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Instructional designers (IDs) are continually seeking opportunities to share teaching and learning design strategies and learn from their fellow IDs. An application of Community of Practice (CoP) has allowed instructional design professionals to participate in an open learning setting as a way to continue their professional development (PD), share thoughts and ideas, and keep up on the trends and issues related to the field of instructional design. This formative evaluation examined semi-annual, CoP-based PD opportunities held openly in Canvas Learning Management System (LMS), which gathered IDs from around the world to participate in online discussions, presentations, and other knowledge-sharing activities without any cost. Data were collected from the LMS usage log and corroborated by insights from co-founders of the group, presenters, and participants of PD obtained through an anonymous survey. Findings show that the lack of time, issues with trust, bonding, and open communication, as well as less-favored activities influenced ID’s participation in the PD events. Implications for improving the CoP-based PD events are additionally presented.

Instructional designers (IDs) need to maintain an understanding of the current trends and issues within the field. Pursuing professional learning informally supports IDs’ effort to keep up with current trends and issues because it is not restricted by curriculum and time. Professional development (PD) offered by Professional Development for Instructional Designers (PD4IDs) learning group can address issues related to geographical and funding limitations. This application paper presents the coordination of PD based on the conceptual framework (e.g., Community of Practice and Social Network Knowledge Construction) and reflections of several PD4IDs members with various roles. The reflections indicate the benefits of participating in PD for shaping IDs’ professional learning and practices. Discussion and implications for IDs intending to pursue non-traditional PD are also presented.

Background: The incidence and prevalence of aging-related diseases such as dementia and cancer are increasing, as are cancer survival rates. Cancer and its treatments have been associated with cognitive effects for those who later develop dementia. Guidelines have suggested that cancer patients return to follow-up in primary care following remission and be referred to specialists for cognitive complications, but it is unclear how well these guidelines are followed. Methods: Electronic health record data at the University of Alabama at Birmingham were extracted from July 2003 May 2020. Rates of specialty care utilization on or after dementia diagnosis were compared by cancer history status in adults 50 years old or older at dementia diagnosis. Predictors of specialty care utilization were examined using logistic regression. Results: Rate of specialty care utilization was lower for those with cancer history compared to those without on the date of dementia diagnosis (11.3% vs. 17.1%) and after diagnosis (13.5% vs. 19.2%). Older age at dementia diagnosis, non-Hispanic Black race, anticholinergic burden, socioeconomic status, and vascular risk factors were associated with lower odds of specialty care utilization. Dementia medication use was associated with higher odds of specialty care utilization on and after dementia diagnosis. Conclusions: Cancer survivors with a dementia diagnosis are less likely to utilize specialty care than those with no history of cancer. Several factors predicted specialty care utilization. Additional studies should assess potential barriers in referring cancer survivors to specialty care for cognitive impairment.

Cancer-related cognitive impairment is a common effect of cancer that shares symptoms with dementia. Only one study examined cancer’s longitudinal association with dementia. This analysis expands to a larger clinical sample. Electronic health record data were extracted from July 2003-February 2020. Baseline cognition/progression on the Alabama Brief Cognitive Screener (ABCs) by cancer history were assessed using linear mixed effects models, with interaction by race. After adjustment for demographics/socioeconomics, those with cancer history had higher baseline cognition (□: 1.49 [0.91-2.07]), and declined slower (□: 0.40 [0.08-0.71]) than those without. Health behaviors/comorbidities attenuated this association. Non-Hispanic Blacks with cancer history demonstrated lower cognition throughout follow-up compared to non-Hispanic Whites / other race/ethnicities with cancer history and participants without cancer history. Health behaviors/comorbidities confound and race modifies the relationship between cancer and dementia. Exploring the role of health behaviors/comorbidities on this association and causes of racial disparities is needed.

Nurse educators are charged with designing and delivering preparation initiatives that will enable graduates to be successful on the National Council Licensure Examination for Registered Nurses (NCLEX-RN®). Research focusing on nursing students from the time of graduation until they take the NCLEX-RN is limited. To assist with increasing NCLEX-RN pass rates, an innovative approach to mentoring BSN graduates while preparing for the NCLEX-RN was developed. The postgraduate mentorship program was implemented through communication, support, mentoring, and tutoring of BSN students after graduation. Results indicate that the mentorship program was successful at increasing pass rates and was beneficial for students.

