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Effective management of uncertainty can lead to better, more informed decisions. However, many decision makers and their advisers do not always face up to uncertainty, in part because there is little constructive guidance or tools available to help. This paper outlines six Uncertainty Principles to manage uncertainty.
Face up to uncertainty
Deconstruct the problem
Don’t be fooled (un/intentional biases)
Models can be helpful, but also dangerous
Think about adaptability and resilience
Bring people with you
These were arrived at following extensive discussions and literature reviews over a 5-year period. While this is an important topic for actuaries, the intended audience is any decision maker or advisor in any sector (public or private).
In recent years, the discovery of massive quasars at $z\sim7$ has provided a striking challenge to our understanding of the origin and growth of supermassive black holes in the early Universe. Mounting observational and theoretical evidence indicates the viability of massive seeds, formed by the collapse of supermassive stars, as a progenitor model for such early, massive accreting black holes. Although considerable progress has been made in our theoretical understanding, many questions remain regarding how (and how often) such objects may form, how they live and die, and how next generation observatories may yield new insight into the origin of these primordial titans. This review focusses on our present understanding of this remarkable formation scenario, based on the discussions held at the Monash Prato Centre from November 20 to 24, 2017, during the workshop ‘Titans of the Early Universe: The Origin of the First Supermassive Black Holes’.
To describe the modification and validation of an existing instrument, the Environment and Policy Assessment and Observation (EPAO), to better capture provider feeding practices.
Design
Modifications to the EPAO were made, validity assessed through expert review, pilot tested and then used to collect follow-up data during a two-day home visit from an ongoing cluster-randomized trial. Exploratory factor analysis investigated the underlying factor structure of the feeding practices. To test predictive validity of the factors, multilevel mixed models examined associations between factors and child’s diet quality as captured by the Healthy Eating Index-2010 (HEI-2010) score (measured via the Dietary Observation in Childcare Protocol).
Setting
Family childcare homes (FCCH) in Rhode Island and North Carolina, USA.
Participants
The modified EPAO was pilot tested with fifty-three FCCH and then used to collect data in 133 FCCH.
Results
The final three-factor solution (‘coercive control and indulgent feeding practices’, ‘autonomy support practices’, ‘negative role modelling’) captured 43 % of total variance. In multilevel mixed models adjusted for covariates, ‘autonomy support practices’ was positively associated with children’s diet quality. A 1-unit increase in the use of ‘autonomy support practices’ was associated with a 9·4-unit increase in child HEI-2010 score (P=0·001).
Conclusions
Similar to the parenting literature, constructs which describe coercive controlling practices and those which describe autonomy-supportive practices emerged. Given that diets of pre-schoolers in the USA remain suboptimal, teaching childcare providers about supportive feeding practices may help improve children’s diet quality.
Seasonal influenza can cause significant morbidity in pregnant women. Much of the existing epidemiological evidence on influenza during pregnancy has focused on the 2009 A/H1N1 pandemic. To measure the epidemiological characteristics of seasonal influenza infection among pregnant women and the impact on infant health, a cohort of 86 779 pregnancies during the influenza season (2012–2014) was established using probabilistic linkage of notifiable infectious disease, hospital admission, and birth information. A total of 192 laboratory-confirmed influenza infections were identified (2·2 per 1000 pregnancies), 14·6% of which were admitted to hospital. There was no difference in the proportion of infections admitted to hospital by trimester or subtype of infection. Influenza B infections were more likely to occur in second trimester compared with influenza A/H3N2 and influenza A/H1N1 infections (41·3%, 23·6%, and 33·3%, respectively), and on average, infants born to women with influenza B during pregnancy had 4·0% (95% CI 0·3–7·6%) lower birth weight relative to optimal compared with infants born to uninfected women (P = 0·03). Results from this linked population-based study suggest that there are differences in maternal infection by virus type and subtype and support the provision of seasonal influenza vaccine to pregnant women.
