ABSTRACT
OBJECTIVES/GOALS: Diabetes mellitus and COVID-19 have converged to form a syndemic. Our team sought to identify and respond to the evolving needs of patients and communities affected by diabetes amid the COVID-19 pandemic and to engage community partners and student leaders in the advancement of health equity research and practice in the state of Iowa. METHODS/STUDY POPULATION: A team of faculty, staff, students, and community partners was assembled to facilitate, design, and implement mixed methods research related to diabetes care in collaboration with more than five sites in Eastern and Western Iowa during the pandemic, with a focus on potentially preventable complications such as diabetes-related foot ulcers and amputations in adult patients. Attention was directed towards the experiences of rural residents, persons working in frontline occupations during the pandemic, persons from minoritized racial or ethnic groups, and persons who speak Spanish. RESULTS/ANTICIPATED RESULTS: A semi-structured interview study about diabetes care revealed themes in the experiences of persons with diabetes during the pandemic. A pilot study of an educational tool called the Foot Book among patients and providers demonstrated the potential for use of this tool in health care and community settings to reduce gaps in diabetes foot care. All study materials and activities were offered in English and Spanish. Study results were combined with input from community partners to develop ongoing interventions to improve care in Iowa communities. DISCUSSION/SIGNIFICANCE: Amid the syndemic of COVID-19 and diabetes, urgent action is needed to mitigate health inequities and prevent further acceleration of these inequities. Our team developed a community-engaged, patient-centered, and student-led research program that can respond to the needs of patients and communities in the pandemic era.
ABSTRACT
Simulated (or standardized) patients (SPs) play a crucial role in the teaching and assessment of communication skills in healthcare. As this methodology has evolved, the SP educator has emerged as its own profession. In 2017, an international team from the Association of SP Educators (ASPE) published Standards of Best Practice (SOBPs) to guide practitioners. Investigators sought to assess the applicability of the SOBPs to the diverse contexts in which SP educators work around the world. In this study, investigators addressed two questions: 1. Are SOBPs relevant to SP educators around the world?;and 2. How can the SOBPs be enhanced or altered in future iterations? Investigators used 60-minute, semi-structured interviews with 12 respondents from 11 countries. Researchers used purposive sampling. Respondents were intentionally recruited from 6 continents. Respondents included individuals who are active SP educators, but who are not ASPE members. All interviews were recorded and transcribed. The data were analyzed using NVivo and investigators used thematic analysis. While respondents provided many insights into the SOBPs and SP methodology, preliminary analysis has revealed three main themes. First, respondents described the role of the SOBPs in affirming current practices and guiding the development of future practices, including domains of safety in simulation and quality control. Second, respondents described how the SOBPs enable professional development through empowering evidence-based practice and promoting scholarship. Third, respondents offered recommendations for adaptation of the SOBPs to online simulation in the context of the Covid-19 pandemic. Successful simulation requires the utilization of practices most likely to lead to optimal learner outcomes. This study indicates that SP educators around the world view ASPE's SOBPs as a powerful tool providing both guidance and flexibility. Results: suggest that the SOBPs serve as a valuable guide for working with SPs in diverse cultural contexts. [ABSTRACT FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
ABSTRACT
As clinical trials evolve, the oversight by Institutional Review Boards (IRBs) has also evolved to meet everexpanding needs for both efficiency and changing regulatory requirements in the protection of human subjects. The most significant regulatory change to occur was the change to the Revised Common Rule Research Provision (45 CFR 46.114(b)) that went into effect on 20 January 2020, requiring all cooperative research subject to the Common Rule to use a single Institutional Review Board (sIRB) to review the research. Since the Common Rule affects all federally funded research, clinical trialists performing multicenter trials using federal grants are now required to use an sIRB instead of individual IRBs at each research site in their trials. For those multicenter trialists, using an sIRB offers