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The weakening and/or removal of floating ice shelves in Antarctica can induce inland ice flow acceleration. Numerical modelling suggests these processes will play an important role in Antarctica's future sea-level contribution, but our understanding of the mechanisms that lead to ice tongue/shelf collapse is incomplete and largely based on observations from the Antarctic Peninsula and West Antarctica. Here, we use remote sensing of structural glaciology and ice velocity from 2001 to 2020 and analyse potential ocean-climate forcings to identify mechanisms that triggered the rapid disintegration of ~2445 km2 of ice mélange and part of the Voyeykov Ice Shelf in Wilkes Land, East Antarctica between 27 March and 28 May 2007. Results show disaggregation was pre-conditioned by weakening of the ice tongue's structural integrity and was triggered by mélange removal driven by a regional atmospheric circulation anomaly and a less extensive latent-heat polynya. Disaggregation did not induce inland ice flow acceleration, but our observations highlight an important mechanism through which floating termini can be removed, whereby the break-out of mélange and multiyear landfast sea ice triggers disaggregation of a structurally-weak ice shelf. These observations highlight the need for numerical ice-sheet models to account for interactions between sea-ice, mélange and ice shelves.
Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14 % being underweight (BMI < 18·5) and 42 % experiencing Fe deficiency anaemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab.
In-depth interviews and focus group discussions were conducted and then analysed using thematic analysis.
Three purposively selected rural districts (Sahiwal, Okara and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan
Mothers with children under age two (n 29) and healthcare providers with at least 5 years of experience working in the district (n 12).
We identified a combination of physiological, socio-cultural and structural barriers that inhibited healthful dietary intake during pregnancy. The primary physiological barriers to optimal dietary intake and dietary practices included food aversions and food cravings. Food classification, fear of a difficult childbirth, fear of high blood pressure and household food politics were the principal socio-cultural barriers. Additionally, two structural barriers, inadequate antenatal counseling and a lack of affordable food options, were identified.
Our study demonstrates that complex barriers prevent pregnant women in the Punjab area from consuming adequate dietary intake and that antenatal health education programmes and structural interventions are needed to support healthful dietary practices during this critical period.
To describe a pilot project infection prevention and control (IPC) assessment conducted in skilled nursing facilities (SNFs) in New York State (NYS) during a pivotal 2-week period when the region became the nation’s epicenter for coronavirus disease 2019 (COVID-19).
A telephone and video assessment of IPC measures in SNFs at high risk or experiencing COVID-19 activity.
SNFs in 14 New York counties, including New York City.
A 3-component remote IPC assessment: (1) screening tool; (2) telephone IPC checklist; and (3) COVID-19 video IPC assessment (ie, “COVIDeo”).
In total, 92 SNFs completed the IPC screening tool and checklist: 52 (57%) were conducted as part COVID-19 investigations, and 40 (43%) were proactive prevention-based assessments. Among the 40 proactive assessments, 14 (35%) identified suspected or confirmed COVID-19 cases. COVIDeo was performed in 26 (28%) of 92 assessments and provided observations that other tools would have missed: personal protective equipment (PPE) that was not easily accessible, redundant, or improperly donned, doffed, or stored and specific challenges implementing IPC in specialty populations. The IPC assessments took ∼1 hour each and reached an estimated 4 times as many SNFs as on-site visits in a similar time frame.
Remote IPC assessments by telephone and video were timely and feasible methods of assessing the extent to which IPC interventions had been implemented in a vulnerable setting and to disseminate real-time recommendations. Remote assessments are now being implemented across New York State and in various healthcare facility types. Similar methods have been adapted nationally by the Centers for Disease Control and Prevention.
More than 50 years of randomized clinical trials for youth psychotherapies have resulted in moderate effect sizes for treatments targeting the most common mental health problems in children and adolescents (i.e., anxiety, depression, conduct problems, and attention disorders). Despite having psychotherapies that are effective for many children, there has been a dearth of progress in identifying the contextual factors that likely influence who will respond to a given psychotherapy, and under what conditions. The developmental psychopathology evidence base consistently demonstrates that psychosocial risk exposures (e.g., childhood adversities, interpersonal stressors, family dysfunction) significantly influence the onset and course of youth psychopathology. However, the developmental psychopathology framework remains to be well integrated into treatment development and psychotherapy research. We argue that advances in basic developmental psychopathology research carry promising implications for the design and content of youth psychotherapies. Research probing the effects of psychosocial risks on youth development can enrich efforts to identify contextual factors in psychotherapy effectiveness and to personalize treatment. In this article we review empirically supported and hypothesized influences of individual- and family-level risk factors on youth psychotherapy outcomes, and we propose a framework for leveraging developmental psychopathology to strengthen psychotherapies.
