Exploring patient perspectives on shared decision making about bariatric surgery in two healthcare systems.

Objective: To assess patient perspectives on the level of shared decision making (SDM) experienced related to bariatric surgery.

Background: Severe obesity is common and has serious health implications. Yet, few eligible patients pursue bariatric surgery.

Identifying barriers to shared decision-making about bariatric surgery in two large health systems.

Objective: Prior research suggests shared decision-making (SDM) could improve patient and health care provider communication about bariatric surgery. The aim of this work was to identify and prioritize barriers to SDM around bariatric surgery to help guide implementation of SDM.

Methods: Two large US health care systems formed multidisciplinary teams to facilitate the implementation of SDM around bariatric surgery.

Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards.

Background: Patients and clinicians expect patient decision aids to be based on the best available research evidence. Since 2005, this expectation has translated into a quality dimension of the International Patient Decision Aid Standards.

Methods: We reviewed the 2005 standards and the available literature on the evidence base of decision aids as well as searched for parallel activities in which evidence is brought to bear to inform clinical decisions.

A systematic development process for patient decision aids.

Background: The original version of the International Patient Decision Aid Standards (IPDAS) recommended that patient decision aids (PtDAs) should be carefully developed, user-tested and open to scrutiny, with a well-documented and systematically applied development process. We carried out a review to check the relevance and scope of this quality dimension and, if necessary, to update it.

Methods: Our review drew on three sources: a) published papers describing PtDAs evaluated in randomised controlled trials and included in the most recent Cochrane Collaboration review; b) linked papers cited in the trial reports that described how the PtDAs had been developed; and c) papers and web reports outlining the development process used by organisations experienced in developing multiple PtDAs.

Redundant manipulator techniques for partially decentralized path planning and control of a platoon of autonomous vehicles.

An approach to real-time trajectory generation for platoons of autonomous vehicles is developed from well-known control techniques for redundant robotic manipulators. The partially decentralized structure of this approach permits each vehicle to independently compute its trajectory in real-time using only locally generated information and low-bandwidth feedback generated by a system exogenous to the platoon. Our work is motivated by applications for which communications bandwidth is severely limited, such for platoons of autonomous underwater vehicles.

Dislodgeable copper, chromium and arsenic from CCA-treated wood surfaces.

Chromated copper arsenate (CCA) is commonly used to preserve wood, but its use poses risk of arsenic exposure. In order to evaluate the extent of exposure to As from physical contact with CCA-treated wood, dislodgeable As from treated wood surfaces (as well as Cu and Cr) was determined as a function of weathering time using dampened polyester wipe materials. Six sets of 2.

Treatment of a colored groundwater by ozone-biofiltration: pilot studies and modeling interpretation.

Pilot studies investigated the fates of color, dissolved organic carbon (DOC), and biodegradable organic matter (BOM) by the tandem of ozone plus biofiltration for treating a source water having significant color (50 cu) and DOC (3.2 mg/l). Transferred ozone doses were from 1.

The transient-state, multiple-species biofilm model for biofiltration processes.

We describe the transient-state, multiple-species biofilm model (TSMSBM), which is a novel synthesis of key modeling features needed to describe multiple-species biofilms that experience time-varying conditions, particularly including periodic detachment by backwashing. The TSMSBM includes six features that are essential for describing multiple-species biofilms that undergo changes over time: (1) four biomass types: heterotrophs, ammonia oxidizers, nitrite oxidizers, and inert biomass; (2) seven chemical species: input biodegradable organic material (BOM), NH4(+)-N, NO2(-)-N, NO3(-)-N, utilization-associated products, biomass-associated products, and dissolved oxygen; (3) eight reactions that describe the rates of consumption or production of the different species, as well as the stoichiometric linkages among the rates; (4) reaction with diffusion of all the soluble species in the biofilm; (5) growth, decay, detachment, and flux of each biomass type by location in the biofilm; and (6) constant or periodic detachment of biofilm, both of which allow for protection of biomass deep inside the biofilm. The last two features of the TSMSBM provide novel additions to biofilm modeling, and the synthesis of all features is a unique advancement.

Accumulation of polychlorinated terphenyls in aquatic biota of an estuarine creek.

Aroclor 5432, a mixture of polychlorinated terphenyls (PCT), was detected in several biological compartments including saltmarsh cordgrass (Spartina alterniflora), American oysters (Crassostrea virginica), red-jointed fiddler crabs (Uca minax), wharf crabs (Sesarma reticulatum), and mummichogs (Fundulus heteroclitus) collected from Tabbs Creek. This tidal creek is located in the southern Chesapeake Bay region and contains sediments with high concentrations of PCT. Samples were collected at four sites, ranging from a suspected outfall near the head of the creek, to its mouth, approximately 2.

Health promotion for older people: all is not well.

The changing nature of disease risks and functional health status with aging suggests the need to focus health promotion efforts in the older population where they will be most effective in reducing morbidity, mortality, and disability. However, there is little consensus in the literature regarding the efficacy of various health promotion practices and the appropriate target groups within a diverse older population. Careful research on and thoughtful application of findings to this older population are needed to ensure the effective use of limited health promotion resources.

Naloxone and shuttlebox self-stimulation in the rat.

Rats self timed electrical brain stimulation on and off periods in a shuttlebox. Electrodes for self-stimulation were located either in the lateral hypothalamic area (LHA) or the periaqueductal gray (PAG). Doses of the narcotic antagonist, naloxone, were administered intraperitoneally immediately prior to self-stimulation testing.

Morphine and shuttlebox self-stimulation in the rat: tolerance studies.

Rats were trained to turn lateral hypothalamic electrical brain stimulation on and off by crossing back and forth in a shuttlebox. Injections of 10 mg/kg morphine doubled the amount of time animals left the stimulation ON without altering OFF times. Tolerance did not develop to this action during 5 daily trials.

Morphine and shuttle-box self-stimulation in the rat: a model for euphoria.

In a shuttle-box self-stimulation paradigm, analgesic doses of morphine increase the amount of time a rat leaves rewarding brain stimulation on, without altering average OFF times. This paradigm may serve as a model for the euphoria induced by narcotic drugs and as a useful tool for evaluating the reinforcing effects of drugs.