Shaker Heights Public Library is a library district in eastern Cuyahoga County, Ohio serving the city of Shaker Heights and that portion of the City of Cleveland, known as Shaker Square, which falls within the Shaker Heights City School District. This service area encompasses 7.5 square miles (19 km2) with a population of approximately 33,000. Shaker Library consists of the Main Library, located at 16500 Van Aken Boulevard, and the Bertram Woods Branch Library, 20600 Fayette Road.The library has circulated as many as 1,365,000 items annually, making it one of America's busiest libraries on a per capita basis. It has also been named a 5-Star Library by Library Journal and received a Top 10 ranking in Hennen's American Public Library Ratings.Shaker Library is governed by a seven-member Board of Trustees. Board members are appointed by the Shaker Heights Board of Education and serve seven-year terms. The first Library Board met on April 27, 1937 and library service began in a storefront building on Lee Road in 1938. The original Main Library structure (now the Stephanie Tubbs Jones Community Building) was opened nearby on January 3, 1951. A branch library was opened in 1960 on property purchased in part through a bequest from railroad engineer Bertram Woods. A new Main Library was dedicated in the renovated Moreland Elementary School building in 1993.Shaker Library is a member of the CLEVNET Library Consortium headquartered at the Cleveland Public Library. CLEVNET is a group of more than 40 libraries in a dozen counties across northern Ohio, which share an automation system that provides a joint catalog and access to downloadable material and other electronic resources. Through the Greater Access Card, CLEVNET cardholders and Cuyahoga County Public Library cardholders may borrow materials from any CLEVNET member library or branch of the county system..
Introduction & Objective: Diabetes self-management education and support (DSMES) decreases risk of diabetes-related complications and improves quality of life. To empower and equip people with pre-diabetes and diabetes (PWD) with self-management skills in an engaging setting, our team implemented one-day in-person DSMES retreats. The purpose of this study is to characterize those who participated in the retreats at baseline to understand how to improve and expand the reach of the retreat. Methods: Participants attended hands-on educational and therapeutic sessions on the ADCES7 self-care behaviors led by an interdisciplinary diabetes care team. Recruitment reached over 700 PWD through targeted emails, Facebook, and men's health clinic. Participants were invited to complete optional demographic, clinical and dietary pre- and post-surveys. Inclusion criteria for analysis were consent to the research surveys and complete pre-retreat data. Results: Of N=68 participants most were White (70.1%), non-Hispanic (96.8%), female (88.1%) and middle-aged (mean 60.09 ±10.11 years old). Many were on private employer-sponsored insurance (57.6%) or Medicare (36.4%). The household income levels varied, with many participants earning between $31-60,000 (32.8%), $61-90,000 (23.4%), or $120,000+ (23.4%). At baseline, there were low levels of interpersonal and physician-related distress yet moderate levels of medication regimen-related distress on the Diabetes Distress Scale (mean score 1.60 ± 0.91 vs 1.70 ± 0.98 vs 2.15 ± 1.19). Conclusion: The results indicate that female middle-aged adults with varying forms of insurance and income levels and moderate levels of diabetes regimen distress engaged in the retreat despite wide recruitment efforts. Future directions include 6, 12 and 24-month follow-ups on diabetes distress, metabolic outcomes, self-management behaviors, Facebook group engagement, and improving the retreat content and structure to engage diverse populations better. Disclosure D. Johnson: None. J.E. Blanchette: Speaker's Bureau; Insulet Corporation. Board Member; Juvenile Diabetes Research Foundation (JDRF). Research Support; American Heart Association, Association of Diabetes Care & Education Specialists, National Institute of Diabetes and Digestive and Kidney Diseases, Leona M. and Harry B. Helmsley Charitable Trust. Advisory Panel; LifeScan Diabetes Institute. Consultant; WellDoc. Advisory Panel; Cardinal Health/Edgepark. O. Yamoah: None. N.J. Bellini: Speaker's Bureau; Abbott. Advisory Panel; Medtronic. Speaker's Bureau; Sanofi. Consultant; embecta. Speaker's Bureau; MannKind Corporation. Advisory Panel; LifeScan Diabetes Institute. Consultant; Insulet Corporation. J. Fetzner: None. E. Rafi: None. C. Lewis: None. N.R. Galloway: Consultant; Tidepool. Board Member; Association Diabetes Care and Education Specialists. Y. Tsushima: None. R. Gorodeski Baskin: None. B. Hatipoglu: Research Support; Tandem Diabetes Care, Inc.
This Viewpoint offers 3 insights in response to the AHRQ report on diagnostic errors made in US emergency departments: focus on the delivery systems instead of individuals, establish ways to set definitions and assess error rates, and design safe delivery systems to prevent errors.