Background: The Affordable Care Act increases access to treatment services for people who suffer from substance use disorders (SUDs), including alcohol use disorders (AUDs) and opioid use disorders (OUDs). This increased access to treatment has broad implications for delivering health services and creates a dramatic need for transformation in clinical care, service lines, and collaborative care models. Medication-assisted treatments (MAT) are effective for helping SUD patients reach better outcomes. This article uses electronic health record (EHR) data to examine the prevalence of EHR-documented SUDs, patient characteristics, and patterns of MAT prescribing and screening for patients within the Community Health Applied Research Network (CHARN), a national network of 17 community health centers that facilitates patient-centered outcomes research among underserved populations. Methods: Hierarchical generalized linear models examined patient characteristics, SUD occurrence rates, MAT prescription, and human immunodeficiency virus (HIV) and hepatitis virus C screening for patients with AUDs or OUDs. Results: Among 572,582 CHARN adult patients, 16,947 (3.0%) had a documented AUD diagnosis and 6,080 (1.1%) an OUD diagnosis. Alcohol MAT prescriptions were documented for 547 AUD patients (3.2%) and opioid MAT for 1,764 OUD patients (29.0%). Among OUD patients, opioid MAT was significantly associated with HIV screening (odds ratio [OR] = 1.31, P < .001) in OUD patients, as was alcohol MAT among AUD patients (OR = 1.30, P = .013). Conclusions: These findings suggest that effective opioid and alcohol MAT may be substantially underprescribed among safety-net patients identified as having OUDs or AUDs.

Purpose/objectives To examine whether a one-hour art-making session during blood and marrow transplantation (BMT) treatment significantly affects therapy-related symptoms, state anxiety, and stress. Design A pre- and post-test crossover design. Setting An urban outpatient cancer center in the midwestern United States. Sample A convenience sample of 20 patients, aged 20-68 years (X = 38.5), receiving treatment at a BMT clinic. Methods Participants completed a demographic questionnaire, the Therapy-Related Symptom Checklist, and the Spielberger State-Trait Anxiety Index, and provided salivary cortisol samples. After pretesting, individuals were assigned to either a wait list or intervention. Individuals in the wait-list group received the usual treatment before completing the post-test measures. Individuals in the intervention group participated in a one-hour art-making session, after which they completed post-test measures. Participants then crossed over to the other group. Main research variables Art making, stress, state anxiety, and therapy-related symptoms. Findings Therapy-related symptom concerns for the intervention group at post-test were significantly lower than at pretest; no change ocurred in the control group. The salivary cortisol levels were significantly lower at post-test in the intervention and control groups. No change occurred in the anxiety levels of participants in the intervention and control groups. The study hypothesis was partially supported. Conclusions Art making decreased therapy-related symptoms (e.g., feeling sluggish, difficulty concentrating). Use of more physiologic indices to measure stress and replication on a larger sample are suggested. Implications for nursing Individuals receiving BMT may benefit from participation in art-making interventions. Art making is easy to implement in a clinic setting and allows for positive interactions between nurses and patients.

Peat plateaus are important landscape features of many high-boreal, wetland-dominated drainage basins. Raised up to 2 m above the surrounding landscape and underlain by permafrost, these forested peatlands provide meltwater drainage to the surrounding wetlands, and to basin runoff. Understanding the factors that control the volume and timing of runoff from peat plateaus is the essential first step towards developing methods of accurately predicting basin runoff from wetland-dominated basins in the region of discontinuous permafrost, as well as understanding the basin response to hydrological changes brought on by the thermal degradation and thaw of permafrost peatlands. In this study, a water balance approach and the Dupuit–Forchheimer equation were used to quantify sub-surface runoff from a forested peat plateau at Scotty Creek, a small (152 km2), wetland-dominated discontinuous permafrost basin in Northwest Territories, Canada. These two computations yielded similar results in both years of study (2004–2005), and showed that runoff accounted for approximately half of the moisture loss from the peat plateau, most of which occurred in response to snowmelt inputs. The melt of ground ice was also a significant source of water during the study periods, which was largely detained in soil storage. Soil moisture conditions prior to soil freezing were a major factor controlling the volume of runoff from the hillslope. Sub-surface drainage rates declined dramatically after the snowmelt runoff period, when the majority of water inputs went to soil storage and evapotranspiration. The minimal lag between rain events and hydrograph response in both years suggests that much of the runoff produced from rain events is rapidly transported to the adjacent wetlands. These results give insight into how current climate warming predictions for northern latitudes could affect the hydrological response of forested peat plateaus, and the basins which they occupy. Copyright © 2008 John Wiley & Sons, Ltd.

