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Groups are increasingly used to deliver behavior change interventions, but such interventions are seldom based on theory and research on social group processes. A consequence of this is that existing group interventions are often heterogenous and difficult to evaluate. The social identity approach addresses important questions relevant to the design and delivery of group interventions for supporting behavior change. Drawing on this approach, the social identity model of behavior change explains how group processes can be harnessed in behavior change interventions. The model prioritizes the establishment of shared social identity among intervention group members and outlines how, through six core group resources, social identification can shape delivery of intervention content to achieve behavior change. Evidence for the key resources specified in the model is presented, and a step-by-step guide provided, to support the operationalization of the model’s principles in practice.
A collision-radiation model of the solid sample cesium sputter ion source led to the rediscovery of anion production by ion-pair production. The model revealed physical processes that may produce high current outputs from such sources and suggested new ways of obtaining high outputs at lower heat and conductive stress to the source. Primary among these solutions is the electron excitation of primary Cs0 recycled from the sample to provide states that efficiently create chosen anions. Here we look at how the processes might apply to gas-fed ion sources.
Increasing demands for small-scale radiocarbon (14C) analyses required the installation of a “SO-110 B” type ion source (HVE Europa B.V.) at our 6 MV Tandetron AMS (HVE) dedicated for the direct injection of CO2 using either the gas injection system (GIS) from Ionplus AG or a EuroVector EA 3000 elemental analyzer (EA). We tested both systems with multiple series of 14C-free and modern standards (2.5–50 µg C) combusted in quartz ampoules or EA containers and were able to quantify exogenous C introduced. In EA-GIS-AMS analysis exogenous C is mainly derived from the EA sample containers. Blank values for 50 µg C combusted in solvent-cleaned tin (Sn) vessels were 0.0127 ± 0.0012 F14C (boats) and 0.0090 ± 0.0010 F14C (capsules), while they were much higher for thermally cleaned silver (Ag) capsules. The processing of gas samples for GIS-AMS yields similar blank values corresponding to 0.30 ± 0.08 µg exogenous C with 0.93 ± 0.23 F14C consisting of 0.28 µg C modern and 0.02 µg C fossil C. The combustion of larger amounts of blank material (1 mg C) in a single quartz tube split into aliquots gives lower blanks (0.0064 ± 0.0008 F14C; 50 µg C). Thus, 14C analysis of small, gaseous samples is now possible at CologneAMS.
We sampled individual growth rings from three ancient remnant bald cypress (Taxodium distichum) trees from a massive buried deposit at the mouth of the Altamaha River on the Georgia Coast to determine the best technique for radiocarbon (14C) dating pretreatment. The results of our comparison of traditional ABA pretreatment and holocellulose and α-cellulose fractions show no significant differences among the pretreatments (<1 sigma) thereby suggesting that ABA pretreatment will prove sufficient for the development of a high-resolution 14C tree-ring chronology based on these ancient bald cypresses which will indicate whether the U.S. Southeast is subject to a regional radiocarbon offset.
Research mentor training is a valuable professional development activity. Options for training customization (by delivery mode, dosage, content) are needed to address the many critical attributes of effective mentoring relationships and to support mentors in different institutional settings.
We conducted a pilot randomized controlled trial to evaluate a hybrid mentor training approach consisting of an innovative, 90-minute, self-paced, online module (Optimizing the Practice of Mentoring, OPM) followed by workshops based on the Entering Mentoring (EM) curriculum. Mentors (n = 59) were randomized to intervention or control arms; the control condition was receipt of a two-page mentoring tip sheet. Surveys (pre, post, 3-month follow up) and focus groups assessed training impact (self-appraised knowledge, skills, behavior change) and participants’ perceptions of the blended training model.
The intervention (∼6.5 hours) produced significant improvements in all outcomes, including skills gains on par with those reported previously for the 8-hour EM model. Knowledge gains and intention-to-change mentoring practices were realized after completion of OPM and augmented by the in-person sessions. Mentors valued the synergy of the blended learning format, noting the unique strengths of each modality and specific benefits to completing a foundational online module before in-person engagement.
