Progress Along the Pathway for Transforming Regional Health: A Pulse Check on Multi-Sector Partnerships

Multi-sector partnerships play an increasingly significant role in the movement to improve heath, equity, and economic prosperity. These partnerships recognize that many of our most pressing challenges defy sector boundaries, and cannot be effectively addressed by any one institution alone. Progress Along the Pathway to Health System Transformation: A Pulse Check on Multi-Sector Partnerships is the only survey of its kind to ask leaders across the U.S. what their partnerships do, how they finance their work, and how their groups have been developing over time. The 2016 Pulse Check report provides a snapshot of 237 multi-sector partnerships throughout the country as well as rich detail around what contributes to—or gets in the way of—moving their important work forward. The survey revealed two sets of findings that are distinct, but closely related. These include characteristics of the partnerships and their efforts, such as composition, portfolio priorities, and financing; as well as developmental phases and the distinctive patterns of momentum builders and pitfalls that groups experience as they evolve. Further, ReThink Health has found that partnerships often face predictable challenges and can catalyze momentum in particularly powerful ways. The Pulse Check explored these barriers and drivers with a view toward understanding how partnerships may evolve along their journey. Pulse Check findings indicate that certain partnership characteristics do indeed show progressive differences across developmental phases (see graphic below). For instance, when compared to respondents in the Earlier and Middle phases, those in the Later phase tend to have partnerships that are more established, with larger staffs, a larger number active sectors, more expansive action portfolios, and longer-term financial plans

Designing a solution to enable agency-academic scientific collaboration for disasters

© The Author(s), 2017. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Ecology and Society 22 (2017): 18, doi:10.5751/ES-09246-220218.As large-scale environmental disasters become increasingly frequent and more severe globally, people and organizations that prepare for and respond to these crises need efficient and effective ways to integrate sound science into their decision making. Experience has shown that integrating nongovernmental scientific expertise into disaster decision making can improve the quality of the response, and is most effective if the integration occurs before, during, and after a crisis, not just during a crisis. However, collaboration between academic, government, and industry scientists, decision makers, and responders is frequently difficult because of cultural differences, misaligned incentives, time pressures, and legal constraints. Our study addressed this challenge by using the Deep Change Method, a design methodology developed by Stanford ChangeLabs, which combines human-centered design, systems analysis, and behavioral psychology. We investigated underlying needs and motivations of government agency staff and academic scientists, mapped the root causes underlying the relationship failures between these two communities based on their experiences, and identified leverage points for shifting deeply rooted perceptions that impede collaboration. We found that building trust and creating mutual value between multiple stakeholders before crises occur is likely to increase the effectiveness of problem solving. We propose a solution, the Science Action Network, which is designed to address barriers to scientific collaboration by providing new mechanisms to build and improve trust and communication between government administrators and scientists, industry representatives, and academic scientists. The Science Action Network has the potential to ensure cross-disaster preparedness and science-based decision making through novel partnerships and scientific coordination.The authors thank the David and Lucile Packard Foundation for a grant to undertake this project and enable participation of a wide range of participants and interviewees. We thank the Center for Ocean Solutions and ChangeLabs for their oversight and support

The Maunakea Spectroscopic Explorer Book 2018

(Abridged) This is the Maunakea Spectroscopic Explorer 2018 book. It is intended as a concise reference guide to all aspects of the scientific and technical design of MSE, for the international astronomy and engineering communities, and related agencies. The current version is a status report of MSE's science goals and their practical implementation, following the System Conceptual Design Review, held in January 2018. MSE is a planned 10-m class, wide-field, optical and near-infrared facility, designed to enable transformative science, while filling a critical missing gap in the emerging international network of large-scale astronomical facilities. MSE is completely dedicated to multi-object spectroscopy of samples of between thousands and millions of astrophysical objects. It will lead the world in this arena, due to its unique design capabilities: it will boast a large (11.25 m) aperture and wide (1.52 sq. degree) field of view; it will have the capabilities to observe at a wide range of spectral resolutions, from R2500 to R40,000, with massive multiplexing (4332 spectra per exposure, with all spectral resolutions available at all times), and an on-target observing efficiency of more than 80%. MSE will unveil the composition and dynamics of the faint Universe and is designed to excel at precision studies of faint astrophysical phenomena. It will also provide critical follow-up for multi-wavelength imaging surveys, such as those of the Large Synoptic Survey Telescope, Gaia, Euclid, the Wide Field Infrared Survey Telescope, the Square Kilometre Array, and the Next Generation Very Large Array.Comment: 5 chapters, 160 pages, 107 figure

Delivery of an Ebola Virus-Positive Stillborn Infant in a Rural Community Health Center, Sierra Leone, 2015.

