Testing a Wellness Indicators Measure for People with Intellectual and Developmental Disabilities

Background and Purpose: People with intellectual and developmental disabilities (IDD) often have health and wellness issues that are not as good as people without disabilities. States are required to monitor health and wellness for people with IDD who use many disability services. However, there are few ways to monitor wellness between states or at different points in time. In this study, we share a new model that states may use to monitor wellness of people with IDD. Methods: We used data from a survey called the National Core Indicators (NCI) to develop this model. First, we developed the model using our state’s data. Then, after we found a model that worked well, we tested that model using the National Core Indicators from the entire U.S. Results: Our final model worked well in both our state NCI data and the national NCI data. This is important because policies at both levels can affect the services that people with disabilities can use. Our model had three parts: heart health, mental health, and behavioral wellness. These are described more in the paper. We also used statistics to test some factors that might predict outcomes related to heart health, mental health, and behavioral wellness. Age, sex, where someone lives[MEH1] , and level of intellectual disability were all good predictors of all three categories of wellness that we studied. Implications: The model of wellness that we developed worked well but should be tested using data from other individual states. It is very important to know about health and wellness right now since the services people with disabilities can use are changing in many states. We think our model can help planners and advocates understand how services affect wellness in a way that is easy to compare from state to state and at different points in time

The RESCueH Programme: Testing New Non-Pharmacologic Interventions for Alcohol Use Disorders

Excessive alcohol consumption is one of the most important lifestyle factors affecting the disease burden in the Western world. The results of treatment in daily practice are modest at best. The aim of the RESCueH programme is to develop and evaluate methods, which are as practice-near as possible, and therefore can be implemented quickly and easily in everyday clinical practice. It is the first clinical alcohol programme to be transatlantic in scope, with implementation in treatment centers located in Denmark, Germany and the US. The RESCueH programme comprises 5 randomized controlled trials, and the studies can be expected to result in (1) more patients starting treatment in specialized outpatient clinics, (2) a greater number of elderly patients being treated, (3) increased patient motivation for treatment and thus improved adherence, (4) more patients with stable positive outcomes after treatment and (5) fewer patients relapsing into harmful drinking. The aim of this paper is to discuss the rationale for the RESCueH programme, to present the studies and expected results

A framework for convection and boundary layer parameterization derived from conditional filtering

A new theoretical framework is derived for parameterization of subgrid physical processes in atmospheric models; the application to parameterization of convection and boundary layer fluxes is a particular focus. The derivation is based on conditional filtering, which uses a set of quasi-Lagrangian labels to pick out different regions of the fluid, such as convective updrafts and environment, before applying a spatial filter. This results in a set of coupled prognostic equations for the different fluid components, including subfilter-scale flux terms and entrainment/detrainment terms. The framework can accommodate different types of approaches to parameterization, such as local turbulence approaches and mass-flux approaches. It provides a natural way to distinguish between local and nonlocal transport processes, and makes a clearer conceptual link to schemes based on coherent structures such as convective plumes or thermals than the straightforward application of a filter without the quasi-Lagrangian labels. The framework should facilitate the unification of different approaches to parameterization by highlighting the different approximations made, and by helping to ensure that budgets of energy, entropy, and momentum are handled consistently and without double counting. The framework also points to various ways in which traditional parameterizations might be extended, for example by including additional prognostic variables. One possibility is to allow the large-scale dynamics of all the fluid components to be handled by the dynamical core. This has the potential to improve several aspects of convection-dynamics coupling, such as dynamical memory, the location of compensating subsidence, and the propagation of convection to neighboring grid columns

The DOE E3SM Coupled Model Version 1: Overview and Evaluation at Standard Resolution

