Provision of God in our Lives: Examining Impact of Church Memorials

The study assumes that church memorials have significant meaning in our faith journey, are visible within the church, and have little meaning if no interpreter is present. If the membership is aware of a memorial’s history, it draws them to understand the memorial as a provision of God. The study’s research question is, “Will people remember the provision of God in their lives when engaging a memorial regularly with an interpreter present?” Memorials used in the study were within Mount Pisgah United Methodist Church. The Bible was the primary literary resource in God’s provision to redeem and restore humanity. The Patriarch Abraham built four types of altars, which were identified as the Altars of Praise, Prayer, Peace and Provision. Creswell’s Phenomenological Research provided a research framework for data collection and analysis. Church members served as the sample for the qualitative study, using a pre-test post-test design. Five key results were identified. First, memorials have an impact on the provision of God as a way to remember their loved ones, and form a shared history. Second, the role of the interpreter is foundational to explain and sustain the memorial’s purpose and intention. Third, the Bible served as the research thesis foundation. Fourth, viewing the Bible through the lens of God’s provision from Genesis through Revelation is foundational to understanding memorials. Fifth, opportunities exist for church governance of memorials. The results of the study provide foundational steps for Mount Pisgah and other churches and a pathway for everyone to become a part of the church’s shared history

Intersystem Collaboration: A Statewide Initiative to Support Families

The study described in this paper utilized a qualitative case study method to assess the processes involved in inter-system collaboration in the context of one state\u27s system change initiative. The collaborative experience is described from the perspective of participating service system professionals and family members. The major themes of collaboration that emerged from the study included changes in communication across systems, changes in inter-system relationships, changes in attitudes, changes in interactions with families, and changes in the ways services are delivered. Lessons learned and practice implications of each theme are discussed

A Patient Activities of Daily Living Scale for Amyotrophic Lateral Sclerosis

Background: Motor neuron disorders are rare, progressive neurodegenerative diseases which affect multiple domains of motor function. The ability to assess function from home using an electronic medical record (EMR) would facilitate pragmatic studies. Objective: To develop a Patient Activity of Daily Living scale for Amyotrophic Lateral Sclerosis and other motor neuron disorders (PADL-ALS) to support large pragmatic trials. Methods: The Greater Plains Collaborative Clinical Data Research Network (GPC) developed and tested the feasibility of using the PADL-ALS.  We convened patient and caregiver focus groups and in-person meetings to recommend changes to the ALS Functional Rating Scale-Revised (ALSFRS-R), which clarified language and added questions about pseudobulbar affect, pain, and faith.  Feasibility was determined by conducting a survey of participants identified using EMR-computable phenotypes and returned via patient-preferred modalities. Results: Surveys were distributed to 1079 participants at nine GPC health systems.  The survey response rate was 44.4% (range 12.9-57.66%): male to female ratio 1.56; 84% self-identified as a patient with ALS.  Patient respondents used computers or tablets more frequently than caregivers responding on their behalf.  The PADL-ALS correlated to clinic-performed ALSFRS-R within 4 weeks of survey completion (n=33, rho=0.93, Kansas only).  The pseudobulbar affect question correlated to functional motor burden.  Over 80% agreed to be contacted for future research opportunities. Conclusion:  We demonstrated the feasibility of determining functional burden with the PADL-ALS using an EMR-computable phenotype.  Future directions include implementing the PADL-ALS to answer pragmatic questions about ALS care

The association between first-time accreditation and the delivery of recommended care:a before and after study in the Faroe Islands

Abstract Background Significant resources are spent on hospital accreditation worldwide. However, documentation of the effects of accreditation on processes, quality of care and outcomes in healthcare remain scarce. This study aimed to examine changes in the delivery of patient care in accordance with clinical guidelines (recommended care) after first-time accreditation in a care setting not previously exposed to systematic quality improvement initiatives. Methods We conducted a before and after study based on medical record reviews in connection with introducing first-time accreditation. We included patients with stroke/transient ischemic attack, bleeding gastric ulcer, diabetes, chronic obstructive pulmonary disease (COPD), childbirth, heart failure and hip fracture treated at public, non-psychiatric Faroese hospitals during 2012–2013 (before accreditation) or 2017–2018 (after accreditation). The intervention was the implementation of a modified second version of The Danish Healthcare Quality Program (DDKM) from 2014 to 2016 including an on-site accreditation survey in the Faroese hospitals. Recommended care was assessed using 63 disease specific patient level process performance measures in seven clinical conditions. We calculated the fulfillment and changes in the opportunity-based composite score and the all-or-none score. Results We included 867 patient pathways (536 before and 331 after). After accreditation, the total opportunity-based composite score was marginally higher though the change did not reach statistical significance (adjusted percentage point difference (%): 4.4%; 95% CI: − 0.7 to 9.6). At disease level, patients with stroke/transient ischemic attack, bleeding gastric ulcer, COPD and childbirth received a higher proportion of recommended care after accreditation. No difference was found for heart failure and diabetes. Hip fracture received less recommended care after accreditation. The total all-or-none score, which is the probability of a patient receiving all recommended care, was significantly higher after accreditation (adjusted relative risk (RR): 2.32; 95% CI: 2.03 to 2.67). The improvement was particularly strong for patients with COPD (RR: 16.22; 95% CI: 14.54 to 18.10). Conclusion Hospitals were in general more likely to provide recommended care after first-time accreditation

