Characterising the health and social care segment of the BCS (The Chartered Institute for IT) membership and their continuing professional development needs.

Objectives: The aim of this study was to identify and characterise the health and social care membership of the British Computer Society (BCS), an international informatics professional organisation, and to determine their ongoing development needs. Methods: A prepiloted online survey included items on professional regulatory body, job role, work sector, qualifications, career stage, BCS membership (type, specialist group/branch activity (committees, event attendance)), use of BCS.org career planning/continuing professional development (CPD) tools, self-reported digital literacy and other professional registrations. The quantitative data were analysed using descriptive statistics in JASP V.0.9.2 to report frequencies and correlations. Results: Responses were received from 152 participants. Most were male (n=103; 68%), aged 50–59 years (n=41; 28%), working in England (n=107; 71%) with master’s or honours degrees (n=80; 53%). Most were either new (5 years or less; n=61; 40%) or long-term members (21 years or more; n=43; 28%) of BCS. Most were not interested in health specialist groups (n=57; 38%) preferring non-health specialist groups such as information management (n=54; 37%) and project management (n=52; 34%). Discussion: This is the first paper to characterise the health and social care membership of an IT-focused professional body and to start to determine their CPD needs. There are further challenges ahead in curating the content and delivery. Conclusion: This study is the starting point from which members’ CPD needs, and ongoing interest, in being recognised as health and social care professional members, can be acknowledged and explored. Further research is planned with the participants who volunteered to be part of designing future CPD content and delivery

Characterising the health and social care segment of the BCS (The Chartered Institute for IT) membership and their continuing professional development needs

OBJECTIVES: The aim of this study was to identify and characterise the health and social care membership of the British Computer Society (BCS), an international informatics professional organisation, and to determine their ongoing development needs. METHODS: A prepiloted online survey included items on professional regulatory body, job role, work sector, qualifications, career stage, BCS membership (type, specialist group/branch activity (committees, event attendance)), use of BCS.org career planning/continuing professional development (CPD) tools, self-reported digital literacy and other professional registrations. The quantitative data were analysed using descriptive statistics in JASP V.0.9.2 to report frequencies and correlations. RESULTS: Responses were received from 152 participants. Most were male (n=103; 68%), aged 50–59 years (n=41; 28%), working in England (n=107; 71%) with master’s or honours degrees (n=80; 53%). Most were either new (5 years or less; n=61; 40%) or long-term members (21 years or more; n=43; 28%) of BCS. Most were not interested in health specialist groups (n=57; 38%) preferring non-health specialist groups such as information management (n=54; 37%) and project management (n=52; 34%). DISCUSSION: This is the first paper to characterise the health and social care membership of an IT-focused professional body and to start to determine their CPD needs. There are further challenges ahead in curating the content and delivery. CONCLUSION: This study is the starting point from which members’ CPD needs, and ongoing interest, in being recognised as health and social care professional members, can be acknowledged and explored. Further research is planned with the participants who volunteered to be part of designing future CPD content and delivery

Consumers\u27 Perceptions of Patient-Accessible Electronic Medical Records

Background: Electronic health information (eHealth) tools for patients, including patient-accessible electronic medical records (patient portals), are proliferating in health care delivery systems nationally. However, there has been very limited study of the perceived utility and functionality of portals, as well as limited assessment of these systems by vulnerable (low education level, racial/ethnic minority) consumers. Objective: The objective of the study was to identify vulnerable consumers’ response to patient portals, their perceived utility and value, as well as their reactions to specific portal functions. Methods: This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June and July 2010, in New York City. Results: Participants included 10 males and 18 females, ranging in age from 21-63 years; 19 non-Hispanic black, 7 Hispanic, 1 non-Hispanic White and 1 Other. None of the participants had higher than a high school level education, and 13 had less than a high school education. All participants had experience with computers and 26 used the Internet. Major themes were enhanced consumer engagement/patient empowerment, extending the doctor’s visit/enhancing communication with health care providers, literacy and health literacy factors, improved prevention and health maintenance, and privacy and security concerns. Consumers were also asked to comment on a number of key portal features. Consumers were most positive about features that increased convenience, such as making appointments and refilling prescriptions. Consumers raised concerns about a number of potential barriers to usage, such as complex language, complex visual layouts, and poor usability features. Conclusions: Most consumers were enthusiastic about patient portals and perceived that they had great utility and value. Study findings suggest that for patient portals to be effective for all consumers, portals must be designed to be easy to read, visually engaging, and have user-friendly navigation