We report the case of an Ebola virus (EBOV) RNA-negative pregnant woman who delivered an EBOV RNA-positive stillborn infant at a community health center in rural Sierra Leone, 1 month after the mother's last possible exposure. The mother was later found to be immunoglobulins M and G positive indicating previous infection. The apparent absence of Ebola symptoms and not recognizing that the woman had previous contact with an Ebola patient led health workers performing the delivery to wear only minimal personal protection, potentially exposing them to a high risk of EBOV infection. This case emphasizes the importance of screening for epidemiological risk factors as well as classic and atypical symptoms of Ebola when caring for pregnant women, even once they have passed the typical time frame for exposure and incubation expected in nonpregnant adults. It also illustrates the need for health-care workers to use appropriate personal protection equipment when caring for pregnant women in an Ebola setting

Destructive leadership: Causes, consequences and countermeasures

In 2010, David Matsuda, an anthropology professor, was asked to study why almost 30 U.S. soldiers in Iraq had committed or attempted suicide in the past year. His investigation showed that while those soldiers often had major problems in their personal lives, the victims also had in common at least one leader (sometimes a couple of leaders) who made their lives hell. While the evidence did not show that the soldiers’ leaders directly caused them to commit or attempt suicide, it did support the notion that the leaders who had made their lives hell had helped to push them over the brink. It was this finding that forced the U.S. military to confront the problem of “toxic” leadership in the army.Full Tex

Oral Syringe Training Animals: Indiscriminable and Discriminable Punishment Contingencies

Animals are commonly trained to perform behaviors during routine husbandry procedures. However, some husbandry procedures have aversive consequences when the real procedure is performed. This commonly results in loss of the trained behavior. The present study assessed whether maintaining the antecedent environmental stimulus conditions between appetitive and aversive outcomes would prevent this effect and, conversely, whether adding a stimulus discrepancy would facilitate this effect. Three domestic rats served as participants in a multiple baseline across participants design with multi-element components. All three rats stopped performing a trained behavior when a discrepant stimulus reliably predicted an aversive outcome. In addition, all three rats continued to perform the same behavior when antecedent environmental stimulus conditions were consistent between aversive and appetitive outcomes. Results are discussed in terms of practical implications for behavior change agents and conceptual implications for learning theory

2021 Pulse Check on Shared Stewardship for Thriving Together Across America

What will it take to live up to our potential to be good stewards of an equitable and thriving future? The 2021 Pulse Check on Shared Stewardship for Thriving Together Across America surveyed more than three hundred leaders who are well-positioned to act as stewards in communities across the U.S. The results track the diffusion of shared stewardship and explore the extent to which the values, priorities, and practices of stewardship are taking hold nationwide.Fielded from October 2020 to July 2021, during the COVID-19 pandemic, the survey provides rare and timely insights about stewarding well-being in a period of significant threat and opportunity. The 2021 Pulse Check was led by ReThink Health, the flagship initiative of the Rippel Foundation, in partnership with the RAND Corporation and funded by the Robert Wood Johnson Foundation and Rippel. It sought to learn:To what extent do changemakers across America endorse stewardship values?What are their priorities for investment and action?How fully are stewardship practices incorporated as organizational norms?What kinds of obstacles and momentum builders are shaping the path forward

The Prevalence of Vitamin D Deficiency Is Similar between Thyroid Nodule and Thyroid Cancer Patients

Introduction. There are reported associations between vitamin D deficiency and breast, prostate, and colon cancer, but the relationship in thyroid cancer has not been evaluated. Methods. We evaluated serum calcium, creatinine, albumin, and 25-hydroxy vitamin D (25-OH-D) in 42 thyroid nodule, 45 thyroid cancer in remission, and 24 active thyroid cancer patients. Results. 25-OH-D was not different between groups. The percent with 25-OH-D levels <75 nmol/L was not significantly different between groups and was not affected by season of measurement, age, or cancer stage. Multivariate regression showed a BMI of ≥30 kg/m2 to be the only significant predictor of vitamin D deficiency. Conclusions. Rates of vitamin D deficiency are similar in thyroid nodules and thyroid cancer, although higher than the general population. This is different than previous studies for other cancers, which show higher rates of vitamin D deficiency. BMI was the only predictor of vitamin D deficiency

Measurements of daily energy intake and total energy expenditure in people with dementia in care homes: the use of wearable technology.

Objectives: To estimate daily total energy expenditure (TEE) using a physical activity monitor, combined with dietary assessment of energy intake to assess the relationship between daily energy expenditure and patterns of activity with energy intake in people with dementia living in care homes. Design and setting: A cross-sectional study in care homes in the UK. Participants: Twenty residents with confirmed dementia diagnosis were recruited from two care homes that specialised in dementia care. Measurements: A physical activity monitor (Sensewear TM Armband , Body Media, Pittsburgh, PA) was employed to objectively determine total energy expenditure, sleep duration and physical activity. The armband was placed around the left upper triceps for up to 7 days. Energy intake was determined by weighing all food and drink items over 4 days (3 weekdays and 1 weekend day) including measurements of food wastage. Results: The mean age was 78.7 (SD ± 11.8) years, Body Mass Index (BMI) 23.0 (SD ± 4.2) kg/m2 ; 50% were women. Energy intake (mean 7.4; SD ± 2.6) MJ/d) was correlated with TEE (mean 7.6; SD ± 1.8 MJ/d; r=0.49, p<0.05). Duration of sleeping ranged from 0.4-12.5 (mean 6.1) hrs/d and time spent lying down was 1.3-16.0 (8.3) hrs/d. On average residents spent 17.9 (6.3-23.4) hrs/d undertaking sedentary activity. TEE was correlated with BMI (r=0.52, p<0.05) and body weight (r=0.81, p<0.001) but inversely related to sleep duration (r=-0.59, p<0.01) and time lying down (r=-0.62, p<0.01). Multiple linear regression analysis revealed that after taking BMI, sleep duration and time spent lying down into account, TEE was no longer correlated with energy intake. Conclusions: The results show the extent to which body mass, variable activity and sleep patterns may be contributing to TEE and together with reduced energy intake, energy requirements were not satisfied. Thus wearable technology has the potential to offer real-time monitoring to provide appropriate nutrition management that is more person-centred to prevent weight loss in dementi