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Our objective was to examine the performance characteristics of a bladder stimulation technique for urine collection among infants presenting to the emergency department (ED).
This prospective cohort study enrolled a convenience sample of infants aged ≤ 90 days requiring urine testing in the ED. Infants were excluded if critically ill, moderately to severely dehydrated, or having significant feeding issues. Bladder stimulation consisted of finger tapping on the lower abdomen with or without lower back massage while holding the child upright. The primary outcome was successful midstream urine collection within 5 minutes of stimulation. Secondary outcomes included sample contamination, bladder stimulation time for successful urine collection, and perceived patient distress on a 100-mm visual analog scale (VAS).
We enrolled 151 infants and included 147 in the analysis. Median age was 53 days (interquartile range [IQR] 27–68 days). Midstream urine sample collection using bladder stimulation was successful in 78 infants (53.1%; 95% confidence interval [CI] 45–60.9). Thirty-nine samples (50%) were contaminated. Most contaminated samples (n = 31; 79.5%) were reported as “no significant growth” or “growth of 3 or more organisms”. Median bladder stimulation time required for midstream urine collection was 45 seconds (IQR 20–120 seconds). Mean VAS for infant distress was 22 mm (standard deviation 23 mm).
The success rate of this bladder stimulation technique was lower than previously reported. The contamination rate was high, however most contaminated specimens were easily identified and had no clinical impact.
The science of studying diamond inclusions for understanding Earth history has developed significantly over the past decades, with new instrumentation and techniques applied to diamond sample archives revealing the stories contained within diamond inclusions. This chapter reviews what diamonds can tell us about the deep carbon cycle over the course of Earth’s history. It reviews how the geochemistry of diamonds and their inclusions inform us about the deep carbon cycle, the origin of the diamonds in Earth’s mantle, and the evolution of diamonds through time.
Psychosocial interventions that mitigate psychosocial distress in cancer patients are important. The primary aim of this study was to examine the feasibility and acceptability of an adaptation of the Mindful Self-Compassion (MSC) program among adult cancer patients. A secondary aim was to examine pre–post-program changes in psychosocial wellbeing.
The research design was a feasibility and acceptability study, with an examination of pre- to post-intervention changes in psychosocial measures. A study information pack was posted to 173 adult cancer patients 6 months–5 years post-diagnosis, with an invitation to attend an eight-week group-based adaptation of the MSC program.
Thirty-two (19%) consented to the program, with 30 commencing. Twenty-seven completed the program (mean age: 62.93 years, SD 14.04; 17 [63%] female), attending a mean 6.93 (SD 1.11) group sessions. There were no significant differences in medico-demographic factors between program-completers and those who did not consent. However, there was a trend toward shorter time since diagnosis in the program-completers group. Program-completers rated the program highly regarding content, relevance to the concerns of cancer patients, and the likelihood of recommending the program to other cancer patients. Sixty-three percent perceived that their mental wellbeing had improved from pre- to post-program; none perceived a deterioration in mental wellbeing. Small-to-medium effects were observed for depressive symptoms, fear of cancer recurrence, stress, loneliness, body image satisfaction, mindfulness, and self-compassion.
Significance of results
The MSC program appears feasible and acceptable to adults diagnosed with non-advanced cancer. The preliminary estimates of effect sizes in this sample suggest that participation in the program was associated with improvements in psychosocial wellbeing. Collectively, these findings suggest that there may be value in conducting an adequately powered randomized controlled trial to determine the efficacy of the MSC program in enhancing the psychosocial wellbeing of cancer patients.
OBJECTIVES/SPECIFIC AIMS: To translate a behavioral theory–informed, evidence-based, face-to-face health education program into an mHealth lifestyle intervention for African-Americans (AAs). METHODS/STUDY POPULATION: This mixed methods study consisted of 4 phases, using an iterative development process to intervention design with the AA community. In Phase 1, we held focus groups with AA community members and church partners (n=23) to gain insight regarding the needs and preferences of potential app end users. In Phase 2, the interdisciplinary research team synthesized input from Phase 1 for preliminary app design and content development. Phase 3 consisted of a sequential 3-meeting series with the church partners (n=13) for iterative app prototyping (assessment, cultural tailoring, final review). Phase 4 was a single group pilot study among AA church congregants (n=50) to assess app acceptability, usability, and satisfaction. RESULTS/ANTICIPATED RESULTS: Phase 1 focus groups indicated preferences for general and health related apps: multifunctional; high-quality graphics/visuals; evidence-based, yet simple health information; and social networking capability. Phase 2 integrated these preferences into the preliminary app prototype. Feedback from Phase 3 was used to refine the FAITH! App prototype for pilot testing. Phase 4 pilot testing indicated high acceptability, usability, and satisfaction of the FAITH! App. DISCUSSION/SIGNIFICANCE OF IMPACT: This study illustrates the process of using formative and CBPR approaches to design a culturally relevant, mHealth lifestyle intervention to address CV health disparities within the AA community. Given the positive perceptions of the app, our study supports the use of an iterative development process by others interested in implementing an mHealth lifestyle intervention for racial/ethnic minority communities.
