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In November 2020, the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) announced it was appointing an Expert Working Group (EWG) to update the quality [...]

In 2020, the International Council for Harmonisation (ICH) published a concept paper (1) that outlined a limited revision to the published guideline ICH Q9 Quality Risk Management (QRM) (2) to [...]

Objective: To illustrate the process of developing and sustaining an academic-public health partnership for behavioral health integration through an expansion of the Aligning Systems for Health (ASfH) framework. Study Setting: Practice-informed primary data (2017-2023) from the Holistic Opportunity Program for Everyone (HOPE) Initiative based in Charlotte, NC. Study Design: The unit of analysis in this descriptive case study is interorganizational, specifically focusing on an academic-public health relationship. We illustrate the partnership process across the ASfH four core areas, including key challenges and insights. Data Collection: Utilized a Critical Moments Reflection methodology and review of HOPE program data. Principal Findings: (1) Formal partnership structures and processes are essential to monitoring the four ASfH core components for on-going system alignment. (2) Aligning systems for health principally involves two ecologies: (i) the health program and (ii) the partnership. The vitality and sustainability of both ecologies require continuous attention and resource investment. (3) Relationships rest at the heart of aligning systems. (4) With comparative advantages in research methods, the academic sector is especially poised to collaborate with healthcare systems and human service organizations to study, develop, implement, and scale evidence-based health interventions. Conclusions: The academic sector shares overlapping purposes with the public health, healthcare, and social services sectors while providing complementary value. It is a critical sectoral partner in advancing population health and health equity. KEYWORDS academic-public health partnership, aligning systems for health, case study, cross-sector partnership, health equity, integrated care What is known on this topic * Cross-sector partnerships are critical to promoting community health and health equity. However, the pathways to effective and sustainable cross-sector partnerships are less well understood. * Aligning Systems for Health is an emergent, prominent theoretical framework for building cross-sector alignment that requires field-testing and refinement. * While the benefits of academic-public health partnerships are well-recognized, descriptive studies about how to effectively establish and sustain this type of cross-sector partnership remain limited. What this study adds * This study expands the Aligning Systems for Health theoretical framework to include the academic sector and demonstrates the opportunities and value associated with integrating this sector. * The article illuminates the process and pitfalls of academic-public health partnership formation, growth, and maintenance; and lends generalizable practice insights for cross-sector partnerships more broadly., 1 | INTRODUCTION Cross-sector partnerships are essential to improving health equity and population health outcomes. (1,2) Defined as a formal alliance between two or more organizations representing different sectors of [...]

Objective: Social risks complicate patients' ability to manage their conditions and access healthcare, but their association with health expenditures is not well established. To identify patient-reported social risk, behavioral, and health factors associated with health expenditures in Veterans Affairs (VA) patients at high risk for hospitalization or death. Data Sources, Study Setting, and Study Design: Prospective cohort study among high-risk Veterans obtaining VA care. Patient-reported social risk, function, and other measures derived from a 2018 survey sent to 10,000 VA patients were linked to clinical and demographic characteristics extracted from VA data. Response-weighted generalized linear and marginalized two-part models were used to examine VA expenditures (total, outpatient, medication, inpatient) 1 year after survey completion in adjusted models. Principal Findings: Among 4680 survey respondents, the average age was 70.9 years, 6.3% were female, 16.7% were African American, 20% had body mass index [greater than or equal to]35, 42.4% had difficulty with two or more basic or instrumental activities of daily living, 19.3% reported transportation barriers, 12.5% reported medication insecurity and 21.8% reported food insecurity. Medication insecurity was associated with lower outpatient expenditures (-$1859.51 per patient per year, 95% confidence interval [CI]: -3200.77 to -518.25) and lower total expenditures (-$4304.99 per patient per year, 95% CI: -7564.87 to -1045.10). Transportation barriers were negatively associated with medication expenditures (-$558.42, 95% CI: -1087.93 to -31.91). Patients with one functional impairment had higher outpatient expenditures ($2997.59 per patient year, 95% CI: 1185.81-4809.36) than patients without functional impairments. No social risks were associated with inpatient expenditures. Conclusions: In this study of VA patients at high risk for hospitalization and mortality, few social and functional measures were independently associated with the costs of VA care. Individuals with functional limitations and those with barriers to accessing medications and transportation may benefit from targeted interventions to ensure that they are receiving the services that they need. KEYWORDS electronic health record, healthcare costs, patient complexity, social and behavioral risk factors, Veterans What is known on this topic * Food insecurity was positively associated with inpatient, medication, and total expenditures but it is unknown what other patient-reported social and behavioral risks are associated with healthcare expenditures of Veterans. What this study adds * Social risks related to food insecurity, transportation barriers, and medication insecurity were fairly common in Veterans at high risk for hospitalization or death. * Medication insecurity, transportation barriers, and basic or instrumental ADL impairment explained meaningful variation in VA total, outpatient, and medication expenditures, but no social risks were associated with inpatient expenditures., 1 | INTRODUCTION Social risks, such as food insecurity, housing instability, and lack of transportation, can complicate patients' ability to manage their conditions and access healthcare, which may adversely affect [...]

