1,387 research outputs found

    An approach to evaluating reactive airborne wind shear systems

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    An approach to evaluating reactive airborne windshear detection systems was developed to support a deployment study for future FAA ground-based windshear detection systems. The deployment study methodology assesses potential future safety enhancements beyond planned capabilities. The reactive airborne systems will be an integral part of planned windshear safety enhancements. The approach to evaluating reactive airborne systems involves separate analyses for both landing and take-off scenario. The analysis estimates the probability of effective warning considering several factors including NASA energy height loss characteristics, reactive alert timing, and a probability distribution for microburst strength

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

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    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

    Measuring Population Health Using Electronic Health Records: Exploring Biases and Representativeness in a Community Health Information Exchange

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    Assessment is a core function of public health. Comprehensive clinical data may enhance community health assessment by providing up-to-date, representative data for use in public health programs and policies, especially when combined with community-level data relevant to social determinants. In this study we examine routinely collected and geospatially-enhanced EHR data to assess population health at various levels of geographic granularity available from a regional health information exchange. We present preliminary findings and discuss important biases in EHR data. Future work is needed to develop methods for correcting for those biases to support routine epidemiology work of public health

    Urgent Challenges for Local Public Health Informatics

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    This editorial highlights the urgent challenges for local public health informatics and provides solutions to face these challenges

    Type Ibc supernovae in disturbed galaxies: evidence for a top-heavy IMF

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    We compare the radial locations of 178 core-collapse supernovae to the R-band and H alpha light distributions of their host galaxies. When the galaxies are split into `disturbed' and `undisturbed' categories, a striking difference emerges. The disturbed galaxies have a central excess of core-collapse supernovae, and this excess is almost completely dominated by supernovae of types Ib, Ic and Ib/c, whereas type II supernovae dominate in all other environments. The difference cannot easily be explained by metallicity or extinction effects, and thus we propose that this is direct evidence for a stellar initial mass function that is strongly weighted towards high mass stars, specifically in the central regions of disturbed galaxies.Comment: 22 pages, 5 figures, accepted for publication in Ap

    Notifiable condition reporting practices: implications for public health agency participation in a health information exchange

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    Abstract Background The future of notifiable condition reporting in the United States is undergoing a transformation with the increasing development of Health Information Exchanges which support electronic data-sharing and -transfer networks and the wider adoption of electronic laboratory reporting. Communicable disease report forms originating in clinics are an important source of surveillance data for public health agencies. However, problems of poor data quality and delayed submission of reports to public health agencies are common. In addition, studies of barriers and facilitators to reporting have assumed that the primary reporter is the treating physician, although the extent to which a provider is involved in the reporting workflow is unclear. We sought to better understand the barriers to and burden of notifiable condition reporting from the perspectives of the three primary groups involved in reporting workflow: providers, clinic staff who bear the principal responsibility for reporting, and the public health workers who receive and process reports from clinics. In addition, we sought to situate these findings within the context of the future of notifiable disease reporting and the potential impacts of electronic lab and medical records on the surveillance system. Methods Seven ambulatory care clinics and 3 public health agencies that are part of a Health Information Exchange in the state of Indiana, USA, participated in the study. Data were obtained from a survey of clinic physicians (N = 29), interviews with clinic reporters (N = 11), and interviews with public health workers (N = 9). Survey data were summarized descriptively and interview transcripts underwent qualitative analysis. Results In both clinics and public health agencies, the laboratory report initiates reporting workflow. Provider involvement with reporting primarily revolves around ordering medications to treat a condition confirmed by the lab result. In clinics, reporting is typically the responsibility of clinic reporters who vary in frequency of reporting. We found an association between frequency of reporting, reporting knowledge and perceptions of reporting burden. In both clinics and public health agencies, interruptions and delays in reporting workflow are encountered due to inaccurate or missing information and impact reporting timeliness, data quality and report completeness. Both providers and clinic reporters lack clarity regarding how data submitted by their reports are used by public health agencies. It is possible that the value of reporting may be diminished when those responsible do not perceive receiving benefit in return. This may account for the low awareness of or recollection of public health communications with clinics that we observed. Despite the high likelihood that public health advisories and guidance are based, in part, on data submitted by clinics, a direct concordance may not be recognized. Conclusions Unlike most studies of notifiable condition reporting, this study included the clinic reporters who bear primary responsibility for completing and submitting reports to public health agencies. A primary barrier to this reporting is timely and easy access to data. It is possible that expanded adoption of electronic health record and laboratory reporting systems will improve access to this data and reduce reporting the burden. However, a complete reliance on automatic electronic extraction of data requires caution and necessitates continued interfacing with clinic reporters for the foreseeable future—particularly for notifiable conditions that are high-impact, uncommon, prone to false positive readings by labs, or are hard to verify. An important finding of this study is the association between frequency of reporting, reporting knowledge and perceptions of reporting burden. Increased automation could result in even lower reporting knowledge and familiarity with reporting requirements which could actually increase reporters’ perception of notifiable condition reporting as burdensome. Another finding was of uncertainty regarding how data sent to public health agencies is used or provides clinical benefit. A strong recommendation generated by these findings is that, given their central role in reporting, clinic reporters are a significant target audience for public health outreach and education that aims to alleviate perceived reporting burden and improve reporting knowledge. In particular, communicating the benefits of public health’s use of the data may reduce a perceived lack of information reciprocity between clinical and public health organizations