efficiencies in time and effort which can aid in bringing trial results to fruition both faster and at a lower cost while still providing protection to human subjects. While commercial sIRBs have been available for many years, sIRBs placed at academic institutions and health care systems are relatively new. They can offer the benefit of lower cost for trialists within an institution, and better overall trial management by having more frequent communication and discussion regarding trial issues as well as improved safety management through aggregate safety review. They can also offer increased speed of research review with cooperative planning between trialist and the sIRB representatives. This session will focus on the use of sIRBs from various perspectives to give the view from an academic sIRB, from end users of both an academic sIRB and a health system IRB, and guidance from a clinical regulatory specialist regarding maintaining a trial master file while using an sIRB. Mr. Jarrod Feld from the University of Iowa will present from his perspective as the External IRB Coordinator at the University of Iowa. Mr. Feld coordinates reliance and compliance for University of Iowa human research studies which use the University of Iowa Institutional Review Board as their sIRB, and studies where Iowa relies on another institutional IRB. Mr. Feld also provides guidance to investigators on using an sIRB. Using his experience, Mr. Feld will outline the nature of reliance agreements, discuss working with a range of local IRBs to develop understanding regarding the reliance program and outline best practices for using an sIRB, and discuss enhanced safety management oversight when using an sIRB for large multisite trial. Ms. Tina Neill-Hudson from the University of Iowa will present from her experience as the sIRB Liaison for both the Acute to Chronic Pain Signature (A2CPS) Consortium, an NIH (National Institutes of Health)- funded multisite observational trial, and the Fibromyalgia and TENS in Physical Therapy Study (FM TIPS) study, an NIH-funded embedded pragmatic clinical trial. Ms. Neill-Hudson works with relying sites on completing the necessary regulatory documents needed for reliance agreements and sIRB approval. Ms. Neill-Hudson will discuss the process for obtaining reliance for institutions who may or may not have local IRB oversight and provide examples of specific steps and procedures for obtaining sIRB approval in a timely manner. Ms. Neill-Hudson will speak to the importance of having an sIRB liaison on the study team and the use of SMART IRB. Ms. Catherine Gladden from MassGeneral Brigham will present on using an sIRB for multicenter NIHfunded trials. Ms. Gladden will discuss the use of a Consortium-level reliance agreement and role of the local IRBs. Ms. Gladden oversees the sIRB liaison team at the Coordinating Center for the NeuroNEXT Network and works with the sIRB and local IRBs to ensure local policies and requirements are followed while maintaining compliance with the sIRB and the NeuroNEXT reliance agreement. Ms. Gladden will be discussing best practices for using an sIRB in a multicenter trial and discuss the experience of using an sIRB in the safety management plan. Ms. Cynthia Diltz from the University of Iowa wi l present on the topic of managing a trial master file while using an sIRB. Ms. Diltz will speak on her experience with electronic trial master files versus hard copy master files, and in using commercial software for trial master file management. Using an electronic trial master file is a necessity in the scheme of using an sIRB to assist sponsors and individual clinical research sites to view Institutional Review Board documents in real time and to provide a single storage location for documentation of Institutional Review Board approvals and activities such as continuing review. This session is timely due to the change to the Common Rule mandating the use of an sIRB for all research subject to the Common Rule, which has the most significant impact on trialists at academic institutions and health care systems. In an era of the need for timely study results for use in addressing urgent public health policy concerns, using an sIRB is becoming a necessity. The speed with which clinical trials need to be managed by an IRB has accelerated during recent public health care crises, notably the COVID-19 pandemic. In addition, it is likely that there will be changes to local IRBs as the norm becomes using an sIRB for any research subject to the Common Rule. Investigators and clinical site staff will require education on the evolution of human subject's protection and research review happening at an sIRB instead of within their local IRBs, and assistance in understanding the process and planning for success will be crucial.