What Are The Top Challenges Today's Discrete Manufacturers Face Today? Today, discrete manufacturers face many challenges including, but not limited to, maintaining aging infrastructure, managing complex production processes, and enabling [...]

This quantitative study measured workflow compliance following an upgraded electronic health record summary page. Data were collected using audit log files and analyzed. Some positive improvements were demonstrated for key workflow tasks; significant time savings and more structured data entry were observed. Key Words: electronic health record, EHR, workflow, optimization, neonatal, Health care can generate huge volumes of data daily (Health Information and Quality Authority [HIQA], 2017). The delivery of safe and effective health care can depend on the availability of [...]

The current International Council for Harmonisation (ICH) Q9(R1) Quality Risk Management (QRM) guideline is a targeted revision of the initial guidance issued in 2005, intended to address subjectivity, formality, risk-based [...]

Objective: To identify which Veteran populations are routinely accessing video-based care. Data Sources and Study Setting: National, secondary administrative data from electronic health records at the Veterans Health Administration (VHA), 2019-2021. Study Design: This retrospective cohort analysis identified patient characteristics associated with the odds of using any video care; and then, among those with a previous video visit, the annual rate of video care utilization. Video care use was reported overall and stratified into care type (e.g., primary, mental health, and specialty video care) between March 10, 2020 and February 28, 2021. Data Collection: Veterans active in VA health care (>1 outpatient visit between March 11, 2019 and March 10, 2020) were included in this study. Principal Findings: Among 5,389,129 Veterans in this evaluation, approximately 27.4% of Veterans had at least one video visit. We found differences in video care utilization by type of video care: 14.7% of Veterans had at least one primary care video visit, 10.6% a mental health video visit, and 5.9% a specialty care video visit. Veterans with a history of housing instability had a higher overall rate of video care driven by their higher usage of video for mental health care compared with Veterans in stable housing. American Indian/Alaska Native Veterans had reduced odds of video visits, yet similar rates of video care when compared to White Veterans. Low-income Veterans had lower odds of using primary video care yet slightly elevated rates of primary video care among those with at least one video visit when compared to Veterans enrolled at VA without special considerations. Conclusions: Variation in video care utilization patterns by type of care identified Veteran populations that might require greater resources and support to initiate and sustain video care use. Our data support service specific outreach to homeless and American Indian/Alaska Native Veterans. KEYWORDS access to care, delivery of health care, COVID-19, disparities, telemedicine, Veterans, 1 | INTRODUCTION Maintaining health care access is a critical priority for the U.S. Department of Veterans Affairs (VA). Virtual care, or health care provided by phone or video, has [...]

Research Objective: To identify patient-reported social risk, behavioral, and health factors associated with emergency department (ED) utilization in high-risk Veterans Affairs (VA) patients. Data Sources: Patient survey, VA, Medicare data. Study Design: Prospective cohort study using multivariable logistic regression to identify patient-reported factors associated with all-cause and ambulatory care sensitive condition (ACSC)-related ED visits among VA patients at high risk for hospitalization or death. Data Extraction Methods: Patient-reported measures derived from a 2018 survey sent to 10,000 VA patients; clinical and demographic characteristics derived from VA data; ED visits derived from VA and Medicare claims. Principal Findings: Among 4680 survey respondents, 52.5% and 16.3% experienced an all-cause or ACSC-related ED visit in the following year, respectively. An ED visit was more likely among individuals with functional status limitations (6.0% points (Confidence Interval [CI] 0.017-0.103)) and transportation barriers (5.2% points [CI 0.005-0.099]). An ACSC-related ED visit was more likely among individuals with functional status limitations (3.2% points [CI 0.003-0.062]) and self-rated poorer health (7.4% points (CI 0.030-0.119) poor; 6.2% points (CI 0.029-0.096) fair; 4.1% points (CI 0.009-0.073) good; compared with excellent/very good). Conclusions: Patient-reported factors not present in most electronic health records were significantly associated with future ED visits in high-risk VA patients. KEYWORDS ambulatory care sensitive conditions, electronic health record, emergency department visits, patient complexity, social and behavioral risk factors, veterans, 1 | INTRODUCTION Social and behavioral risks, such as financial difficulty, housing instability, food insecurity, and lack of transportation, can pose barriers to self-care. When unaddressed, these factors can influence [...]

