To characterize factors influencing the development and sustainability of data sharing in the Mid-Ohio Farmacy (MOF), a produce referral program implemented in partnership between a community-based ...organization (the Mid-Ohio Food Collective "Food Collective") and an academic medical center (The Ohio State University Wexner Medical Center OSUWMC).
We used an in-depth case study approach to identify challenges that arose during implementation of the MOF and related solutions via semistructured interviews with representatives of both organizations (May-September 2020).
Key informants from OSUWMC (n = 20) and the Food Collective (n = 11) were identified using a combination of purposive and convenience sampling; they included administrators, project champions, clinical providers, and food pantry representatives. Interview transcripts were coded using a deductive dominant approach guided by a logic model aimed at determining the resources and activities relevant to the development of the partnership.
Challenges of cross-sector data sharing fit into 3 themes: data sharing regulations, data exchange capabilities, and cross-sector data integration. Overcoming these challenges required creative workarounds-for example, linking patients across organizations was done via establishment of a unique, partnership-specific patient identifier, which was incorporated into the health system's electronic health record for continuity.
Our findings suggest that current regulatory frameworks are misspecified to the growing interest in cross-sector partnerships between health care and community-based organizations. Future efforts to support these relationships should consider clarifying rules around data sharing and increasing Medicaid support for nonmedical, health-related social needs.
The forward and reverse bias dc characteristics, the long-term stability under forward and reverse bias, and the reverse recovery performance of 4H-SiC junction barrier Schottky (JBS) diodes that are ...capable of blocking in excess of 10 kV with forward conduction of up to 10 A at a forward voltage of less than 3.5 V (at 25degC) are described. The diodes show a positive temperature coefficient of resistance and a stable Schottky barrier height of up to 200degC. The diodes show stable operation under continuous forward current injection at 20 A/cm 2 and under continuous reverse bias of 8 kV at 125degC. When switched from a 10-A forward current to a blocking voltage of 3 kV at a current rate-of-fall of 30 A/mus, the reverse recovery time and the reverse recovery charge are nearly constant at 300 ns and 425 nC, respectively, over the entire temperature range of 25degC-175degC.
Mortuary Synthesis Goldstein, Lynne; Sewell, Kristin J.; Heilen, Michael P. ...
Uncovering Identity in Mortuary Analysis,
2012
Book Chapter
This chapter summarizes and integrates the major findings about the cemetery and to identify overall patterns and their potential meanings. Strictly in terms of the time frame of cemetery use, one ...might associate the Alameda-Stone cemetery with the Victorian cemetery movement. Archaeologically, we were able to identify military cemetery based on a variety of contextual clues, including the spatial locations and positions of graves in that section, artifact types, osteological variables, and other factors that correlate with historical records. Osteological analyses of skeletal materials allowed us to infer the ages, sexes, and biological affinities of individuals as well as possible occupations or domestic activities, based on degenerative changes and musculoskeletal evidence for work. Religious or ceremonial artifacts recovered from graves in Tucson cemetery clearly signify some of the influence that Catholicism had on population. Items such as jewelry included crosses, crucifixes, medallions, beads, and other elements of fragmented rosaries as well as wire from floral funerary crowns.
The excavation and analysis of individuals recovered from the Alameda-Stone cemetery do not fall under the provisions of the native American graves protection and repatriation act (NAGPRA), because ...for excavations conducted after 1990, NAGPRA applies only on Federal and Indian land. The distinction drawn between Arizona's cultural affinity and what NAGPRA terms cultural affiliation is significant, because there are some differences in definition and because this project has approached these assessments in a manner different from that of some other projects. An accurate assessment of cultural affinity requires a close examination of all the available archaeological, osteological, and historical evidence. The burial agreement for the Alameda-Stone cemetery excavations included lists of artifacts and other contextual indicators provided by claimant descendant groups that they considered useful for distinguishing cultural affinities among the burials. The analysis of the affinity assessments demonstrated much of what we already know: Tucson in the nineteenth century was a culturally diverse town with a largely Hispanic population.
Ripples on the seafloor affect acoustic scattering and transmission loss, wave attenuation, and the amount of sediment transported in shallow water. Historically, seafloor roughness (a function of ...ripples, bedforms, sediment type, and size) is assumed to be spatially homogeneous and temporally static in hydrodynamic and acoustic models despite the often dynamic nature of the seafloor in the nearshore region. We present a spectral ripple model, Navy Seafloor Evolution Archetype (NSEA), which simulates the variations in seafloor roughness given measured or predicted wave conditions in sandy environments. NSEA simulates sand ripple formation and evolution based on bottom velocities either measured or predicted by a wave model. The time dependency is a function of equilibrium ripple geometries and the amount of sediment transport needed to reach an equilibrium state, which is dependent on the relict ripples. Spectral decay due to bioturbation is incorporated as a diffusive process. NSEA was validated with time series observations obtained in water depths of 7.5 and 20 m from April 20, 2013 to May 23, 2013 during the 2013 Target and Reverberation Experiment (TREX13) offshore of Panama City, FL, USA. The model predicted spectral ripple wavelengths that were in good agreement with observed spectral ripple wavelengths obtained using a fixed platform, high-frequency (2.25 MHz) sector scanning sonar. Likewise, the variations in the predicted normalized ripple heights and orientations were similar to the normalized spectral decay and orientations estimated from the sector scanning sonar imagery.