ABSTRACT
Food insecurity is "a household-level economic and social condition of limited or uncertain access to adequate food" and has been identified as a hidden epidemic which has expanded with the recent COVID pandemic. Increased attention has been given to the importance of health care provider (HCP) assessment of a patient's food security. Little is known about if and how HCPs make the decision to discuss food insecurity with patients. Stereotypes of what types of patients experience food insecurity may result in patients at risk not being identified. Because HCPS may perceive this as a difficult topic to address in healthcare encounters, opportunity exists to understand how and when they choose to inquire about food insecurity. This study seeks to identify how HCPs make the decision to?screen patients for food insecurity and barriers and bias that may impact screening. As a pilot study, 50 urban and rural HCPs will be surveyed about their?decision-making process when screening patients for food insecurity. A subset of respondents will participate in in-depth interviews exploring food security screening experiences and attitudes. Initial survey and interview data will be used to develop more salient survey questions to be distributed to all primary care physicians (N-310) who participate as volunteer subjects in an established statewide research network. By ICCH 2022 the initial survey and interviews will have been completed. Findings: from the project should help identify how many providers regularly ask patients about food security and how and when they choose to do this. In addition, barriers and effective approaches to these conversations will be identified. Understanding food security screening practices and barriers can support identification of patients facing this health challenge and HCPs communication needs in engaging in food security conversations. [ABSTRACT FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
ABSTRACT
Background. Antibiotic treatment of asymptomatic bacteriuria (ASB) is unnecessary except in pregnant women or those undergoing invasive urologic procedures. Unnecessary treatment of ASB is an important driver of inappropriate antimicrobial use (IAU), leading to antimicrobial resistance, Clostridioides difficile infection, adverse drug events, and increased costs. Because ASB requires detection to be treated, unnecessary urine cultures (UC) are a key cause of IAU. Strong evidence supports not obtaining a UC from asymptomatic patients. Methods. To reduce unnecessary UC orders at the Minneapolis Veterans Affairs Health Care System (MVAHCS), UC orders within the electronic health record (EHR) were redirected to a UC clinical decision support (CDS) menu (Figure 1). Selection of an indication from the defined list is required to place a UC order and provides tracking. UC order data was obtained from the Corporate Data Warehouse (CDW), the VA's data program. Patient bed days were collected from a CDW dashboard developed by the Iowa City Veteran's Affairs Health Care System. Data was visualized using Microsoft Power BITM platform. Results. The UC CDS menu was implemented at the MVAHCS in September 2020. UC orders from 16 months prior to implementation (9/1/2018 - 12/31/2019) was compared to orders 16 months after implementation (9/1/2020 - 12/31/2021). Data from 1/1/2020 - 8/31/2020 was not included due to atypical patient care patterns during the COVID-19 pandemic.4 The monthly number of UC orders after implementation significantly decreased from an average of 765 to 564, a 26.3% reduction (P < .001;2-sided t-test) (Figure 2). The average patient bed days prior to and following implementation was not significantly different (Figure 3). Most UC orders came from the UC CDS menu (8103, 89.8%) compared to orders placed from other order menus or directly from the drug file (920, 10.2%). The most common indication selected was dysuria, frequency, and urgency (4050, 44.9%) followed by fever or sepsis (1230, 13.6%) then pre-operative urologic screening (1056, 11.7%) (Figure 4). Conclusion. Implementation of a UC CDS menu within the MVAHCS EHR resulted in significantly fewer UC orders. Most UC orders had an appropriate indication suggesting the decrease was primarily due to preventing unnecessary UC orders. (Figure Presented).
