Practice management: observations, issues, and empirical evidence.

PubMed

Wong, H M; Braithwaite, J

2001-02-01

The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

Observational evidence for black holes

NASA Astrophysics Data System (ADS)

Hutchings, J. B.

1985-02-01

Observational data supporting the existence of black holes are presented graphically and characterized in a general review. Object classes discussed include quasars as galaxy cores, X-ray-emitting binaries (Cyg X-1, LMC X-3, and the apparent miniature quasar SS 433), radio galaxies and quasars with twin jets, and interacting galaxies. This evidence is found to strongly suggest that quasars are accreting black holes of mass about 10 to the 8th solar mass, that they formed more easily in earlier stages of the universe (corresponding to redshifts around 2), and that they are analogous in many ways to the stellar-mass object SS 433.

Do health economic evaluations using observational data provide reliable assessment of treatment effects?

PubMed Central

2013-01-01

Economic evaluation in modern health care systems is seen as a transparent scientific framework that can be used to advance progress towards improvements in population health at the best possible value. Despite the perceived superiority that trial-based studies have in terms of internal validity, economic evaluations often employ observational data. In this review, the interface between econometrics and economic evaluation is explored, with emphasis placed on highlighting methodological issues relating to the evaluation of cost-effectiveness within a bivariate framework. Studies that satisfied the eligibility criteria exemplified the use of matching, regression analysis, propensity scores, instrumental variables, as well as difference-in-differences approaches. All studies were reviewed and critically appraised using a structured template. The findings suggest that although state-of-the-art econometric methods have the potential to provide evidence on the causal effects of clinical and policy interventions, their application in economic evaluation is subject to a number of limitations. These range from no credible assessment of key assumptions and scarce evidence regarding the relative performance of different methods, to lack of reporting of important study elements, such as a summary outcome measure and its associated sampling uncertainty. Further research is required to better understand the ways in which observational data should be analysed in the context of the economic evaluation framework. PMID:24229445

Observational Evidence for Tidal Interaction in Close Binary Systems

NASA Astrophysics Data System (ADS)

Mazeh, T.

This paper reviews the rich corpus of observational evidence for tidal effects, mostly based on photometric and radial-velocity measurements. This is done in a period when the study of binaries is being revolutionized by large-scaled photometric surveys that are detecting many thousands of new binaries and tens of extrasolar planets. We begin by examining the short-term effects, such as ellipsoidal variability and apsidal motion. We next turn to the long-term effects, of which circularization was studied the most: a transition period between circular and eccentric orbits has been derived for eight coeval samples of binaries. The study of synchronization and spin-orbit alignment is less advanced. As binaries are supposed to reach synchronization before circularization, one can expect finding eccentric binaries in pseudo-synchronization state, the evidence for which is reviewed. We also discuss synchronization in PMS and young stars, and compare the emerging timescale with the circularization timescale. We next examine the tidal interaction in close binaries that are orbited by a third distant companion, and review the effect of pumping the binary eccentricity by the third star. We elaborate on the impact of the pumped eccentricity on the tidal evolution of close binaries residing in triple systems, which may shrink the binary separation. Finally we consider the extrasolar planets and the observational evidence for tidal interaction with their parent stars. This includes a mechanism that can induce radial drift of short-period planets, either inward or outward, depending on the planetary radial position relative to the corotation radius. Another effect is the circularization of planetary orbits, the evidence for which can be found in eccentricity-versus-period plot of the planets already known. Whenever possible, the paper attempts to address the possible confrontation between theory and observations, and to point out noteworthy cases and observations that can be

The Lesson Observation On-Line (Evidence Portfolio) Platform

ERIC Educational Resources Information Center

Cooper, David G.

2015-01-01

At a time when teacher training is being moved to school-based programmes it is important to engage in a research-informed dialogue about creating more distinctive, and cost-effective 21st century models of teacher training. Three years ago I began feasibility field testing the Lesson Observation On-line (Evidence Portfolio) Platform [LOOP]…

Observational Evidence for Atoms.

ERIC Educational Resources Information Center

Jones, Edwin R., Jr.; Childers, Richard L.

1984-01-01

Discusses the development of the concept of atomicity and some of the many which can be used to establish its validity. Chemical evidence, evidence from crystals, Faraday's law of electrolysis, and Avogadro's number are among the areas which show how the concept originally developed from a purely philosophical idea. (JN)

Observational Evidence of Magnetic Waves in the Solar Atmosphere

NASA Astrophysics Data System (ADS)

McIntosh, Scott W.

2012-03-01

The observational evidence in supporting the presence of magnetic waves in the outer solar atmosphere is growing rapidly - we will discuss recent observations and place them in context with salient observations made in the past. While the clear delineation of these magnetic wave "modes" is unclear, much can be learned about the environment in which they originated and possibly how they are removed from the system from the observations. Their diagnostic power is, as yet, untapped and their energy content (both as a mechanical source for the heating of coronal material and acceleration of the solar wind) remains in question, but can be probed observationally - raising challenges for modeling efforts. We look forward to the IRIS mission by proposing some sample observing sequences to help resolve some of the zoological issues present in the literature.

Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes.