There is limited evidence describing utilization of clinic-based food referral programs intended to support healthy eating for food-insecure patients. To address this gap, this study aims to describe ...the utilization of the Mid-Ohio Farmacy (MOF). MOF is a partnership between a regional foodbank and local health care providers, including an academic medical center (AMC), that enables referrals of patients that experience food insecurity to a network of participating food pantries.
This observational study uses data from 2 AMC family medicine clinics that offered the MOF referral from September 2019 to November 2020. Patients who screened positive for food insecurity and had an eligible chronic disease (eg, diabetes, hypertension, obesity) were referred to the MOF. We compared demographic and clinical characteristics of patients that filled their referral (ie, visitors) to those that did not (ie, non-visitors). Among visitors, we also assessed patterns of pantry utilization.
In total, 51% (164 of 322) of patients referred to the MOF visited a food pantry at least once. Visitors were more likely to be older, have diabetes, and have visited a food pantry before their referral. Patients with uncontrolled hypertension were less likely to visit a food pantry following their referral. Patients that had visited a food pantry before their referral had more visits in total and more produce-specific visits following their referral.
Our results suggest that while the MOF can connect patients to food resources, further attention may be needed to encourage its use among patients who have not previously accessed pantries.
Research Objective
Evidence suggests that clinic‐based food referral programs (FRP) offer health benefits to food insecure patients, yet little attention has been paid to understanding patient ...utilization of such programs. Our study addresses this gap by reporting on the patient characteristics associated with uptake and utilization of a FRP—the Mid‐Ohio Farmacy (MOF). The MOF is a partnership between a Midwestern regional foodbank and local healthcare providers, including a large, academic medical center (AMC). The MOF uses a variation on food vouchers: an electronic referral from a patient's primary care provider to one of 14 partner food pantries in the metropolitan area. Referred patients who visit a participating pantry are eligible to receive fresh produce once weekly.
Study Design
This observational study leverages data from two AMC family medicine clinics offering the MOF referral from September 2019 to November 2020. Using multivariable logistic regression, we examined the association between filling a MOF referral (i.e., pantry visitor vs. non‐visitor) and patient demographic and clinical characteristics. Patients and their pantry visits were characterized based on their pre‐referral utilization (i.e., new or existing patrons; pre‐ or post‐referral pantry visit) to assess patterns of pantry utilization.
Population Studied
AMC patients 18 years or older who screened positive for food insecurity and had an eligible chronic condition. Eligible conditions included a diagnosis of diabetes with hemoglobin A1c (HbA1C) >9%, obesity (BMI ≥ 30 kg/m2), or hypertension; uncontrolled diabetes defined as a HbA1C > 9% with or without a diabetes diagnosis; or uncontrolled hypertension defined as blood pressure > 140/90 with a hypertension diagnosis.
Principal Findings
In total, 51% (164/322) of patients who received a MOF referral visited a pantry at least once during the study period. Three factors were associated with an increased likelihood of filling a MOF referral: a 1‐year increase in age (0.7%; p < 0.01); diabetes diagnosis (11%; p < 0.05); and pantry visits prior to referral (36%; p < 0.001). Patients with uncontrolled hypertension were 19% (p < 0.001) less likely to visit a pantry following their referral. Relative to new visitors, existing visitors had a greater total number of visits following referral, shorter days to their first visit following referral, and travelled shorter distances. Existing visitors had more total pantry visits and more produce‐specific visits in the 90‐days following their referral relative to the 90‐days prior to their referral.
Conclusions
Our results suggest that while the MOF can connect patients to food resources, further attention may be needed to encourage its use among patients who have not previously accessed pantries.
Implications for Policy or Practice
Changes to the MOF program may be necessary such as adding one additional question to the food insecurity screening process (e.g., “Have you used a food pantry in the last year?”), so that potential first‐time users could be targeted for resources (e.g., transportation support such as Lyft credits or bus passes) to address barriers to pantry use. Additionally, reminding patients about the opportunity to visit the pantry, for instance through text message reminders or secure health portal messages, could help encourage patients to use this community resource.
Primary Funding Source
Crisafi‐Monte Foundation.
•Central Belize Valley maintained population affinity with the Peten region.•Dental morphology indicates lack of continuity between ECB and LCB collections.•Social status can be a factor in the ...divergence between ECB and LCB.
This study expands upon previous bioarchaeological research in Central Belize, focusing on broadening the current understanding of the region’s population history through a comparative analysis of nonmetric dental traits. Estimates of biological distance were calculated using several statistical methods to identify consistent relationships between groups. In general, groups tended to cluster as expected based on geographic proximity, with Petén, Calakmul, and Late Classic Belize Valley forming one regional node and sites in the northern Yucatan forming another. The Early Central Belize group (Late Preclassic / Protoclassic, 300 BCE – AD 300) was most closely affiliated with sites to the west, including Barton Ramie in the neighboring Upper Belize River Valley, and Petén, which is consistent with archaeological indicators of early economic and political ties among sites in this broader region. However, the Late Central Belize group (Late – Terminal Classic, AD 590–880) is morphologically distinct from the earlier Central Belize group, and does not show clear and consistent affinities to any of the other samples. We interpret these results to mean that the rapid construction of large civic ceremonial centers in the Roaring Creek and Caves Branch River Valleys of Central Belize around the 7th century CE coincided with the arrival of a new group or groups, likely from a region not represented in our current comparative sample.
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