The Effects of Volcanic Ash on Dissolved Neodymium as a Water Mass Tracer

Dissolved Neodymium (Nd) in the ocean is often used as a water mass tracer to reconstruct what the oceanic circulation in a certain area may have looked like in the past (van de Flierdt et al. 2012). The incorporated Nd in fish debris, specifically teeth, generally retains a sound record of deep seawater (Martin and Scher 2003). However, continental input may alter or add to the dissolved Nd, which further leads to Nd isotopic compositions that reflect sediment input and not ocean circulation (van de Flierdt et al. 2012). Additionally, dispersed volcanic ash in the ocean affects the isotopic composition of pore water and the pore water Nd is incorporated into fish debris (Abbott et al. 2015). By understanding how volcanic ash input affects the dissolved Nd isotopic signal we can further elucidate how to successfully determine oceanic circulation changes over time in the North Pacific. Understanding the paleo-ocean circulation, and the factors and processes that drive and affect it, is necessary to understand the current state of the ocean, as well as how it may change in the future. This requires a comprehensive understanding of the components may alter the dissolved isotopic Nd signal, such as volcanic ash. Here we compare the Nd isotopic composition of fish debris with the isotopic composition across three leached sediment phases of the same site to establish an understanding of how volcanic ash input affects the Nd in fish debris, as well as the Nd isotopic composition in the North Pacific over time. It is necessary to understand and be able to account for the effect of volcanic ash input when using dissolved Nd as a water mass tracer in order to get an accurate representation of the paleo-ocean circulation in the North Pacific over time. My research focuses on sediment dating back to the Cretaceous period (125-180 Ma) using samples collected from Ocean Drilling Program (ODP) Site 1149 in the North Pacific

Cultural Intelligence as it Relates to American Sign Language Interpretation

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Metabolic Syndrome in a Workplace: Prevalence, Co-Morbidities, and Economic Impact

Background: Although the prevalence of metabolic syndrome has been studied in nationally representative populations, little is known about its prevalence specifically among working adults. Because corporations are often the primary payers of health-care costs in the United States, they have a vested interest in knowing the impact of metabolic syndrome in employed individuals. Methods: A total of 4188 employees (83.4% male, 92.1% Caucasian, average age 40.8 years) of a midwestern U.S. manufacturing corporation participated in a health risk appraisal and biometric screening in 2006 and also used the company's medical plan. Those with metabolic syndrome were compared to those without metabolic syndrome in terms of their 2006 health risks, health conditions, health-care costs, pharmacy costs, short-term disability costs, and a measure of on-the-job productivity loss known as presenteeism. Results: A total of 30.2% of employees met the criteria for metabolic syndrome and were more likely to also have a variety of additional health risks and health conditions compared to those without metabolic syndrome. For example, 9.4% of those with metabolic syndrome self-reported having diabetes compared to 1.4% of those without metabolic syndrome. Health-care costs, pharmacy costs, and short-term disability costs were significantly higher for those with metabolic syndrome compared to those without metabolic syndrome, and increasing numbers of metabolic syndrome health risks were associated with greater numbers of employees reporting on-the-job productivity losses (presenteeism). Conclusions: Because metabolic syndrome is prevalent among the employees of this manufacturing company and is associated with significant economic costs, employers would be wise to address the health risks of employees through health promotion programs and benefit plan designs that help individuals improve their health and receive appropriate health screenings and medical care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78143/1/met.2009.0008.pd

The Burden and Management of Dyslipidemia: Practical Issues

Abstract The objective of this study is to describe briefly the burden of dyslipidemia, and to discuss and present strategies for health professionals to improve dyslipidemia management, based on a review of selected literature focusing on interventions for dyslipidemia treatment adherence. Despite the availability of effective lifestyle and pharmaceutical therapies for dyslipidemias, they continue to present a significant economic burden in the United States. Adherence to evidence-based guidelines for the treatment of dyslipidemias is unsatisfactory. The reasons for medication nonadherence are complex and specific to each patient. The lack of progress in achieving optimal lipid targets is caused by many factors: patient (medication adherence, cost of medication, literacy), medication (adverse effects, complexity of regimen), provider (lack of adherence to evidence-based practice guidelines, poor communication), and the US healthcare system (being focused on acute care rather than prevention, lack of continuity of care, general lack of use of an electronic health record). Combined interventions that target each part of the system have been effective in improving treatment adherence and achieving lipid goals. Patients, providers, pharmacists, and employers all play a role in management of dyslipidemia. No single approach will solve the complex issue of improving dyslipidemia management. The required lifestyle changes are known and effective medications are available. The challenge is for all interested parties?including nurses, nurse practitioners, doctors, pharmacists, other health care professionals, employers, and health plans?to help patients achieve behavioral changes. (Population Health Management 2012;15:302?308)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98471/1/pop%2E2011%2E0081.pd