PubMed

Eide, Per Kristian; Vatnehol, Svein Are Sirirud; Emblem, Kyrre Eeg; Ringstad, Geir

2018-05-08

Pre-clinical research in rodents provides evidence that the central nervous system (CNS) has functional lymphatic vessels. In-vivo observations in humans, however, are not demonstrated. We here show data on CNS lymphatic drainage to cervical lymph nodes in-vivo by magnetic resonance imaging (MRI) enhanced with an intrathecal contrast agent as a cerebrospinal fluid (CSF) tracer. Standardized MRI of the intracranial compartment and the neck were acquired before and up to 24-48 hours following intrathecal contrast agent administration in 19 individuals. Contrast enhancement was radiologically confirmed by signal changes in CSF nearby inferior frontal gyrus, brain parenchyma of inferior frontal gyrus, parahippocampal gyrus, thalamus and pons, and parenchyma of cervical lymph node, and with sagittal sinus and neck muscle serving as reference tissue for cranial and neck MRI acquisitions, respectively. Time series of changes in signal intensity shows that contrast enhancement within CSF precedes glymphatic enhancement and peaks at 4-6 hours following intrathecal injection. Cervical lymph node enhancement coincides in time with peak glymphatic enhancement, with peak after 24 hours. Our findings provide in-vivo evidence of CSF tracer drainage to cervical lymph nodes in humans. The time course of lymph node enhancement coincided with brain glymphatic enhancement rather than with CSF enhancement.

Training medical providers in evidence-based approaches to suicide prevention.

PubMed

DeHay, Tamara; Ross, Sarah; McFaul, Mimi

2015-01-01

Suicide is a significant issue in the United States and worldwide, and its prevention is a public health imperative. Primary care practices are an important setting for suicide prevention, as primary care providers have more frequent contact with patients at risk for suicide than any other type of health-care provider. The Western Interstate Commission for Higher Education, in partnership with the Suicide Prevention Resource Center, has developed a Suicide Prevention Toolkit and an associated training curriculum. These resources support the education of primary care providers in evidence-based strategies for identifying and treating patients at risk for suicide. The application of this curriculum to post-graduate medical training is presented here. © The Author(s) 2015.

Making and Recording Observations: When Done Well, Observations Can Serve as Evidence When Engaging in Science Practices

ERIC Educational Resources Information Center

Arias, Anna Maria; Davis, Elizabeth A.

2016-01-01

Making and recording scientific observations is a fundamental activity of the scientific community. Scientists use their senses and tools (e.g., magnifying glasses, rulers, colored pencils) to make records of the phenomena (e.g., light energy, ecosystems) they are investigating. These observations often serve as evidence in the scientific…

Visual adaptation provides objective electrophysiological evidence of facial identity discrimination.

PubMed

Retter, Talia L; Rossion, Bruno

2016-07-01

Discrimination of facial identities is a fundamental function of the human brain that is challenging to examine with macroscopic measurements of neural activity, such as those obtained with functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). Although visual adaptation or repetition suppression (RS) stimulation paradigms have been successfully implemented to this end with such recording techniques, objective evidence of an identity-specific discrimination response due to adaptation at the level of the visual representation is lacking. Here, we addressed this issue with fast periodic visual stimulation (FPVS) and EEG recording combined with a symmetry/asymmetry adaptation paradigm. Adaptation to one facial identity is induced through repeated presentation of that identity at a rate of 6 images per second (6 Hz) over 10 sec. Subsequently, this identity is presented in alternation with another facial identity (i.e., its anti-face, both faces being equidistant from an average face), producing an identity repetition rate of 3 Hz over a 20 sec testing sequence. A clear EEG response at 3 Hz is observed over the right occipito-temporal (ROT) cortex, indexing discrimination between the two facial identities in the absence of an explicit behavioral discrimination measure. This face identity discrimination occurs immediately after adaptation and disappears rapidly within 20 sec. Importantly, this 3 Hz response is not observed in a control condition without the single-identity 10 sec adaptation period. These results indicate that visual adaptation to a given facial identity produces an objective (i.e., at a pre-defined stimulation frequency) electrophysiological index of visual discrimination between that identity and another, and provides a unique behavior-free quantification of the effect of visual adaptation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Providers' Perceptions of and Receptivity toward Evidence-Based HIV Prevention Interventions

ERIC Educational Resources Information Center

Owczarzak, Jill; Dickson-Gomez, Julia

2011-01-01

Since 1999, the Centers for Disease Control and Prevention have trained over 10,000 service providers from more than 5,000 agencies to implement evidence-based HIV prevention interventions through its Diffusion of Effective Behavioral Interventions DEBI) program. Based on in-depth, semistructured interviews with a convenience sample of 22 HIV…

Providers' response to child eating behaviors: A direct observation study.

PubMed

Tovar, Alison; Vaughn, Amber E; Fallon, Megan; Hennessy, Erin; Burney, Regan; Østbye, Truls; Ward, Dianne S

2016-10-01

Child care providers play an important role in feeding young children, yet little is known about children's influence on providers' feeding practices. This qualitative study examines provider and child (18 months -4 years) feeding interactions. Trained data collectors observed 200 eating occasions in 48 family child care homes and recorded providers' responses to children's meal and snack time behaviors. Child behaviors initiating provider feeding practices were identified and practices were coded according to higher order constructs identified in a recent feeding practices content map. Analysis examined the most common feeding practices providers used to respond to each child behavior. Providers were predominately female (100%), African-American (75%), and obese (77%) and a third of children were overweight/obese (33%). Commonly observed child behaviors were: verbal and non-verbal refusals, verbal and non-verbal acceptance, being "all done", attempts for praise/attention, and asking for seconds. Children's acceptance of food elicited more autonomy supportive practices vs. coercive controlling. Requests for seconds was the most common behavior, resulting in coercive controlling practices (e.g., insisting child eat certain food or clean plate). Future interventions should train providers on responding to children's behaviors and helping children become more aware of internal satiety and hunger cues. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mariner 9 observations of the south polar cap of Mars - Evidence for residual CO2 frost

NASA Technical Reports Server (NTRS)

Paige, D. A.; Herkenhoff, K. E.; Murray, B. C.

