Qualitative Assessment of Participant Utilization and Satisfaction With the Seattle Senior Farmers’ Market Nutrition Pilot Program

INTRODUCTION: The Seattle Senior Farmers' Market Nutrition Pilot Program delivered fresh fruits and vegetables to homebound seniors in King County, Washington, from June through October 2001. A primary objective of the program was to increase participants' intake of fruits and vegetables. A qualitative study was conducted to examine the impact of the program on participating homebound seniors. METHODS: Semi-structured interviews were performed with 27 participants in their homes to identify benefits and barriers they encountered and to measure their use and sense of satisfaction with the program. RESULTS: Analysis of the transcribed interviews revealed several common themes:  Participants appreciated the variety and quality of the fresh fruits and vegetables. . Some participants would not have had access to fresh fruits and vegetables without the program. . Home-delivered baskets of fresh fruits and vegetables brought participants joy, stimulated interest in healthy foods, and improved quality of life. . The program newsletter supported consumption of fresh produce. CONCLUSION: Program success was rooted in the multiple ways the program addressed potential barriers and reinforced behavioral intent

An Informatics Approach to Interprofessional Management of Low Back Pain: A Feasibility Study using the Omaha System

Background: Low back pain (LBP) is a complex health care issue that often involves multiple providers across various care settings. Health information technology (HIT) holds promise to improve care delivery by providing infrastructure for communication, clinical documentation, and management of patient data. Standardized terminology is essential for interoperability and enables evaluation of clinical data generated by documentation in an electronic health record (EHR).Objective: The purpose of this study was to demonstrate the feasibility of mapping evidence-based practice for conservative management of low back pain to the Omaha System and foster inter-professional communication and collaboration among diverse practitioners and patients.Methods: Evidence-based practice (EBP) guidelines for non-invasive treatment of low back pain were mapped to the Omaha System using a clinical expert approach with attention to content feasibility, linguistic validity, and granularity of terms. Results: A clinical guideline for low back pain management was developed consisting of 13 interventions for Pain and Neuro-musculo-skeletal problems. The most common intervention categories were Case management followed by Treatments and procedures, Teaching, guidance, and counseling and Surveillance. Scope of practice overlap was identified between primary care, chiropractic, and physical therapy practice.Conclusion: Use of the guideline may facilitate clinical documentation using the Omaha System for low back pain management, and has potential to generate meaningful data to evaluate clinical effectiveness and promote quality research. The use of encoded EBP evidence within an EHR can increase use of available evidence, enable interprofessional communication, improve quality of care, and enhance usability of data across care settings

Nanostructured MnGa films on Si/SiO2 with 20.5 kOe room temperature coercivity

This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics.Nanostructured Mn67Ga33 films exhibiting high room temperature coercivity (HC = 20.5 kOe) have been prepared by sputtering onto thermally oxidized Si substrates. Both the morphology and the coercivity of the films can be tuned by varying the growth parameters. The low deposition rate film, sputtered at a reduced power and working pressure, demonstrates a discontinuous island-like growth and the highest HC. The large HC is linked to the presence of the high anisotropy DO22 Mn3Ga phase and the single domain character of the exchange isolated, dipolar interacting, single crystal islands

Comparative regulomics supports pervasive selection on gene dosage following whole genome duplication

publishedVersio

Accuracy and variability of acoustic measures of voicing onset

Five commonly used methods for determining the onset of voicing of syllable-initial stop consonants were compared. The speech and glottal activity of 16 native speakers of Cantonese with normal voice quality were investigated during the production of consonant vowel (CV) syllables in Cantonese. Syllables consisted of the initial consonants /ph/, /th/, /kh/, /p/, /t/, and /k/ followed by the vowel /a/. All syllables had a high level tone, and were all real words in Cantonese. Measurements of voicing onset were made based on the onset of periodicity in the acoustic waveform, and on spectrographic measures of the onset of a voicing bar (f0), the onset of the first formant (F1), second formant (F2), and third formant (F3). These measurements were then compared against the onset of glottal opening as determined by electroglottography. Both accuracy and variability of each measure were calculated. Results suggest that the presence of aspiration in a syllable decreased the accuracy and increased the variability of spectrogram-based measurements, but did not strongly affect measurements made from the acoustic waveform. Overall, the acoustic waveform provided the most accurate estimate of voicing onset; measurements made from the amplitude waveform were also the least variable of the five measures. These results can be explained as a consequence of differences in spectral tilt of the voicing source in breathy versus modal phonation. ©2003 Acoustical Society of America.published_or_final_versio

Homocysteine levels in preterm infants: is there an association with intraventricular hemorrhage? A prospective cohort study.

