scholarly journals Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19

10.2196/20157 ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. e20157 ◽  
Author(s):  
Ujjwal Ramtekkar ◽  
Jeffrey A Bridge ◽  
Glenn Thomas ◽  
Eric Butter ◽  
Jennifer Reese ◽  
...  
Keyword(s):  
Large Scale ◽  
Psychiatric Care ◽  
Care Delivery ◽  
Key Factors ◽  
Factors Associated ◽  
The Past ◽  
Telebehavioral Health ◽  
Large Health Care System ◽  
Improve Access

The use of telebehavioral health has been expanding in the past decade to improve access to psychiatric care and address critical shortages in the psychiatric workforce. The coronavirus (COVID-19) pandemic forced a sudden shift from traditional in-person visits to alternative modalities. There are key factors associated with successful transitional and large-scale implementation of telehealth with existing resources. We describe the experience of a large health care system using telehealth technology, and we identify strategies and discuss considerations for long-term sustainability after the pandemic.

scholarly journals Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19 (Preprint)

2020 ◽  
Author(s):  
Ujjwal Ramtekkar ◽  
Jeffrey A Bridge ◽  
Glenn Thomas ◽  
Eric Butter ◽  
Jennifer Reese ◽  
...  
Keyword(s):  
Large Scale ◽  
Psychiatric Care ◽  
Care Delivery ◽  
Key Factors ◽  
Factors Associated ◽  
The Past ◽  
Telebehavioral Health ◽  
Large Health Care System ◽  
Improve Access

UNSTRUCTURED The use of telebehavioral health has been expanding in the past decade to improve access to psychiatric care and address critical shortages in the psychiatric workforce. The coronavirus (COVID-19) pandemic forced a sudden shift from traditional in-person visits to alternative modalities. There are key factors associated with successful transitional and large-scale implementation of telehealth with existing resources. We describe the experience of a large health care system using telehealth technology, and we identify strategies and discuss considerations for long-term sustainability after the pandemic.

scholarly journals Global climatology and trends in convective environments from ERA5 and rawinsonde data

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Mateusz Taszarek ◽  
John T. Allen ◽  
Mattia Marchio ◽  
Harold E. Brooks
Keyword(s):  
Large Scale ◽  
Climate Models ◽  
Global Climate ◽  
Convective Available Potential Energy ◽  
Global Climate Models ◽  
Convective Precipitation ◽  
The Past ◽  
The Tropics ◽  
Rawinsonde Data

AbstractGlobally, thunderstorms are responsible for a significant fraction of rainfall, and in the mid-latitudes often produce extreme weather, including large hail, tornadoes and damaging winds. Despite this importance, how the global frequency of thunderstorms and their accompanying hazards has changed over the past 4 decades remains unclear. Large-scale diagnostics applied to global climate models have suggested that the frequency of thunderstorms and their intensity is likely to increase in the future. Here, we show that according to ERA5 convective available potential energy (CAPE) and convective precipitation (CP) have decreased over the tropics and subtropics with simultaneous increases in 0–6 km wind shear (BS06). Conversely, rawinsonde observations paint a different picture across the mid-latitudes with increasing CAPE and significant decreases to BS06. Differing trends and disagreement between ERA5 and rawinsondes observed over some regions suggest that results should be interpreted with caution, especially for CAPE and CP across tropics where uncertainty is the highest and reliable long-term rawinsonde observations are missing.

scholarly journals Understanding the Processes Causing the Early Intensification of Hurricane Dorian through an Ensemble of the Hurricane Analysis and Forecast System (HAFS)

Atmosphere ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 93
Author(s):  
Andrew Hazelton ◽  
Ghassan J. Alaka ◽  
Levi Cowan ◽  
Michael Fischer ◽  
Sundararaman Gopalakrishnan
Keyword(s):  
Tropical Cyclone ◽  
Large Scale ◽  
Early Stage ◽  
Early Period ◽  
Storm Track ◽  
Key Factors ◽  
Complex Interplay ◽  
Forecast System ◽  
Model Initialization

