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https://www.readbyqxmd.com/read/28737412/integrated-care-clinic-creating-enhanced-clinical-pathways-for-integrated-behavioral-health-care-in-a-family-medicine-residency-clinic-serving-a-low-income-minority-population
#1
Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S Utržan, Michele Mandrich, Andrew Slattengren, Tanner Nissly, Laura Miller, Macaran Baird, Eli Coleman, Michael Wootten
INTRODUCTION: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28730802/sensing-single-molecule-penetration-into-nanopores-pushing-the-time-resolution-to-the-diffusion-limit
#2
Igor Bodrenko, Jiajun Wang, Samuele Salis, Mathias Winterhalter, Matteo Ceccarelli
To quantify small molecule penetration into and eventually permeation through nanopores, we applied an improved excess-noise analysis of the ion current fluctuation caused by entering molecules. The kinetic parameters of substrate entry and leave are derived from a two-state Markov model, analyzing the substrate concentration depen- dence of the average ion current and its variance. Including filter corrections allows one to detect the transition rates beyond the cutoff frequency, fc, of the instrumental ion-current filter...
July 21, 2017: ACS Sensors
https://www.readbyqxmd.com/read/28726531/looking-forward-and-looking-back-older-adults-views-of-the-impacts-of-stopping-driving
#3
Nadia W Mullen, Barbara Parker, Elaine Wiersma, Arne Stinchcombe, Michel Bédard
This project aimed to identify the impact of driving cessation from the perspectives of older drivers and former drivers. Participants included 17 adults aged 65-88 years residing in a city in Northwestern Ontario, Canada. Using a semi-structured interview guide (with questions regarding mobility, personal impact, impact on others, engagement with life, and finances), two focus groups were held with nine current drivers, and one-on-one interviews were held with six former drivers and two current drivers. Two themes emerged concerning stopping driving...
July 20, 2017: Occupational Therapy in Health Care
https://www.readbyqxmd.com/read/28726520/rural-and-urban-substance-use-differences-effects-of-the-transition-to-college
#4
Karen J Derefinko, Zoran Bursac, Michael G Mejia, Richard Milich, Donald R Lynam
BACKGROUND: With approximately 20% of Americans residing in rural communities, substance use differences is an important topic for appropriate use of resources, policy decisions, and the development of prevention and intervention programs. OBJECTIVES: The current study examined differences in alcohol, tobacco, and marijuana use among students from rural and urban backgrounds across the transition to college. METHODS: Participants were 431 (48% male) undergraduate students from a large, public southeastern university who provided yearly alcohol, tobacco, and marijuana use data during freshman, sophomore, and junior years...
July 20, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28726156/remote-monitoring-and-consultation-of-inpatient-populations-with-diabetes
#5
REVIEW
Robert J Rushakoff, Joshua A Rushakoff, Zachary Kornberg, Heidemarie Windham MacMaster, Arti D Shah
PURPOSE OF REVIEW: Inpatient hyperglycemia is common and is linked to increased morbidity and mortality. We review current and innovative ways diabetes specialists consult in the management of inpatient diabetes. RECENT FINDINGS: With electronic medical records (EMRs), remote monitoring and intervention may improve the management of inpatient hyperglycemia. Automated reports allow monitoring of glucose levels and allow diabetes teams to intervene through formal or remote consultation...
September 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28724371/association-between-full-service-and-fast-food-restaurant-density-dietary-intake-and-overweight-obesity-among-adults-in-delhi-india
#6
Opal Patel, Safraj Shahulhameed, Roopa Shivashankar, Mohammad Tayyab, Atiqur Rahman, Dorairaj Prabhakaran, Nikhil Tandon, Lindsay M Jaacks
BACKGROUND: The food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs). The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India. METHODS: Data are from a cross-sectional, population-based study conducted in Delhi...
July 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28715979/a-serendipitous-scientist
#7
Robert J Lefkowitz
Growing up in a middle-class Jewish home in the Bronx, I had only one professional goal: to become a physician. However, as with most of my Vietnam-era MD colleagues, I found my residency training interrupted by the Doctor Draft in 1968. Some of us who were academically inclined fulfilled this obligation by serving in the US Public Health Service as commissioned officers stationed at the National Institutes of Health. This experience would eventually change the entire trajectory of my career. Here I describe how, over a period of years, I transitioned from the life of a physician to that of a physician scientist; my 50 years of work on cellular receptors; and some miscellaneous thoughts on subjects as varied as Nobel prizes, scientific lineages, mentoring, publishing, and funding...
