Integrating E-Books: DDA, E-Approvals, and E-Firm Orders

Learn how one library loads DDA (Demand-Driven Acquisition) ebook records (full bibs and order records) and e-book-approval / e-book -firm (full bib/order / invoice info) records into Sierra via batch processing

Eating As Treatment (EAT): A Stepped-Wedge, Randomized Controlled Trial of a Health Behavior Change Intervention Provided by Dietitians to Improve Nutrition in Patients With Head and Neck Cancer Undergoing Radiation Therapy (TROG 12.03)

Purpose: Malnutrition in head and neck cancer (HNC) treatment is common and associated with poorer morbidity and mortality outcomes. This trial aimed to improve nutritional status during radiation therapy (RT) using a novel method of training dietitians to deliver psychological techniques to improve nutritional behaviors in patients with HNC. Methods and Materials: This trial used a stepped-wedge, randomized controlled design to assess the efficacy of the Eating As Treatment (EAT) program. Based on motivational interviewing and cognitive behavioral therapy, EAT was designed to be delivered by oncology dietitians and integrated into their clinical practice. During control steps, dietitians provided treatment as usual, before being trained in EAT and moving into the intervention phase. The training was principles based and sought to improve behavior-change skills rather than provide specific scripts. Patients recruited to the trial (151 controls, 156 intervention) were assessed at 4 time points (the first and the final weeks of RT, and 4 and 12 weeks afterward). The primary outcome was nutritional status at the end of RT as measured by the Patient-Generated Subjective Global Assessment. Results: Patients who received the EAT intervention had significantly better scores on the primary outcome of nutritional status at the critical end-of-treatment time point (β = −1.53 [−2.93 to −.13], P =.03). Intervention patients were also significantly more likely than control patients to be assessed as well-nourished at each time point, lose a smaller percentage of weight, have fewer treatment interruptions, present lower depression scores, and report a higher quality of life. Although results were not statistically significant, patients who received the intervention had fewer and shorter unplanned hospital admissions. Conclusions: This trial is the first of its kind to demonstrate the effectiveness of a psychological intervention to improve nutrition in patients with HNC who are receiving RT. The intervention provides a means to ameliorate malnutrition and the important related outcomes and consequently should be incorporated into standard care for patients receiving RT for HNC

Knowledge as quality non-conformance : A critical case study of ISO 9000 and adult education in the workplace.

The study focused on the impact of the process seeking ISO 9000 registration and the way in which learning processes come to be defined as defective

Lung cancer stigma predicts timing of medical help-seeking in individuals with lung cancer

Purpose/Objectives To examine relationships among demographic variables, healthcare system distrust, lung cancer stigma, smoking status, and timing of medical help–seeking behavior in individuals with symptoms suggestive of lung cancer after controlling for ethnicity, socioeconomic status, and social desirability. Design Descriptive, cross-sectional, correlational study. Setting Outpatient oncology clinics in Louisville, KY. Sample 94 patients diagnosed in the past three weeks to six years with all stages of lung cancer. Methods Self-report, written survey packets were administered in person followed by a semistructured interview to assess symptoms and timing characteristics of practice-identified patients with lung cancer. Main Research Variables Timing of medical help–seeking behavior, healthcare system distrust, lung cancer stigma, and smoking status. Findings Lung cancer stigma was independently associated with timing of medical help–seeking behavior in patients with lung cancer. Healthcare system distrust and smoking status were not independently associated with timing of medical help–seeking behavior. Conclusions Findings suggest that stigma influences medical help–seeking behavior for lung cancer symptoms, serving as a barrier to prompt medical help–seeking behavior. Implications for Nursing When designing interventions to promote early medical help–seeking behavior in individuals with symptoms suggestive of lung cancer, methods that consider lung cancer stigma as a barrier that can be addressed through public awareness and patient-targeted interventions should be included

Derivative Analysis of AVIRIS Data for Crop Stress Detection

Low-altitude Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) hyperspectral imagery of a cornfield in Nebraska was used to determine whether derivative analysis methods provided enhanced plant stress detection compared with narrow-band ratios. The field was divided into 20 plots representing 4 replicates each of 5 nitrogen (N) fertilization treatments that ranged from 0 to 200 kg N/ha in 50 kg/ha increments. The imagery yielded a 3 m ground pixel size for 224 spectral bands. Derivative analysis provided no advantage in stress detection compared with the performance of narrow-band indices derived from the literature. This result was attributed to a high leaf area index at the time of overflight (LAI approx. equal to 5 to 6t) and the high signal-to-noise character of the narrow AVIRIS bands

