Teaching Population Health: Innovations in the integration of the healthcare and public health systems

Population health is a critical concept in healthcare delivery today. Many healthcare administrators are struggling to adapt their organization from fee-for-service to value delivery. Payers and patients expect healthcare leaders to understand how to deliver care under this new model. Health administration programs play a critical role in training future leaders of healthcare organizations to be adaptable and effective in this dynamic environment. The purpose of this research was to: (a) engage current educators of health administration students in a dialogue about the best practices of integrating the healthcare and public health systems; (b) identify the content and pedagogy for population health in the undergraduate and graduate curricula; and (c) discuss exemplar population health curriculum models, available course materials, and curriculum integration options. Authors conducted focus groups of participants attending this educational session at the 2017 annual AUPHA meeting. Qualitative analysis of the focus group discussions was performed and themes identified by a consensus process. Study findings provide validated recommendations for population health in the health administration curriculum. The identification of key content areas and pedagogical approaches serves to inform health educators as they prepare future health administrators to practice in this new era of population health

Pedagogy: How to best teach population health to future healthcare leaders

Our healthcare system is moving from a fee-for-service reimbursement model to one that provides payment for improvements in three areas related to care: quality, coordination, and cost. Healthcare organizations must use a population health approach when delivering care under this new paradigm. Health administration programs play a critical role in training future leaders of healthcare organizations to be adaptable and effective in this dynamic environment. The purpose of this research was to: (1) engage health administration educators in a dialogue about population health and its relevance to healthcare administration education; (2) describe pedagogical methods appropriate for teaching population health skills and abilities needed for successful careers in our healthcare environment; and (3) identify current student learning outcomes that participants can tailor to utilize in their undergraduate and graduate health management courses. Authors conducted focus groups of participants attending this educational session at the 2018 annual AUPHA meeting. Qualitative analysis of the focus group discussions identified themes by a consensus process. Study findings provide validated recommendations for population health in the health administration curriculum. The identification of pedagogical approaches serves to inform educators as they prepare future health administrators to practice in this new era of healthcare delivery

Apparatus and method for high-speed characterization of surfaces

This invention permits rapid determination of a three-dimensional contour of an object. The apparatus directs a laser beam onto a point on an object, and the scattered light is received by a position sensitive detector (PSD). The location at which scattered light is received can be related to the displacement of the point on the object, using basic trigonometry. The laser beam is deflected non-mechanically, by passing it through a crystal whose index of refraction is varied in a controlled manner. By proper control of the index of refraction, one can scan the beam across a desired area of the object, without using any moving parts, and can therefore obtain complete information about the contour of the object. The device operates without making any conventional images, and is therefore much faster than comparable devices of the prior art. Also, the laser and beam deflector can be housed in a small optical head which enables the device to reach normally inaccessible areas. The device can compare the test object with a reference object, or it can compare two objects for differences

Multi-Pulse Laser Wakefield Acceleration: A New Route to Efficient, High-Repetition-Rate Plasma Accelerators and High Flux Radiation Sources

Laser-driven plasma accelerators can generate accelerating gradients three orders of magnitude larger than radio-frequency accelerators and have achieved beam energies above 1 GeV in centimetre long stages. However, the pulse repetition rate and wall-plug efficiency of plasma accelerators is limited by the driving laser to less than approximately 1 Hz and 0.1% respectively. Here we investigate the prospects for exciting the plasma wave with trains of low-energy laser pulses rather than a single high-energy pulse. Resonantly exciting the wakefield in this way would enable the use of different technologies, such as fibre or thin-disc lasers, which are able to operate at multi-kilohertz pulse repetition rates and with wall-plug efficiencies two orders of magnitude higher than current laser systems. We outline the parameters of efficient, GeV-scale, 10-kHz plasma accelerators and show that they could drive compact X-ray sources with average photon fluxes comparable to those of third-generation light source but with significantly improved temporal resolution. Likewise FEL operation could be driven with comparable peak power but with significantly larger repetition rates than extant FELs

Visualizing Epigenetics: Current Advances and Advantages in HDAC PET Imaging Techniques

