One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations

Proposes a framework for meeting patients' cultural and linguistic needs: policies and procedures that support cultural competence, data collection, population-tailored services, and internal and external collaborations. Includes a self-assessment tool

Wildlife Health Surveillance on the National Bison Range – Monitoring for M. Paratuberculosis in Bison

The wildlife health surveillance program on the National Bison Range was designed to assess the presence and prevalence of diseases in wildlife populations. Annual sampling and disease testing has been conducted at the range for decades. Starting in 2000, a statistically derived disease detection model for bison was designed and implemented to enhance detection of several diseases, including M. paratuberculosis. This disease, commonly known as Johne’s disease, is a bacterial intestinal disease that causes diarrhea, severe weight loss, and eventual death in bison and cattle. Targeting analysis of both populations as a whole and the status of individual animals, the program includes; (1) year-round direct observations aimed at detecting acute injuries, chronic conditions, mortalities, and emerging disease, and (2) regular diagnostic laboratory testing for a suite of diseases of particular concern and to evaluate exposure to several viral, parasitic and bacterial diseases common in the cattle industry. Information from direct observation is documented and shared with staff experienced in dealing with injuries, mortalities, and necropsies. Diagnostic analysis depends on routine coordination with our wildlife health office in Bozeman, Montana, by providing guidance concerning disease or other life-threatening conditions, and annual summary analysis of data. This is a long term adaptive process that includes periodically assessing local and regional wildlife threats, updating protocols according to sample results and providing management with necessary information to maintain healthy wildlife populations within a fenced boundary

ASSESSMENT OF PROCEDURAL ASPECTS AND QUALITY CONTROL IN HUMAN PLACENTAL RNA ISOLATION PROTOCOLS

poster abstractHigh quality RNA is of paramount importance in accurately interpreting gene expression changes in the placenta throughout pregnancy, as well as in common placental pathologies. The purpose of this study was to develop a standard operating procedure for the collection of human placental tissue and isolation of high quality RNA for pregnancy-related molecular studies. To accomplish this task, we compared several different parameters to minimize RNA degradation, including preservation (liquid nitrogen vs. RNAlater), dis-ruption (mortar/pestle vs. homogenization), and isolation (Trizol vs. RNeasy). We performed 150 RNA isolations from 30 term placentas. The overall yield was 365 ± 197 ng RNA per mg of tissue. The A260/280 ratio for all samples was 2.11 ± 0.1 (mean ± s.d.) and the RQI was 7.1 ± 1.4. No significant differences in RNA purity, yield, or quality were observed between different placental collections or RNA isolation techniques. However, poor RQI values of 2.7 to 3.3 were obtained after brief thawing of frozen placental samples. We also compared storage of RNAlater stabilized tissue at 4 de-grees or room temperature for 1 day, 7 days, and 30 days. The integrity of RNA stored at room temperature for 1 day was significantly better (P‹0.05 RQI 7.3 ± 0.58, mean ± s.d) than RNA stored at room temperature for 30 days (RQI 5.0 ±1.2, mean ± s.d). The results of these studies will be useful for establishing standard procedures for placenta collection for pregnancy biobanks

A rehabilitation program for lung cancer patients during postthoracotomy chemotherapy

Objective: The objective of this pilot study was to describe the effects of a 16-week home-based rehabilitative exercise program on cancer-related fatigue (CRF), other symptoms, functional status, and quality of life (QOL) for patients with non-small cell lung cancer (NSCLC) after thoracotomy starting within days after hospital discharge and continuing through the initiation and completion of chemotherapy. Materials and methods: Five patients with NSCLC completed the Brief Fatigue Inventory (measuring CRF severity) and the MD Anderson Symptom Inventory (measuring symptom severity) before and after thoractomy, and at the end of each week of the 16-week exercise program. Additionally, the Medical Outcomes Study Short Form-36 (measuring physical and mental functional status) and the Quality of Life Index (measuring QOL) were completed before and after thoracotomy, after weeks 3, 6, 12, and 16 (the end of the exercise program). Further, the 6-minute walk test (measuring functional capacity) was administered before thoracotomy, prior to the initiation of chemotherapy and/or radiation therapy, and at the end of the 16-week exercise program, after completion of chemotherapy. Results: Participants had a mean age of 63 years and a mean of five comorbid conditions; the exercise program was initiated within 4 days after hospital discharge. Participants\u27 CRF severity scores were reduced to mild levels, while the mean number of symptoms decreased from 9 postthoracotomy to 6 after the exercise program, with mean levels of severity and interference decreasing to below prethoracotomy levels. Likewise, participants\u27 functional status and QOL after completing the exercise program improved to near or above prethoracotomy levels. Conclusion: The home-based, light-intensity exercise program for NSCLC patients receiving and completing adjuvant chemotherapy postthoracotomy showed promising trends in improving CRF severity, other symptom severity, functional status, and QOL. Further testing via a two-arm randomized controlled trial is being conducted