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The current research sought to better understand the effect of mindfulness on well-being by examining self-connection as a potential mediator. We define self-connection as: (1) an awareness of oneself, (2) an acceptance of oneself based on this awareness, and (3) an alignment of one’s behavior with this awareness. Based on this definition, we measured self-connection, mindfulness and well-being using two distinct samples and two different operationalizations of well-being. In Study 1, we recruited 101 people from Amazon’s Mechanical Turk (MTurk) and asked them about their connection to themselves, mindfulness and flourishing. In Study 2, we surveyed an additional 104 people from MTurk, again measuring mindfulness and self-connection. However, this time we operationalized well-being as satisfaction with life. As expected, mindfulness predicted self-connection and well-being in both studies. Self-connection also predicted well-being and partially mediated the relationship between mindfulness and well-being. These results suggest that mindfulness bolsters self-connection, which in turn increases people’s well-being.
Low rates of bystander cardiopulmonary resuscitation (CPR) were identified as a shortcoming in the “chain of survival” for out-of-hospital cardiac arrest (OHCA) care in the Korean city of Ansan. This study sought to evaluate the effect of an initiative to increase bystander CPR and quality of out-of-hospital resuscitation on outcome from OHCA. The post-intervention data were used to determine the next quality improvement (QI) target as part of the “Plan-Do-Study-Act” (PDSA) model for QI.
The study hypothesis was that bystander CPR, return of spontaneous circulation (ROSC), and survival to discharge after OHCA would increase in the post-intervention period.
This was a retrospective pre/post study. The data from the pre-intervention period were abstracted from 2008–2011 and the post-intervention period from 2012–2013. The effect of the intervention on the odds of ROSC and survival to hospital discharge was determined using a generalized estimating equation to account for confounders and the effect of clustering within medical centers. The analysis was then used to identify other factors associated with outcomes to determine the next targets for intervention in the chain of survival for cardiac arrest in this community.
Rates of documented bystander CPR increased from 13% in the pre-intervention period to 37% in the post-intervention period. The overall rate of ROSC decreased from 18.4% to 14.3% (risk difference −4.1%; 95% CI, −7.1%–1.0%), whereas survival to hospital discharge increased from 3.9% to 5.0% (risk difference 1.1%; 95% CI, −1.8%–3.8%), and survival with good neurologic outcome increased from 0.8% to 1.6% (risk difference 0.8%; 95% CI, −0.8%–2.4%). In multivariable analyses, there was no association between the intervention and the rate of ROSC or survival to hospital discharge. The designated level of the treating hospital was a significant predictor of both survival and ROSC.
In this case study, there were no observed improvements in outcomes from OHCA after the targeted intervention to improve out-of-hospital CPR. However, utilizing the PDSA model for QI, the designated level of the treating hospital was found to be a significant predictor of survival in the post-period, identifying the next target for intervention.
A collaborative research model was developed and tested to enable regional healthcare systems to join multisite clinical trials emanating from the Clinical and Translational Science Award (CTSA) Trial Innovation Network (TIN) by the Institute of Translational Health Sciences at the University of Washington and the Northwest Participant and Clinical Interactions (NW PCI) Network. The NW PCI is a collaborative group of regional research programs located at medical centers, healthcare systems, and universities across Washington, Wyoming, Alaska, Montana, and Idaho. This article describes the purpose, development, barriers, and initial experience with feasibility assessment for TIN-supported studies in the NW PCI. The tools and processes of the NW PCI Network were adapted to enable network sites to assess studies for clinical relevance and feasibility. Seven of seventeen TIN-supported studies were reviewed for consideration; three of which resulted in successful completion of study documentation for site selection by NW PCI sites. The NW PCI/TIN model can be adapted by other CTSAs to increase involvement of regional research programs in national multisite clinical research studies. Barriers to expanding TIN-supported trials to regional networks include short timelines for study document submissions, insufficient site reimbursement rates, and non-feasible study designs.
We employ global input–output analysis to quantify amplification of exogenous disturbances in compressible boundary layer flows. Using the spatial structure of the dominant response to time-periodic inputs, we explain the origin of steady reattachment streaks in a hypersonic flow over a compression ramp. Our analysis of the laminar shock–boundary layer interaction reveals that the streaks arise from a preferential amplification of upstream counter-rotating vortical perturbations with a specific spanwise wavelength. These streaks are associated with heat-flux striations at the wall near flow reattachment and they can trigger transition to turbulence. The streak wavelength predicted by our analysis compares favourably with observations from two different hypersonic compression ramp experiments. Furthermore, our analysis of inviscid transport equations demonstrates that base-flow deceleration contributes to the amplification of streamwise velocity and that the baroclinic effects are responsible for the production of streamwise vorticity. Finally, the appearance of the temperature streaks near reattachment is triggered by the growth of streamwise velocity and streamwise vorticity perturbations as well as by the amplification of upstream temperature perturbations by the reattachment shock.
