PERCEPTIONS AND EXPERIENCES OF ADOPTING A TECHNOLOGY BASED INTERVENTION FOR ALCOHOL SCREENING AND REFERRAL TO TREATMENT IN PRIMARY CARE

Alcohol abuse is a significant concern in the United States. Today in the U.S., 15.1 million adults ages 18 and older, have been identified as having an alcohol use disorder. Alcohol abuse and binge drinking are highest amongst college students. More than 58.0 percent of college students admit to regular binge drinking or heavy alcohol use every month. Left unaddressed, this leads to negative health consequences later in life. The United States Preventive Services Task Force states that there is strong evidence that screening patients in primary care can reduce alcohol use disorder. Though screening, brief intervention, and referral to treatment (SBIRT) in primary care are critical steps towards preventing alcohol use disorder, it is not routinely done. Providers state that they are time-constrained and need processes that will help them carry out screenings. The use of technology integrated with the electronic health record is one way to address the issue. The purpose of this study was to provide an understanding of the health care provider\u27s perceptions and experiences with technology adoption in alcohol use disorder and clinical SBIRT. The study used an exploratory, descriptive methods approach to gain a comprehensive understanding of what acts as a facilitator or barrier to technology adoption in SBIRT in primary care. The findings show that there is a gap in the understanding of how to integrate behavioral health screenings in the primary care workflow and EHR. Providers want to do SBIRT in clinical care, yet time-constrained visits remain an issue. Providers highlighted the importance of mapping the workflow in advance of practice change and using pilots before undertaking a broader practice change

Design and pilot evaluation of an evidence-based worksheet and clinician guide to facilitate nutrition counselling for patients with severe mental illness.

BACKGROUND: Schizophrenia spectrum disorders (SSD) are severe, persistent mental illnesses resulting in considerable disability and premature mortality. Emerging evidence suggests that diet may be a modifiable risk factor in mental illness; however, use of nutritional counselling as a component of psychiatric clinical practice is limited. The objective of this project is the design and evaluate a worksheet and clinician guide for use in facilitating nutritional counseling in the context of existing mental health care. METHODS: The worksheet and clinician guide were developed based on the results of a recent scoping review on the relationship between diet and mental health symptoms among individuals with SSD. A feedback process involved a focus group with psychiatrists and interviews with individuals with lived experience with psychosis. Participants were asked a series of structured and open-ended questions. Interviews were transcribed and data units were allocated to categories from an existing framework. The comments were used to guide modifications to the worksheet and clinician guide. A brief interview with all participants was completed to gather feedback on the final version. RESULTS: Five psychiatrist participants and six participants with lived experience completed interviews. Participants provided positive comments related to the worksheet design, complexity and inclusion of interactive components. A novel theme emerged relating to the lack of nutritional counselling in psychiatric training and clinical practice. Many constructive comments were provided which resulted in meaningful revisions and improvements to the worksheet and clinician guide design and content. All participants were satisfied with the final versions. CONCLUSIONS: A worksheet and clinician guide designed to facilitate nutritional counselling with individuals with SSD was found to be acceptable to all participants following a process of feedback and revision. Further research and dissemination efforts aimed at increasing the use of nutritional counselling in psychiatric practice are warranted

The genomic health of ancient hominins

The genomes of ancient humans, Neandertals, and Denisovans contain many alleles that influence disease risks. Using genotypes at 3180 disease-associated loci, we estimated the disease burden of 147 ancient genomes. After correcting for missing data, genetic risk scores were generated for nine disease categories and the set of all combined diseases. These genetic risk scores were used to examine the effects of different types of subsistence, geography, and sample age on the number of risk alleles in each ancient genome. On a broad scale, hereditary disease risks are similar for ancient hominins and modern-day humans, and the GRS percentiles of ancient individuals span the full range of what is observed in present day individuals. In addition, there is evidence that ancient pastoralists may have had healthier genomes than hunter-gatherers and agriculturalists. We also observed a temporal trend whereby genomes from the recent past are more likely to be healthier than genomes from the deep past. This calls into question the idea that modern lifestyles have caused genetic load to increase over time. Focusing on individual genomes, we find that the overall genomic health of the Altai Neandertal is worse than 97% of present day humans and that Ötzi the Tyrolean Iceman had a genetic predisposition to gastrointestinal and cardiovascular diseases. As demonstrated by this work, ancient genomes afford us new opportunities to diagnose past human health, which has previously been limited by the quality and completeness of remain

Dietary modification in the treatment of schizophrenia spectrum disorders: A systematic review.