El Mirón is an important archaeological cave site in Cantabria (Spain) with a stratigraphy covering the late Middle Paleolithic to the Modern Period. The Magdalenian levels are especially rich in artifacts, faunal remains, and features, and included the burial of an adult female (“the Red Lady”), as well as other scattered human remains, while the Neolithic levels contained the oldest combined evidence of ceramics, domesticated grain and livestock in the region. However, in the absence of diagnostic artifacts in many levels that would always provide a traditional cultural chronology, radiocarbon dating has been essential in understanding the temporal framework for human activity at the site. Over the duration of more than two decades, the El Mirón Project has therefore obtained 93 radiocarbon dates, which cover the entire stratigraphic record as found in several different excavation areas. In light of the considerable methodological advances that radiocarbon dating has seen since 1996 we aim to evaluate the reliability of the published 14C record for El Mirón Cave, and to improve the accuracy of the radiocarbon based chronostratigraphy through Bayesian modeling. The results shed light on which dates may be used for future research and where dating discrepancies reflect taphonomic processes, thereby advancing intra-site and regional archaeological comparisons.
ABSTRACT IMPACT: The results of this research may influence NCCN guidelines on PET/CT surveillance for this population of patients for whom the guidelines are currently vague. OBJECTIVES/GOALS: We aim to quantify and describe the yield of surveillance PET/CT for detecting asymptomatic recurrence of melanoma after primary surgical treatment for stages IIB, IIC, and IIIA. Our goal is to provide evidence to inform appropriate guidelines for scheduling surveillance PET/CT for this population. METHODS/STUDY POPULATION: This is a retrospective study of patients who have undergone a PET/CT at Barnes-Jewish Hospital. Data will be collected in our Research Electronic Data Capture (REDCap) database. The sample size is 158. Data analysis will be explanatory for the yield of imaging and description of false positives and additional unnecessary workup. Survival endpoints will be reported and multivariate analysis with subgroups will be performed for predictors of PET/CT results. Cost-efficiency analysis will be conducted in collaboration with the Center for Health Economics and Policy (CHEP), with emphasis on a patient-oriented perspective. RESULTS/ANTICIPATED RESULTS: To date, we have collected data for 158 patients, with approximately equal numbers of each stage (56 IIB, 54 IIC, 48 IIIA). Due to lack of clear guidelines for this population, there is significant variation of imaging schedules and results between similar patients or groups of patients. This makes it difficult to anticipate results. Based on clinical experience, literature review, and preliminary data, we may anticipate lower yield of routine PET/CT for the detection of asymptomatic recurrence, with frequent false negatives and occasional false positives, in addition to detection and further workup of benign processes. DISCUSSION/SIGNIFICANCE OF FINDINGS: The high-risk stages IIB, IIC, and IIIA currently occupy a gray area where surveillance PET/CT remains controversial. For this group of patients, it is important to weigh the benefits of early detection and risks of false positives, unnecessary workup and anxiety, and cost.
Strong competitive ability of introduced plant species has been frequently stated as a key factor promoting successful invasion. The dynamics of invasive species may depend on their abilities to compete for resources and exploit disturbances relative to native species. This study compares the growth performance of the invasive blackberry (Rubus niveus Thunb.) with four of the most common woody native species of the Scalesia forest in the Galapagos Islands. Using a series of greenhouse and field studies, the growth rate and biomass production of native species alone and in competition with R. niveus was compared under different water and light stress conditions. Rubus niveus showed a faster growth rate and biomass production than the native species as well as a broad tolerance to light and water stress conditions. Competitive ability was also assessed by looking at the seedbank and regeneration processes after herbicide control in the field. Although the number of R. niveus seedlings that germinated from the soil samples was considerably larger than that of native species, recruitment of the invasive on the experimental plots was limited. Overall, R. niveus showed superior competitive ability over native species with comparable growth forms, suggesting a possible mechanism that enables R. niveus to successfully invade a wide range of habitats in the Galapagos Islands. Implementing an integrated management strategy including biological control, seedbank reduction, and active revegetation, should improve the efficiency of R. niveus management, enabling the restoration of degraded vegetation in the Galapagos.
