How can diagnostic assessment programs be implemented to enhance inter-professional collaborative care for cancer?

BackgroundInter-professional collaborative care (ICC) for cancer leads to multiple system, organizational, professional, and patient benefits, but is limited by numerous challenges. Empirical research on interventions that promote or enable ICC is sparse so guidance on how to achieve ICC is lacking. Research shows that ICC for diagnosis could be improved. Diagnostic assessment programs (DAPs) appear to be a promising model for enabling ICC. The purpose of this study was to explore how DAP structure and function enable ICC, and whether that may be associated with organizational and clinical outcomes.MethodsA case study approach will be used to explore ICC among eight DAPs that vary by type of cancer (lung, breast), academic status, and geographic region. To describe DAP function and outcomes, and gather information that will enable costing, recommendations expressed in DAP standards and clinical guidelines will be assessed through retrospective observational study. Data will be acquired from databases maintained by participating DAPs and the provincial cancer agency, and confirmed by and supplemented with review of medical records. We will conduct a pilot study to explore the feasibility of estimating the incremental cost-effectiveness ratio using person-level data from medical records and other sources. Interviews will be conducted with health professionals, staff, and referring physicians from each DAP to learn about barriers and facilitators of ICC. Qualitative methods based on a grounded approach will be used to guide sampling, data collection and analysis.DiscussionFindings may reveal opportunities for unique structures, interventions or tools that enable ICC that could be developed, implemented, and evaluated through future research. This information will serve as a formative needs assessment to identify the nature of ongoing or required improvements, which can be directly used by our decision maker collaborators, and as a framework by policy makers, cancer system managers, and DAP managers elsewhere to strategically plan for and implement diagnostic cancer services

Idaho National Laboratory Cultural Resource Management Office FY 2011 Activity Report

The Idaho National Laboratory (INL) Site is home to vast numbers and a wide variety of important cultural resources representing at least a 13,500 year span of human land use in the region. As a federal agency, the Department of Energy, Idaho Operations Office (DOE-ID) has legal responsibility for the management and protection of the resources and has contracted these responsibilities to Battelle Energy Alliance (BEA). The BEA professional staff is committed to maintaining a cultural resource management program that accepts the challenge of preserving INL cultural resources in a manner reflecting their importance in local, regional, and national history. This report is intended as a stand-alone document that summarizes activities performed by the INL Cultural Resource Management Office (CRMO) staff during fiscal year 2011. This work is diverse, far-reaching and though generally confined to INL cultural resource compliance, also includes a myriad of professional and voluntary community activities. This document is intended to be informative to both internal and external stakeholders, serve as a planning tool for future INL cultural resource management work, and meet an agreed upon legal requirement

Interfacial-Redox-Induced Tuning of Superconductivity in YBa2Cu3O7-δ.

Solid-state ionic approaches for modifying ion distributions in getter/oxide heterostructures offer exciting potentials to control material properties. Here, we report a simple, scalable approach allowing for manipulation of the superconducting transition in optimally doped YBa2Cu3O7-δ (YBCO) films via a chemically driven ionic migration mechanism. Using a thin Gd capping layer of up to 20 nm deposited onto 100 nm thick epitaxial YBCO films, oxygen is found to leach from deep within the YBCO. Progressive reduction of the superconducting transition is observed, with complete suppression possible for a sufficiently thick Gd layer. These effects arise from the combined impact of redox-driven electron doping and modification of the YBCO microstructure due to oxygen migration and depletion. This work demonstrates an effective step toward total ionic tuning of superconductivity in oxides, an interface-induced effect that goes well into the quasi-bulk regime, opening-up possibilities for electric field manipulation