ABSTRACT
Background: Whether working on COVID-19 designated units put healthcare workers (HCWs) at higher risk of acquiring COVID-19 is not fully understood. We report trends of COVID-19 incidence among nonphysician HCWs and the association between the risk of acquiring COVID-19 and work location in the hospital. Methods: The University of Iowa Hospitals & Clinics (UIHC) is an 811-bed, academic medical center serving as a referral center for Iowa. We retrospectively collected COVID-19–associated data for nonphysician HCWs from Employee Health Clinic between June 1st 2020 and July 31th 2021. The data we ed included age, sex, job title, working location, history of COVID-19, and date of positive COVID-19 test if they had a history of COVID-19. We excluded HCWs who did not have a designated working location and those who worked on multiple units during the same shift (eg, medicine resident, hospitalist, etc) to assess the association between COVID-19 infections and working location. Job titles were divided into the following 5 categories: (1) nurse, (2) medical assistant (MA), (3) technician, (4) clerk, and (5) others (eg patient access, billing office, etc). Working locations were divided into the following 6 categories: (1) emergency department (ED), (2) COVID-19 unit, (3) non–COVID-19 unit, (4) Clinic, (5) perioperative units, and (6) remote work. Results: We identified 6,971 HCWs with work locations recorded. During the study period, 758 HCWs (10.8%) reported being diagnosed with COVID-19. Of these 758 COVID-19 cases, 658 (86.8%) were diagnosed before vaccines became available. The location with the highest COVID-19 incidence was the ED (17%), followed by both COVID-19 and non–COVID-19 units (12.7%), clinics (11.0%), perioperative units (9.4%) and remote work stations (6.6%, p Conclusions: Strict and special infection control strategies may be needed for HCWs in the ED, especially where vaccine uptake is low. The administrative control of HCWs working remotely may be associated with a lower incidence of COVID-19. Given that the difference in COVID-19 incidence among HCWs by location was lower and comparable after the availability of COVID-19 vaccines, facilities should make COVID-19 vaccination mandatory as a condition of employment for all HCWs, especially in areas where the COVID-19 incidence is high.Funding: NoneDisclosures: None
ABSTRACT
Since the repeal of Prohibition in 1933, most states have relied on some form of a three-tier system to regulate the manufacture, distribution, and sale of alcohol. With the rapid changes in technology, e-commerce, and consumer habits today, the use of unlicensed third-party providers ("TPPs") to solicit and deliver alcohol orders on behalf of licensed retailers threatens to upend alcohol regulation and the three-tier system. This would be undesirable because it might frustrate several goals of alcohol regulation such as protecting public health and safety, ensuring a fair and orderly alcohol market, and holding entities involved in the alcohol industry accountable to the public. Examining Iowa Code section 123.46A, Iowa's third-party alcohol delivery law that was enacted in July 2021, this Note argues that more effective regulation of TPP activity can be achieved by: (1) issuing TPP licenses, (2) requiring licensed retailers to exercise control over every part of the transaction facilitated by TPPs, and (3) amending Iowa 's tied-house law to prohibit manufacturers and distributors from acquiring an economic interest in TPPs.
ABSTRACT
Copacabana treats Valerie Solanas' 1967 SCUM Manifesto as "occupying a position that is both fascinating and disturbing--like so many manifestos of the male avant-garde tradition that came before it." Solanas wrote the SCUM Manifesto as a parody that, using the vernacular of her epoch, mocks popular, sexist, and heterocentric thinking about gender and sexuality of the time, upon reading it "everyone freaked out, because when we talk about men the same way men have talked about women for centuries, it reads as grotesque and insanely violent, un-compassionate, and shocking"--which was exactly the point of Solanas' intervention.
ABSTRACT
Panelists included Eric Bradley, deputy health director of Linn County Public Health;Tom Gonzales, public health director of the Larimer County Department of Health and Environment;and Niki Lemin, assistant health commissioner and director of environmental health for Franklin County Public Health. William (Bill) Marler, JD, attorney and food safety expert from Marler Clark, The Food Safety Law Firm, closed out the AEC by speaking virtually to attendees about a lawyer's view of modern foodborne outbreaks. During the first 2 years of the COVID-19 pandemic, he was environmental health manager for the Scott County Health Department in Davenport, Iowa. * Tom Gonzales, public health director for the Larimer County Department of Health and Environment in Fort Collins, Colorado. Prior to this position, he served as deputy public Featured Speakers health director at El Paso County Public Health in Colorado Springs, Colorado, and oversaw programs for environmental health and emergency preparedness and response. * Niki Lemin, assistant health commissioner and environmental health director of Franklin County Public Health in Columbus, Ohio.
