162 research outputs found
Health coaching to encourage obese adults to enroll in commercially-available weight management programs: The path to health study
Physicians are recommended to screen and refer obese patients to weight management programs (WMPs). There are often limited referral options for physicians, though commercially-available WMPs could be a potential solution. The purpose of this study (Path to Health) was to evaluate the efficacy of health coaching to promote enrollment in commercially-available WMPs through a two-arm, RCT with obese patients (n = 168) randomly assigned to intervention (n = 84) or control groups (n = 84). Intervention participants received phone health coaching to help them select and enroll in WMPs. We collected data on program enrollment, weight, self-reported physical activity (PA), and fruit and vegetable (FV) intake at baseline, 3- and 6-months. We used logistic regression to assess the intervention effect on enrollment in WMPs and longitudinal regression models to evaluate the effect on weight change, PA and FV intake. The average age was 54.7 years, 59% were female and 43% were Black and 49% were White. At 6 months, 39% of the intervention group (vs. 29% of control) had enrolled in WMPs. We found no longitudinal intervention effect on weight, PA and FV intake. We found that there was more weight loss for those who completed ≥4 calls as compared to those who completedstudy, we found that phone health coaching was successful in increasing obese adults\u27 enrollment in commercially-available WMPs and that there was a dose response relationship for weight and behavioral outcomes
Implementation of a Sustainable Medicare Annual Wellness Visit Workflow Into a Primary Care Setting Quality Improvement Project.
The Sky is Falling: Chemical Characterization and Corrosion Evaluation of Deposition Produced During the Static Testing of Solid Rocket Motors
Static tests of horizontally restrained rocket motors at the ATK facility in Promontory UT, USA result in the deposition of entrained soil and fuel combustion products, referred to as Test Fire Soil (TFS), over areas as large as 30–50 mile2 (80–130 km2) and at distances up to 10–12 miles (16–20 km) from the test site. Chloride is the main combustion product generated from the ammonium perchlorate–aluminum based composite propellant. Deposition sampling/characterization and a 6-month field corrosivity study using mild steel coupons were conducted in conjunction with the February 25th 2010 FSM-17 static test. The TFS deposition rates at the three study sites ranged from 1 to 5 g/min/m2. TFS contained significantly more chloride than the surface soil collected from the test site. The TFS collected during two subsequent tests had similarly elevated chloride, suggesting that the results obtained in this study are applicable to other tests assuming that the rocket fuel composition remains similar. The field-deployed coupons exposed to the TFS had higher corrosion rates (3.6–5.0 mpy) than paired non-exposed coupons (1.6–1.8 mpy). Corrosion rates for all coupon
The Grizzly, March 27, 2003
America at War: President Bush says Victory is Certain in Iraq • A Day in the Life of a UN Weapons Inspector • Celebrate Women\u27s History Month • A Fine Ursinus Fellow • Project Vote Smart Approves Five Scholarships for Ursinus College Students • Psyched up for Psycho Beach Party • Calling All Talents • Silence Broken: Korean Comfort Women • Men\u27s Basketball Falls to Scranton • Howard Earns All-American Honors • Dougherty 11th at NCAA Track Championshipshttps://digitalcommons.ursinus.edu/grizzlynews/1532/thumbnail.jp
A core outcome set for localised prostate cancer effectiveness trials
Objective:
To develop a core outcome set (COS) applicable for effectiveness trials of all interventions for localised prostate cancer.
Background:
Many treatments exist for localised prostate cancer, although it is unclear which offers the optimal therapeutic ratio. This is confounded by inconsistencies in the selection, definition, measurement and reporting of outcomes in clinical trials.
Subjects and methods:
A list of 79 outcomes was derived from a systematic review of published localised prostate cancer effectiveness studies and semi-structured interviews with 15 prostate cancer patients. A two-stage consensus process involving 118 patients and 56 international healthcare professionals (HCPs) (cancer specialist nurses, urological surgeons and oncologists) was undertaken, consisting of a three-round Delphi survey followed by a face-to-face consensus panel meeting of 13 HCPs and 8 patients.
Results:
The final COS included 19 outcomes. Twelve apply to all interventions: death from prostate cancer, death from any cause, local disease recurrence, distant disease recurrence/metastases, disease progression, need for salvage therapy, overall quality of life, stress urinary incontinence, urinary function, bowel function, faecal incontinence, sexual function. Seven were intervention-specific: perioperative deaths (surgery), positive surgical margin (surgery), thromboembolic disease (surgery), bothersome or symptomatic urethral or anastomotic stricture (surgery), need for curative treatment (active surveillance), treatment failure (ablative therapy), and side effects of hormonal therapy (hormone therapy). The UK-centric participants may limit the generalisability to other countries, but trialists should reason why the COS would not be applicable. The default position should not be that a COS developed in one country will automatically not be applicable elsewhere.
