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

Heavy Quark Thermalization in Classical Lattice Gauge Theory: Lessons for Strongly-Coupled QCD

Thermalization of a heavy quark near rest is controlled by the correlator of two electric fields along a temporal Wilson line. We address this correlator within real-time, classical lattice Yang-Mills theory, and elaborate on the analogies that exist with the dynamics of hot QCD. In the weak-coupling limit, it can be shown analytically that the dynamics on the two sides are closely related to each other. For intermediate couplings, we carry out non-perturbative simulations within the classical theory, showing that the leading term in the weak-coupling expansion significantly underestimates the heavy quark thermalization rate. Our analytic and numerical results also yield a general understanding concerning the overall shape of the spectral function corresponding to the electric field correlator, which may be helpful in subsequent efforts to reconstruct it from Euclidean lattice Monte Carlo simulations.Comment: 22 pages. v2: a reference and clarifications added; published versio

Ciprofloxacin/amikacin combination therapy: evaluation in biofilms of Pseudomonas aeruginosa overproducting efflux pumps

International audienc

Transition from inspiral to plunge in precessing binaries of spinning black holes

We investigate the non-adiabatic dynamics of spinning black hole binaries by using an analytical Hamiltonian completed with a radiation-reaction force, containing spin couplings, which matches the known rates of energy and angular momentum losses on quasi-circular orbits. We consider both a straightforward post-Newtonian-expanded Hamiltonian (including spin-dependent terms), and a version of the resummed post-Newtonian Hamiltonian defined by the Effective One-Body approach. We focus on the influence of spin terms onto the dynamics and waveforms. We evaluate the energy and angular momentum released during the final stage of inspiral and plunge. For an equal-mass binary the energy released between 40Hz and the frequency beyond which our analytical treatment becomes unreliable is found to be, when using the more reliable Effective One-Body dynamics: 0.6% M for anti-aligned maximally spinning black holes, 5% M for aligned maximally spinning black hole, and 1.8% M for non-spinning configurations. In confirmation of previous results, we find that, for all binaries considered, the dimensionless rotation parameter J/E^2 is always smaller than unity at the end of the inspiral, so that a Kerr black hole can form right after the inspiral phase. By matching a quasi-normal mode ringdown to the last reliable stages of the plunge, we construct complete waveforms approximately describing the gravitational wave signal emitted by the entire process of coalescence of precessing binaries of spinning black holes.Comment: 31 pages, 7 tables, and 13 figure

Iron Displacements and Magnetoelastic Coupling in the Spin-Ladder Compound BaFe2Se3

We report long-range ordered antiferromagnetism concomitant with local iron displacements in the spin-ladder compound BaFe$_2$Se$_3$. Short-range magnetic correlations, present at room temperature, develop into long-range antiferromagnetic order below T$_N$ = 256 K, with no superconductivity down to 1.8 K. Built of ferromagnetic Fe$_4$ plaquettes, the magnetic ground state correlates with local displacements of the Fe atoms. These iron displacements imply significant magnetoelastic coupling in FeX$_4$-based materials, an ingredient hypothesized to be important in the emergence of superconductivity. This result also suggests that knowledge of these local displacements is essential for properly understanding the electronic structure of these systems. As with the copper oxide superconductors two decades ago, our results highlight the importance of reduced dimensionality spin ladder compounds in the study of the coupling of spin, charge, and atom positions in superconducting materials

In Situ Diazotroph Population Dynamics Under Different Resource Ratios in the North Pacific Subtropical Gyre.

Major advances in understanding the diversity, distribution, and activity of marine N2-fixing microorganisms (diazotrophs) have been made in the past decades, however, large gaps in knowledge remain about the environmental controls on growth and mortality rates. In order to measure diazotroph net growth rates and microzooplankton grazing rates on diazotrophs, nutrient perturbation experiments and dilution grazing experiments were conducted using free-floating in situ incubation arrays in the vicinity of Station ALOHA in March 2016. Net growth rates for targeted diazotroph taxa as well as Prochlorococcus, Synechococcus and photosynthetic picoeukaryotes were determined under high (H) and low (L) nitrate:phosphate (NP) ratio conditions at four depths in the photic zone (25, 45, 75, and 100 m) using quantitative PCR and flow cytometry. Changes in the prokaryote community composition in response to HNP and LNP treatments were characterized using 16S rRNA variable region tag sequencing. Microzooplankton grazing rates on diazotrophs were measured using a modified dilution technique at two depths in the photic zone (15 and 125 m). Net growth rates for most of the targeted diazotrophs after 48 h were not stimulated as expected by LNP conditions, rather enhanced growth rates were often measured in HNP treatments. Interestingly, net growth rates of the uncultivated prymnesiophyte symbiont UCYN-A1 were stimulated in HNP treatments at 75 and 100 m, suggesting that N used for growth was acquired through continuing to fix N2 in the presence of nitrate. Net growth rates for UCYN-A1, UCYN-C, Crocosphaera sp. (UCYN-B) and the diatom symbiont Richelia (associated with Rhizosolenia) were uniformly high at 45 m (up to 1.6 ± 0.5 d-1), implying that all were growing optimally at the onset of the experiment at that depth. Differences in microzooplankton grazing rates on UCYN-A1 and UCYN-C in 15 m waters indicate that the grazer assemblage preyed preferentially on UCYN-A1. Deeper in the water column (125 m), both diazotrophs were grazed at substantial rates, suggesting grazing pressure may increase with depth in the photic zone. Constraining in situ diazotroph growth and mortality rates are important steps for improving parameterization for diazotrophs in global ecosystem models