808 research outputs found
A survey of the likes and dislikes of children in grade two for the stories in the Ginn and Company basal reader We are Neighbors.
Thesis (Ed.M.)--Boston Universit
Improving Colorectal Cancer Screening Decision Making Processes
Introduction:
Although shared decision making is recommended for cancer screening, it is not routinely completed in practice because of time constraints. We evaluated a process for improving decision making about colorectal cancer (CRC) screening using mailed decision aids (DA) with follow-up telephone support in primary care practices.
Methods:
We identified patients aged 50-75 who were not up to date with CRC screening in three primary care practices. DA were distributed via mail with telephone follow-up to eligible patients, and charts were reviewed six months later for CRC screening completion.
Results:
Among 1,064 eligible patients who received the mailed DA, 513 (48.2%) were reached by phone. During the six months after the intervention, 148/1064 (13.9%) patients were screened for CRC (4.8% underwent FIT, 9.1% underwent colonoscopy). Younger patients (aged 50-54) had higher rates of any screening (32.4%) compared with all other age groups (range 12.8%-19.6%), p=0.026, while Medicaid patients had the lowest rates of screening (4.0%), and insured patients had the highest rates (45.3%), p=0.003. Overall, 113/513 (22.0%) who were reached by phone went on to complete screening within 6 months, compared with 35/551 (6.4%) of patients who were not reached by phone (p
Conclusion:
A standard process for identifying patients unscreened for CRC and DA distribution via mail with telephone decision support modestly increased CRC screening and is consistent with the goal of providing preference-sensitive care and informed decision making. Improving care processes to include decision support outside of office visits is possible in primary care practices
Temperature quenching of CDOM fluorescence sensors: temporal and spatial variability in the temperature response and a recommended temperature correction equation
Field-based instruments measuring chromophoric dissolved organic matter (CDOM) fluorescence are often used as a proxy for dissolved organic carbon concentrations in lakes and streams. CDOM fluorescence yield is, however, affected by water temperature at the time of measurement, a factor which varies on both diel and seasonal timescales. A temperature correction must therefore be applied to these data. We present data on temporal and site-specific variability in temperature quenching of CDOM fluorescence for water from a humic lake and one of its main inflows in the west of Ireland. In addition, we present a temperature compensation equation and show that this equation is an improvement on methods previously proposed.Marine Institute and Dundalk Institute of Technolog
Centerscope
Centerscope, formerly Scope, was published by the Boston University Medical Center "to communicate the concern of the Medical Center for the development and maintenance of improved health care in contemporary society.
Body mass index trajectories in young adulthood predict nonâ alcoholic fatty liver disease in middle age: The CARDIA cohort study
Background & AimsNonâ alcoholic fatty liver disease is an epidemic. Identifying modifiable risk factors for nonâ alcoholic fatty liver disease development is essential to design effective prevention programmes. We tested whether 25â year patterns of body mass index change are associated with midlife nonâ alcoholic fatty liver disease.MethodsIn all, 4423 participants from Coronary Artery Risk Development in Young Adults, a prospective populationâ based biracial cohort (age 18â 30), underwent body mass index measurement at baseline (1985â 1986) and 3 or more times over 25Ă years. At Year 25, 3115 had liver fat assessed by nonâ contrast computed tomography. Nonâ alcoholic fatty liver disease was defined as liver attenuation â ¤40 Hounsfield Units after exclusions. Latent mixture modelling identified 25â year trajectories in body mass index per cent change (%Ă ) from baseline.ResultsWe identified four distinct trajectories of BMI%Ă : stable (26.2% of cohort, 25â year BMI %Ă Ă =Ă 3.1%), moderate increase (46.0%, BMI%Ă Ă =Ă 21.7%), high increase (20.9%, BMI%Ă Ă =Ă 41.9%) and extreme increase (6.9%, BMI%Ă Ă =Ă 65.9%). Y25 nonâ alcoholic fatty liver disease prevalence was higher in groups with greater BMI %Ă : 4.1%, 9.3%, 13.0%, and 17.6%, respectively (Pâ trend <.0001). In multivariable analyses, participants with increasing BMI%Ă had increasingly greater odds of nonâ alcoholic fatty liver disease compared to the stable group: OR: 3.35 (95% CI: 2.07â 5.42), 7.80 (4.60â 13.23) and 12.68 (6.68â 24.09) for moderate, high and extreme body mass index increase, respectively. Associations were only moderately attenuated when adjusted for baseline or Y25 body mass index.ConclusionsTrajectories of weight gain during young adulthood are associated with greater nonâ alcoholic fatty liver disease prevalence in midlife independent of metabolic covariates and baseline or concurrent body mass index highlighting the importance of weight maintenance throughout adulthood as a target for primary nonâ alcoholic fatty liver disease prevention.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142937/1/liv13603.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142937/2/liv13603_am.pd
