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Poluição do Ar em Ambientes Fechados , Automóveis , Retardadores de Chama , Emissões de Veículos , Retratos como Assunto , Emissões de Veículos/análise , Poluição do Ar/estatística & dados numéricos , Automóveis/legislação & jurisprudência , Automóveis/normas , Automóveis/estatística & dados numéricos , Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Indicadores Básicos de Saúde , Análise Custo-Benefício , Política Ambiental , Humanos , United States Government Agencies , Política de SaúdeRESUMO
This Viewpoint describes how the overturning of Chevron deference would shift the ability to make policy decisions about public health and the environment from administrative agencies to the courts.
Assuntos
Regulamentação Governamental , Decisões da Suprema Corte , United States Government Agencies , Humanos , Estados Unidos , United States Government Agencies/legislação & jurisprudênciaRESUMO
This Viewpoint describes implications for medicine and public health if the US Supreme Court decides to overturn or narrow Chevron deference.
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Regulamentação Governamental , Saúde Pública , Decisões da Suprema Corte , United States Government Agencies , Humanos , COVID-19/prevenção & controle , Saúde Pública/legislação & jurisprudência , Estados Unidos , United States Government Agencies/legislação & jurisprudência , Vacinas contra COVID-19/uso terapêuticoRESUMO
BACKGROUND: A joint statement from two federal agencies in the United States calls for coordination and collaboration between programs serving families of infants and toddlers who are at risk or developmentally delayed or disabled U.S. Department of Education and U.S. Department of Health and Human Services. Policy guidance: Joint statement on collaboration and coordination of the MIECHV and IDEA Part C programs. (2017). Individuals with Disabilities Education Act. ED/HHS Joint Guidance Document: Collaboration and Coordination of the Maternal, Infant, and Early Childhood Home Visiting Program and the Individuals with Disabilities Education Act Part C Programs. Young Native American children living on tribal lands in this country are currently eligible for two federal programs associated with these agencies which overlap in mission and implementation. PURPOSE: This paper outlines potential strategies for creating a more seamless system of services for tribal families involving more centralized intake processes and procedures, cross training of staff to work across programs, and adopting more unifying approaches to program implementation. CONCLUSION: A streamlined system of services will result in interventions that better support family and child outcomes while reducing duplication of services, consolidating the limited number of qualified professionals available to provide services, and increasing convenience and cultural attunement of services to Native American families currently participating in both programs.
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Indígena Americano ou Nativo do Alasca , Serviços de Saúde da Criança , Atenção à Saúde , Serviços de Saúde do Indígena , Visita Domiciliar , Serviços de Saúde Materna , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Gravidez , Nativos do Alasca , Crianças com Deficiência , Indígenas Norte-Americanos , Estados Unidos , United States Government Agencies , Atenção à Saúde/etnologiaRESUMO
This Viewpoint discusses recently released information regarding the practice of "rectal feeding" among detainees at Guantanamo Bay and Central Intelligence Agency (CIA) secret prisons.
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Ética Clínica , Métodos de Alimentação , Pessoal de Saúde , Prisioneiros , Prisões , Tortura , Humanos , Pessoal de Saúde/ética , Prisões/ética , Métodos de Alimentação/ética , Governo Federal , United States Government Agencies/ética , Tortura/éticaRESUMO
U.S. government project bets big on intranasal vaccines and monoclonal antibodies, but omits more ambitious approaches.
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Anticorpos Monoclonais , Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , Humanos , Anticorpos Monoclonais/administração & dosagem , Anticorpos Neutralizantes/administração & dosagem , Anticorpos Antivirais/administração & dosagem , COVID-19/prevenção & controle , Governo , Administração Intranasal , Vacinas contra COVID-19/administração & dosagem , United States Government Agencies , Estados Unidos , Imunização SecundáriaRESUMO
The Department of Veterans Affairs (VA) has launched an organization-wide transformation to a Whole Health System of Care that will ideally begin at the time of transition from active duty through the end of a Veteran's life. A brief history and overview of the Whole Health approach are provided along with selected evaluation results and planned initial actions as a result of the Total Force Fitness-Whole Health Summit held in March 2022. More work is required to strengthen the natural linkages between the Department of Defense's Total Force Fitness and Veterans Affairs' Whole Health approach to care. The Total Force Fitness-Whole Health collaboration is a model of whole-person care for the nation.
