Meanings of Community: Educational Developers Experience Care, Satisfying Contributions, and Belonging in a Collaboration across Institutions

We share insights from a mixed methods study to describe the experience of educational developers participating in a community of practice (CoP). This CoP consisted of 19 leaders at eight institutions, serving collectively as facilitators of a hybrid, across-institutional, seven-week workshop series on course design for graduate students and postdoctoral scholars. From results of a survey examining the functional and sustaining features of the community, we illustrate that members experience the community aspect of our CoP primarily as a sense of satisfaction/personal fulfillment and, to an extent, in the effectiveness/productiveness of collaborations between members. Members of our CoP experience several community-related benefits specific to their across-institution collaborations. We demonstrate the importance of members’ sense of belonging, overall professional development, and well-being for sustaining our CoP

Psychometric Evaluation and Design of Patient-Centered Communication Measures for Cancer Care Settings

Objective To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC). Methods Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty. For each Function we conducted factor analyses, item response theory modeling, and tests for differential item functioning, and assessed reliability and construct validity. Results Participants included 501 respondents; 46% had a high school education or less. Reliability within each Function ranged from 0.90 to 0.96. The PCC-Ca-36 (36-question survey; reliability=0.94) and PCC-Ca-6 (6-question survey; reliability=0.92) measures differentiated between individuals with poor and good health (i.e., known-groups validity) and were highly correlated with the HINTS communication scale (i.e., convergent validity). Conclusion This study provides theory-grounded PCC measures found to be reliable and valid in colorectal cancer patients in North Carolina. Future work should evaluate measure validity over time and in other cancer populations. Practice implications The PCC-Ca-36 and PCC-Ca-6 measures may be used for surveillance, intervention research, and quality improvement initiatives

The biogeochemistry of carbon across a gradient of streams and rivers within the Congo Basin

Author Posting. © American Geophysical Union, 2014. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Biogeosciences 119 (2014): 687–702, doi:10.1002/2013JG002442.Dissolved organic carbon (DOC) and inorganic carbon (DIC, pCO2), lignin biomarkers, and theoptical properties of dissolved organic matter (DOM) were measured in a gradient of streams and rivers within the Congo Basin, with the aim of examining how vegetation cover and hydrology influences the composition and concentration of fluvial carbon (C). Three sampling campaigns (February 2010, November 2010, and August 2011) spanning 56 sites are compared by subbasin watershed land cover type (savannah, tropical forest, and swamp) and hydrologic regime (high, intermediate, and low). Land cover properties predominately controlled the amount and quality of DOC, chromophoric DOM (CDOM) and lignin phenol concentrations (∑8) exported in streams and rivers throughout the Congo Basin. Higher DIC concentrations and changing DOM composition (lower molecular weight, less aromatic C) during periods of low hydrologic flow indicated shifting rapid overland supply pathways in wet conditions to deeper groundwater inputs during drier periods. Lower DOC concentrations in forest and swamp subbasins were apparent with increasing catchment area, indicating enhanced DOC loss with extended water residence time. Surface water pCO2 in savannah and tropical forest catchments ranged between 2,600 and 11,922 µatm, with swamp regions exhibiting extremely high pCO2 (10,598–15,802 µatm), highlighting their potential as significant pathways for water-air efflux. Our data suggest that the quantity and quality of DOM exported to streams and rivers are largely driven by terrestrial ecosystem structure and that anthropogenic land use or climate change may impact fluvial C composition and reactivity, with ramifications for regional C budgets and future climate scenarios.This work was supported by the National Science Foundation as part of the ETBC Collaborative Research: Controls on the Flux, Age, and Composition of Terrestrial Organic Carbon Exported by Rivers to the Ocean (0851101 and 0851015).2014-10-3

Radiative Corrections to the Inflaton Potential as an Explanation of Suppressed Large Scale Power in Density Perturbations and the Cosmic Microwave Background

The Wilkinson Microwave Anisotropy Probe microwave background data suggest that the primordial spectrum of scalar curvature fluctuations is suppressed at small wavenumbers. We propose a UV/IR mixing effect in small-field inflationary models that can explain the observable deviation in WMAP data from the concordance model. Specifically, in inflationary models where the inflaton couples to an asymptotically free gauge theory, the radiative corrections to the effective inflaton potential can be anomalously large. This occurs for small values of the inflaton field which are of the order of the gauge theory strong coupling scale. Radiative corrections cause the inflaton potential to blow up at small values of the inflaton field. As a result, these corrections can violate the slow-roll condition at the initial stage of the inflation and suppress the production of scalar density perturbations.Comment: 20 pages, 2 figures, v2: refs added, v3: JCAP versio

