The Challenges of Multimorbidity from the Patient Perspective

BACKGROUND Although multiple co-occurring chronic illnesses within the same individual are increasingly common, few studies have examined the challenges of multimorbidity from the patient perspective. OBJECTIVE The aim of this study is to examine the self-management learning needs and willingness to see non-physician providers of patients with multimorbidity compared to patients with single chronic illnesses. DESIGN. This research is designed as a cross-sectional survey. PARTICIPANTS Based upon ICD-9 codes, patients from a single VHA healthcare system were stratified into multimorbidity clusters or groups with a single chronic illness from the corresponding cluster. Nonproportional sampling was used to randomly select 720 patients. MEASUREMENTS Demographic characteristics, functional status, number of contacts with healthcare providers, components of primary care, self-management learning needs, and willingness to see nonphysician providers. RESULTS Four hundred twenty-two patients returned surveys. A higher percentage of multimorbidity patients compared to single morbidity patients were "definitely" willing to learn all 22 self-management skills, of these only 2 were not significant. Compared to patients with single morbidity, a significantly higher percentage of patients with multimorbidity also reported that they were "definitely" willing to see 6 of 11 non-physician healthcare providers. CONCLUSIONS Self-management learning needs of multimorbidity patients are extensive, and their preferences are consistent with team-based primary care. Alternative methods of providing support and chronic illness care may be needed to meet the needs of these complex patients.US Department of Veterans Affairs (01-110, 02-197); Agency for Healthcare Research and Quality (K08 HS013008-02

Growth Rate, Life Span and Molting Cycle of the Crayfish Orconectes Sanborni

Author Institution: The Department of Zoology, The Ohio State UniversityOrconectes sanborni young were found to hatch in the spring and to undergo several closely spaced molts. These juveniles could be sexed by mid-summer. A molt occurring in the autumn of the first year was the beginning of a pattern of two molts per year, one in the spring and one in the summer or autumn, although the precise timing of these molts was variable. Both sexes usually reached sexual maturity by the autumn of the second year. At this time the males became form I (breeding) and the oocytes in the females began to increase in size. The maximum life span was found to be thirty-seven months

Crayfish and Bivalve Distribution in a Valley in Southwestern Ohio

Author Institution: Department of Zoology, The Ohio State UniversityThe crayfish and bivalve fauna of 2 stream systems in an ancient valley in southwestern Ohio were examined. The distribution of the various species was mapped and the topography and environmental conditions of each collecting site were noted. The greatest diversity of species was usually found at the edge of the valley, while environmentally stressed sites harbored neither decapods nor bivalves. One species of crayfish, Orconectes sloanii, was found in the northwestern drainage system of the valley, but not in the southeastern drainage system, even though the 2 stream systems were once connected

A generic multi-flex-body dynamics, controls simulation tool for space station

An order (n) multiflex body Space Station simulation tool is introduced. The flex multibody modeling is generic enough to model all phases of Space Station from build up through to Assembly Complete configuration and beyond. Multibody subsystems such as the Mobile Servicing System (MSS) undergoing a prescribed translation and rotation are also allowed. The software includes aerodynamic, gravity gradient, and magnetic field models. User defined controllers can be discrete or continuous. Extensive preprocessing of 'body by body' NASTRAN flex data is built in. A significant aspect, too, is the integrated controls design capability which includes model reduction and analytic linearization

Longitudinal Spin Asymmetry and Cross Section of Inclusive pi0 Production in Polarized p+p Collisions at RHIC

We present the first measurement of the cross section and the double longitudinal spin asymmetry of inclusive pi0 production in polarized p+p collisions at Sqrt(s) = 200 GeV at mid-rapidity with the STAR detector, using the barrel electromagnetic calorimeter. The measured cross section is compared to NLO pQCD calculations and can provide constraints on the pion fragmentation functions. Fragmentation is studied directly by measuring the momentum fraction of pi0 in jets, a quantity that is affected by the fragmentation process and jet reconstruction effects. The double longitudinal spin asymmetry is compared to NLO pQCD calculations based on different assumptions for the gluon polarization in the nucleon to provide constraints on delta g/g. At the present level of statistics the measured asymmetry disfavors a large positive gluon polarization, but can not yet distinguish between other scenarios.Comment: 4 pages, 2 figures, submitted to the proceedings of the 17th International Spin Physics Symposium (SPIN2006), Kyoto, Japan, October 2 to 7, 200