Evaluation of a Technology-Based Survivor Care Plan for Breast Cancer Survivors: Pre-Post Pilot Study.

BACKGROUND: As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors. OBJECTIVE: This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. METHODS: A single group pretest-posttest design was used to study breast cancer survivors in an academic cancer center and a community cancer center during their medical visit after they completed chemotherapy. The intervention was a technology-based survivor care plan. Measures were taken before, immediately after, and 1 month after receipt of the survivor care plan. RESULTS: A total of 38 breast cancer survivors agreed to participate in the study. Compared to baseline levels before receipt of the survivor care plan, participants reported increased knowledge both immediately after its receipt at the academic center (P\u3c.001) and the community center (P\u3c.001) as well as one month later at the academic center (P=.002) and the community center (P\u3c.001). Participants also reported increased confidence immediately following receipt of the survivor care plan at the academic center (P=.63) and the community center (P=.003) and one month later at both the academic center (P=.63) and the community center (P\u3c.001). Activation was increased from baseline to post-survivor care plan at both the academic center (P=.05) and community center (P\u3c.001) as well as from baseline to 1-month follow-up at the academic center (P=.56) and the community center (P\u3c.001). Overall, community center participants had lower knowledge, confidence, and activation at baseline compared with academic center participants. Overall, 22/38 (58%) participants chose the fully functional electronic survivor care plan. However, 12/23 (52%) in the community center group chose the paper version compared to 4/15 (27%) in the academic center group. Satisfaction with the format (38/38 participants) and the content (37/38 participants) of the survivor care plan was high for both groups. CONCLUSIONS: This study provides evidence that knowledge, confidence, and activation of survivors were associated with implementation of the survivor care plan. This research agrees with previous research showing that cancer survivors found the technology-based survivor care plan to be acceptable. More research is needed to determine the optimal approach to survivor care planning to ensure that all cancer survivors can benefit from it

Microbial methane cycling in sediments of Arctic thermokarst lagoons

Thermokarst lagoons represent the transition state from a freshwater lacustrine to a marine environment, and receive little attention regarding their role for greenhouse gas production and release in Arctic permafrost landscapes. We studied the fate of methane (CH4) in sediments of a thermokarst lagoon in comparison to two thermokarst lakes on the Bykovsky Peninsula in northeastern Siberia through the analysis of sediment CH4 concentrations and isotopic signature, methane-cycling microbial taxa, sediment geochemistry, lipid biomarkers, and network analysis. We assessed how differences in geochemistry between thermokarst lakes and thermokarst lagoons, caused by the infiltration of sulfate-rich marine water, altered the microbial methane-cycling community. Anaerobic sulfate-reducing ANME-2a/2b methanotrophs dominated the sulfate-rich sediments of the lagoon despite its known seasonal alternation between brackish and freshwater inflow and low sulfate concentrations compared to the usual marine ANME habitat. Non-competitive methylotrophic methanogens dominated the methanogenic community of the lakes and the lagoon, independent of differences in porewater chemistry and depth. This potentially contributed to the high CH4 concentrations observed in all sulfate-poor sediments. CH4 concentrations in the freshwater-influenced sediments averaged 1.34 ± 0.98 μmol g−1, with highly depleted δ13C-CH4 values ranging from −89‰ to −70‰. In contrast, the sulfate-affected upper 300 cm of the lagoon exhibited low average CH4 concentrations of 0.011 ± 0.005 μmol g−1 with comparatively enriched δ13C-CH4 values of −54‰ to −37‰ pointing to substantial methane oxidation. Our study shows that lagoon formation specifically supports methane oxidizers and methane oxidation through changes in pore water chemistry, especially sulfate, while methanogens are similar to lake conditions

