Decarbonizing Water: The Potential to Apply the Voluntary Carbon Market toward Global Water Security.

The increase in global water insecurity is one of the first perceivable effects of climate change. Two billion people are now without access to safe drinking water, and four billion experience water stress at least once a year, primarily in low per-capita emission countries. This nexus between climate change and water insecurity has significant implications for the global economy, with the water sector contributing 10% of global emissions.

Disaggregating Latino nativity in equity research using electronic health records.

Objective: To develop and validate prediction models for inference of Latino nativity to advance health equity research.

Data Sources/study Setting: This study used electronic health records (EHRs) from 19,985 Latino children with self-reported country of birth seeking care from January 1, 2012 to December 31, 2018 at 456 community health centers (CHCs) across 15 states along with census-tract geocoded neighborhood composition and surname data.

Study Design: We constructed and evaluated the performance of prediction models within a broad machine learning framework (Super Learner) for the estimation of Latino nativity.

A continuous, in-situ, near-time fluorescence sensor coupled with a machine learning model for detection of fecal contamination risk in drinking water: Design, characterization and field validation.

We designed and validated a sensitive, continuous, in-situ, remotely reporting tryptophan-like fluorescence sensor and coupled it with a machine learning model to predict high-risk fecal contamination in water (>10 colony forming units (CFU)/100mL E. coli). We characterized the sensor's response to multiple fluorescence interferents with benchtop analysis.

Estimating groundwater use and demand in arid Kenya through assimilation of satellite data and in-situ sensors with machine learning toward drought early action.

Groundwater is an important source of water for people, livestock, and agriculture during drought in the Horn of Africa. In this work, areas of high groundwater use and demand in drought-prone Kenya were identified and forecasted prior to the dry season. Estimates of groundwater use were extended from a sentinel network of 69 in-situ sensored mechanical boreholes to the region with satellite data and a machine learning model.

Mobility and social deprivation on primary care utilisation among paediatric patients with asthma.

Objective: Asthma care is negatively impacted by neighbourhood social and environmental factors, and moving is associated with undesirable asthma outcomes. However, little is known about how movement into and living in areas of high deprivation relate to primary care use. We examined associations between neighbourhood characteristics, mobility and primary care utilisation of children with asthma to explore the relevance of these social factors in a primary care setting.

Role of social deprivation on asthma care quality among a cohort of children in US community health centres.

Objective: Social deprivation is associated with worse asthma outcomes. The Social Deprivation Index is a composite measure of social determinants of health used to identify neighbourhood-level disadvantage in healthcare. Our objective was to determine if higher neighbourhood-level social deprivation is associated with documented asthma care quality measures among children treated at community health centres (CHCs).

Improving rural health care reduces illegal logging and conserves carbon in a tropical forest.

Tropical forest loss currently exceeds forest gain, leading to a net greenhouse gas emission that exacerbates global climate change. This has sparked scientific debate on how to achieve natural climate solutions. Central to this debate is whether sustainably managing forests and protected areas will deliver global climate mitigation benefits, while ensuring local peoples' health and well-being.

Assessment of Opioid Prescribing Patterns in a Large Network of US Community Health Centers, 2009 to 2018.

Importance: Understanding opioid prescribing patterns in community health centers (CHCs) that disproportionately serve low-income patients may help to guide strategies to reduce opioid-related harms.

Objective: To assess opioid prescribing patterns between January 1, 2009, and December 31, 2018, in a network of safety-net clinics serving high-risk patients.

Design, Setting, And Participants: Cross-sectional study of 3 227 459 opioid prescriptions abstracted from the electronic health records of 2 129 097 unique primary care patients treated from 2009 through 2018 at a network of CHCs that included 449 clinic sites in 17 states.

Smoking Assessment and Current Smoking Status Among Adolescents in Primary Care Settings.

Introduction: Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued use into adulthood. Primary care visits provide opportunities for the assessment and treatment of tobacco use; however, little is known about prevalence and correlates of assessing smoking status and current use among adolescents in these settings.

Aims And Methods: Using electronic health record data from the OCHIN network, we identified adolescents with greater than or equal to one primary care visit to a study clinic (n = 366 clinics from 15 US states) during January 1, 2016 to December 31, 2017.

Disparities in Biomarkers for Patients With Diabetes After the Affordable Care Act.

Background: Racial and ethnic minorities are disproportionately affected by diabetes and at greater risk of experiencing poor diabetes-related outcomes compared with non-Hispanic whites. The Affordable Care Act (ACA) was implemented to increase health insurance coverage and reduce health disparities.

Objective: Assess changes in diabetes-associated biomarkers [hemoglobin A1c (HbA1c) and low-density lipoprotein] 24 months pre-ACA to 24 months post-ACA Medicaid expansion by race/ethnicity and insurance group.

Associations between Psychiatric Disorders and Cannabis-Related Disorders Documented in Electronic Health Records.

Data from a large network of community health centers connected via a single electronic health record (EHR) system examined associations between psychiatric disorders and documentation of a cannabis-related disorder among patients with reported cannabis use. Participants were adults who had at least one ambulatory visit at a clinic in three states between 1/1/2012 and 12/31/2016 and had either 1) a documented cannabis-related disorder indicated by an ICD-9/10 code on the problem list or encounter list or 2) documentation of cannabis use in the EHR social history section. Clinics included 101,405 patients with either cannabis use recorded in the social history of the EHR (n = 71,660) or a cannabis-related disorder documented in the encounter or problem list (n = 29,745).

Oral corticosteroid use, obesity, and ethnicity in children with asthma.

: Comorbid asthma and obesity leads to poorer asthma outcomes, partially due to decreased response to controller medication. Increased oral steroid prescription, a marker of uncontrolled asthma, may follow. Little is known about this phenomenon among Latino children.