ABSTRACT
The increased amount of virtual care during the COVID-19 pandemic has exacerbated the challenge of providing appropriate medical board oversight to ensure proper quality of care delivery and safety of patients. This is partly due to the conventional model of each state medical board (SMB) holding responsibility for medical standards and oversight only within the jurisdiction of that state board and partly due to regulatory waivers and reduced enforcement of privacy policies. Even with a revoked license in one state, significant number of physicians have continued to practice by obtaining a medical license in a different state. Individualized requests were sent to 63 medical boards with questions related to practice of telemedicine and digital health by debarred or penalized medical doctors. The responses revealed major deficiencies and the urgent need to adopt a nationwide framework and to create an anchor point to serve as the coordinator of all relevant information related to incidents of improper medical practice. The ability to cause damage to large number of patients is significantly more now. Federal and state agencies urgently need to provide more attention and funding to issues related to quality of care and patient care in the changing ecosystem that includes medical specialists at a distance and the use of evolving digital health services and products. The creation, maintenance, and use of an integrated information system at national and multinational levels is increasingly important.
ABSTRACT
The first documented use of telemedicine in US abortion care was in Iowa in 2008, where it was used to extend the reach of the small number of physicians willing to provide medication abortion there.1 Because of regulations imposed by the US Food and Drug Administration (FDA), patients still needed to come into a medical office to receive the mifepristone, used together with misoprostol. In the first 16 months of the service, 33% of medication abortions at a Planned Parenthood affiliate in Iowa were provided using telemedicine.1 This proportion increased overtime, and data from the affiliate spanning seven years after the service was introduced demonstrated that 46% of medication abortions were provided using telemedicine.2 Research on this modelof providing telemedicine found it to be safe and effective, with a high level of satisfaction among patients.1,2 In our previous article,3 we found that in the two years after the model was introdi iced, there was a small but significant decline in second-trimester abortion. Overall, our findings s ıggested that telemedicine improved access to medication abortion and to early abortion generally. Since our article was published, there has been a rapid expansion of the use of telemedicine in all aspects of medicine, including for abortion care.
ABSTRACT
Background: The objective of this study was to determine how levels of distress and disruption during the COVID-19 pandemic compared between ovarian cancer survivors and a community sample;how clinical and demographic characteristics of survivors were related to COVID-related distress and disruption;and if perceived stress, depression, and emotional well-being at cancer diagnosis predicted COVID-related distress during the first year of the pandemic. Methods: Ovarian cancer patients (N=90) who were part of 3 ongoing studies completed COVID surveys through mail and on REDCAP between 6/20 and 12/20. Responses were compared to those of community females (N=1110) who participated in a COVID survey mailed to an Iowa Statewide Voter Registration-based sample between 8/20 and 12/20. Pre-COVID data on perceived stress, depression, and emotional well-being (EWB) from ovarian cancer patients at the time of diagnosis was available for 30 long-term (≥4 yrs) and 60 shorter-term (<4 yrs) survivors. Hierarchical regressions examined whether psychosocial features at diagnosis, controlling for age, stage, total COVID disruption (healthcare, financial, and daily-life), and time since diagnosis, predicted COVID-related distress. Results: Compared to the community sample, ovarian cancer survivors reported lower levels of healthcare disruption (p=.016), financial hardship (p<.001), and distress (p=.009), but no difference in disruption of daily activities (p=.089). Among survivors, there were no differences in distress or total COVID-related disruptions based on stage or time since diagnosis (all p values ≥0.10). Younger survivors (<63 yr median) showed significantly greater distress (p=.009) and disruption (p=.001) than older survivors. Adjusting for covariates, perceived stress (β=.237, p=.006) and EWB (β= -.338, p<.001) at diagnosis were significant predictors of total COVID-related distress, whereas depression was not. Conclusions: Surprisingly, cancer survivors reported fewer COVID-related disruptions and distress compared to a community sample. Older patients reported less distress and disruptions during COVID, but stage and time since diagnosis were not associated with these factors. The relationship between distress and well-being at diagnosis and COVID-related distress suggests the possibility of identifying patients particularly at-risk during environmental challenges.