Sources of CO2 Produced in Freshly Thawed Pleistocene-Age Yedoma Permafrost

The release of greenhouse gases from the large organic carbon stock in permafrost deposits in the circumarctic regions may accelerate global warming upon thaw. The extent of this positive climate feedback is thought to be largely controlled by the microbial degradability of the organic matter preserved in these sediments. In addition, weathering and oxidation processes may release inorganic carbon preserved in permafrost sediments as CO2, which is generally not accounted for. We used C-13 and C-14 analysis and isotopic mass balances to differentiate and quantify organic and inorganic carbon released as CO2 in the field from an active retrogressive thaw slump of Pleistocene-age Yedoma and during a 1.5-years incubation experiment. The results reveal that the dominant source of the CO2 released from freshly thawed Yedoma exposed as thaw mound is Pleistocene-age organic matter (48-80%) and to a lesser extent modern organic substrate (3-34%). A significant portion of the CO2 originated from inorganic carbon in the Yedoma (17-26%). The mixing of young, active layer material with Yedoma at a site on the slump floor led to the preferential mineralization of this young organic carbon source. Admixtures of younger organic substrates in the Yedoma thaw mound were small and thus rapidly consumed as shown by lower contributions to the CO2 produced during few weeks of aerobic incubation at 4 degrees C corresponding to approximately one thaw season. Future CO2 fluxes from the freshly thawed Yedoma will contain higher proportions of ancient inorganic (22%) and organic carbon (61-78%) as suggested by the results at the end, after 1.5 years of incubation. The increasing contribution of inorganic carbon during the incubation is favored by the accumulation of organic acids from microbial organic matter degradation resulting in lower pH values and, in consequence, in inorganic carbon dissolution. Because part of the inorganic carbon pool is assumed to be of pedogenic origin, these emissions would ultimately not alter carbon budgets. The results of this study highlight the preferential degradation of younger organic substrates in freshly thawed Yedoma, if available, and a substantial release of CO2 from inorganic sources

Air temperature, thaw depth and total organic carbon pools in the active layer from thaw slump soils in the Lena Delta, Russia measured in 2019

The dataset comprises the thaw depth, the total organic carbon pools in the active layer measured at different thaw slump soils in the Lena Delta, Siberia, Russia in July 2019

Carbon dioxide and and methane flux from thaw slump soils in the Lena Delta, Russia measured in 2016 and 2019

The dataset comprises in situ CO2 and CH4 fluxes from different non-vegetated soils in an active thaw slump in the Lena Delta, Siberia, Russia, measured in July 2019 and July 2019

Dairy Farm Business Summary, Western and Central Plateau Region, 1999

E.B. 2000-06Dairy farm managers throughout New York State have been participating in Cornell Cooperative Extension's farm business summary and analysis program since the early 1950's. Managers of each participating farm business receive a comprehensive summary and analysis of their farm business. The information in this report represents averages of the data submitted from dairy farms in the Western and Central Plateau Region for 1999. Program Objective The primary objective of the dairy farm business summary, DFBS, is to help farm managers improve the business and financial management of their business through appropriate use of historical data and the application of modern farm business analysis techniques. This information can also be used to establish goals that enable the business to better fulfill its mission. In short, DFBS provides business and financial information needed in identifying and evaluating strengths and weaknesses of the farm business. Format Features This regional report follows the same general format as the 1999 DFBS individual farm report received by participating dairy farmers. The analysis tables have an open column or section labeled M y Farm . It may be used by any dairy farm manager who wants to compare his or her business with the average data of this region. The individual farm data, the regional averages and other data can then be used to establish goals for the business. A DFBS Data Check-in Form can be used by non-DFBS participants to summarize their businesses

Active layer temperature profiles from thaw slump soils in the Lena Delta, Russia measured in 2016

The dataset comprises the active layer temperature profiles measured at different thaw slump soils in the Lena Delta, Siberia, Russia in July 2016

Carbon dioxide and and methane flux data, temperature and thaw depth from thaw slump soils in the Lena Delta, Russia measured in 2016 and 2019

The dataset comprises in situ CO2 and CH4 fluxes, active layer depths, thawed carbon pools and soil temperatures from different non-vegetated soils in an active thaw slump in the Lena Delta, Siberia, Russia, measured in July 2016 and July 2019

Active layer temperature profiles from thaw slump soils in the Lena Delta, Russia measured in 2019

The dataset comprises the active layer temperature profiles measured at different thaw slump soils in the Lena Delta, Siberia, Russia in July 2019