1990-01-01

The first spacecraft observations of the south residual polar cap of Mars were obtained by the Mariner 9 orbiter during the Martian southern summer season, 1971-1972. Analyses of Viking orbiter observations obtained 3 Mars years later have shown that residual carbon dioxide frost was present at the south polar cap in 1977. In this study, Mariner 9 infrared interferometer spectrometer spectra and television camera images are used in conjuction with multispectral thermal emission models to constrain the temperatures of dark bare ground and bright frost regions within the south residual cap. The results provide strong evidence that carbon dioxide frost was present throughout the summer season despite the fact that the residual frost deposits observed by Mariner 9 were less extensive than those observed by Viking.

Additional specimen of Microraptor provides unique evidence of dinosaurs preying on birds

PubMed Central

O'Connor, Jingmai; Zhou, Zhonghe; Xu, Xing

2011-01-01

Preserved indicators of diet are extremely rare in the fossil record; even more so is unequivocal direct evidence for predator–prey relationships. Here, we report on a unique specimen of the small nonavian theropod Microraptor gui from the Early Cretaceous Jehol biota, China, which has the remains of an adult enantiornithine bird preserved in its abdomen, most likely not scavenged, but captured and consumed by the dinosaur. We provide direct evidence for the dietary preferences of Microraptor and a nonavian dinosaur feeding on a bird. Further, because Jehol enantiornithines were distinctly arboreal, in contrast to their cursorial ornithurine counterparts, this fossil suggests that Microraptor hunted in trees thereby supporting inferences that this taxon was also an arborealist, and provides further support for the arboreality of basal dromaeosaurids. PMID:22106278

Sleep EEG Provides Evidence that Cortical Changes Persist into Late Adolescence

PubMed Central

Tarokh, Leila; Van Reen, Eliza; LeBourgeois, Monique; Seifer, Ronald; Carskadon, Mary A.

2011-01-01

Study Objectives: To examine developmental changes in the human sleep electroencephalogram (EEG) during late adolescence. Setting: A 4-bed sleep laboratory. Participants: Fourteen adolescents (5 boys) were studied at ages 15 or 16 (initial) and again at ages 17 to 19 (follow-up). Interventions: N/A Measurements and Results: All-night polysomnography was recorded at each assessment and scored according to the criteria of Rechtschaffen and Kales. A 27% decline in duration of slow wave sleep, and a 22% increase of stage 2 sleep was observed from the initial to the follow-up session. All-night spectral analysis of 2 central and 2 occipital leads revealed a significant decline of NREM and REM sleep EEG power with increasing age across frequencies in both states. Time-frequency analysis revealed that the decline in power was consistent across the night for all bands except the delta band. The decreases in power were most pronounced over the left central (C3/A2) and right occipital (O2/A1) derivations. Conclusions: Using longitudinal data, we show that the developmental changes to the sleeping EEG that begin in early adolescence continue into late adolescence. As with early adolescents, we observed hemispheric asymmetry in the decline of sleep EEG power. This decline was state and frequency nonspecific, suggesting that it may be due to the pruning of synapses known to occur during adolescence. Citation: Tarokh L; Van Reen E; LeBourgeois M; Seifer R; Carskadon MA. Sleep EEG provides evidence that cortical changes persist into late adolescence. SLEEP 2011;34(10):1385–1393. PMID:21966070

Identifying Perceived Barriers along the HIV Care Continuum: Findings from Providers, Peer Educators, and Observations of Provider–Patient Interactions in Ethiopia

PubMed Central

Kulkarni, Sarah; Hoffman, Susie; Gadisa, Tsigereda; Melaku, Zenebe; Fantehun, Mesganaw; Yigzaw, Muluneh; El-Sadr, Wafaa; Remien, Robert; Tymejczyk, Olga; Nash, Denis; Elul, Batya

2015-01-01

Increasing the proportion of HIV-positive individuals who link promptly to and are retained in care remains challenging in sub- Saharan Africa, but little evidence is available from the provider perspective. In 4 Ethiopian health facilities, we (1) interviewed providers and peer educators about their perceptions of service delivery- and patient-level barriers and (2) observed provider–patient interactions to characterize content and interpersonal aspects of counseling. In interviews, providers and peer educators demonstrated empathy and identified nonacceptance of HIV status, anticipated stigma from unintended disclosure, and fear of antiretroviral therapy as patient barriers, and brusque counseling and insufficient counseling at provider-initiated testing sites as service delivery-related. However, observations from the same clinics showed that providers often failed to elicit patients’ barriers to retention, making it unlikely these would be addressed during counseling. Training is needed to improve interpersonal aspects of counseling and ensure providers elicit and address barriers to HIV care experienced by patients. PMID:26173944

A visual processing advantage for young-adolescent deaf observers: Evidence from face and object matching tasks

PubMed Central

Megreya, Ahmed M.; Bindemann, Markus

2017-01-01

It is unresolved whether the permanent auditory deprivation that deaf people experience leads to the enhanced visual processing of faces. The current study explored this question with a matching task in which observers searched for a target face among a concurrent lineup of ten faces. This was compared with a control task in which the same stimuli were presented upside down, to disrupt typical face processing, and an object matching task. A sample of young-adolescent deaf observers performed with higher accuracy than hearing controls across all of these tasks. These results clarify previous findings and provide evidence for a general visual processing advantage in deaf observers rather than a face-specific effect. PMID:28117407

Observational evidence for cloud cover enhancement over western European forests

PubMed Central

Teuling, Adriaan J.; Taylor, Christopher M.; Meirink, Jan Fokke; Melsen, Lieke A.; Miralles, Diego G.; van Heerwaarden, Chiel C.; Vautard, Robert; Stegehuis, Annemiek I.; Nabuurs, Gert-Jan; de Arellano, Jordi Vilà-Guerau

2017-01-01

Forests impact regional hydrology and climate directly by regulating water and heat fluxes. Indirect effects through cloud formation and precipitation can be important in facilitating continental-scale moisture recycling but are poorly understood at regional scales. In particular, the impact of temperate forest on clouds is largely unknown. Here we provide observational evidence for a strong increase in cloud cover over large forest regions in western Europe based on analysis of 10 years of 15 min resolution data from geostationary satellites. In addition, we show that widespread windthrow by cyclone Klaus in the Landes forest led to a significant decrease in local cloud cover in subsequent years. Strong cloud development along the downwind edges of larger forest areas are consistent with a forest-breeze mesoscale circulation. Our results highlight the need to include impacts on cloud formation when evaluating the water and climate services of temperate forests, in particular around densely populated areas. PMID:28074840

Observational evidence for cloud cover enhancement over western European forests.