Exploring the Intersection of Culture and Education in Nunavik

During the last century, Nunavik’s Inuit population has experienced social transformations which have manifested themselves in a range of social issues. Nunavik lies north of the 55th parallel in Quebec, Canada and is one of four regions in Canada that comprise Inuit Nunaat (Inuvialuit, Nunatsiavut, Nunavik, and Nunavut) – Inuit homeland. The Inuit are one of three distinct Indigenous groups in Canada as defined by the Constitution Act, 1982, with distinct cultural heritage and language. Community Capability and Development in Nunavik, a collaborative project between McGill School of Social Work researchers and an Advisory Committee composed of representatives from key Inuit institutions, explored social issues and community assets in Nunavik. This study sought to (a) provide a forum for community members to voice issues important to them; (b) inform policy development prior to the vote on regional government; and (c) increase the growth of community linkages that support research dissemination via a network of researchers, community members and organizations

Estimating State-Specific Contributions to PM2.5- and O3-Related Health Burden from Residential Combustion and Electricity Generating Unit Emissions in the United States

BACKGROUND: Residential combustion (RC) and electricity generating unit (EGU) emissions adversely impact air quality and human health by increasing ambient concentrations of fine particulate matter (PM2.5) and ozone (O3). Studies to date have not isolated contributing emissions by state of origin (source-state), which is necessary for policy makers to determine efficient strategies to decrease health impacts. OBJECTIVES: In this study, we aimed to estimate health impacts (premature mortalities) attributable to PM2.5 and O3 from RC and EGU emissions by precursor species, source sector, and source-state in the continental United States for 2005. METHODS: We used the Community Multiscale Air Quality model employing the decoupled direct method to quantify changes in air quality and epidemiological evidence to determine concentration-response functions to calculate associated health impacts. RESULTS: We estimated 21,000 premature mortalities per year from EGU emissions, driven by sulfur dioxide emissions forming PM2.5. More than half of EGU health impacts are attributable to emissions from eight states with significant coal combustion and large downwind populations. We estimate 10,000 premature mortalities per year from RC emissions, driven by primary PM2.5 emissions. States with large populations and significant residential wood combustion dominate RC health impacts. Annual mortality risk per thousand tons of precursor emissions (health damage functions) varied significantly across source-states for both source sectors and all precursor pollutants. CONCLUSIONS: Our findings reinforce the importance of pollutant-specific, location-specific, and source-specific models of health impacts in design of health-risk minimizing emissions control policies. Citation: Penn SL, Arunachalam S, Woody M, Heiger-Bernays W, Tripodis Y, Levy JI. 2017. Estimating state-specific contributions to PM2.5- and O3-related health burden from residential combustion and electricity generating unit emissions in the United States. Environ Health Perspect 125:324-332; http://dx.doi.org/10.1289/EHP550

HSD3B1 genotype identifies glucocorticoid responsiveness in severe asthma

Asthma resistance to glucocorticoid treatment is a major health problem with unclear etiology. Glucocorticoids inhibit adrenal androgen production. However, androgens have potential benefits in asthma. HSD3B1 encodes for 3β-hydroxysteroid dehydrogenase-1 (3β-HSD1), which catalyzes peripheral conversion from adrenal dehydroepiandrosterone (DHEA) to potent androgens and has a germline missense-encoding polymorphism. The adrenal restrictive HSD3B1(1245A) allele limits conversion, whereas the adrenal permissive HSD3B1(1245C) allele increases DHEA metabolism to potent androgens. In the Severe Asthma Research Program (SARP) III cohort, we determined the association between DHEA-sulfate and percentage predicted forced expiratory volume in 1 s (FEV1PP). HSD3B1(1245) genotypes were assessed, and association between adrenal restrictive and adrenal permissive alleles and FEV1PP in patients with (GC) and without (noGC) daily oral glucocorticoid treatment was determined (n = 318). Validation was performed in a second cohort (SARP I&II; n = 184). DHEA-sulfate is associated with FEV1PP and is suppressed with GC treatment. GC patients homozygous for the adrenal restrictive genotype have lower FEV1PP compared with noGC patients (54.3% vs. 75.1%; P < 0.001). In patients with the homozygous adrenal permissive genotype, there was no FEV1PP difference in GC vs. noGC patients (73.4% vs. 78.9%; P = 0.39). Results were independently confirmed: FEV1PP for homozygous adrenal restrictive genotype in GC vs. noGC is 49.8 vs. 63.4 (P < 0.001), and for homozygous adrenal permissive genotype, it is 66.7 vs. 67.7 (P = 0.92). The adrenal restrictive HSD3B1(1245) genotype is associated with GC resistance. This effect appears to be driven by GC suppression of 3β-HSD1 substrate. Our results suggest opportunities for prediction of GC resistance and pharmacologic intervention

