Dynamics of Race, Culture and Key Indicators of Health in the Nation's 100 Largest Cities and Their Suburbs

Profiles the 2000 status of, and changes since 1990, in rates of health and health-related measures to identify patterns in race/ethnicity, foreign-born status, language use, poverty, income, low birth weight, teen births, prenatal care, and tuberculosis

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Precision of EMR Data: The Case For a Drug and Alcohol Service

Error-laden data can negatively affect clinical and operational decision making, research findings and funding allocation. This study examined the number and types of data errors in an electronic medical record (EMR) system in a Drug and Alcohol service. Specifically, errors in service data were examined. 9,379 errors were identified from ten error reports generated between March 2015 and May 2016, three months after the implementation of the EMR system. These errors were grouped into four types: mismatched data fields (60.5%), duplicate medical record error (3.2%), date/time error (8.8%) and blank field error (27.4%). The errors can be prevented by adding functions such as alert messages in the EMR system. How and why the errors occur need to be investigated in future studies

Quality of Life in the Nation's 100 Largest Cities and Suburbs: New and Continuing Challenges for Improving Health and Well-Being

Examines the progress made in the largest U.S. cities and their suburbs in alleviating poverty, improving educational achievement, and reducing unemployment and violent crime from 1990 to 2000

Weathering the Storm

Weathering the Storm takes us into the lives of fishing guides, anglers, business owners and experts as they navigate both the challenges imposed by COVID-19 restrictions and the rollercoaster of emotions while operating during a pandemic. Fly fishing plays a key role in Montana’s tourism industry. COVID-19 restrictions and shutdowns shuttered the dynamic industry during the spring of 2020. When the state opened up, record numbers of people, both local and out-of-state, flocked to Montana’s beautiful rivers, challenging the organizations slated with managing and protecting our waterways. Hear the personal struggles Montana fly-fishing guides encountered as the crippling effects of statewide shutdowns and closures stymied tourism and their businesses. Witness retail and fly shop owners struggling to keep their doors open and businesses afloat, while trying to keep retain their staff and provide top notch service to their clients. Listen to conservation experts trying to manage and protect Montana’s rivers and fish during a summer that saw a dramatic increase in recreational traffic. The film follows industry voices such as Carlye Luft, Director of the Montana Women’s Fly-Fishing School, lifetime angler George Kesel, Blackfoot River Outfitter owners John and Terri Herzer and fly fishing guide Jenny West. Their stories highlight the resiliency and adaptability of the fly fishing industry in Montana during this unprecedented time. Student filmmakers from the University of Montana School of Journalism spent three months reporting and documenting these stories while diving into the complex issues each of these industry members and businesses faced. This film was made possible by the Greater Montana Foundation and the University of Montana School of Journalism

Weathering the Storm: A Student Documentary

Weathering the Storm takes us into the lives of fishing guides, anglers, business owners and experts as they navigate both the challenges imposed by COVID-19 restrictions and the rollercoaster of emotions while operating during a pandemic. Fly fishing plays a key role in Montana’s tourism industry. COVID-19 restrictions and shutdowns shuttered the dynamic industry during the spring of 2020. When the state opened up, record numbers of people, both local and out-of-state, flocked to Montana’s beautiful rivers, challenging the organizations slated with managing and protecting our waterways. Hear the personal struggles Montana fly-fishing guides encountered as the crippling effects of statewide shutdowns and closures stymied tourism and their businesses. Witness retail and fly shop owners struggling to keep their doors open and businesses afloat, while trying to keep retain their staff and provide top notch service to their clients. Listen to conservation experts trying to manage and protect Montana’s rivers and fish during a summer that saw a dramatic increase in recreational traffic. The film follows industry voices such as Carlye Luft, Director of the Montana Women’s Fly-Fishing School, lifetime angler George Kesel, Blackfoot River Outfitter owners John and Terri Herzer and fly fishing guide Jenny West. Their stories highlight the resiliency and adaptability of the fly fishing industry in Montana during this unprecedented time. Student filmmakers from the University of Montana School of Journalism spent three months reporting and documenting these stories while diving into the complex issues each of these industry members and businesses faced. This film was made possible by the Greater Montana Foundation and the University of Montana School of Journalism

Trend in data errors after the implementation of an electronic medical record system: A longitudinal study in an Australian regional Drug and Alcohol Service

© 2020 Elsevier B.V. Objectives: To investigate trends in data errors over the 40 months after the implementation of an electronic medical record (eMR) system in an Australian regional Drug and Alcohol (D&A) Service. Methods: One hundred and twenty three error reports and data on occasions of service were obtained from the D&A Service. Statistical analysis was conducted to describe types of errors, to compare distribution of error types among different documentation forms, D&A Service sites and job roles. Error rates were also analysed. Results: In the 40 months after the implementation, a total of 18,549 errors occurred. These errors were grouped into four types: mismatched data fields (54.5 %), duplicate medical record (1.8 %), date/time error (8.2 %) and blank field (35.4 %). The distribution of error types differed in the forms being completed, the sites and the job roles. Quarterly error rate increased from 28.8 errors per 100 occasions of service in Year 1 Quarter 1–40.6 in Quarter 3, then decreased to 18.1 in Quarter 4. It dropped to 6.6 in Year 2 Quarter 2 and continued to decrease to 2.5 in Year 4 Quarter 1. Monthly error rate was the highest at 44.6 in Month 8, fell to the lowest at 1.0 in Month 18 and remained at under 7.3 from Month 19 to Month 40. Conclusions: After the implementation of the eMR system, the error rate increased in the first three quarters before decreasing. It reached stability about one and a half years after implementation. There were significant differences in the error distribution among the documentation forms, sites and job roles. The findings of this study could be used by eMR trainers to tailor training sessions for specific sites and job roles. These findings might also be useful for managers of other D&A Services to plan for the implementation of new electronic documentation systems

Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: Utility, technical performance and service provider perspective

<p>Abstract</p> <p>Background</p> <p>Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions.</p> <p>Methods</p> <p>A teleneurophysiology service providing routine EEG investigation was established. Service use, technical performance and satisfaction of clinical neurophysiology personnel were assessed qualitatively and quantitatively. These were contrasted with a previously reported analysis of the need for teleneurophysiology, and examination of expectation and satisfaction with clinical neurophysiology services in Ireland. A preliminary cost-benefit analysis was also conducted.</p> <p>Results</p> <p>Over the course of 40 clinical sessions during 20 weeks, 142 EEG investigations were recorded and stored on a file server at a satellite centre which was 130 miles away from the host clinical neurophysiology department. Using a virtual private network, the EEGs were accessed by a consultant neurophysiologist at the host centre for interpretation. The model resulted in a 5-fold increase in access to EEG services as well as reducing average waiting times for investigation by a half. Technically the model worked well, although a temporary loss of virtual private network connectivity highlighted the need for clarity in terms of responsibility for troubleshooting and repair of equipment problems. Referral quality, communication between host and satellite centres, quality of EEG recordings, and ease of EEG review and reporting indicated that appropriate organisational processes were adopted by the service. Compared to traditional CN service delivery, the teleneurophysiology model resulted in a comparable unit cost per EEG.</p> <p>Conclusion</p> <p>Observations suggest that when traditional organisational boundaries are crossed challenges associated with the social dimension of service delivery may be amplified. Teleneurophysiology requires a governance and management that recognises its socio-technical nature.</p