ARM identified significant lymphatic variations draining the upper extremities and facilitated preservation in all but one case. ARM added to present-day ALND and SLNB further defines the axilla and may be useful to prevent lymphedema.

In 2014, the Midwest Interprofessional Practice, Education and Research Center partnered with a Federally Qualified Health Center (FQHC) to implement an interprofessional collaborative practice (IPCP) education program to improve the health of adult patients with diabetes and to improve practice efficiency. This partnership included integrating an interprofessional team of students with the practice team. Twenty-five students and 20 staff engaged in the IPCP program, which included completion of educational modules on IPCP and implementation of daily huddles, focus patient visits, phone calls, team-based case presentations, medication reconciliation, and student-led group diabetes education classes. This study used a sequential mixed methods design. Tools used for collecting data from staff and students included demographic forms, the Interdisciplinary Education Perception Scale (IEPS), the Entry-level Interprofessional Questionnaire, the Collaborative Practice Assessment Tool, and pre/post module knowledge tests completed at baseline and at one-year post implementation. Patient clinical indicators included HgbA1c, glucose, lipid panel laboratory assessments, body mass index, blood pressure, and documentation of annual dental, foot, and eye examinations. Practice efficiency was measured by the average number of patients seen per provider per hour. Both students and staff showed significant knowledge gains in IPCP on Team Dynamics and Tips for Behavioural Changes knowledge tests (p < .05). Patients who had an HgbA1c of ≥ 7% significantly decreased their HgbA1c (p < .05) and glucose (p < .01). However, BMI and annual dental and eye examinations did not improve. Providers demonstrated an increase in the number of patients seen per hour. This IPCP intervention showed improvement in practice efficiencies and select patient outcomes in a family practice clinic.

This study examines the process through which a fear appeal may transform low-involvement audiences into active publics. Cognitive and emotional responses of uninvolved viewers to a film on environmental Contamination are analyzed, together with the coping strategies used to deal with the threat. The research integrates Grunig 's situational theo y ofpublics with Rogers' protection-motivation theo y to expand the predictive ability of the situational theory. The data indicate that post-test public membenh@, cognitive activity and emotional arousal during viewing are sign ficantly related to viewers' preferences for coping through message resistance, seeking additional information, or taking action on the film's topic. Results suggest that both cognition and affect mediate viewers' responses to a fearful message, thereby contributing to the creation of active publics who arepersuaded to take action on aproblem.The family of constructs that indicate heightened audience engagement with media content has repeatedly been shown to predict more powerful and enduring exposure effects. This family encompasses audience activity, interest, personal relevance, problem recognition, and involvement, a5 well as a number of other related concepts.Of all these constructs, involvement has received the most attention. High involvement has been found to lead to deeper message processing and more enduring attitude change (Petty & Cacioppo, 1986); a more "rational" hierarchy of effects (Ray et al., 1973); higher knowledge-attitude-behavior consistency

This study suggests that HUG is more accurate in localizing non-palpable lesions than NLBB. By eliminating the additional procedure needed for NLBB, HUG may also be more time- and cost efficient. HUG makes VABB not only a less invasive diagnostic procedure, but also a localization procedure.

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This study examines the way that need for cognition (NFC) affects thinking about free speech issues. Past research has shown a large disparity between general support for abstract principles of free speech and willingness to apply those principles in specific situations. The results of this study show a smaller tolerance disparity for high NFC respondents; they are more likely to apply free speech principles in forming opinions in specific issue situations.

Our medical students appear quite willing to accept shared decision making as a skill that they should have in working with patients, and this was the primary focus of the newly implemented module. However, we have learned that students need to deepen their understanding of screening services in order to help patients understand the associated benefits and risks. The final videotaped interaction with a simulated patient about colorectal cancer screening has been very helpful in making it more obvious to faculty what students believe and know about screening for colorectal cancer. As the students are asked to discuss clinical issues with patients and discuss the pros and cons of screening tests as part of the shared decision-making process, their thinking becomes transparent and it is evident where curricular changes and enhancements are required. We have found that an explicit model that allows students to demonstrate a process for shared decision making is a good introductory tool. We think it would be helpful to provide students with more formative feedback. We would like to develop faculty development programs around shared decision making so that more of our clinical faculty would model such a process with patients. Performance-based assessments are resource-intensive, but they appear to be worth the added effort in terms of enhanced skills development and a more comprehensive appraisal of student learning.