Developing Effective Diabetes Programming for Black Men.

The purpose of this study is to obtain feedback from 20 men on developing effective programming to reduce the impact of diabetes (t2dm) among Black men. Three focus groups were convened in Des Moines, Iowa. Men were recruited, all either diagnosed with t2dm (n = 10), pre-diabetic (n = 1), or experienced t2dm through family and friends (n = 9). The results highlighted themes related to t2dm knowledge, masculinity, and behavioral health; gender-centered diabetes management education; and family support and functioning. Men provided recommendations for program format and content, desirable facilitator characteristics, and whether to include spouses/partners, relatives, and friends. These results provide guidance and ideas to nurses wishing to enhance t2dm education and patient outcomes for Black men

Prevention effects on trajectories of African American adolescents\u27 exposure to interparental conflict and depressive symptoms.

The present study investigates the trajectory of children\u27s exposure to interparental conflict during adolescence, its effects on adolescents\u27 psychological adjustment, as well as the ability of a family-centered prevention program to alter this trajectory. A total of 331 African American couples with an adolescent or preadolescent child participated in a randomized control trial of the Promoting Strong African American Families program, a newly developed program targeting couple and cocaregiving processes. Using a multi-informant, latent growth curve approach, child exposure to interparental conflict during adolescence was found to be stable over a period of 2 years among families in the control group, but significantly declined among families in the treatment condition. Rates of change were significantly different between intervention and control groups based on parents\u27 report of youth exposure to interparental conflict, but not for child\u27s report. Structural equation models found trajectory parameters of interparental conflict predicted changes in adolescent depressive symptoms, with increasing rates of changes in conflict associated with increases in adolescent internalizing symptoms over the 2-year duration of the study. Finally, a significant indirect effect was identified linking treatment, changes in parents\u27 reports of child exposure to interparental conflict, and adolescent depressive symptoms. The implications for research and intervention are discussed

The low level of debris disk activity at the time of the Late Heavy Bombardment: a Spitzer study of Praesepe

We present 24 micron photometry of the intermediate-age open cluster Praesepe. We assemble a catalog of 193 probable cluster members that are detected in optical databases, the Two Micron All Sky Survey (2MASS), and at 24 micron, within an area of ~ 2.47 square degrees. Mid-IR excesses indicating debris disks are found for one early-type and for three solar-type stars. Corrections for sampling statistics yield a 24 micron excess fraction (debris disk fraction) of 6.5 +- 4.1% for luminous and 1.9 +- 1.2% for solar-type stars. The incidence of excesses is in agreement with the decay trend of debris disks as a function of age observed for other cluster and field stars. The values also agree with those for older stars, indicating that debris generation in the zones that emit at 24 micron falls to the older 1-10 Gyr field star sample value by roughly 750 Myr. We discuss our results in the context of previous observations of excess fractions for early- and solar-type stars. We show that solar-type stars lose their debris disk 24 micron excesses on a shorter timescale than early-type stars. Simplistic Monte Carlo models suggest that, during the first Gyr of their evolution, up to 15-30% of solar-type stars might undergo an orbital realignment of giant planets such as the one thought to have led to the Late Heavy Bombardment, if the length of the bombardment episode is similar to the one thought to have happened in our Solar System. In the Appendix, we determine the cluster's parameters via boostrap Monte Carlo isochrone fitting, yielding an age of 757 Myr (+- 36 Myr at 1 sigma confidence) and a distance of 179 pc (+- 2 pc at 1 sigma confidence), not allowing for systematic errors.Comment: 22 pages, 14 figures, 9 tables, emulateapj format; Accepted for publication in The Astrophysical Journa

Tension of knotted surgical sutures shows tissue specific rapid loss in a rodent model

