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OBJECTIVES The amount of colorectal cancer (CRC) screening using the noninvasive fecal immunochemical test (FIT) at a federally qualified health center, Five Rivers Health Clinic (Dayton, Ohio), has been low historically. Our quality improvement (QI) project aimed to improve CRC screening adherence in eligible patients who opted for FIT. METHODS Three hundred ninety-two patients with FIT orders for CRC were screened during an 11-month period. The preintervention group (pre-I) was enrolled from December 1, 2018 to May 31, 2019, and the postintervention group (post-I) from June 1, 2019 to October 31, 2019. Three interventions were used: resident physicians trained during clinic meetings regarding FIT education for patients, posters displayed in patient rooms outlining the benefits of CRC screening, and standardized US mail reminder letters sent to FIT patients. Patient demographics and clinical variables were collected along with return rate. RESULTS The return rate for post-I was twice that of pre-I (74.4%, 95% confidence interval 64.6-82.3 vs 31.1, 95% confidence interval 26.2-36.6; P < 0.001). The pre-I/post-I groups did not differ on demographic and clinical characteristics, and, except for race, none of these variables was associated with returning the FIT screening card. CONCLUSIONS The compliance rate for FIT completion and return more than doubled among our clinic patients after using a three-component QI intervention. Except for a difference in race, the lack of association between demographic and clinical characteristics with either pre-I/post-I group or return/no return of the FIT card leads us to conclude that our QI program for increasing FIT compliance is effective. Other settings where CRC screening is a prominent component of preventive care may benefit from adopting a similar QI intervention.

Eight reinforced concrete beams with two different concrete strengths and four different schemes of reinforcing were tested to failure in pure torsion. SR⁻⁴ strain gages were used to measure the concrete strains at the surface of the test beams. A review of analytical and experimental studies in the literature is presented and briefly discussed. The test results were then compared with the theoretical predictions developed by Cowan, Ernst and Gesund. In general the failure surface of the test beams agreed with those previously predicted. The test ultimate torque varied considerably from the predicted ultimate torque of Cowan and Gesund. Ernst’s basic equation was modified to compensate for less than the minimum longitudinal reinforcement in four of the beams. With this modification Ernst’s theoretical predictions were very close to the test results. A study of the test results also shows that one of the presented theories is valid for one particular case, but that none of the theories is valid for every case. Consequently, there is a need for further research in this subject in order to develop a more exact theory for use in design. Master of Science