The early stages of a tropical cyclone can be a challenge to forecast, as a storm consolidates and begins to grow based on the local and environmental conditions. A high-resolution ensemble of the Hurricane Analysis and Forecast System (HAFS) is used to study the early intensification of Hurricane Dorian, a catastrophic 2019 storm in which the early period proved challenging for forecasters. There was a clear connection in the ensemble between early storm track and intensity: stronger members moved more northeast initially, although this result did not have much impact on the long-term track. The ensemble results show several key factors determining the early evolution of Dorian. Large-scale divergence northeast of the tropical cyclone (TC) appeared to favor intensification, and this structure was present at model initialization. There was also greater moisture northeast of the TC for stronger members at initialization, favoring more intensification and downshear development of the circulation as these members evolved. This study highlights the complex interplay between synoptic and storm scale processes in the development and intensification of early-stage tropical cyclones.

scholarly journals Number of long-term inpatients in Japanese psychiatric care beds: trend analysis from the Patient Survey and the 630 Survey

2020 ◽  
Author(s):  
Tatsushi Okayama ◽  
Kentaro Usuda ◽  
Emi Okazaki ◽  
Yoshio Yamanouchi
Keyword(s):  
Mental Illness ◽  
Psychiatric Care ◽  
Patient Survey ◽  
Multifaceted Approach ◽  
The Past ◽  
Natural Decrease ◽  
Hospital Bed ◽  
The Mean ◽  
Using Data

Abstract BackgroundThe number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge.MethodsUsing data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients.ResultsIn 2017, nearly one-third of all long-term hospitalized patients were aged ≥75 years, and an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040.ConclusionsWe believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.

scholarly journals Number of long-term inpatients in Japanese psychiatric care beds: trend analysis from the patient survey and the 630 survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tatsushi Okayama ◽  
Kentaro Usuda ◽  
Emi Okazaki ◽  
Yoshio Yamanouchi
Keyword(s):  
Mental Illness ◽  
Psychiatric Care ◽  
Patient Survey ◽  
Multifaceted Approach ◽  
The Past ◽  
Natural Decrease ◽  
Hospital Bed ◽  
The Mean ◽  
Using Data

Abstract Background The number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge. Methods Using data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients. Results In 2017, nearly one-third of all long-term hospitalized patients were aged ≥75 years, and an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040. Conclusions We believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.

Lessons for Health Service: the Chernobyl Accident and the COVID-19 Pandemic

2020 ◽  
Vol 65 (3) ◽  
pp. 79-84
Author(s):  
A. Bushmanov ◽  
I. Galstyan ◽  
V. Solov'ev ◽  
M. Konchalovsky
Keyword(s):  
Chernobyl Accident ◽  
Large Scale ◽  
Medical Personnel ◽  
The Body ◽  
Key Factors ◽  
Vital Functions ◽  
Medical Institutions ◽  
Emergency Drugs ◽  
To Receive

Purpose: The article is devoted to the analysis of organizational measures to overcome the medical consequences of two large-scale events: the Chernobyl accident on 26.04.1986 and the COVID-19 pandemic. Results: A comparison of the causes, key factors, numbers affected and involved in these events persons, and the availability of the source of knowledge about the clinical picture, diagnosis, prevention and treatment of diseases, developing as a result of radiation exposure and the virus SARS-Cov-2. The article considers the availability of special medical institutions, the infectability of medical workers, the presence of long-term consequences for the health of victims and for the economy. Conclusions: In the development of such catastrophic events, an important role should be played by 1) Timely and adequate information to the population. 2) It is necessary to have a sufficient number of beds that can be repurposed in accordance with the needs and provided with appropriate equipment to support the vital functions of the body. 3) Planned training of qualified medical personnel should be carried out. 4) It is necessary to have stocks of emergency drugs close to the institutions where it is possible to receive victims.

