Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey

OBJECTIVE: To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce. DESIGN: Cross-sectional study. SETTING: US local and state health agencies. PARTICIPANTS: Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, "information technology specialist or information system manager" (IT/IS), "public health science" (PHS), and "clinical and laboratory" workers. MAIN OUTCOME MEASURE: Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs. RESULTS: A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills. CONCLUSIONS: The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce

Spoken Communication

This Grants Collection uses the grant-supported open course Spoken Communication from Clayton State University: http://clayton.libguides.com/SpokenCommunication This Grants Collection for Spoken Communication was created under a Round Three ALG Textbook Transformation Grant. Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process. Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials: Linked Syllabus Initial Proposal Final Reporthttps://oer.galileo.usg.edu/communication-collections/1001/thumbnail.jp

Amorphous oxide semiconductors in circuit applications

The focus of this thesis is the investigation of thin-film transistors (TFTs) based on amorphous oxide semiconductors (AOSs) in two circuit applications. To date, circuits implemented with AOS-based TFTs have been primarily enhancement-enhancement inverters, ring oscillators based on these inverters operating at peak frequencies up to ~400 kHz, and two-transistor one-capacitor pixel driving circuits for use with organic light-emitting diodes (OLEDS). The first application investigated herein is AC/DC rectification using two circuit configurations based on staggered bottom-gate TFTs employing indium gallium oxide (IGO) as the active channel layer; a traditional full bridge rectifier with diode-tied transistors and a cross-tied full-wave rectifier are demonstrated, which is analogous to what has been reported previously using p-type organic TFTs. Both circuit configurations are found to operate successfully up to at least 20 MHz; this is believed to be the highest reported operating frequency to date for circuits based on amorphous oxide semiconductors. Output voltages at one megahertz are 9 V and ~10.5 V, respectively, when driven with a differential 7.07 Vrms sine wave. This performance is superior to that of previously reported organic-based rectifiers. The second AOS-based TFT circuit application investigated is an enhancement-depletion (E-D) inverter based on heterogeneous channel materials. Simulation results using models based on a depletion-mode indium zinc oxide (IZO) TFT and an enhancement-mode IGO TFT result in a gain of ~15. Gains of other oxide-based inverters have been limited to less than 2; the large gain of the E-D inverter makes it well suited for digital logic applications. Deposition parameters for the IGO and IZO active layers are optimized to match the models used in simulation by fabricating TFTs on thermally oxidized silicon and patterned via shadow masks. Integrated IGO-based TFTs exhibit a similar turn-on voltage and decreased mobility compared to the shadow masked TFTs. However, the integrated IZO-based TFTs fabricated to date are found to be conductive and exhibit no gate modulation. Due to the conductive nature of the load, the fabricated E-D inverter shows no significant output voltage variation. This discrepancy in performance between the integrated and shadow-masked IZO devices is attributed to processing complications

BarraCUDA - a fast short read sequence aligner using graphics processing units

Abstract Background With the maturation of next-generation DNA sequencing (NGS) technologies, the throughput of DNA sequencing reads has soared to over 600 gigabases from a single instrument run. General purpose computing on graphics processing units (GPGPU), extracts the computing power from hundreds of parallel stream processors within graphics processing cores and provides a cost-effective and energy efficient alternative to traditional high-performance computing (HPC) clusters. In this article, we describe the implementation of BarraCUDA, a GPGPU sequence alignment software that is based on BWA, to accelerate the alignment of sequencing reads generated by these instruments to a reference DNA sequence. Findings Using the NVIDIA Compute Unified Device Architecture (CUDA) software development environment, we ported the most computational-intensive alignment component of BWA to GPU to take advantage of the massive parallelism. As a result, BarraCUDA offers a magnitude of performance boost in alignment throughput when compared to a CPU core while delivering the same level of alignment fidelity. The software is also capable of supporting multiple CUDA devices in parallel to further accelerate the alignment throughput. Conclusions BarraCUDA is designed to take advantage of the parallelism of GPU to accelerate the alignment of millions of sequencing reads generated by NGS instruments. By doing this, we could, at least in part streamline the current bioinformatics pipeline such that the wider scientific community could benefit from the sequencing technology. BarraCUDA is currently available from http://seqbarracuda.sf.netRIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Characterizing Informatics Roles and Needs of Public Health Workers: Results from the Public Health Workforce Interests and Needs Survey

