2,748 research outputs found
Binge Eating Disorder Mediates Links between Symptoms of Depression and Anxiety and Caloric Intake in Obese Women
Despite considerable comorbidity between mood disorders, binge eating disorder (BED), and obesity, the underlying mechanisms remain unresolved. Therefore, the purpose of this study was to examine models by which internalizing behaviors of depression and anxiety influence food intake in overweight/obese women. Thirty-two women (15 BED, 17 controls) participated in a laboratory eating-episode and completed questionnaires assessing symptoms of anxiety and depression. Path analysis was used to test mediation and moderation models to determine the mechanisms by which internalizing symptoms influenced kilocalorie (kcal) intake. The BED group endorsed significantly more symptoms of depression (10.1 versus 4.8, P=0.005 ) and anxiety (8.5 versus 2.7, P=0.003). Linear regression indicated that BED diagnosis and internalizing symptoms accounted for 30% of the variance in kcal intake. Results from path analysis suggested that BED mediates the influence of internalizing symptoms on total kcal intake. The associations between internalizing symptoms and food intake are best described as operating indirectly through a BED diagnosis. This suggests that symptoms of depression and anxiety influence whether one engages in binge eating, which influences kcal intake. Greater understanding of the mechanisms underlying the associations between mood, binge eating, and food intake will facilitate the development of more effective prevention and treatment strategies for both BED and obesity
Predicting dentists decisions: a choice-based conjoint analysis of Medicaid participation
Objectives: Private practice dentists are the major source of care for the dental
safety net; however, the proportion of dentists who participate in state Medicaid
programs is low, often due to poor perceptions of the program’s administration
and patient population. Using a discrete choice experiment and a series of
hypothetical scenarios, this study evaluated trade-offs dentists make when deciding
to accept Medicaid patients.
Methods: An online choice-based conjoint survey was sent to 272 general dentists
in Iowa. Hypothetical scenarios presented factors at systematically varied levels.
The primary determination was whether dentists would accept a new Medicaid
patient in each scenario. Using an ecological model of behavior, determining
factors were selected from the categories of policy, administration, community, and
patient population to estimate dentists’ relative preferences.
Results: 62 percent of general dentists responded to the survey. The probability of
accepting a new Medicaid patient was highest (81 percent) when reimbursement
rates were 85 percent of the dentist’s fees, patients never missed appointments,
claims were approved on first submission, and no other practices in the area
accepted Medicaid. Although dentists preferred higher reimbursement rates, 56
percent would still accept a new Medicaid patient when reimbursement decreased
to 55 percent if they were told that the patient would never miss appointments and
claims would be approved on initial submission.
Conclusions: This study revealed trade-offs that dentists make when deciding to
participate in Medicaid. Findings indicate that states can potentially improve
Medicaid participation without changing reimbursement rates by making
improvements in claims processing and care coordination to reduce missed
appointments.Funding for this project came from an Innovation Fund for
Oral Health award from the DentaQuest Foundation (Boston,
MA)
Collisional Plasma Models with APEC/APED: Emission Line Diagnostics of Hydrogen-like and Helium-like Ions
New X-ray observatories (Chandra and XMM-Newton) are providing a wealth of
high-resolution X-ray spectra in which hydrogen- and helium-like ions are
usually strong features. We present results from a new collisional-radiative
plasma code, the Astrophysical Plasma Emission Code (APEC), which uses atomic
data in the companion Astrophysical Plasma Emission Database (APED) to
calculate spectral models for hot plasmas. APED contains the requisite atomic
data such as collisional and radiative rates, recombination cross sections,
dielectronic recombination rates, and satellite line wavelengths. We compare
the APEC results to other plasma codes for hydrogen- and helium-like
diagnostics, and test the sensitivity of our results to the number of levels
included in the models. We find that dielectronic recombination with
hydrogen-like ions into high (n=6-10) principal quantum numbers affects some
helium-like line ratios from low-lying (n=2) transitions.Comment: 5 pages, 6 figures, accepted by ApJ Letter
Interleukin (IL)-1 promotes allogeneic T cell intimal infiltration and IL-17 production in a model of human artery rejection
Interleukin (IL) 1α produced by human endothelial cells (ECs), in response to tumor necrosis factor (TNF) or to co-culture with allogeneic T cells in a TNF-dependent manner, can augment the release of cytokines from alloreactive memory T cells in vitro. In a human–mouse chimeric model of artery allograft rejection, ECs lining the transplanted human arteries express IL-1α, and blocking IL-1 reduces the extent of human T cell infiltration into the artery intima and selectively inhibits IL-17 production by infiltrating T cells. In human skin grafts implanted on immunodeficient mice, administration of IL-17 is sufficient to induce mild inflammation. In cultured cells, IL-17 acts preferentially on vascular smooth muscle cells rather than ECs to enhance production of proinflammatory mediators, including IL-6, CXCL8, and CCL20. Neutralization of IL-17 does not reduce T cell infiltration into allogeneic human artery grafts, but markedly reduces IL-6, CXCL8, and CCL20 expression and selectively inhibits CCR6+ T cell accumulation in rejecting arteries. We conclude that graft-derived IL-1 can promote T cell intimal recruitment and IL-17 production during human artery allograft rejection, and suggest that targeting IL-1 in the perioperative transplant period may modulate host alloreactivity