Data were pooled from three Australian sentinel general practice influenza surveillance networks to estimate Australia-wide influenza vaccine coverage and effectiveness against community presentations for laboratory-confirmed influenza for the 2012, 2013 and 2014 seasons. Patients presenting with influenza-like illness at participating GP practices were swabbed and tested for influenza. The vaccination odds of patients testing positive were compared with patients testing negative to estimate influenza vaccine effectiveness (VE) by logistic regression, adjusting for age group, week of presentation and network. Pooling of data across Australia increased the sample size for estimation from a minimum of 684 to 3,683 in 2012, from 314 to 2,042 in 2013 and from 497 to 3,074 in 2014. Overall VE was 38% [95% confidence interval (CI) 24–49] in 2012, 60% (95% CI 45–70) in 2013 and 44% (95% CI 31–55) in 2014. For A(H1N1)pdm09 VE was 54% (95% CI–28 to 83) in 2012, 59% (95% CI 33–74) in 2013 and 55% (95% CI 39–67) in 2014. For A(H3N2), VE was 30% (95% CI 14–44) in 2012, 67% (95% CI 39–82) in 2013 and 26% (95% CI 1–45) in 2014. For influenza B, VE was stable across years at 56% (95% CI 37–70) in 2012, 57% (95% CI 30–73) in 2013 and 54% (95% CI 21–73) in 2014. Overall VE against influenza was low in 2012 and 2014 when A(H3N2) was the dominant strain and the vaccine was poorly matched. In contrast, overall VE was higher in 2013 when A(H1N1)pdm09 dominated and the vaccine was a better match. Pooling data can increase the sample available and enable more precise subtype- and age group-specific estimates, but limitations remain.
The Health Protection Agency/QSurveillance national surveillance system utilizes QSurveillance® a recently developed general practitioner database covering over 23 million people in the UK. We describe the spread of the first wave of the influenza A(H1N1) pandemic 2009 using data on consultations for influenza-like illness (ILI), respiratory illness and prescribing for influenza from 3400 contributing general practices. Daily data, provided from 27 April 2009 to 28 January 2010, were used to give a timely overview for those managing the pandemic nationally and locally. The first wave particularly affected London and the West Midlands with a peak in ILI in week 30. Children aged between 1 and 15 years had consistently high consultation rates for ILI. Daily ILI rates were used for modelling national weekly case estimates. The system enabled the ‘real-time’ monitoring of the pandemic to a small geographical area, linking morbidity and prescribing for influenza and other respiratory illnesses.
By
R. Maiolino, INAF – Astronomical Observatory of Rome, Italy,
S. Arribas, CSIC – Departamento de Astrofísica Molecular e Infrarroja, Madrid, Spain,
T. Böker, European Space Agency – ESTEC, Noordwijk, the Netherlands,
A. Bunker, School of Physics, University of Exeter, Exeter, UK,
S. Charlot, Institute d'Astrophysique de Paris, Paris, France,
G. de Marchi, European Space Agency – ESTEC, Noordwijk, the Netherlands,
P. Ferruit, CRAL – Observatoire de Lyon, 9 Avenue Charles André, Saint-Genis Laval, France,
M. Franx, Leiden Observatory, Leiden, the Netherlands,
P. Jakobsen, European Space Agency – ESTEC, Noordwijk, the Netherlands,
H. Moseley, NASA – Goddard Space Flight Center, MD, USA,
T. Nagao, National Astronomical Observatory of Japan, Osawa, Japan,
L. Origlia, INAF – Astronomical Observatory of Bologna, Bologna, Italy,
B. Rauscher, Leiden Observatory, Leiden, the Netherlands,
M. Regan, Space Telescope Science Institute, Baltimore, MD, USA,
H. W. Rix, Max-Planck-Institut für Astronomie, Heidelberg, Germany,
C. J. Willott, Herzberg Institute of Astrophysics, Victoria, Canada
The James Webb Space Telescope is a 6.6-m-aperture, passively cooled space observatory optimized for near-IR observations. It will be one of the most important observing facilities in the next decade, and it is designed to address numerous outstanding issues in astronomy. In this article we focus specifically on its capabilities to investigate the chemical abundances of various classes of astronomical objects and their metallicity evolution through the cosmic epochs.
