern, Chelsie Batko Aug 2015

How Fear And Anxiety In Response To Countertransference And Somatic Countertransference Impacted The Clinical Decision-Making Of A Dance/Movement Therapy Intern, Chelsie Batko

Creative Arts Therapies Theses

This artistic inquiry self-study explored how fear and anxiety, in response to countertransference and somatic countertransference, impacted the clinical decision-making process of a dance/movement therapy intern. Primary questions surrounding the research included: How did fear and anxiety, in response to countertransference and somatic countertransference, impact the clinical decision-making of myself as a dance/movement therapy intern? Was what I experienced, as a dance/movement therapy intern, both fear and anxiety? How did I physiologically experience and embody fear and anxiety in response to countertransference and somatic countertransference? Data were collected in the form of journal entries and video recorded movement and were …


Developing An Informed Clinical Practice Through The Embodied Discovery Of Somatic Countertransference: An Artistic Inquiry, Nell Mccarty Aug 2015

Developing An Informed Clinical Practice Through The Embodied Discovery Of Somatic Countertransference: An Artistic Inquiry, Nell Mccarty

Creative Arts Therapies Theses

This thesis is an arts-based research project exploring how a new clinician developed an informed clinical practice through gaining embodied awareness of somatic countertransference when working with children who had experienced sexual abuse. Through embodied movement sessions, choreography, and public performance, a dance was created presenting a collection of movement qualities that reflected this author’s somatic countertransference experiences that were had during her time at her internship. A review of literature was conducted on the development of an informed clinical practice for dance/movement therapists, somatic countertransference, 95 pages. embodiment, and artistic inquiry used in research. A description of this project’s …


What's Happening: August 10, 2015, Maine Medical Center Aug 2015

What's Happening: August 10, 2015, Maine Medical Center

What's Happening

No abstract provided.


Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays, Cezar Mamaril Aug 2015

Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays, Cezar Mamaril

Health Management and Policy Presentations

This workshop provides an overview of the design and implementation of economic evaluation studies of public health programs and policies. Strategies for integrating economic evaluation principles, measurement strategies, analytic approaches, and results into the routine operations of public health agencies are examined.


Summary Of Proposed Updates To The National Health Security Preparedness Index For 2015-2016, Glen P. Mays, Michael T. Childress, Pierre Martin Dominique Zephyr, Christopher R. Bollinger, Anna Goodman Hoover Aug 2015

Summary Of Proposed Updates To The National Health Security Preparedness Index For 2015-2016, Glen P. Mays, Michael T. Childress, Pierre Martin Dominique Zephyr, Christopher R. Bollinger, Anna Goodman Hoover

Health Management and Policy Reports

This report describes proposed updates in methodology and measures for the 2015-16 release of the National Health Security Preparedness Index


Application Of Β-Lactamase Reporter Fusions As An Indicator Of Effector Protein Secretion During Infections With The Obligate Intracellular Pathogen Chlamydia Trachomatis , Konrad E. Mueller, Kenneth A. Fields Aug 2015

Application Of Β-Lactamase Reporter Fusions As An Indicator Of Effector Protein Secretion During Infections With The Obligate Intracellular Pathogen Chlamydia Trachomatis , Konrad E. Mueller, Kenneth A. Fields

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Chlamydia spp. utilize multiple secretion systems, including the type III secretion system (T3SS), to deploy host-interactive effector proteins into infected host cells. Elucidation of secreted proteins has traditionally required ectopic expression in a surrogate T3SS followed by immunolocalization of endogenous candidate effectors to confirm secretion by chlamydiae. The ability to transform Chlamydia and achieve stable expression of recombinant gene products has enabled a more direct assessment of secretion. We adapted TEM-1 β-lactamase as a reporter system for assessment of chlamydial protein secretion. We provide evidence that this system facilitates visualization of secretion in the context of infection. Specifically, our findings …


School Of Nursing News, Georgia Southern University Aug 2015

School Of Nursing News, Georgia Southern University

Nursing: News & Publications (2013-2023)

  • Georgia Southern University Receives $1.6 Million Grant for Advanced Nursing Education


Fruit And Vegetable Consumption And Cardiovascular Risk Factors In Older Chinese: The Guangzhou Biobank Cohort Study, Yangbo Sun, Chao Qiang Jiang, Kar Keung Cheng, Wei Sen Zhang, Gabriel M. Leung, Tai Hing Lam, Mary Schooling Aug 2015

Fruit And Vegetable Consumption And Cardiovascular Risk Factors In Older Chinese: The Guangzhou Biobank Cohort Study, Yangbo Sun, Chao Qiang Jiang, Kar Keung Cheng, Wei Sen Zhang, Gabriel M. Leung, Tai Hing Lam, Mary Schooling

Publications and Research

Objective
To examine the adjusted associations of fruit consumption and vegetable consumption with the Framingham score and its components in the non-Western setting of Southern China, considering health status.

Method
Linear regression was used to assess the cross-sectional associations of fruit and vegetable consumption with the Framingham score and its components, among 19,518 older Chinese (50 years) from the Guangzhou Biobank Cohort Study in Southern China (2003– 2006), and whether these differed by health status.