Advanced EFL learners' beliefs about language learning and teaching: a comparison between grammar, pronunciation, and vocabulary
This paper reports on the results of a study exploring learners’ beliefs on the learning and teaching of English grammar, pronunciation and vocabulary at tertiary level. While the importance of learners’ beliefs on the acquisition process is generally recognized, few studies have focussed on and compared learners’ views on different components of the language system. A questionnaire containing semantic scale and Likert scale items probing learners’ views on grammar, pronunciation and vocabulary was designed and completed by 117 native speakers of Dutch in Flanders, who were studying English at university. The analysis of the responses revealed that (i) vocabulary was considered to be different from grammar and pronunciation, both in the extent to which an incorrect use could lead to communication breakdown and with respect to the learners’ language learning strategies, (ii) learners believed in the feasibility of achieving a native-like proficiency in all three components, and (iii) in-class grammar, pronunciation and vocabulary exercises were considered to be useful, even at tertiary level. The results are discussed in light of pedagogical approaches to language teaching
Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions
PURPOSE: Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and strains the oncology workforce. We assessed whether the 4R Oncology model for team-based interdependent care delivery and patient self-management affected team functioning in a large community-based health system.
METHODS: 4R was deployed at four locations in breast and lung cancers and assessed along four characteristics of high-functioning teams: recognition as a team internally and externally; commitment to an explicit shared goal; enablement of interdependent work to achieve the goal; and engagement in regular reflection to adapt objectives and processes.
RESULTS: We formed an internally and externally recognized team of 24 specialties committed to a shared goal of delivering multidisciplinary care at the optimal time and sequence from a patient-centric viewpoint. The team conducted 40 optimizations of interdependent care (22 for breast, seven for lung, and 11 for both cancers) at four points in the care continuum and established an ongoing teamwork adaptation process. Half of the optimizations entailed low effort, while 30% required high level of effort; 78% resulted in improved process efficiency.
CONCLUSION: 4R facilitated development of a large high-functioning team and enabled 40 optimizations of interdependent care along the cancer care continuum in a feasible way. 4R may be an effective approach for fostering high-functioning teams, which could contribute to improving viability of the oncology workforce. Our intervention and taxonomy of results serve as a blueprint for other institutions motivated to strengthen teamwork to improve patient-centered care
Models and Studies of Aging: Executive Summary of a Report from the U13 Conference Series
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148241/1/jgs15788.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148241/2/jgs15780-sup-0001-supinfo.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148241/3/jgs15788_am.pd
Consensus recommendations for a standardized brain tumor imaging protocol for clinical trials in brain metastases.
A recent meeting was held on March 22, 2019, among the FDA, clinical scientists, pharmaceutical and biotech companies, clinical trials cooperative groups, and patient advocacy groups to discuss challenges and potential solutions for increasing development of therapeutics for central nervous system metastases. A key issue identified at this meeting was the need for consistent tumor measurement for reliable tumor response assessment, including the first step of standardized image acquisition with an MRI protocol that could be implemented in multicenter studies aimed at testing new therapeutics. This document builds upon previous consensus recommendations for a standardized brain tumor imaging protocol (BTIP) in high-grade gliomas and defines a protocol for brain metastases (BTIP-BM) that addresses unique challenges associated with assessment of CNS metastases. The "minimum standard" recommended pulse sequences include: (i) parameter matched pre- and post-contrast inversion recovery (IR)-prepared, isotropic 3D T1-weighted gradient echo (IR-GRE); (ii) axial 2D T2-weighted turbo spin echo acquired after injection of gadolinium-based contrast agent and before post-contrast 3D T1-weighted images; (iii) axial 2D or 3D T2-weighted fluid attenuated inversion recovery; (iv) axial 2D, 3-directional diffusion-weighted images; and (v) post-contrast 2D T1-weighted spin echo images for increased lesion conspicuity. Recommended sequence parameters are provided for both 1.5T and 3T MR systems. An "ideal" protocol is also provided, which replaces IR-GRE with 3D TSE T1-weighted imaging pre- and post-gadolinium, and is best performed at 3T, for which dynamic susceptibility contrast perfusion is included. Recommended perfusion parameters are given
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