Mindful Mornings: Piloting a Meditation Group with Vulnerable Adults in a Drop-in Center

An accumulation of stress and lack of coping resources can contribute to a higher incidence of mental and physical health disparities. Homeless adults are one of the most vulnerable subgroups who utilize Enterprise Resource Center, a peer-run day-center in Marin County. Because stress from multiple factors was identified in this transient and high-risk population, an intervention for stress reduction and management was explored. The findings from the needs assessment suggested that there was a need for an integrated approach for stress reduction and management. The challenge of sustaining a program was also highlighted during the needs assessment. A brief mindfulness meditation program was piloted as an evidence-based intervention for its feasibility and potential effectiveness at the day-center. The peer-facilitation model was also explored in order to fit the model and culture of the center. The pilot meditation group was conducted over a six-week period with seven group sessions. The total of nine different individuals participated over the duration of the program. The most common feedbacks received from participants included feelings of calmness and relaxation after meditating for 20 minutes in a group. This suggests that a brief meditation program may be added to the regular programming to create a more integrated approach to manage mental, physical, and emotional comorbidity seen in this highly vulnerable population. Further research should be done to explore the safety of meditation programs especially for vulnerable adults as there is currently no guideline for screening individuals for risks for adverse effects of meditation

Increasing Access to Medicare Annual Wellness Visits in Primary Care; Utilizing Registered Nurses as part of an Interdisciplinary Team Based Approach

Background: In order to provide evidence-based preventive care to the aging population, Medicare began providing free annual wellness visits (AWVs) to its beneficiaries in 2011. The AWVs are a great opportunity for primary care providers to develop personalized preventive care as well as health promotion. However, many primary care practices especially those with limited resources struggle to incorporate AWVs into their busy primary care practice. Centers for Medicare and Medicaid Services allows other providers than physicians, NPs and PAs to perform those visits including registered nurses, health educators, and registered dietitians. Methods: A pilot project was conducted with 12 patients using a RN/MA/physician team-based approach for AWV. Efficacy, satisfaction, and a cost benefit analysis was completed for analysis of the outcomes. Results: Sixty-seven percent of the patients completed within one hour, and none of the visits required physician or other providers’ attention during the wellness visit. Ten out of 12 patients reported satisfaction about the visits conducted by the RN, and all staff members were satisfied with the process. The cost-benefit analysis for 0.2 FTE of RN will demonstrate that a clinic can expect the return on investment of 37.2% in the first year, and 52% thereafter. Conclusion: Primary care practices are increasingly concerned about how to meet the demand of the aging population. Moving forward into the future, team-based approaches in primary care to conduct AVWs is necessary in order to provide preventive care to a larger sector of the population. Registered nurses are well poised to provide necessary assessment and screening for AWVs as well as an added opportunity to provide education during AWVs, and it can be a feasible option to utilize an RN to conduct AWVs

Coexistence of superconductivity and antiferromagnetism in self-doped bilayer t-t'-J model

A self-doped bilayer t-t'-J model of an electron- and a hole-doped planes is studied by the slave-boson mean-field theory. A hopping integral between the differently doped planes, which are generated by a site potential, are renormalized by the electron-electron correlation. We find coexistent phases of antiferromagnetic (AFM) and superconducting orders, although the magnitudes of order parameters become more dissimilar in the bilayer away from half-filling. Fermi surfaces (FS's) with the AFM order show two pockets around the nodal and the anti-nodal regions. These results look like a composite of electron- and hole-doped FS's. In the nodal direction, the FS splitting is absent even in the bilayer system, since one band is flat due to the AFM order.Comment: 6 pages, 4 figure

High-Tc Nodeless s_\pm-wave Superconductivity in (Y,La)FeAsO_{1-y} with Tc=50 K: 75As-NMR Study

We report 75As-NMR study on the Fe-pnictide high-Tc superconductor Y0.95La0.05FeAsO_{1-y} (Y0.95La0.051111) with Tc=50 K that includes no magnetic rare-earth elements. The measurement of the nuclear-spin lattice-relaxation rate 75(1/T1) has revealed that the nodeless bulk superconductivity takes place at Tc=50 K while antiferromagnetic spin fluctuations (AFSFs) develop moderately in the normal state. These features are consistently described by the multiple fully-gapped s_\pm-wave model based on the Fermi-surface (FS) nesting. Incorporating the theory based on band calculations, we propose that the reason that Tc=50 K in Y0.95La0.051111 is larger than Tc=28 K in La1111 is that the FS multiplicity is maximized, and hence the FS nesting condition is better than that in La1111.Comment: 4 pages, 3 figures, accepted for publication in Phys Rev. Let

Universality of dispersive spin-resonance mode in superconducting BaFe2As2

Spin fluctuations in superconducting BaFe2(As1-xPx)2 (x=0.34, Tc = 29.5 K) are studied using inelastic neutron scattering. Well-defined commensurate magnetic signals are observed at ({\pi},0), which is consistent with the nesting vector of the Fermi surface. Antiferromagnetic (AFM) spin fluctuations in the normal state exhibit a three-dimensional character reminiscent of the AFM order in nondoped BaFe2As2. A clear spin gap is observed in the superconducting phase forming a peak whose energy is significantly dispersed along the c-axis. The bandwidth of dispersion becomes larger with approaching the AFM ordered phase universally in all superconducting BaFe2As2, indicating that the dispersive feature is attributed to three-dimensional AFM correlations. The results suggest a strong relationship between the magnetism and superconductivity.Comment: 5 pages, 5 figure