A different kind of family: Retrospective accounts of growing up at Centrepoint and implications for adulthood

no abstract availabl

Strategies For Successful Diversity Training In Corporate America

Corporate America is facing both a workforce and a customer base which are increasingly diversified.  Diversity training initiatives are proliferating as a way to not only avoid legal problems but, more importantly, to find strategic advantage in this diversity.  This article investigates the fundamentals of diversity training by answering a series of questions including: What is diversity training? Why is diversity training needed? Who is doing diversity training? When does diversity training fail? More importantly, the article focuses on strategies by suggesting how to design a successful diversity training program

Millennials Seeking Healthcare: Examining the Degree to Which Patients Utilize Online Resources

Introduction. According to the 2020 U.S. Census, a Silver Tsunami is looming, with more than 75.4 million persons aged 57 to 75 expected to need more costly medical care. However, a larger wave of 83.1 million Millennials nearing adulthood is approaching rapidly. Therefore, it is important to understand how this population finds their physician and what may influence this decision. Methods. Paper-based surveys were administered to adult patients at primary care and geriatric clinics located at the University of Kansas Medical Center in Kansas City, Kansas. Questions included demographic information, utilization and influence of online reviews, and the effects negative and positive reviews have on a patient’s choice of physician. Descriptive statistics were calculated for respondent characteristics and survey responses. Chi-square and McNemar’s tests were performed to evaluate differences between age and gender groups, and to determine how influential review ratings are in choosing a physician for medical care. Statistical significance was determined at the 0.05 level. Results. A sample of 284 patients completed the survey (44.35 ± 17.54 years old [range = 18-90], 60.6% female, 57.4% white). Of Millennials, 67.2% read online reviews before choosing a physician. Millennials were significantly more likely to read online reviews before choosing a physician (p = 0.004) and utilize online resources to search for a new physician (p < 0.001) than older patients. Conclusions. Millennials were more likely to research online reviews before choosing a physician. Therefore, an online review presence will be beneficial to one’s practice to acquire this new wave of patients

Optimal Lipid Modification: the Rationale for Combination Therapy

This is the publisher's version, also available electronically from "http://www.dovepress.com".No abstract available

Optimal Lipid Modification: The Rationale for Combination Therapy

James M Backes1, Cheryl A Gibson2, Patricia A Howard31Department of Pharmacy Practice, Lipid, Atherosclerosis, Metabolic and LDL Apheresis Center, University of Kansas Medical Center, Kansas City, KS, USA; 2Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA; 3Department of Pharmacy Practice, University of Kansas School of Pharmacy, Kansas City, KS, USABackground: An emphasis on more aggressive lipid-lowering, particularly of low-density lipoprotein cholesterol, to improve patient outcomes has led to an increased use of combination lipid-lowering drugs. This strategy, while potentially beneficial, has triggered concerns regarding fears of adverse effects, harmful drug interactions, and patient nonadherence.Objective: To present key data regarding combination lipid-altering therapy including use, rationale, major trials, benefits, potential adverse effects, compliance issues, and limitations. Method: Literature was obtained from MEDLINE (1966 – June 2005) and references from selected articles.Results: A substantial body of evidence from epidemiological data and clinical trials indicates that aggressive lipid modification, especially low-density lipoprotein reduction, is associated with reduced cardiovascular events. Numerous studies utilizing various combinations of cholesterol-lowering agents including statin/fibrate, statin/niacin, statin/bile acid resin, and statin/ezetimibe have demonstrated significant changes in the lipid profile with acceptable safety. Long-term trials of combination therapy evaluating clinical outcomes or surrogate markers of cardiovascular disease, while limited, are promising.Conclusion: Combining lipid-altering agents results in additional improvements in lipoproteins and has the potential to further reduce cardiovascular events beyond that of monotherapy.Keywords: combination therapy, coronary heart disease, hypercholesterolemia, lipid-lowering, low-density lipoprotein, statin