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Veteranos , Estados Unidos , Humanos , Exercício Físico , Programas Governamentais , Autocuidado , United States Government AgenciesAssuntos
Infecções por HIV , United States Government Agencies , Humanos , África/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/economia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Estados Unidos , United States Government Agencies/economia , United States Government Agencies/organização & administração , Cooperação InternacionalAssuntos
Pesquisa Biomédica , Orçamentos , Assunção de Riscos , United States Government Agencies , Estados Unidos , National Institutes of Health (U.S.)/organização & administração , National Institutes of Health (U.S.)/tendências , Humanos , United States Government Agencies/economia , United States Government Agencies/organização & administração , United States Government Agencies/tendências , Pesquisa Biomédica/economia , Pesquisa Biomédica/organização & administração , Pesquisa Biomédica/tendênciasAssuntos
Disseminação de Informação , Ciência , United States Government Agencies , United States National Aeronautics and Space Administration , Estados Unidos , United States National Aeronautics and Space Administration/organização & administração , United States Government Agencies/organização & administraçãoRESUMO
Presidents and executive branch agencies often have adversarial relationships. Early accounts suggest that these antagonisms may have been deeper and broader under President Trump than under any recent President. Yet careful appraisals have sometimes shown that claims about what President Trump has done to government and politics are over-stated, require greater nuance, or are just plain wrong. In this article, we use federal employment records from the Office of Personnel Management to examine rates of entry and exit at agencies across the executive branch during President Trump's term. A key challenge in this endeavor is that agencies vary in size dramatically, and this variability makes direct comparisons of rates of entry and exit across agencies problematic. Small agencies are overrepresented among agencies with large and small rates. Yet small agencies do important work and cannot simply be ignored. To address such small-area issues, we use a Bayesian hierarchical model to generate size-adjusted rates that better reflect the fundamental uncertainty about what is happening in small agencies as well as the substantial likelihood that these entities are less unusual than raw statistics imply. Our analysis of these adjusted rates leads to three key findings. First, total employment at the end of the Trump administration was largely unchanged from where it began in January of 2017. Second, this aggregate stability masks significant variation across departments, with immigration-focused bureaus and veterans-affairs bureaus growing significantly and certain civil-rights focused bureaus exhibiting signs of stress. Finally, compared to the first terms of Presidents Bush and Obama, separation rates under President Trump were markedly higher for most agencies.
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Política , United States Government Agencies , Estados Unidos , Teorema de Bayes , Máscaras , ProbabilidadeRESUMO
INTRODUCTION: This study evaluated the use of an online learning platform [Joint Knowledge Online (JKO)] for dissemination of the Veterans Affairs and Department of Defense Clinical Practice Guidelines for Management of Posttraumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD). User satisfaction with the training program was assessed, users were asked to estimate their knowledge base about PTSD and ASD, and users provided comments about how they might use the course material in their clinical practice. MATERIALS AND METHODS: A total of 4,442 users took at least one of three courses offered via JKO related to the PTSD Clinical Practice Guidelines (CPG) between July 1, 2019 and June 25, 2020. A total of 1,663 users took the post-test after the JKO courses and 235 applied to a second website (J7) which granted Continuing Education (CE) credits. Data were gathered from the JKO post-course survey, as well as the J7 course survey, which also asked for respondents' written comments. RESULTS: User satisfaction was analyzed using the JKO survey Likert scale data for each course, and results found most users rated the courses as "good" or "great." Users were also asked to evaluate their knowledge about PTSD management before and after the course. Results from all three courses showed a statistically significant change in pre-post knowledge with a medium effect size. Thematic analysis was performed on the write-in comments from each course. Comments indicated participants found the assessment tools provided in the courses to be of particular value. CONCLUSIONS: The VA/DoD's online learning platform (JKO) was a user-friendly, effective tool for training users on PTSD and ASD clinical practice guidelines. Users were satisfied with their experience of the trainings on JKO and improved their knowledge base about the CPG. This study did not evaluate patient data for CPG compliance, but the future study may benefit from these outcomes to demonstrate provider adherence to the guidelines.