Management of multimorbidity using a patient-centred care model:a pragmatic cluster-randomised trial of the 3D approach

Background: The management of people with multiple chronic conditions challenges health-care systems designed around single conditions. There is international consensus that care for multimorbidity should be patient-centred, focus on quality of life, and promote self-management towards agreed goals. However, there is little evidence about the effectiveness of this approach. Our hypothesis was that the patient-centred, so-called 3D approach (based on dimensions of health, depression, and drugs) for patients with multimorbidity would improve their health-related quality of life, which is the ultimate aim of the 3D intervention. Methods: We did this pragmatic cluster-randomised trial in general practices in England and Scotland. Practices were randomly allocated to continue usual care (17 practices) or to provide 6-monthly comprehensive 3D reviews, incorporating patient-centred strategies that reflected international consensus on best care (16 practices). Randomisation was computer-generated, stratified by area, and minimised by practice deprivation and list size. Adults with three or more chronic conditions were recruited. The primary outcome was quality of life (assessed with EQ-5D-5L) after 15 months' follow-up. Participants were not masked to group assignment, but analysis of outcomes was blinded. We analysed the primary outcome in the intention-to-treat population, with missing data being multiply imputed. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN06180958. Findings: Between May 20, 2015, and Dec 31, 2015, we recruited 1546 patients from 33 practices and randomly assigned them to receive the intervention (n=797) or usual care (n=749). In our intention-to-treat analysis, there was no difference between trial groups in the primary outcome of quality of life (adjusted difference in mean EQ-5D-5L 0·00, 95% CI −0·02 to 0·02; p=0·93). 78 patients died, and the deaths were not considered as related to the intervention. Interpretation: To our knowledge, this trial is the largest investigation of the international consensus about optimal management of multimorbidity. The 3D intervention did not improve patients' quality of life. Funding: National Institute for Health Research

The Iowa Homemaker vol.3, no.9

Table of Contents Books – Why Not? by Charles H. Brown, page 3 A Visit to the Bazaars of Stamboul by Eda Lord Murphy, page 4 Glimpses in a Christmas Shop by Helen Brennan, page 4 That Roast Fowl by Viola M. Bell, page 5 Echoes from State Home Economics Convention by Katherine Goeppinger, page 6 Toys That Interest by Bertha Mann, page 7 Christmas Festivities in Foreign Lands by Barbara Dewell, page 8 Christmas Dinner for Two – by Louise Doole, page 9 Italian Hemstitching by Lora Ann Stanke, page 10 Eda Lord Murphy Writes from Constantinople by Eda Lord Murphy, page 10 Who is Responsible for the Child? by Minne Elisabeth Allen, page 11 Holiday Sweets by Alma Riemenschneider, page 12 The Perfect Guest by Lucile Barta, page 12 The Evolution of Home Economics at Iowa State by Ruth Elaine Wilson, page 13 Baskets Which Will Lead Long Useful Lives by Viola Jammer, page 14 Who’s There and Where by Helen I. Putnam, page 1

Early and Middle Holocene Hunter-Gatherer Occupations in Western Amazonia: The Hidden Shell Middens

We report on previously unknown early archaeological sites in the Bolivian lowlands, demonstrating for the first time early and middle Holocene human presence in western Amazonia. Multidisciplinary research in forest islands situated in seasonally-inundated savannahs has revealed stratified shell middens produced by human foragers as early as 10,000 years ago, making them the oldest archaeological sites in the region. The absence of stone resources and partial burial by recent alluvial sediments has meant that these kinds of deposits have, until now, remained unidentified. We conducted core sampling, archaeological excavations and an interdisciplinary study of the stratigraphy and recovered materials from three shell midden mounds. Based on multiple lines of evidence, including radiocarbon dating, sedimentary proxies (elements, steroids and black carbon), micromorphology and faunal analysis, we demonstrate the anthropogenic origin and antiquity of these sites. In a tropical and geomorphologically active landscape often considered challenging both for early human occupation and for the preservation of hunter-gatherer sites, the newly discovered shell middens provide evidence for early to middle Holocene occupation and illustrate the potential for identifying and interpreting early open-air archaeological sites in western Amazonia. The existence of early hunter-gatherer sites in the Bolivian lowlands sheds new light on the region's past and offers a new context within which the late Holocene "Earthmovers" of the Llanos de Moxos could have emerged. © 2013 Lombardo et al