5,818 research outputs found

    Yale New Haven Health Partnership Evaluation Pilot: Yale New Haven Hospital and Healthier Greater New Haven Partnership

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    In 2010, new regulations associated with the Affordable Care Act mandated hospitals to demonstrate their involvement in community benefits programs to keep their tax-exempt status. This included implementation of a community needs assessment, a community health improvement plan (CHIP), and an evaluation of the implemented plan demonstrating efforts to meet the goals of the CHIP. The Healthier Greater New Haven Partnership is a coalition of more than sixty individuals and organizations working collaboratively within the Greater New Haven area to improve the health and quality of life in the community. The Partnership’s current CHIP is the result of a community health needs assessment conducted in 2015 and implemented in 2016. A CHIP outlines the priority health issues for a defined community, and how the issues will be addressed, including specific goals, strategies, measurable indicators (short and long-term), action steps and partners. The priority areas are Access to Care, Healthy Lifestyles and Mental Health and Substance Abuse. Conducting program evaluation is critical in obtaining feedback from the partnership which builds trust and specifies how the Partnership can improve. The majority of partnership members surveyed agreed that the partnership is diverse and functioning effectively and more than 90% believed that partnership is serving as a catalyst for positive change related to the health and well-being in the Greater New Haven area. There were areas identified for improvement, which will be implemented in the future as circumstances allow. The Data Dashboard is a necessary step in tracking the progress of the CHIP in the short- and long-term.https://elischolar.library.yale.edu/ysph_pbchrr/1048/thumbnail.jp

    STED-FLCS:An Advanced Tool to Reveal Spatiotemporal Heterogeneity of Molecular Membrane Dynamics

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    Heterogeneous diffusion dynamics of molecules play an important role in many cellular signaling events, such as of lipids in plasma membrane bioactivity. However, these dynamics can often only be visualized by single-molecule and super-resolution optical microscopy techniques. Using fluorescence lifetime correlation spectroscopy (FLCS, an extension of fluorescence correlation spectroscopy, FCS) on a super-resolution stimulated emission depletion (STED) microscope, we here extend previous observations of nanoscale lipid dynamics in the plasma membrane of living mammalian cells. STED-FLCS allows an improved determination of spatiotemporal heterogeneity in molecular diffusion and interaction dynamics via a novel gated detection scheme, as demonstrated by a comparison between STED-FLCS and previous conventional STED-FCS recordings on fluorescent phosphoglycerolipid and sphingolipid analogues in the plasma membrane of live mammalian cells. The STED-FLCS data indicate that biophysical and biochemical parameters such as the affinity for molecular complexes strongly change over space and time within a few seconds. Drug treatment for cholesterol depletion or actin cytoskeleton depolymerization not only results in the already previously observed decreased affinity for molecular interactions but also in a slight reduction of the spatiotemporal heterogeneity. STED-FLCS specifically demonstrates a significant improvement over previous gated STED-FCS experiments and with its improved spatial and temporal resolution is a novel tool for investigating how heterogeneities of the cellular plasma membrane may regulate biofunctionality

    Searching for sterile neutrinos in ice

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    Oscillation interpretation of the results from the LSND, MiniBooNE and some other experiments requires existence of sterile neutrino with mass 1\sim 1 eV and mixing with the active neutrinos Uμ02(0.020.04)|U_{\mu 0}|^2 \sim (0.02 - 0.04). It has been realized some time ago that existence of such a neutrino affects significantly the fluxes of atmospheric neutrinos in the TeV range which can be tested by the IceCube Neutrino Observatory. In view of the first IceCube data release we have revisited the oscillations of high energy atmospheric neutrinos in the presence of one sterile neutrino. Properties of the oscillation probabilities are studied in details for various mixing schemes both analytically and numerically. The energy spectra and angular distributions of the νμ\nu_\mu-events have been computed for the simplest νs\nu_s-mass, and νsνμ\nu_s - \nu_\mu mixing schemes and confronted with the IceCube data. An illustrative statistical analysis of the present data shows that in the νs\nu_s-mass mixing case the sterile neutrinos with parameters required by LSND/MiniBooNE can be excluded at about 3σ3\sigma level. The νsνμ\nu_s- \nu_\mu mixing scheme, however, can not be ruled out with currently available IceCube data.Comment: 41 pages, 16 figures. Accepted for publication in JHEP. Minor changes from the previous versio

    Costs of early detection systems for epidemic malaria in highland areas of Kenya and Uganda

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    BACKGROUND: Malaria epidemics cause substantial morbidity and mortality in highland areas of Africa. The costs of detecting and controlling these epidemics have not been explored adequately in the past. This study presents the costs of establishing and running an early detection system (EDS) for epidemic malaria in four districts in the highlands of Kenya and Uganda. METHODS: An economic costing was carried out from the health service provider's perspective in both countries. Staff time for data entry and processing, as well as supervising and coordinating EDS activities at district and national levels was recorded and associated opportunity costs estimated. A threshold analysis was carried out to determine the number of DALYs or deaths that would need to be averted in order for the EDS to be considered cost-effective. RESULTS: The total costs of the EDS per district per year ranged between US$ 14,439 and 15,512. Salaries were identified as major cost-drivers, although their relative contribution to overall costs varied by country. Costs of relaying surveillance data between facilities and district offices (typically by hand) were also substantial. Data from Uganda indicated that 4% or more of overall costs could potentially be saved by switching to data transfer via mobile phones. Based on commonly used thresholds, 96 DALYs in Uganda and 103 DALYs in Kenya would need to be averted annually in each district for the EDS to be considered cost-effective. CONCLUSION: Results from this analysis suggest that EDS are likely to be cost-effective. Further studies that include the costs and effects of the health systems' reaction prompted by EDS will need to be undertaken in order to obtain comprehensive cost-effectiveness estimates

