Results for “Health care” — Page 2

DOE OSTI2020

Breathe Well, Live Well: Implementing an Adult Asthma Self-Management Education Program

Asthma remains a significant health problem in the United States. Adults with poorly controlled asthma can affect their community in a number of ways, from lost productivity in the workplace to health care costs to premature death. Asthma self-management education helps individuals achieve better control of their asthma and is critical for the overall health and well-being of individuals with asthma. While there are numerous programs and initiatives targeting children with asthma, there is a lack of comparable focus on the needs of adults with asthma. The American Lung Association developed Breathe Well, Live Well, an adult asthma self-management education program, and launched it nationwide in 2007. The program for adults has a flexible delivery format for community-based implementation. This article describes the development, dissemination, and transformation of the program. Each stage of implementation showed positive changes in asthma self-management practices that contribute to better asthma control, and one local implementation additionally showed decreased reports of missed work and unscheduled health care visits among participants. The findings from the three evaluations support the use of Breathe Well, Live Well for broad community-based implementation to improve asthma self-management efficacy and behaviors.

Gardner, Emily A.↗

DOE OSTI2020

CPAP Ventilators Needed for Rapid Response to COVID-19 by Modification of CPAP Equipment

Early on in the COVID-19 pandemic, potential ventilator shortages were a critical issue identified by national health care providers. Capacity modeling at the time suggested patient demand may exceed ventilator supply. Thus, the challenge became finding an urgent interim solution to meet health care needs. Our initial hypothesis was that CPAP technology could be modified to provide similar functionality to a ventilator, relieving demand and allowing physicians to decide which patients need high end machines, ultimately saving lives. In conjunction with medical experts and pulmonologists, we were able to identify three key thrusts associated with this research problem: (1) modification of CPAP technology to allow for 02 input that would be capable of providing ventilation; (2) development of an alarming function that would provide real-time audible alarms to alert medical personnel to critical conditions, which would be used inline with CPAP technology; and (3) a method of sterilizing expiratory air from such a system in order to protect medical personnel from biohazard, since CPAPs vent to the atmosphere. We were unable to realize results for thrust 1 (CPAP modification for 02); we identified potential safety issues associated with utilizing medical grade oxygen with a common CPAP device. In order to characterize and mitigate these issues, we would need to partner closely with a device manufacturer; such a partnership could not be achieved in the timeframe needed for this rapid response work. However, we determined that some medical grade BiPAP devices do not need this modification and that the significant progress on thrusts 2 and 3 would be sufficient to buy down risk of a massive ventilator shortage. Our team built a prototype alarm system that can be utilized with any assistive respiratory device to alert on all key conditions identified by medical personnel (high pressure, low pressure, apnea, loss of power, low battery). Finally, our team made significant progress in the rapid prototyping and demonstration of an inline UV air purifier device. The device is cost efficient and can be manufactured at scale with both commercially available and additively manufactured parts. Initial tests with SARS-CoV-2 analog bacteriophage MS2 show 99% efficacy at reducing bioburden. Following a successful demonstration of the prototype device with medical personnel, we were able to obtain follow-on (non-LDRD) funding to provide additional device characterization, validation, and production in order to respond to an immediate regional need.

42 ENGINEERING↗

DOE OSTI2020

Low-Income Energy Affordability: Conclusions From A Literature Review

This paper examines the persistent problem of high energy burdens among low-income households, based on a review of more than 180 publications that pointed to several promising opportunities to address energy affordability including inclusive solar programs, leveraged health care benefits, and behavioral economics. using an equity and affordability lens. Even after decades of weatherization and bill-payment programs, low-income households, on average, continue to spend a higher share of their income on electricity and natural gas bills than any other income group. Energy burden for low-income households is not declining, and it remains persistently high, particularly in the South, in rural America, among minority households, and those with children and elderly residents. On a per household basis, utility companies spend less on energy-efficiency programs for low-income households than for other income groups. In addition, government and utility programs that promote rooftop solar power, electric vehicles, and home energy storage are largely inaccessible to low-income households. Our review identifies promising opportunities to address energy affordability including inclusive solar programs, leveraged health care benefits, behavioral economics, data analytics, advanced information and communication technologies, and grid resiliency. Scalable approaches require linking implementing agencies, programs and policies to tackle the complex web of causes and impacts on low-income households with high energy burdens.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