Nociceptin Is a Chemorepellent in \u3ci\u3eTetrahymena thermophila\u3c/i\u3e

Tetrahymena thermophila are free-living, ciliated, eukaryotic organisms that respond to stimuli by moving toward chemoattractants and avoiding chemorepellents. Chemoattractant responses involve faster ciliary beating, which propels the organisms forward more rapidly. Chemorepellent signaling involves ciliary reversal, which disrupts forward swimming, and causes the organism to jerk back and forth, swim in small circles, or spin in an attempt to get away from the repellent. Many food sources, such as proteins, are chemoattractants for Tetrahymena, while a variety of compounds are repellents. Repellents in nature are thought to come from the secretions of predators, or from ruptured organisms, which may serve as “danger” signals. Several hormones involved in human pain signaling have been shown to be chemorepellents in Tetrahymena, including substance P, ACTH, PACAP, VIP, and nociceptin. We have been studying the response of Tetrahymena to nociceptin, using pharmacological inhibitors in order to elucidate components of the nociceptin signaling pathway. We have found that G-protein inhibitors and a number of mammalian tyrosine kinase inhibitors have no effect on nociceptin avoidance. However, the tyrosine kinase inhibitor, genistein, inhibits avoidance to nociceptin, likely by an unrelated mechanism. Nociceptin avoidance is also inhibited by the calcium chelator, EGTA, and partially inhibited by the ER calcium ATPase inhibitor, thapsigargin. Whole cell electrophysiology experiments in a calcium-containing buffer show that addition of 50 μM nociceptin to the buffer causes a sustained depolarization of approximately 30 mV. This depolarization is nearly eliminated in the presence of EGTA, further supporting the hypothesis that calcium is involved in nociceptin signaling. J-113397, an inhibitor of the human nociceptin receptor, also inhibits nociceptin avoidance in Tetrahymena, though other nociceptin antagonists we tested had no effect on avoidance. Further experimentation on this organism will give a more complete picture of the signaling pathway, as well as allowing greater comparison between nociceptin avoidance in Tetrahymena and nociceptin signaling in vertebrates

Community Recruitment and Retention of New Residents: A Study Using a Market Assessment Process

In declining population regions, such as much of the rural Great Plains, many rural communities are competing for both employment opportunities and people to fill the work-force needs. While the former (jobs) has been traditionally emphasized in community development efforts, it is increasingly evident that new resident recruitment and retention is just as critical, if not more, to community sustainability. As part of a larger study of new resident migration into Nebraska’s Panhandle region, the purpose of this study was to explore new resident recruitment and retention patterns perceptions and development strategies from both sides of the market—the demand side (new residents) and the supply/provider side (communities marketing themselves as a desirable places to live). Using an iterative Delphi survey process of community practitioners, with input fed into the analysis from new-resident focus group findings, we were able to assess current market performance in terms of the relative effectiveness of new resident recruitment and retention programs and draw implications for future improvement

Community Recruitment and Retention of New Residents: A Study Using a Market Assessment Process

In declining population regions, such as much of the rural Great Plains, many rural communities are competing for both employment opportunities and people to fill the work-force needs. While the former (jobs) has been traditionally emphasized in community development efforts, it is increasingly evident that new resident recruitment and retention is just as critical, if not more, to community sustainability. As part of a larger study of new resident migration into Nebraska’s Panhandle region, the purpose of this study was to explore new resident recruitment and retention patterns perceptions and development strategies from both sides of the market—the demand side (new residents) and the supply/provider side (communities marketing themselves as a desirable places to live). Using an iterative Delphi survey process of community practitioners, with input fed into the analysis from new-resident focus group findings, we were able to assess current market performance in terms of the relative effectiveness of new-resident recruitment and retention programs and draw implications for future improvement

Feasibility and acceptability of a televideo physical activity and nutrition program for recent kidney transplant recipients

This work is licensed under a Creative Commons Attribution 4.0 International License.Background Post-transplant weight gain affects 50–90% of kidney transplant recipients adversely affecting survival, quality of life, and risk for diabetes and cardiovascular disease. Diet modification and physical activity may help prevent post-transplant weight gain. Methods for effective implementation of these lifestyle modifications are needed. The objective of this study is to assess the feasibility and acceptability of a remotely delivered nutrition and physical activity intervention among kidney transplant recipients. Secondary aims were to estimate the effectiveness of the intervention in producing changes in physical activity, qualify of life, fruit and vegetable intake, and consumption of whole grains and water from baseline to 6 months. Methods A randomized controlled study for stable kidney transplant recipients between 6 and 12 months post-transplantation was conducted. Participants were randomly assigned 1:1 to a technology-based, lifestyle modification program (intervention) or to enhanced usual care (control). Results The first 10 kidney transplant recipients screened were eligible and randomized into the intervention and control groups with no significant between-group differences at baseline. Health coaching attendance (78%) and adherence to reporting healthy behaviors (86%) were high. All participants returned for final assessments. The weight in controls remained stable, while the intervention arm showed weight gain at 3 and 6 months. Improvements were found for physical activity, quality of life, and fruit and vegetable intake in both groups. All participants would recommend the program to other transplant recipients. Conclusions Our data suggest that a remotely delivered televideo nutrition and physical activity intervention is feasible and valued by patients. These findings will aid in the development of a larger, more prescriptive, randomized trial to address weight gain prevention