ABSTRACT
Background: Nowadays, noninvasive ventilation is the mainstay of the ventilation strategy in the neonatal intensive care units (NICUs) and most of infants, especially preterm infants, having respiratory problems, are provided noninvasive ventilation (NIV) upon their demands. Nevertheless, complication of NIV device-related pressure injury was common, the incidence of nasal injury ranged from 20% to 60%. Limited studies were found evaluating the nursing care of preterm infants receiving NIV. Aims: This study aimed to develop an evidence-based clinical practice guideline for preterm infants receiving NIV, implement the guideline in a NICU of a regional hospital, and evaluate infant outcomes including comfort, incidence of NIV device-related pressure injury. Besides, improvement on nurse's knowledge and practice for caring infants under NIV were assessed. Study Design and Methods: The Iowa Model-Revised was adopted as the theoretical framework to guide the study process. A multidisciplinary workgroup consists of eight stakeholders in NICU was formed for the process and acted as the champions for the new practice. A before and after study design was adopted and included the preimplementation and post-implementation phases. An integrative review was conducted to identify relevant studies from eight electronic databases before the study. All eligible studies were appraised using the Johns Hopkins University's evidence appraisal tool. Neonatal Pain, Agitation and Sedation Scale (N-PASS) for pain assessment and two self-developed NIV care bundle knowledge test and audit tool were used for the study. Results: Due to the COVID-19 pandemic in 2020, the study was extended for a month and ended in January 2021. A total of 74 infants in Pre-implementation phase (before group) and 67 infants in Post-implementation phase (after group) were recruited. Logistic regression model was used to compare the incidence of pressure injury between groups after adjusted for all substantial covariates in the study. Infants in after group had an 84% decreased odds of acquiring pressure injury (adjusted OR=0.149, 95% CI 0.045-0.495, p=0.002). Infant's comfort level whilst receiving NIV was not determined in the study as the after group having a significantly lesser mean time (p<0.001) in calm state but lower N-PASS score. Regarding nurse participants, 71 nurses received the training programme on NIV care bundle, and overall nurses' knowledge level improved immediately (adjusted p<0.001) and at 12 weeks after the programme. Three audits were conducted to evaluate nurses' practice, nurses' compliance rate to the care bundle significantly improved at 12 (p<0.001) and 24 weeks (p<0.001) in comparison with baseline compliance rate in the pre-implementation phase. However, nurses' knowledge retention at 12-week and compliance rate at 24-week after the training programme declined. Conclusion: The evidence-based clinical practice guideline aims to promote comfort and prevent injury in infants receiving NIV, and outcomes of the infants depend on vigilant nursing care and compliance to this clinical practice guideline. Declining of nurse's knowledge level and practice compliance found in the study indicates the needs of continuous education and audit on the practice to sustain the service quality and patient's safety.
ABSTRACT
Purpose: Despite decades of safety and effectiveness data, human papillomavirus (HPV) vaccination rates remain low, and one-third of adolescents fail to initiate the series by age 13, the age at which it should be completed. While there is extensive research on factors related to uptake, there is less known about the times that eligible adolescents do not get vaccinated (missed opportunities [MOs]). This study sought to quantify the extent of MOs among adolescents ages 11 to 13 during both preventive and acute care visits. Methods: Medical claims data from years 2010 to 2017 from a large midwestern insurance provider were used to calculate total numbers of MOs between ages 11 and 13. Adolescents included had continuous health insurance enrollment born between 2001 and 2004 in Iowa for the three-year period between ages 11 and 13 (n=14,505). The creation of the MO definition was informed by input from primary care and pediatric providers to ensure that all visits that could be potential vaccination opportunities were included. MOs were divided into several categories: total, among non-initiators, occurring prior to initiation, occurring after the first dose, and occurring between the first and last dose. Two subgroup comparisons for all categories (urban vs. rural;male vs. female) were explored using t-tests. Results: Overall, less than one-third of adolescents in the sample initiated the series by age 13. Females experienced significantly fewer MOs;5.98 (SD=5.49) for females compared to 6.18 (SD=6.04) for males. For initiators, the majority of MOs occurred prior to initiation of the series, which on average, occurred at age 12;again females experienced significantly fewer MOs compared to males;means for males and females were 3.62 and 4.07, respectively. In sub-group comparisons, rural adolescents tended to have fewer MOs than their urban counterparts and females tended to have fewer MOs than males. For example, urban females had significantly more MOs overall (M=6.08) compared to rural females (M=5.85). Conclusions: Results from this study highlight not only the extent of MOs, but also the utility of medical claims data in understanding patterns of adolescent health care utilization. Claims data provides a comprehensive view and level of granularity not available in other immunization data source. Future research could focus on better understanding the issue of MOs in other geographic areas or among populations with public insurance. Overall, in this sample of privately insured adolescents, it is clear that a lack of opportunity was not a barrier to HPV vaccination, as there were many opportunities in this critical age range, particularly among males and urban adolescents. Additionally, low rates of HPV vaccination have been compounded by the COVID-19 pandemic with many adolescents missing preventive care visits during the pandemic. Moving forward, it will be critical for providers to take advantage of any opportunities to vaccinate, both acute and preventive care visits, to ensure adolescents receive the vaccines they need and reduce these MOs going forward. Sources of Support: Cooperative Agreement 3 U48 DP005021-01S4 from the Centers for Disease Control and Prevention and the National Cancer Institute.
