Home Healthcare Clinicians’ Perspectives on Electronic Health Records: A Qualitative Study

Clinicians’ perspectives on the electronic health records (EHR) in home healthcare (HHC) are understudied. To explore this topic, qualitative interviews were conducted with 15 HHC clinicians in the Northeastern USA. Thematic analysis was conducted to identify key themes emerging from the interviews. While some EHR benefits were recognized, overall satisfaction with the EHR was low. The results suggest EHR limitations are tied to poor usability, restrictions, and redundancy in documentation leading to increased documentation workload. Clinicians have recommendations to mitigate these limitations via additional EHR functions and better patient risk detection. Future stakeholders should consider the results of this study when developing and updating the EHR in HHC.

Historical Accounts Provide Inference into Population Dynamics of American Kestrels (Falco sparverius) in the Northeastern USA

ABSTRACT American Kestrels (Falco sparverius) are declining across much of North America, yet the initial timing of the population decrease is unclear. In an attempt to elucidate when kestrel declines began, we examined historical descriptions of abundance within the northeastern United States. Within The Peregrine Fund's research library, we found 54 descriptions of kestrel abundance in northeastern states dating from 1839 to 2013. Our analysis indicates a cubic trend in descriptions of kestrel abundance with a peak occurring in 1951. After that peak, the population began its current decline, yet the population appears to have been stable beforehand. That the current decline is apparent in our data set lends credence to our methodology and suggests that populations were likely secure until approximately 1951. Our results thus suggest that populations of American Kestrels in the northeastern United States began declining before systematic monitoring began in 1966. Future research should thus examine what environmental changes occurred around the early- to mid-20th century in the northeastern USA to cause population declines of American Kestrels.

Extreme rainfall events in the Northeastern USA become more frequent with rising temperatures, but their intensity distribution remains stable

Both intensities of individual extreme rainfall events and the frequency of such events are important for infrastructure planning. We develop a new statistical extreme value model, the PGEV model, which makes it possible to use high quality annual maximum series data instead of lesswell checked daily data to estimate trends in intensity and frequency separately. The method is applied to annual maxima data from the NOAA Atlas 14, Volume 10, dating from approximately 1900 to 2014, showing that in the majority of 333 rain gauge stations in the Northeastern USA the frequency of extreme rainfall events increases as mean temperature increases, but that there is little evidence of trends in the distribution of the intensities of individual extreme rainfall events. The median of the frequency trends corresponds to extreme rainfalls becoming 83% more frequent for each centigrade degree of temperature increase. Naturally, increasing trends in frequency also increase the yearly or 10-yearly risks of very extreme rainfall events. Three other large areas in the contiguous USA, the Midwest, the Southeast, and Texas, are also studied, and show similar but weaker trends than those in the Northeast.

Lachnellula willkommii (European larch canker).

The European larch canker pathogen, L. willkommii, is apparently native to Japan, but established in Europe, where it became well known due to its damage to plantations of exotic and native Larix species, beginning in the nineteenth century. It attacks and spreads among the various species of Larix once it has been introduced. It was detected as an invasive to North America on two occasions; once in the northeastern USA in the 1920s (Hahn and Ayres, 1936) and once in the eastern maritime provinces of Canada in the 1980s (Magasi and Pond, 1982). Efforts to prevent its introduction across natural barriers include regulation and restriction of trade and transport of susceptible species and bark-bearing products made from them. Control by destruction of infected plants or plant parts is often made difficult by the size of the trees concerned (Tegethoff, 1965). Local spread of the fungus between trees appears to depend on dissemination and survival of airborne ascospores. Climatic conditions of humidity and temperature appear to limit natural spread from regions of establishment (Ostaff, 1985).

Historical Indigenous Food Preparation Using Produce of the Three Sisters Intercropping System

For centuries, some Indigenous Peoples of the Americas have planted corn, beans and squash or pumpkins together in mounds, in an intercropping complex known as the Three Sisters. Agriculturally, nutritionally and culturally, these three crops are complementary. This literature review aims to compile historical foods prepared from the products of the Three Sisters planting system used in Indigenous communities in the region encompassing southern Quebec and Ontario in Canada, and northeastern USA. The review does not discuss cultural aspects of the Three Sisters cropping system or describe foods specific to any one Indigenous group, but rather, gives an overview of the historical foods stemming from this intercropping system, many foods of which are common or similar from one group to another. Some of the methods of food preparation used have continued over generations, some of the historical foods prepared are the foundation for foods we eat today, and some of both the methods and foods are finding revival.

Wolbachiain the spittlebugProsapia ignipectus:Variable infection frequencies, but no apparent effect on host reproductive isolation

Animals serve as hosts for complex communities of microorganisms, including endosymbionts that live inside their cells.Wolbachiabacteria are perhaps the most common endosymbionts, manipulating host reproduction to propagate. ManyWolbachiacause intense cytoplasmic incompatibility (CI) that promotes their spread to high and relatively stable frequencies.Wolbachiathat cause weak or no CI tend to persist at intermediate, often variable, frequencies.Wolbachiacould also contribute to host reproductive isolation (RI), although current support for such contributions is limited to a few systems. To test forWolbachiafrequency variation and effects on host RI, we sampled several localProsapia ignipectus(Fitch)(Hemiptera: Cercopidae) spittlebug populations in the northeastern USA over two years, including closely juxtaposed Maine populations with different monomorphic color forms, “black” and “lined”. We discovered a group-BWolbachia(wPig) infectingP. ignipectusthat diverged from group-AWolbachia—likemodelwMel andwRi strains inDrosophila—6to 46 MYA. Populations of the sister speciesProsapia bicincta(Say) from Hawaii and Florida are uninfected, suggesting thatP. ignipectusacquiredwPig after their initial divergence.wPig frequencies were generally high and variable among sites and between years. While phenotypingwPig effects on host reproduction is not currently feasible, thewPig genome contains three divergent sets of CI loci, consistent with highwPig frequencies. Finally, Maine monomorphic black and monomorphic lined populations ofP. ignipectusshare bothwPig and mtDNA haplotypes, implying no apparent effect ofwPig on the maintenance of this morphological contact zone. We hypothesizeP. ignipectusacquiredwPig horizontally as observed for manyDrosophilaspecies, and that significant CI and variable transmission produce high but variablewPig frequencies.