In recent years, a variety of efforts have been made in political science to enable, encourage, or require scholars to be more open and explicit about the bases of their empirical claims and, in turn, make those claims more readily evaluable by others. While qualitative scholars have long taken an interest in making their research open, reflexive, and systematic, the recent push for overarching transparency norms and requirements has provoked serious concern within qualitative research communities and raised fundamental questions about the meaning, value, costs, and intellectual relevance of transparency for qualitative inquiry. In this Perspectives Reflection, we crystallize the central findings of a three-year deliberative process—the Qualitative Transparency Deliberations (QTD)—involving hundreds of political scientists in a broad discussion of these issues. Following an overview of the process and the key insights that emerged, we present summaries of the QTD Working Groups’ final reports. Drawing on a series of public, online conversations that unfolded at www.qualtd.net, the reports unpack transparency’s promise, practicalities, risks, and limitations in relation to different qualitative methodologies, forms of evidence, and research contexts. Taken as a whole, these reports—the full versions of which can be found in the Supplementary Materials—offer practical guidance to scholars designing and implementing qualitative research, and to editors, reviewers, and funders seeking to develop criteria of evaluation that are appropriate—as understood by relevant research communities—to the forms of inquiry being assessed. We dedicate this Reflection to the memory of our coauthor and QTD working group leader Kendra Koivu.1
Understanding place-based contributors to health requires geographically and culturally diverse study populations, but sharing location data is a significant challenge to multisite studies. Here, we describe a standardized and reproducible method to perform geospatial analyses for multisite studies. Using census tract-level information, we created software for geocoding and geospatial data linkage that was distributed to a consortium of birth cohorts located throughout the USA. Individual sites performed geospatial linkages and returned tract-level information for 8810 children to a central site for analyses. Our generalizable approach demonstrates the feasibility of geospatial analyses across study sites to promote collaborative translational research.
Ice shelves restrain flow from the Greenland and Antarctic ice sheets. Climate-ocean warming could force thinning or collapse of floating ice shelves and subsequently accelerate flow, increase ice discharge and raise global mean sea levels. Petermann Glacier (PG), northwest Greenland, recently lost large sections of its ice shelf, but its response to total ice shelf loss in the future remains uncertain. Here, we use the ice flow model Úa to assess the sensitivity of PG to changes in ice shelf extent, and to estimate the resultant loss of grounded ice and contribution to sea level rise. Our results have shown that under several scenarios of ice shelf thinning and retreat, removal of the shelf will not contribute substantially to global mean sea level (<1 mm). We hypothesize that grounded ice loss was limited by the stabilization of the grounding line at a topographic high ~12 km inland of its current grounding line position. Further inland, the likelihood of a narrow fjord that slopes seawards suggests that PG is likely to remain insensitive to terminus changes in the near future.
Pollination services are critical for food production. Although domesticated honey bees are important pollinators in agriculture, there is growing interest in supporting naturally occurring wild bees. Diversifying pollination management strategies by encouraging healthy wild bee communities may be especially useful for growers of insect-pollinated crops, such as apples. Although research has identified several land management practices that can enhance local pollinator communities on farms, there are few studies on the factors that influence growers to adopt pollinator-supporting actions on their land. Here, we surveyed 75 Canadian apple growers and used regression models to explore the influence of farm characteristics and perceptions about bees on the likelihood of adopting 15 unique pollinator-supporting practices. We also provide a descriptive analysis of growers' pollination management practices and self-assessed resourcefulness on the ability to improve habitat for wild pollinators on the farm. We found that an increase in three variables: awareness of wild bees, perception of the severity of threats facing wild populations, and the perception of the benefits provided by wild bees is associated with more pollinator-supporting practices on the farm. Overall, growers were less likely to adopt pollinator-friendly practices as the fraction of rented land increased and as the perceived costs of implementing these practices rose. We found ‘low-hanging fruit’ (i.e., pollinator-supporting practices that could be easily and inexpensively implemented) were adopted by less than one-third of growers and that the majority of those surveyed had little to no knowledge on what actions to take if they wanted to improve their farms for wild bees or where to go for that knowledge. Our results suggest that policies and programs that focus on raising grower awareness of wild bees, increasing grower perception of their benefits, and reducing the perceived costs of implementing pollinator-supporting practices may positively affect their uptake. A deeper understanding of grower perceptions will provide essential insight into how growers may contribute to wild pollinator conservation while potentially increasing agricultural production and reducing vulnerability borne of heavy reliance on managed pollinators.
To examine children’s sugar-sweetened beverage (SSB) and water intakes in relation to implemented intervention activities across the social ecological model (SEM) during a multilevel community trial.
Children’s Healthy Living was a multilevel, multicomponent community trial that reduced young child obesity (2013–2015). Baseline and 24-month cross-sectional data were analysed from nine intervention arm communities. Implemented intervention activities targeting reduced SSB and increased water consumption were coded by SEM level (child, caregiver, organisation, community and policy). Child SSB and water intakes were assessed by caregiver-completed 2-day dietary records. Multilevel linear regression models examined associations of changes in beverage intakes with activity frequencies at each SEM level.
US-Affiliated Pacific region.
Children aged 2–8 years (baseline: n 1343; 24 months: n 1158).