Reply to a comment by Watras et al. (2014) on temperature compensation method for field measurements of CDOM fluorescence Submitted as a Comment to Limnology and Oceanography: Methods
Abstract The recent comment by clarifies the calculation of the temperature correction coefficient (q) in Comment In our recently published paper ( We regret that there was misinterpretation in our understanding of the text i
Twentyâ fiveâ year trajectories of insulin resistance and pancreatic Ă²â cell response and diabetes risk in nonalcoholic fatty liver disease
Background & AimsInsulin resistance is a risk marker for nonâ alcoholic fatty liver disease, and a risk factor for liver disease progression. We assessed temporal trajectories of insulin resistance and Ă²â cell response to serum glucose concentration throughout adulthood and their association with diabetes risk in nonâ alcoholic fatty liver disease.MethodsThree thousand and sixty participants from Coronary Artery Risk Development in Young Adults, a prospective biâ racial cohort of adults age 18â 30Ă years at baseline (1985â 1986; Y0) who completed up to 5 exams over 25Ă years and had fasting insulin and glucose measurement were included. At Y25 (2010â 2011), nonâ alcoholic fatty liver disease was assessed by noncontrast computed tomography after exclusion of other liver fat causes. Latent mixture modelling identified 25â year trajectories in homeostatic model assessment insulin resistance and Ă²â cell response homeostatic model assessmentâ Ă².ResultsThree distinct trajectories were identified, separately, for homeostatic model assessment insulin resistance (lowâ stable [47%]; moderateâ increasing [42%]; and highâ increasing [12%]) and homeostatic model assessmentâ Ă² (lowâ decreasing [16%]; moderateâ decreasing [63%]; and highâ decreasing [21%]). Y25 nonâ alcoholic fatty liver disease prevalence was 24.5%. Among nonâ alcoholic fatty liver disease, highâ increasing homeostatic model assessment insulin resistance (referent: lowâ stable) was associated with greater prevalent (OR 95% CIĂ =Ă 8.0, 2.0â 31.9) and incident (ORĂ =Ă 10.5, 2.6â 32.8) diabetes after multivariable adjustment including Y0 or Y25 homeostatic model assessment insulin resistance. In contrast, nonâ alcoholic fatty liver disease participants with lowâ decreasing homeostatic model assessmentâ Ă² (referent: highâ decreasing) had the highest odds of prevalent (ORĂ =Ă 14.1, 3.9â 50.9) and incident (ORĂ =Ă 10.3, 2.7â 39.3) diabetes.ConclusionTrajectories of insulin resistance and Ă²â cell response during young and middle adulthood are robustly associated with diabetes risk in nonâ alcoholic fatty liver disease. Thus, how persons with nonâ alcoholic fatty liver disease develop resistance to insulin provides important information about risk of diabetes in midlife above and beyond degree of insulin resistance at the time of nonâ alcoholic fatty liver disease assessment.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146427/1/liv13747_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146427/2/liv13747.pd
BMQ
BMQ: Boston Medical Quarterly was published from 1950-1966 by the Boston University School of Medicine and the Massachusetts Memorial Hospitals
Toward quantifying the increasing role oceanic heat in sea ice loss in the new Arctic
Author Posting. Š American Meteorological Society, 2015. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Bulletin of the American Meteorological Society 96 (2015): 2079â2105, doi:10.1175/BAMS-D-13-00177.1.The loss of Arctic sea ice has emerged as a leading signal of global warming. This, together with acknowledged impacts on other components of the Earth system, has led to the term âthe new Arctic.â Global coupled climate models predict that ice loss will continue through the twenty-first century, with implications for governance, economics, security, and global weather. A wide range in model projections reflects the complex, highly coupled interactions between the polar atmosphere, ocean, and cryosphere, including teleconnections to lower latitudes. This paper summarizes our present understanding of how heat reaches the ice base from the original sourcesâinflows of Atlantic and Pacific Water, river discharge, and summer sensible heat and shortwave radiative fluxes at the ocean/ice surfaceâand speculates on how such processes may change in the new Arctic. The complexity of the coupled Arctic system, and the logistic and technological challenges of working in the Arctic Ocean, require a coordinated interdisciplinary and international program that will not only improve understanding of this critical component of global climate but will also provide opportunities to develop human resources with the skills required to tackle related problems in complex climate systems. We propose a research strategy with components that include 1) improved mapping of the upper- and middepth Arctic Ocean, 2) enhanced quantification of important process, 3) expanded long-term monitoring at key heat-flux locations, and 4) development of numerical capabilities that focus on parameterization of heat-flux mechanisms and their interactions.2016-06-0
- âŚ