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We measured the optical properties of epitaxial thin films of the metastable hexagonal polymorph of LuFeO3 by absorption spectroscopy, magnetic circular dichroism, and photoconductivity. Comparison with complementary electronic structure calculations reveals a 1.1 eV direct gap involving hybridized Fe 3dz² þ O2pz → Fe d excitations at the T and A points, with a higher energy direct gap at 2.0 eV. Both charge gaps nicely overlap the solar spectrum. [ABSTRACT FROM AUTHOR]

We report high-resolution angle-resolved photoemission studies of epitaxial thin films of the correlated 4d transition metal oxide ferromagnet SrRuO3. The Fermi surface in the ferromagnetic state consists of well-defined Landau quasiparticles exhibiting strong coupling to low-energy bosonic modes which contributes to the large effective masses observed by transport and thermodynamic measurements. Upon warming the material through its Curie temperature, we observe a substantial decrease in quasiparticle coherence but negligible changes in the ferromagnetic exchange splitting, suggesting that local moments play an important role in the ferromagnetism in SrRuO3. [ABSTRACT FROM AUTHOR]

We report high-resolution angle-resolved photoemission studies of epitaxial thin films of the correlated 4d transition metal oxide ferromagnet SrRuO(3). The Fermi surface in the ferromagnetic state consists of well-defined Landau quasiparticles exhibiting strong coupling to low-energy bosonic modes which contributes to the large effective masses observed by transport and thermodynamic measurements. Upon warming the material through its Curie temperature, we observe a substantial decrease in quasiparticle coherence but negligible changes in the ferromagnetic exchange splitting, suggesting that local moments play an important role in the ferromagnetism in SrRuO(3).

Biaxial strain is known to induce ferroelectricity in thin films of nominally nonferroelectric materials such as SrTiO3. By a direct comparison of the strained and strain-free SrTiO3 films using dielectric, ferroelectric, Raman, nonlinear optical and nanoscale piezoelectric property measurements, we conclude that all SrTiO3 films and bulk crystals are relaxor ferroelectrics, and the role of strain is to stabilize longer-range correlation of preexisting nanopolar regions, likely originating from minute amounts of unintentional Sr deficiency in nominally stoichiometric samples. These findings highlight the sensitive role of stoichiometry when exploring strain and epitaxy-induced electronic phenomena in oxide films, heterostructures, and interfaces.

Setting: The State of Alabama Department of Public Health Division of Tuberculosis Control., Objective: To standardize contact investigation protocols and implement an intervention to increase TB field worker adherence to the protocols with the goal of promoting efficiency and effectiveness in contact investigations., Design: A process evaluation of existing data collection and management systems and protocols was performed. Standardized protocols and an intervention to increase TB field worker adherence to the protocols were created and pilot tested. These were then implemented and formative evaluation data were collected., Results: The process evaluation revealed considerable variance among field workers with regard to protocols and definitions of variables related to contact investigations. Protocols were standardized and an intervention targeted at TB field workers was developed. The intervention consisted of a training workshop and the development of a computer-based contact investigation module. This was successfully implemented throughout the state., Conclusions: To perform effective contact investigations and conduct studies to improve the effectiveness of these investigations, TB control programs must pay careful attention to precisely defining variables and concepts related to the contact investigation. Furthermore, protocols must be standardized and resources devoted to training of TB field workers to ensure adherence to protocols.

Systematic reductions in the deposition rate of organic C, N, P, and chlorophyll (Chl) are documented for Ca2+ polluted, culturally eutrophic, Onondaga Lake, NY, based on analyses of weekly sediment trap collections over the May-October interval for 10 years of the 1980-1992 period. Inputs of both nutrient-rich domestic waste and industrial salt waste (including Ca2+) decreased over this period. Constituent ratios of the collected sediment indicate phytoplankton biomass was the dominant source of the deposited organic C, N, and Chl. Substantial decreases in downward fluxes of these constituents occurred starting in 1987: 37, 42, 25, and 54%, on average, for organic C, N, P, and Chl, respectively. These reductions were driven primarily by the decreases in the lake's salinity and Ca2+ concentration, that resulted from the closure of a soda ash manufacturing facility (1986), rather than decreases in water column P concentrations from reductions in domestic waste loading. Three different mechanisms for the decreased deposition, related to the reductions in salinity and Ca2+ concentration, are considered: (i) decrease in coating of phytoplankton with CaCO3 precipitate, (ii) increased grazing of phytoplankton by large cladocerans, and (iii) decreases in coagulation of phytoplankton. The greater loss of phytoplankton biomass through deposition, driven by salt waste inputs from the industry, exacerbated the lake's problem of high primary production. This response is consistent with ecological theory for nutrient saturated phytoplankton growth but has not previously been demonstrated on a whole-lake basis.