Clinically recognizable error rate after the transfer of comprehensive chromosomal screened euploid embryos is low

ObjectiveTo determine the clinically recognizable error rate with the use of quantitative polymerase chain reaction (qPCR)–based comprehensive chromosomal screening (CCS).DesignRetrospective study.SettingMultiple fertility centers.Patient(s)All patients receiving euploid designated embryos.Intervention(s)Trophectoderm biopsy for CCS.Main Outcome Measure(s)Evaluation of the pregnancy outcomes following the transfer of qPCR-designated euploid embryos. Calculation of the clinically recognizable error rate.Result(s)A total of 3,168 transfers led to 2,354 pregnancies (74.3%). Of 4,794 CCS euploid embryos transferred, 2,976 gestational sacs developed, reflecting a clinical implantation rate of 62.1%. In the cases where a miscarriage occurred and products of conception were available for analysis, ten were ultimately found to be aneuploid. Seven were identified in the products of conception following clinical losses and three in ongoing pregnancies. The clinically recognizable error rate per embryo designated as euploid was 0.21% (95% confidence interval [CI] 0.10–0.37). The clinically recognizable error rate per transfer was 0.32% (95% CI 0.16–0.56). The clinically recognizable error rate per ongoing pregnancy was 0.13% (95% CI 0.03–0.37). Three products of conception from aneuploid losses were available to the molecular laboratory for detailed examination, and all of them demonstrated fetal mosaicism.Conclusion(s)The clinically recognizable error rate with qPCR-based CCS is real but quite low. Although evaluated in only a limited number of specimens, mosaicism appears to play a prominent role in misdiagnoses. Mosaic errors present a genuine limit to the effectiveness of aneuploidy screening, because they are not attributable to technical issues in the embryology or analytic laboratories

Efficacy and Safety of Lenabasum, a Cannabinoid Type 2 Receptor Agonist, in a Phase 3 Randomized Trial in Diffuse Cutaneous Systemic Sclerosis

INTRODUCTION: Efficacy and safety of lenabasum, a cannabinoid type 2-receptor agonist, was tested in a Phase 3 study in patients with diffuse cutaneous systemic sclerosis (dcSSc). METHODS: A multi-national double-blind study was conducted in 365 dcSSc patients who were randomized and dosed 1:1:1 with lenabasum 20 mg, lenabasum 5 mg, or placebo, each twice daily and added to background treatments including immunosuppressive therapies (IST). RESULTS: The primary endpoint, ACR Combined Response Index in dcSSc (ACR-CRISS) score at Week 52, lenabasum 20 mg BID versus placebo, was not met, with ACR-CRISS scores of 0.888 versus 0.887, P = 0.4972, mixed models repeated measures (MMRM). Change in modified Rodnan Skin Score (mRSS) at Week 52 was -6.7 versus -8.1 points for lenabasum 20 mg BID versus placebo, P = 0.1183, MMRM. Pre-specified analyses showed higher ACR-CRISS scores, greater improvement in mRSS, and less decline in forced vital capacity in subjects on background mycophenolate and those receiving IST for ≤ 1 year duration. No deaths or excess in serious or severe adverse events related to lenabasum were observed. CONCLUSIONS: A benefit of lenabasum in dcSSc was not demonstrated. The majority of patients were treated with background IST, and treatment with MMF in particular was associated with better outcomes. This supports the use of IST in the treatment of dcSSc, and highlights the challenge of demonstrating a treatment effect when investigational treatment is added to standard of care IST. These findings have relevance to trial design in SSc, as well as clinical care