Hillslope runoff in permafrost regions covered by organic soil is strongly influenced by subsurface flow in the active layer, as well as surface flow where the active layer is very shallow. Flow rates in the organic-rich active layer are strongly dependent on the depth to the thawing front (i.e. frost table) and the corresponding soil hydraulic conductivity at that depth. Therefore, hydrological models for permafrost terrains need to simulate the thawing of the active layer accurately. In order to simulate the downward movement of the frost table, a simple heat-conduction model was proposed and compared to field data from a wet, organic-covered watershed in a discontinuous permafrost region of Canada. Ground heat flux was measured simultaneously using the calorimetric, gradient, and flux-plate methods to increase the confidence in data sets. The majority (>86%) of ground heat flux was used to melt the ice in frozen soil, and the soil temperature had a linear profile from the ground surface to the frost table when averaged over several days. Assuming a linear temperature profile, the proposed method calculates the daily rate of thawing from ground surface temperature and bulk thermal conductivity, where the latter is essentially determined by soil water content. Simulated depths to the frost table during three thaw seasons (2003-2005) matched closely with the observed data for two contrasting ground-cover types with distinctly different thaw rates. The method can be easily implemented in hydrological models, and will provide a useful tool for simulating hillslope drainage in organic-covered permafrost terrains, and for evaluating the effects of topography and land cover on the temporal and seasonal variability of the frost table.

The spatial distribution of benthic (up to 0.05 m depth) and hyporheic (0.25 and 0.5 m depth) macroinvertebrates from downwelling zones at the heads of riffles and upwelling zones at the tails of riffles was examined in two studies on a 4th order chalk stream in Dorset, England. In the first study, differences in benthic and hyporheic macroinvertebrate community composition between the head and tail of a single riffle were investigated. In the second study, a replicated design involving eight riffles was used to compare benthic and hyporheic macroinvertebrate community composition both between heads and tails of the same riffles and between riffles. In the first (single riffle) study there were significantly higher mean numbers of benthic invertebrates and families at the riffle head (715 individuals and 13.8 families per 0.0225 m2) compared to the tail (192 individuals and 8.7 families). ANOSIM analysis also showed that the community structure of head and tail benthic samples was significantly different. In the second (replicated riffle) study, there were also significantly more benthic invertebrates at riffle heads (\(\bar{x}\) = 594 per 0.0225 m2) compared to tails (\(\bar{x}\) = 417 per 0.0225 m2), although this was not the case for families, and community structure also differed significantly between riffle heads and tails. In contrast, in the hyporheic zone, there were no significant differences between the total numbers of invertebrates in the riffle heads and tails, or between riffles, although a significant difference in family richness between riffle head and tail samples was identified in the first study. Community analysis revealed progressively poorer separation of riffle head and tail samples at 0.25 m and 0.5 m hyporheic depths. Whilst being able to identify clear differences in benthic communities from riffles heads and tails, the physically heterogeneous nature of the riffle habitats studied made it difficult to account for the consistent differences in macroinvertebrate communities observed with the physical variables measured.

Generic alendronate was approved in the United States on February 6, 2008. Medicare beneficiaries might pay for generic alendronate out-of-pocket without having claims submitted, resulting in misclassification of generic alendronate use in Medicare data.To estimate the completeness of generic alendronate use in 2008 Medicare Part D data; to identify factors associated with staying on branded alendronate versus switching to a generic product.We identified Medicare beneficiaries highly adherent (medication possession ratio ≥80%) with branded alendronate during 1/1/06-2/6/07 ("2007 cohort") and during 1/1/07-2/6/08 ("2008 cohort"). The outcome was medication status at the end of follow-up (12/31/2007 or 12/31/2008), classified as continued branded alendronate, switched to generic alendronate, switched to another bisphosphonate or presumed discontinued bisphosphonate therapy. Cox regression estimated the hazard ratio (HR) for discontinuation in 2008 compared to 2007. Multinomial logistic regression identified factors associated with medication status for the 2008 cohort.Among 15,310 subjects using branded alendronate in the 2008 cohort, 81% switched to generic alendronate. The proportion presumably discontinuing bisphosphonate therapy was 8.9% in 2008 compared to 7.7% in the 2007 cohort (adjusted HR, 1.15; 95% confidence interval, 1.05, 1.26). Factors associated with staying on branded alendronate in 2008 were higher income, eligibility for a low income subsidy and use of Fosamax® plus vitamin D.Evaluation of Medicare prescription drug data suggests that the amount of missing claims for generic alendronate in 2008 was not substantial, and misclassification of exposure in studies examining alendronate use post-generic product availability should be minimal.

