Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care.

Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities.

An Examination of the Surface and Sub-Surface of Modern and Historical Platinum Photographic Prints Using Low Vacuum High-Resolution Scanning Electron Microscopy.

Photographic prints of platinum metal on paper supports are some of the most exquisite and expressive in the world of fine art photography. Platinum prints were produced from about 1890 to 1920 in the USA and Europe. The chemical and material nature of these valuable prints is of great interest to many who are interested in their long-term preservation, in the intersection of science and art, and in the scientific and technical study of cultural heritage.

Fine Particulate Matter Pollution and Hospital Admissions for Respiratory Diseases in Beijing, China.

Fine particulate matter has become the premier air pollutant of Beijing in recent years, enormously impacting the environmental quality of the city and the health of the residents. Fine particles with aerodynamic diameters of 0~0.3 μm, 0.

Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans: A Prospective, Randomized, Placebo-Controlled Trial.

Introduction: Chronic lower back pain (CLBP) is problematic in older veterans. Spinal manipulative therapy (SMT) is commonly utilized for CLBP in older adults, yet there are few randomized placebo-controlled trials evaluating SMT.

Methods: The purpose of the study was to compare the effectiveness of SMT to a sham intervention on pain (Visual Analogue Scale, SF-36 pain subscale), disability (Oswestry Disability Index), and physical function (SF-36 subscale, Timed Up and Go) by performing a randomized placebo-controlled trial at 2 Veteran Affairs Clinics.

Evaluation of a modified clinical prediction rule for use with spinal manipulative therapy in patients with chronic low back pain: a randomized clinical trial.

Background: Spinal Manipulative Therapy (SMT) and Active Exercise Therapy (AET) have both demonstrated efficacy in the treatment of Chronic Lower Back Pain (CLBP). A Clinical Prediction Rule (CPR) for responsiveness to SMT has been validated in a heterogeneous lower back pain population; however there is a need to evaluate this CPR specifically for patients with CLBP, which is a significant source of disability.

Methods: We conducted a randomized controlled trial (RCT) in Veteran Affairs and civilian outpatient clinics evaluating a modification of the original CPR (mCPR) in CLBP, eliminating acute low back pain and altering the specific types of SMT to improve generalizability.

Spatial distance effect of bienzymes on the efficiency of sequential reactions in a microfluidic reactor packed with enzyme-immobilized microbeads.

Three different configurations of microfluidic reactors packed with enzyme-bearing microbeads were examined to show that the overall efficiency of coupled enzyme-catalyzed reactions depends on the spatial relationship of two enzymes immobilized on the bead surfaces. The spatial distances of glucose oxidase (GOx) and horseradish peroxidase (HRP) enzymes were controlled by using microbeads as a supporting matrix for immobilizing the two enzymes and packing them in two microfluidic chambers. A microreactor packed with microbeads coimmobilized with the two enzymes showed a better overall reaction efficiency than the other two reactors, where the two enzymes were spatially distant, under a flow condition.

Empathic responsivity at 3 years of age in a sample of cocaine-exposed children.

This study examined the association between prenatal exposure to cocaine and behavioral and physiological responsivity. Participants were 216 mother-infant dyads (116 cocaine exposed-CE, 100 nonexposed-NCE) recruited at birth. Measures of heart rate (HR) and respiratory sinus arrhythmia (RSA) were obtained during baseline and during a task designed to elicit empathy (exposure to infant crying).

Profiles of Reactivity in Cocaine-Exposed Children.

This study explored the possibility that specific, theoretically consistent profiles of reactivity could be identified in a sample of cocaine-exposed infants and whether these profiles were associated with a range of infant and/or maternal characteristics. Cluster analysis was used to identify distinct groups of infants based on physiological, behavioral and maternal reported measures of reactivity. Five replicable clusters were identified which corresponded to 1) Dysregulated/High Maternal Report Reactors, 2) Low Behavioral Reactors, 3) High Reactors, 4) Optimal Reactors and 5) Dysregulated/Low Maternal Report Reactors.

Modeling TGF-mediated flow dynamics in a system of three coupled nephrons.

This paper focuses on a mathematical model of a system of three closely coupled nephrons and accompanying analytical and computational analysis. In our previous modeling efforts, we have shown how coupling magnifies the tendency of many coupled identical nephrons to oscillate owing to tubuloglomerular feedback (TGF) mechanism. However, in this study, our focus is on the coupled nonidentical nephrons and their dynamics due to the TGF system.

Clusters in irregular areas and lattices.

Geographic areas of different sizes and shapes of polygons that represent counts or rate data are often encountered in social, economic, health, and other information. Often political or census boundaries are used to define these areas because the information is available only for those geographies. Therefore, these types of boundaries are frequently used to define neighborhoods in spatial analyses using geographic information systems and related approaches such as multilevel models.

Pregnancy and adoption among infertile women following ovulation induction and intrauterine insemination.

Using a retrospective cohort study, 214 clinically diagnosed infertile women who underwent ovulation induction and intrauterine insemination between 1991 and 1994 at a hospital-based centre of reproductive medicine, were followed up 5 years after treatment to assess their overall health, pregnancy and adoption status. Multivariate logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for these outcomes, adjusted for age, education, infertility diagnosis, infertility status, parity, number of prior intrauterine insemination cycles, pregnancy following intrauterine insemination treatment, and undergoing other assisted reproductive procedures. Significant increased likelihood of pregnancy was observed for younger women, for women with secondary versus primary infertility, and for women who underwent other assisted reproductive procedures versus those who did not.