The US Veterans Health Administration’s Disaster Emergency Medical Personnel System (DEMPS) is a team of employee disaster response volunteers who provide clinical and non-clinical staffing assistance when local systems are overwhelmed. This study evaluated attitudes and recommendations of the DEMPS program to understand the impact of multi-modal training on volunteer perceptions.
DEMPS volunteers completed an electronic survey in 2012 (n=2120). Three training modes were evaluated: online, field exercise, and face-to-face. Measures included: “Training Satisfaction,” “Attitudes about Training,” “Continued Engagement in DEMPS.” Data were analyzed using χ2 and logistic regression. Open-ended questions were evaluated in a manner consistent with grounded theory methodology.
Most respondents participated in DEMPS training (80%). Volunteers with multi-modal training who completed all 3 modes (14%) were significantly more likely to have positive attitudes about training, plan to continue as volunteers, and would recommend DEMPS to others (P-value<0.001). Some respondents requested additional interactive activities and suggested increased availability of training may improve volunteer engagement.
A blended learning environment using multi-modal training methods, could enhance satisfaction and attitudes and possibly encourage continued engagement in DEMPS or similar programs. DEMPS training program modifications in 2015 expanded this blended learning approach through new interactive online learning opportunities. (Disaster Med Public Health Preparedness. 2018;12:744-751)
A late Holocene carbonate spring mound and associated wetland deposits at Cienega Amarilla, New Mexico, contain a 4000-yr record of geomorphic, paleoenvironmental, and hydroclimatic change on the southern Colorado Plateau. Forty-four 14C dates support a century-scale chronostratigraphic framework. Pollen, plant macrofossil, mollusk, ostracode, and soil analyses indicate rapid spring mound growth and wetland expansion beginning ~2300 cal yr BP, followed by a pronounced decline in groundwater discharge (GWD) between ~1500 and 1000 cal yr BP. The isotopic composition of Cienega Amarilla springwater suggests GWD is driven primarily by winter precipitation. Historical climate data indicate that El Niño and warm Pacific Decadal Oscillation (PDO) conditions foster wetter-than-average winters in the Cienega Amarilla area, whereas dry winters are associated with La Niña conditions regardless of PDO phase. The ~2300–1500 cal yr BP Cienega Amarilla pluvial appears to represent an interval of peak, late Holocene cool-season precipitation that implies unusually strong or persistent El Niño–like and warm PDO–like conditions in the Pacific. Other southwestern paleoenvironmental records corroborate atypically wet conditions during this interval, and pluvial conditions related to increased winter precipitation likely fostered significant prehistoric cultural changes throughout the region, including increased sedentism, population, and dependence on agriculture.
Recent archaeological investigations at Pueblo Bonito in Chaco Canyon reveal that residents constructed a large diversion channel during the eleventh century A.D. as dramatic growth resulted in the expansion of the building onto the main valley floor. Sediments in the diversion channel reflect repeated episodes of flooding, rather than slow moving water typically found in irrigation canals, and archaeobotanical data indicate deposition during late summer or early fall. Although an agricultural function is possible, the channel may have been built primarily to divert floodwaters away from Pueblo Bonito while providing a nearby water source for construction and domestic use. The diversion channel was destroyed by the entrenchment of the “Bonito paleo-channel” in the late A.D. 1000s, and then buried by a combination of cultural debris and valley flooding. Although the canyon stream system changed throughout the occupation of Pueblo Bonito, there is no evidence that the formation of a deep natural channel in the floodplain had any negative effect on the growth of the great house
We determined the profitability and risk for spring- and fall-calving beef cows in Tennessee. Simulation models were developed using 19 years of data and considered the seasonality of cattle prices and feed prices for least-cost feed rations to find a distribution of net returns for spring- and fall-calving seasons for two weaning months. Fall calving was more profitable than the spring calving for all feed rations and weaning months. Fall calving was also risk preferred over spring calving for all levels of risk aversion. Higher calf prices at weaning were the primary factor influencing the risk efficiency of fall calving.