July 17, 2017: Annual Review of Pharmacology and Toxicology
https://www.readbyqxmd.com/read/28712833/transitioning-to-independent-practice-a%C3%A2-successful-fourth-year-radiology-resident%C3%A2-curriculum
#8
Darel E Heitkamp, Jason M Ford, Colleen M Madden, Kevin L Smith, Matthew J Nartker, John M Ponting, Scott D Steenburg, Vasantha D Aaron, Aaron P Kamer
No abstract text is available yet for this article.
July 13, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28712155/economic-activity-and-patterns-of-infant-growth-in-a-high-altitude-district-of-peru
#9
Morgan K Hoke
OBJECTIVES: Changing economic activities bring significant cultural, epidemiological, and nutritional transitions. Infancy represents a critical period when rapid growth and metabolic programming occur, making infants particularly vulnerable to long-lasting biological changes due to such transitions. This paper examines the relationship between residence in distinct economic production zones (urban, herding, and dairy) and early growth in a highland district of Peru. METHODS: The length, weight, body mass index, and triceps skinfold of 93 infants (55 boys and 38 girls, aged 2 to 24 months) from 3 economic zones were measured at two time points 6 months apart...
July 16, 2017: American Journal of Human Biology: the Official Journal of the Human Biology Council
https://www.readbyqxmd.com/read/28710920/thermodynamics-and-kinetics-of-rna-tertiary-structure-formation-in-the-junctionless-hairpin-ribozyme
#10
Neil A White, Charles G Hoogstraten
The hairpin ribozyme consists of two RNA internal loops that interact to form the catalytically active structure. This docking transition is a rare example of intermolecular formation of RNA tertiary structure without coupling to helix annealing. We have used temperature-dependent surface plasmon resonance (SPR) to characterize the thermodynamics and kinetics of RNA tertiary structure formation for the junctionless form of the ribozyme, in which loops A and B reside on separate molecules. We find docking to be strongly enthalpy-driven and to be accompanied by substantial activation barriers for association and dissociation, consistent with the structural reorganization of both internal loops upon complex formation...
July 8, 2017: Biophysical Chemistry
https://www.readbyqxmd.com/read/28709781/radiology-resident-supply-and-demand-a%C3%A2-regional-perspective
#11
Cory M Pfeifer
PURPOSE: Radiology was subject to crippling deficits in the number of jobs available to graduates of training programs from 2012 through 2015. As the specialty transitions to the assimilation of osteopathic training programs and the welcoming of direct competition from new integrated interventional radiology programs, the assessment of growth in radiology training positions over the 10 years preceding this pivotal time will serve to characterize the genesis of the crisis while inspiring stakeholders to avoid similar negative fluctuations in the future...
July 11, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28707354/additive-neurogenesis-supported-by-multiple-stem-cell-populations-mediates-adult-spinal-cord-development-a-spatio-temporal-statistical-mapping-analysis-in-a-teleost-model-of-indeterminate-growth
#12
Ruxandra F Sîrbulescu, Iulian Ilieş, Annette Meyer, Günther K H Zupanc
The knifefish Apteronotus leptorhynchus exhibits indeterminate growth throughout adulthood. This phenomenon extends to the spinal cord, presumably through the continuous addition of new neurons and glial cells. However, little is known about the developmental dynamics of cells added during adult growth. The present work characterizes the structural and functional development of the adult spinal cord in this model organism through a comprehensive quantitative analysis of the spatial and temporal dynamics of new cells at various developmental stages...
July 13, 2017: Developmental Neurobiology
https://www.readbyqxmd.com/read/28705161/entrustment-of-the-on-call-senior-medical-resident-role-implications-for-patient-safety-and-collective-care
#13
Noureen Huda, Lisa Faden, Mark Goldszmidt
BACKGROUND: The on-call responsibilities of a senior medicine resident (SMR) may include the admission transition of patient care on medical teaching teams (MTT), supervision of junior trainees, and ensuring patient safety. In many institutions, there is no standardised assessment of SMR competency prior to granting these on-call responsibilities in internal medicine. In order to fulfill competency based medical education requirements, training programs need to develop assessment approaches to make and defend such entrustment decisions...
