Reimagining Relationship-Based Health Care in a Post-COVID World.

The US health care system has a long history of discouraging the creation and maintenance of meaningful relationships between patients and providers. Fee-for-service payment models, the 1-directional, paternalistic approach of care providers, electronic health records, anddocumentation requirements, all present barriers to the development of meaningful relationships in clinic visits. As patients and providers adopt and experiment with telemedicine and other systems changes to accommodate the impact of Coronavirus disease 2019, there is an opportunity to reimagine visits entirely-both office-based and virtual-and leverage technology to transform a unidirectional model into one that values relationships as critical facilitators of health and well-being for both patients and providers.

The Effects of Mind-Body Interventions on Sleep Quality: A Systematic Review.

Study Objectives. To evaluate the effect of mind-body interventions (MBI) on sleep. Methods. We reviewed randomized controlled MBI trials on adults (through 2013) with at least one sleep outcome measure. We searched eleven electronic databases and excluded studies on interventions not considering mind-body medicine. Studies were categorized by type of MBI, whether sleep was primary or secondary outcome measure and outcome type. Results. 1323 abstracts were screened, and 112 papers were included. Overall, 67 (60%) of studies reported a beneficial effect on at least one sleep outcome measure. Of the most common interventions, 13/23 studies using meditation, 21/30 using movement MBI, and 14/25 using relaxation reported at least some improvements in sleep. There were clear risks of bias for many studies reviewed, especially when sleep was not the main focus. Conclusions. MBI should be considered as a treatment option for patients with sleep disturbance. The benefit of MBI needs to be better documented with objective outcomes as well as the mechanism of benefit elucidated. There is some evidence that MBI have a positive benefit on sleep quality. Since sleep has a direct impact on many other health outcomes, future MBI trials should consider including sleep outcome measurements.

Leaching of nutrients and trace elements from stockpiled turkey litter into soil.

In addition to nutrients, poultry are fed trace elements (e.g., As) for therapeutic purposes. Although a large proportion of the nutrients are assimilated by the birds, nearly all of the As is excreted. Hence, turkey litter constituents can leach into the soil and contaminate shallow ground water when it is stockpiled uncovered on bare soil. This study quantified the leaching of turkey litter constituents from uncovered stockpiles into the underlying soil. Four stockpiles were placed on Orangeburg loamy sand in summer 2004 for 162 d; 14 d after their removal, four stockpiles were created over the same footprints and left over winter for 162 d. Soil samples at depths of 7.6 to 30.5 cm and 30.5 to 61 cm adjacent to and beneath the stockpiles were compared for pH, electrical conductivity, total C, dissolved organic C, N species, P, water-extractable (WE)-P, As, WE-As, Cu, Mn, and Zn. All WE constituents affected the 7.6- to 30.5-cm layer, and some leached deeper; for example, NH(4)(+)-N concentrations were 184 and 62 times higher in the shallow and deep layers, respectively. During winter stockpiling, WE-As concentrations beneath the stockpiles tripled and doubled in the 7.6- to 30.5-cm and 30.5- to 61-cm layers, respectively, with WE-As being primarily as As(V). Heavy dissolved organic C and WE-P leaching likely increased solubilization of soil As, although WE-As concentrations were low due to the Al-rich soil and low-As litter. When used as drinking water, shallow ground water should be monitored on farms with a history of litter stockpiling on bare soil; high litter As; and high soil As, Fe, and Mn concentrations.

Analysis of sleep parameters in patients with obstructive sleep apnea studied in a hospital vs. a hotel-based sleep center.

BACKGROUND: Polysomnography is associated with changes in sleep architecture called the first-night effect. This effect is believed to result from sleeping in an unusual environment and the technical equipment used to study sleep. Sleep experts hope to decrease this variable by providing a more familiar, comfortable atmosphere for sleep testing through hotel-based sleep centers. In this study, we compared the sleep parameters of patients studied in our hotel-based and hospital-based sleep laboratories. METHODS: We retrospectively reviewed polysomnograms completed in our hotel-based and hospital-based sleep laboratories from August 2003 to July 2005. All patients were undergoing evaluation for obstructive sleep apnea. Hospital-based patients were matched for age and apnea-hypopnea index with hotel-based patients. We compared the sleep architecture changes associated with the first-night effect in the two groups. The associated conditions and symptoms listed on the polysomnography referral forms are also compared. RESULTS: No significant differences were detected between the two groups in sleep onset latency, sleep efficiency, REM sleep latency, total amount of slow wave sleep (NREM stages 3 and 4), arousal index, and total stage 1 sleep. CONCLUSIONS: This pilot study failed to show a difference in sleep parameters associated with the first-night effect in patients undergoing sleep studies in our hotel and hospital-based sleep laboratories. Future studies need to compare the first-night effect in different sleep disorders, preferably in multi-night recordings.

Dissolution of phosphate in a phosphorus-enriched ultisol as affected by microbial reduction.

Phosphorus dissolution often increases as soils become more reduced, but the mechanisms are not fully understood. The objectives of this research were to determine rates and mechanisms of P dissolution during microbial reduction of a surface soil from the North Carolina Coastal Plain. Duplicate suspensions of silt + clay fractions from a Cape Fear sandy clay loam (fine, mixed, semiactive, thermic Typic Umbraquult) were reduced in a continuously stirred redox reactor for 40 d. We studied the effects of three treatments on P dissolution: (i) 2 g dextrose kg(-1) solids added as a microbial carbon source at time 0 d; (ii) 2 g dextrose kg(-1) solids split into three additions at 0, 12, and 26 d; and (iii) no added dextrose. After 40 d of reduction, concentrations of dissolved reactive phosphorus (DRP) were similar for all treatments and increased up to sevenfold from 1.5 to 10 mg L(-1). The initial rate of reduction and dissolution of DRP was significantly greater for the 0-d treatment. A linear relationship (R(2) = 0.79) was found between DRP and dissolved organic carbon (DOC). Dissolved Fe and Al and pH increased, suggesting the formation of aqueous Fe- and Al-organic matter complexes. Separate batch experiments were performed to study the effects of increasing pH and citrate additions on PO(4) dissolution under aerobic conditions. Increasing additions of citrate increased concentrations of DRP, Fe, and Al, while increasing pH had no effect. Results indicated that increased dissolved organic matter (DOM) during soil reduction contributed to the increase in DRP, perhaps by competitive adsorption or formation of aqueous ternary DOM-Fe-PO(4) or DOM-Al-PO(4) complexes.