A pre-requisite for understanding the transition to the Neolithic in the Levant is the establishment of a robust chronology, most notably for the late Epi-Palaeolithic and Pre-Pottery Neolithic A (PPNA) periods. In this contribution we undertake a dating analysis of the Pre-Pottery Neolithic site of WF16, southern Jordan, drawing on a sample of 46 AMS 14C dates. We utilise Bayesian methods to quantify an old wood effect to provide an offset that we factor into chronological models for a number of individual structures at WF16 and for the settlement as a whole. In doing so we address the influence of slope variations in the calibration curve and expose the significance of sediment and sample redeposition within sites of this nature. We conclude that for the excavated deposits at WF16 human activity is likely to have started by c. 11.84 ka cal bp and lasted for at least c. 1590 years, ceasing by c. 10.24 ka cal bp. This is marked by a particularly intensive period of activity lasting for c. 350 years centred on 11.25 ka cal bp followed by less intensive activity lasting a further c. 880 years. The study reveals the potential of WF16 as a laboratory to explore methodological issues concerning 14C dating of early Neolithic sites in arid, erosional environments.
We previously reported an association between 5HTTLPR genotype and
outcome following cognitive–behavioural therapy (CBT) in child anxiety
(Cohort 1). Children homozygous for the low-expression short-allele
showed more positive outcomes. Other similar studies have produced mixed
results, with most reporting no association between genotype and CBT
To replicate the association between 5HTTLPR and CBT outcome in child
anxiety from the Genes for Treatment study (GxT Cohort 2,
n = 829).
Logistic and linear mixed effects models were used to examine the
relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both
cohorts were performed.
There was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2.
Mega-analyses identified a significant association between 5HTTLPR and
remission from all anxiety disorders at follow-up (odds ratio 0.45,
P = 0.014), but not primary anxiety disorder
The association between 5HTTLPR genotype and CBT outcome did not
replicate. Short-allele homozygotes showed more positive treatment
outcomes, but with small, non-significant effects. Future studies would
benefit from utilising whole genome approaches and large, homogenous
This fifth volume in the New South African Review series takes as its starting point the shock wave emanating from the events at Marikana on 16 August 2012 and how it has reverberated throughout politics and society. Some of the chapters in the volume refer directly to Marikana. In others, the infl uence of that fateful day is pervasive if not direct. Marikana has, for instance, made us look differently at the police and at how order is imposed on society. Monique Marks and David Bruce write that the massacre ‘has come to hold a central place in the analysis of policing, and broader political events since 2012’.The chapters highlight a range of current concerns – political, economic and social. David Dickinson’s chapter looks at the life of the poor in a township from within. In contrast, the chapter on foreign policy by Garth le Pere analyses South Africa’s approach to international relations in the Mandela, Mbeki and Zuma eras. Anthony Turton’s account, ‘When gold mining ends’ is a chilling forecast of an impending environmental catastrophe. Both Devan Pillay and Noor Nieftagodien focus attention on the left and, in different ways, ascribe its rise to a new politics in the wake of Marikana.The essays in NSAR 5: Beyond Marikana present a range of topics and perspectives of interest to general readers, but the book will also be a useful work of reference for students and researchers.
Beyond Marikana, the fifth edition of the New South African Review, continues to present informed, scholarly discussion and debate about key issues animating the South African experience. Produced between January 2014 and May 2015, this particular volume was shaped largely around the contention that there are significant political shifts underway in South Africa today, with several chapters tracing their fault lines to the 2012 massacre by police of striking mineworkers in a place called Marikana.
Although the third volume in the New South African Review series offered an analysis and critique of the various forces immediately implicated in the tragedy associated with Marikana, it could not have anticipated the kinds of political ructions that we have since witnessed, especially from within different parts of the African National Congress (ANC) Alliance. The fifth volume once again, then, consciously draws attention to Marikana, but this time asking what its effects and affects have been, and why it has had such an impact. In this way, Marikana becomes the starting point for a much broader discussion and debate about the potential for new political alliances and forms to emerge in the current context, a discussion that resonates globally in the wake of the political experiments of movements, such as Occupy Tahrir, Occupy Wall Street and the Spanish Indignados, and will hopefully continue in editions to come.
New South African Review 5 also offers close analyses of contemporary developments with regard to other aspects of, and issues affecting, South African society – including corruption, the economy, the Constitution, and uranium poisoning as a by-product of the mining industry.
This volume would not have been possible without the generosity of all its authors, to whom we are extremely grateful. Thanks must also go to the team at Wits University Press who continue to provide excellent guidance, assistance, skill and support to us as editors, and ensure that there is a final product for us to share. Particular thanks to the Dean of Humanities, Professor Ruksana Osman; Head of the School of Social Studies, Professor Shahid Vawda; and the Strategic Planning and Allocation of Resources Committee (Sparc) Fund for their ongoing support of the New South African Review.