A Multi-Level Fit-Based Quality Improvement Initiative to Improve Colorectal Cancer Screening in a Managed Care Population.

IntroductionColorectal cancer (CRC) is a common but largely preventable disease with suboptimal screening rates despite national guidelines to screen individuals age 50-75. Single-component interventions aimed to improve screening uptake only modestly improve rates; data suggest that multi-modal approaches may be more effective.MethodsWe designed, implemented, and evaluated the impact of a multi-modal intervention on CRC screening uptake among unscreened patients in a large managed care population. Patient-level components included a mailed letter with education about screening options and pre-colonoscopy telephone counseling. For providers, we facilitated communication of screening test results and work-flow for abnormal results. System-level modifications included establishment of a patient navigator, expedited work-up for abnormal results, and stream-lined colonoscopy scheduling. We measured the rate of screening uptake overall, screening uptake by modality, change in the proportion of the population screened, and positive fecal immunochemical test (FIT) follow-up rates in the 1-year study period.ResultsThere were 5093 patients in the intervention cohort. Of these, 33.2% participated in FIT or colonoscopy screening within 1 year of the mailing. A total of 1078 (21.2%) participants completed a FIT and 611 (12.0%) completed a screening colonoscopy. The screening rate in the managed care population increased from 65.1 to 76.6%. Fifty-nine patients (5.5%) had a positive FIT, of which 30 (50.8%) completed a diagnostic colonoscopy.ConclusionMulti-modal interventions can result in substantial improvement in CRC screening uptake in large and diverse managed care populations.Translational impactHealth systems should shift their focus from single-level to multi-level interventions when addressing barriers to CRC screening

S-, P- and D-wave resonances in positronium-sodium and positronium-potassium scattering

Scattering of positronium (Ps) by sodium and potassium atoms has been investigated employing a three-Ps-state coupled-channel model with Ps(1s,2s,2p) states using a time-reversal-symmetric regularized electron-exchange model potential fitted to reproduce accurate theoretical results for PsNa and PsK binding energies. We find a narrow S-wave singlet resonance at 4.58 eV of width 0.002 eV in the Ps-Na system and at 4.77 eV of width 0.003 eV in the Ps-K system. Singlet P-wave resonances in both systems are found at 5.07 eV of width 0.3 eV. Singlet D-wave structures are found at 5.3 eV in both systems. We also report results for elastic and Ps-excitation cross sections for Ps scattering by Na and K.Comment: 9 pages, 5 figures, Accepted in Journal of Physics

Convergent variational calculation of positronium-hydrogen-atom scattering lengths

We present a convergent variational basis-set calculational scheme for elastic scattering of positronium atom by hydrogen atom in S wave. Highly correlated trial functions with appropriate symmetry are needed for achieving convergence. We report convergent results for scattering lengths in atomic units for both singlet ($=3.49\pm 0.20$) and triplet ($=2.46\pm 0.10$) states.Comment: 11 pages, 1 postscript figure, Accepted in J. Phys. B (Letter

Measurement of a W-band gyro-TWA experiment based on a helically corrugated interaction region

Measurements of an upgraded W-band gyro-TWA with a helically corrugated waveguide and a cusp electron gun are presented. With upgraded input coupler and output systems a gain of ~37 dB was measured from the experiment with a maximum output power of over 2 kW. The amplification from the gyro-TWA was measured in the frequency range of 90 GHz to 96 GHz

Developments of a W-band gyro-TWA for high PRF operation

Latest developments of a gyrotron travelling wave amplifier (gyro-TWA) with a helically corrugated waveguide and a cusp electron gun for operation over a bandwidth of 90-100 GHz at a high pulse repetition rate (5 kHz) are presented. Performance upgrades of the input coupler, pulsed power system and beam collector with water-cooling capability were realized for the high power wide band gyro-TWA

Design and experiment of a broadband W-band gyro-TWA based on a helically corrugated interaction region

The design and experiment of an upgraded W-band gyrotron travelling wave amplifier (gyro-TWA) based on a helically corrugated interaction region is presented. The upgrade of the input coupler, output window, corrugated output mode converter enabled a measured output power of a few kWs from the gyro-TWA with an unsaturated gain of up to 40 dB and a 3 dB frequency bandwidth of at least 5.5 GHz

Further experiments of a W-band gyro-TWA based on a helically corrugated interaction region

Latest results of a W-band gyro-TWA with a helically corrugated waveguide and a cusp electron gun for operation at a high pulse repetition rate are presented. Performance upgrades of input coupler, output window, corrugated horn, pulsed power system and beam collector with water-cooling capability were realized. With an input seed signal from an 1.5 W, 90-96 GHz solid state source the amplification gain and minimum bandwidth were measured from the experiment

A Multichannel DNA SoC for Rapid Point-of-Care Gene Detection

Published versio

High pulse repetition frequency operation of a W-band Gyro-TWA based on a cusp electron beam source

The components of a W-band gyro-TWA including input coupler, output window, corrugated output mode converter, pulsed power system and water-cooled beam dump are being upgraded to achieve an output power of 5 kW and a high pulse repetition rate of 2 kHz for cloud radar applications. Latest results of the W-band gyro-TWA with a helically corrugated waveguide and a cusp electron gun are presented

Low-energy quenching of positronium by helium

Very low-energy scattering of orthopositronium by helium has been investigated for simultaneous study of elastic cross section and pick-off quenching rate using a model exchange potential. The present calculational scheme, while agrees with the measured cross section of Skalsey et al, reproduces successfully the parameter ^ 1Z_{\makebox{eff}}, the effective number of electrons per atom in a singlet state relative to the positron. Together with the fact that this model potential also leads to an agreement with measured medium energy cross sections of this system, this study seems to resolve the long-standing discrepancy at low energies among different theoretical calculations and experimental measurements.Comment: 4 latex pages, 3 postscript figure