PubMed

Teuling, Adriaan J; Taylor, Christopher M; Meirink, Jan Fokke; Melsen, Lieke A; Miralles, Diego G; van Heerwaarden, Chiel C; Vautard, Robert; Stegehuis, Annemiek I; Nabuurs, Gert-Jan; de Arellano, Jordi Vilà-Guerau

2017-01-11

Forests impact regional hydrology and climate directly by regulating water and heat fluxes. Indirect effects through cloud formation and precipitation can be important in facilitating continental-scale moisture recycling but are poorly understood at regional scales. In particular, the impact of temperate forest on clouds is largely unknown. Here we provide observational evidence for a strong increase in cloud cover over large forest regions in western Europe based on analysis of 10 years of 15 min resolution data from geostationary satellites. In addition, we show that widespread windthrow by cyclone Klaus in the Landes forest led to a significant decrease in local cloud cover in subsequent years. Strong cloud development along the downwind edges of larger forest areas are consistent with a forest-breeze mesoscale circulation. Our results highlight the need to include impacts on cloud formation when evaluating the water and climate services of temperate forests, in particular around densely populated areas.

Availability and accessibility of evidence-based information resources provided by medical libraries in Australia.

PubMed

Ritchie, A; Sowter, B

2000-01-01

This article reports on the results of an exploratory survey of the availability and accessibility of evidence-based information resources provided by medical libraries in Australia. Although barriers impede access to evidence-based information for hospital clinicians, the survey revealed that Medline and Cinahl are available in over 90% of facilities. In most cases they are widely accessible via internal networks and the Internet. The Cochrane Library is available in 69% of cases. The Internet is widely accessible and most libraries provide access to some full-text, electronic journals. Strategies for overcoming restrictions and integrating information resources with clinical workflow are being pursued. State, regional and national public and private consortia are developing agreements utilising on-line technology. These could produce cost savings and more equitable access to a greater range of evidence-based resources.

Observational Evidence of Magnetic Reconnection for Brightenings and Transition Region Arcades in IRIS Observations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhao, Jie; Li, Hui; Feng, Li

By using a new method of forced-field extrapolation, we study the emerging flux region AR11850 observed by the Interface Region Imaging Spectrograph and Solar Dynamical Observatory . Our results suggest that the bright points (BPs) in this emerging region exhibit responses in lines formed from the upper photosphere to the transition region, which have relatively similar morphologies. They have an oscillation of several minutes according to the Atmospheric Imaging Assembly data at 1600 and 1700 Å. The ratio between the BP intensities measured in 1600 and 1700 Å filtergrams reveals that these BPs are heated differently. Our analysis of themore » Helioseismic and Magnetic Imager vector magnetic field and the corresponding topology in AR11850 indicates that the BPs are located at the polarity inversion line and most of them are related to magnetic reconnection or cancelation. The heating of the BPs might be different due to different magnetic topology. We find that the heating due to the magnetic cancelation would be stronger than the case of bald patch reconnection. The plasma density rather than the magnetic field strength could play a dominant role in this process. Based on physical conditions in the lower atmosphere, our forced-field extrapolation shows consistent results between the bright arcades visible in slit-jaw image 1400 Å and the extrapolated field lines that pass through the bald patches. It provides reliable observational evidence for testing the mechanism of magnetic reconnection for the BPs and arcades in the emerging flux region, as proposed in simulation studies.« less

Direct Observation of Clinical Skills Feedback Scale: Development and Validity Evidence.

PubMed

Halman, Samantha; Dudek, Nancy; Wood, Timothy; Pugh, Debra; Touchie, Claire; McAleer, Sean; Humphrey-Murto, Susan

2016-01-01

Construct: This article describes the development and validity evidence behind a new rating scale to assess feedback quality in the clinical workplace. Competency-based medical education has mandated a shift to learner-centeredness, authentic observation, and frequent formative assessments with a focus on the delivery of effective feedback. Because feedback has been shown to be of variable quality and effectiveness, an assessment of feedback quality in the workplace is important to ensure we are providing trainees with optimal learning opportunities. The purposes of this project were to develop a rating scale for the quality of verbal feedback in the workplace (the Direct Observation of Clinical Skills Feedback Scale [DOCS-FBS]) and to gather validity evidence for its use. Two panels of experts (local and national) took part in a nominal group technique to identify features of high-quality feedback. Through multiple iterations and review, 9 features were developed into the DOCS-FBS. Four rater types (residents n = 21, medical students n = 8, faculty n = 12, and educators n = 12) used the DOCS-FBS to rate videotaped feedback encounters of variable quality. The psychometric properties of the scale were determined using a generalizability analysis. Participants also completed a survey to gather data on a 5-point Likert scale to inform the ease of use, clarity, knowledge acquisition, and acceptability of the scale. Mean video ratings ranged from 1.38 to 2.96 out of 3 and followed the intended pattern suggesting that the tool allowed raters to distinguish between examples of higher and lower quality feedback. There were no significant differences between rater type (range = 2.36-2.49), suggesting that all groups of raters used the tool in the same way. The generalizability coefficients for the scale ranged from 0.97 to 0.99. Item-total correlations were all above 0.80, suggesting some redundancy in items. Participants found the scale easy to use (M = 4.31/5) and clear

