Metabolic Bone Disease in the Bariatric Surgery Patient

Bariatric surgery has proven to be a life-saving measure for some, but for others it has precipitated a plethora of metabolic complications ranging from mild to life-threatening, sometimes to the point of requiring surgical revision. Obesity was previously thought to be bone protective, but this is indeed not the case. Morbidly obese individuals are at risk for metabolic bone disease (MBD) due to chronic vitamin D deficiency, inadequate calcium intake, sedentary lifestyle, chronic dieting, underlying chronic diseases, and the use of certain medications used to treat those diseases. After bariatric surgery, the risk for bone-related problems is even greater, owing to severely restricted intake, malabsorption, poor compliance with prescribed supplements, and dramatic weight loss. Patients presenting for bariatric surgery should be evaluated for MBD and receive appropriate presurgical interventions. Furthermore, every patient who has undergone bariatric surgery should receive meticulous lifetime monitoring, as the risk for developing MBD remains ever present

Methodology for Sampling Women at High Maternal Risk in Administrative Data

Background: In population level studies, the conventional practice of categorizing women into low and high maternal risk samples relies upon ascertaining the presence of various comorbid conditions in administrative data. Two problems with the conventional method include variability in the recommended comorbidities to consider and inability to distinguish between maternal and fetal risks. High maternal risk sample selection may be improved by using the Obstetric Comorbidity Index (OCI), a system of risk scoring based on weighting comorbidities associated with maternal end organ damage. The purpose of this study was to compare the net benefit of using OCI risk scoring vs the conventional risk identification method to identify a sample of women at high maternal risk in administrative data. Methods: This was a net benefit analysis using linked delivery hospitalization discharge and vital records data for women experiencing singleton births in Georgia from 2008 to 2012. We compared the value identifying a sample of women at high maternal risk using the OCI score to the conventional method of dichotomous identification of any comorbidities. Value was measured by the ability to select a sample of women designated as high maternal risk who experienced severe maternal morbidity or mortality. Results: The high maternal risk sample created with the OCI had a small but positive net benefit (+ 0.6), while the conventionally derived sample had a negative net benefit indicating the sample selection performed worse than identifying no woman as high maternal risk. Conclusions: The OCI can be used to select women at high maternal risk in administrative data. The OCI provides a consistent method of identification for women at risk of maternal morbidity and mortality and avoids confounding all obstetric risk factors with specific maternal risk factors. Using the OCI may help reduce misclassification as high maternal risk and improve the consistency in identifying women at high maternal risk in administrative data

Percepciones de docentes acerca de las experiencias de desarrollo profesional: una preocupación que continúa

Teachers’ perceptions of professional development experiences related to process, content, and context were explored to better address leadership preparation needs. Teachers responded to the Professional Development Questionnaire, three demographic variables (teaching experience, Title 1 status, and current grade level) pertaining to the individual, and one open-ended comment field. A total of 327 teachers from a large western school district in the United States responded. The findings indicated that there were no significant differences for the three demographic grouping variables. Overall, results revealed low mean values, indicating that teachers disagreed or strongly disagreed with statements related to their professional development experiences. Teachers also indicated that their own building administrators did not value professional development. Finally, teachers’ perceptions of professional development also suggested that professional development topics were irrelevant, and that they were not provided with enough time to integrate topics into their current practice.Se exploraron las percepciones de maestros acerca de las experiencias de desarrollo profesional relacionadas con el proceso, el contenido y el contexto, a fin de responder mejor a las necesidades de preparación para el liderazgo. Maestros respondieron al Cuestionario de Desarrollo Profesional, tres variables de agrupaciones demográficas (experiencia enseñando, estado de Título 1, y nivel de grado actual) pertenecientes al individuo, y un campo de comentarios de composición abierta. Un total de 327 maestros de un distrito escolar grande del occidente de los Estados Unidos respondió. Los resultados revelaron que no había diferencias significativas para las tres variables de agrupación demográfica. En general, los resultados revelaron bajos valores promedios, indicando que los maestros estaban en desacuerdo, o fuertemente en desacuerdo con las declaraciones relacionadas a sus experiencias de desarrollo profesional. Los maestros también indicaron que sus propios administradores no valoraban el desarrollo profesional. Finalmente, las percepciones de los maestros de desarrollo profesional también sugirieron que los temas al respecto eran irrelevantes y que ellos no tenían suficiente tiempo para integrar dichas cuestiones en su práctica cotidiana