A Worksite Occupational Health Clinic-Based Diabetes Mellitus Management Program

This study is an analysis of a workplace diabetes management program offered to employees of a Fortune 100 financial services corporation located in the United States. The 12-month worksite-based educational program was for employees who were at risk for diabetes, had prediabetes, or were diagnosed with diabetes. This employed population, with health benefits, generally had acceptable control of their diabetes at the start of the program. They statistically improved most self-efficacy measures, but improvement in biometric tests at 6 and 12 months were not significantly different from baseline. Mean hemoglobin A1c at baseline, 6 months, and 12 months was 7.2%, 7.2%, and 7.3%, respectively. At 12 months, about 40% of preprogram survey participants completed all screenings and the post-program questionnaire. Disease management programs at the workplace can be an important component in helping employees enhance their knowledge of diabetes and maintain and improve their health. (Population Health Management 2015;18:429?436)Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140190/1/pop.2014.0141.pd

Asthma Disease Management: A Worksite-Based Asthma Education Program

Asthma accounts for an estimated 3 million workdays lost each year in the United States in addition to reduced worker productivity. Although asthma disease management programs are relatively common in managed care organizations, they have generally not been offered at the workplace. Seventy-six employees participated in a five-session worksite-based asthma education program. A total of 47 of 76 (61.8%) employees completed baseline and 12-month follow-up Asthma Therapy Assessment Questionnaires (ATAQ). The ATAQ includes measurement of poor asthma control, behavior/attitude barriers, knowledge barriers, patient/provider communication barriers, and efficiency. Significant improvement was noted in measures of asthma control (p < 0.05), communication (p < 0.005), knowledge (p < 0.001), and the total ATAQ Index declined from 5.53 to 4.04 (p < 0.001). Employee satisfaction results for the program were exceptionally high. A worksite-based asthma education program should reduce medical care costs, worker absenteeism, and improve worker productivity. The worksite can be a very effective location for disease education programs.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63128/1/109350701300038208.pd

Worker Productivity Loss Associated with Arthritis

This study at a major financial services corporation sought to investigate the association of arthritis with on-the-job productivity, also termed "presenteeism." Using a modified version of the Work Limitations Questionnaire (WLQ) incorporated into a Health Risk Appraisal (HRA), 17,685 employees responded to the survey in 2002. Of the 16,651 respondents meeting inclusion criteria, 2,469 (14.8%) reported having arthritis, and 986 (39.9% of those with arthritis) also reported that they were under medical care and/or taking medication for arthritis. Employees with arthritis were older, predominantly female, and reported a higher number of comorbidities. Although all four domains of the WLQ (physical, time, mental, and output) were impacted by arthritis, the greatest productivity effect, as expected, was on physical work tasks. Health risks also play a role in the relationship between arthritis and presenteeism, with high-risk individuals reporting 7%–10% additional loss of productivity compared to lowrisk individuals. In addition, those who reported receiving medication and/or treatment for arthritis had a 2.5% excess productivity loss independently attributed to their arthritis, which equals approximately $1,250 per employee per year, or$5.4 million to the corporation. This arthritis effect was discernible in those with low and moderate levels of health risk, but was not as evident in those with high health risks; in that group, health-associated decrements in productivity were much larger. Arthritis is associated with work productivity loss. Disease management programs should focus on pain management and arthritis-associated health risks and comorbidities in order to significantly decrease arthritis-related losses in on-the-job productivity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63221/1/dis.2006.9.131.pd

Multilocus haplotypes reveal variable levels of diversity and population structure of Plasmodium falciparum in Papua New Guinea, a region of intense perennial transmission