Nature's Notebook Provides Phenology Observations for NASA Juniper Phenology and Pollen Transport Project

NASA Technical Reports Server (NTRS)

Luval, J. C.; Crimmins, T. M.; Sprigg, W. A.; Levetin, E.; Huete, A.; Nickovic, S.; Prasad, A.; Vukovic, A.; VandeWater, P. K.; Budge, A. M.;

Observational Evidence for Enhanced Greenhouse Effect Reinforcing Wintertime Arctic Amplification and Sea Ice Melting Onset

NASA Astrophysics Data System (ADS)

Cao, Y.; Liang, S.

2017-12-01

Despite an apparent hiatus in global warming, the Arctic climate continues to experience unprecedented changes. Summer sea ice is retreating at an accelerated rate, and surface temperatures in this region are rising at a rate double that of the global average, a phenomenon known as Arctic amplification. Although a lot of efforts have been made, the causes this unprecedented phenomenon remain unclear and are subjects of considerable debate. In this study, we report strong observational evidence, for the first time from long-term (1984-2014) spatially complete satellite records, that increased cloudiness and atmospheric water vapor in winter and spring have caused an extraordinary downward longwave radiative flux to the ice surface, which may then amplify the Arctic wintertime ice-surface warming. In addition, we also provide observed evidence that it is quite likely the enhancement of the wintertime greenhouse effect caused by water vapor and cloudiness has advanced the time of onset of ice melting in mid-May through inhibiting sea-ice refreezing in the winter and accelerating the pre-melting process in the spring, and in turn triggered the positive sea-ice albedo feedback process and accelerated the sea ice melting in the summer.

African American Preschoolers' Emotion Explanations Can Provide Evidence of Their Pragmatic Skills

ERIC Educational Resources Information Center

Curenton, Stephanie M.

2015-01-01

This study provides qualitative and quantitative evidence of how an emotion explanation task can reflect African American preschoolers' pragmatic skills. We used an emotion explanation task to assess pragmatic skills among 19 children (aged 3-5 years) related to (1) engaging in conversational turn-taking, (2) answering "Wh-" questions,…

Feedback to providers improves evidence-based implantable cardioverter-defibrillator programming and reduces shocks.

PubMed

Silver, Marc T; Sterns, Laurence D; Piccini, Jonathan P; Joung, Boyoung; Ching, Chi-Keong; Pickett, Robert A; Rabinovich, Rafael; Liu, Shufeng; Peterson, Brett J; Lexcen, Daniel R

2015-03-01

Implantable cardioverter-defibrillator (ICD) shocks are associated with increased anxiety, health care utilization, and potentially mortality. The purpose of the Shock-Less Study was to determine if providing feedback reports to physicians on their adherence to evidence-based shock reduction programming could improve their programming behavior and reduce shocks. Shock-Less enrolled primary prevention (PP) and secondary prevention (SP) ICD patients between 2009 and 2012 at 118 study centers worldwide and followed patients longitudinally after their ICD implant. Center-specific therapy programming reports (TPRs) were delivered to each center 9 to 12 months after their first enrollment. The reports detailed adherence to evidence-based programming targets: number of intervals to detect ventricular fibrillation (VF NID), longest treatment interval (LTI), supraventricular tachycardia (SVT) discriminators (Wavelet, PR Logic), SVT limit, Lead Integrity Alert (LIA), and antitachycardia pacing (ATP). Clinicians programmed ICDs at their discretion. The primary outcome measure was the change in utilization of evidence-based shock reduction programming before (phase I, n = 2694 patients) and after initiation of the TPR (phase II, n = 1438 patients). Patients implanted after feedback reports (phase II) were up to 20% more likely to have their ICDs programmed in line with evidence-based shock reduction programming (eg, VF NID in PP patients 30/40 in 33.5% vs 18.6%, P < .0001). Patients implanted in phase II had a lower risk of all-cause shock (adjusted hazard ratio 0.72, 95% confidence interval 0.58-0.90, P = .003). Providing programming feedback reports improves adherence to evidence-based shock reduction programming and is associated with lower risk of ICD shocks. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Evidence-Based Practice Knowledge, Use, and Factors that Influence Decisions: Results from an Evidence-Based Practice Survey of Providers in American Indian/Alaska Native Communities

ERIC Educational Resources Information Center

Sheehan, Angela; Walrath-Greene, Christine; Fisher, Sylvia; Crossbear, Shannon; Walker, Joseph

2007-01-01

Data from the Evidence-based Treatment Survey were used to compare providers serving families in American Indian and Alaska Native communities to their counterparts in non-American Indian/Alaska Native communities on provider characteristics and factors that influence their decision to use evidence-based practices (N = 467). The findings suggest…

Chasing discs around O-type (proto)stars: Evidence from ALMA observations

NASA Astrophysics Data System (ADS)

Cesaroni, R.; Sánchez-Monge, Á.; Beltrán, M. T.; Johnston, K. G.; Maud, L. T.; Moscadelli, L.; Mottram, J. C.; Ahmadi, A.; Allen, V.; Beuther, H.; Csengeri, T.; Etoka, S.; Fuller, G. A.; Galli, D.; Galván-Madrid, R.; Goddi, C.; Henning, T.; Hoare, M. G.; Klaassen, P. D.; Kuiper, R.; Kumar, M. S. N.; Lumsden, S.; Peters, T.; Rivilla, V. M.; Schilke, P.; Testi, L.; van der Tak, F.; Vig, S.; Walmsley, C. M.; Zinnecker, H.

