Knowledge and Awareness Among Patients with Chronic Kidney Disease Stage 3

Knowledge is a prerequisite for changing behavior, and is useful for improving outcomes and reducing mortality rates in patients diagnosed with chronic kidney disease (CKD). The purpose of this article is to describe baseline CKD knowledge and awareness obtained as part of a larger study testing the feasibility of a self-management intervention. Thirty patients were recruited who had CKD Stage 3 with coexisting diabetes and hypertension. Fifty-four percent of the sample were unaware of their CKD diagnosis. Participants had a moderate amount of CKD knowledge. This study suggests the need to increase knowledge in patients with CKD Stage 3 to aid in slowing disease progression

An innovative approach to improve ear, nose and throat surgical access for remote living Cape York Indigenous children

Introduction: On a background of high rates of severe otitis media (OM) with associated hearing loss, children from the Torres Strait and Cape York region requiring ear, nose and throat (ENT) surgery, faced waiting times exceeding three years. After numerous clinical safety incidents were raised, indicating a failure of the current system to deliver appropriate care, the governing Hospital and Health service opted to deliver surgical care through an alternate process. ENT surgeries were performed on 16 consented children from two remote locations via the private health care system, funded by a health provider partnership. Methods: We examined the collaboration processes alongside clinical findings from this ENT surgery. Collated patient data, included patient demographics, clinical and audiometry presentation features were reviewed and compared pre and post-operatively. Cost savings associated with the use of TeleHealth post-operatively were briefly examined. Results: Surgeries were successfully completed in all 16 children. The reported mean waitlist time for ENT surgery was 1.2 years. Pre-surgery pure-tone average hearing thresholds were reported at left: 30.9 dB, right: 38.2 dB. The majority of presentations were for bilateral OM with Effusion (69%). Post-surgical follow up indicated successful clinical outcomes in 80% of patients and successful hearing outcomes in 88% of patients. Mean difference pure-tone average hearing thresholds, left: 8.4 dB and right: 11.2 dB. Furthermore, the majority of patients reported improved hearing and breathing. The use of TeleHealth for post-operative review enabled a minimum cost saving of AUD$21,664 for these 16 children. Overall, a high level of staffing resources was required to successfully coordinate this intense surgical activity. Conclusion: This innovative approach to a health system crisis enabled successful ENT surgical and hearing outcomes in 16 children, whose waitlisted time grossly exceeded state health recommendations. Using private health facilities funded by a health partnership, while unlikely to be a suitable model of care for routine service delivery; may be applied as an adjunct service model when blockages and delays lead to sub-standard service provision. This approach may be applicable to other health care facilities when facing extended elective surgery wait times in ENT or other specialty areas

Movements of Spawning and Non-Spawning Shovelnose Sturgeon in the Missouri River Above Fort Peck Reservoir

During the last 40 yrs there has been a lack of pallid sturgeon (Scaphirhynchus albus) recruitment in the upper Missouri River (UMR). However, shovelnose sturgeon (Scaphirhynchus platorynchus) continue to exhibit recruitment in the UMR. Understanding the recruitment dichotomy between species is receiving much attention throughout their range. The objectives of this study were to identify the effects of varying discharge on spawning locations and spawning movements for pallid and shovelnose sturgeon. Two female pallid sturgeon, 32 gravid female shovelnose sturgeon, and 32 non-reproductively active female shovelnose sturgeon were radio tagged at three locations and tracked from 1 May to 5 July 2009. Unfortunately, no data are available for spawning pallid sturgeon movements because fish were not reproductively active. Upstream movement by gravid shovelnose sturgeon varied from 20 percent of the fish tagged at Judith Landing to 56 percent of the fish tagged at Coal Banks Recreation Area (CBRA). Mean maximum upstream movement of gravid shovelnose sturgeon varied from 35.7 km at CBRA to 87.9 km at Fred Robinson Bridge (FRB), mean maximum downstream movement varied from 24.9 km at FRB to 80.3 km at CBRA. Reproductively inactive shovelnose sturgeon exhibited lower mean maximum movements than reproductively active fish (mean maximum distance 5.7 km). Shovelnose sturgeon in the UMR exhibit both upstream and downstream movements prior to spawning and are using several spawning areas. Thus, maintaining spawning habitat throughout a regulated river is important with regard to shovelnose sturgeon conservation

