Development and Implementation of an Experiential Longitudinal Health Systems Science Thread Into an Existing Medical School Curriculum.

Problem: Medical school graduates enter a complex health care delivery system involving interprofessional teamwork and multifaceted value-based patient care decisions. However, current curricula on health systems science (HSS) are piecemeal, lecture based, and confined to preclinical training.

Approach: The VISTA program is a longitudinal, immersive learning curriculum integrated into the University of Chicago Pritzker School of Medicine curriculum between 2016 and 2018.

Reliability of Markerless Motion Capture Systems for Assessing Movement Screenings.

Background: Movement screenings are commonly used to detect unfavorable movement patterns. Markerless motion capture systems have been developed to track 3-dimensional motion.

Purpose: To determine the reliability of movement screenings assessed using a markerless motion capture system when comparing the results of multiple systems and multiple collection periods.

Initiative to increase family presence and participation in daily rounds on a paediatric acute care cardiology unit.

Introduction: Family-centred rounds benefit families and clinicians and improve outcomes in general paediatrics, but are understudied in subspecialty settings. We sought to improve family presence and participation in rounds in a paediatric acute care cardiology unit.

Methods: We created operational definitions for family presence, our process measure, and participation, our outcome measure, and gathered baseline data over 4 months of 2021.

Reciprocal Interactions Between the Gut Microbiome and Mammary Tissue Mast Cells Promote Metastatic Dissemination of HR+ Breast Tumors.

Establishing commensal dysbiosis, defined as an inflammatory gut microbiome with low biodiversity, before breast tumor initiation, enhances early dissemination of hormone receptor-positive (HR+) mammary tumor cells. Here, we sought to determine whether cellular changes occurring in normal mammary tissues, before tumor initiation and in response to dysbiosis, enhanced dissemination of HR+ tumors. Commensal dysbiosis increased both the frequency and profibrogenicity of mast cells in normal, non-tumor-bearing mammary tissues, a phenotypic change that persisted after tumor implantation.

Cable deployment system for unmanned ground vehicle (UGV) mobile microgrids.

An ad hoc autonomous mobile microgrid system requires electrical connections to be formed between physically separated resources. This work proposes the use of unmanned ground vehicles (UGVs) as the means to deploy the electrical cable that creates these connections. This operation requires careful control of the cabling at variable speeds to avoid entanglement with the deploying UGV or obstacles in complex outdoor environments.

Interferon-β acts directly on T cells to prolong allograft survival by enhancing regulatory T cell induction through Foxp3 acetylation.

Type I interferons (IFNs) are pleiotropic cytokines with potent antiviral properties that also promote protective T cell and humoral immunity. Paradoxically, type I IFNs, including the widely expressed IFNβ, also have immunosuppressive properties, including promoting persistent viral infections and treating T-cell-driven, remitting-relapsing multiple sclerosis. Although associative evidence suggests that IFNβ mediates these immunosuppressive effects by impacting regulatory T (Treg) cells, mechanistic links remain elusive.

Attracting New Talent to the Governmental Public Health Workforce: Strategies for Improved Recruitment of Public Health Graduates.

Context: Governmental public health (GPH) agencies need a diverse, skilled, and motivated workforce to advance health and well-being, but they face a number of recruitment challenges. While there has been massive growth in public health degree programs and graduates, those with a degree in public health are underrepresented in the GPH workforce.

Objectives: This study evaluates potential reasons undergraduate and graduate public health degree holders are underrepresented in the GPH workforce, assesses student awareness of and interest in GPH jobs, and identifies strategies for improved recruitment.

Outbreaks of Hepatitis A in US Communities, 2017-2018: Firsthand Experiences and Operational Lessons From Public Health Responses.

To identify and analyze common challenges from multiple US communities affected by the hepatitis A epidemic beginning in March 2017, and to identify operational lessons to support preparedness for similar future public health emergencies. We conducted semistructured interviews with health officials from 9 city or county health departments to collect the firsthand experience of public health responders. We collected data from January to October 2018 via teleconference.

A Thpok-Directed Transcriptional Circuitry Promotes Bcl6 and Maf Expression to Orchestrate T Follicular Helper Differentiation.

The generation of high-affinity neutralizing antibodies, the objective of most vaccine strategies, occurs in B cells within germinal centers (GCs) and requires rate-limiting "help" from follicular helper CD4 T (Tfh) cells. Although Tfh differentiation is an attribute of MHC II-restricted CD4 T cells, the transcription factors driving Tfh differentiation, notably Bcl6, are not restricted to CD4 T cells. Here, we identified a requirement for the CD4-specific transcription factor Thpok during Tfh cell differentiation, GC formation, and antibody maturation.

Local Public Health Policymakers' Views on State Preemption: Results of a National Survey, 2018.

To learn about local health policymakers' experiences and responses to preemption-the ability of a higher level of government to limit policy activity at a lower level. Between March and June 2018, we conducted an anonymous Web-based survey of mayors and health officials in US cities with populations of 150 000 or more. We used descriptive statistics to analyze multiple-choice responses.

Epidemiology Workforce Capacity in 27 Large Urban Health Departments in the United States, 2017.

Objectives: The Council of State and Territorial Epidemiologists (CSTE) has periodically assessed the epidemiological capacity of states since 2001, but the data do not reflect the total US epidemiology capacity. CSTE partnered with the Big Cities Health Coalition (BCHC) in 2017 to assess epidemiology capacity in large urban health departments. We described the epidemiology workforce capacity of large urban health departments in the United States and determined gaps in capacity among BCHC health departments.

