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AIMS: 1) Can virtual fall risk screens be performed safely? 2) Are older adults able to manage technology to participate in telehealth? 3) Does an algorithm aid in referral appropriate evidence-based (EBP) fall prevention programs? METHODS: An algorithm was piloted using the Zoom platform to screen for falls, to assign to intervention groups, and to guide referral to EBR Statistical analysis of data included descriptive, parametric, and non-parametric tests. RESULTS: Forty-four participants, aged 55-94 years, were screened. A significant relationship between 30-second chair stand and referral between two programs was found (p<0.05). Spearman correlations revealed statistically significant negative correlation between 30-second chair stand and timed up-and-go (TUG) (r = -0.584; 0=0.003). No safety incidents occurred. Ninety-five percent of screened participants managed technology requirements successfully. CONCLUSION: Virtual fall risk screens are feasible and offer clinicians an alternative means to screen and refer older adults for EBP. [ABSTRACT FROM AUTHOR]

Background: Environmental and behavioral interventions hold promise to reduce sugar-sweetened beverage (SSBs) consumption.Purpose: To test, among frequent SSB consumers, whether motivations to consume SSBs moderated the effects of (a) a workplace SSB sales ban (environmental intervention) alone, and (b) a "brief motivational intervention" (BI) in addition to the sales ban, on changes in SSB consumption.Methods: We assessed whether (1) baseline motivations to consume SSBs (craving, psychological stress, or taste enjoyment) impacted changes in daily SSB consumption at 6-month follow-up among frequent (>12oz of SSBs/day) SSB consumers (N = 214); (2) participants randomized to the BI (n = 109) versus to the sales ban only (n = 105) reported greater reductions in SSB consumption at follow-up; and (3) motivations to consume SSBs moderated any changes in SSB consumption.Results: In response to the sales ban alone, individuals with stronger SSB cravings (+1 SD) at baseline showed significantly smaller reductions in daily SSB consumption at 6-month follow-up relative to individuals with weaker (-1 SD) SSB cravings (2.5 oz vs. 22.5 oz), p < .01. Receiving the BI significantly increased reductions for those with stronger SSB cravings: Among individuals with stronger cravings, those who received the BI evidenced significantly greater reductions in daily SSB consumption [M(SE) = -19.2 (2.74) oz] than those who did not [M(SE) = -2.5 (2.3) oz, p < .001], a difference of 16.72 oz.Conclusions: Frequent SSB consumers with stronger SSB cravings report minimal reductions in daily SSB consumption with a sales ban only, but report greater reductions if they also receive a motivational intervention. Future multilevel interventions for institutions should consider both environmental and individualized multi-level interventions.Clinical Trial Information: NCT02585336. [ABSTRACT FROM AUTHOR]

The global thermohaline circulation plays a major role in regulating global climate, driven by the formation of North Atlantic Deep Water (NADW). ODP Site 1063 on the Bermuda Rise, at the interface of NADW and Southern Ocean‐sourced water, appears an ideal location to study the relationships between ocean circulation and climate. This study reports Nd isotope ratios at Site 1063 that extend to ~1 Ma. The data show Nd isotope values during portions of interglacials that are much lower than modern NADW. However, interglacial Nd isotope values at Site 607, located within the core of NADW, off the abyssal seafloor in the North Atlantic, are consistently similar to modern NADW. In contrast to glacial values, we infer that interglacial Nd isotopes at Site 1063 are not representative of NADW and do not solely record water mass mixing. We conclude that the low Ndisotope ratios reflect regional particle‐seawater exchange as a consequence of input of freshly ground bedrock from the Canadian shield, which is eroded into the North Atlantic during major ice sheet retreats. The result is a deep, thin, and regionally constrained layer of seawater tagged with this anomalous low Nd isotope signature that is unrepresentative of the Atlantic Meridional Overturning Circulation (AMOC). We suggest that a benthic nepheloid layer, whose development is linked to the behavior of a deep‐recirculating gyre system, regulated by the interaction between the Gulf Stream and the deep western boundary current, facilitates the periodic masking of the Nd isotope signature of the North Atlantic AMOC end‐member in this region at these depths. Key Points: Glacial‐interglacial changes at the deep Bermuda Rise during the Middle and early Lower Pleistocene were recorded with εNdGlacial εNd values in the deep Bermuda Rise record the AMOC, interglacial εNd values do notDynamic benthic nepheloid layers temporally mask εNd at the deep Bermuda Rise during parts of interglacials [ABSTRACT FROM AUTHOR]

Objective: To survey pregnant patients about whether their health care providers assessed insomnia, the types of treatment recommendations providers made, and the types of treatments patients utilized. Participants: Participants were 423 English-speaking pregnant women. Methods: In this cross-sectional study, participants self-reported insomnia symptoms on the Insomnia Severity Index and indicated whether they discussed their sleep with a health care provider, whether they received any recommendations to improve their sleep, and whether they utilized any interventions or aids to improve their sleep during their current pregnancy. Results: Approximately one-third (39%) of participants reported that they discussed their sleep with a health care provider at some point during their pregnancy. Among participants who reported moderate to severe insomnia symptoms (Insomnia Severity Index>14), 57% reported that they had discussed their sleep with a health care provider, and 28% reported receiving an insomnia diagnosis. Over-the-counter medication was the most commonly recommended (53%) and utilized (39%) sleep intervention among women with moderate to severe insomnia symptoms. Conclusions: According to patient report, insomnia may be under-detected during pregnancy. When insomnia is recognized, treatment recommendations do not match clinical practice guidelines or women's preferences for receiving cognitive behavior therapy for insomnia. Taken together with previous research on the prevalence and consequences of prenatal insomnia, these findings suggest the need for an increased focus on the importance of sleep during pregnancy. [ABSTRACT FROM AUTHOR]

The article talks about cultural humility in the neonatal intensive care unit (NICU). Topics discussed include the power imbalances in the patient-physician dynamic, attitudes of patients and providers towards the role and relative importance of religion, spirituality and folk medicine in the NICU; and culturally competent guidelines for withdrawal of life-sustaining treatment from a Hindu perspective.

