It is well known that the lack of care coordination in the healthcare system causes numerous problems including cost inefficiency and inconsistent care, specifically for complex pediatric and adult patients. Many pediatric patients have complex medical and social service needs which can be expensive for both the patient’s parents and the general healthcare system. Therefore, it is difficult for the healthcare system to deliver the highest quality care possible, due to the number of appointments that have to be scheduled (with some being out of state), the large volume of physical health records, and overall lack of time parents have to coordinate this care while also caring for themselves and other family members. It is integral to find a more efficient way to coordinate care for these patients, in order to improve overall care, cost efficiency, and outcomes. <br/>A number of stakeholders in Arizona came together to work on this problem over several years. They were funded through a PCORI Eugene Washington Engagement grant to investigators at ASU. This project, Take Action for Arizona's Children through Care Coordination: A Bridge to Action was developed in order to further develop a research agenda and build the network (PCOR). Regional conferences were conducted in Flagstaff, Yuma, Phoenix, and Tucson, as well as a final capstone conference held in Phoenix. At these conferences, frustrations, suggestions, and opinions regarding Children with Special Health Care Needs (CSHCN) and navigating the healthcare system were shared and testimonials were transcribed.<br/>This study focused on the capstone conference. The study design was a strategic design workshop; results of the design analysis were analyzed qualitatively using descriptive content analysis. Themes described parent’s common experiences navigating the system, impacts resulting from such experiences, and desires for the care coordination system. Quotes were then grouped into major themes and subthemes for the capstone conference. After these themes were determined, the overarching goals of stakeholders could be assessed, and implementation projects could be described.

The purpose of this study was to examine the validity of a modified Assisted Cycling Therapy bicycle for improving depression in children with Down Syndrome (DS). Seven participants completed 2x/week for 8 weeks, 30 minutes at a time of ACT, in which participants’ voluntary pedaling rates were augmented via the bicycle motor, ensuring that they were pedaling at a rate greater than their self-paced rate. Depression was measured using a modified version of the Children’s Depressive Inventory, called the CDI-2. Our study demonstrated that the scores from the CDI-2 decreased, demonstrating less depressive symptomatology after the conclusion of the 8 week intervention. Our results were interpreted via our model of the mechanisms involved in influencing the success of ACT. Future research would include a greater sample size, a more relevant measure of depressive scores, and a consistent data collection environment. However our initial pilot study showed promising results for improving mental health in children with DS.

Animal agriculture is a growing industry worldwide as the global demand for animal products increases. This has resulted in many harmful unintended consequences for human health, the environment, and animal welfare. This paper aims to uncover the hidden costs of negative externalities by answering the question: What types of subsidies is the US government distributing to the animal agriculture industry and in what amount? This paper will begin with some background on a few of the externalities created by the animal agriculture industry focusing specifically on environmental issues of water, air, and deforestation. Once this background is established, this will show that animal agriculture is in fact a negative-externality-generating industry. Next, subsidies will be defined and the principal findings of the research will reveal the different forms of support that the US government provides to animal agriculture. Lastly, these subsidies, both direct and indirect, will be quantified.