Big City Health Officials' Conceptualizations of Health Equity.

Context: Senior health officials of local health departments are uniquely positioned to provide transformational leadership on health disparities and inequities.

Objective: This study aimed to understand how senior health officials in large US cities define health equity and its relationship with disparities and characterize these senior health officials' perceptions of using health equity and disparity language in local public health practice.

Design: In 2016, we used a general inductive qualitative design and conducted 23 semistructured interviews with leaders of large local health departments.

Cognitive function during exacerbations of chronic obstructive pulmonary disease.

Background: The reported prevalence of cognitive impairment in patients with stable chronic obstructive pulmonary disease (COPD) ranges 36-77%. Few studies report the prevalence of cognitive impairment in acutely unwell COPD patients.

Aims: To determine the prevalence and time course of cognitive impairment in patients with COPD during and after an admission to hospital with an exacerbation of the disease.

The Governmental Public Health Workforce in 26 Cities: PH WINS Results From Big Cities Health Coalition Members.

Context: More than 80% of Americans live in urban areas. Over the past 20 years, an increasing number of local governmental public health departments, particularly those in big cities, have taken pioneering action to improve population health. This article focuses on members of the Big Cities Health Coalition (BCHC) who participated in the 2017 Public Health Workforce Interest and Needs Survey (PH WINS).

The First Nationally Representative Benchmark of the Local Governmental Public Health Workforce: Findings From the 2017 Public Health Workforce Interests and Needs Survey.

Context: A changing public health landscape requires local governmental health departments (LHDs) to have a workforce prepared to meet complex challenges. While previous assessments looked at organizational data on the LHD workforce, the Public Health Workforce Interests and Needs Survey (PH WINS) is the first nationally representative survey to examine individual perceptions of training needs, workplace environment, job satisfaction, and awareness of emerging concepts in public health.

Objectives: Characterize key interests and needs of the local governmental public health workforce.

Assessing the Knowledge, Skills, and Abilities of Public Health Professionals in Big City Governmental Health Departments.

Objective: To identify essential knowledge, skills, and abilities (KSAs) for and characterize gaps in KSAs of professionals working in large, urban health departments.

Design: A survey was disseminated to potentially eligible supervisors within 26 of 28 health departments in the largest, most urban jurisdictions in the country. A supervisor was eligible to participate if he or she supervised at least 1 staff member whose highest level of education was a master's degree.

The Impact of a Scholarly Concentration Program on Student Interest in Career-Long Research: A Longitudinal Study.

Purpose: Concerns remain regarding the future of the physician-scientist workforce. One goal of scholarly concentration (SC) programs is to give students skills and motivation to pursue research careers. The authors describe SC and student variables that affect students' career plans.

A Community Checklist for Health Sector Resilience Informed by Hurricane Sandy.

This is a checklist of actions for healthcare, public health, nongovernmental organizations, and private entities to use to strengthen the resilience of their community's health sector to disasters. It is informed by the experience of Hurricane Sandy in New York and New Jersey and analyzed in the context of findings from other recent natural disasters in the United States. The health sector is defined very broadly, including-in addition to hospitals, emergency medical services (EMS), and public health agencies-healthcare providers, outpatient clinics, long-term care facilities, home health providers, behavioral health providers, and correctional health services.

Genetically Modified (GM) Mosquito Use to Reduce Mosquito-Transmitted Disease in the US: A Community Opinion Survey.

Introduction: Mosquito-borne infectious diseases such as dengue, chikungunya, and now Zika, pose a public health threat to the US, particularly Florida, the Gulf Coast states, and Hawaii. Recent autochthonous transmission of dengue and chikungunya in Florida, the recent dengue outbreak in Hawaii, and the potential for future local spread of Zika in the US, has led to the consideration of novel approaches to mosquito management. One such novel approach, the release of sterile genetically modified mosquitoes, has been proposed as a possible intervention, and a trial release of GM mosquitoes is being considered in one Florida community.

Hospital Evacuation and Shelter-in-Place: Who Is Responsible for Decision-Making?

Objective: During natural disasters, hospital evacuation may be necessary to ensure patient safety and care. We aimed to examine perceptions of stakeholders involved in these decisions throughout the Mid-Atlantic region of the United States during Hurricane Sandy in October 2012.

Methods: Semistructured interviews were conducted from March 2014 to February 2015 to characterize stakeholders' perceptions about authority and responsibility for acute care hospital evacuation/shelter-in-place decision-making in Delaware, Maryland, New Jersey, and New York during Hurricane Sandy.

Legal Preparedness for Hurricane Sandy: Authority to Order Hospital Evacuation or Shelter-in-Place in the Mid-Atlantic Region.

Hospitals were once thought to be places of refuge during catastrophic hurricanes, but recent disasters such as Hurricanes Katrina and Sandy have demonstrated that some hospitals are unable to ensure the safety of patients and staff and the continuity of medical care at key times. The government has a duty to safeguard public health and a responsibility to ensure that appropriate protective action is taken when disasters threaten or impair the ability of hospitals to sustain essential services. The law can enable the government to fulfill this duty by providing necessary authority to order preventive or reactive responses--such as ordering evacuation of or sheltering-in-place in hospitals--when safety is imperiled.