Believe it or not, the federal government provides more money to states and local governments through grants than it does through contracts (and that even includes the contracts from the [...]

When he first heard news reports about ChatGPT and its powers to search the internet and create readable text, rhymes, and fanciful tales, Micah Gaudet immediately saw the use for [...]

EVERY SIX YEARS, the accountability police swoop down on my campus in the form of WASC, the Western Association of Schools and Colleges. The West Coast accreditation organization comes to [...]

* Bowen, Rhys. The Rose Arbor. Lake Union. Aug. 2024. 379p. ISBN 9781662504211. $28.99. SUSPENSE Bowen ('Royal Spyness' series) skillfully crafts a new historical mystery, featuring Liz Houghton, a newspaper [...]

As a pastor who has served in ten different Presbyterian churches and with about 15 different church musicians, I read Peter Marty's article ("In praise of church musicians," April) with […]

A volcano erupts, and at first there's just chaos and destruction. Lava flows down over the landscape, and ash chokes the air. Then the dust settles, the lava cools, the [...]

With the arrival of COVID, downtowns in many major cities shut down, almost to the breaking point, as staffers began working from their homes. Even though many have returned, a [...]

Deborah Herman Founder + President Fabric Innovations After graduating from Brigham Young University in Provo, Utah with a bachelor's degree in fine art, Deborah Herman entered the family hospitality business, [...]

Information-literacy instruction embedded into courses offers academic librarians the opportunity to shine in front of a large audience who, in theory, are there to develop their understanding of how to [...]

Silvio Ursini Bulgari Hotels & Resorts It has taken Bulgari Hotels & Resorts, part of Marriott International, nearly 20 years to make its mark on Rome, the luxury brand's hometown. [...]

Objective: To examine outpatient care fragmentation and its association with future hospitalization among patients at high risk for hospitalization. Data Sources: Veterans Affairs (VA) and Medicare data. Study Design: We conducted a longitudinal study, using logistic regression to examine how outpatient care fragmentation in FY14 (as measured by number of unique providers, Breslau's Usual Provider of Care (UPC), Bice-Boxerman's Continuity of Care Index (COCI), and Modified Modified Continuity Index (MMCI)) was associated with all-cause hospitalizations and hospitalizations related to ambulatory care sensitive conditions (ACSC) in FY15. We also examined how fragmentation varied by patient's age, gender, race, ethnicity, marital status, rural status, history of homelessness, number of chronic conditions, Medicare utilization, and mental health care utilization. Data Extraction Methods: We extracted data for 130,704 VA patients [greater than or equal to]65 years old with a hospitalization risk [greater than or equal to]90th percentile and [greater than or equal to] four outpatient visits in the baseline year. Principal Findings: The mean (SD) of FY14 outpatient visits was 13.2 (8.6). Fragmented care (more providers, less care with a usual provider, more dispersed care based on COCI) was more common among patients with more chronic conditions and those receiving mental health care. In adjusted models, most fragmentation measures were not associated with all-cause hospitalization, and patients with low levels of fragmentation (more concentrated care based on UPC, COCI, and MMCI) had a higher likelihood of an ACSC-related hospitalization (AOR, 95% CI = 1.21 (1.09-1.35), 1.27 (1.14-1.42), and 1.28 (1.18-1.40), respectively). Conclusions: Contrary to expectations, outpatient care fragmentation was not associated with elevated all-cause hospitalization rates among VA patients in the top 10th percentile for risk of admission; in fact, fragmented care was linked to lower rates of hospitalization for ACSCs. In integrated settings such as the VA, multiple providers, and dispersed care might offer access to timely or specialized care that offsets risks of fragmentation, particularly for conditions that are sensitive to ambulatory care. KEYWORDS care fragmentation, continuity of care, multimorbidity, health system outcome models, care coordination What is known on this topic * Care fragmentation (dispersion of a patient's care across clinicians and health care settings) is a common challenge for patients, particularly for those with multiple chronic conditions. * Fragmentation within primary care and across multiple prescribers and settings has been associated with higher rates of hospitalization and emergency department visits. What this study adds * In this study of Veterans Affairs patients at high-risk for hospitalization, fragmented care (more providers, less care with a usual provider, more dispersed care) was more common among patients with more chronic conditions and those receiving mental health care. * Contrary to expectations, we found that fragmented outpatient care did not increase risk of future all-cause hospitalization among patients in the top 10th percentile for the VA patient population, and in fact was associated with a lower likelihood of hospitalization for ambulatory care-sensitive conditions., 1 | INTRODUCTION Care fragmentation--dispersion of a patient's care across clinicians and health care settings-is a common challenge, particularly for patients with multiple chronic conditions. (1-5) One study found that [...]