<p>Abstract</p> <p>Background</p> <p>Every surgical suture compresses the enclosed tissue with a tension that depends from the knotting force and the resistance of the tissue. The aim of this study was to identify the dynamic change of applied suture tension with regard to the tissue specific cutting reaction.</p> <p>Methods</p> <p>In rabbits we placed single polypropylene sutures (3/0) in skin, muscle, liver, stomach and small intestine. Six measurements for each single organ were determined by tension sensors for 60 minutes. We collected tissue specimens to analyse the connective tissue stability by measuring the collagen/protein content.</p> <p>Results</p> <p>We identified three phases in the process of suture loosening. The initial rapid loss of the first phase lasts only one minute. It can be regarded as cutting through damage of the tissue. The percentage of lost tension is closely related to the collagen content of the tissue (r = -0.424; p = 0.016). The second phase is characterized by a slower decrease of suture tension, reflecting a tissue specific plastic deformation. Phase 3 is characterized by a plateau representing the remaining structural stability of the tissue. The ratio of remaining tension to initial tension of phase 1 is closely related to the collagen content of the tissue (r = 0.392; p = 0.026).</p> <p>Conclusions</p> <p>Knotted non-elastic monofilament sutures rapidly loose tension. The initial phase of high tension may be narrowed by reduction of the surgeons' initial force of the sutures' elasticity to those of the tissue. Further studies have to confirm, whether reduced tissue compression and less local damage permits improved wound healing.</p

Survey of prescriptive authority among psychiatric pharmacists in the United States

Introduction: Despite the high prevalence of those with mental illnesses, there is a critical shortage of psychiatric providers in the United States. Psychiatric pharmacists are valuable members of the health care team who meet patient care needs, especially those practicing with prescriptive authority (PA). Methods: A cross-sectional electronic survey was administered to Board Certified Psychiatric Pharmacists (BCPPs) and non-BCPP members of the College of Psychiatric and Neurologic Pharmacists. The objective of this study was to compare demographic and practice characteristics between respondents with and without PA. Results: Of the 334 respondents, 155 (46.4%) reported having PA. Those with PA, including those with Veterans Affairs (VA) affiliated PA, had fewer mean number of years of licensure than those without PA (P =.008 and P =.007, respectively). The majority with PA practiced in outpatient settings (53.5%). Respondents with PA (including those with VA-affiliated PA) were more likely to have their positions funded by practice sites (P <.001). The most common referral source for medication management for those with PA were physicians although pharmacists also provided referrals in both VA and non-VA settings. Pharmacists with PA were more likely to track practice outcomes versus those without PA (P<.001). Discussion: The current study confirms the variability in PA among psychiatric pharmacists. Demographics of the respondents reflect changes in residency accreditation and increased numbers of psychiatric residencies within VA facilities. Psychiatric pharmacists with PA reported treating psychiatric and medical conditions, creating added value. Psychiatric pharmacists should be empowered to track outcomes and help meet the critical shortage of psychiatric providers

Volcanic CO2 output at the Central American subduction zone inferred from melt inclusions in olivine crystals from mafic tephras

The volatile contents of olivine‐hosted (Fo89–71) melt inclusion glasses in rapidly quenched mafic tephras from volcanic front volcanoes of the Central American Volcanic Arc (CAVA) in Guatemala, Nicaragua, and Costa Rica, were analyzed by secondary ion mass spectrometry (SIMS) in order to derive the minimum eruptive output of CO2, along with H2O, Cl, and S. Details of the analytical method are provided that establish melt inclusion CO2 analyses with the Cameca ims6f at the Helmholtz Centre Potsdam. The highest CO2 concentrations (up to 1800 mg/g) are observed in Nicaraguan samples, while melt inclusions from Guatemala and Costa Rica have CO2 contents between 50 and 500 mg/g. CO2 does not positively covary with sediment/slab fluid tracers such as Ba/La, Ba/Th, or U/La. Instead, the highest CO2 concentrations occur in the inclusions with the most depleted incompatible element compositions and low H2O, approaching the composition of mid‐ocean ridge basalts (MORBs), whereas the most H2O‐rich inclusions are relatively CO2‐poor (<800 mg/g). This suggests that CO2 degassing was more extensive in the melts with the highest slab contribution. CO2/Nb ratios in the least degassed CAVA melt inclusions are similar to those of primitive MORBs. These are interpreted here as recording a minimum CO2 output rate from the mantle wedge, which amounts to 2.8 × 104 g/s for the ∼1100 km long CAVA. Previously published estimates from quiescent degassing and numerical modeling, which also encompassed the slab contribution, are 3 times higher. This comparison allows us to estimate the proportion of the total CO2 output derived from the mantle wedge

Best practice model for outpatient psychiatric pharmacy practice, part 2: Confirmation of the attribute statements