Purpose: Advance directives have been available in parts of the United States for more than 20 years, but research shows that only a small percentage of adults (5-25%) have some form of written advance directive. The purose of this study was to examine the presence of advance directives among persons entering cardiac and pulmonary rehabilitation, and identify characteristics of persons most likely to have advance directives., Methods: The sample consisted of 336 cardiac patients and 181 pulmonary patients who enrolled in the University of Alabama at Birmingham's Cardiopulmonary Rehabilitation Program between January 1996 and December 1999. As part of the initial program assessment, patients were asked two questions: (1) Do you have a living will? (2) Do you have any advance directives? For the purposes of this study, the two questions were combined to examine the presence of either a living will or other type of advance directive., Results: Results indicate that 25% of both subgroups (cardiac and pulmonary patients) report having written advance directives. Logistic regression analysis indicates that among cardiac patients whites and older persons were more likely to have advance directives. Among pulmonary patients, females and whites were more likely to have advance directives., Conclusions: These results indicate that only a minority of cardiopulmonary rehabilitation patients have advance directives upon entry into the program, and that the prevalence differs among gender, racial, and age groups. Cardiac and pulmonary rehabilitation programs may be valuable sites for educating patients about advance directives and efforts by rehabilitation personnel may increase the prevalence of advance directives among patients.

To address the shortage of health care professionals trained in the nutritional aspects of cancer prevention, the University of Alabama at Birmingham in 1988 initiated the Cancer Prevention and Control Training Program (CPCTP), with R25 grant support from the NIH/NCI. The CPCTP has enrolled 11 predoctoral and 12 postdoctoral trainees, of whom 18 have completed training and five remain in the program. The curriculum and other program elements are described, and the trainees' academic achievements and ultimate careers are reported. The CPCTP has become a significant resource for training cancer nutrition professionals.

The pre- and postdoctoral Cancer Prevention and Control Training Program (CPCTP) at the University of Alabama at Birmingham (UAB) has attracted high-quality trainees from all over the United States. The trainees have pursued courses of study in epidemiology, nutrition sciences, health behavior, environmental health sciences, biostatistics, or public health nutrition; and research projects in cessation of tobacco use, cancer screening, cancer epidemiology, diet modification, nutrient-cancer relationships, statistical modeling of carcinogenesis, medical-nutrition education, and obesity, in precise alignment with NCI cancer control objectives. Both courses and research projects have been interdisciplinary, taking advantage of the strong interdepartmental collaborative atmosphere at UAB. Former trainees have been successfully placed in academic, administrative, and practice positions in which they can strategically apply their cancer prevention and control expertise.

Background: During the past 15 years, programs to improve self-management practices in adults with asthma have reported improvement in functional status and reduction of inappropriate use of health care services. However, these programs usually represent an ideal approach, applying multiple patient education methods. Consequently, when these programs are found to be efficacious, it is important to replicate the programs as well as to evaluate less complex methods that may be more appropriate for nonacademic health care settings., Methods: We compared the following 3 standardized self-management treatments in a randomized, controlled trial: (1) a replication of the self-management program developed at a university medical center that was previously shown to be efficacious; (2) a modified version of this program including only the core elements; and (3) a usual-care program. Outcome measures included medication and inhaler regimen adherence, asthma symptoms, respiratory illness, functional status, and use of health care resources., Results: All 3 groups improved on measures of respiratory illnesses, use of health care services, and functional status. Patients in both education groups did no better than the usual-care group., Conclusions: The results are inconsistent with the results of the first asthma self-management study at this institution and with those of efficacy studies of similar programs. Two factors, selection of the patient population and historical changes in asthma treatment, most likely contributed to the lack of impact of the self-management programs. As a result of the improved standards for usual care due to both factors, the opportunity to effect patient outcomes was substantially reduced.

Background/purpose: The exposure to research during residency is currently an integral part of most academic surgical training programs. In this study, graduates of two surgical programs were surveyed to characterize their research experience and to determine the effects on their careers., Methods: Between 1975 and 1990, 86 and 61 residents completed general surgical training programs at UCLA Medical Center and at Harbor-UCLA Medical Center, respectively. An anonymous survey was sent to each graduate regarding his research experience and current practice., Results: Of the graduates who spent 2 years in research, 47% now hold academic positions, compared with 23% for those who spent less than 2 years (P = .18). When the graduates were segregated according to their desire to enter the laboratory, 49% of graduates who requested research time hold academic positions, whereas only 13% of those who would not request research are in academic positions (P = .01)., Conclusions: Residents who strongly desire a period of research during surgical residency are also more productive in the laboratory. This information should be considered in selecting residents for research training in the current era of academic budget restriction and managed health care.

The status of cancer education in U.S. medical schools was reassessed in the Cancer Education Survey II, which was initiated in 1989. One thousand and thirty-five cancer educators from 126 of the country's 128 medical schools participated, including 65 pediatric oncologists and 36 family physicians. All agreed that the most important aspects of cancer to teach medical students are early detection and cancer prevention; they considered less important electives in basic science, radiation therapy, and surgical oncology. The 101 pediatric oncologists and family physicians believed that more curriculum time should be devoted to cancer epidemiology, psychosocial aspects, and palliative care. Approximately one third of these 101 physicians also expressed the desire to have more teaching materials available in five general areas: patient education about pediatric cancer, nutrition, epidemiology, palliative care, and continuing care. Lay-language information about pediatric cancer, participation in clinical trials, and current cancer research is still needed.