Following the sudden cancellation of an April 30 court hearing between Carmelite nuns in Arlington, Texas, and Bishop Michael Olson of Fort Worth, lawyers representing the diocese told the Fort [...]

Hugely so. 20 years ago, you could still make an argument that maybe black holes aren't real--they're just a figment of mathematics. But with the Laser Interferometer Gravitational-Wave Observatory, with [...]

Until recently, Fort Collins, Colorado, Senior Accounting Coordinator Renee Reeves was frustrated by the amount of time it took her to reconcile the city's credit receipts with its bank records. [...]

I INTRODUCTION A good credit score is said to be a ticket to financial growth and freedom.* (1) Credit scoring of individuals in the United States emerged as a response [...]

As I first transitioned into working digitally, I felt overwhelmed with the amount of freedom I had. I'm sure it's something a lot of us can relate to. With an [...]

Organizations, whether in the public or private sector, must brand themselves as employers of choice, in order to attract and retain the right talent. The brand communicates the values of [...]

Organizations, whether in the public or private sector, must brand themselves as employers of choice, in order to attract and retain the right talent. The brand communicates the values of [...]

Initially regarded by many in the horn community as an overly flashy technical display for the horn, Richard Strauss's Horn Concerto No. 2 in E-flat (1942) has since evolved to [...]

Erik Nissen Johansen Owner, Founder + Creative Director Stylt Trampoli Sweden-based, Norway-born designer Erik Nissen Johansen has been pushing the boundaries of design for more than 30 years with his [...]

For the lifestyle brand's New York debut, Pendry's cofounder and creative director Michael Fuerstman tasked local firm Gachot with creating a space that reflected his own lifestyle. 'The dichotomy of [...]

Check out a handful of showstopping finds debuting on the show floor 1 Designed by AB Concept, Cooper & Grahams Aiades collection takes inspiration from the fluidity of water across [...]

Loris Ognibene, Boris Mathias, and Tatiana Sheveleva Founders Chapi Chapo Design A competition for the renovation of a local InterContinental hotel is what led Toronto friends Loris Ognibene, Boris Mathias, [...]

Sculptural fixtures add dramatic flair to any room 1 Marset's Ambrosia is the result of Ciszak Dalmas' vision. Clean lines connect a tubular LED to the ceiling in one of [...]

At a time when trust in government is a fragile commodity, the role of state and local government auditors has become even more important. These people, whether through auditing financial [...]

William Butler Yeats posed this dilemma: One must choose the perfection of life or that of the work Denise Levertov offers a refutation of that choice. As one the most [...]

Over the summer of 2023, the fiscal status of local governments and states appeared to be in reasonably good condition. Property values--especially for homes--were strong, so property taxes were holding [...]

After all these years, I'm still a knight. I don't mean a medieval tin-can clanging knight. I graduated from high school in 1975 at a ceremony held, not at the [...]

There's no argument about the value of public input in making important government decisions. According to GFOA, good public participation practices can help governments be more accountable and responsive and [...]

It seems like ages since so many of us suddenly had to take a crash course in critical race theory (CRT). Then, seemingly five minutes later, just as Christopher Rufo, [...]

