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BLINC stands for Business Librarianship in North Carolina. Fourteen public, special, and academic librarians created this group in 2003. In that year, BLINC began its tradition of hosting workshops...

Purpose The purpose of this pilot study was to determine the effectiveness of an edited Diabetes Prevention Program (DPP) Lifestyle Resources Core Teaching Plan for managing patients with type 2 diabetes in an urban underserved setting. Modifications were made to attempt to cut to the bare essentials to work within the constrained budgets of safety net providers. The primary aim was to achieve a mean absolute reduction in HbA1c level of 1 percentage point. Methods The authors conducted a randomized controlled trial of 9 months' duration for patients with type 2 diabetes with an HbA1c>or=8.0%. A total of 67 patients randomized into usual-care and case management groups were evaluated with an intention-to-treat analysis. A modified DPP workbook was used during 7 monthly visits with a nurse case manager. Results As compared with the usual-care group, those in the case management group experienced a greater reduction in HbA1c level (-1.87 vs -0.54; P=.011) and weight (-2.47 kg vs +0.88 kg; P=.011). Conclusion Use of an edited version of the DPP workbook in an urban, low-income, minority population with type 2 diabetesproduced a significant absolute reduction in HbA1c percentage and weight.

Renal lithiasis affects approximately 5% of the general population, with higher risks for men and increasing risks with increasing age. The forward deployment of the Air Force into austere desert environments with integration of the active duty, Reserves, and Guard presents increasing risks to mission accomplishment with the increased risk of developing renal lithiasis.This paper describes seven cases of presumed renal lithiasis in a deployed desert setting in Air Force personnel on flying status. Their status and the location of the base acted as a focus for a review of the literature on kidney stone causation, prevention, diagnosis, and management.A review of the literature revealed that current military recommendations to hydrate in the field may not be sufficient for the primary prevention of kidney stones. Beverage choice may prove more useful for prevention. Situations precipitating voluntary dehydration need to be prevented. Although there are superior ways to diagnose renal lithiasis, in the deployed setting patient history and physical examination are usually the only available means. Ultrasound is a viable diagnostic option for use in the deployed setting based on its portability, affordability, and ease of use. Additions to the standard management of renal lithiasis, such as subcutaneous Lidocaine and heat may have value in the deployed setting if the supply of narcotics is limited.In the deployed setting, hydration choices, the addition of portable ultrasound to the diagnostic process, and pain management with nontraditional therapies need to be explored.

Healthy eating and increased physical activity can prevent or delay diabetes and its complications. Techniques that facilitate adherence to these lifestyle changes can be adapted to primary care. Often, the patient's readiness to work toward change must be developed gradually. To prepare patients who are reluctant to change, it is effective to assess and address their conviction and confidence. Patients facing the long-term task of making lifestyle changes benefit from assistance in setting highly specific behavior-outcome goals and short-term behavior targets. Individualization is achieved by tailoring these goals and targets to the patient's preferences and progress, building the patient's confidence in small steps, and implementing more intensive interventions according to a stepped-care model. At each office visit, physician follow-up of the patient's self-monitored goals and targets enhances motivation and allows further customization of the plan. A coaching approach can be used to encourage positive choices, develop self-sufficiency, and assist the patient in identifying and overcoming barriers. More intensive intervention using a team approach maximizes adherence.

Background Journal Club at a University-based residency program was restructured to introduce, reinforce and evaluate residents understanding of the concepts of Evidence Based Medicine. Methods Over the course of a year structured pre and post-tests were developed for use during each Journal Club. Questions were derived from the articles being reviewed. Performance with the key concepts of Evidence Based Medicine was assessed. Study subjects were 35 PGY2 and PGY3 residents in a University based Family Practice Program. Results Performance on the pre-test demonstrated a significant improvement from a median of 54.5 % to 78.9 % over the course of the year (F 89.17, p < .001). The post-test results also exhibited a significant increase from 63.6 % to 81.6% (F 85.84, p < .001). Conclusions Following organizational revision, the introduction of a pre-test/post-test instrument supported achievement of the learning objectives with a better understanding and utilization of the concepts of Evidence Based Medicine.