Limited availability of fish oils (FO), rich in n-3 long-chain (≥C20) PUFA, is a major constraint for further growth of the aquaculture industry. Long-chain n-3 rich oils from crops GM with algal genes are promising new sources for the industry. This project studied the use of a newly developed n-3 canola oil (DHA-CA) in diets of Atlantic salmon fingerlings in freshwater. The DHA-CA oil has high proportions of the n-3 fatty acids (FA) 18 : 3n-3 and DHA and lower proportions of n-6 FA than conventional plant oils. Levels of phytosterols, vitamin E and minerals in the DHA-CA were within the natural variation of commercial canola oils. Pesticides, mycotoxins, polyaromatic hydrocarbons and heavy metals were below lowest qualifiable concentration. Two feeding trials were conducted to evaluate effects of two dietary levels of DHA-CA compared with two dietary levels of FO at two water temperatures. Fish increased their weight approximately 20-fold at 16°C and 12-fold at 12°C during the experimental periods, with equal growth in salmon fed the FO diets compared with DHA-CA diets. Salmon fed DHA-CA diets had approximately the same EPA+DHA content in whole body as salmon fed FO diets. Gene expression, lipid composition and oxidative stress-related enzyme activities showed only minor differences between the dietary groups, and the effects were mostly a result of dietary oil level, rather than the oil source. The results demonstrated that DHA-CA is a safe and effective replacement for FO in diets of Atlantic salmon during the sensitive fingerling life-stage.
Whether maternal obesity and gestational weight gain (GWG) are associated with early-childhood development in low-income, urban, minority populations, and whether effects differ by child sex remain unknown. This study examined the impact of prepregnancy BMI and GWG on early childhood neurodevelopment in the Columbia Center for Children’s Environmental Health Mothers and Newborns study. Maternal prepregnancy weight was obtained by self-report, and GWG was assessed from participant medical charts. At child age 3 years, the Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Intelligence were completed. Sex-stratified linear regression models assessed associations between prepregnancy BMI and pregnancy weight gain z-scores with child PDI and MDI scores, adjusting for covariates. Of 382 women, 48.2% were normal weight before pregnancy, 24.1% overweight, 23.0% obese, and 4.7% underweight. At 3 years, mean scores on the PDI and MDI were higher among girls compared to boys (PDI: 102.3 vs. 97.2, P = 0.0002; MDI: 92.8 vs. 88.3, P = 0.0001). In covariate-adjusted models, maternal obesity was markedly associated with lower PDI scores in boys [b = −7.81, 95% CI: (−13.08, −2.55), P = 0.004], but not girls. Maternal BMI was not associated with MDI in girls or boys, and GWG was not associated with PDI or MDI among either sex (all-P > 0.05). We found that prepregnancy obesity was associated with lower PDI scores at 3 years in boys, but not girls. The mechanisms underlying this sex-specific association remain unclear, but due to elevated obesity exposure in urban populations, further investigation is warranted.
To (i) determine the proportion of deaths from CVD that could be avoided in both rural and metropolitan Australia if public health recommendations were met; (ii) assess the impact on the rural CVD mortality; and (iii) determine if policy priorities should be different by rurality for CVD prevention.
A macro-simulation modelling study of population data. Population, risk factor and CVD death data stratified by rurality were analysed using the Preventable Risk Integrated Model. The baseline scenario was the current risk factor levels (including physical activity, smoking, diet and alcohol). The counterfactual scenario was the population levels of these risk factors expected if public health recommendations were met.
Metropolitan and rural Australia.
Rural- and metropolitan-dwelling adults in Australia.
Both populations would experience similar relative declines in the proportion of deaths from CVD. A total of 14 892 deaths from CVD would be avoided annually; with similar declines in the proportions of deaths by rurality. Critically, the order of policy priorities for public health recommendation attainment would differ by rurality CVD prevention, with addressing fat intakes being a higher priority in rural areas.
Achieving public health recommendations in Australia would result in large declines in CVD mortality. Despite declines in overall CVD mortality under this scenario, an inequality in CVD burden would persist for rural populations. The order of risk factor priorities would differ by rurality.
To analyse the evolution of the soft drink industry’s use of self-regulation as a response to obesity and examine the motivations driving its development and the strategies used to promote it to policy makers.