This work documents the first version of the U.S. Department of Energy (DOE) new Energy Exascale Earth System Model (E3SMv1). We focus on the standard resolution of the fully coupled physical model designed to address DOE mission-relevant water cycle questions. Its components include atmosphere and land (110-km grid spacing), ocean and sea ice (60 km in the midlatitudes and 30 km at the equator and poles), and river transport (55 km) models. This base configuration will also serve as a foundation for additional configurations exploring higher horizontal resolution as well as augmented capabilities in the form of biogeochemistry and cryosphere configurations. The performance of E3SMv1 is evaluated by means of a standard set of Coupled Model Intercomparison Project Phase 6 (CMIP6) Diagnosis, Evaluation, and Characterization of Klima simulations consisting of a long preindustrial control, historical simulations (ensembles of fully coupled and prescribed SSTs) as well as idealized CO2 forcing simulations. The model performs well overall with biases typical of other CMIP-class models, although the simulated Atlantic Meridional Overturning Circulation is weaker than many CMIP-class models. While the E3SMv1 historical ensemble captures the bulk of the observed warming between preindustrial (1850) and present day, the trajectory of the warming diverges from observations in the second half of the twentieth century with a period of delayed warming followed by an excessive warming trend. Using a two-layer energy balance model, we attribute this divergence to the model’s strong aerosol-related effective radiative forcing (ERFari+aci = -1.65 W/m2) and high equilibrium climate sensitivity (ECS = 5.3 K).Plain Language SummaryThe U.S. Department of Energy funded the development of a new state-of-the-art Earth system model for research and applications relevant to its mission. The Energy Exascale Earth System Model version 1 (E3SMv1) consists of five interacting components for the global atmosphere, land surface, ocean, sea ice, and rivers. Three of these components (ocean, sea ice, and river) are new and have not been coupled into an Earth system model previously. The atmosphere and land surface components were created by extending existing components part of the Community Earth System Model, Version 1. E3SMv1’s capabilities are demonstrated by performing a set of standardized simulation experiments described by the Coupled Model Intercomparison Project Phase 6 (CMIP6) Diagnosis, Evaluation, and Characterization of Klima protocol at standard horizontal spatial resolution of approximately 1° latitude and longitude. The model reproduces global and regional climate features well compared to observations. Simulated warming between 1850 and 2015 matches observations, but the model is too cold by about 0.5 °C between 1960 and 1990 and later warms at a rate greater than observed. A thermodynamic analysis of the model’s response to greenhouse gas and aerosol radiative affects may explain the reasons for the discrepancy.Key PointsThis work documents E3SMv1, the first version of the U.S. DOE Energy Exascale Earth System ModelThe performance of E3SMv1 is documented with a set of standard CMIP6 DECK and historical simulations comprising nearly 3,000 yearsE3SMv1 has a high equilibrium climate sensitivity (5.3 K) and strong aerosol-related effective radiative forcing (-1.65 W/m2)Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151288/1/jame20860_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151288/2/jame20860.pd

42nd Annual Albert M. Biele, MD, Memorial Lecture: The Past, Present, and Future of Psychedelic Medicine - January 26, 2022

Outline Review the development of psychedelic medicine up to the present Describe the status of current research on clinical applications of serotonergic psychedelic medications Discuss possible therapeutic mechanisms, with a focus on what is known about the role of subjective experienc

Benefit-cost analysis of SBIRT interventions for substance using patients in emergency departments

Screening, brief intervention, and referral to treatment (SBIRT) has been widely implemented as a method to address substance use disorders in general medical settings, and some evidence suggests that its use is associated with decreased societal costs. In this paper, we investigated the economic impact of SBIRT using data from Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED), a multisite, randomized controlled trial. Utilizing self-reported information on medical status, health services utilization, employment, and crime, we conduct a benefit-cost analysis. Findings indicate that neither of the SMART-ED interventions resulted in any significant changes to the main economic outcomes, nor had any significant impact on total economic benefit. Thus, while SBIRT interventions for substance abuse in Emergency Departments may be appealing from a clinical perspective, evidence from this economic study suggests resources could be better utilized supporting other health interventions. •A screening, assessment, and referral to treatment intervention in EDs was estimated be $90.97 per participant.•A brief intervention, with follow-up booster sessions was estimated to cost an additional$57.34 per treated participant.•A high-level of healthcare utilization and crime was found in substance using patients in emergency departments.•Neither SMART-ED treatment condition resulted a significant change in any of the identified benefit outcomes domains.•This SBIRT model for substance using patients in EDs was not found to be effective from an economic perspective