On average (± sd), communities implemented 74 ± 39 SSB and 72 ± 40 water activities. More than 90 % of activities targeted both beverages together. Community-level activities (e.g. social marketing campaign) were most common (61 % of total activities), and child-level activities (e.g. sugar counting game) were least common (4 %). SSB activities across SEM levels were not associated with SSB intake changes. Additional community-level water activities were associated with increased water intake (0·62 ml/d/activity; 95 % CI: 0·09, 1·15) and water-for-SSB substitution (operationalised as SSB minus water: –0·88 ml/d/activity; 95 % CI: –1·72, –0·03). Activities implemented at the organization level (e.g. strengthening preschool wellness guidelines) and policy level (e.g. SSB tax advocacy) also suggested greater water-for-SSB substitution (P < 0·10).
Community-level intervention activities were associated with increased water intake, alone and relative to SSB intake, among young children in the Pacific region.
Women in academic publishing and academic psychiatry face many challenges of gender inequality, including significant pay differentials, poor visibility in senior positions and a male-dominated hierarchical system. We discuss this problem and outline how the BJPsych plans to tackle these issues it in its own publishing.
Food insecurity is associated with a greater risk of depression among low-income adults in the USA. Members of food-insecure households have lower diet diversity than their food-secure counterparts. This study examined whether diet diversity moderates the association between food insecurity and depression.
Multiple logistic regression was conducted to examine independent associations between food insecurity and depression, between diet diversity and depression, and the moderating effect of diet diversity in the food insecurity–depression link.
Cross-sectional data from the National Health and Nutrition Examination Survey (2013–2014).
2636 low-income adults aged 18 years and older.
There was a positive association between food insecurity and depression among low-income adults. Diet diversity was not associated with depression. Diet diversity had a moderating effect on the association between food insecurity and depression among low-income adults.
Food insecurity is independently associated with depression among low-income adults in the USA. However, this association differs across levels of diet diversity. Longitudinal studies are needed to confirm the role diet diversity may play in the pathway between food insecurity and depression.
In a global society experiencing an increasing shortage of qualified workers and the recognition that individuals with autism spectrum disorder (ASD) can be effective employees, there is an uptick in private sector initiatives to address employment needs through the recruitment of workers with ASD. A case study methodology with consensual qualitative research analysis was used to gain a rich understanding of employment of people with ASD at a medium-sized clothier in collaboration with a service provider for people with ASD. Perceptions of implementation and effectiveness were collected. Results suggest the hiring of people with ASD was positively perceived by employees. Components of this success included changes to the physical work environment, diversity training specific to individuals with disabilities, and a company climate of engaging and supporting employees with ASD. This research suggests that the collaborative initiative may prove a meaningful model for other companies interested in employing people with ASD.
The Eating Assessment in Toddlers FFQ (EAT FFQ) has been shown to have good reliability and comparative validity for ranking nutrient intakes in young children. With the addition of food items (n 4), we aimed to re-assess the validity of the EAT FFQ and estimate calibration factors in a sub-sample of children (n 97) participating in the Growing Up Milk – Lite (GUMLi) randomised control trial (2015–2017). Participants completed the ninety-nine-item GUMLi EAT FFQ and record-assisted 24-h recalls (24HR) on two occasions. Energy and nutrient intakes were assessed at months 9 and 12 post-randomisation and calibration factors calculated to determine predicted estimates from the GUMLi EAT FFQ. Validity was assessed using Pearson correlation coefficients, weighted kappa (κ) and exact quartile categorisation. Calibration was calculated using linear regression models on 24HR, adjusted for sex and treatment group. Nutrient intakes were significantly correlated between the GUMLi EAT FFQ and 24HR at both time points. Energy-adjusted, de-attenuated Pearson correlations ranged from 0·3 (fibre) to 0·8 (Fe) at 9 months and from 0·3 (Ca) to 0·7 (Fe) at 12 months. Weighted κ for the quartiles ranged from 0·2 (Zn) to 0·6 (Fe) at 9 months and from 0·1 (total fat) to 0·5 (Fe) at 12 months. Exact agreement ranged from 30 to 74 %. Calibration factors predicted up to 56 % of the variation in the 24HR at 9 months and 44 % at 12 months. The GUMLi EAT FFQ remained a useful tool for ranking nutrient intakes with similar estimated validity compared with other FFQ used in children under 2 years.
Approximately, 1.7 million individuals in the United States have been infected with SARS-CoV-2, the virus responsible for the novel coronavirus disease-2019 (COVID-19). This has disproportionately impacted adults, but many children have been infected and hospitalised as well. To date, there is not much information published addressing the cardiac workup and monitoring of children with COVID-19. Here, we share the approach to the cardiac workup and monitoring utilised at a large congenital heart centre in New York City, the epicentre of the COVID-19 pandemic in the United States.