Survey of HIE Leaders: Assessment of HIE Research Participation and Perceptions

Introduction: Health information exchanges (HIEs) allow for healthcare providers to effectively and securely access patient information from various healthcare networks. Some HIEs have acknowledged the important role they can play in research, however, this is not standard practice despite recognition that availability of research and outcomes data is a main limitation to evidence-based practice. Methods: We created an electronic survey in collaboration with Health Share Exchange (an HIE in Philadelphia) with the aim of assessing HIE leader perceptions regarding the importance of and barriers to participation in research. The survey was disseminated via a Strategic Health Information Exchange Collaborative (the national association for HIEs) listserv that encompasses 70 HIEs in 49 states. Results: Leaders of HIEs from Philadelphia, Georgia, Colorado, and Michigan responded to our survey (n = 4). All HIEs represented in this survey either participate in research currently or indicated an interest in participating in research, and all noted that they face barriers to participating in research, including (but not limited to) legal concerns, logistical barriers to sharing data, and reluctance from clients to allow sharing of data for research purposes. HIEs that indicated the need for assistance with research participation noted that legal and policy-related support is needed to improve research participation. Conclusions: The HIEs that participated in our survey indicated that although they are interested in participating in research, there are legal and logistical barriers that prevent them from doing so. Future work should survey additional HIEs across the U.S. and discuss solutions to the barriers acknowledged in this work

Overcoming capacity gaps in fecal sludge management through education and training

2.7 billion people around the world are in need of Fecal Sludge Management (FSM) services, and this number is expected to rise to 4.9 billion by 2030. Key FSM challenges include the gap in knowledge related to the science behind FSM, the lack of skills and experience in viable implementation models, and the absence of policy to ensure an enabling environment. The Centre for Affordable Water and Sanitation Technologies (CAWST) is working toward filling the capacity gaps in FSM through developing and delivering education and training activities to sanitation implementers. This paper describes the systematic program development process that CAWST undertook to plan and develop the education materials, pilot the FSM workshop to sanitation implementers in Nepal, and use the feedback to improve and finalize the education materials. Results and feedback from the pilot workshop are discussed, and next steps are explained

A Turtle Population Study in an Isolated Urban Wetland Complex in Ontario Reveals a Few Surprises

We report on the results of the first mark–recapture survey of freshwater turtles in an isolated urban wetland complex in one of Canada’s fastest growing municipalities. Although we found turtles in every surveyed wetland, the density and assemblage of turtles in smaller wetlands were significantly different than in larger wetland bodies. We also documented two species of turtles that were thought to be absent from this wetland complex, the Northern Map turtle and Eastern Musk turtle. We noted that a wetland that was bisected by a high-traffic road showed a male-skewed sex ratio in the population of Midland Painted turtles but not in the population of Eastern Snapping turtles. As a whole, the sex ratios inside the wetland complex were not skewed. These results reinforce the conclusions of a previous study of a single wetland within this same complex that had found a correlation between road mortality and a male-skewed sex ratio in Midland painted turtles. We discuss population sources and sinks within the complex and the importance of protecting the overland corridors that support the safe turtle movements within this provincially significant wetland complex.York University Librarie

Training on WASH in the transition from emergency to development in earthquake affected areas of Nepal

The magnitude 7.8 earthquake that struck Nepal in April 2015 caused extensive damage to water and sanitation networks, resulting in a high risk of negative health impacts from diarrhoeal diseases. In response to the disaster, the Environment and Public Health Organization (ENPHO) collaborated with the Centre for Affordable Water and Sanitation Technology (CAWST), to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training focused on acute response, and the second focused on longer term recovery. Using these programs, ENPHO trained over 470 community volunteers during the acute phase and has since trained another 226 volunteers during the recovery phase. Through training these volunteers, ENPHO has reached many communities, providing services in 11 of 14 earthquake-affected districts. CAWST plans to assess the feasibility of decontextualizing the training and support materials so they can be widely disseminated and used in the emergencies

Principles of Hypotensive Shock: A Video Introduction to Pathophysiology and Treatment Strategies