The WHOI Moored Array Project 1963-1978 : data directory and bibliography

General information about mooring locations, durations and data gathered by the Moored Array Project (also known as Buoy Group) between late 1963 and 1978 is listed. Also included is a comprehensive list of scientific and technical publications written by the Buoy Group staff.Prepared for the Office of Naval Research under Contract N00014-76-C-0197; NR 083-400 and for the National Science Foundation under Grant OCE 77-19403

Brain Trust: Students for Students: VCU to RPS Mentorship Program

As a public, urban research institution, Virginia Commonwealth University embraces the importance of developing university-community partnerships that generate innovative solutions to societal challenges and prepare engaged citizens of tomorrow. The Students for Students: VCU to RPS Mentorship Program provides a model that will connect current VCU students to current Richmond Public Schools (RPS) students through a formal, multi-year mentorship. The ultimate goal of this program is to support and positively influence RPS students, while providing current VCU students with an opportunity to give back to the community while developing their mentorship skills. The mentoring relationship will seek to motivate RPS sophomores, juniors and seniors to improve school performance, graduate on time, and craft a post-high school path

Adrenocortical and Pituitary Glucocorticoid Feedback in Abstinent Alcohol-Dependent Women

The long-term ingestion of alcohol diminishes hypothalamic–pituitary–adrenal (HPA) axis reactivity in alcohol-dependent men, potentially altering future relapse risk. Although sex differences in HPA axis functioning are apparent in healthy controls, disruptions in this system have received little attention in alcohol-dependent women. In this study, we assessed the basal secretory profile of adrenocorticotropic hormone (ACTH) and cortisol, adrenocortical sensitivity in both the presence and absence of endogenous corticotropic pituitary activation, and feedback pituitary glucocorticoid sensitivity to dexamethasone.Seven women 4- to 8-week abstinent alcohol-only dependent subjects and 10 age-matched female healthy controls were studied. All subjects were between 30 and 50 years old, not taking oral contraceptives, and were studied during the early follicular phase of their menstrual cycle. Circulating concentrations of ACTH and cortisol were measured in blood samples collected at frequent intervals from 2000 to 0800 hour. A submaximal dose of cosyntropin (0.01 μg/kg), a synthetic ACTH (1–24), was administered at 0800 hour to assess adrenocortical sensitivity. In a separate session, low-dose cosyntropin was also administered following high-dose dexamethasone (8 mg intravenous) to assess adrenocortical sensitivity in the relative absence of endogenous ACTH. In addition, the ACTH response to dexamethasone was measured to determine the pituitary glucocorticoid negative feedback. Sessions were 5 days apart, and blood draws were obtained every 5 to 10 minutes.Mean concentrations and pulsatile characteristics of ACTH and cortisol over 12 hours were not statistically different between the 2 groups. Healthy controls had a somewhat higher ( p  < 0.08) net peak, but not net integrated, cortisol response to cosyntropin relative to the alcohol-dependent women. There were no significant group differences in either the ACTH or cortisol response to dexamethasone nor in the net cortisol response to cosyntropin following dexamethasone.Significant differences in pituitary–adrenal function were not apparent between alcohol-dependent women and matched controls. Despite the small n , it appears that alcohol-dependent women do not show the same disruptions in HPA activity as alcohol-dependent men. These findings may have relevance for gender-specific treatment effectiveness.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79204/1/j.1530-0277.2010.01164.x.pd

