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Sexual assault, including unwanted sexual contact, coercion, and rape, is a social phenomenon that has been approached in a variety of ways in different global contexts. Attempts to address risk and protective factors for perpetrators and victims are limited by the difficulty of collecting empirical data on experiences that can be traumatic, stigmatizing, complicated, and private. This chapter explores current and historic definitions of sexual assault as well as how these definitions influence estimates of sexual assault prevalence and subsequent psychological and public health responses. We describe best practices in sexual assault measurement, explore the need for culturally acceptable interventions that acknowledge intersections of identity, critique current victim response services, and finally provide recommendations for future directions in sexual assault prevention and response.
Introduced species can have strong ecological, social and economic effects on their non-native environment. Introductions of megafaunal species are rare and may contribute to rewilding efforts, but they may also have pronounced socio-ecological effects because of their scale of influence. A recent introduction of the hippopotamus Hippopotamus amphibius into Colombia is a novel introduction of a megaherbivore onto a new continent, and raises questions about the future dynamics of the socio-ecological system into which it has been introduced. Here we synthesize current knowledge about the Colombian hippopotamus population, review the literature on the species to predict potential ecological and socio-economic effects of this introduction, and make recommendations for future study. Hippopotamuses can have high population growth rates (7–11%) and, on the current trajectory, we predict there could be 400–800 individuals in Colombia by 2050. The hippopotamus is an ecosystem engineer that can have profound effects on terrestrial and aquatic environments and could therefore affect the native biodiversity of the Magdalena River basin. Hippopotamuses are also aggressive and may pose a threat to the many inhabitants of the region who rely upon the Magdalena River for their livelihoods, although the species could provide economic benefits through tourism. Further research is needed to quantify the current and future size and distribution of this hippopotamus population and to predict the likely ecological, social and economic effects. This knowledge must be balanced with consideration of social and cultural concerns to develop appropriate management strategies for this novel introduction.
Using existing data from clinical registries to support clinical trials and other prospective studies has the potential to improve research efficiency. However, little has been reported about staff experiences and lessons learned from implementation of this method in pediatric cardiology.
We describe the process of using existing registry data in the Pediatric Heart Network Residual Lesion Score Study, report stakeholders’ perspectives, and provide recommendations to guide future studies using this methodology.
The Residual Lesion Score Study, a 17-site prospective, observational study, piloted the use of existing local surgical registry data (collected for submission to the Society of Thoracic Surgeons-Congenital Heart Surgery Database) to supplement manual data collection. A survey regarding processes and perceptions was administered to study site and data coordinating center staff.
Survey response rate was 98% (54/55). Overall, 57% perceived that using registry data saved research staff time in the current study, and 74% perceived that it would save time in future studies; 55% noted significant upfront time in developing a methodology for extracting registry data. Survey recommendations included simplifying data extraction processes and tailoring to the needs of the study, understanding registry characteristics to maximise data quality and security, and involving all stakeholders in design and implementation processes.
Use of existing registry data was perceived to save time and promote efficiency. Consideration must be given to the upfront investment of time and resources needed. Ongoing efforts focussed on automating and centralising data management may aid in further optimising this methodology for future studies.
To assess the feasibility of electronic data capture of postdischarge durations and evaluate total durations of antimicrobial exposure related to inpatient hospital stays.
Multicenter, retrospective cohort study.
Two community hospitals and 1 academic medical center.
Hospitalized patients who received ≥1 dose of a systemic antimicrobial agent.
We collected and reviewed electronic data on inpatient and discharge antimicrobial prescribing from April to September 2016 in 3 pilot hospitals. Inpatient antimicrobial use was obtained from electronic medication administration records. Postdischarge antimicrobial use was calculated from electronic discharge prescriptions. We completed a manual validation to evaluate the ability of electronic prescriptions to capture intended postdischarge antibiotics. Inpatient, postdischarge, and total lengths of therapy (LOT) per admission were calculated to assess durations of antimicrobial therapy attributed to hospitalization.