DOE OSTI2022

A prospective study on myocardial injury after BNT162b2 mRNA COVID ‐19 fourth dose vaccination in healthy persons

Aims To prospectively evaluate the incidence of myocardial injury after the administration of the fourth dose BNT162b2 mRNA vaccine (Pfizer‐BioNTech) against COVID‐19. Methods and results Health care workers who received the BNT162b2 vaccine during the fourth dose campaign had blood samples collected for high‐sensitivity cardiac troponin (hs‐cTn) during vaccine administration and 2–4 days afterward. Vaccine‐related myocardial injury was defined as hs‐cTn elevation above the 99th percentile upper reference limit and >50% increase from baseline measurement. Participants with evidence of myocardial injury underwent assessment for possible myocarditis. Of 324 participants, 192 (59.2%) were female and the mean age was 51.8 ± 15.0 years. Twenty‐one (6.5%) participants had prior COVID‐19 infection, the mean number of prior vaccine doses was 2.9 ± 0.4, and the median time from the last dose was 147 (142–157) days. Reported vaccine‐related adverse reactions included local pain at injection site in 57 (17.59%), fatigue in 39 (12.04%), myalgia in 32 (9.88%), sore throat in 21 (6.48%), headache in 18 (5.5%), fever ≥38°C in 16 (4.94%), chest pain in 12 (3.7%), palpitations in 7 (2.16%), and shortness of breath in one (0.3%) participant. Vaccine‐related myocardial injury was demonstrated in two (0.62%) participants, one had mild symptoms and one was asymptomatic; both had a normal electrocardiogram and echocardiography. Conclusion In a prospective investigation, an increase in serum troponin levels was documented among 0.62% of healthy health care workers receiving the fourth dose BNT162b2 vaccine. The two cases had mild or no symptoms and no clinical sequela. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT05308680.

Levi, Nir↗

DOE OSTI2023

Dataset Repository for Investigating Suicide Risk Using Social and Environmental Determinants of Health

Suicide is frequently modeled as a function of genetics and environment, where the latter refers to factors other than direct biological consequences, such as air quality, financial level, social connectivity, transportation and food access, and homelessness status. According to the World Health Organization, clean air, a stable climate, adequate water, sanitation and hygiene, safe chemical use, radiation protection, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved natural environment are all prerequisites for good health. Understanding the relationships between these determinants and mental health outcomes requires standardized data that can be included in healthcare programs and health outcome models. There is a wealth of publicly available data on social and environmental factors provided by various US organizations that can benefit the design of health care systems and public health interventions, as well as improve our comprehension of factors that impact health. Such information would not only help improve the understanding of individual and community risk but also identify new risk factors that have not previously been therapeutically targeted, especially in terms of their impact on mental health. However, curating and standardizing such datasets is challenging because they are often recorded at numerous geographical and temporal resolutions and with varying spatial and temporal granularities. To address this challenge, we launched an endeavor in conjunction with the Veterans Health Administration to collect publicly available socioeconomic and environmental determinants of health statistics in the US. In this manuscript, we describe a social and environmental determinants of health (SEDH) datasets repository, data curation documentation, and a pipeline framework for data generation; This effort started in 2020, when we began constructing a scalable pipeline to automate the download, extraction, preparation, analysis, and production of datasets. These datasets have been made available to the VHA and may be shared upon agreement with collaborating organizations.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2026

VA Community Determinants of Health Data Curation Documentation FY26-Q2

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Community Determinants of Health (EDH) Data project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1 km grid) to another (e.g., U.S. Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, U.S. Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1 km grids. Some economic data may only be available at the ZIP code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., U.S. Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Community Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2023

The United States Department of Energy and National Institutes of Health Collaboration: Medical Care Advances via Discovery in Physical Sciences