Conclusion:
We have established a COS for trials of effectiveness in localised prostate cancer, applicable across all interventions which should be measured in all localised prostate cancer effectiveness trials
The VENUSS prognostic model to predict disease recurrence following surgery for non-metastatic papillary renal cell carcinoma: development and evaluation using the ASSURE prospective clinical trial cohort
Abstract: Background: The current World Health Organization classification recognises 12 major subtypes of renal cell carcinoma (RCC). Although these subtypes differ on molecular and clinical levels, they are generally managed as the same disease, simply because they occur in the same organ. Specifically, there is a paucity of tools to risk-stratify patients with papillary RCC (PRCC). The purpose of this study was to develop and evaluate a tool to risk-stratify patients with clinically non-metastatic PRCC following curative surgery. Methods: We studied clinicopathological variables and outcomes of 556 patients, who underwent full resection of sporadic, unilateral, non-metastatic (T1–4, N0–1, M0) PRCC at five institutions. Based on multivariable Fine-Gray competing risks regression models, we developed a prognostic scoring system to predict disease recurrence. This was further evaluated in the 150 PRCC patients recruited to the ASSURE trial. We compared the discrimination, calibration and decision-curve clinical net benefit against the Tumour, Node, Metastasis (TNM) stage group, University of California Integrated Staging System (UISS) and the 2018 Leibovich prognostic groups. Results: We developed the VENUSS score from significant variables on multivariable analysis, which were the presence of VEnous tumour thrombus, NUclear grade, Size, T and N Stage. We created three risk groups based on the VENUSS score, with a 5-year cumulative incidence of recurrence equalling 2.9% in low-risk, 15.4% in intermediate-risk and 54.5% in high-risk patients. 91.7% of low-risk patients had oligometastatic recurrent disease, compared to 16.7% of intermediate-risk and 40.0% of high-risk patients. Discrimination, calibration and clinical net benefit from VENUSS appeared to be superior to UISS, TNM and Leibovich prognostic groups. Conclusions: We developed and tested a prognostic model for patients with clinically non-metastatic PRCC, which is based on routine pathological variables. This model may be superior to standard models and could be used for tailoring postoperative surveillance and defining inclusion for prospective adjuvant clinical trials
The DECam Ecliptic Exploration Project (DEEP) II. Observational Strategy and Design
We present the DECam Ecliptic Exploration Project (DEEP) survey strategy
including observing cadence for orbit determination, exposure times, field
pointings and filter choices. The overall goal of the survey is to discover and
characterize the orbits of a few thousand Trans-Neptunian Objects (TNOs) using
the Dark Energy Camera (DECam) on the Cerro Tololo Inter-American Observatory
(CTIO) Blanco 4 meter telescope. The experiment is designed to collect a very
deep series of exposures totaling a few hours on sky for each of several 2.7
square degree DECam fields-of-view to achieve a magnitude of about 26.2 using a
wide VR filter which encompasses both the V and R bandpasses. In the first
year, several nights were combined to achieve a sky area of about 34 square
degrees. In subsequent years, the fields have been re-visited to allow TNOs to
be tracked for orbit determination. When complete, DEEP will be the largest
survey of the outer solar system ever undertaken in terms of newly discovered
object numbers, and the most prolific at producing multi-year orbital
information for the population of minor planets beyond Neptune at 30 au.Comment: 29 pages, 4 figures and 4 table
Release of mineral-bound water prior to subduction tied to shallow seismogenic slip off Sumatra
Plate-boundary fault rupture during the 2004 Sumatra-Andaman subduction earthquake extended closer to the trench than expected, increasing earthquake and tsunami size. International Ocean Discovery Program Expedition 362 sampled incoming sediments offshore northern Sumatra, revealing recent release of fresh water within the deep sediments. Thermal modeling links this freshening to amorphous silica dehydration driven by rapid burial-induced temperature increases in the past 9 million years. Complete dehydration of silicates is expected before plate subduction, contrasting with prevailing models for subduction seismogenesis calling for fluid production during subduction. Shallow slip offshore Sumatra appears driven by diagenetic strengthening of deeply buried fault-forming sediments, contrasting with weakening proposed for the shallow Tohoku-Oki 2011 rupture, but our results are applicable to other thickly sedimented subduction zones including those with limited earthquake records
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