Fornix deep brain stimulation enhances acetylcholine levels in the hippocampus

Deep brain stimulation (DBS) of the fornix has gained interest as a potential therapy for advanced treatment-resistant dementia, yet the mechanism of action remains widely unknown. Previously, we have reported beneficial memory effects of fornix DBS in a scopolamine induced rat model of dementia, which is dependent on various brain structures including hippocampus. To elucidate mechanisms of action of fornix DBS with regard to memory restoration, we performed c-Fos immunohistochemistry in the hippocampus. We found that fornix DBS induced a selective activation of cells in the CA1 and CA3 subfields of the dorsal hippocampus. In addition, hippocampal neurotransmitter levels were measured using microdialysis before, during and after 60 min of fornix DBS in a next experiment. We observed a substantial increase in the levels of extracellular hippocampal acetylcholine, which peaked 20 min after stimulus onset. Interestingly, hippocampal glutamate levels did not change compared to baseline. Therefore, our findings provide first experimental evidence that fornix DBS activates the hippocampus and induces the release of acetylcholine in this region.Publisher PDFPeer reviewe

The stress-sensing domain of activated IRE1α forms helical filaments in narrow ER membrane tubes

The signaling network of the unfolded protein response (UPR) adjusts the protein folding capacity of the endoplasmic reticulum (ER) according to need. The most conserved UPR sensor, IRE1α, spans the ER membrane and activates through oligomerization. IRE1α oligomers accumulate in dynamic foci. We determined the in-situ structure of IRE1α foci by cryogenic correlated light and electron microscopy (cryo-CLEM), combined with electron cryo-tomography (cryo-ET) and complementary immuno-electron microscopy. IRE1α oligomers localize to a network of narrow anastomosing ER tubes (diameter ~28 nm) with complex branching. The lumen of the tubes contains protein filaments, likely composed of linear arrays of IRE1α lumenal domain dimers, arranged in two intertwined, left-handed helices. Our findings define a previously unrecognized ER subdomain and suggest positive feedback in IRE1 signaling

What is the comparative health status and associated risk factors for the Métis? A population-based study in Manitoba, Canada

<p>Abstract</p> <p>Background</p> <p>Métis are descendants of early 17^thcentury relationships between North American Indians and Europeans. This study's objectives were: (1) to compare the health status of the Métis people to all other residents of Manitoba, Canada; and (2) to analyze factors in predicting the likelihood of diabetes and related lower limb amputation.</p> <p>Methods</p> <p>Using de-identified administrative databases plus the Métis Population Database housed at the Manitoba Centre for Health Policy, age/sex-adjusted rates of mortality and disease were calculated for Métis (n = 73,016) and all other Manitobans (n = 1,104,672). Diseases included: hypertension, arthritis, diabetes, ischemic heart disease (age 19+); osteoporosis (age 50+); acute myocardial infarction (AMI) and stroke (age 40+); total respiratory morbidity (TRM, all ages). Using logistic regression, predictors of diabetes (2004/05-2006/07) and diabetes-related lower-limb amputations (2002/03-2006/07) were analyzed.</p> <p>Results</p> <p>Disease rates were higher for Métis compared to all others: premature mortality before age 75 (4.0 vs. 3.3 per 1000, p < .001); total mortality (9.7 vs. 8.4 per 1000, p < .001); injury mortality (0.58 vs. 0.51 per 1000, p < .03); Potential Years of Life Lost (64.6 vs. 54.6 per 1000, p < .001); all-cause 5-year mortality for people with diabetes (20.8% vs. 18.6%, p < .02); hypertension (27.9% vs. 24.8%, p < .001); arthritis (24.2% vs. 19.9%, p < .001), TRM (13.6% vs. 10.6%, p < .001); diabetes (11.8% vs. 8.8%, p < .001); diabetes-related lower limb amputation (24.1 vs. 16.2 per 1000, p < .001); ischemic heart disease (12.2% vs. 8.7%, p < .001); osteoporosis (12.2% vs. 12.3%, NS), dialysis initiation (0.46% vs. 0.34%, p < .001); AMI (5.4 vs. 4.3 per 1000, p < .001); stroke (3.6 vs. 2.9 per 1000, p < .001). Controlling for geography, age, sex, income, continuity of care and comorbidities, Métis were more likely to have diabetes (aOR = 1.29, 95% CI 1.25-1.34), but not diabetes-related lower limb amputation (aOR = 1.13, 95% CI 0.90-1.40, NS). Continuity of care was associated with decreased risk of amputation both provincially (aOR = 0.71, 95% CI 0.62-0.81) and for Métis alone (aOR = 0.62, 95% CI 0.40-0.96).</p> <p>Conclusion</p> <p>Despite universal healthcare, Métis' illness and mortality rates are mostly higher. Although elevated diabetes risk persists for the Métis even after adjusting for sociodemographic, healthcare and comorbidity variables, the risk of amputation for Métis appears more related to healthcare access rather than ethnicity.</p