Trends in the frequency, extent, and severity of spruce budworm outbreaks in eastern Canada

1983 ◽  
Vol 13 (4) ◽  
pp. 539-547 ◽  
Author(s):  
J. R. Blais
Keyword(s):  
20Th Century ◽  
Large Scale ◽  
Spruce Budworm ◽  
Forest Composition ◽  
Eastern Canada ◽  
Clear Cutting ◽  
The Past ◽  
Spruce Stands ◽  
History Of

The history of spruce budworm (Choristoneurafumiferana (Clem.)) outbreaks for the past 200 to 300 years, for nine regions in eastern Canada, indicates that outbreaks have occurred more frequently in the 20th century than previously. Regionally, 21 outbreaks took place in the past 80 years compared with 9 in the preceding 100 years. Earlier infestations were restricted to specific regions, but in the 20th century they have coalesced and increased in size, the outbreaks of 1910, 1940, and 1970 having covered 10, 25, and 55 million ha respectively. Reasons for the increase in frequency, extent, and severity of outbreaks appear mostly attributable to changes caused by man, in the forest ecosystem. Clear-cutting of pulpwood stands, fire protection, and use of pesticides against budworm favor fir–spruce stands, rendering the forest more prone to budworm attack. The manner and degree to which each of these practices has altered forest composition is discussed. In the future, most of these practices are expected to continue and their effects could intensify, especially in regions of recent application. Other practices, including large-scale planting of white spruce, could further increase the susceptibility of forest stands. Forest management, aimed at reducing the occurrence of extensive fir–spruce stands, has been advocated as a long-term solution to the budworm problem. The implementation of this measure at a time when man's actions result in the proliferation of fir presents a most serious challenge to forest managers.

scholarly journals Predisposing factors of long-term responsiveness in a cardio-metabolic cohort: Tehran Lipid and Glucose Study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leila Cheraghi ◽  
Parisa Amiri ◽  
Golnaz Vahedi-Notash ◽  
Sara Jalali-Farahani ◽  
Davood Khalili ◽  
...  
Keyword(s):  
Large Scale ◽  
Response Rate ◽  
Age Groups ◽  
Lifestyle Factors ◽  
Men And Women ◽  
Lower Response ◽  
Factors Associated ◽  
Lower Response Rate

Abstract Background Non-participation in cohort studies, if associated with both the exposure and occurrence of the event, can introduce bias in the estimates of interest. This study aims to identify factors associated with follow-up participation in Tehran Lipid and Glucose Study, a large-scale community-based prospective study in West Asia. Methods A sample of 10,368 adults from TLGS was included in the analysis. All analyses were split according to sex and age groups (20–39, 40–59, and 60 years). The associations between socio-demographic, health, and lifestyle factors with response rate were identified using the Generalized Estimating Equations model. Results Over the median of 15.7 years of follow up the response rate was 64.5%. The highest response rate was observed in those aged 40–59 years for both sexes. Current smokers had lower odds of response in both sexes for all age groups, ranging from 0.51 to 0.74, p < 0.01. In young adults, being single (OR = 0.79, OR = 0.57, p ≤ 0.01, respectively for men and women) and unemployed (OR = 0.73, OR = 0.76, p ≤ 0.01, respectively for men and women) in both sexes, high physical activity in men (OR = 0.77, p < 0.01), high education (OR = 0.75, p = 0.02) and obesity (OR = 0.85, p = 0.05) in women were associated with lower response rate. For the middle-aged group, diabetes in men (OR = 0.77, p = 0.05) and hypertension (OR = 0.84, p = 0.05), and having a history of cancer (OR = 0.43, p = 0.03) in women were factors associated with lower response rates. Finally, interventions for both sexes (OR = 0.75, OR = 0.77, p ≤ 0.05, respectively for men and women) and being divorced/widow in women (OR = 0.77, p = 0.05) were the factors associated with the lower response rate in the elderly. Conclusions Long-term participation was influenced by socio-demographic, health, and lifestyle factors in different sex- and age-specific patterns in TLGS. Recruitment strategies targeting these factors may improve participant follow-up in longitudinal studies.