    The novel CXCR4 antagonist POL5551 mobilizes hematopoietic stem and progenitor cells with greater efficiency than Plerixafor

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    Mobilized blood has supplanted bone marrow (BM) as the primary source of hematopoietic stem cells for autologous and allogeneic stem cell transplantation. Pharmacologically enforced egress of hematopoietic stem cells from BM, or mobilization, has been achieved by directly or indirectly targeting the CXCL12/CXCR4 axis. Shortcomings of the standard mobilizing agent, granulocyte colony-stimulating factor (G-CSF), administered alone or in combination with the only approved CXCR4 antagonist, Plerixafor, continue to fuel the quest for new mobilizing agents. Using Protein Epitope Mimetics technology, a novel peptidic CXCR4 antagonist, POL5551, was developed. In vitro data presented herein indicate high affinity to and specificity for CXCR4. POL5551 exhibited rapid mobilization kinetics and unprecedented efficiency in C57BL/6 mice, exceeding that of Plerixafor and at higher doses also of G-CSF. POL5551-mobilized stem cells demonstrated adequate transplantation properties. In contrast to G-CSF, POL5551 did not induce major morphological changes in the BM of mice. Moreover, we provide evidence of direct POL5551 binding to hematopoietic stem and progenitor cells (HSPCs) in vivo, strengthening the hypothesis that CXCR4 antagonists mediate mobilization by direct targeting of HSPCs. In summary, POL5551 is a potent mobilizing agent for HSPCs in mice with promising therapeutic potential if these data can be orroborated in humans

    EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2

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    The provisional EULAR recommendations address several aspects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus, and the disease caused by SARS-CoV-2, COVID-19 and are meant for patients with rheumatic and musculoskeletal diseases (RMD) and their caregivers. A task force of 20 members was convened by EULAR that met several times by videoconferencing in April 2020. The task force finally agreed on five overarching principles and 13 recommendations covering four generic themes: (1) General measures and prevention of SARS-CoV-2 infection. (2) The management of RMD when local measures of social distancing are in effect. (3) The management of COVID-19 in the context of RMD. (4) The prevention of infections other than SARS-CoV-2. EULAR considers this set of recommendations as a 'living document' and a starting point, which will be updated as soon as promising new developments with potential impact on the care of patients with RMD become available

    Proactive and politically skilled professionals: What is the relationship with affective occupational commitment?

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    The aim of this study is to extend research on employee affective commitment in three ways: (1) instead of organizational commitment the focus is on occupational commitment; (2) the role of proactive personality on affective occupational commitment is examined; and (3) occupational satisfaction is examined as a mediator and political skills as moderator in the relationship between proactive personality and affective occupational commitment. Two connected studies, one in a hospital located in the private sector and one in a university located in the public sector, are carried out in Pakistan, drawing on a total sample of over 400 employees. The results show that proactive personality is positively related to affective occupational commitment, and that occupational satisfaction partly mediates the relationship between proactive personality and affective occupational commitment. No effect is found for a moderator effect of political skills in the relationship between proactive personality and affective occupational commitment. Political skills however moderate the relationship between proactive personality and affective organizational commitment

    Learners' decisions for attending Pediatric Grand Rounds: a qualitative and quantitative study

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    BACKGROUND: Although grand rounds plays a major educational role at academic medical centers, there has been little investigation into the factors influencing the learners' decision to attend. Greater awareness of attendees' expectations may allow grand rounds planners to better accommodate the learners' perspective, potentially making continuing education activities more attractive and inviting. METHODS: We used both qualitative (part A) and quantitative (part B) techniques to investigate the motivators and barriers to grand rounds attendance. Part A investigated contextual factors influencing attendance as expressed through attendee interviews. Transcripts of the interviews were analyzed using grounded theory techniques. We created a concept map linking key factors and their relationships. In part B we quantified the motivators and barriers identified during the initial interviews through a survey of the grand rounds audience. RESULTS: Sixteen persons voluntarily took part in the qualitative study (part A) by participating in one of seven group interview sessions. Of the 14 themes that emerged from these sessions, the most frequent factors motivating attendance involved competent practice and the need to know. All sessions discussed intellectual stimulation, social interaction, time constraints and convenience, licensure, content and format, and absence of cost for attending sessions. The 59 respondents to the survey (part B) identified clinically-useful topics (85%), continuing education credit (46%), cutting-edge research (27%), networking (22%), and refreshments (8%) as motivators and non-relevant topics (44%) and too busy to attend (56%) as barriers. CONCLUSION: Greater understanding of the consumers' perspective can allow planners to tailor the style, content, and logistics to make grand rounds more attractive and inviting
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