2017-06-01

Context. Circumstellar discs around massive stars could mediate the accretion onto the star from the infalling envelope, and could minimize the effects of radiation pressure. Despite such a crucial role, only a few convincing candidates have been provided for discs around deeply embedded O-type (proto)stars. Aims: In order to establish whether disc-mediated accretion is the formation mechanism for the most massive stars, we have searched for circumstellar, rotating discs around a limited sample of six luminous (>105L⊙) young stellar objects. These objects were selected on the basis of their IR and radio properties in order to maximize the likelihood of association with disc+jet systems. Methods: We used ALMA with 0.̋2 resolution to observe a large number of molecular lines typical of hot molecular cores. In this paper we limit our analysis to two disc tracers (methyl cyanide, CH3CN, and its isotopologue, 13CH3CN), and an outflow tracer (silicon monoxide, SiO). Results: We reveal many cores, although their number depends dramatically on the target. We focus on the cores that present prominent molecular line emission. In six of these a velocity gradient is seen across the core,three of which show evidence of Keplerian-like rotation. The SiO data reveal clear but poorly collimated bipolar outflow signatures towards two objects only. This can be explained if real jets are rare (perhaps short-lived) in very massive objects and/or if stellar multiplicity significantly affects the outflow structure.For all cores with velocity gradients, the velocity field is analysed through position-velocity plots to establish whether the gas is undergoing rotation with νrot ∝ R- α, as expected for Keplerian-like discs. Conclusions: Our results suggest that in three objects we are observing rotation in circumstellar discs, with three more tentative cases, and one core where no evidence for rotation is found. In all cases but one, we find that the gas mass is less than the mass of

Provider-to-Provider Electronic Communication in the Era of Meaningful Use: A Review of the Evidence

PubMed Central

Walsh, Colin; Siegler, Eugenia L; Cheston, Erin; O'Donnell, Heather; Collins, Sarah; Stein, Daniel; Vawdrey, David K.; Stetson, Peter D.

2014-01-01

Background Electronic communication between providers occurs daily in clinical practice but has not been well studied. Purpose To assess the impact of provider-to-provider electronic communication tools on communication and healthcare outcomes through literature review. Data sources OVID Medline, Pubmed, Google Scholar, CINAHL, and Academic Search Premier. Study Selection Publication in English language peer-reviewed journals. Studies provided quantitative provider-to-provider communication data, provider satisfaction statistics, or EHR communication data. Data Extraction Literature review. Data Synthesis Two reviewers conducted the title review to determine eligible studies from initial search results. Three reviewers independently reviewed titles, abstracts, and full text (where appropriate) against inclusion and exclusion criteria. Limitations Small number of eligible studies; few described trial design (20%). Homogeneous provider-type (physicians). English-only studies. Conclusions Of twenty-five included studies, all focused on physicians; most were observational (68%). Most (60%) described electronic specialist referral tools. Although overall use has been measured, there were no studies of the effectiveness of intra-EHR messaging. Literature describing the effectiveness of provider-to-provider electronic communications is sparse and narrow in scope. Complex care, such as that envisioned for the Patient Centered Medical Home, necessitates further research. PMID:24101544

Depression Treatment by Non-Mental-Health Providers: Incremental Evidence for the Effectiveness of Listening Visits

PubMed Central

O’Hara, Michael W.; Segre, Lisa S.

2017-01-01

Maternal depression is a prevalent public health problem, particularly for low-income mothers of young children. Intervention development efforts, which often focus on surmounting instrumental barriers to care, have not successfully engaged and retained women in treatment. Task-sharing approaches like Listening Visits (LV) could overcome key instrumental and psychological barriers by leveraging the access of trusted, community caregivers to deliver treatment. A recent randomized controlled trial (RCT) demonstrated the efficacy of LV delivered by non-mental-health providers as compared to usual care. The present report presents results from a follow-up phase of that RCT during which participants who had completed LV were followed for an additional 8 weeks and completed measures of depression and quality of life. In addition, participants who were initially randomized to the wait-list control group received LV and were assessed. Treatment gains previously observed in participants completing LV were enhanced during the 8-week follow-up period. Participants receiving LV during the follow-up period experienced significant improvement in depressive symptoms. Results demonstrate the sustainability of LV delivered by non-mental-health providers, and provide preliminary evidence for the replicability of this approach in a sample of predominately low-income pregnant women and mothers of young children. PMID:28349604

76 FR 9551 - Proposed Information Collection; Comment Request; Northeast Region Observer Providers Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Northeast Region Observer Providers Requirements AGENCY: National Oceanic and...; formally request observer training by the Northeast Fisheries Observer Program (NEFOP); submit observer...

Anthropic Reasoning about Fine-Tuning, and Neoclassical Cosmology: Providence, Omnipresence, and Observation Selection Theory

NASA Astrophysics Data System (ADS)

Walker, Theodore, Jr.

2011-10-01

Anthropic reasoning about observation selection effects upon the appearance of cosmic providential fine-tuning (fine-tuning that provides for life) is often motivated by a desire to avoid theological implications (implications favoring the idea of a divine cosmic provider) without appealing to sheer lucky-for-us-cosmic-jackpot happenstance and coincidence. Cosmic coincidence can be rendered less incredible by appealing to a multiverse context. Cosmic providence can be rendered non-theological by appealing to an agent-less providential purpose, or by appealing to less-than-omnipresent/local providers, such as alien intelligences creating life- providing baby universes. Instead of choosing either cosmic coincidence or cosmic providence, as though they were mutually exclusive; it is better to accept both. Neoclassical thought accepts coincidence and providence, plus many local providers and one omnipresent provider. Moreover, fundamental observation selection theory should distinguish the many local observers of some events from the one omnipresent observer of all events. Accepting both coincidence and providence avoids classical theology (providence without coincidence) and classical atheism (coincidence without providence), but not neoclassical theology (providence with coincidence). Cosmology cannot avoid the idea of an all-inclusive omnipresent providential dice-throwing living-creative whole of reality, an idea essential to neoclassical theology, and to neoclassical cosmology.