<p>Abstract</p> <p>Background</p> <p>The South West Pacific nation of Papua New Guinea has intense year round transmission of <it>Plasmodium falciparum </it>on the coast and in the low-lying inland areas. Local heterogeneity in the epidemiology of malaria suggests that parasites from multiple locations will need to be surveyed to define the population biology of <it>P. falciparum </it>in the region. This study describes the population genetics of <it>P. falciparum </it>in thirteen villages spread over four distinct catchment areas of Papua New Guinea.</p> <p>Methods</p> <p>Ten microsatellite loci were genotyped in 318 <it>P. falciparum </it>isolates from the parasite populations of two inland catchment areas, namely Wosera (number of villages (n) = 7) and Utu (n = 1) and; and two coastal catchments, Malala (n = 3) and Mugil (n = 3). Analysis of the resultant multilocus haplotypes was done at different spatial scales (2-336 km) to define the genetic diversity (allelic richness and expected heterozygosity), linkage disequilibrium and population structure throughout the study area.</p> <p>Results</p> <p>Although genetic diversity was high in all parasite populations, it was also variable with a lower allelic richness and expected heterozygosity for inland populations compared to those from the more accessible coast. This variability was not correlated with two proxy measures of transmission intensity, the infection prevalence and the proportion multiple infections. Random associations among the microsatellite loci were observed in all four catchments showing that a substantial degree of out-crossing occurs in the region. Moderate to very high levels of population structure were found but the amount of genetic differentiation (<it>F_ST</it>) did not correlate with geographic distance suggesting that parasite populations are fragmented. Population structure was also identified between villages within the Malala area, with the haplotypes of one parasite population clustering with the neighbouring catchment of Mugil.</p> <p>Conclusion</p> <p>The observed population genetics of <it>P. falciparum </it>in this region is likely to be a consequence of the high transmission intensity combined with the isolation of human and vector populations, especially those located inland and migration of parasites via human movement into coastal populations. The variable genetic diversity and population structure of <it>P. falciparum </it>has important implications for malaria control strategies and warrants further fine scale sampling throughout Papua New Guinea.</p

Analysis of the Association between Metabolic Syndrome and Disease in a Workplace Population over Time

Objectives:  While research has confirmed an association between metabolic syndrome (MetS) and diseases such as heart disease and diabetes, none of these studies have been conducted in a worksite population. Because corporations are often the primary payer of health-care costs in the United States, they have a vested interest in identifying the magnitude of MetS risk factors in employed populations, and also in knowing if those risk factors are associated with other health risks or medical conditions. Methods:  This study identified the prevalence of MetS risk factors and self-reported disease in employees (N = 3285) of a manufacturing corporation who participated in a health risk appraisal and biometric screening in both 2004 and 2006. Health-care costs, pharmacy costs, and short-term disability costs were compared for those with and without MetS and disease. Results:  The prevalence of MetS increased from 2004 to 2006 in this employed population. Those with MetS were significantly more likely to self-report arthritis, chronic pain, diabetes, heartburn, heart disease, and stroke. Employees with MetS in 2004 were also significantly more likely to report new cases of arthritis, chronic pain, diabetes, and heart disease in 2006. The costs of those with MetS and disease were 3.66 times greater than those without MetS and without disease. Conclusions:  MetS is associated with disease and increased costs in this working population. There is an opportunity for health promotion to prevent MetS risk factors from progressing to disease status which may improve vitality for employees, as well as limit the economic impact to the corporation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75375/1/j.1524-4733.2009.00651.x.pd

Trends in Gender Authorship and Collaborations: A 30-Year Comparative Bibliometric Analysis of Manuscripts from The Journal of Bone and Joint Surgery and The Bone and Joint Journal

Publishing original peer-reviewed research is essential for advancement through all career stages. Fewer women than men hold senior-level positions in academic medicine and, therefore, examining publication trends relative to gender is important. The goal of this study was to examine and compare publication trends in The Journal of Bone and Joint Surgery (JBJS) and The Bone and Joint Journal (BJJ) with a particular emphasis on trends regarding author gender. Data was collected and analyzed for manuscripts published in JBJS and BJJ over the past 30 years. For manuscripts published in 1986, 1996, 2006, and 2016, we recorded the numbers of authors, manuscript pages, references, collaborating institutions, the position in the byline of the corresponding author, the country of the corresponding author, and the names of the first and corresponding author. We also calculated the normalized number of citations and corresponding author position. The number of authors, institutions, and countries collaborating on manuscripts published in both JBJS and BJJ increased over time. JBJS published more manuscripts from North America and BJJ published more manuscripts from Europe. In both journals, the percentage of women as first and/or corresponding author increased over time. Trends over the past 30 years have shown increased collaborations with greater citations in manuscripts published in JBJS and BJJ. In the same time period, both journals demonstrated a rise in the percentage of manuscripts with women first and/or corresponding authors, suggesting a decrease in the gender gap