Lactation alters maternal metabolism and increases food intake in rats to support milk production. Pancreatic lipase (PL) is primarily responsible for fat digestion in adults and is regulated by dietary fat. The present research determined the regulation of PL by lactation and dietary fat. In Expt 1, eighteen Sprague–Dawley dams and twelve age-matched virgins (controls) were fed a low-fat diet (LF; 11 % energy as safflower oil) for 7–63 d. At postpartum (day 0), peak lactation (day 15) and post-lactation (day 56) and after 7 d in virgins, the pancreas was removed for mRNA and enzyme analyses. In Expt 2, thirty-six Sprague–Dawley dams were fed LF until day 9 postpartum when dams were divided into three groups of twelve; one continued to be fed LF, one was fed a moderate-fat diet (MF; 40 % energy as safflower oil); and one was fed a high-fat diet (HF; 67 % energy as safflower oil) diet. At peak lactation (day 15) and post-lactation (day 56), the pancreas was removed for mRNA and enzyme analyses. Expt 1 revealed that lactation and post-lactation significantly (P<0·001) decreased PL mRNA (67 % and 76 %, respectively), but only post-lactation decreased PL activity. Increased dietary fat in Expt 2 significantly increased PL mRNA (LF<MF<HF, P<0·001) and PL activity (LF<MF=HF, P<0·02) in both lactation and post-lactation. In summary, lactation and post-lactation decreased PL mRNA significantly even though dietary fat still regulated PL activity and mRNA in lactation and post-lactation.
A postal survey was sent to all consultants in the psychiatry of learning disability from four English regions. Their views on job satisfaction, their core roles and the management re-structuring of services were elicited.
Results
The proportion agreeing or strongly agreeing with each management option was 79% for integrated mental health–learning disability trusts, 61% for specialist learning disability trusts, 47% for care trusts, 10% for primary care trusts and 5% for social services. Only 34% felt consulted or able to influence the process of change and only 33% were satisfied with the current management changes within their trust but 67% were satisfied overall with their jobs.
Clinical Implications
Management from integrated mental health–learning disability trusts is the most preferred option for psychiatrists in learning disability. A large number of consultants, though otherwise satisfied with their jobs, feel excluded or unable to influence the current changes in management structures. A model of integrated service provision in line with the government's learning disability strategy is presented.
Experiments to demonstrate the effects of various
beam-smoothing techniques have been performed on the 60-beam,
30-kJ UV OMEGA laser system. These include direct measurements
of the effect beam-smoothing techniques have on laser beam
nonuniformity and on both planar and spherical targets.
Demonstrated techniques include polarization smoothing
and “dual-tripler” third-harmonic generation
required for future broad bandwidth (∼1 THz) smoothing
by spectral dispersion (SSD). The effects of improvements
in single-beam uniformity are clearly seen in the target-physics
experiments, which also show the effect of the laser pulse
shape on the efficacy of SSD smoothing. Saturation of the
Rayleigh-Taylor (RT) growth of the broad-bandwidth features,
in agreement with the Haan model (Haan, 1989), produced
by laser imprinting has also been observed.
University research in the UK with high power lasers is carried out at the SERC's Central Laser Facility with a multi-terawatt neodymium glass laser, VULCAN, and a developmental KrF laser, SPRITE. These systems are briefly described together with the design of a new KrF laser to supersede VULCAN. The new laser design, SUPERSPRITE, is based on optical and Raman multiplexing which is being developed with the present SPRITE system. The specification of SUPERSPRITE is for 3.5 kJ in 1 ns and a peak power of 300 TW in short pulses. The new technology is seen as highly cost effective in relation to neodymium glass lasers. A resume of the development of XUV lasers in the UK in collaboration with laboratories overseas is given. The work is based on laser action through recombination in highly ionized ions and recent progress includes collaborative experiments on the GEKKO XII facility in Japan which have demonstrated laser action at the shortest wavelength to date at 45 A in Mg XII. The physics of energy transport in short pulses is fundamental to the extrapolation of recombination lasers to shorter wavelengths and is being studied from a more basic standpoint using both the VULCAN and SPRITE facilities. Some details of this work are given.
Two patients developed an extrapyramidal syndrome after therapy with lithium carbonate. Although the clinical features of this syndrome were indistinguishable from those of drug-induced parkinsonism, it was made worse by the anti-parkinsonian drug, orphenadrine. These findings were reproduced later under laboratory conditions when extrapyramidal symptoms and physiological tremor were recorded before and after challenge doses of orphenadrine. This unwanted effect of lithium carbonate may be explained by selective blockade of dopamine receptors.
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