Using Evidence-Centered Design to Create a Special Educator Observation System

ERIC Educational Resources Information Center

Johnson, Evelyn S.; Crawford, Angela R.; Moylan, Laura A.; Zheng, Yuzhu

2018-01-01

The Evidence-Centered Design (ECD) framework was used to create a special education teacher observation system, Recognizing Effective Special Education Teachers (RESET). Extensive reviews of research informed the domain analysis and modeling stages, and led to the conceptual framework in which effective special education teaching is…

Carcinogen-induced mutations in the mouse c-Ha-ras gene provide evidence of multiple pathways for tumor progression.

PubMed Central

Brown, K; Buchmann, A; Balmain, A

1990-01-01

A number of mouse skin tumors initiated by the carcinogens N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), methylnitrosourea (MNU), 3-methylcholanthrene (MCA), and 7,12-dimethylbenz[a]anthracene (DMBA) have been shown to contain activated Ha-ras genes. In each case, the point mutations responsible for activation have been characterized. Results presented demonstrate the carcinogen-specific nature of these ras mutations. For each initiating agent, a distinct spectrum of mutations is observed. Most importantly, the distribution of ras gene mutations is found to differ between benign papillomas and carcinomas, suggesting that molecular events occurring at the time of initiation influence the probability with which papillomas progress to malignancy. This study provides molecular evidence in support of the existence of subsets of papillomas with differing progression frequencies. Thus, the alkylating agents MNNG and MNU induced exclusively G ---- A transitions at codon 12, with this mutation being found predominantly in papillomas. MCA initiation produced both codon 13 G ---- T and codon 61 A ---- T transversions in papillomas; only the G ---- T mutation, however, was found in carcinomas. These findings provide strong evidence that the mutational activation of Ha-ras occurs as a result of the initiation process and that the nature of the initiating event can affect the probability of progression to malignancy. Images PMID:2105486

Geomorphological Evidence for Pervasive Ground Ice on Ceres from Dawn Observations of Craters and Flows.

NASA Astrophysics Data System (ADS)

Schmidt, B. E.; Chilton, H.; Hughson, K.; Scully, J. E. C.; Russell, C. T.; Sizemore, H. G.; Nathues, A.; Platz, T.; Bland, M. T.; Schenk, P.; Hiesinger, H.; Jaumann, R.; Byrne, S.; Schorghofer, N.; Ammannito, E.; Marchi, S.; O'Brien, D. P.; Sykes, M. V.; Le Corre, L.; Capria, M. T.; Reddy, V.; Raymond, C. A.; Mest, S. C.; Feldman, W. C.

2015-12-01

Five decades of observations of Ceres' albedo, surface composition, shape and density suggest that Ceres is comprised of both silicates and tens of percent of ice. Historical suggestions of surficial hydrated silicates and evidence for water emission, coupled with its bulk density of ~2100 kg/m3 and Dawn observations of young craters containing high albedo spots support this conclusion. We report geomorphological evidence from survey data demonstrating that evaporative and fluid-flow processes within silicate-ice mixtures are prevalent on Ceres, and indicate that its surface materials contain significant water ice. Here we highlight three classes of features that possess strong evidence for ground ice. First, ubiquitous scalloped and "breached" craters are characterized by mass wasting and by the recession of crater walls in asymmetric patterns; these appear analogous to scalloped terrain on Mars and protalus lobes formed by mass wasting in terrestrial glaciated regions. The degradation of crater walls appears to be responsible for the nearly complete removal of some craters, particularly at low latitudes. Second, several high latitude, high elevation craters feature lobed flows that emanate from cirque-shaped head walls and bear strikingly similar morphology to terrestrial rock glaciers. These similarities include lobate toes and indications of furrows and ridges consistent with ice-cored or ice-cemented material. Other lobed flows persist at the base of crater walls and mass wasting features. Many flow features evidently terminate at ramparts. Third, there are frequent irregular domes, peaks and mounds within crater floors that depart from traditional crater central peaks or peak complexes. In some cases the irregular domes show evidence for high albedo or activity, and thus given other evidence for ice, these could be due to local melt and extrusion via hydrologic gradients, forming domes similar to pingos. The global distribution of these classes of features

Lessons Learned from Providing Internet Support for the Shoemaker-Levy 9 Observing Campaign

NASA Astrophysics Data System (ADS)

Raugh, A. C.

1994-12-01

In January of 1994, the comet/asteroid team of the University of Maryland Astronomy Department (including staff of the Small Bodies Node of the Planetary Data System) accepted the task of providing a central communications link for observers of the SL9 impact. To that end we established an email exploder, a log-in type bulletin board account, World Wide Web pages and an anonymous FTP server on an existing department node. It was obvious from the comments received from observers, however, that the nature of the impacts made reliable communication on the timescale of minutes to hours absolutely essential to extracting the best possible data from the concerted observations. To provide as stable a link as possible, we took several specific actions: we focused our efforts on providing well-defined services to the smaller community of observers, rather than attempting to provide complete service to the general public; we kept the solutions simple, both to implement and to maintain; and we developed contingency plans to be implemented immediately in the event of hardware failure, network failure or CPU overload.

Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice

PubMed Central

Aarons, Gregory A.; Sawitzky, Angelina C.

2006-01-01

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice. PMID:17183411

Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice.