July 14, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28697747/exploring-residents-experiences-of-mealtimes-in-care-homes-a-qualitative-interview-study
#14
Ross Watkins, Victoria A Goodwin, Rebecca A Abbott, Abi Hall, Mark Tarrant
BACKGROUND: Many interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents' health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents' experiences of mealtimes have on health outcomes. The aim of this study was to gain an insight into these experiences and explore some of the issues that may impact on residents' enjoyment of meals, and resulting health and wellbeing...
July 11, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28694712/creating-physicians-of-the-21st-century-assessment-of-the-clinical-years
#15
Allison A Vanderbilt, Sara Q Perkins, Moriah K Muscaro, Thomas J Papadimos, Reginald F Baugh
Medical education has been under a constant state of revision for the past several years. The overarching theme of the curriculum revisions for medical schools across the USA has been creating better physicians for the 21st century, with the same end result: graduating medical students at the optimal performance level when entering residency. We propose a robust, thorough assessment process that will address the needs of clerkships, residents, students, and, most importantly, medical schools to best measure and improve clinical reasoning skills that are required for the learning outcomes of our future physicians...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28689483/the-influence-of-positioning-of-the-nellix-endovascular-aneurysm-sealing-system-on-suprarenal-and-renal-flow-an-in-vitro-study
#16
Johannes T Boersen, Erik Groot Jebbink, Lennart Van de Velde, Michel Versluis, Guillaume Lajoinie, Cornelius H Slump, Jean-Paul P M de Vries, Michel M P J Reijnen
PURPOSE: To examine the influence of device positioning and infrarenal neck diameter on flow patterns in the Nellix endovascular aneurysm sealing (EVAS) system. METHODS: The transition of the aortic flow lumen into two 10-mm-diameter stents after EVAS creates a mismatched area. Flow recirculation may affect local wall shear stress (WSS) profiles and residence time associated with atherosclerosis and thrombosis. To examine these issues, 7 abdominal aortic aneurysm flow phantoms were created, including 3 unstented controls and 3 stented models with infrarenal neck diameters of 24, 28, and 32 mm...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28688664/a-novel-flight-surgeon-training-model-at-a-joint-military-and-civilian-surgical-residency-program
#17
Erik S DeSoucy, Scott A Zakaluzny, Joseph M Galante
BACKGROUND: Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. METHODS: From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28683890/how-can-surgeons-facilitate-resident-intraoperative-decision-making
#18
Katherine A Hill, Mohini Dasari, Eliza B Littleton, Giselle G Hamad
BACKGROUND: Cognitive skills such as decision-making are critical to developing operative autonomy. We explored resident decision-making using a recollection of specific examples, from the attending surgeon and resident, after laparoscopic cholecystectomy. METHODS: In a separate semi-structured interview, the attending and resident both answered five questions, regarding the resident's operative roles and decisions, ways the attending helped, times when the attending operated, and the effect of the relationship between attending and resident...
June 23, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28682607/mechanism-and-rate-of-thermal-decomposition-of-hexachlorocyclopentadiene-and-its-importance-in-pcdd-f-formation-from-the-combustion-of-cyclodiene-pesticides
#19
Nirmala Kumuduni Dharmarathne, John C Mackie, Eric M Kennedy, Michael Stockenhuber
Thermal decomposition of hexachlorocyclopentadiene (HCCP) has been studied in inert gas and under oxidative conditions in a silica flow reactor at a residence time of 5.0 s between 690 - 923 K and 1 atm pressure. Pyrolysis was initiated by Cl bond fission to form pentachlorocyclopentadienyl radical; two such radicals then combine to undergo a series of intramolecular rearrangements and Cl fissions producing principally octachloronaphthalene (8ClNP) and Cl2. This process has been studied by quantum chemical calculation and a reaction potential energy surface developed...
July 6, 2017: Journal of Physical Chemistry. A
https://www.readbyqxmd.com/read/28682444/selecting-a-skilled-nursing-facility-for-postacute-care-individual-and-family-perspectives
#20
Emily A Gadbois, Denise A Tyler, Vincent Mor
OBJECTIVES: To describe individuals' experiences during the hospital discharge planning and skilled nursing facility (SNF) selection process. DESIGN: Semistructured interviews focusing on discharge planning and nursing facility selection, including how facilities were chosen, who was involved, and what factors were important in decision-making. SETTING: 14 SNFs in five cities across the United States. PARTICIPANTS: Newly admitted, previously community-dwelling SNF residents (N = 98) and their family members...
July 6, 2017: Journal of the American Geriatrics Society
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