BackgroundSchizophrenia spectrum disorders impact functioning, reduce quality of life and increase the risk of physical illness and premature mortality. Nutritional intervention studies aimed at decreasing body weight have demonstrated efficacy in improving metabolic outcomes; however, few studies have explored the impact of interventions designed to modify diet on mental health outcomes.AimTo synthesize the existing experimental studies of adjunctive diet modification as an intervention in the treatment of psychotic disorders, analyze findings related to effectiveness and safety, highlight knowledge gaps and limitations, and set forward recommendations for future research studies.MethodsAn extensive a priori search strategy was developed and the databases Embase, Embase Classic, Ovid MEDLINE were searched. Screening and data extraction were completed in duplicate. Studies included in this analysis were experimental studies of an adjunctive dietary intervention (overall dietary pattern or education on dietary change) for treatment of schizophrenia spectrum disorders. No restrictions were placed on control groups or blinding. The studies were required to report a mental health outcome.ResultsTwenty-five clinical trials were identified, along with two additional protocols and two meta-analyses. Nineteen of the clinical trials reported improvement in one or more mental health domain including psychosis symptoms, cognition, and quality of life. A high level of heterogeneity was found with respect to patient population, intervention, and study design. All of the studies included lifestyle or psychosocial components in addition to dietary modification. The nutrition advice provided to participants was poorly described overall and compliance was not assessed. The studies that showed benefit tended to have a smaller sample size and were less likely to be randomized but were more likely to use a group delivery intervention.ConclusionFurther research assessing effectiveness and efficacy of clearly reported dietary interventions is warranted, especially those using rigorous methodology, modifying diet in isolation and assessing participant compliance

Cognitive Understanding of Reverse Engineering Assistant

The Cognitive Understanding of Reverse Engineering Assistant, or C.U.R.E. Assistant for short, is an independently developed program with the purpose of introducing students of the software reverse-engineering world to the art of disassembly. Reverse Engineering, or R.E. for short, is the process of deducing the source instructions or mechanisms of a device. This can be done to software to figure out how it works and how it can be exploited. While hackers employ this method for breaking into software systems, this is very useful for security researchers to determine security vulnerabilities in internet browsers, operating systems, apps, and more, so they can fix the problems before people using the software get exploited. Unfortunately, this is a very difficult and even expensive skill to learn, but C.U.R.E. Assistant seeks to mitigate that effort and cost. By analyzing a binary and then displaying the results in a user-friendly graphical interface, C.U.R.E. Assistant is able to point out areas of interest to those who may not know what to look for or where to start. In addition, it is designed with added functionality to ease users into learning the intricate, but popular, reverse-engineering tool, Radare2. Inspired by the massive learning curve and scant available training for software dissection, C.U.R.E. Assistant aims to both streamline the process for experienced engineers as well as educate those new to the field in a friendly and informative manner

Le FORUM, Vol. 34 No. 1

https://digitalcommons.library.umaine.edu/francoamericain_forum/1025/thumbnail.jp

Novel analysis of global DNA methylation in the limbic system of the bovine brain

Citation: Cantrell, B. A., McKay, S. D., Weaber, R. L., Funston, R. N., & Lachance, H. (2016). Novel analysis of global DNA methylation in the limbic system of the bovine brain. Journal of Animal Science, 94, 43-43. doi:10.2134/jas2016.94supplement443xThere has been limited research focusing on the genetic-environmental interactions in bovine brains. Global DNA methylation has been measured in brains of several species, but has yet to be examined in bovine. The objective of this study was to characterize global DNA methylation in 9 regions of the limbic system in the bovine brain: amygdala, bed nucleus of the stria terminalis, cingulate gyrus, dorsal raphe, hippocampus, hypothalamus, nucleus accumbens, periaqueductal gray, and prefrontal cortex. DNA was extracted from brain and blood samples of 6 Red Angus × Simmental steers (less than 20 mo of age), using the DNA Extraction Kit from Agilent Technologies (Santa Clara, CA) and a phenol chloroform extraction. Percent of global DNA methylation was determined using the MethylFlash Methylated DNA Quantification Kit (Colormetric) from Epigentek (Farmingdale, NY). Varying amounts of global DNA methylation were observed among the 9 functionally distinct regions of the bovine limbic system. Amygdala, bed nucleus of the stria terminalis, cingulate gyrus, dorsal raphe, periaqueductal gray, prefrontal cortex, and nucleus accumbens are all significantly different (P < 0.05) from 1 or more brain tissue type, using a paired t test in SPSS (IBM, Armonk, NY). Conversely, global DNA methylation of blood was not significantly different (P < 0.05) from any brain tissue type. This study shows significant differences in global DNA methylation among different tissue types in the limbic system of the bovine brain. Understanding the differences in global DNA methylation within different tissues in the brain will facilitate future research involving the effects of differential methylation with regard to economically important traits

Le FORUM, Vol. 33 No. 4

https://digitalcommons.library.umaine.edu/francoamericain_forum/1023/thumbnail.jp

Sodium fast reactor safety and licensing research plan. Volume I.

This report proposes potential research priorities for the Department of Energy (DOE) with the intent of improving the licensability of the Sodium Fast Reactor (SFR). In support of this project, five panels were tasked with identifying potential safety-related gaps in available information, data, and models needed to support the licensing of a SFR. The areas examined were sodium technology, accident sequences and initiators, source term characterization, codes and methods, and fuels and materials. It is the intent of this report to utilize a structured and transparent process that incorporates feedback from all interested stakeholders to suggest future funding priorities for the SFR research and development. While numerous gaps were identified, two cross-cutting gaps related to knowledge preservation were agreed upon by all panels and should be addressed in the near future. The first gap is a need to re-evaluate the current procedures for removing the Applied Technology designation from old documents. The second cross-cutting gap is the need for a robust Knowledge Management and Preservation system in all SFR research areas. Closure of these and the other identified gaps will require both a reprioritization of funding within DOE as well as a re-evaluation of existing bureaucratic procedures within the DOE associated with Applied Technology and Knowledge Management