No abstract

Background Although a poor diet is the number one risk factor for early death in the United States and globally, physicians receive little to no training in dietary interventions and lack confidence counseling patients about lifestyle modifications. Innovative, interprofessional strategies to address these gaps include the emergence of culinary medicine, a hands-on approach to teaching the role of food in health outcomes. We sought to assess the impact of a culinary medicine elective on counseling confidence, awareness of an evidence-based approach to nutrition, and understanding of the role of interprofessional teamwork in dietary lifestyle change among medical students at one undergraduate medical school. Methods We administered pre- and post-course surveys to two cohorts of medical students (n = 64 at pre-test and n = 60 at post-test) participating in a culinary medicine enrichment elective. Chi-square analysis was used to assess the relationship between participation in the course and a positive response to each survey item. Results Compared with the baseline, students participating in culinary medicine were more likely to feel confident discussing nutrition with patients (29% vs 92%; p < 0.001), to feel familiar with the Mediterranean diet (54% vs. 97%; p < 0.001), and to understand the role of dietitians in patient care (37% vs. 93%; p < 0.001). Conclusions Culinary medicine shows promise as an impactful educational strategy among first-year medical students for increasing counseling confidence, promoting familiarity with evidence-based nutrition interventions, and augmenting understanding of the role of interprofessional engagement to address lifestyle-related disease.

No abstract

An ion-tcmpcraturc~gradient driven instability is investigated in the Columbia Linear Machinc (CLM). A transit-time r.f. techniquc is used to heat the core of the plasma column. This produces the

The design of randomized controlled clinical studies can greatly benefit from iterative assessments of population representativeness of eligibility criteria. We propose a multi-trait metric - GIST 2.0 that can compute the a priori generalizability based on the population representativeness of a clinical study by explicitly modeling the dependencies among all eligibility criteria. We evaluate this metric on twenty clinical studies of two diseases and analyze how a study’s eligibility criteria affect its generalizability (collectively and individually). We statistically analyze the effects of trial setting, trait selection and trait summarizing technique on GIST 2.0. Finally we provide theoretical as well as empirical validations for the expected properties of GIST 2.0.

Most tokamak experimental results [Nucl. Fusion 33, 1205 (1993)]] and basic physics experiments [Phys. Rev. Lett. 89, 095001 (2002)]] in the Columbia Linear Machine indicate dependence of the ion thermal conductivity on the isotopic mass close to chi( perpendicular ) approximately A(-0.5)(i), i.e., inverse gyro-Bohm. This is in stark contradiction to most present theoretical models predicting Bohm (A(0)(i)) or gyro-Bohm (A(0.5)(i)) scaling. A series of experiments designed to explore the physics basis of this scaling appears to lead to a new model for this scaling based on 3-wave coupling of two ion temperature gradient radial harmonics and an ion acoustic wave.

The role of self-generated zonal flows (ZF) in transport regulation in magnetic confinement devices via its shear is a potent concept and a physics issue. However, as the experimental evidence of its existence in tokamaks is meagre, a basic physics experimental study of ZF associated with ion temperature gradient (ITG) drift modes has been performed in the Columbia Linear Machine. The difficult problem of detection of ZF has been solved via a novel diagnostic using the paradigm of frequency modulation (FM) in radio transmission. Using this and discrete short time Fourier transform, we find a power spectrum peak at ITG ('carrier') frequency of ∼120 kHz and FM sidebands at frequency of ∼2 kHz, which is identified as a ZF. It has all the signatures of a ZF: a potential at near zero frequency and poloidal symmetry (m = 0), toroidal symmetry (k = 0) and radial variations only. The results roughly agree with theoretical estimates given here.

Screening with fecal occult blood tests (FOBT) reduces colorectal cancer mortality. Failure to complete repeat tests may compromise screening effectiveness. We conducted a systematic review of repeat FOBT across diverse health care settings. We searched MEDLINE, Embase, and the Cochrane Library for studies published from 1997 to 2017 and reported repeat FOBT over 2 screening rounds. Studies (n ¼ 27 reported in 35 articles) measured repeat FOBT as (i) proportion of Round 1 participants completing repeat FOBT in Round 2; (ii) proportion completing two, consecutive FOBT; or (iii) proportion completing 3 rounds. Among those who completed FOBT in Round 1, 24.6% to 89.6% completed repeat FOBT in Round 2 [median: 82.0%; interquartile range (IQR): 73.7%-84.6%]. The proportion completing FOBT in two rounds ranged from 16.4% to 80.0% (median: 46.6%; IQR: 40.5%-50.0%), and in studies examining 3 rounds, repeat FOBT ranged from 0.8% to 64.1% (median: 39.2%; IQR: 19.7%-49.4%). Repeat FOBT appeared higher in mailed outreach (69.1%-89.6%) compared with opportunistic screening (24.6%-48.6%). Few studies examined correlates of repeat FOBT. In summary, we observed a wide prevalence of repeat FOBT, and prevalence generally declined in successive screening rounds. Interventions that increase and maintain participation in FOBT are needed to optimize effectiveness of this screening strategy.