Objective: To characterize public health workers who specialize in informatics and to assess informatics-related aspects of the work performed by the public health workforce. Methods (Design, Setting, Participants): Using the nationally representative Public Health Workforce Interests and Needs Survey (PH WINS), we characterized and compared responses from informatics, information technology (IT), clinical and laboratory, and other public health science specialists working in state health agencies. Main Outcome Measures: Demographics, income, education, and agency size were analyzed using descriptive statistics. Weighted medians and interquartile ranges were calculated for responses pertaining to job satisfaction, workplace environment, training needs, and informatics-related competencies. Results: Of 10 246 state health workers, we identified 137 (1.3%) informatics specialists and 419 (4.1%) IT specialists. Overall, informatics specialists are younger, but share many common traits with other public health science roles, including positive attitudes toward their contributions to the mission of public health as well as job satisfaction. Informatics specialists differ demographically from IT specialists, and the 2 groups also differ with respect to salary as well as their distribution across agencies of varying size. All groups identified unmet public health and informatics competency needs, particularly limited training necessary to fully utilize technology for their work. Moreover, all groups indicated a need for greater future emphasis on leveraging electronic health information for public health functions. Conclusions: Findings from the PH WINS establish a framework and baseline measurements that can be leveraged to routinely monitor and evaluate the ineludible expansion and maturation of the public health informatics workforce and can also support assessment of the growth and evolution of informatics training needs for the broader field. Ultimately, such routine evaluations have the potential to guide local and national informatics workforce development policy

Health communication and adolescents: What do their emails tell us?

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Family Practice following peer review. The definitive publisher-authenticated version Brown, B.J. et al (2008) Health communication and adolescents: What do their emails tell us? Family Practice, 25, pp.304-311. is available online at: http://dx.doi.org/10.1093/fampra/cmn029Background. It is widely known that barriers exist in communication between adolescents and health professionals. However, little is known about the actual language used by young people articulating such difficulties and whether email might allow them to overcome these problems. Objectives. The aims of this study were to investigate concerns and difficulties relating to communication among adolescents seeking online health advice. Methods. The study design was a corpus linguistic analysis of a million-word adolescent health email database based on 62 794 emails from young people requesting health advice from a prominent UK-hosted and doctor-led website. Results. Young people reported various concerns about their health. They described numerous difficulties in disclosing such concerns to other people, in particular to parents and doctors. However, they readily expressed their concerns by email, displaying elevated levels of directness, particularly in relation to potentially sensitive or embarrassing topics. Conclusion. Email has the potential to facilitate and supplement face-to-face consultations with health professionals. Increased adoption of email by health providers may be an efficient means of engaging with a generation often reluctant to access more traditional health care services and thus encourage them to enter the primary care setting more readily

Investigating the Etiology of Sour Knuckles in Postchilled Beef Carcasses

Development of sourness in beef round muscle cuts, such as knuckles, has been a long-standing issue in the beef industry with little characterization. Therefore, the objective of this study was to investigate and characterize the sour odor associated with beef knuckles using sensory, analytical (gas chromatography-mass spectrometry [GC-MS]), and microbiological approaches. Knuckles (n = 10) with no sour odor (control), a slight sour odor, or severe sour odor were collected during fabrication from a commercial beef processing plant. In addition, the synovial fluid from the femur joint, and the femur surface associated with the collected knuckles, were sponge-sampled. Knuckles were separated into 2 halves, with one half subjected to an odor panel, GC-MS, and microbial analyses on the day of collection (day 0). The remaining half was analyzed for odor and microbial populations following 35 d of vacuum-packaged storage at 0°C ± 2°C (day 35). Odor panelists identified differences (P < 0.05) between control and sour knuckles (slight sour odor and severe sour odor) for all attributes tested (off-odor, oxidation, putrid, and sour notes) regardless of storage day. GC-MS analysis found no statistical difference (P > 0.05) in volatiles between control and severe-sour-odor samples. Microbial analysis (aerobic plate counts and lactic acid bacteria counts) of muscle tissue on day 0 and day 35 of storage revealed no (P > 0.05) differences between the 3 treatment groups. Similarly, no (P > 0.05) differences between the treatment groups were obtained following analysis of synovial fluid and femur surface sponge samples for psychrotrophic anaerobic sporeformer counts. The findings of the study indicated that the souring condition in knuckles exists at identifiable intensities with no volatile acid or microbial population differences; therefore, further investigation is needed to determine the etiology

Podiatry intervention versus usual care to prevent falls in care homes: pilot randomised controlled trial (the PIRFECT study)