The Journey Home- Guiding Intangible Knowledge Production in the Analysis of Ancestral Remains (Final Report)

This study, co-developed by David Schaepe, Director, Stó:lo Research and Resource Management Centreand Susan Rowley, Associate Professor, Department of Anthropology, University of British Columbia, stems from the Journey Home Project, a repatriation of ancestral remains from the UBC Lab of Archaeology (LOA) to the Stó:lo Nation of southwestern B.C.    For the Stó:lo, knowing as much as possible about these ancestors informs their process. How can scientific research address Stó:lo questions and aid this repatriation? Opportunity recently arose for scientific study, stimulating a Stó:lo-LOA dialogue touching on multiple issues of scientific process, knowledge production and intellectual property. What types of anthropological research and scientific analyses can be applied to answer community-based questions? What are the details and cultural implications of analyses — both destructive and non-destructive? Who decides which questions to ask and which means of research to implement? Who interprets the results? Who owns those data? How do ‘scientific’ and ‘cultural’ ways of knowing relate? Who is allowed to share in and benefit from this knowledge? These questions are central to the Stó:lo ’s relationship with both their ancestors and LOA.   This study aims to provide guidelines for generating knowledge within a mutually acceptable framework of authority, control, and use. These critical issues are at the forefront of our conversations as we work together to complete The Journey Home

Volume 19. Article 2. Aspects of oceanography of Long Island Sound.

https://elischolar.library.yale.edu/bulletin_yale_bingham_oceanographic_collection/1166/thumbnail.jp

Rotational dynamics and heating of trapped nanovaterite particles

We synthesize, optically trap, and rotate individual nanovaterite crystals with a mean particle radius of 423 nm. Rotation rates of up to 4.9 kHz in heavy water are recorded. Laser-induced heating due to residual absorption of the nanovaterite particle results in the superlinear behavior of the rotation rate as a function of trap power. A finite element method based on the Navier-Stokes model for the system allows us to determine the residual optical absorption coefficient for a trapped nanovaterite particle. This is further confirmed by the theoretical model. Our data show that the translational Stokes drag force and rotational Stokes drag torque need to be modified with appropriate correction factors to account for the power dissipated by the nanoparticle

Multi-wavelength Data Analysis of ONC X-ray Sources

To take advantage of the increasing amount of available multi-wavelength astronomical data, we are statistically merging data from several wavelength regimes to analyze astronomical objects. This simultaneous analysis of emission across a wide range of wavelengths will help to provide a composite understanding of young stellar objects. A statistical clustering technique coupled with fused multi-wavelength data from the optical, infrared, and X-ray can provide insight into the physical mechanisms responsible for the intense emission from young stars in different wavelength regimes and can be used to view trends and correlations between those regimes. We present some details of the data fusion followed by our results thus far analyzing spectral data from pre-main sequence (PMS) stars in the Orion Nebula Cluster (ONC)

Low-cost, high-resolution imaging for detecting cervical precancer in medically-underserved areas of Texas

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940\u27s, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center. METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers of varying skill and training. Colposcopy, followed by HRME imaging, was performed on eligible women. The sensitivity and specificity of traditional colposcopy and colposcopy followed by HRME to detect CIN2+ were compared and HRME image quality was evaluated. RESULTS: 174 women (227 cervical sites) were included in the final analysis, with 12% (11% of cervical sites) diagnosed with CIN2+ on histopathology. On a per-site basis, a colposcopic impression of low-grade precancer or greater had a sensitivity of 84% and a specificity of 45% to detect CIN2+. While there was no significant difference in sensitivity (76%, p = 0.62), the specificity when using HRME was significantly higher than that of traditional colposcopy (56%, p = 0.01). There was no significant difference in HRME image quality between clinical sites (p = 0.77) or medical providers (p = 0.33). CONCLUSIONS: HRME imaging increased the specificity for detecting CIN2+ when compared to traditional colposcopy. HRME image quality remained consistent across different clinical settings