Fearless: Casey Butrico and Melanie Emerson

Casey Butrico (‘16) and Melanie Emerson (‘16) recently started a discussion group called Students for Reproductive Justice. This group is dedicated to the belief that women should control all aspects of their reproduction, including education about and access to safe birth control. They also aim to focus on gynecological care, pre-natal care, and abortion as human rights. These two fearless first-years have made a mission to educate and raise awareness about local and national issues that relate to women’s reproductive autonomy and the legal restrictions threatening it. [excerpt

Perceptions of Public Health 3.0: Concordance Between Public Health Agency Leaders and Employees

CONTEXT AND BACKGROUND: The newest era of public health, deemed "Public Health 3.0," supports cross-sector collaborations to address social determinants of health. These activities often require collaborations with nontraditional public health entities. As this new era begins, it is important to understand perceptions of the public health workforce with regard to Public Health 3.0. OBJECTIVE: To assess perceptions of support toward Public Health 3.0 activities by the public health workforce, identify characteristics associated with support, and measure concordance in support between agency directors and the general workforce. DESIGN: This cross-sectional study utilizes the 2017 Public Health Workforce Interests and Needs Survey to understand support and concordance regarding Public Health 3.0 activities by a nationally representative sample of governmental public health employees. Logistic regression models are used to identify characteristics associated with support of each 3.0 activity and concordance. MAIN OUTCOME MEASURES: Governmental public health employees' opinions on how involved their agency should be in the K-12 education system, the economy, the built environment, transportation, housing, social connectedness, and health equity within their jurisdiction and concordance in support of involvement between agency directors and the general workforce. RESULTS: Overall, individual perceptions supporting involvement were highest for health equity and social connectedness and lowest for transportation. Supervisory status, education, and being at a local health department were associated with greater odds of supporting all 3.0 activities. Concordance with agency directors was greatest among other executives relative to nonsupervisors. CONCLUSIONS: There is overall generally high support of many 3.0 activities, but there are gaps in agreement by supervisory status, gender, race/ethnicity, education, role type, and jurisdiction. Findings may help support agency leaders in better communicating the role of their agencies in Public Health 3.0 activities, and workforce education regarding such activities may be necessary for the success of Public Health 3.0's success

Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

Background: Since the inception of Accountable Care Organizations (ACOs), many have acknowledged the potential synergy between ACOs and health information technology (IT) in meeting quality and cost goals. Objective: We conducted a systematic review of the literature in order to describe what research has been conducted at the intersection of health IT and ACOs and identify directions for future research. Methods: We identified empirical studies discussing the use of health IT via PubMed search with subsequent snowball reference review. The type of health IT, how health IT was included in the study, use of theory, population, and findings were extracted from each study. Results: Our search resulted in 32 studies describing the intersection of health IT and ACOs, mainly in the form of electronic health records and health information exchange. Studies were divided into three streams by purpose; those that considered health IT as a factor for ACO participation, health IT use by current ACOs, and ACO performance as a function of health IT capabilities. Although most studies found a positive association between health IT and ACO participation, studies that address the performance of ACOs in terms of their health IT capabilities show more mixed results. Conclusions: In order to better understand this emerging relationship between health IT and ACO performance, we propose future research should consider more quasi-experimental studies, the use of theory, and merging health, quality, cost, and health IT use data across ACO member organizations

An age-of-allele test of neutrality for transposable element insertions

How natural selection acts to limit the proliferation of transposable elements (TEs) in genomes has been of interest to evolutionary biologists for many years. To describe TE dynamics in populations, many previous studies have used models of transposition-selection equilibrium that rely on the assumption of a constant rate of transposition. However, since TE invasions are known to happen in bursts through time, this assumption may not be reasonable in natural populations. Here we propose a test of neutrality for TE insertions that does not rely on the assumption of a constant transposition rate. We consider the case of TE insertions that have been ascertained from a single haploid reference genome sequence and have subsequently had their allele frequency estimated in a population sample. By conditioning on the age of an individual TE insertion (using information contained in the number of substitutions that have occurred within the TE sequence since insertion), we determine the probability distribution for the insertion allele frequency in a population sample under neutrality. Taking models of varying population size into account, we then evaluate predictions of our model against allele frequency data from 190 retrotransposon insertions sampled from North American and African populations of Drosophila melanogaster. Using this non-equilibrium model, we are able to explain about 80% of the variance in TE insertion allele frequencies based on age alone. Controlling both for nonequilibrium dynamics of transposition and host demography, we provide evidence for negative selection acting against most TEs as well as for positive selection acting on a small subset of TEs. Our work establishes a new framework for the analysis of the evolutionary forces governing large insertion mutations like TEs, gene duplications or other copy number variants.Comment: 40 pages, 6 figures, Supplemental Data available: [email protected]

