The implementation of TBI prediction rules and provision of risks of ciTBIs by using CDS was associated with modest, safe, but variable decreases in CT use. However, some secular trends were also noted.

While attention has been paid recently to the effectiveness of HIV/AIDS interventions among injection drug users, less focus has been given to out-of-treatment noninjecting drug users. This study examines the the NIDA Cooperative Agreement standard intervention versus an enhanced intervention for HIV/AIDS risk among noninjecting drug users. Data come from five sites of the NIDA-funded Cooperative Agreement on HIV risk behaviors. The sample is comprised of those who never injected drugs or reported not injecting in the 12 months prior to the interview; and who completed a three-month follow-up assessment. Three risk behaviors in the prior 30 days were analyzed: frequency of crack/cocaine use, number of sex partners, and frequency of condom use. The levels of both baseline and follow-up risk were analyzed. Individuals remaining at low risk or decreasing risk behaviors were classified as "improved." Those increasing risk behavior or remaining at moderate or high levels were classified as "worsened." Of the 1,434 noninjecting crack/cocaine users, 82% improved crack/cocaine use at the follow-up. The enhanced intervention group showed more improvement in crack/cocaine use than the standard intervention group. Overall, 76% reported reducing sexual partners, maintaining a one-partner relationship, or abstaining from sex at both time periods. Women in the enhanced intervention group improved more than women in the standard intervention (81% versus 75%). In terms of condom use, more respondents worsened than improved (55% versus 45%). This study confirms that HIV/AIDS interventions can reduce crack/cocaine use; however, high-risk sexual behaviors are more difficult to change. Reasons for this lack of improvement and suggestions for future interventions are discussed.

No abstract

No abstract

Because newborn hearing screening has become the standard of care in the United States, every state has established an early hearing detection and intervention (EHDI) program responsible for establishing, maintaining, and improving the system of services needed to serve children with hearing loss and their families. While significant developments have occurred in the last 20 years, challenges to newborn hearing screening, follow up, and early intervention still exist. In 2009, the National Center for Hearing and Assessment Management (NCHAM) initiated a national strategic planning activity to help EHDI program coordinators identify ways to improve their programs through the use of a strengths, weaknesses, opportunities, and threats (SWOT) analysis framework. A SWOT analysis, and subsequent threats, opportunities, weaknesses, and strengths (TOWS) matrix analysis, are commonly used methods of strategic planning. This article summarizes the history and status of EHDI programs to provide a context for the strategic planning process, and explains the methodology used in completing the SWOT analysis. 2. Audiological Evaluation This EHDI area covers all aspects of audiological evaluations and documentation. 3. Early Intervention This EHDI area covers all aspects of early intervention including, but not limited to, Part C and non-Part C communication options and technology options. 4. Medical Homes/ Medical Professionals This EHDI area includes the medical home and all medical professionals responsible for the continuity of care for children who have or are at-risk for hearing loss. 5. Loss to Follow-Up This EHDI area includes all issues related to loss to followup during the EHDI process (screening to identification to intervention). 6. Family Support This EHDI area includes all aspects of family support services as well as both educational materials and services that are culturally and linguistically sensitive as well as readily available. Continued Strategic Planning for EHDI Programs The results of these analyses suggest concrete ways in which the various components of an EHDI system can be improved by using opportunities to maximize strengths and minimize weaknesses, using strengths to reduce threats, and finding ways to reduce the threats to identified weaknesses. History and Status of EHDI Programs Many people have worked to reduce the age at which children with congenital hearing loss are identified since Ewing and Ewing (1944) called attention to the issue almost 70 years ago. For example, following the pioneering work EHDI Area Description 7. Periodic Early Childhood Hearing Screening This EHDI area includes all aspects of screening for hearing loss in children who passed their initial hearing screening but are at-risk for hearing loss, have an identified diagnosis that is associated with hearing loss, or are being screened to find late-onset hearing loss. 8. Professional Development This EHDI area represents all education and professional development for individuals who provide services related to universal ne...