The United States Needs A Better Testing Playbook For Future Public Health Emergencies.

The absence of a comprehensive national playbook for developing and deploying testing has hindered the United States' ability to rapidly suppress recent biological emergencies (for example, the COVID-19 pandemic and outbreaks of mpox). We describe here the Testing Playbook for Biological Emergencies, a national testing playbook we developed. It includes a set of decisions and actions for US officials to take at specific times during infectious disease emergencies to implement testing rapidly and to ensure that available testing meets clinical and public health needs.

A new ground level neutron monitor for space weather assessment.

We report on a new ground-level neutron monitor design for studying cosmic rays and fluxes of solar energetic particles at the Earth's surface. The first-of-its-kind instrument, named the NM-2023 after the year it was standardised and following convention, will be installed at a United Kingdom Meteorological Office observatory (expected completion mid 2024) and will reintroduce such monitoring in the UK for the first time since ca. 1984.

Evaluating the Effects of a Medication Adherence Packaging Program on Outcomes in Older People.

To determine the impact of an adherence packaging and medication synchronization program on hospital visits for older people living independently in the community. A retrospective pre-post study that evaluated patient outcomes over a 24-month period was conducted. Patient-specific socio-demographic, medical, and hospital visit-related data were collected for 12 months before and after patient enrollment in the adherence packaging program.

Comparison of Neutron Detection Performance of Four Thin-Film Semiconductor Neutron Detectors Based on Geant4.

Third-generation semiconductor materials have a wide band gap, high thermal conductivity, high chemical stability and strong radiation resistance. These materials have broad application prospects in optoelectronics, high-temperature and high-power equipment and radiation detectors. In this work, thin-film solid state neutron detectors made of four third-generation semiconductor materials are studied.

Depicting corrosion-born defects in pipelines with combined neutron/γ ray backscatter: a biomimetic approach.

The identification of corrosion, cracks and defects in pipelines used for transporting oil and gas can reduce the possibility of leaks, and consequently, it can limit the extent of an environmental disaster, public hazard and the associated financial impact of such events. Typically, corrosion in oil pipelines is measured with non-destructive ultrasonic or electromagnetic techniques, on the basis that corrosion and defects are often manifest as a change of thickness in the steel from which pipelines are made. However, such approaches are not practical for underground pipelines and their deployment can be complicated for the case of pipelines covered by insulation.

Integration of Ground- Penetrating Radar and Gamma-Ray Detectors for Nonintrusive Characterisation of Buried Radioactive Objects.

The characterisation of buried radioactive wastes is challenging because they are not readily accessible. Therefore, this study reports on the development of a method for integrating ground-penetrating radar (GPR) and gamma-ray detector measurements for nonintrusive characterisation of buried radioactive objects. The method makes use of the density relationship between soil permittivity models and the flux measured by gamma ray detectors to estimate the soil density, depth and radius of a disk-shaped buried radioactive object simultaneously.

A remotely triggered fast neutron detection instrument based on a plastic organic scintillator.

A detector system for the characterization of radiation fields of both fast neutrons and γ rays is described comprising of a gated photomultiplier tube (PMT), an EJ299-33 solid organic scintillator detector, and an external trigger circuit. The objective of this development was to conceive a means by which the PMT in such a system can be actuated remotely during the high-intensity bursts of pulsed γ-ray contamination that can arise during active interrogation procedures. The system is used to detect neutrons and γ rays using established pulse-shape discrimination (PSD) techniques.

Structuring the patient-physician encounter: Joint creation of an actionable roadmap to health.

The patient׳s experiences and costs related to their care are largely dictated by each patient-physician interaction along the continuum of care. However, the amount of time that a physician spends with a patient creating a medical action plan is highly variable and often not related to the severity or complexity of the patient׳s condition. Adding a structured process to guide and inform patient-physician encounters, including outlining expectations and follow-up by both sides is needed.

The business value and cost-effectiveness of genomic medicine.

Genomic medicine offers the promise of more effective diagnosis and treatment of human diseases. Genome sequencing early in the course of disease may enable more timely and informed intervention, with reduced healthcare costs and improved long-term outcomes. However, genomic medicine strains current models for demonstrating value, challenging efforts to achieve fair payment for services delivered, both for laboratory diagnostics and for use of molecular information in clinical management.

Assessing the quality of prescribing and monitoring erythropoiesis-stimulating agents in the nursing home setting.

Introduction: As many as 50% of all nursing home (NH) residents meet the World Health Organization criteria for anemia. The objectives of this study were to determine the prevalence and appropriateness of prescribing and monitoring of erythropoiesis-stimulating agents (ESAs) used to treat anemia in the NH setting.

Methods: Cross-sectional, 1-month study of all NH residents in 4 community-based, university-affiliated NHs between January and February 2008.

Evaluating the impact of involving young people in developing children's services in an acute hospital trust.

Aims And Objectives: The aim of this paper is to reflect on how an acute hospital trust involved a youth council comprising 17 young people aged 11-18 years to improve children's service delivery in one NHS trust in the UK.

Background: Over the last decade, there has been an increased emphasis on the active involvement and participation of children and young people in the decision-making processes that affect them. However, one challenge in involving users in acute hospital trusts is how their views are used to develop services.

Realizing the promise of personalized medicine.

Scientific advances have begun to give doctors the power to customize therapy for individuals. However, adoption of this approach has progressed slowly and unevenly because the trial-and-error treatment model still governs how the health care system develops, regulates, pays for, and delivers therapies. Aspinall, the president of Genzyme Genetics, and Hamermesh, chair of a Harvard Business School initiative to improve leadership in health care organizations, discuss the barriers to personalized medicine and suggest ways to overcome them.

Improving adverse-drug-reaction reporting in ambulatory care clinics at a Veterans Affairs hospital.

The detection of adverse drug reactions (ADRs) by a traditional passive reporting system and by a method involving patient and provider interviews was studied. The study sample consisted of randomly selected outpatients seen by their primary care provider during scheduled appointments in January and February 2001 at a Veterans Affairs medical center. After ambulatory care clinic sessions, patients and providers were asked (by telephone and in person, respectively) to identify potential ADRs.

Relationship between effective coping and perceived quality of life in spinal cord injured patients.

This article describes a study that explored the relationship between coping effectiveness and perceived quality of life in spinal cord injured patients. The subjects were 40 functionally disabled inpatient wheelchair-bound individuals from two rehabilitation units at the Long Beach VA Medical Center in Long Beach, CA. Data were analyzed using Pearson's correlation coefficient (r) and descriptive statistics.

Evaluating patient outcomes.

In this study, nurses effectively demonstrated that in addition to stating goals in observable outcomes, they could develop rating scales to measure a patient's progress toward goal attainment. An unexpected finding was that improvement in evaluation was accompanied by corresponding improvement in other components of the nursing process. For example, prior to the study period, nurses rarely listened to chest sounds or measured ventilatory volume to assess lung congestion, even though many had received training in physical assessment and a respirometer was available on the unit.

Use of a decision tree to improve accuracy of diagnosis.

Thirty triads of nurses matched for educational background, length of experience, and previous performance were studied to determine if use of a decision tree would improve diagnostic accuracy. One experimental and two control groups were given a written case study and asked to list all possible diagnoses that could cause the change in behavior exhibited by the patient. Experimental group nurses were given a set of decision trees to enable them to use the information systematically to determine if characteristics of each condition were present.