Ionic Tuning of Cobaltites at the Nanoscale

Control of materials through custom design of ionic distributions represents a powerful new approach to develop future technologies ranging from spintronic logic and memory devices to energy storage. Perovskites have shown particular promise for ionic devices due to their high ion mobility and sensitivity to chemical stoichiometry. In this work, we demonstrate a solid-state approach to control of ionic distributions in (La,Sr)CoO$_{3}$ thin films. Depositing a Gd capping layer on the perovskite film, oxygen is controllably extracted from the structure, up-to 0.5 O/u.c. throughout the entire 36 nm thickness. Commensurate with the oxygen extraction, the Co valence state and saturation magnetization show a smooth continuous variation. In contrast, magnetoresistance measurements show no-change in the magnetic anisotropy and a rapid increase in the resistivity over the same range of oxygen stoichiometry. These results suggest significant phase separation, with metallic ferromagnetic regions and oxygen-deficient, insulating, non-ferromagnetic regions, forming percolated networks. Indeed, X-ray diffraction identifies oxygen-vacancy ordering, including transformation to a brownmillerite crystal structure. The unexpected transformation to the brownmillerite phase at ambient temperature is further confirmed by high-resolution scanning transmission electron microscopy which shows significant structural - and correspondingly chemical - phase separation. This work demonstrates room-temperature ionic control of magnetism, electrical resistivity, and crystalline structure in a 36 nm thick film, presenting new opportunities for ionic devices that leverage multiple material functionalities

A cost-effective method to quantify biological surface sediment reworking

We propose a simple and inexpensive method to determine the rate and pattern of surface sediment reworking by benthic organisms. Unlike many existing methods commonly used in bioturbation studies, which usually require sediment sampling, our approach is fully non-destructive and is well suited for investigating non-cohesive fine sediments in streams and rivers. Optical tracer (e.g., luminophores or coloured sand) disappearance or appearance is assessed through time based on optical quantification of surfaces occupied by tracers. Data are used to calculate surface sediment reworking (SSR) coefficients depicting bioturbation intensities. Using this method, we evaluated reworking activity of stream organisms (three benthic invertebrates and a fish) in laboratory microcosms mimicking pool habitats or directly in the field within arenas set in depositional zones. Our method was sensitive enough to measure SSR as low as 0.2 cm2.d-1, such as triggered by intermediate density (774 m-2) of Gammarus fossarum (Amphipoda) in microcosms. In contrast, complex invertebrate community in the field and a fish (Barbatula barabatula) in laboratory microcosms were found to yield to excessively high SSR (>60 cm2.d-1). Lastly, we suggest that images acquired during experiments can be used for qualitative evaluation of species-specific effects on sediment distribution

Emotional Support and Mental Health Among Somali Men in a Rural Midwestern Town

Perceived social support has been correlated with refugees’ positive mental health outcomes; yet, little is known about the perceived sources of support after secondary migration to new-destination rural towns. Somali refugee men (n _ 49) residing in a rural Midwest United States community were recruited using respondent-driven sampling to complete a self-administered structured survey in English or Somali using audio computer-assisted self-interview software. Questions assessed perceived sources of support, psychological distress, and happiness. Somali participants reported low utilization of both informal (30.4%) and formal (24.4%) supports when sad, stressed, or worried. Two thirds of participants reported low levels of distress and 98% reported being happy or very happy. This exploratory research contributes to understandings of Somali men’s perceived support in a postsecondary migration setting. We discuss implications for social support interventions and culturally tailored assessment, diagnoses, and treatment to enhance Somalis’ support and psychological well-being

Idaho National Laboratory Cultural Resource Management Office FY 2010 Activity Report

The Idaho National Laboratory (INL) Site is home to vast numbers and a wide variety of important cultural resources representing at least a 13,500 year span of human land use in the region. As a federal agency, the Department of Energy, Idaho Operations Office (DOE-ID) has legal responsibility for the management and protection of the resources and has contracted these responsibilities to Battelle Energy Alliance (BEA). The BEA professional staff is committed to maintaining a cultural resource management program that accepts the challenge of preserving INL cultural resources in a manner reflecting their importance in local, regional, and national history. This report summarizes activities performed by the INL Cultural Resource Management Office (CRMO) staff during fiscal year 2010. This work is diverse, far-reaching and though generally confined to INL cultural resource compliance, also includes a myriad of professional and voluntary community activities. This document is intended to be informative to both internal and external stakeholders and to serve as a planning tool for future INL cultural resource management work

