Preparing Students for Team-Based Care for Vulnerable Populations

Health professionals have an obligation to improve both the health of the individual and the public in a time of scarce resources. The Institute of Medicine (IOM), Healthy People Curriculum Task Force and professional education accreditation standards indicate the need for health care professionals to demonstrate competencies related to community engagement, basic health promotion skills and the ability to work effectively in interprofessional teams. An Interprofessional Course, IPE 413: Developing Care for a Vulnerable Population provides students the opportunity to collaborate to address health needs in cooperation with a community partner. Students work in teams to address the complex health care needs of an individual community member. The one hour elective course is open to students from nursing, occupational therapy, pharmacy, social work, and exercise science. Efforts are underway to explore the possibility of offering this course to medical students. Students are assessed on the knowledge and experience gained through this interprofessional experience using the Team Skills Scale and student reflections. Faculties from each of the disciplines utilize a collaborative model in the instructional design of the course. The content is co-taught and faculty not only role model interprofessional care, but also serve as mentors and resource personnel for the students as they work with their clients

Constraining the Origin of Impact Craters on Al Foils from the Stardust Interstellar Dust Collector

Preliminary examination (PE) of the aerogel tiles and Al foils from the Stardust Interstellar Dust Collector has revealed multiple impact features. Some are most likely due to primary impacts of interstellar dust (ISD) grains, and others are associated with secondary impacts of spacecraft debris, and possibly primary impacts of interplanetary dust particles (IDPs) [1, 2]. The current focus of the PE effort is on constraining the origin of the individual impact features so that definitive results from the first direct laboratory analysis of contemporary ISD can be reported. Because crater morphology depends on impacting particle shape and composition, in addition to the angle and direction of impact, unique particle trajectories are not easily determined. However, elemental analysis of the crater residues can distinguish real cosmic dust from the spacecraft debris, due to the low cosmic abundance of many of the elements in the spacecraft materials. We present here results from the elemental analysis of 24 craters and discuss the possible origins of 4 that are identified as candidate ISD impact

Cosmic Rays from the Knee to the Highest Energies

This review summarizes recent developments in the understanding of high-energy cosmic rays. It focuses on galactic and presumably extragalactic particles in the energy range from the knee (10^15 eV) up to the highest energies observed (>10^20 eV). Emphasis is put on observational results, their interpretation, and the global picture of cosmic rays that has emerged during the last decade.Comment: Invited review, submitted to Progress in Particle and Nuclear Physic

KASCADE measurements of energy spectra for elemental groups of cosmic rays: Results and open problems

A composition analysis of KASCADE air shower data is performed by means of unfolding the two-dimensional frequency spectrum of electron and muon numbers. Aim of the analysis is the determination of energy spectra for elemental groups representing the chemical composition of primary cosmic rays. Since such an analysis depends crucially on simulations of air showers the two different hadronic interaction models QGSJet and SIBYLL are used for their generation. The resulting primary energy spectra show that the knee in the all particle spectrum is due to a steepening of the spectra of light elements but, also, that neither of the two simulation sets is able to describe the measured data consistently over the whole energy range with discrepancies appearing in different energy regions.Comment: 39 pages, accepted for publication in Astropart. Phy

Final Reports of the Stardust ISPE: Seven Probable Interstellar Dust Particles

The Stardust spacecraft carried the first spaceborne collector specifically designed to capture and return a sample of contemporary interstellar dust to terrestrial laboratories for analysis [1]. The collector was exposed to the interstellar dust stream in two periods in 2000 and 2002 with a total exposure of approximately 1.8 10(exp 6) square meters sec. Approximately 85% of the collector consisted of aerogel, and the remainder consisted of Al foils. The Stardust Interstellar Preliminary Examination (ISPE) was a consortiumbased effort to characterize the collection in sufficient detail to enable future investigators to make informed sample requests. Among the questions to be answered were these: How many impacts are consistent in their characteristics with interstellar dust, with interplanetary dust, and with secondary ejecta from impacts on the spacecraft? Are the materials amorphous or crystalline? Are organics detectable? An additional goal of the ISPE was to develop or refine the techniques for preparation, analysis, and curation of these tiny samples, expected to be approximately 1 picogram or smaller, roughly three orders of magnitude smaller in mass than the samples in other small particle collections in NASA's collections - the cometary samples returned by Stardust, and the collection of Interplanetary Dust Particles collected in the stratosphere