Results
The association of fruit consumption with the Framingham score varied by health status (P-value

Conclusion
This large study from a non-western setting found that …


Mistrust: An Exploration Of African Americans' Attitudes And Perspectives Toward Healthcare, Adolfo Gabriel Cuevas Aug 2015

Mistrust: An Exploration Of African Americans' Attitudes And Perspectives Toward Healthcare, Adolfo Gabriel Cuevas

Dissertations and Theses

This dissertation explored mistrust through focus group discussions (study 1), responses to standardized laboratory vignettes (study 2), and survey questionnaires (study 3). In the first study, I found that African American community members (N=60) experienced perceived discrimination, medical mistrust, and poor communication in numerous and interrelated ways. For example, medical mistrust occurred when clinicians did not convey respect to patients, leaving patients to wonder whether their clinician's treatment was discriminatory or not. Based on these findings, I wanted to see whether these experiences of perceived discrimination and mistrust were related to other dimensions of Black experience, such as racial identity. …


Applying Failure Modes And Effects Analysis To Public Health Models: The Breathe Easy At Home Program, Johnna S. Murphy, Margaret Reid, Amanda Ali, Laura Harrington, Megan Sandel Aug 2015

Applying Failure Modes And Effects Analysis To Public Health Models: The Breathe Easy At Home Program, Johnna S. Murphy, Margaret Reid, Amanda Ali, Laura Harrington, Megan Sandel

Frontiers in Public Health Services and Systems Research

Failure Modes and Effects Analysis (FMEA) is a structured process used to identify and prioritize risks by ranking them based on severity, occurrence, and detectability. Historically, FMEA has been used within industries, including automotive and health care. This project explored the adaption of the FMEA template to a small public health program designed to improve asthma outcomes. The Breathe Easy at Home (BEAH) program is a multi-sector partnership that uses a web-based system to link clinical sites with housing code inspections and enforcement for patients with asthma.

In July and August 2014, an FMEA was conducted to uncover risks within …


Economic Evaluation Of Fungal Meningitis Outbreak Response In New River Valley: Local Health Department Perspective, Kaja M. Abbas, Nargesalsadat Dorratoltaj, Margaret L. O’Dell, Paige Bordwine, Thomas M. Kerkering, Kerry J. Redican Aug 2015

Economic Evaluation Of Fungal Meningitis Outbreak Response In New River Valley: Local Health Department Perspective, Kaja M. Abbas, Nargesalsadat Dorratoltaj, Margaret L. O’Dell, Paige Bordwine, Thomas M. Kerkering, Kerry J. Redican

Frontiers in Public Health Services and Systems Research

Background: The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was injection of contaminated lots of methylprednisolone acetate used in epidural spinal injections. Roanoke and New River Valley were the epicenter of this outbreak in Virginia, with two clinical centers having administered the contaminated injections to their patients. New River Health District, in coordination with hospitals, and state and federal agencies, deployed its resources to control the local impact of the outbreak.

Purpose: The objective of this study was to conduct an economic evaluation of the fungal meningitis outbreak response in New River …


Implementation Of Electronic Disease Reporting Systems By Local Health Departments, Gulzar H. Shah, Karmen Williams, Bushra G. Shah Aug 2015

Implementation Of Electronic Disease Reporting Systems By Local Health Departments, Gulzar H. Shah, Karmen Williams, Bushra G. Shah

Frontiers in Public Health Services and Systems Research

Background: Electronic disease reporting systems (EDRSs) are imperative for local health departments (LHDs) operating in the post-H1N1 and evidence-based public health practice era. Studies regarding functionality and factors responsible for variation in implementation are important but rare.

Purpose: This primary objective for this study was to provide evidence regarding the level to which LHDs have implemented electronic disease reporting systems and factors associated with variation in implementation of electronic disease reporting systems.

Methods: A quantitative analysis was performed of the 2013 Profile of Local Health Departments Survey conducted by the National Association of County and City Health Officials (NACCHO). The …


Impact Of Organizational Networks On The Cost Of Core Services In Ohio’S Local Health Departments, Jason E. Orcena, Michael Petros, Patrick M. Bernet Aug 2015

Impact Of Organizational Networks On The Cost Of Core Services In Ohio’S Local Health Departments, Jason E. Orcena, Michael Petros, Patrick M. Bernet

Frontiers in Public Health Services and Systems Research

Introduction: Although several studies have linked population size to the cost of service delivery in local health departments, none have looked at the network position of the LHD. This study expands the understanding of how the position of an LHD in Ohio’s local health department network affects its expenditures in providing core, or nonclinical, services.

Methods: In 2014, 44% (55 of 124 eligible) of Ohio’s health officers responded to the PARTNER survey, a web-based network analysis program, with the analysis completed by the spring of 2015. Network data were then included in a regression analysis of the Core Plus-Scale model …


Measuring Changes In Local Surveillance And Investigation Capacity, Christine A. Bevc, Mary V. Davis, Anna P. Schenck Aug 2015

Measuring Changes In Local Surveillance And Investigation Capacity, Christine A. Bevc, Mary V. Davis, Anna P. Schenck

Frontiers in Public Health Services and Systems Research

Background: The outbreak of Ebola virus disease in West Africa and confirmation of the first cases in the United States highlight the need for robust and responsive public health surveillance system. With a 25% decline in funding since 2007, the impact on local surveillance capacities has not previously been described.

Purpose: The Surveillance & Investigation domain of the Local Health Department Preparedness Capacities Survey (PCAS) was reweighted to reflect the national profile of LHDs. Changes in subdomain performance of capacities and the effect of population size on subdomain capacity performance were examined over time.

Methods: Participating LHDs (n=208) …