A Framework to Support the Sharing and Reuse of Computable Phenotype Definitions Across Health Care Delivery and Clinical Research Applications.

INTRODUCTION: The ability to reproducibly identify clinically equivalent patient populations is critical to the vision of learning health care systems that implement and evaluate evidence-based treatments. The use of common or semantically equivalent phenotype definitions across research and health care use cases will support this aim. Currently, there is no single consolidated repository for computable phenotype definitions, making it difficult to find all definitions that already exist, and also hindering the sharing of definitions between user groups. METHOD: Drawing from our experience in an academic medical center that supports a number of multisite research projects and quality improvement studies, we articulate a framework that will support the sharing of phenotype definitions across research and health care use cases, and highlight gaps and areas that need attention and collaborative solutions. FRAMEWORK: An infrastructure for re-using computable phenotype definitions and sharing experience across health care delivery and clinical research applications includes: access to a collection of existing phenotype definitions, information to evaluate their appropriateness for particular applications, a knowledge base of implementation guidance, supporting tools that are user-friendly and intuitive, and a willingness to use them. NEXT STEPS: We encourage prospective researchers and health administrators to re-use existing EHR-based condition definitions where appropriate and share their results with others to support a national culture of learning health care. There are a number of federally funded resources to support these activities, and research sponsors should encourage their use.

Health, ageing migrants and care strategies

This article is the result of a study that seeks to understand the relationship between socio-economic conditions, health and active ageing. Behaviours related to active ageing in relation to health were identified as were the strategies used in active ageing and their determinants. A qualitative methodology was adopted in the form of semi-structured interviews. Data processing consisted of thematic content analysis in interviews. Two socio-economic groups of elderly Cape Verdean men and women composed the study sample. Both groups totalled 22 cases. Findings indicated that the socio-economic status interferes directly in the affairs of active ageing rather than health issues. In the higher socio-economic group, it was found that status determines active ageing rather than health issues.

Iowa Highway Programs, Finances, and Progress, 1951

(a) Iowa has a total of 101,620 miles of rural roads, both primary and secondary. (b) On January 1, 1951, a total of 68,869 miles of these rural roads were surfaced - mostly with gravel and crushed stone. (c) Additional roads are being surfaced at the rate of 2676 miles per year. (d) Iowa's highway program provides for a surfaced road to every reasonably located rural home and a paved or other type of dustless surface on all primary roads. (e) Iowa's highway funds come 26.0 per cent from property taxes, 63.5 per cent from road use taxes, 10.5 per cent from Federal aid. (f) Annual income under present laws, available for highway construction, is approximately For primary roads ----------------- $24,000,000 For secondary roads---------------- $41,967,000 (g) Iowa's highway improvements are being paid for as built. No new bonds are being issued. (h) Unobligated available farm to market road funds are rapidly being placed under contract. (i) The letting of highway contracts is increasing rapidly. (j)- Iowa's highway program is estimated to cost $945,000,000 and will require twenty years to build. These are the highlights of Iowa's highway program. The details will follow in succeeding paragraphs.

Iowa Highway Programs, Finances, and Progress, 1952

(a) Iowa has a total of 101,620 miles of rural roads, both primary and secondary. (b) On January 1, 1952, a total of 71,493 miles of these rural roads were surfaced - mostly with gravel and crushed stone. (c) Additional roads are being surfaced at the rate of 2662 miles per year. (d) Iowa's highway program provides for a surfaced road to every reasonably located rural home and a paved or other type of dustless surface on all primary roads. (e) Iowa's highway funds come 26.0 per cent from property taxes, 63.5 per cent from road use taxes, 10.5 per cent from Federal aid. (f) Annual income under present laws, available for highway construction, is approximately For primary roads------------------$23,000,000 For secondary roads---------------- 41,967,000 (g) Iowa's highway improvements are being paid for as built. No new bonds are being issued. (h) The surplus of farm to market road funds created during and immediately following the War have now been placed under contract, with only a minimum working balance remaining in the fund. (i) Iowa's highway program was estimated to cost $945,000,000 and to require twenty years to build, by the 1948 Legislative Committee. This estimate would now have to be increased due to price increases and higher required standards. These are the highlights of Iowa's highway program. The details will follow in succeeding paragraphs.

Assessing variation in personal health service delivery and workplace smoking ban enforcement by local health departments

Thesis (Ph.D.)--University of Washington, 2016-08

Facility and Programs Roles and Responsibilities in Suspected Dependent Adult Abuse, October 2, 2013

Explanation of vital role in protecting residents/tenants living in long-term care facilities and assisted living programs.