An applied ecology of fear framework: linking theory to conservation practice

Research on the ecology of fear has highlighted the importance of perceived risk from predators and humans in shaping animal behavior and physiology, with potential demographic and ecosystem-wide consequences. Despite recent conceptual advances and potential management implications of the ecology of fear, theory and conservation practices have rarely been linked. Many challenges in animal conservation may be alleviated by actively harnessing or compensating for risk perception and risk avoidance behavior in wild animal populations. Integration of the ecology of fear into conservation and management practice can contribute to the recovery of threatened populations, human–wildlife conflict mitigation, invasive species management, maintenance of sustainable harvest and species reintroduction plans. Here, we present an applied framework that links conservation interventions to desired outcomes by manipulating ecology of fear dynamics. We discuss how to reduce or amplify fear in wild animals by manipulating habitat structure, sensory stimuli, animal experience (previous exposure to risk) and food safety trade-offs to achieve management objectives. Changing the optimal decision-making of individuals in managed populations can then further conservation goals by shaping the spatiotemporal distribution of animals, changing predation rates and altering risk effects that scale up to demographic consequences. We also outline future directions for applied research on fear ecology that will better inform conservation practices. Our framework can help scientists and practitioners anticipate and mitigate unintended consequences of management decisions, and highlight new levers for multi-species conservation strategies that promote human–wildlife coexistence

Industrial constructions of publics and public knowledge: a qualitative investigation of practice in the UK chemicals industry

This is a post print version of the article. The official published version can be obtained from the link below - © 2007 by SAGE PublicationsWhile the rhetoric of public engagement is increasingly commonplace within industry, there has been little research that examines how lay knowledge is conceptualized and whether it is really used within companies. Using the chemicals sector as an example, this paper explores how companies conceive of publics and "public knowledge," and how this relates to modes of engagement/communication with them. Drawing on qualitative empirical research in four companies, we demonstrate that the public for industry are primarily conceived as "consumers" and "neighbours," having concerns that should be allayed rather than as groups with knowledge meriting engagement. We conclude by highlighting the dissonance between current advocacy of engagement and the discourses and practices prevalent within industry, and highlight the need for more realistic strategies for industry/public engagement.Funding was received from the ESRC Science in Society Programme

Assessment of Potential Augmentation and Management Strategies for Razorback Sucker \u3cem\u3eXyrauchen texanus\u3c/em\u3e in Lake Mead and Grand Canyon: A 2021 Science Panel Summary

Razorback Sucker Xyrauchen texanus is a large-bodied, long-lived species endemic to the Colorado River Basin. This species historically ranged throughout the basin from the Colorado River delta in Mexico to Wyoming and Colorado. Currently, the species persists ,in a small portion of its historical range with the help of intensive management efforts including augmentation. Recruitment to adult life stages is extremely limited in the wild, but is documented consistently in Lake Mead. Research and monitoring efforts in Lake Mead are ongoing since 1996 and have recently expanded to include the Colorado River inflow area and portions of lower Grand Canyon. Despite evidence of recruitment, the current population size in Lake Mead and Grand Canyon is believed to be small (data) and susceptible to stochastic effects. This raised interest in the potential to augment the population to prevent loss of genetic diversity and increase abundance and distribution in general, as well as explore recruitment bottlenecks. To address critical uncertainties surrounding this management option and to brainstorm other potential options, a Planning Committee and Steering Committee made up of representatives of state (Arizona, Nevada), tribal (Hualapai Tribe, Navajo Nation), and federal (Bureau of Reclamation, National Park Service, and U.S. Fish and Wildlife Service) management agencies convened an Expert Science Panel (ESP; 2021), to consider augmentation and management strategies for Razorback Sucker in Lake Mead and Grand Canyon. The purpose of this report is to summarize those findings