After leading software engineering projects for 12 years, 'Nancy' took a break from professional work to raise a family and take care of a parent with a terminal illness. Years [...]

Olson Kundig New York While many companies moved away from traditional office spaces during the COVID-19 pandemic (and some eschewed them altogether) Olson Kundig did the opposite, instead designing its [...]

Life-threatening thrombotic events and neurological symptoms are prevalent in COVID-19 and are persistent in patients with long COVID experiencing post-acute sequelae of SARS-CoV-2 infection1–4. Despite the clinical evidence1,5–7, the underlying mechanisms of coagulopathy in COVID-19 and its consequences in inflammation and neuropathology remain poorly understood and treatment options are insufficient. Fibrinogen, the central structural component of blood clots, is abundantly deposited in the lungs and brains of patients with COVID-19, correlates with disease severity and is a predictive biomarker for post-COVID-19 cognitive deficits1,5,8–10. Here we show that fibrin binds to the SARS-CoV-2 spike protein, forming proinflammatory blood clots that drive systemic thromboinflammation and neuropathology in COVID-19. Fibrin, acting through its inflammatory domain, is required for oxidative stress and macrophage activation in the lungs, whereas it suppresses natural killer cells, after SARS-CoV-2 infection. Fibrin promotes neuroinflammation and neuronal loss after infection, as well as innate immune activation in the brain and lungs independently of active infection. A monoclonal antibody targeting the inflammatory fibrin domain provides protection from microglial activation and neuronal injury, as well as from thromboinflammation in the lung after infection. Thus, fibrin drives inflammation and neuropathology in SARS-CoV-2 infection, and fibrin-targeting immunotherapy may represent a therapeutic intervention for patients with acute COVID-19 and long COVID.

The Additive Manufacturing Benchmark Test Series (AM Bench) provides rigorous measurement data for validating additive manufacturing (AM) simulations for a broad range of AM technologies and material systems. AM Bench includes extensive in situ and ex situ measurements, simulation challenges for the AM modeling community, and a corresponding conference series. In 2022, the second round of AM Bench measurements, challenge problems, and conference were completed, focusing primarily upon laser powder bed fusion (LPBF) processing of metals, and both material extrusion processing and vat photopolymerization of polymers. In all, more than 100 people from 10 National Institute of Standards and Technology (NIST) divisions and 21 additional organizations were directly involved in the AM Bench 2022 measurements, data management, and conference organization. The international AM community submitted 138 sets of blind modeling simulations for comparison with the in situ and ex situ measurements, up from 46 submissions for the first round of AM Bench in 2018. Analysis of these submissions provides valuable insight into current AM modeling capabilities. The AM Bench data are permanently archived and freely accessible online. The AM Bench conference also hosted an embedded workshop on qualification and certification of AM materials and components.

Environmental enteric dysfunction (EED), a chronic inflammatory condition of the small intestine, is an important driver of childhood malnutrition globally. Quantifying intestinal morphology in EED allows for exploration of its association with functional and disease outcomes.

This article provides a summary of the 15th Annual A-List Awards, which recognizes the outstanding work of the design community. The awards cover a range of categories, including bath design, kitchen design, and modern architecture. The winners will be announced at a networking gala and awards ceremony in September 2024. The article also mentions two companies, Tischler and Hobbs, Inc., that offer custom windows, doors, and home building services, as well as Fairview Hearthside, a provider of hearth products in the Hudson Valley. Additionally, the document lists various businesses and professionals in Fairfield County, CT, specializing in landscaping, home design, renovations, and automotive sales. It highlights the values and services of Karl Chevrolet and Marvin, emphasizing their commitment to customer satisfaction and quality products. [Extracted from the article]

This article from Fine Woodworking provides a collection of workshop tips for woodworking enthusiasts. The tips include a smart sled for cutting spline slots in mitered boxes, a sanding block made from a spare platen for a disk sander, using a combination square as a work stop on a miter saw, creating a 4-in-1 clamping caul for even pressure, making benchdogs using a bullet catch, using a three-way pool valve as a blast gate for a shop vacuum, attaching solid tops to casework, and using a credit card as a saw guard. The article also mentions a woodworking instructor named Robert Roemer who teaches traditional hand skills in a barn he built. [Extracted from the article]