ABSTRACT
Distance Education When I received my master's degree from Iowa State University, most of my classes were via distance learning. Students and Society Traditions Our students are missing out on special traditions that signify and celebrate their accomplishments and the focus on their growing independence and maturity. Free webinars, virtual meetings, health updates, school updates, e-mails, news releases, and expert opinions. What was coming into my head usually was from reliable sources-the president, the governor, the CDC, the FDA, the USDA, major medical experts, or professional organizations.
ABSTRACT
Godwin has a M.A. in English from the University of Iowa and a B.A. in English from the University of Oklahoma, has completed graduate work in instructional design and technology, and is a graduate of the Advanced Management Program at Wharton School, University of Pennsylvania. Godwin served on the board of education of the Iowa City Community School District from 2017-2021 and currently serves on the board of MidWestONE Bank. In my six-year role as chief operating officer, I brought insights to the organization that helped streamline our processes and zero in on our commitment to the many organizations and millions of people served by ACT every year. [...]more states and districts than ever have students testing for free during the school day, ensuring equitable access to testing for more than one million students, many of whom will be the first in their families to go to college and earn a degree.
ABSTRACT
It is reported that the USDA outlook for US agriculture in 2021 is generally positive. Most agricultural markets, including the major markets for Iowa, have recovered from the depths of the price declines that struck during the early days of the COVID-19 pandemic. Some of the basic statistics (such as production, exports, imports, and prices) for cattle/beef, pigs/pigmeat, maize and soyabeans are presented.
ABSTRACT
This report presents organized and structured information on soybean trade indicators across geographical space and through time. The indicators considered are exports, imports and prices. These also are presented at the by-product level. The levels of aggregation are global, U.S. and North Dakota. The information of each indicator is presented in the form of trends and descriptive statistics. The former reveals the direction of the growth, while the latter reveals the magnitude of expectations. The descriptive statistics are represented by the mean, standard deviation, coefficient of variation and share contribution to the total. The report is presented in six sections: (I) global temporal soybean trade, (II) global spatial soybean export, (III) global spatial soybean import, (IV) U.S. temporal soybean export, (V) U.S. spatial soybean export and (VI) U.S. state level soybean export. At the global level, the trends of the indicators are presented in addition to the descriptive statistics of the top 15 exporting and importing countries. The trends and descriptive statistics for the top 15 exporting states also are provided at the U.S. level. This report is important because it serves as an informational guide on exports, our competitors for exports and potential markets for soybeans to our producers. In the current environment, the success (productivity and net farm income stability) of agricultural business depends on accurate prediction of potential demand for soybeans and their products to help producers in making decisions for domestic or foreign markets. Hence, having a comprehensive and accurate database on exports and imports at the global, national and state levels will enable producers in decisionmaking with confidence. To formulate trade policies related to the international market, the trends and the descriptive statistics are useful to producers in identifying variations in demand for soybeans and their products. For decision makers, this information is helpful in the development of risk management tools for potential export losses due to risky events such as politically driven tariffs and uncertain events such as COVID-19. Finally, in the years of decline, identifying sources of variation or risk in changing consumer preferences, genetically modified restrictive index, trade facilitation and prosperity indexes is important. The study reveals that: Global Trade * The soybean market has shifted to processed products. * Soybean grain, residue and