Psychosocial Distress Screening in a Community Cancer Center: An Exploratory Study of Distress Screening Across the Cancer Treatment Continuum

Purpose: The primary goal of this exploratory study is to demonstrate that distress screening across the course of cancer treatment is possible and provides valuable information about patient needs over time. Distress screening is aligned with guidelines from national accrediting organizations and may lead to improved health-related quality of life, satisfaction with medical care, and possibly survival.Methods: Medical, surgical, and radiation oncology patients completed a screening instrument before their appointments during a six-month period. Patients indicated their level of distress on four domains (practical, emotional, health and social concerns). De-identified data was collected, aggregated and descriptive statistics were analyzed.Results: Approximately 3000 screens were collected and 1500 cancer patients were screened. Of patients who indicated distress, 54% demonstrated a distress level of five or greater. Distress level eight was the most frequent level of distress indicated. The Cancer Dietitian was the most commonly requested healthcare team provider. The Health Concern domain was most frequently endorsed.Conclusion: NCCN, IOM and COC guidelines recommend distress screening in all cancer treatment centers, however implementation has proven difficult. This study adds to the literature about distress in cancer patients, demonstrates the feasibility of repeated distress screening and provides a model program demonstrating the implementation of repeated distress screening at a community cancer center. Findings highlight the importance of supportive oncology services due to the prevalence of high levels of distress. Findings demonstrate the importance of the Cancer Dietitian in supportive cancer care. Additionally, the research reveals a potential perceived stigma in seeking psychosocial oncology services.

DUI program as OEF/OIF Veterans Outreach: Descriptive Data from Two Community-Based Outpatient Clinics

Although initially conceived as providing simply the preventive portion of an extended continuum of care for veterans, the Driving Under the Influence (DUI) program has turned out to be an important outreach service for active duty or recently discharged OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) veterans. Veterans receive empirically-based, state-mandated education and therapy under the only Department of Veterans Affairs (VA) - sponsored DUI program in the State of Colorado, with the advantage of having providers who are sensitive to symptoms of Post-Traumatic Stress Disorder (PTSD) and other relevant diagnoses specific to this population, including Traumatic Brain Injury (TBI). In this paper, the rapid growth of this program is described, as well as summary data regarding the completion, discontinuation, and augmentation of services from the original referral concern. Key results indicated that for nearly one third (31.9%) of the OEF/OIF veterans who were enrolled in the DUI program, this was their initial contact with the VA health care system. Furthermore, following their enrollment in the DUI program, more than one fourth (27.6%) were later referred to and attended other VA programs including PTSD rehabilitation and group therapy, anger management, and intensive inpatient or outpatient dual diagnosis programs. These and other findings from this study suggest that the DUI program may be an effective additional pathway for providing treatment that is particularly salient to the distinctive OEF/OIF population; one that may also result in earlier intervention for problem drinking and other problems related to combat. Relevant conclusions discussed herein primarily aim to improve providers' understanding of effective outreach, and to enhance the appropriate linkages between OEF/OIF veterans and existing VA services.

The Foundations of the Artists’ Community of Estes Park

"Estes Park lies in a beautiful location amongst the Rocky Mountains, sixty-five miles from Denver. Settlers came to the region in the second half of the nineteenth century. Among them in 1898 was artist R.H. Tallant who became a prominent landscape painter of the Rocky Mountains. Settling shortly after him was well-known painter Charles Partridge Adams. While Tallant and Adams founded the artists’ community, renowned artist Birger Sandzén and soon to be popular Dave Stirling were the mainstays pushing the artists’ community to new heights through the 1920s and 1930s. The establishment of a thriving artists’ community by Tallant, Adams, Sandzén and Stirling made Estes Park a recognizable place for attracting numerous artists throughout its history"

Symbol for a Community: The Dickens Opera House and Theaters of the American West

This paper reveals the importance of the Dickens Opera House to the local history of Longmont, Colorado. Through an exploration of pioneer history and of architectural patronage and audience accommodation, this paper illustrates how the Dickens Opera House participated in the construction of cultural identity and civic aspirations of the city of Longmont. Using the Tabor Opera House of Leadville and Wright Opera House of Ouray as framing examples to place the Dickens Opera House within its proper architectural and historical context, I approach the building’s inception, construction, and early years as a way to track the early civic identity of a community through a work of architecture. The Dickens Opera House provided a point for the citizens of Longmont to focus their hopes of success and respectability in a newly formed community. An opera house provided a high-class perception of a town that provided a projection of respectability. Such a construction was built from various sources – the architecture of the building, simply calling the building an ‘opera house’, furnishings in the latest fashions and equipment of the latest technology, and extravagant scenery and curtains. In addition to these outward projections, opera houses also provided a place for community events. It was the location in town that brought people together.