Audience: Emergency medicine interns, medical students, and mid-level providers (physician assistants, nurse practitioners). Introduction: Shock is defined as a state of global tissue hypoxia and is typically the result of hypotension and circulatory system failure. A variety of disease states may ultimately culminate in hypotensive shock through one or more generally recognized mechanisms – hypovolemic, cardiogenic, obstructive, and/or distributive shock. These mechanisms differ significantly in terms of their pathophysiology and requisite treatment. While the effects of hypotensive shock are initially reversible, untreated hypotensive shock may rapidly progress to multiorgan failure and death. Hence, the ability to promptly recognize a state of hypotensive shock, identify the underlying mechanism, and administer appropriate therapies are skills required of those caring for critically ill patients. The evaluation of hypotensive shock in the Emergency Department is relatively commonplace. Mortality rates associated with shock are high, ranging from 22.6% - 56.2%, depending upon the underlying etiology.3 For these reasons, the authors believe that a web-based learning module addressing topics related to hypotensive shock would be beneficial to healthcare professionals who are likely to encounter it in clinical practice. The web-based nature of the module would lend itself to convenient viewing and would allow for utilization as a just-in-time training modality. Presenting these topics in an animated format may also be a useful way of displaying the complex nature of cardiovascular physiology. Educational Objectives: By the end of this module, participants should be able to: 1) Review basic principles of cardiovascular physiology 2) Describe the four general pathophysiologic mechanisms of hypotensive shock 3) Recognize various etiologies for each mechanism of hypotensive shock 4) Recognize differences in the clinical presentation of each mechanism of hypotensive shoc

Improving Site-Specific STI Screening in a Philadelphia-Based Academic Family Medicine Office

Background In the last decade, rates of sexually transmitted infections (STIs) are rising both in Philadelphia and across the United States1, 2 STIs are often asymptomatic3 Site-specific screening for gonorrhea and chlamydia (GC/CT) infections may increase STI detection o Genitourinary (GU), pharyngeal, and rectal sites o GU is the most common site tested, but GU-only testing may lead to missed diagnoses

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale

OBJECTIVE: To assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient. DESIGN: Participants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Interrater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use. SETTING: Web-based survey. PARTICIPANTS: Respondents (N=170) from 29 countries. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Consensual validity (percent agreement and Kendall tau), criterion validity (Spearman rank correlation), and interrater reliability (Kendall concordance and intraclass coefficients). RESULTS: The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed strong consensual validity, criterion validity, and interrater reliability. Scenarios involving liquid-only diets, transition from nonoral feeding, or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed greater sensitivity than the FOIS to specific changes in diet. Most (\u3e70%) respondents indicated enthusiasm for implementing the International Dysphagia Diet Standardisation Initiative Functional Diet Scale. CONCLUSIONS: This initial validation study suggests that the International Dysphagia Diet Standardisation Initiative Functional Diet Scale has strong consensual and criterion validity and can be used reliably by clinicians to capture diet texture restriction and progression in people with dysphagia

Update on the Preliminary Design of SCALES: the Santa Cruz Array of Lenslets for Exoplanet Spectroscopy

SCALES (Santa Cruz Array of Lenslets for Exoplanet Spectroscopy) is a 2-5 micron high-contrast lenslet integral-field spectrograph (IFS) driven by exoplanet characterization science requirements and will operate at W. M. Keck Observatory. Its fully cryogenic optical train uses a custom silicon lenslet array, selectable coronagraphs, and dispersive prisms to carry out integral field spectroscopy over a 2.2 arcsec field of view at Keck with low ($<300$) spectral resolution. A small, dedicated section of the lenslet array feeds an image slicer module that allows for medium spectral resolution ($5000-10 000$), which has not been available at the diffraction limit with a coronagraphic instrument before. Unlike previous IFS exoplanet instruments, SCALES is capable of characterizing cold exoplanet and brown dwarf atmospheres ($<600$ K) at bandpasses where these bodies emit most of their radiation while capturing relevant molecular spectral features.Comment: 24 pages, 13 figures, SPIE Astronomical Instruments and Telescopes 2020 conferenc