Findings from this pilot trial support the value of e-learning approaches, both as standalone curricula or as a component of hybrid implementation models, for the professional development of research mentors.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Properties of helioseismic acoustic oscillations (p modes) are modified by flows and magnetic fields in the solar interior, with frequencies, amplitudes and damping rates all varying systematically through the solar cycle. Crucially, now, we have a long enough baseline of helioseismic data to compare of the different activity cycles. We review recent efforts along these lines, from the impact of near-surface magnetic fields on p-mode frequencies to the evolution of the torsional oscillation and meridional circulation. We show that each activity cycle for which we have helioseismic data is slightly different in terms of the relationship between p mode frequencies and atmospheric proxies of activity, and in terms of the rotation and meridional circulation flows. However, many challenges remain, crucially including our ability to constrain flows and magnetic fields in the deep solar interior.
Solar simulations and observations showed that the detection of Earth twins around Sun-like stars is difficult in radial velocities with current methods techniques. The Sun has proved to be very useful to test processes, models, and analysis methods. The convective blueshift effect, dominating for the Sun, decreases towards lower mass stars, providing more suitable conditions to detect low mass planets. We describe the basic processes at work and how we extended a realistic solar model of radial velocity, photometry, astrometry and LogR′HK variability, using a coherent grid of stellar parameters covering a large range in mass and average activity levels. We present selected results concerning the impact of magnetic activity on Earth-mass planet detectability as a function of stellar type. We show how such realistic simulations can help characterizing the effect of stellar activity on RV and astrometric exoplanet detection.
Hospitals may implement admission screening cultures and may review transfer documentation to identify patients colonized with carbapenem-resistant Enterobacteriaceae (CRE) to implement isolation precautions; however, outcomes and logistical considerations have not been well described.
At an academic hospital in Chicago, we retrospectively studied the implementation and outcomes of CRE admission screening from 2013 to 2016 during 2 periods. During period 1, we implemented active CRE rectal culture screening for all adults patients admitted to intensive care units (ICUs) and for those transferred from outside facilities to general wards. During period 2, screening was restricted only to adults transferred from outside facilities. For a subset of transferred patients who were previously reported to the health department as CRE positive, we reviewed transfer paperwork for appropriate documentation of CRE.
Overall, 11,757 patients qualified for screening; rectal cultures were performed for 8,569 patients (73%). Rates of CRE screen positivity differed by period, previous facility type (if transferred), and current inpatient location. A higher combined CRE positivity rate was detected in the medical and surgical ICUs among period 2 patients (3.3%) versus all other ward-period comparisons (P<.001). Among 13 transferred patients previously known to be CRE colonized, appropriate CRE transfer documentation was available for only 4 patients (31%).
Active screening for CRE is feasible, and screening patients transferred from outside facilities to the medical or surgical ICU resulted in the highest screen positivity rate. Furthermore, CRE carriage was inconsistently documented in transfer paperwork, suggesting that admission screening or enhanced inter-facility communication are needed to improve the identification of CRE-colonized patients.
Background: Central neuropathic pain syndromes are a result of central nervous system injury, most commonly related to stroke, traumatic spinal cord injury, or multiple sclerosis. These syndromes are distinctly less common than peripheral neuropathic pain, and less is known regarding the underlying pathophysiology, appropriate pharmacotherapy, and long-term outcomes. The objective of this study was to determine the long-term clinical effectiveness of the management of central neuropathic pain relative to peripheral neuropathic pain at tertiary pain centers. Methods: Patients diagnosed with central (n=79) and peripheral (n=710) neuropathic pain were identified for analysis from a prospective observational cohort study of patients with chronic neuropathic pain recruited from seven Canadian tertiary pain centers. Data regarding patient characteristics, analgesic use, and patient-reported outcomes were collected at baseline and 12-month follow-up. The primary outcome measure was the composite of a reduction in average pain intensity and pain interference. Secondary outcome measures included assessments of function, mood, quality of life, catastrophizing, and patient satisfaction. Results: At 12-month follow-up, 13.5% (95% confidence interval [CI], 5.6-25.8) of patients with central neuropathic pain and complete data sets (n=52) achieved a ≥30% reduction in pain, whereas 38.5% (95% CI, 25.3-53.0) achieved a reduction of at least 1 point on the Pain Interference Scale. The proportion of patients with central neuropathic pain achieving both these measures, and thus the primary outcome, was 9.6% (95% CI, 3.2-21.0). Patients with peripheral neuropathic pain and complete data sets (n=463) were more likely to achieve this primary outcome at 12 months (25.3% of patients; 95% CI, 21.4-29.5) (p=0.012). Conclusion: Patients with central neuropathic pain syndromes managed in tertiary care centers were less likely to achieve a meaningful improvement in pain and function compared with patients with peripheral neuropathic pain at 12-month follow-up.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
Both Zuckert and Strauss take the “surface” of Machiavelli's work as the necessary starting point for their interpretations. Zuckert differs from Strauss, however, with respect to what she takes the surface to be. She focuses more attentively on the literary character of the work, as written or literary, and so is led to a different series of observations and emphases in her interpretation of Machiavelli.