scholarly journals Number of long-term inpatients in Japanese psychiatric care beds: trend analysis from the Patient Survey and the 630 Survey

2020 ◽  
Author(s):  
Tatsushi Okayama ◽  
Kentaro Usuda ◽  
Emi Okazaki ◽  
Yoshio Yamanouchi
Keyword(s):  
Mental Illness ◽  
Length Of Stay ◽  
Psychiatric Care ◽  
Patient Survey ◽  
Multifaceted Approach ◽  
The Past ◽  
Natural Decrease ◽  
Hospital Bed ◽  
The Mean

Abstract BackgroundThe number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, inpatients in psychiatric care beds are aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward about current psychiatric bed resources has emerged as a new challenge. MethodsUsing data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients. ResultsIn 2017, of all long-term hospitalized patients, those aged ≤74 years accounted for 68% and those aged ≥75 years accounted for 32%; however, an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040. ConclusionsWe believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.

Improvements in XCO2 accuracy from OCO-2 with the latest ACOS v10 product

2021 ◽  
Author(s):  
Christopher ODell ◽  
Annmarie Eldering ◽  
Michael Gunson ◽  
David Crisp ◽  
Brendan Fisher ◽  
...  
Keyword(s):  
Power Plants ◽  
Large Scale ◽  
Regional Scale ◽  
Surface Fluxes ◽  
Retrieval Algorithm ◽  
The Past ◽  
Tropical Oceans ◽  
Desert Areas ◽  
Global Carbon

&lt;p&gt;While initial plans for measuring carbon dioxide from space hoped for 1-2 ppm levels of accuracy (bias) and precision in the CO&lt;sub&gt;2&lt;/sub&gt; column mean dry air mole fraction (XCO&lt;sub&gt;2&lt;/sub&gt;), in the past few years it has become clear that accuracies better than 0.5 ppm are required for most current science applications.&amp;#160; These include measuring continental (1000+ km) and regional scale (100s of km) surface fluxes of CO&lt;sub&gt;2&lt;/sub&gt; at monthly-average timescales.&amp;#160; Considering the 400+ ppm background, this translates to an accuracy of roughly 0.1%, an incredibly challenging target to hit.&amp;#160;&lt;/p&gt;&lt;p&gt;Improvements in both instrument calibration and retrieval algorithms have led to significant improvements in satellite XCO&lt;sub&gt;2&lt;/sub&gt; accuracies over the past decade.&amp;#160; The Atmospheric Carbon Observations from Space (ACOS) retrieval algorithm, including post-retrieval filtering and bias correction, has demonstrated unprecedented accuracy with our latest algorithm version as applied to the Orbiting Carbon Observatory-2 (OCO-2) satellite sensor.&amp;#160; &amp;#160;This presentation will discuss the performance of the v10 XCO&lt;sub&gt;2&lt;/sub&gt; product by comparisons to TCCON and models, and showcase its performance with some recent examples, from the potential to infer large-scale fluxes to its performance on individual power plants.&amp;#160; The v10 product yields better agreement with TCCON over land and ocean, plus reduced biases over tropical oceans and desert areas as compared to a median of multiple global carbon inversion models, allowing better accuracy and faith in inferred regional-scale fluxes. &amp;#160;More specifically, OCO-2 has single sounding precision of ~0.8 ppm over land and ~0.5 ppm over water, and RMS biases of 0.5-0.7 ppm over both land and water.&amp;#160; Given the six-year and growing length of the OCO-2 data record, this also enables new studies on carbon interannual variability, while at the same time allowing identification of more subtle and temporally-dependent errors.&amp;#160; Finally, we will discuss the prospects of future improvements in the next planned version (v11), and the long-term prospects of greenhouse gas retrievals in the coming years.&amp;#160;&lt;/p&gt;&lt;p&gt;&amp;#160;&lt;/p&gt;

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