Abnormal gene regulation as a consequence of flawed epigenetic mechanisms may be central to the initiation and persistence of many human diseases. However, the association of epigenetic dysfunction with disease and the development of therapeutic agents for treatment are slow. Developing new methodologies used to visualize chromatin-modifying enzymes and their function in the human brain would be valuable for the diagnosis of brain disorders and drug discovery. We provide an overview of current invasive and noninvasive techniques for measuring expression and functions of chromatin-modifying enzymes in the brain, emphasizing tools applicable to histone deacetylase (HDAC) enzymes as a leading example. The majority of current techniques are invasive and difficult to translate to what is happening within a human brain in vivo. However, recent progress in molecular imaging provides new, noninvasive ways to visualize epigenetics in the human brain. Neuroimaging tool development presents a unique set of challenges in order to identify and validate CNS radiotracers for HDACs and other histone-modifying enzymes. We summarize advances in the effort to image HDACs and HDAC inhibitory effects in the brain using positron emission tomography (PET) and highlight generalizable techniques that can be adapted to investigate other specific components of epigenetic machinery. Translational tools like neuroimaging by PET and magnetic resonance imaging provide the best way to link our current understanding of epigenetic changes with in vivo function in normal and diseased brains. These tools will be a critical addition to ex vivo methods to evaluate – and intervene – in CNS dysfunction.Chemistry and Chemical Biolog

Body of Knowledge for Health Administration Education: Teaching Epidemiology in the Age of Health Care Reform

As we embark on reforming the U.S. healthcare system, population-based healthcare is becoming even more important, and epidemiology is the basic science we will use to evaluate our effectiveness. Although recent research has shown that most undergraduate and graduate programs in health administration teach epidemiology courses in their curricula, the goals, objectives, and final content for such a course remain inconsistent across the programs. There are limited guiding principles (e.g., accreditation and certification criteria) on what health administration programs should expect of students studying epidemiology. To assess the similarities and differences in epidemiological content taught at the undergraduate and graduate levels, we systematically reviewed epidemiology content by querying those who teach this specific course via a national survey tool and syllabi obtained from programs. The purpose of this paper is to describe, for health administration programs, the (a) body of knowledge (i.e., content, principles) for a course in epidemiology taught at the undergraduate and graduate levels; and (b) perspectives of instructors regarding their approach in teaching epidemiology at the undergraduate or graduate level. This work will serve as a guide that can help educators when developing the competencies, goals, and objectives for epidemiology courses in their health administration programs

Apparent optical properties of the Canadian Beaufort Sea - Part 1: Observational overview and water column relationships

A data set of radiometric measurements collected in the Beaufort Sea (Canadian Arctic) in August 2009 (Malina project) is analyzed in order to describe apparent optical properties (AOPs) in this sea, which has been subject to dramatic environmental changes for several decades. The two properties derived from the measurements are the spectral diffuse attenuation coefficient for downward irradiance, Kd, and the spectral remote sensing reflectance, Rrs. The former controls light propagation in the upper water column. The latter determines how light is backscattered out of the water and becomes eventually observable from a satellite ocean color sensor. The data set includes offshore clear waters of the Beaufort Basin as well as highly turbid waters of the Mackenzie River plumes. In the clear waters, we show Kd values that are much larger in the ultraviolet and blue parts of the spectrum than what could be anticipated considering the chlorophyll concentration. A larger contribution of absorption by colored dissolved organic matter (CDOM) is responsible for these high Kd values, as compared to other oligotrophic areas. In turbid waters, attenuation reaches extremely high values, driven by high loads of particulate materials and also by a large CDOM content. In these two extreme types of waters, current satellite chlorophyll algorithms fail. This questions the role of ocean color remote sensing in the Arctic when Rrs from only the blue and green bands are used. Therefore, other parts of the spectrum (e.g., the red) should be explored if one aims at quantifying interannual changes in chlorophyll in the Arctic from space. The very peculiar AOPs in the Beaufort Sea also advocate for developing specific light propagation models when attempting to predict light availability for photosynthesis at depth

Interseeded cover crops, soil health, and nitrogen supply for grain corn in Ontario

