Effects of preprandial versus postprandial nutritional insulin administration in the inpatient setting.

Aims: Hospitalized patients can have inconsistent nutritional intake due to acute illness, changing diet, or unpredictable meal delivery. The aim of this study was to evaluate whether implementation of a hospital-wide policy shifting nutritional insulin administration from pre-meal to post-meal was associated with changes in glycemic control or length of stay (LOS).

Methods: This retrospective study performed at a community hospital evaluated adult inpatients receiving nutritional insulin across three time periods.

Development of Quality Measures for Inpatient Diabetes Care and Education Specialists: A Call to Action.

Diabetes and hyperglycemia are associated with an increased risk of in-hospital complications that lead to longer lengths of stay, increased morbidity, higher mortality, and risk of readmission. Diabetes care and education specialists (DCESs) working in hospital settings are uniquely prepared and credentialed to serve as content experts to facilitate change and implement processes and programs to improve glycemic-related outcomes. A recent survey of DCESs explored the topic of productivity and clinical metrics.

Phytomanagement of Pb/Zn/Cu tailings using biosolids-biochar or -humus combinations: Enhancement of bioenergy crop production, substrate functionality, and ecosystem services.

The extreme characteristics of mine tailings generally prohibit microbial processes and natural plant growth. Consequently, vast and numerous tailings sites remain barren for decades and highly susceptible to windblown dust and water erosion. Amendment-assisted phytostabilization is a cost-effective and ecologically productive approach to mitigate the potential transport of residual metals.

Amendment-assisted revegetation of mine tailings: improvement of tailings quality and biomass production.

Mining activities have left a legacy of metals containing tailings impoundments. After mine closure, reclamation of mine wastes can be achieved by restoration of a vegetation cover. This study investigated the impact of biochar (BC), biosolids (BS), humic substances (HS), and mycorrhizal fungi (MF) for improving mine tailings fertility and hydraulic properties, supporting plant establishment, tailings revegetation, and enabling growth of energy crops.

Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans.

Phylogeography of sea oats (Uniola paniculata), a dune-building coastal grass in southeastern North America.

We tested the hypothesis that Uniola paniculata populations are divided into eastern and western lineages, with the primary geographic break at the southern tip of Florida, as observed in codistributed animal taxa. We asked whether the geographic distribution of chloroplast DNA (cpDNA) variation in U. paniculata corresponds to 1) genetic structure in nuclear variation reported in previous studies, and 2) the geographic distribution of morphological adaptive traits reported in previous studies.

The impact of landscape disturbance on spatial genetic structure in the Guanacaste tree, Enterolobium cyclocarpum (Fabaceae).

We examined spatial genetic structure (SGS) in Enterolobium cyclocarpum (the Guanacaste tree), a dominant tree of Central American dry forests in 4 sites in Guanacaste Province, Costa Rica. In disturbed dry forest sites (e.g.

The business case for quality.

Among the lessons St. Joseph Medical Center learned in implementing a diabetes care management program were that: There is a sound business case for quality with such a program. A sound business plan based on a track record of accomplishments by other organizations is key to gaining clinician buy-in.

Comparison of clonal diversity in mountain and Piedmont populations of Trillium cuneatum (Melanthiaceae-Trilliaceae), a forest understory species.

The balance between clonal and sexual reproduction can vary widely among plant populations, and the extent of clonality may be influenced by the combined effects of historical land use and variation in environmental conditions. We investigated patterns of clonal spread in five Trillium cuneatum populations, two in the Appalachian Mountains characterized by mesic, cooler conditions, and three at lower elevations experiencing warmer, drier conditions and greater disturbance. Using a new measure of the genet effective number and innovative orthogonal contrast methods, we quantified genet structure, contrasting clonal growth in the mountains with that in the Piedmont.

A heterogeneity test for fine-scale genetic structure.

For organisms with limited vagility and/or occupying patchy habitats, we often encounter nonrandom patterns of genetic affinity over relatively small spatial scales, labelled fine-scale genetic structure. Both the extent and decay rate of that pattern can be expected to depend on numerous interesting demographic, ecological, historical, and mating system factors, and it would be useful to be able to compare different situations. There is, however, no heterogeneity test currently available for fine-scale genetic structure that would provide us with any guidance on whether the differences we encounter are statistically credible.

Pollen-mediated gene dispersal within continuous and fragmented populations of a forest understorey species, Trillium cuneatum.

Pollen movement plays a critical role in the distribution of genetic variation within and among plant populations. Direct measures of pollen movement in the large, continuous populations that characterize many herbaceous plant species are often technically difficult and biologically unreliable. Here, we studied contemporary pollen movement in four large populations of Trillium cuneatum.