Fossil Pollen and Insect Evidence for Postglacial Environmental Conditions, Nushagak and Holitna Lowland Regions, Southwest Alaska

This paper discusses the results of pollen and insect analyses of postglacial samples from the Nushagak and Holitna lowlands, southwest Alaska. Although radiocarbon dating control is poor, the samples can be arranged in a relative-age sequence based on stratigraphic occurrence. The fossil pollen data record the regional transition from a late-glacial dry graminoid tundra through the postglacial Birch, Alder, and Spruce zones. The lack of xeric insect species in the early postglacial suggests that the lowlands of southwest Alaska experienced maritime climatic conditions, in contrast to the interior. Rapid climatic warming is subsequently indicated by the fossil insect data, although the arrival of alder in the region postdates 8500 yr BP. There is no evidence for coniferous forest in the Nushagak lowland at any time in the postglacial, although spruce arrived in the Holitna lowland in the mid-postglacial.Key words: pollen analysis, fossil insects, paleoenvironments, postglacial, southwest AlaskaR&Eacute;SUM&Eacute;. Cet article traite des r&eacute;sultats d&rsquo;analyses polliniques et d&rsquo;insectes d&rsquo;&eacute;chantillons postglaciaires venant des basses-terres de Nushagak et d&rsquo;Holitna, dans le sud-ouest de l&rsquo;Alaska. Bien que le contr&ocirc;le de la datation par le radiocarbone soit m&eacute;diocre, les &eacute;chantillons peuvent &ecirc;tre class&eacute;s en ordre d&rsquo;&acirc;ger elatif, d&rsquo;apr&egrave;s leur occurrence stratigraphique. Les donn&eacute;es de pollens fossiles traduisent le passage de la r&eacute;gion d&rsquo;une toundra s&egrave;che de gramin&eacute;es datant de la fin de l&rsquo;&eacute;poque glaciaire, &agrave; des zones postglaciaires de bouleaux, d&rsquo;aulnes et d&rsquo;&eacute;pic&eacute;as. L&rsquo;absence d&rsquo;esp&egrave;ces d&rsquo;insectes x&eacute;rophiles au d&eacute;but du postglaciaire donne &agrave; penser que les basses-terres du sud-ouest de l&rsquo;Alaska ont connu des conditions climatiques maritimes, contrairement &agrave; l&rsquo;int&eacute;rieur. Les donn&eacute;es sur les insectes fossiles permettent donc d&rsquo;&eacute;tablir qu&rsquo;il y a eu un r&eacute;chauffement climatique rapide, bien que l&rsquo;arriv&eacute;e de l&rsquo;aulne dans la r&eacute;gion soit post&eacute;rieure &agrave; 8500 ans avant le pr&eacute;sent. On n&rsquo;a pas de preuve de l&rsquo;existence d&rsquo;une for&ecirc;t de coniferes dans la basse-terre de Nushagak &agrave; un moment quelconque du postglaciaire, bien que l&rsquo;&eacute;pic&eacute;a fasse son arriv&eacute;e dans la basse-terre d&rsquo;Holitna au milieu du postglaciaire.Mots cl&eacute;s: analyse pollinique, insectes fossiles, pal&eacute;oenvironnements, postglaciaire, sud-ouest de l&rsquo;Alask

Using a Trait Approach to Analyze the Impact of Global Information Technology Applications

The objective of this study is to investigate how global IT applications are being used and to develop a means of assessing their impact. Building on the prior work of Palvia (1997), Sethi and King (1994), and Mahmood and Soon (1991), a multi-factor global IT impact model is developed. This model exhibits a high degree of reliability and validity. From a theoretical perspective, this study develops a measurement model that can be used to evaluate the use and impact of IT in a global environment. From a practitioner’s point of view, the study provides a better understanding of the factors that influence the use and impact of global IT applications