Interpretation of Absorption Bands in Airborne Hyperspectral Radiance Data

It is demonstrated that hyperspectral imagery can be used, without atmospheric correction, to determine the presence of accessory phytoplankton pigments in coastal waters using derivative techniques. However, care must be taken not to confuse other absorptions for those caused by the presence of pigments. Atmospheric correction, usually the first step to making products from hyperspectral data, may not completely remove Fraunhofer lines and atmospheric absorption bands and these absorptions may interfere with identification of phytoplankton accessory pigments. Furthermore, the ability to resolve absorption bands depends on the spectral resolution of the spectrometer, which for a fixed spectral range also determines the number of observed bands. Based on this information, a study was undertaken to determine under what circumstances a hyperspectral sensor may determine the presence of pigments. As part of the study a hyperspectral imager was used to take high spectral resolution data over two different water masses. In order to avoid the problems associated with atmospheric correction this data was analyzed as radiance data without atmospheric correction. Here, the purpose was to identify spectral regions that might be diagnostic for photosynthetic pigments. Two well proven techniques were used to aid in absorption band recognition, the continuum removal of the spectra and the fourth derivative. The findings in this study suggest that interpretation of absorption bands in remote sensing data, whether atmospherically corrected or not, have to be carefully reviewed when they are interpreted in terms of photosynthetic pigments

Allelic Ratios and the Mutational Landscape Reveal Biologically Significant Heterozygous SNVs

The issue of heterozygosity continues to be a challenge in the analysis of genome sequences. In this article, we describe the use of allele ratios to distinguish biologically significant single-nucleotide variants from background noise. An application of this approach is the identification of lethal mutations in Caenorhabditis elegans essential genes, which must be maintained by the presence of a wild-type allele on a balancer. The h448 allele of let-504 is rescued by the duplication balancer sDp2. We readily identified the extent of the duplication when the percentage of read support for the lesion was between 70 and 80%. Examination of the EMS-induced changes throughout the genome revealed that these mutations exist in contiguous blocks. During early embryonic division in self-fertilizing C. elegans, alkylated guanines pair with thymines. As a result, EMS-induced changes become fixed as either G→A or C→T changes along the length of the chromosome. Thus, examination of the distribution of EMS-induced changes revealed the mutational and recombinational history of the chromosome, even generations later. We identified the mutational change responsible for the h448 mutation and sequenced PCR products for an additional four alleles, correlating let-504 with the DNA-coding region for an ortholog of a NFκB-activating protein, NKAP. Our results confirm that whole-genome sequencing is an efficient and inexpensive way of identifying nucleotide alterations responsible for lethal phenotypes and can be applied on a large scale to identify the molecular basis of essential genes

High variablity of Greenland surface temperature over the past 4000 years estimated from trapped air in ice core

第2回極域科学シンポジウム　氷床コアセッション 11月16日（水） 国立極地研究所 2階大会議

Chemical composition tuning in quaternary p-type Pb-chalcogenides – a promising strategy for enhanced thermoelectric performance

Recently a significant improvement in the thermoelectric performance of p-type ternary PbTe–PbSe and PbTe–PbS systems has been realized through alternating the electronic band structure and introducing nano-scale precipitates to bulk materials respectively. However, the quaternary system of PbTe–PbSe–PbS has received less attention. In the current work, we have excluded phase complexity by fabricating single phase sodium doped PbTe, alloyed with PbS up to its solubility limit which is extended to larger concentrations than in the ternary system of PbTe–PbS due to the presence of PbSe. We have presented a thermoelectric efficiency of approximately 1.6 which is superior to ternary PbTe–PbSe and PbTe–PbS at similar carrier concentrations and the binary PbTe, PbSe and PbS alloys. The quaternary system shows a larger Seebeck coefficient than the ternary PbTe–PbSe alloy, indicative of a wider band gap, valence band energy offset and heavier carriers effective mass. In addition, the existence of PbS in the alloy further reduces the lattice thermal conductivity originated from phonon scattering on solute atoms with high contrast atomic mass. Single phase quaternary PbTe–PbSe–PbS alloys are promising thermoelectric materials that provide high performance through adjusting the electronic band structure by regulating chemical composition

Refining the impact of TCF7L2 gene variants on type 2 diabetes and adaptive evolution

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldWe recently described an association between risk of type 2diabetes and variants in the transcription factor 7-like 2 gene (TCF7L2; formerly TCF4), with a population attributable risk (PAR) of 17%-28% in three populations of European ancestry. Here, we refine the definition of the TCF7L2 type 2diabetes risk variant, HapB(T2D), to the ancestral T allele of a SNP, rs7903146, through replication in West African and Danish type 2 diabetes case-control studies and an expanded Icelandic study. We also identify another variant of the same gene, HapA, that shows evidence of positive selection in East Asian, European and West African populations. Notably, HapA shows a suggestive association with body mass index and altered concentrations of the hunger-satiety hormones ghrelin and leptin in males, indicating that the selective advantage of HapA may have been mediated through effects on energy metabolism