Motivational Interviewing in Dialysis Adherence Study (MIDAS).

OBJECTIVE: To examine the feasibility and efficacy of a staff-delivered motivational interviewing technique on treatment, diet, medication, and fluid adherence in adult patients receiving outpatient hemodialysis. DESIGN: A pre-post design was used for this pilot study. SAMPLE/SETTING: Twenty-nine participants were recruited from a non-profit, free-standing hemodialysis clinic in the central United States. METHODS: Prior to and after the three-month motivational interviewing intervention, three months of adherence data and the Health Care Climate Questionnaire (HCCQ) were collected. RESULTS: Motivational interviewing appeared to influence dialysis attendance, frequency of shortened treatments, and phosphorous and albumin levels favorably while less favorably impacting interdialytic weight gain. Changes in the HCCQ scores were not statistically significant from pre- to post-intervention, though the trend was in the direction of improvement in autonomy support, a main component of motivational interviewing. Patients and staff found the approach acceptable. CONCLUSIONS: Motivational interviewing shows promise as an intervention to improve adherence in adults undergoing hemodialysis.

Continuous measurement of macronutrient ions in the transpiration stream of intact plants using the meadow spittlebug coupled with ion chromatography.

A method is described for continuous, nondestructive analysis of xylem-borne mineral nutrients in intact transpiring plants. The method uses the xylem-feeding insect the meadow spittlebug (Philaenus spumarius L. [Homoptera: Cercopidae]). This insect will feed from a wide range of plant species and organs. Insect excreta can be collected at all times of the day and night, and its mineral ion content can be analyzed rapidly, and without purification, by ion chromatography. The excreta will have a mineral content virtually identical to that of xylem sap. Cages suitable for containing the insects and collecting excreta from any desired location on plants in both laboratory and greenhouse are described. Even in the greenhouse, evaporation had only a minor effect on the sample ion content. Example results are presented which illustrate dynamics, over several days, in the xylem concentrations of sodium (Na(+)), potassium (K(+)), NH(4)(+), magnesium (Mg(2+)), calcium (Ca(2+)), chloride (Cl(-)), NO(3)(-), PO(4)(3-), and SO(4)(2-). These data were collected from young plants growing in pots of compost in the laboratory and from fully mature pepper (Capsicum annuum L. cv Bellboy) plants growing in hydroponics (rockwool) in the greenhouse. This method should facilitate studies of macronutrient uptake and transport in a range of plants and environments.