Introduction: The American Association of Psychiatric Pharmacists (AAPP) used multiple modalities to develop and refine 28 attribute statements to describe a best practice model for outpatient psychiatric pharmacists. Before addressing implementation, assessment, and field testing, it was necessary to finalize and confirm the statements and their supporting narratives among stakeholders. The objective of this project was to confirm the attribute statements and supporting justifications for a best practice model for outpatient psychiatric pharmacists providing direct patient care. Methods: The 4 phases that resulted in the 28 attribute statements and supporting narratives have been described and published elsewhere. As part of phase 5, the confirmation survey was distributed to pharmacists and resident members of AAPP in November 2021 for 3 weeks. Results: The survey respondents (n = 74; 6.1%) were licensed pharmacists for an average of 15.6 years (SD = 12.0) and had been practicing as psychiatric pharmacists for an average of 11.3 years (SD = 10.4). Slightly more than half (54.2%) of the respondents reported practicing in the outpatient setting and three-fourths (74.3%) were Board Certified Psychiatric Pharmacists. For each of the 28 statements, more than 90% of respondents either agreed or agreed with minimal reservations. Discussion: Given the high degree of agreement on the proposed practice model statements, they will be used as the basis for the outpatient psychiatric pharmacist best practice model. Next steps in developing this model include establishing implementation guidance, determining appropriate metrics for evaluation of these statements in practice, and establishing appropriate field-testing methods

A multicenter randomized controlled trial evaluating the effect of small stitches on the incidence of incisional hernia in midline incisions

Contains fulltext : 95575.pdf (publisher's version ) (Open Access)BACKGROUND: The median laparotomy is frequently used by abdominal surgeons to gain rapid and wide access to the abdominal cavity with minimal damage to nerves, vascular structures and muscles of the abdominal wall. However, incisional hernia remains the most common complication after median laparotomy, with reported incidences varying between 2-20%. Recent clinical and experimental data showed a continuous suture technique with many small tissue bites in the aponeurosis only, is possibly more effective in the prevention of incisional hernia when compared to the common used large bite technique or mass closure. METHODS/DESIGN: The STITCH trial is a double-blinded multicenter randomized controlled trial designed to compare a standardized large bite technique with a standardized small bites technique. The main objective is to compare both suture techniques for incidence of incisional hernia after one year. Secondary outcomes will include postoperative complications, direct costs, indirect costs and quality of life. A total of 576 patients will be randomized between a standardized small bites or large bites technique. At least 10 departments of general surgery and two departments of oncological gynaecology will participate in this trial. Both techniques have a standardized amount of stitches per cm wound length and suture length wound length ratio's are calculated in each patient. Follow up will be at 1 month for wound infection and 1 year for incisional hernia. Ultrasound examinations will be performed at both time points to measure the distance between the rectus muscles (at 3 points) and to objectify presence or absence of incisional hernia. Patients, investigators and radiologists will be blinded during follow up, although the surgeon can not be blinded during the surgical procedure. CONCLUSION: The STITCH trial will provide level 1b evidence to support the preference for either a continuous suture technique with many small tissue bites in the aponeurosis only or for the commonly used large bites technique

The unusual M-dwarf Warm Jupiter TOI-1899~b: Refinement of orbital and planetary parameters

TOI-1899~b is a rare exoplanet, a temperate Warm Jupiter orbiting an M-dwarf, first discovered by \citet{Canas2020_toi1899} from a TESS single-transit event. Using new radial velocities (RVs) from the precision RV spectrographs HPF and NEID, along with additional TESS photometry and ground-based transit follow-up, we are able to derive a much more precise orbital period of $P = 29.090312_{-0.000035}^{+0.000036}$~d, along with a radius of $R_p = 0.99\pm0.03$~\unit{R_{J}}. We have also improved the constraints on planet mass, $M_p = 0.67\pm{0.04}$~\unit{M_{J}}, and eccentricity, which is consistent with a circular orbit at 2$\sigma$ ($e = 0.044_{-0.027}^{+0.029}$). TOI-1899~b occupies a unique region of parameter space as the coolest known ($T_{eq} \approx$ 380~K) Jovian-sized transiting planet around an M-dwarf; we show that it has great potential to provide clues regarding the formation and migration mechanisms of these rare gas giants through transmission spectroscopy with JWST as well as studies of tidal evolution.Comment: 19 pages, 7 figures, 3 tables, submitted to AJ (comments welcome