The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study

BACKGROUND: The morbidity of gay, lesbian or bisexual people attending family practice has not been previously assessed. We compared health measures of family practice attendees classified as lesbian, gay and bisexual. METHODS: We conducted a cross-sectional, controlled study conducted in 13 London family practices and compared the responses of 26 lesbian and 85 bisexual classified women, with that of 934 heterosexual classified women and 38 gay and 23 bisexual classified men with that of 373 heterosexual classified men. Our outcomes of interest were: General health questionnaire; CAGE questionnaire; short form12; smoking status; sexual experiences during childhood; number of sexual partners and sexual function and satisfaction. RESULTS: In comparison to people classified as heterosexuals: men classified as gay reported higher levels of psychological symptoms (OR 2.48, CI 1.05–5.90); women classified as bisexual were more likely to misuse alcohol (OR 2.73, 1.70–4.40); women classified as bisexual (OR 2.53, 1.60–4.00) and lesbian (OR 3.13, 1.41–6.97) and men classified as bisexual (OR 2.48, 1,04, 5.86) were more likely to be smokers and women classified as bisexual (OR 3.27, 1.97–5.43) and men classified as gay (OR 4.86, 2.28–10.34) were much more likely to report childhood sexual experiences in childhood. Psychological distress was associated with reporting sexual experiences in childhood in men classified as gay and bisexual and women classified as heterosexual. Men classified as bisexual (OR 5.00, 1.73–14.51) and women classified as bisexual (OR 2.88, 1.24- 6.56) were more likely than heterosexuals to report more than one sexual partner in the preceding four weeks. Lesbian, gay and bisexual classified people encountered no more sexual function problems than heterosexuals but men classified as bisexual (OR 2.74, 1.12–6.70) were more dissatisfied with their sex lives. CONCLUSION: Bisexual and lesbian classified people attending London general practices were more likely to be smokers and gay classified men were at increased risk of psychological distress in comparison to heterosexual classified people. Increased awareness of the sexuality of people seen in primary care can provide opportunities for health promotion

The Intention–Behavior Gap

© 2016 John Wiley & Sons LtdBitter personal experience and meta-analysis converge on the conclusion that people do not always do the things that they intend to do. This paper synthesizes research on intention–behavior relations to address questions such as: How big is the intention–behavior gap? When are intentions more or less likely to get translated into action? What kinds of problems prevent people from realizing their intentions? And what strategies show promise in closing the intention–behavior gap and helping people do the things that they intend to do?

Assessment of splenic function

Hyposplenic patients are at risk of overwhelming post-splenectomy infection (OPSI), which carries mortality of up to 70%. Therefore, preventive measures are warranted. However, patients with diminished splenic function are difficult to identify. In this review we discuss immunological, haematological and scintigraphic parameters that can be used to measure splenic function. IgM memory B cells are a potential parameter for assessing splenic function; however, more studies are necessary for its validation. Detection of Howell–Jolly bodies does not reflect splenic function accurately, whereas determining the percentage of pitted erythrocytes is a well-evaluated method and seems a good first-line investigation for assessing splenic function. When assessing spleen function, 99mTc-labelled, heat-altered, autologous erythrocyte scintigraphy with multimodality single photon emission computed tomography (SPECT)-CT technology is the best approach, as all facets of splenic function are evaluated. In conclusion, although scintigraphic methods are most reliable, they are not suitable for screening large populations. We therefore recommend using the percentage of pitted erythrocytes, albeit suboptimal, as a first-line investigation and subsequently confirming abnormal readings by means of scintigraphy. More studies evaluating the value of potentially new markers are needed