Non-Peer ReviewedInterseeded cover crops are a promising option for improving environmental sustainability in corn-based rotations. Field plots were established in 2015 under conventional tillage and regional corn N fertilization practices and repeated over two seasons at three sites in southern Ontario: Ridgetown, Elora, and Peterborough. The objectives were to evaluate the effects of interseeded annual ryegrass (ARG) and red clover (RCL) on grain corn yield and N uptake; soil mineral N (Nmin); and soil biological parameters. At each site, ARG, RCL, an ARG/RCl blend (MIX), and a no-cover control (BARE) were arranged in a RCBD replicated four times. The cover crops were seeded between the corn rows at the 5-leaf stage using an InterSeederTM drill. Cover crops accumulated 15 - 860 kg C ha-1 and 1.3 - 77 kg N ha-1 per season, and their yields were significantly correlated with soil microbial biomass, β-Glucosidase activity, and particulate organic matter. Community-level physiological profiling (BIOLOG EcoplatesTM) showed that microbial community diversity was significantly greater in ARG than BARE. Grain N concentration (10.8 - 11.2 g kg-1) and aboveground corn N uptake (100 - 154 kg ha-1) were not significantly reduced by cover crops at all sites. Although residual Nmin levels measured at grain corn harvest (0-30 cm) and the following spring (0-15 cm) were generally low (2.4 - 9.3 mg kg-1) at all sites, ARG had 48% lower Nmin than BARE. The effects of cover crops on soil health parameters, corn N uptake and Nmin were more affected by site and seasonal variability than by cover crop treatments. However, the results indicate the potential for improving soil health when there is successful establishment of interseeded annual ryegrass or red clover

High T(sub c) leads for remote sensing applications

Several NASA programs designed to monitor the Earth's atmosphere from space utilize infrared detectors which operate at or below 4.2 K for optimum performance. At present, the detectors are maintained at cryogenic temperatures by a stored volume of liquid helium. These detectors must be electrically linked to amplification electronics data storage instruments maintained at 80 K. The electrical connections over the temperature gradient account for approximately 20% of the total heat load on the Dewar for some systems, accelerating the boil-off of liquid helium cryogen and reducing the operational lifetime of the space-borne instruments. The recent discovery of high temperature superconductors has provided an opportunity to develop electrically conductive, thermally insulating links to bridge this thermal gradient. This paper describes the modelling of the thermal transport properties of thick film, high T(sub c) electrical bridges across a 4.2-80 K temperature gradient and the impact of such devices on a spaceborne remote sensing system

Optical Characterisation of Suspended Particles in the Mackenzie River Plume (Canadian Arctic Ocean) and Implications for Ocean Colour Remote Sensing

Climate change significantly impacts Arctic shelf regions in terms of air temperature, ultraviolet radiation, melting of sea ice, precipitation, thawing of permafrost and coastal erosion. Direct consequences have been observed on the increasing Arctic river flow and a large amount of organic carbon sequestered in soils at high latitudes since the last glacial maximum can be expected to be delivered to the Arctic Ocean during the coming decade. Monitoring the fluxes and fate of this terrigenous organic carbon is problematic in such sparsely populated regions unless remote sensing techniques can be developed and proved to be operational. The main objective of this study is to develop an ocean colour algorithm to operationally monitor dynamics of suspended particulate matter (SPM) on the Mackenzie River continental shelf (Canadian Arctic Ocean) using satellite imagery. The water optical properties are documented across the study area and related to concentrations of SPM and particulate organic carbon (POC). Robust SPM and POC : SPM proxies are identified, such as the light backscattering and attenuation coefficients, and relationships are established between these optical and biogeochemical parameters. Following a semi-analytical approach, a regional SPM quantification relationship is obtained for the inversion of the water reflectance signal into SPM concentration. This relationship is reproduced based on independent field optical measurements. It is successfully applied to a selection of MODIS satellite data which allow estimating fluxes at the river mouth and monitoring the extension and dynamics of the Mackenzie River surface plume in 2009, 2010 and 2011. Good agreement is obtained with field observations representative of the whole water column in the river delta zone where terrigenous SPM is mainly constrained (out of short periods of maximum river outflow). Most of the seaward export of SPM is observed to occur within the west side of the river mouth. Future work will require the validation of the developed SPM regional algorithm based on match-ups with field measurements, then the routine application to ocean colour satellite data in order to better estimate the fluxes and fate of SPM and POC delivered by the Mackenzie River to the Arctic Ocean