Improved outcome measures for asthma research, especially measures of functional status and quality of life, have become increasingly important. This research describes one such measure, the University of Alabama at Birmingham (UAB) Functional Impairment Scale. This scale consists of eight items to assess the impact of asthma on various aspects of daily living. The psychometric properties of the UAB Scale were assessed in two samples. The coefficient alpha reliabilities were high in both samples (.83 and .84), and the item-total correlations indicated all items were measuring the same trait. The score distributions covered the entire range of possible scores, and the central tendencies and dispersions confirmed the presence of enough variation to detect differences in functional impairment among individuals. Correlations between the UAB Scale and other asthma-related measures support construct validity. All of these results support the potential usefulness of the UAB Scale.

Health education programs developed in academic medical centers are not optimally disseminated to community clinical settings. Strategies are needed to translate the findings of research on health education programs into programs useful in a wide range of health care settings. Focus group techniques were used to provide data for revising a successful university-based asthma self-management program to make it more practical for use by community physicians. Physicians representing a variety of specialties attended the sessions and provided feedback on the utility of various components of the original program. The discussions revealed that many physicians felt they did not have the time or resources to conduct the original program and identified elements viewed as impractical. This physician input contributed significantly to the development of a revised program with a briefer, less costly intervention. The revised program was later evaluated by focus group participants. Eighty-eight percent of those who evaluated the revised program agreed they would be able and willing to use the program in their own practices. As a formative evaluation tool, the focus group technique made available useful information that would have been difficult to obtain through evaluation forms alone.

This is the fourth survey of physician clinical-nutrition training programs. As in previous reports, current fellowship training programs were identified, descriptive information obtained, and program content surveyed. In addition, a questionnaire developed by the American Board of Nutrition Committee on Fellowship Training Programs was used to determine the degree of emphasis given to content in the areas of basic nutrition science, clinical applications, and research training. Among the 38 programs identified, uniform ratings of importance were found in all major topic areas. There was also uniformity in most subtopics, with minor exceptions. As expected, in the area of nutrition in the life cycle, pediatric training programs emphasized infancy and childhood whereas medical-surgical programs emphasized adulthood and aging. Alcoholism was emphasized in medical-surgical training programs whereas cystic fibrosis and inborn errors of metabolism were emphasized in pediatric programs. Nutrition in burn patients received minor emphasis in all programs. The overall uniformity of curricular content in training programs confirms the contention that clinical nutrition has a defined clinical scope and should be considered for establishment as a recognized subspecialty in American medicine.

The Cancer Education Survey collected data from 126 of 128 US Medical Schools on the current status of cancer-related educational activities for undergraduate medical students. The study was conducted by a Supervisory Committee of the American Association for Cancer Education, with funding from the American Cancer Society. The survey obtained data concerning institutional characteristics in support of undergraduate medical student cancer education, ie, administrative structures, current cancer-related curricula, sources of financial support, and anticipated changes in these characteristics. Institutions were also queried on specific topics of cancer prevention, detection, and diagnosis that might be taught as identifiable areas of instruction for medical students. Three-fourths of the institutions had a lecture on the principles of cancer screening, and, among those, nearly three-fourths classified it as a part of a required course or rotation. Detection of common cancers is taught in virtually all institutions. The least likely cancer prevention lecture topics are related to prevention and cessation of smoking, a well-verified cancer risk. Also, no consistent pattern emerges that might indicate that association with a cancer center imparts to a medical school a greater emphasis on delivery of cancer prevention topics.

The AACE Cancer Education Survey-II offers an unusual opportunity based on data from 125 medical schools and 1,035 experienced cancer educators to effect constructive change with regard to cancer education. The changes suggested include more coordination; integration; and a shift of emphasis to include more on topics of prevention, early diagnosis, tumor biology, rehabilitation, palliative care, and psychosocial issues. Ample opportunities, especially in the ambulatory care arena, exist at most medical schools, and there is a great deal of interest in improving the situation. This article reviews the factors contributing to resistance to change, the data on adult learning, and the major movements and dilemmas facing medical education today. It also discusses some of the external forces like the Liaison Committee on Medical Education (LCME) and foundation support, which are being harnessed to effect change. Given these barriers, forces, and opportunities, the article ends with a possible action plan for an individual, an institution, and national bodies interested in cancer education. The knowledge, skills, values, and attitudes must be defined, taught effectively, and evaluated. It is an opportune time, armed with this useful data, to bring about change in how cancer subjects are taught. The ultimate goal is more knowledgeable and effective practitioners and scientists who can decrease the morbidity and mortality from cancer.