A total of 45,693 inpatient admissions were evaluated. Antimicrobials were given during 23,447 admissions (51%), and electronic discharge prescriptions were captured in 7,442 admissions (16%). Manual validation revealed incomplete data capture in scenarios in which prescribers avoided the electronic system. The postdischarge LOT among admissions with discharge antimicrobials was median 8 days (range, 1–360) with peaks at 5, 7, 10, and 14 days. Postdischarge days accounted for 38% of antimicrobial exposure days.
Discharge antimicrobial therapy accounted for a large portion of antimicrobial exposure related to inpatient hospital stays. Discharge prescription data can feasibly be captured through electronic prescribing records and may aid in designing stewardship interventions at transitions of care.
Copper-alumina and copper-silica aerogels formed by impregnation of a copper(II) salt into an alumina or silica wet gel before supercritical extraction have been found to contain copper in multiple oxidation states: Cu0, Cu+1 and Cu+2. These aerogels are effective at catalyzing the reduction of NO and the oxidation of HCs and CO under conditions similar to those found in automotive three way catalysts. In this work we have developed a preparation method incorporating Cu0, Cu+1 and Cu+2 nanoparticles directly into silica aerogels. Nanoparticles in the form of (a) Cu0 nanorods (100 nm diameter, 10-20 μm length); (b) Cu+1 nanoparticles (350 nm diameter); and (c) Cu+2 nanoparticles (25-55 nm diameter) were added (0.5-15% by weight) to separate precursor mixtures consisting of tetramethyl orthosilicate, methanol, water and ammonia. These precursor mixtures were then processed using a rapid supercritical extraction (RSCE) method to form aerogels. The resulting aerogels show evidence of nanoparticles dispersed throughout the silica aerogel structure. Addition of Cu+1 and Cu+2 nanoparticles decreases the surface area of the aerogels significantly. X-Ray diffraction shows that regardless of initial oxidation state of the nanoparticles, crystalline Cu0 is detected after RSCE processing to 290 °C. Following heat treatment at 700 °C, crystalline Cu+2 is detected. The copper containing silica aerogels are found to be catalytically active with light-off temperatures (50% conversion) for NO and CO at 400 °C in three-way catalytic applications.
High-quality evidence on morale in the mental health workforce is
To describe staff well-being and satisfaction in a multicentre UK
National Health Service (NHS) sample and explore associated factors.
A questionnaire-based survey (n = 2258) was conducted in
100 wards and 36 community teams in England. Measures included a set of
frequently used indicators of staff morale, and measures of perceived job
characteristics based on Karasek's demand–control–support model.
Staff well-being and job satisfaction were fairly good on most
indicators, but emotional exhaustion was high among acute general ward
and community mental health team (CMHT) staff and among social workers.
Most morale indicators were moderately but significantly intercorrelated.
Principal components analysis yielded two components, one appearing to
reflect emotional strain, the other positive engagement with work. In
multilevel regression analyses factors associated with greater emotional
strain included working in a CMHT or psychiatric intensive care unit
(PICU), high job demands, low autonomy, limited support from managers and
colleagues, age under 45 years and junior grade. Greater positive
engagement was associated with high job demands, autonomy and support
from managers and colleagues, Black or Asian ethnic group, being a
psychiatrist or service manager and shorter length of service.
Potential foci for interventions to increase morale include CMHTs, PICUs
and general acute wards. The explanatory value of the
demand–support–control model was confirmed, but job characteristics did
not fully explain differences in morale indicators across service types
A detailed comparison between the experimental evolution of a two-dimensional soap froth and the large Q state Potts model is presented. The pattern evolution starting from identical initial conditions will be compared as well as a variety of distribution functions and correlations of the two systems. Simulations on different lattices show that the discrete lattice of the Potts model causes deviations from universal domain growth by weakening the vertex angle boundary conditions that form the basis of von Neumann's law. We show that the anisotropy inherent in a discrete lattice simulation, which masks the underlying ‘universal’ grain growth, can be overcome by increasing the range of the interaction between spins or increasing the temperature. Excellent overall agreement between the kinetics, topological distributions and domain size distributions between the low lattice anisotropy Potts-model simulations and the soap froth suggests that the Potts model is useful for studying domain growth in a wide variety of physical systems.
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