There is limited empirical information on service-level outcome domains and indicators for the large number of people with intellectual disabilities being treated in forensic psychiatric hospitals.
This study identified and developed the domains that should be used to measure treatment outcomes for this population.
A systematic review of the literature highlighted 60 studies which met eligibility criteria; they were synthesised using content analysis. The findings were refined within a consultation and consensus exercises with carers, patients and experts.
The final framework encompassed three a priori superordinate domains: (a) effectiveness, (b) patient safety and (c) patient and carer experience. Within each of these, further sub-domains emerged from our systematic review and consultation exercises. These included severity of clinical symptoms, offending behaviours, reactive and restrictive interventions, quality of life and patient satisfaction.
To index recovery, services need to measure treatment outcomes using this framework.
OBJECTIVES/SPECIFIC AIMS: To diversify the biomedical research workforce by training postdoctoral scholars and junior faculty from 6 Minority Serving Institutions (MSIs) on practical research skills such as Critical and Creative Thinking, Formulating the Problem, Asking the Right Question, Grant Writing, and Team Science METHODS/STUDY POPULATION: In collaboration with our partners, we identified 11 topics where trainees lack research funding. Next, we identified instructors for these topics. We converted the topics to online module with modules ranging from 2 to 8 weeks. In working with an online education expert, we developed innovative online training using Moodle as the content management system. Scholars complete readings, videos, self-assessments and participate in discussion board each week. In addition, we have weekly synchronous sessions for each module. All scholars are required to take the grant writing module and 8 other modules. After each module, trainees complete a brief survey to evaluate the module. The leaders at the MSI participated in an intensive face-to-face training session on how to be a career coach so that they could be career coaches for the LEADS Scholars at their home institutions. RESULTS/ANTICIPATED RESULTS: In the first year, we selected 13 LEADS Scholars. All but 3 scholars elected to take every module. The 3 scholars did not enroll in the Peer Reviewing module. Results of the brief survey at the end of each module indicate that the scholars value each of the modules and rate them very highly. When 1 scholar wanted to leave the program, we decided to have a conference call with all of the LEADS Scholars to determine what was working and what was not working with the program. All scholars recognized the value of LEADS. Some scholars felt that the weekly synchronous session was too demanding as they have competing demands on their time. We consulted with the leadership at the MSI and decided to modify the requirements of the program such that every synchronous call was not required for successful completion of the module and to earn a badge. Scholars need to have at least 9 badges to earn a certificate. In addition to the training, we decided that scholars would also benefit from mock reviews of their grants. This will help them submit successful grants. We learned that the best way to serve the needs of the scholars is to work iteratively with the scholars and leadership to develop a successful program that most effectively meets their needs of the scholars and helps them launch a successful career. DISCUSSION/SIGNIFICANCE OF IMPACT: Postdoctoral scholars and junior faculty from MSI need practical research training to help launch their research career. We suspect that this is true of many institutions and plan to develop these modules so that they can be widely disseminated to other institutions.
Soft tissue-to-bone interfaces are complex structures that consist of gradients of extracellular matrix materials, cell phenotypes, and biochemical signals. These interfaces, called entheses for ligaments, tendons, and the meniscus, are crucial to joint function, transferring mechanical loads and stabilizing orthopedic joints. When injuries occur to connected soft tissue, the enthesis must be re-established to restore function, but due to structural complexity, repair has proven challenging. Tissue engineering offers a promising solution for regenerating these tissues. This prospective review discusses methodologies for tissue engineering the enthesis, outlined in three key design inputs: materials processing methods, cellular contributions, and biochemical factors.