Integration of Sustainable Development Principles into a Community Park

Characteristics of six operating hot spring recreational facilities were reviewed to identify opportunities for integrating a range of sustainable design and operation approaches into a community park. Potential operating cost savings were evaluated for a conceptual landscape project, bathhouse project, and swimming pool project that reduced the use of electricity, natural gas, water, the discharge of water, and solid waste generation. The projects showed a combined cost savings of approximately $40,000 per year by adopting passive solar design, energy efficient lighting, native vegetation, water efficient fixtures, and a natural swimming pool. The greatest potential operating cost reductions were observed for cutbacks in the use of swimming pool water and reductions in natural gas needed for building and swimming pool heating.

Community attributes determine facilitation potential in a semi-arid steppe

Studies on positive plant–plant relations have traditionally focused on pair-wise interactions. Conversely, the interaction with other co-occurring species has scarcely been addressed, despite the fact that the entire community may affect plant performance. We used woody vegetation patches as models to evaluate community facilitation in semi-arid steppes. We characterized biotic and physical attributes of 53 woody patches (patch size, litter accumulation, canopy density, vegetation cover, species number and identity, and phylogenetic distance), and soil fertility (organic C and total N), and evaluated their relative importance for the performance of seedlings of Pistacia lentiscus, a keystone woody species in western Mediterranean steppes. Seedlings were planted underneath the patches, and on their northern and southern edges. Woody patches positively affected seedling survival but not seedling growth. Soil fertility was higher underneath the patches than elsewhere. Physical and biotic attributes of woody patches affected seedling survival, but these effects depended on microsite conditions. The composition of the community of small shrubs and perennial grasses growing underneath the patches controlled seedling performance. An increase in Stipa tenacissima and a decrease in Brachypodium retusum increased the probability of survival. The cover of these species and other small shrubs, litter depth and community phylogenetic distance, were also related to seedling survival. Seedlings planted on the northern edge of the patches were mostly affected by attributes of the biotic community. These traits were of lesser importance in seedlings planted underneath and in the southern edge of patches, suggesting that constraints to seedling establishment differed within the patches. Our study highlights the importance of taking into consideration community attributes over pair-wise interactions when evaluating the outcome of ecological interactions in multi-specific communities, as they have profound implications in the composition, function and management of semi-arid steppes.

From community approaches to single-cell genomics: the discovery of ubiquitous hyperhalophilic Bacteroidetes generalists

The microbiota of multi-pond solar salterns around the world has been analyzed using a variety of culture-dependent and molecular techniques. However, studies addressing the dynamic nature of these systems are very scarce. Here we have characterized the temporal variation during 1 year of the microbiota of five ponds with increasing salinity (from 18% to >40%), by means of CARD-FISH and DGGE. Microbial community structure was statistically correlated with several environmental parameters, including ionic composition and meteorological factors, indicating that the microbial community was dynamic as specific phylotypes appeared only at certain times of the year. In addition to total salinity, microbial composition was strongly influenced by temperature and specific ionic composition. Remarkably, DGGE analyses unveiled the presence of most phylotypes previously detected in hypersaline systems using metagenomics and other molecular techniques, such as the very abundant Haloquadratum and Salinibacter representatives or the recently described low GC Actinobacteria and Nanohaloarchaeota. In addition, an uncultured group of Bacteroidetes was present along the whole range of salinity. Database searches indicated a previously unrecognized widespread distribution of this phylotype. Single-cell genome analysis of five members of this group suggested a set of metabolic characteristics that could provide competitive advantages in hypersaline environments, such as polymer degradation capabilities, the presence of retinal-binding light-activated proton pumps and arsenate reduction potential. In addition, the fairly high metagenomic fragment recruitment obtained for these single cells in both the intermediate and hypersaline ponds further confirm the DGGE data and point to the generalist lifestyle of this new Bacteroidetes group.

The Cultural Construction of Political Action: The Case of the European Community's Single Market Program. CES Germany & Europe Working Papers, No. 04.3, December 1993

Explaining the emergence of the European Community's Single Market Program requires making sense of how that institutional project carne onto the political agenda. I suggest that there are two features of the political process that have been not well understood. First, large-scale institutional projects usually require political opportunities to come to fruition. Second, they require strategic actors who can frame such projects in broad ways in order to attract a wide variety of groups. My basic argument is that the European Commission is an organization whose function is primarily to solve the bargaining game that characterizes interaction within the Community and act as a strategic actor. This does not suggest that they are always successful or are the only source of ideas, but instead that they are the collective actor responsible for trying to frame collective interests in new cultural ways. To illustrate this point, I document how the; Single Market program evolved within the Commission and how other important Community actors carne to sign on to its goals over time.