The Relationship Between Health Department Accreditation and Workforce Satisfaction, Retention, and Training Needs

BACKGROUND: To improve quality and consistency of health departments, a voluntary accreditation process was developed by the Public Health Accreditation Board. Understanding accreditation's role as a mediator in workforce training needs, satisfaction, and awareness is important for continued improvement for governmental public health. OBJECTIVE: To compare differences in training needs, satisfaction/intent to leave, and awareness of public health concepts for state and local health department staff with regard to their agency's accreditation status. DESIGN: This cross-sectional study considered the association between agency accreditation status and individual perceptions of training needs, satisfaction, intent to leave, and awareness of public health concepts, using 2017 Public Health Workforce Interests and Needs Survey (PH WINS) data. Respondents were categorized on the basis of whether their agencies (at the time of survey) were (1) uninvolved in accreditation, (2) formally involved in accreditation, or (3) accredited. RESULTS: Multivariate logistic regression models found several significant differences, including the following: individuals from involved state agencies were less likely to report having had their training needs assessed; staff from accredited and involved agencies identified more gaps in selected skills; and employees of accredited agencies were more aware of quality improvement. While state employees in accredited and formally involved agencies reported less job satisfaction, there were no significant differences in intent to leave or burnout. Differences were identified concerning awareness of various public health concepts, especially among respondents in state agencies. CONCLUSIONS: While some findings were consistent with past research (eg, link between accreditation and quality improvement), others were not (eg, job satisfaction). Several self-reported skill gaps were unanticipated, given accreditation's emphasis on training. Potentially, as staff are exposed to accreditation topics, they gain more appreciation of skills development needs. Findings suggest opportunities to strengthen workforce development components when revising accreditation measures

The Persuasive Force of the Ad Baculum

Standard accounts of the ad baculum locate its fallaciousness either in irrelevance or dialogue shift. Such accounts, however, fail to explain its persuasiveness. This paper offers a new account where the real target of an ad baculum is an audience downstream from the initial ad baculum exchange. This means that the ad baculum consists in misrepresenting the quality of evidence by means of the forced adoption of a particular standpoint

Effect of Dimple Pattern on the Suppression of Boundary Layer Separation on a Low Pressure Turbine Blade

Three dimple patterns were investigated to ascertain their relative effectiveness on controlling boundary layer separation from a low-pressure turbine blade. The three cases included a single row of dimples at 65% of the axial chord with 2.22 cm spacing, a single row of dimples at 65% of the axial chord with 4.44 cm spacing, and a two-row staggered pattern with rows at 65% and 76% of the axial chord with 4.44 cm spacing. The multiple row case was such that the center of the upstream dimple set at the midpoint between two downstream dimples. The dimple spacing was measured center-on-center. Each of the dimple patterns was studied and compared to an unmodified blade at axial chord Reynolds numbers based on inlet velocity of 25k, 45k, and 100k. Experimental data was collected in a low-speed, draw down wind tunnel containing a linear turbine cascade of 8 Pak-B blades. Measurements of surface pressure, boundary layer parameters, wake velocity, and total pressure losses were made to examine the flow. No dimple pattern dramatically outperformed the others. Each of the dimple patterns studied improved the average total pressure loss coefficient by 34% for Re 25k and 1% Tu. Complementing the experimental effort was a three-dimensional computational fluid dynamics study. Four models were built and analyzed. The models included an unmodified blade, blades with dimples at 65% of the axial chord with 2 cm or 4 cm spacing, respectively, and a multiple row case consisting of dimples at 65% and 76% of the axial chord with 2 cm spacing. Again the upstream dimple set at the midpoint between two downstream dimples. The computational fluid dynamics study provided detailed flow visualization in and around the dimples as well as a comparison to experimental data for solver verification. It was shown that the computational and experimental results showed similar trends in wake loss and boundary layer traverses