Quantifying Barriers to Meditation as a Health Behavior: Exploratory and Confirmatory Factor Analysis of the Determinants of Meditation Practice Inventory

Although the benefits of mindfulness meditation practices have been widely documented, research data suggest that there are barriers to regularly engaging in meditation behavior. In order to explore research questions pertaining to meditation initiation and adherence, psychometrically valid scales to assess barriers to meditation practice are necessary. The aim of the present study was to explore the factor structure and construct validity of the Determinants of Meditation Practice Inventory (DMPI) (Williams et al., 2011), a perceived barriers to meditation scale. Exploratory and confirmatory factor analyses along with construct validity tests were performed on data obtained from two large, community samples. Results supported the DMPI as a valid scale assessing perceived barriers with four factors, Lack of Interest, Knowledge Concerns, Pragmatic Concerns and Sociocultural Beliefs. The present study offers a DMPI-revised scale that may be reliably used to assess attitudes and beliefs that might impede meditation behavior.

Information and communication technologies in tourism: challenges and trends

The integration of Information and Communication Technologies (ICT) in the tourism industry is an essential element for the success of any tourism enterprise. ICTs provide access to information of tourism products from anywhere and at any time. Tour companies may also reach out to target customers around the world through a series of emerging technologies. This paper aims to make a review of the main key factors of ICT in Tourism. Aspects such as the quality of the website, Digital Marketing, Social Networking, Multimedia, Mobile Technologies and Intelligent Environments are discussed.

Psychometric properties of the oral health impact profile and new methodological approach

Objective: Evaluate the validity, reliability, and factorial invariance of the complete Portuguese version of the Oral Health Impact Profile (OHIP) and its short version (OHIP-14). Methods: A total of 1,162 adults enrolled in the Faculty of Dentistry of Araraquara/UNESP participated in the study; 73.1% were women; and the mean age was 40.7 ± 16.3 yr. We conducted a confirmatory factor analysis, where χ2/df, comparative fit index, goodness of fit index, and root mean square error of approximation were used as indices of goodness of fit. The convergent validity was judged from the average variance extracted and the composite reliability, and the internal consistency was estimated by Cronbach standardized alpha. The stability of the models was evaluated by multigroup analysis in independent samples (test and validation) and between users and nonusers of dental prosthesis. Results: We found best-fitting models for the OHIP-14 and among dental prosthesis users. The convergent validity was below adequate values for the factors “functional limitation” and “physical pain” for the complete version and for the factors “functional limitation” and “psychological discomfort” for the OHIP-14. Values of composite reliability and internal consistency were below adequate in the OHIP-14 for the factors “functional limitation” and “psychological discomfort.” We detected strong invariance between test and validation samples of the full version and weak invariance for OHIP-14. The models for users and nonusers of dental prosthesis were not invariant for both versions. Conclusion: The reduced version of the OHIP was parsimonious, reliable, and valid to capture the construct “impact of oral health on quality of life,” which was more pronounced in prosthesis users.

Wave climate in the Arctic 1992-2014: seasonality and trends

Over the past decade, the diminishing Arctic sea ice has impacted the wave field, which depends on the ice-free ocean and wind. This study characterizes the wave climate in the Arctic spanning 1992–2014 from a merged altimeter data set and a wave hindcast that uses CFSR winds and ice concentrations from satellites as input. The model performs well, verified by the altimeters, and is relatively consistent for climate studies. The wave seasonality and extremes are linked to the ice coverage, wind strength, and wind direction, creating distinct features in the wind seas and swells. The altimeters and model show that the reduction of sea ice coverage causes increasing wave heights instead of the wind. However, trends are convoluted by interannual climate oscillations like the North Atlantic Oscillation (NAO) and Pacific Decadal Oscillation. In the Nordic Greenland Sea the NAO influences the decreasing wind speeds and wave heights. Swells are becoming more prevalent and wind-sea steepness is declining. The satellite data show the sea ice minimum occurs later in fall when the wind speeds increase. This creates more favorable conditions for wave development. Therefore we expect the ice freeze-up in fall to be the most critical season in the Arctic and small changes in ice cover, wind speeds, and wave heights can have large impacts to the evolution of the sea ice throughout the year. It is inconclusive how important wave–ice processes are within the climate system, but selected events suggest the importance of waves within the marginal ice zone.