BackgroundCommon foot problems are independent risk factors for falls in older people. There is evidence that podiatry can prevent falls in community-dwelling populations. The feasibility of implementing a podiatry intervention and trial in the care home population is unknown. To inform a potential future definitive trial, we performed a pilot randomised controlled trial to assess: (i) the feasibility of a trial of a podiatry intervention to reduce care home falls, and (ii) the potential direction and magnitude of the effect of the intervention in terms of number of falls in care home residents.MethodsInformed by Medical Research Council guidance on developing and evaluating complex interventions, we conducted a single blind, pilot randomised controlled trial in six care homes in the East of Scotland. Participants were randomised to either: (i) a three month podiatry intervention comprising core podiatry care, foot and ankle exercises, orthoses and footwear provision or (ii) usual care. Falls-related outcomes (number of falls, time to first fall) and feasibility-related outcomes (recruitment, retention, adherence, data collection rates) were collected. Secondary outcomes included: generic health status, balance, mobility, falls efficacy, and ankle joint strength.Results474 care home residents were screened. 43 (9.1%) participants were recruited: 23 to the intervention, 20 to control. Nine (21%) participants were lost to follow-up due to declining health or death. It was feasible to deliver the trial elements in the care home setting. 35% of participants completed the exercise programme. 48% reported using the orthoses ‘all or most of the time’. Completion rates of the outcome measures were between 93% and 100%. No adverse events were reported. At the nine month follow-up period, the intervention group per-person fall rate was 0.77 falls vs. 0.83 falls in the control group.ConclusionsA podiatry intervention to reduce falls can be delivered to care home residents within a pilot randomised controlled trial of the intervention. Although not powered to determine effectiveness, these preliminary data provide justification for a larger trial, incorporating a full process evaluation, to determine whether this intervention can significantly reduce falls in this high-risk population.Trial registrationClinicalTrials.gov identifier: NCT02178527; Date of registration: 17 June 2014

Dissemination of clinical practice guidelines: A content analysis of patient versions

Background. Clinical practice guidelines (CPGs) are typically written for health care professionals but are meant to assist patients with health care decisions. A number of guideline producers have started to develop patient versions of CPGs to reach this audience. Objective. To describe the content and purpose of patient versions of CPGs and compare with patient and public views of CPGs. Design. A descriptive qualitative study with a directed content analysis of a sample of patient versions of CPGs published and freely available in English from 2012 to 2014. Results. We included 34 patient versions of CPGs from 17 guideline producers. Over half of the patient versions were in dedicated patient sections of national/professional agency websites. There was essentially no information about how to manage care in the health care system. The most common purpose was to equip people with information about disease, tests or treatments, and recommendations, but few provided quantitative data about benefits and harms of treatments. Information about beliefs, values and preferences, accessibility, costs, or feasibility of the interventions was rarely addressed. Few provided personal stories or scenarios to personalize the information. Three versions described the strength of the recommendation or the level of evidence. Limitations. Our search for key institutions that produce patient versions of guidelines was comprehensive, but we only included English and freely available versions. Future work will include other languages. Conclusions. This review describes the current landscape of patient versions of CPGs and suggests that these versions may not address the needs of their targeted audience. Research is needed about how to personalize information, provide information about factors contributing to the recommendations, and provide access

Observations of ¹⁴CO₂ in ecosystem respiration from a temperate deciduous forest in Northern Wisconsin

The ¹⁴CO₂ composition of plant and soil respiration can be used to determine the residence time of photosynthetically fixed carbon before it is released back to the atmosphere. To estimate the residence time of actively cycled carbon in a temperate forest, we employed two approaches for estimating the Δ¹⁴CO₂ of ecosystem respiration (Δ¹⁴C-R[subscript eco]) at the Willow Creek AmeriFlux site in Northern Wisconsin, USA. Our first approach was to construct nighttime Keeling plots from subcanopy profiles of Δ¹⁴CO₂ and CO₂, providing estimates of Δ¹⁴C-R[subscript eco] of 121.7‰ in June and 42.0‰ in August 2012. These measurements are likely dominated by soil fluxes due to proximity to the ground level. Our second approach utilized samples taken over 20 months within the forest canopy and from 396 m above ground level at the nearby LEF NOAA tall tower site (Park Falls, WI). In this canopy-minus-background approach we employed a mixing model described by Miller and Tans (2003) for estimating isotopic sources by subtracting time-varying background conditions. For the period from May 2011 to December 2012 the estimated Δ¹⁴C-R[subscript eco] using the Miller-Tans model was 76.8‰. Together, these Δ¹⁴C-R[subscript eco] values represent mean R[subscript eco] carbon ages of approximately 1–19 years. We also found that heterotrophic soil-respired Δ¹⁴C at Willow Creek was 5–38‰ higher (i.e., 1–10 years older) than predicted by the Carnegie-Ames-Stanford Approach global biosphere carbon model for the 1 × 1 pixel nearest to the site. This study provides much needed observational constraints of ecosystem carbon residence times, which are a major source of uncertainty in terrestrial carbon cycle models.This is the publisher’s final pdf. The published article is copyrighted by American Geophysical Union and can be found at: http://agupubs.onlinelibrary.wiley.com/agu/jgr/journal/10.1002/%28ISSN%292169-8961/Keywords: AmeriFlux, respiration, Keeling plot, radiocarbonKeywords: AmeriFlux, respiration, Keeling plot, radiocarbo