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

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    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

    The Effects of Physical Activity on Learning Behaviors in Elementary School Children: A Randomized Controlled Trial

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    This work is licensed under a Creative Commons Attribution 4.0 International License.Research in education and developmental psychology indicates that behavioral engagement in learning is a critical predictor of children’s academic success. In an effort to improve academic achievement, school administrators are continually in search of methods to increase behavioral engagement. Previous research has indicated that classroom-based physical activity (PA) lessons have a positive impact on academic achievement. However, little research has been done in assessing the impact of such interventions on the behavioral engagement of students with learning behavior difficulties. This study assesses the impact of classroom-based PA on teacher-rated classroom behaviors of students with identified learning behavior difficulties. Two schools (one intervention, one control) participating in a larger, cluster-randomized trial provided scores on a teacher-administered classroom behavior scale. This scale was used to collect information on 15 characteristics identified as being essential to behavioral engagement. Participants included male and female students in second and third grade classrooms who were identified by their classroom teacher and school counselor as having difficulties with learning behaviors. Mixed linear modeling for repeated measures was used to examine the changes over time in the classroom behavior scores. The intervention group showed significant improvement over time in classroom behavior while the control group showed no change or a slight degradation over time (i.e., group × time interaction, F[2132] = 4.52, p = 0.01). Schools must meet the diverse needs of students today, including those who exhibit less than optimal learning behaviors. Combined with the evidence that PA is linked to several health and cognitive-behavior benefits, providing classroom-based PA that is incorporated within the curriculum provides common ground for all students to participate. It is a potential solution to increasing behavioral engagement, and in turn stimulating and enhancing learning

    Measuring Infrared SurfaceBrightness Fluctuation Distances with HST WFC3: Calibration and Advice

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    We present new calibrations of the near-infrared (near-IR) surface brightness fluctuation (SBF) distance method for the F110W ( ) and F160W ( ) bandpasses of the Wide Field Camera 3 Infrared Channel (WFC3/IR) on the Hubble Space Telescope. The calibrations are based on data for 16 early-type galaxies in the Virgo and Fornax clusters observed with WFC3/IR and are provided as functions of both the optical and near-infrared colors. The scatter about the linear calibration relations for the luminous red galaxies in the sample is approximately 0.10 mag, corresponding to a statistical error of 5% in distance. Our results imply that the distance to any suitably bright elliptical galaxy can be measured with this precision out to about 80 Mpc in a single-orbit observation with WFC3/IR, making this a remarkably powerful instrument for extragalactic distances. The calibration sample also includes much bluer and lower-luminosity galaxies than previously used for IR SBF studies, revealing interesting population differences that cause the calibration scatter to increase for dwarf galaxies. Comparisons with single-burst population models show that as expected, the redder early-type galaxies contain old, metal-rich populations, while the bluer dwarf ellipticals contain a wider range of ages and lower metallicities than their more massive counterparts. Radial SBF gradients reveal that IR color gradients are largely an age effect; the bluer dwarfs typically have their youngest populations near their centers, while the redder giant ellipticals show only weak trends and in the opposite sense. Because of the population variations among bluer galaxies, distance measurements in the near-IR are best limited to red early-type galaxies. We conclude with some practical guidelines for using WFC3/IR to measure reliable SBF distances
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