Weakly basic carbon nucleophiles have added efficiently to a Fmoc-protected N,O-acetal compound. The new reactions have highlighted the compatibility of the Fmoc protecting group with basic reaction conditions and have served as a model for developing more efficient syntheses of Fmoc-protected amino acids.

Provides evidence of the potential for using interactive multimedia environments to develop analytic problem-solving ability in a specific content domain. Study of the effects of multimedia on learning; `Cognitive Psychology in Classroom'; General goals set for the study; Evaluation of the instructional environment in terms of student response.

In general, glucose consumption improves cognitive performance; however, it is unknown whether glucose specifically alters attentional food bias, and how this process may vary by BMI status. We hypothesized that glucose consumption would increase attentional food bias among individuals of obese BMI status more so than among individuals of lean BMI status. Participants (N = 35) completed the n-back, a working memory task modified to assess attentional food bias (ATT-Food), under fasting and glucose challenge conditions. We computed pre-post changes in ATT-Food, blood glucose and insulin (∆BG & ∆BI), and perceived task-stress (∆stress). After the second cognitive test and blood draw, participants ate lunch and completed a "taste test" of highly palatable foods, and we recorded food consumption. Pre-post changes in ATT-Food were greater among participants of obese (relative to lean) BMI status (F (1,33) = 5.108, p =.031). Greater ∆ATT-Food was significantly associated with greater ∆BG (r =.462, p =.007) and reduced ∆stress (r =-.422, p =.011), and marginally associated with greater taste-test eating (r =.325, p =.057), but was not associated with ∆BI. Our findings suggest that individuals of obese BMI status may exhibit "sweet cognition," as indexed by greater attentional food bias following glucose ingestion, relative to individuals of lean BMI status. Among individuals of obese BMI status, sweet cognition may arise from difficulty broadening attention toward non-food cues after consuming a high glucose load, thereby potentially perpetuating sugar consumption. If confirmed by further research, measures of sweet cognition may help identify individuals with a phenotype of risk for obesity and greater sugar consumption, who may benefit from tailored interventions. • Individuals of obese BMI status show greater attentional food bias after consuming glucose • We refer to changes in attention to food cues following glucose ingestion as "sweet cognition" • Greater sweet cognition was associated with greater decreases in acute mental stress • Greater sweet cognition was associated with greater non-homeostatic eating of sugar-laden food • Sweet cognition may be due to greater capacity among lean individuals to attend to non-food cues after consuming glucose. [ABSTRACT FROM AUTHOR]

Background: Diet patterns have a profound influence on glycemic control for individuals with type 2 diabetes mellitus (T2DM), and craving-related eating is an important obstacle to dietary adherence. A growing body of research suggests that carbohydrate-restricted (CR) diets can improve glycemic control and reduce medication dependence in T2DM. However, limited data speak to the effects of long-term adherence to CR diets. Mindful eating training has been shown to reduce craving-related eating in overweight populations but has yet to be examined as a behavioral support for dietary adherence in T2DM. This trial examines behavioral mechanisms, particularly craving-related eating, through which mindful eating training might improve adherence to CR dietary recommendations in T2DM. This will clarify the importance of focusing on craving-related eating in the optimization of dietary adherence interventions., Objective: The aim of this trial is to determine whether providing training in mindful eating increases adherence to a CR dietary recommendation in T2DM., Methods: We are randomizing 60 participants to receive a CR diet with or without mindful eating training (12-week group intervention) and are following participants for 12 weeks after intervention completion. We hypothesize that participants who receive mindful eating training (relative to those who do not) will demonstrate greater adherence to the CR diet., Results: Our primary outcome is change in craving-related eating, as assessed using an ecological momentary assessment mobile phone-based platform. Secondary behavioral pathway outcomes include changes in stress-related eating, impulsivity, glycemic control, weight change, dietary adherence, and resumption of dietary adherence after dietary nonadherence., Conclusions: This theory-driven trial will shed light on the impact of mindfulness training on mechanisms that may impact dietary adherence in T2DM., Trial Registration: ClinicalTrials.gov NCT03207711; https://clinicaltrials.gov/ct2/show/NCT03207711 (Archived by WebCite at http://www.webcitation.org/73pXscwaU)., International Registered Report Identifier (irrid): DERR1-10.2196/11002., (©Ashley E Mason, Laura Saslow, Patricia J Moran, Sarah Kim, Hiba Abousleiman, Alison Hartman, Robert Richler, Samantha Schleicher, Wendy Hartogensis, Elissa S Epel, Frederick Hecht. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 20.02.2019.)