Over several months, representatives from the U.S. Department of Energy (DOE) Office of Science and National Institutes of Health (NIH) had a number of meetings that lead to the conclusion that innovations in the Nation's health care could be realized by more directed interactions between NIH and DOE. It became clear that the expertise amassed and instrumentation advances developed at the DOE physical science laboratories to enable cutting-edge research in particle physics could also feed innovation in medical healthcare. To meet their scientific mission, the DOE laboratories created advances in such technologies as particle beam generation, radioisotope production, high-energy particle detection and imaging, superconducting particle accelerators, superconducting magnets, cryogenics, high-speed electronics, artificial intelligence, and big data. To move forward, NIH and DOE initiated the process of convening a joint work- shop which occurred on July 12th and 13th, 2021. Here, this Special Report presents a summary of the findings of the collaborative workshop and introduces the goals of the next one.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

DOE OSTI2021

Towards prevention and prediction of infectious diseases with virus sterilization using ultraviolet light and low-temperature plasma and bio-sensing devices for health and hygiene care

Inspired by the ideas of many authors, we provide insight on state-of-the-art potential technologies for the prevention and prediction of infectious diseases before they spread. This review also surveys virus sterilization with ultraviolet light and low temperature plasma technologies. Researchers in the various fields of medicine, materials, electronics, and plasma sciences have addressed increasingly challenging demands and the discussion encompasses the major challenges in societies that are faced with the threat of infectious diseases. In addition, technologies that use nanomaterials are evaluated for infection prevention and hygiene purposes. Advances in biomedical diagnostics for health care in terms of complementary metal-oxide-semiconductor transistors-based devices and telemetry for health monitoring are also reviewed.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Characteristics of Veterans With Depression Who Use the Veterans Choice Program of the Veterans Health Administration

Objective: The Veterans Choice Program (VCP) of the Veterans Health Administration (VHA) allowed eligible veterans to use their benefits with participating providers outside the VHA. The authors aimed to identify characteristics of veterans with depression who used or did not use mental health care through the VCP. Methods: In this cross-sectional study, the authors analyzed secondary data from the national VHA Corporate Data Warehouse. VHA administrative data were linked with VCP claims to examine characteristics of VCP-eligible veterans with depression. Further, the study sample included 595,943 unique veterans who were enrolled in the VHA before 2013, were eligible for the VCP in 2016, were alive in 2018, and had an assessed Patient Health Questionnaire–9 (PHQ-9) score or depressive disorder diagnosis documented in the VHA between 2016 and 2018. Results: Veterans who used the VCP had lower medical comorbidity scores and lived in less socioeconomically disadvantaged counties, compared with veterans who received only VHA care. VCP veterans were also more likely to have a PHQ-9 score assessment and to have higher mean depression scores. Mean counts of annual mental health visits per 1,000 veterans were markedly higher for direct VHA care than for care provided via the VCP. As a percentage of the total counts of visits per 1,000 veterans across the VCP and VHA, residential programs and outpatient procedures were the services that were most frequently delivered through the VCP. Conclusions: Between 2016 and 2018, the VCP was used primarily to augment mental health care provided by the VHA, rather than to fill a gap in care.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

VA EDH Data Curation Documentation (FY24-Q1)

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2024

VA EDH Data Curation Documentation (FY24-Q2)

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2024

VA EDH Data Curation Documentation (FY24-Q3)

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2024

VA EDH Data Curation Documentation FY24-Q4

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. Health outcomes, including suicide, are typically influenced by both genetics and environmental factors, such as air quality, transportation access, food availability, homelessness, and more. Mental health outcomes are associated with various stressors across socioeconomic, economic, and physical environments. Analyzing the connections between these stressors, covariates, and health outcomes relies on standardized data, which can be integrated into models like the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET). The World Health Organization (WHO) defines Environmental Determinants of Health (EDH) as factors like clean air, stable climate, water and sanitation, chemical safety, radiation protection, safe workplaces, sustainable agriculture, healthy urban environments, and nature preservation, all of which are crucial for good health.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2025

VA Determinants of Health Data Curation Documentation FY25-Q2

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2025

VA Determinants of Health Data Curation Documentation FY25-Q3

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2025

VA Community Determinants of Health Data Curation Documentation FY25-Q4

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2025

VA Community Determinants of Health Data Curation Documentation FY26-Q1

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Community Determinants of Health (EDH) Data project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Community Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2022

VA EDH Data Curation Documentation FY22-Q2, Rev. 2

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. VA is working to eliminate suicide among all Veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates and health outcomes, requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) is clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

60 APPLIED LIFE SCIENCES↗