The 5-HT3 receptor antagonist tropisetron (ICS 205-930) was found to be a potent and selective partial agonist at alpha7 nicotinic receptors. Two other 5-HT3 receptor antagonists, ondansetron and LY-278,584, were found to lack high affinity at the alpha7 nicotinic receptor. Quinuclidine analogues (1 and 2) of tropisetron were also found to be potent and selective partial agonists at alpha7 nicotinic receptors.

[1] The distribution of frost table depths on a peat-covered permafrost slope was examined in a discontinuous permafrost region in northern Canada over 4 consecutive years at a variety of spatial scales, to elucidate the role of active layer development on runoff generation. Frost table depths were highly variable over relatively short distances (0.25–1 m), and the spatial variability was strongly correlated to soil moisture distribution, which was partly influenced by lateral flow converging to frost table depressions. On an interannual basis, thaw rates were temporally correlated to air temperature and the amount of precipitation input. Simple simulations show that lateral subsurface flow is governed by the frost table topography having spatially variable storage that has to be filled before water can spill over to generate flow downslope, in a similar manner that bedrock topography controls subsurface flow. However, unlike the bedrock surface, the frost table is variable with time and strongly influenced by the heat transfer involving water. Therefore, it is important to understand the feedback between thawing and subsurface water flow and to properly represent the feedback in hydrological models of permafrost regions.

The effectiveness of four aquatic plants including water hyacinth (Eichornia crassipes), water lettuce (Pistia stratiotes), zebra rush (Scirpus tabernaemontani) and taro (Colocasia esculenta) were evaluated for their capabilities in removing mercury from water. The plants were exposed to concentrations of 0 mg/L, 0.5 mg/L or 2 mg/L of mercury for 30 days. Assays were conducted using both Microtox (water) and cold vapor Atomic Absorption Spectroscopy (AAS) (roots and water). The Microtox results indicated that the mercury induced acute toxicity had been removed from the water. AAS confirmed an increase of mercury within the plant root tissue and a corresponding decrease of mercury in the water. All species of plants appeared to reduce mercury concentrations in the water via root uptake and accumulation. Water lettuce and water hyacinth appeared to be the most effective, followed by taro and zebra rush, respectively.

Few studies have assessed the effectiveness of different drugs for osteoporosis (OP). We aimed to determine if fracture and mortality rates vary among patients initiating different OP medications.We used the Medicare 5% sample to identify new users of intravenous (IV) zoledronic acid (n=1.674), oral bisphosphonates (n=32.626), IV ibandronate (n=492), calcitonin (n=2.606), raloxifene (n=1.950), or parathyroid hormone (n=549). We included beneficiaries who were ≥65 years of age, were continuously enrolled in fee-for-service Medicare and initiated therapy during 2007-2009. Outcomes were hip fracture, clinical vertebral fracture, and all-cause mortality, identified using inpatient and physician diagnosis codes for fracture, procedure codes for fracture repair, and vital status information. Cox regression models compared users of each medication to users of IV zoledronic acid, adjusting for multiple confounders.During follow-up (median, 0.8-1.5 years depending on the drug), 787 subjects had hip fractures, 986 had clinical vertebral fractures, and 2.999 died. Positive associations included IV ibandronate with hip fracture (adjusted hazard ratio (HR), 2.37; 95% confidence interval (CI) 1.25-4.51), calcitonin with vertebral fracture (HR=1.59, 95%CI 1.04-2.43), and calcitonin with mortality (HR=1.31; 95%CI 1.02-1.68). Adjusted HRs for other drug-outcome comparisons were not statistically significant.IV ibandronate and calcitonin were associated with higher rates of some types of fracture when compared to IV zolendronic acid. The relatively high mortality associated with use of calcitonin may reflect the poorer health of users of this agent.