Share Icon Share Twitter Facebook Reddit LinkedIn Reprints and Permissions Cite Icon Cite Search Site Citation James T. Dakin, Terry McGowan; Commentary: Capturing the history of GE Lighting. Physics Today 1 September 2023; 76 (9): 10–11. https://doi.org/10.1063/PT.3.5299 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentPhysics Today Search Advanced Search
Case Presentation: A 69-year-old male with a history of chronic recurrent pericarditis presented with a 3-week episode of chest pain. Despite treatment with ibuprofen, colchicine, prednisone, and anakinra, he experienced multiple flares upon attempting to wean off anakinra. His current workup revealed an elevated C-reactive protein and an echocardiogram showing a small pericardial effusion. Cardiac magnetic resonance imaging showed mild pericardial late gadolinium enhancement and increased pericardial signal on T2 STIR imaging, confirming a flare of recurrent pericarditis. The patient was started on rilonacept while being weaned off anakinra. During a follow-up after 3 months, the patient reported new onset polyarthralgia, prompting a referral to rheumatology. Rheumatoid factor was negative, but anti-citrullinated protein antibodies were positive, leading to a diagnosis of rheumatoid arthritis (RA). Azathioprine was added to the treatment regimen alongside rilonacept. Discussion: The patient's recurrent pericarditis was initially considered idiopathic but, with the subsequent RA diagnosis, it was suspected that RA may have been the underlying cause. While pericarditis is a known cardiac complication of RA, it is uncommon for pericarditis to be the initial manifestation of RA. Anakinra and rilonacept are both interleukin-1 (IL-1) inhibitors, with anakinra being FDA-approved for RA treatment. However, rilonacept has not been extensively studied in patients with RA. The case suggests that the use of certain medications may have masked RA symptoms, and as those medications were tapered, the RA symptoms became more evident. This case highlights the possibility of idiopathic pericarditis evolving into an autoimmune etiology, such as RA, over time. The combination of rilonacept and azathioprine for treating RA has limited evidence, emphasizing the need for further research in this area.
Background: The Ohio Cardiovascular and Diabetes Health Collaborative (Cardi-OH) unites the 7 medical schools in Ohio to improve cardiovascular (CV) and diabetes health outcomes and eliminate disparities in Ohio’s Medicaid population. The purpose of the Cardi-OH needs assessment was to identify high priority clinical topics for the dissemination of evidenced-based best practices to providers across the state. Methods: The cross-sectional survey was distributed via REDCap (research electronic data capture) to Cardi-OH members and its external contacts (i.e., people who have engaged with Cardi-OH but are not members) in 2022. Question topics were identified by Cardi-OH members based on perceived gaps in existing content. Results: A total of 88% (n=103) of 117 Cardi-OH members and 8% (n=98) of 1,204 external contacts participated. Of those, 51% (n=53) of Cardi-OH members and 47% (n=46) of external contacts provided direct clinical care. The top items for Cardi-OH members (clinical and non-clinical combined) were: 1) lifestyle prescriptions (n=50, 49%), 2) atypical diabetes (n=38, 37%), 3) COVID-19 and cardiovascular disease (CVD) (n=38, 37%), and 3) mental health and CVD (n=38, 37%). For external contacts, the top topics were: 1) lifestyle prescriptions (n=53, 54.1%), 2) mental health and CVD (n=39, 39.8%), 3) alcohol and CVD (n=27, 27.6%), and 3) CV complications (n=27, 27.6%). Regarding social determinants of health (SDOH), Cardi-OH members prioritized: 1) weight bias and stigma (n=44, 43%), 2) family-focused interventions (n=40, 39%), and 3) adverse childhood experiences (ACEs, n=37, 36%). External contacts selected: 1) family-focused interventions (n=51, 52%), 2) implicit bias (n=43, 43.9%), and 3) ACEs (n=39, 39.8%). Conclusions: Shared prioritized topics included lifestyle, SDOH, and behavioral health; these may be useful to other professional organizations as they consider dissemination priorities. Disclosure E.A.Beverly: None. A.Kinsella: None. L.J.Lammert: None. A.Nevar: None. G.Irwin: None. C.Rollins: None. M.W.Konstan: None. S.D.Bolen: None. S.Koopman gonzalez: Research Support; Bristol Myers Squibb Foundation. K.M.Dungan: Board Member; Elsevier, Consultant; Eli Lilly and Company, Dexcom, Inc., Other Relationship; UpToDate, Research Support; Dexcom, Inc., Abbott, ViaCyte, Inc., Sanofi, Speaker's Bureau; Academy for Continued Healthcare Learning, Cardiometabolic Health Congress, Medscape, Integritas. J.T.Wright: Advisory Panel; Medtronic. K.R.Baughman: None. R.Wexler: None. L.D.Dworkin: None. G.D.Solomon: None. J.F.Lamb: None. Funding Ohio Department of Medicaid’s Medicaid Technical Assistance and Policy Program