A new high-intensity-beam line with a wiggler magnet source is described. This project, in final stages of design, is a joint effort between Lawrence Berkeley Laboratory (LBL), the Exxon Research and Engineering Company (EXXON), and the Stanford Synchrotron Radiation Laboratory (SSRL). Installation at SSRL will begin in the summer of 1982. The goal of this project is to provide extremely high-brightness synchrotron radiation beams over a broad spectral range from 50 eV to 40 keV. The radiation source is a 27 period (i.e., 55 pole) permanent magnet wiggler of a new design. The wiggler utilizes rare-earth cobalt (REC) material in the steel hybrid configuration to achieve high magnetic fields with short periods. An analysis has been made of the polarization, angular distribution and power density of the radiation produced by the wiggler. Details of the wiggler design are presented. The magnet is outside a thin walled (1mm) variable gap stainless steel vacuum chamber. The chamber gap will be opened to 1.8 cm for beam injection into SPEAR and then closed to 1.0 cm (or less) for operation. Five remotely controlled drives are provided; to change the wiggler gap, to change the vacuum chamber aperture and to position the wiggler. Detailsmore » of the beam line optics and end stations are presented. Thermal loading on beam line components is severe. The peak power density at 7.5 m is 5 kW/cm/sup 2/ for the nominal wiggler field and present SPEAR beam currents and will approach 20 kW/cm/sup 2/ with the maximum wiggler field and projected SPEAR beam currents.« less

The Wisconsin Department of Transportation WISDOT) has sponsored investigations on the causes of freeze-thaw scaling damage on Portland Cement Concrete (PCC) roadways within the state that are coated with membrane forming curing compounds (MFCCs). Several studies have identified excess bleed water at the time of curing compound application as a potential cause of reduced scaling resistance of concrete pavements. Increasing the delay between concrete finishing steps and MFC application should serve to lessen scaling damage. However, there is currently no literature that sought to quantify a possible linkage between MFCC application time and the scaling resistance. The primary goal of this research was to evaluate the influence of MFCC application time on the freeze-thaw scaling damage resistance of roadway concrete made with materials native to Wisconsin. A factorial experiment was designed to probe the effect of MFCC application time on scaling damage as measured by ASTM C672. Three emulsion-based curing compounds, Linseed Oil, Wax, and Poly-alpha-methyl-styrene (PAMS) were evaluated at three application times on concrete specimens prepared with one of two sources of coarse aggregate and one of three cementitious materials. An Acrylic solvent-based sealing compound was evaluated at two application times with respect to concrete scaling resistance. Untreated specimens from each mix type were cured in a wet room and tested as controls. A secondary goal of this project was to evaluate a new method for determining the presence of bleed water on a concrete surface by constructing a device to detect changes in the relative humidity of the air above the concrete surface over time to more reliably determine the cessation of the bleeding than current methods. To achieve this goal, a device was built and its operational capability was tested during the study. ii Concrete mixes were designed and specimens were prepared according to WISDOT procedures to provide a good representation of the pavements within Wisconsin. Freeze-thaw scaling damage testing was performed on all specimens and data was recorded following the appropriate testing standard. Properties such as fresh concrete slump, air content, 28-day compressive strength, and curing compound application rates were measured and recorded to ensure compliance with WISDOT standards. Results in this study indicate that the influence of MFCC application time on the scaling resistance of concrete is dependent upon the compound chosen. The Linseed Oil and Acrylic formulations displayed significantly increased scaling resistance with an increase in application time. The Wax and PAMS formulations did not display significant increases in scaling resistance with an increase in application time. Results from the untreated wet room cured specimens indicate that curing compounds do not promote scaling resistance levels that compare favorably to the humidity control method wet room curing. Scaling resistance was also found to be dependent upon composition of the concrete, especially with respect to the coarse aggregate and cementitious material choice. Elevated levels of ambient relative humidity at the time of specimen manufacture appeared to decrease the scaling resistance, regardless of application time. The device was found not to be reliable for monitoring the presence of bleed water in its current design. Analysis of the data collected by the device showed that future modifications could be made improve its operational capability.