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Transtornos de Estresse Pós-Traumáticos , Transtornos de Estresse Traumático Agudo , Veteranos , Estados Unidos , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia , United States Department of Veterans Affairs , United States Government AgenciesRESUMO
Identification of novel non-invasive biomarkers is critical for the early diagnosis of lung adenocarcinoma (LUAD), especially for the accurate classification of pulmonary nodule. Here, a multiplexed assay is developed on an optimized nanoparticle-based laser desorption/ionization mass spectrometry platform for the sensitive and selective detection of serum metabolic fingerprints (SMFs). Integrative SMFs based multi-modal platforms are constructed for the early detection of LUAD and the classification of pulmonary nodule. The dual modal model, metabolic fingerprints with protein tumor marker neural network (MP-NN), integrating SMFs with protein tumor marker carcinoembryonic antigen (CEA) via deep learning, shows superior performance compared with the single modal model Met-NN (p < 0.001). Based on MP-NN, the tri modal model MPI-RF integrating SMFs, tumor marker CEA, and image features via random forest demonstrates significantly higher performance than the clinical models (Mayo Clinic and Veterans Affairs) and the image artificial intelligence in pulmonary nodule classification (p < 0.001). The developed platforms would be promising tools for LUAD screening and pulmonary nodule management, paving the conceptual and practical foundation for the clinical application of omics tools.
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Adenocarcinoma de Pulmão , Inteligência Artificial , Estados Unidos , Humanos , United States Government Agencies , Adenocarcinoma de Pulmão/diagnóstico , Diagnóstico Precoce , Biomarcadores TumoraisRESUMO
Major physics projects and national lab infrastructure will get $1.5 billion over 5 years.
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Mudança Climática , Atenção à Saúde , Atenção à Saúde/legislação & jurisprudência , Humanos , Laboratórios , Física , Política , Estados Unidos , United States Government AgenciesAssuntos
Neoplasias , United States Government Agencies , Pesquisa Biomédica/economia , Pesquisa Biomédica/organização & administração , Equidade em Saúde , Humanos , Neoplasias/diagnóstico , Neoplasias/mortalidade , Neoplasias/prevenção & controle , Neoplasias/terapia , Estados Unidos , United States Government Agencies/economia , United States Government Agencies/legislação & jurisprudência , United States Government Agencies/organização & administraçãoRESUMO
During the past 40 years, the National Institute of Standards and Technology (NIST) has developed over 180 natural matrix Standard Reference Materials® (SRMs) for the determination of trace organic constituents in environmental, clinical, food, and dietary supplement matrices. A list of the Top Ten SRMs intended for organic analysis was identified based on selection criteria including analytical challenge to assign certified values, challenges in material preparation, novel matrices, longevity, widespread use, and unique design concept or intended use. The environmental matrix SRMs include air particulate matter, marine sediment, mussel tissue, and human serum with the focus on contaminants such as polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), chlorinated pesticides, and polybrominated diphenyl ethers (PBDEs). Human serum and plasma SRMs for clinical diagnostic markers including vitamin D metabolites represent clinical analysis, whereas infant formula, multivitamin/multielement tablets, and Ginkgo biloba constitute the food and dietary supplement matrices on the list. Each of the SRMs on the Top Ten list is discussed relative to the selection criteria and significance of the material, and several overall lessons learned are summarized.