crude oil are primary with an increase in flour. * Brazil, Argentina, Paraguay and Canada are the major competitors with the U.S. for soybean grains. * China, Japan, Netherlands, Spain and Germany are the major destinations for soybean grain. * Soybean grain prices have been on the decline in recent years. U.S. Trade vii * China, Mexico, Japan, Indonesia and Netherlands are the major destinations for U.S. soybean grains. * Turkey, Russia, Argentina and Italy are among the top 15 importers of soybean grains but not part of the top 15 U.S. export destinations. U.S. State Trade * Our state-level estimates of trade are consistent with U.S. Department of Agriculture (USDA) Economic Research Service (ERS) exports. In contrast, the USDA Foreign Agricultural Service (FAS) under- and overestimates state exports because they are based on the location of the port. * Our production-adjusted state export estimates suggest the major exporters of soybeans are Illinois, Iowa, Minnesota, Nebraska, Indiana, Ohio, Missouri, South Dakota, North Dakota and Kansas. North Dakota Trade * North Dakota soybean exports are underestimated by the USDA FAS. * For instance, the production adjusted export value predicts a value of $885,365,842 in 2018, while the ERS method predicted $887,896,380 for North Dakota. On the other hand, the FAS method presents a value of $62,543,314.
ABSTRACT
Coronavirus Disease 2019 (COVID-19) was declared a global pandemic on March 11, 2020, by the World Health Organization. By April 2020, COVID-19 resulted in the simultaneous closure or reduced operations of many processing plants in the upper Midwest, which quickly resulted in supply chain disruptions. Iowa is the leading pork production and processing state, and these disruptions caused producer uncertainty, confusion, and stress, including time-sensitive challenges for maintaining animal care. The Resource Coordination Center (RCC) was quickly created and launched from the Iowa Department of Agriculture and Land Stewardship. The RCC had strategic collaborations with public representation from the Iowa Pork Producers Association, Iowa Pork Industry Center, and Iowa State University Extension and Outreach, and private partners through producers, veterinarians, and technical specialists. The RCC’s mission was four-fold: (1) implement appropriate actions to ensure the health and safety of RCC members, stakeholders, and the public, (2) evaluate and reassess appropriate actions as needed for continuity of pork production operations, (3) provide information to pork producers during supply chain disruptions, and (4) maintain a safe and abundant pork supply for consumers. The command structure included Incident Commanders, Command Staff, and four Section Chiefs whom worked with their respective experts. Sections covered (1) operations, (2) planning, (3) logistics, and (4) finance and administration. As it related to animal welfare, the RCC provided information on management decisions, dietary alterations to slow pig growth, pig movement to increase living space, alternative markets, on-farm euthanasia and mass depopulation. Veterinary oversight was continually maintained. A manual was created to provide up-to-date information to inform producer decisions and aid. Although originally created for swine, the RCC also assisted poultry, cattle and sheep producers. In a crisis, Iowa created a model that reacted to producer’s pragmatic and emotional needs. This model could be replicated for any emergency by other states.
ABSTRACT
This article shows how the agricultural commodity markets and the land market have gained noticeable strength since fall 2020 due to COVID-19. Record government support, historically low interest rates, and surging agricultural exports led to a near-10% hike in farmland values for almost all Midwestern states. The two most recent quarterly surveys on farmland values of agricultural lenders by the Federal Reserve Banks of Kansas City and Chicago are presented in this paper. Moreover, the surging crop and land prices offer optimism to landowners, producers, and agricultural professionals, and once again proves the resiliency of agricultural real estate values. The estimates from an online survey on land value trends and crop prices for corn and soybean in Iowa were provided. Overall, agricultural professionals expect a continuation of the growth spree in farmland values in their local service areas over the next 18 months.