Pollen profiles from a Late Palaeolithic site in the community of Bad Buchau-Kappel, Baden-Wuerttemberg, Germany

Excavations were carried out in a Late Palaeolithic site in the community of Bad Buchau-Kappel between 2003 and 2007. Archaeological investigations covered a total of more than 200 m**2. This site is the product of what likely were multiple occupations that occurred during the Late Glacial on the Federsee shore in this location. The site is situated on a mineral ridge that projected into the former Late Glacial lake Federsee. This beach ridge consists of deposits of fine to coarse gravel and sand and was surrounded by open water, except for a connection to the solid shore on the south. A lagoon lay between the hook-shaped ridge and the shore of the Federsee. This exposed location provided optimal access to the water of the lake. In addition, the small lagoon may have served as a natural harbor for landing boats or canoes. Sedimentological and palynological investigations document the dynamic history of the location between 14,500 and 11,600 years before present (cal BP). Evidence of the deposition of sands, gravels and muds since the Bølling Interstadial is provided by stratigraphic and palynological analyses. The major occupation occurred in the second half of the Younger Dryas period. Most of the finds were located on or in the sediments of the ridge; fewer finds occurred in the surrounding mud, which was also deposited during the Younger Dryas. Direct dates on some bone fragments, however, demonstrate that intermittent sporadic occupations also took place during the two millennia of the Meiendorf, Bølling, and Allerød Interstadials. These bones were reworked during the Younger Dryas and redeposited in the mud. A 14C date from one bone of 11,600 years ago (cal BP) places the Late Palaeolithic occupation of the ridge at the very end of the Younger Dryas, which is in agreement with stratigraphic observations. Stone artifacts, numbering 3,281, comprise the majority of finds from the site. These include typical artifacts of the Late Palaeolithic, such as backed points, short scrapers, and small burins. There are no bipointes or Malaurie-Points, which is in accord with the absolute date of the occupation. A majority of the artifacts are made from a brown chert that is obtainable a few kilometers north of the site in sediments of the Graupensandrinne. Other raw materials include red and green radiolarite that occur in the fluvioglacial gravels of Oberschwaben, as well as quartzite and lydite. The only non-local material present is a few artifacts of tabular chert from the region near Kelheim in Bavaria. A unique find consists of two fragments of a double-barbed harpoon made of red deer antler, which was found in the Younger Dryas mud. It is likely, but not certain, that this find belongs to the same assemblage as the numerous stone artifacts. Although not numerous, animal bones were also found in the excavations. Most of them lay in sediments of the Younger Dryas, but several 14C dates place some of these bones in earlier periods, including the Meiendorf, Bølling, and Allerød Interstadials. These bones were reworked by water and redeposited in mud sediments during the Younger Dryas. As a result, it is difficult to attribute individual bones to particular chronological positions without exact dates. Species that could be identified include wild horse (Equus spec.), moose or elk (Alces alces), red deer (Cervus elaphus), roe deer (Capreolus capreolus), aurochs or bison (Bos spec.), wild boar (Sus scrofa), as well as birds and fish, including pike (Esox Lucius).

Patenting Systems, Patentable Subject Matter, and Prior Art

The International School of Solid State Physics presented the 56th Course"Materials for Renewable Energy” in Erice (Italy), from July 18th to 28th 2012. This course was sponsored by the Italian Ministry of Education, University and Scientific Research, the Materials Research Society and the European Materials Research Society. The event was hosted at the "Ettore Majorana Foundation and Centre for Scientific Culture”. The school reviewed critical materials issues for the production and storage of renewable and sustainable energy. The aim of the School was to present the state-of-the-art and future perspectives in this critical area. It was to bring together the international community of students, young scientists, and experts in a unique atmosphere for reciprocal benefits in terms of enthusiasm, knowledge and new ideas.

Planning local solar projects.

"Prepared by Design Alternatives, Inc., Washington, DC, for the Community Services Administration under contract no. B9AF-009."

Emergency care systems demonstration projects. Volume 3: operational plans. Final report.

National Highway Safety Bureau, Washington, D.C.

Safety belt cooperative education and networking outreach projects Final report.

National Highway Traffic Safety Administration, Office of Occupant Protection, Washington, D.C.

Color in everyday : a manual for lay students, artisans and artists on the principles of color combination and color arrangement, and their applications in dress, home, business, the theatre and community play /

"The book has grown out of a course of lectures on 'Color and its applications, based on a study of Museum originals' given at the Metropolitan Museum of Art under the auspices of New York University."--Introd.

The art of landscape architecture /

"March 1990."