Zephyr: The Thirteenth Issue

This is the thirteenth issue of Zephyr, the University of New England\u27s journal of creative expression. Since 2000, Zephyr has published original drawings, paintings, photography, prose, and verse created by current and former members of the University community. Zephyr\u27s Editorial Board is made up exclusively of matriculating students.https://dune.une.edu/zephyr/1012/thumbnail.jp

Zephyr: The Fourteenth Issue

This is the fourteenth issue of Zephyr, the University of New England\u27s journal of creative expression. Since 2000, Zephyr has published original drawings, paintings, photography, prose, and verse created by current and former members of the University community. Zephyr\u27s Editorial Board is made up exclusively of matriculating students.https://dune.une.edu/zephyr/1013/thumbnail.jp

Zephyr: The Twelfth Issue

This is the twelfth issue of Zephyr, the University of New England\u27s journal of creative expression. Since 2000, Zephyr has published original drawings, paintings, photography, prose, and verse created by current and former members of the University community. Zephyr\u27s Editorial Board is made up exclusively of matriculating students.https://dune.une.edu/zephyr/1011/thumbnail.jp

Rationale and design of the Novel Uses of adaptive Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) pragmatic adaptive randomized trial: a trial protocol

Background: The prescribing of high-risk medications to older adults remains extremely common and results in potentially avoidable health consequences. Efforts to reduce prescribing have had limited success, in part because they have been sub-optimally timed, poorly designed, or not provided actionable information. Electronic health record (EHR)-based tools are commonly used but have had limited application in facilitating deprescribing in older adults. The objective is to determine whether designing EHR tools using behavioral science principles reduces inappropriate prescribing and clinical outcomes in older adults. Methods: The Novel Uses of Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) project uses a two-stage, 16-arm adaptive randomized pragmatic trial with a “pick-the-winner” design to identify the most effective of many potential EHR tools among primary care providers and their patients ≥ 65 years chronically using benzodiazepines, sedative hypnotic (“Z-drugs”), or anticholinergics in a large integrated delivery system. In stage 1, we randomized providers and their patients to usual care (n = 81 providers) or one of 15 EHR tools (n = 8 providers per arm) designed using behavioral principles including salience, choice architecture, or defaulting. After 6 months of follow-up, we will rank order the arms based upon their impact on the trial’s primary outcome (for both stages): reduction in inappropriate prescribing (via discontinuation or tapering). In stage 2, we will randomize (a) stage 1 usual care providers in a 1:1 ratio to one of the up to 5 most promising stage 1 interventions or continue usual care and (b) stage 1 providers in the unselected arms in a 1:1 ratio to one of the 5 most promising interventions or usual care. Secondary and tertiary outcomes include quantities of medication prescribed and utilized and clinically significant adverse outcomes. Discussion: Stage 1 launched in October 2020. We plan to complete stage 2 follow-up in December 2021. These results will advance understanding about how behavioral science can optimize EHR decision support to improve prescribing and health outcomes. Adaptive trials have rarely been used in implementation science, so these findings also provide insight into how trials in this field could be more efficiently conducted. Trial registration: Clinicaltrials.gov (NCT04284553, registered: February 26, 2020

Texas Business Review, November 1961

The Business Situation in Texas; Residential Building Spurs Record; Inorganic Chemicals: A Texas Survey; Retail Trade: With A Quarter To Go; Population Growth in the Small Urban Places of TexasBureau of Business Researc

Can the Inca site of Choqek'iraw be considered an agro-pastoral calendar?

International audience"Situated in the heart of the Vilcabamba cordillera in Peru, some 150 km northwest of Cuzco, the ancient Inca state capital, Choqek'iraw or Choquequirao (“the golden cradle” in Quechua), is one of the most beautiful achievements of Inca architecture, and one of the very few pre-Hispanic sites displaying large wall mosaics, the only one known from Inca times. This article will attempt to demonstrate that the figures represented on the walls convey cosmological significance and are laid out following textile principles. After describing the site and its geo-cultural setting, the mosaics' main characteristics will be examined in detail, in an attempt to grasp their meaning. Finally, the author suggests that some of the scenes depicted could have been inspired by pre-Columbian myths and could be linked to astronomical concepts." (source éditeur)"Ubicado en el corazón de la cordillera de Vilcabamba, a unos 150 kilómetros de Cuzco, la antigua capital del estado inca, Choqek'iraw o Choquequirao (la cuna del oro en quechua), es uno de los logros más hermosos de la arquitectura Inca y el único sitio de época inca, con un gran mosaico mural. En este trabajo se intentará demostrar que las figuras representadas en las paredes podrían transmitir significado cosmológico y se distribuyen siguiendo principios textiles. Asimismo, después de hacer una breve descripción del sitio, ubicándolo en sus contextos geográfico y cultural, se analizarán las principales decoraciones que allí se encuentran para tratar de entenderlas. Los temas representados podrían referirse a antiguos mitos andinos y concepciones de orden astronómicos." (source éditeur