BACKGROUND: The purpose of this study was to characterize total homocysteine (tHcy) levels at birth in preterm and term infants and identify associations with intraventricular hemorrhage (IVH) and other neonatal outcomes such as mortality, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and thrombocytopenia. METHODS: 123 infants \u3c 32 weeks gestation admitted to our Level III nursery were enrolled. A group of 25 term infants were enrolled for comparison. Two blood spots collected on filter paper with admission blood drawing were analyzed by a high performance liquid chromatography (HPLC) method. Statistical analysis included ANOVA, Spearman\u27s Rank Order Correlation and Mann-Whitney U test. RESULTS: The median tHcy was 2.75 micromol/L with an interquartile range of 1.34 - 4.96 micromol/L. There was no difference between preterm and term tHcy (median 2.76, IQR 1.25 - 4.8 micromol/L vs median 2.54, IQR 1.55 - 7.85 micromol/L, p = 0.07). There was no statistically significant difference in tHcy in 31 preterm infants with IVH compared to infants without IVH (median 1.96, IQR 1.09 - 4.35 micromol/L vs median 2.96, IQR 1.51 - 4.84 micromol/L, p = 0.43). There was also no statistically significant difference in tHcy in 7 infants with periventricular leukomalacia (PVL) compared to infants without PVL (median 1.55, IQR 0.25 - 3.45 micromol/L vs median 2.85, IQR 1.34 - 4.82 micromol/L, p = 0.07). Male infants had lower tHcy compared to female; prenatal steroids were associated with a higher tHcy. CONCLUSION: In our population of preterm infants, there is no association between IVH and tHcy. Male gender, prenatal steroids and preeclampsia were associated with differences in tHcy levels

In utero exposure to cigarette chemicals induces sex-specific disruption of one-carbon metabolism and DNA methylation in the human fetal liver

Background: Maternal smoking is one of the most important modifiable risk factors for low birthweight, which is strongly associated with increased cardiometabolic disease risk in adulthood. Maternal smoking reduces the levels of the methyl donor vitamin B12 and is associated with altered DNA methylation at birth. Altered DNA methylation may be an important mechanism underlying increased disease susceptibility; however, the extent to which this can be induced in the developing fetus is unknown. Methods: In this retrospective study, we measured concentrations of cobalt, vitamin B12, and mRNA transcripts encoding key enzymes in the 1-carbon cycle in 55 fetal human livers obtained from 11 to 21 weeks of gestation elective terminations and matched for gestation and maternal smoking. DNA methylation was measured at critical regions known to be susceptible to the in utero environment. Homocysteine concentrations were analyzed in plasma from 60 fetuses. Results: In addition to identifying baseline sex differences, we found that maternal smoking was associated with sex-specific alterations of fetal liver vitamin B12, plasma homocysteine and expression of enzymes in the 1-carbon cycle in fetal liver. In the majority of the measured parameters which showed a sex difference, maternal smoking reduced the magnitude of that difference. Maternal smoking also altered DNA methylation at the imprinted gene IGF2 and the glucocorticoid receptor (GR/NR3C1). Conclusions: Our unique data strengthen studies linking in utero exposures to altered DNA methylation by showing, for the first time, that such changes are present in fetal life and in a key metabolic target tissue, human fetal liver. Furthermore, these data propose a novel mechanism by which such changes are induced, namely through alterations in methyl donor availability and changes in 1-carbon metabolism

Multiple micronutrient supplementation improves vitamin B12 and folate concentrations of HIV infected children in Uganda: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The effect of multiple micronutrient supplementation on vitamin B₁₂and folate has hither to not been reported in African HIV infected children. This paper describes vitamin B₁₂and folate status of Ugandan HIV infected children aged 1-5 years and reports the effect of multiple micronutrient supplementation on serum vitamin B₁₂and folate concentrations.</p> <p>Methods</p> <p>Of 847 children who participated in a multiple micronutrient supplementation trial, 214 were assessed for vitamin B₁₂and folate concentrations pre and post supplementation. One hundred and four children were randomised to two times the recommended dietary allowance (RDA) of a 14 multiple micronutrient supplement (MMS) and 114 to a 'standard of care' supplement of 6 multivitamins (MV). Serum vitamin B₁₂was measured by an electrochemiluminescence immunoassay and folate by a competitive protein-binding assay using Modular E (Roche) automatic analyzer. Vitamin B₁₂concentrations were considered low if less than 221picomoles per litre (pmol/L) and folate if < 13.4 nanomoles per litre (nmol/L). The Wilcoxon Signed Ranks test was used to measure the difference between pre and post supplementation concentrations.</p> <p>Results</p> <p>Vitamin B₁₂was low in 60/214 (28%) and folate in 62/214 (29.0%) children. In the MMS group, the median concentration (IQR) of vitamin B₁₂at 6 months was 401.5 (264.3 - 518.8) pmol/L compared to the baseline of 285.5 (216.5 - 371.8) pmol/L, p < 0.001. The median (IQR) folate concentrations increased from 17.3 (13.5 - 26.6) nmol/L to 27.7 (21.1 - 33.4) nmol/L, p < 0.001. In the 'standard of care' MV supplemented group, the median concentration (IQR) of vitamin B₁₂at 6 months was 288.5 (198.8 - 391.0) pmol/L compared to the baseline of 280.0 (211.5 - 386.3) pmol/L while the median (IQR) folate concentrations at 6 months were 16.5 (11.7 - 22.1) nmol/L compared to 15.7 (11.9 - 22.1) nmol/L at baseline. There was a significant difference in the MMS group in both vitamin B₁₂and folate concentrations but no difference in the MV group.</p> <p>Conclusions</p> <p>Almost a third of the HIV infected Ugandan children aged 1-5 years had low serum concentrations of vitamin B₁₂and folate. Multiple micronutrient supplementation compared to the 'standard of care' supplement of 6 multivitamins improved the vitamin B₁₂and folate status of HIV infected children in Uganda.</p> <p>Trial registration</p> <p><url>http://ClinicalTrials.gov</url><a href="http://www.clinicaltrials.gov/ct2/show/NCT00122941">NCT00122941</a>)</p