Improving the Quality and Delivery of Substance Use Disorder Resource List

Introduction The state of New Mexico has numerous organizations that help individuals with substance use disorders (SUDs). University of New Mexico Hospital (UNMH) social workers had previously started a list of these resources; however, it was neither updated nor used often. We aim to improve the quality, awareness, and delivery of this list on UNMH internal medicine (IM) inpatient units. Methods To improve the quality of the list we developed a concise SUD resource document using the pre-existing list as a template. We modified the list after feedback from patients, providers and literacy specialists. The final list was organized alphabetically and categorized according to the services offered, with brief descriptions about each facility added. For baseline data on awareness of the list, we administered surveys to available inpatient IM providers. 31st increase the awareness of the list, we educated IM residents on clinical inpatient services at UNMH biweekly about its purpose and availability. We administered surveys before each education session for two months. To improve the accessibility of the list, we regularly supplied each resident workroom with the resource list. After receiving hospital approval, we uploaded the list onto the UNMH electronic medical record system. Results At baseline, we surveyed 37 IM providers. 89% viewed the delivery of resources to patients with SUD as important. Of this group, 55% were aware that the list was available to give patients and only 20% of them knew how to access it. After two months of education, 100% of surveyed providers viewed the delivery of resources to patients with SUD as important. We increased the awareness and knowledge of its accessibility by 18% and 60%, respectively, from baseline. Conclusion Our quality improvement project increased awareness and ease of access of the SUD resource list. These successes demonstrate that a simple delivery method for resource lists can be implemented in a short time. Our next steps include spreading awareness of how to access the list electronically through biweekly education sessions and ongoing surveying, as well as educating other hospital departments. We are currently assessing whether retrospective chart reviews may help determine the frequency of its use

An analysis of the ABO blood group clines in Europe

With estimates of the fitnesses of the genotypes and selection by incompatibility for the ABO locus which seem reasonable given the state of knowledge, a computer model has been developed to replicate the clines of the A and B genes in Europe. With a fitness change in the BB and BO genotypes of as little as 0.5%, the differences in the frequencies in East and West Europe can be maintained at equilibrium. Appreciable changes in the amount of migration does not affect the equilibrium frequencies in the two areas significantly, while with no selection through incompatibility the equilibrium frequencies were changed about 5%.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37489/1/1330310102_ftp.pd

Medial temporal lobe activation during encoding and retrieval of novel face-name pairs

The human medial temporal lobe (MTL) is known to be involved in declarative memory, yet the exact contributions of the various MTL structures are not well understood. In particular, the data as to whether the hippocampal region is preferentially involved in the encoding and/or retrieval of associative memory have not allowed for a consensus concerning its specific role. To investigate the role of the hippocampal region and the nearby MTL cortical areas in encoding and retrieval of associative versus non-associative memories, we used functional magnetic resonance imaging (fMRI) to measure brain activity during learning and later recognition testing of novel face-name pairs. We show that there is greater activity for successful encoding of associative information than for non-associative information in the right hippocampal region, as well as in the left amygdala and right parahippocampal cortex. Activity for retrieval of associative information was greater than for non-associative information in the right hippocampal region also, as well as in the left perirhinal cortex, right entorhinal cortex, and right parahippocampal cortex. The implications of these data for a clear functional distinction between the hippocampal region and the MTL cortical structures are discussed. © 2004 Wiley-Liss, Inc

On the Existence of Undistorted Progressive Waves (UPWs) of Arbitrary Speeds 0≤v<∞0 \leq v< \infty in Nature

We present the theory, the experimental evidence, and fundamental physical consequences concerning the existence of families of undistorted progressive waves (UPWs) of arbitrary speeds $0\leq v < \infty$, which are solutions of the homogeneous wave equation, Maxwell equations, and Dirac and Weyl equations.Comment: 77 pages, Latex article, with figures. Includes corrections to the published versio

The interaction of bacterial pathogens with platelets.

In recent years, the frequency of serious cardiovascular infections such as endocarditis has increased, particularly in association with nosocomially acquired antibiotic-resistant pathogens. Growing evidence suggests a crucial role for the interaction of bacteria with human platelets in the pathogenesis of cardiovascular infections. Here, we review the nature of the interactions between platelets and bacteria, and the role of these interactions in the pathogenesis of endocarditis and other cardiovascular diseases

Cardiac Catheterization after Bypass Surgery

After coronary artery bypass graft (CABG) surgery, the typical patient will have progression of the original native coronary disease as well as atherosclerosis of the bypass grafts. When this leads to angina or myocardial infarction, repeat cardiac catheterization may be necessary. However, the risks of catheterization in post-CABG patients are higher than in non-CABG patients, and the benefits are smaller, so optimal medical therapy should be employed and clear indications should be present before post-CABG catheterization is undertaken. In the past decade, two advancements have been made in strategies for post-CABG catheterization. First, for patients with a left internal mammary artery graft, left radial access should be routinely used and is safer than femoral access. Second, diseased saphenous vein bypass grafts may offer a retrograde approach to chronic total occlusions of the native artery. When successful, retrograde stenting of the bypassed native coronary artery is more durable than interventions on the saphenous vein graft supplying it. This chapter summarizes indications, techniques, and tricks of catheterization and strategies for coronary intervention in patients with prior CABG