We used a data set of industry documents published by the Australian Beverages Council (ABC) between 1998 and 2016. We analysed how the ABC voiced its political motivations about self-regulation and what internal nutrition policies it developed prior to its public launch of self-regulation. We also analysed two promotional strategies: funding research and writing policy submissions.
Between 1998 and 2006, the ABC shifted from a defensive strategy that denied the role of its products in obesity to more conciliatory strategy that emphasised the role of the soft drink industry in solutions to obesity. The ABC deliberately timed the launch of its self-regulation to coincide with an international public health congress. Following its launch, the ABC funded research demonstrating the efficacy of self-regulation and wrote submissions to government nutrition policies arguing that further regulation was unnecessary.
The soft drink industry uses self-regulation to bolster its reputation and influence nutrition policy. Strategic timing plays a key role in the political influence of self-regulation.
Six on-farm studies determined the effects of a rolled rye cover crop, herbicide program, and planting technique on cotton stand, weed control, and cotton yield in Georgia. Treatments included: (1) rye drilled broadcast with 19-cm row spacing and a broadcast-herbicide program (2) rye drilled with a 25-cm rye-free zone in the cotton row and a broadcast-herbicide program (3) rye drilled with a 25-cm rye-free zone in the cotton row with PPI and PRE herbicides banded in the cotton planting row, and (4) no cover crop (i.e., weedy cover) with broadcast herbicides. At two locations, cotton stand was lowest with rye drilled broadcast; at these sites the rye-free zone maximized stand equal to the no-cover system. At a third location, cover crop systems resulted in greater stand, due to enhanced soil moisture preservation compared with the no-cover system. Treatments did not influence cotton stand at the other three locations and did not differ in the control of weeds other than Palmer amaranth at any location. Treatments controlled Palmer amaranth equally at three locations; however, differences were observed at the three locations having the greatest glyphosate-resistant plant densities. For these locations, when broadcasting herbicides, Palmer amaranth populations were reduced 82% to 86% in the broadcast rye and rye-free zone systems compared with the no-cover system at harvest. The system with banded herbicides was nearly 21 times less effective than the similar system broadcasting herbicides. At these locations, yields in the rye broadcast and rye-free zone systems with broadcast herbicides were increased 9% to 16% compared with systems with no cover or a rye-free zone with PPI and PRE herbicides banded. A rolled rye cover crop can lessen weed emergence and selection pressure while improving weed control and cotton yield, but herbicides should be broadcast in fields heavily infested with glyphosate-resistant Palmer amaranth.
Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.
Eating disorders are prevalent, potentially lethal, and treatable, yet remain underprioritised within clinical care, research and policy. Further, with rising public health focus on obesity, there is heightened risk for inadvertent exacerbation of disordered eating and further marginalisation of these serious mental disorders. This editorial calls for corrective action.
This chapter examines Marx’s involvement in French socialist thought and action. Contrary to the standard view, Marx’s ideas were widely available in France at this time through a series of translations that appeared from 1872. These translations presented a ‘French Marx’ that was subtly, but noticeably, different from the German original and other versions, and whose ideas were more finely attuned to French circumstances. The construction of this French Marx was overseen and encouraged by Marx himself, who in translation was often willing to sacrifice the ‘purity’ of his ideas in order to broaden their appeal. The chapter contrasts this with his rigidity in the First International – where most French socialists met Marx for the first time, and which forms the basis for most studies of French Marxism – and argues that historians must combine the two. In order to fully understand why ideas such as Marxism spread, we must supplement the social and organisational histories of international socialism with attentive studies of its ideas, its texts, and their dissemination.
This chapter calls into question a widely held historiographical perception that the failure of the Commune marked the end of a French revolutionary tradition inaugurated by the Revolution of 1789 and perpetuated by the Revolutions of 1830 and 1848. It reassesses the contexts in which the word ‘revolution’ was used and shows that this dominant interpretation conflicts with the actual writings of ex-Communards on the subject. Activists referred frequently to the events of the recent revolutionary past, but these references were not indicative of the desire to create a static and prescriptive ‘French revolutionary tradition’. Revolutionaries were preoccupied with placing events since 1789 within a longer and broader French genealogy in order to define revolution as a social movement rather than a political event. This was partly a response to moderate Republican efforts to claim and historicise the French Revolution after 1871, but was not solely a product of circumstances. Using the work of Louis Auguste Blanqui, I demonstrate that neutrality regarding the Revolution (1789 and the more radical 1793) had been an element of revolutionary thought since the 1850s. Consequently, I also suggest that the intellectual differences between revolutionaries and more moderate republicans during this period have been overstated.