PubMed

Aarons, Gregory A; Sawitzky, Angelina C

2006-02-01

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice.

A rapid evidence-based service by librarians provided information to answer primary care clinical questions.

PubMed

McGowan, Jessie; Hogg, William; Rader, Tamara; Salzwedel, Doug; Worster, Danielle; Cogo, Elise; Rowan, Margo

2010-03-01

A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence-based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web-based platform and using hand-held devices and computers with Web access. Librarians were given technical training in evidence-based medicine, including how to summarise evidence. To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Evaluation included librarian interviews and a clinician exit satisfaction survey. Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important 'lessons learned' in the clinical use of hand-held devices, knowledge translation and training for clinicians and librarians. The Just-in-Time Librarian Consultation Service showed that it was possible to provide evidence-based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.

Steroidal contraceptives and bone fractures in women: evidence from observational studies.

PubMed

Lopez, Laureen M; Chen, Mario; Mullins Long, Sarah; Curtis, Kathryn M; Helmerhorst, Frans M

2015-07-21

) with 95% confidence interval (CI). Due to varied study designs, we did not conduct meta-analysis. We included 14 studies (7 case-control and 7 cohort studies). These examined oral contraceptives (OCs), depot medroxyprogesterone acetate (DMPA), and the hormonal intrauterine device (IUD). This section focuses on the sensitivity analysis with six studies that provided moderate or high quality evidence.All six studies examined oral contraceptive use. We noted few associations with fracture risk. One cohort study reported OC ever-users had increased risk for all fractures (RR 1.20, 95% CI 1.08 to 1.34). However, a case-control study with later data from a subset reported no association except for those with 10 years or more since use (OR 1.55, 95% CI 1.03 to 2.33). Another case-control study reported increased risk only for those who had 10 or more prescriptions (OR 1.09, 95% CI 1.03 to 1.16). A cohort study of postmenopausal women found no increased fracture risk for OC use after excluding women with prior fracture. Two other studies found little evidence of association between OC use and fracture risk. A cohort study noted increased risk for subgroups, such as those with longer use or specific intervals since use. A case-control study reported increased risk for any fracture only among young women with less than average use.Two case-control studies also examined progestin-only contraceptives. One reported increased fracture risk for DMPA ever-use (OR 1.44, 95% CI 1.01 to 2.06), more than four years of use (OR 2.16, 95% CI 1.32 to 3.53), and women over 50 years old. The other reported increased risk for any past use, including one or two prescriptions (OR 1.17, 95% CI 1.07 to 1.29) and for current use of 3 to 9 prescriptions (OR 1.36, 95% CI 1.15 to 1.60) or 10 or more (OR 1.54, 95% CI 1.33 to 1.78). For the levonorgestrel-releasing IUD, one study reported reduced fracture risk for ever-use (OR 0.75, 95% CI 0.64 to 0.87) and for longer use. Observational studies do not

Does a ban on informal health providers save lives? Evidence from Malawi

PubMed Central

Godlonton, Susan; Okeke, Edward N.

2015-01-01

Informal health providers ranging from drug vendors to traditional healers account for a large fraction of health care provision in developing countries. They are, however, largely unlicensed and unregulated leading to concern that they provide ineffective and, in some cases, even harmful care. A new and controversial policy tool that has been proposed to alter household health seeking behavior is an outright ban on these informal providers. The theoretical effects of such a ban are ambiguous. In this paper, we study the effect of a ban on informal (traditional) birth attendants imposed by the Malawi government in 2007. To measure the effect of the ban, we use a difference-in-difference strategy exploiting variation across time and space in the intensity of exposure to the ban. Our most conservative estimates suggest that the ban decreased use of traditional attendants by about 15 percentage points. Approximately three quarters of this decline can be attributed to an increase in use of the formal sector and the remainder is accounted for by an increase in relative/friend-attended births. Despite the rather large shift from the informal to the formal sector, we do not find any evidence of a statistically significant reduction in newborn mortality on average. The results are robust to a triple difference specification using young children as a control group. We examine several explanations for this result and find evidence consistent with quality of formal care acting as a constraint on improvements in newborn health. PMID:26681821

Development of Innovative Technology to Provide Low-Cost Surface Atmospheric Observations

NASA Astrophysics Data System (ADS)

Kucera, Paul; Steinson, Martin

2016-04-01

Accurate and reliable real-time monitoring and dissemination of observations of surface weather conditions is critical for a variety of societal applications. Applications that provide local and regional information about temperature, precipitation, moisture, and winds, for example, are important for agriculture, water resource monitoring, health, and monitoring of hazard weather conditions. In many regions in Africa (and other global locations), surface weather stations are sparsely located and/or of poor quality. Existing stations have often been sited incorrectly, not well-maintained, and have limited communications established at the site for real-time monitoring. The US National Weather Service (NWS) International Activities Office (IAO) in partnership with University Corporation for Atmospheric Research (UCAR)/National Center for Atmospheric Research (NCAR) and funded by the United States Agency for International Development (USAID) Office of Foreign Disaster Assistance (OFDA) has started an initiative to develop and deploy low-cost weather instrumentation in sparsely observed regions of the world. The goal is to provide observations for environmental monitoring, and early warning alert systems that can be deployed at weather services in developing countries. Instrumentation is being designed using innovative new technologies such as 3D printers, Raspberry Pi computing systems, and wireless communications. The initial effort is focused on designing a surface network using GIS-based tools, deploying an initial network in Zambia, and providing training to Zambia Meteorological Department (ZMD) staff. The presentation will provide an overview of the project concepts, design of the low cost instrumentation, and initial experiences deploying a surface network deployment in Zambia.

Observational Evidence of the "Tightening of Hadley Ascent"

NASA Astrophysics Data System (ADS)

Su, H.; Wu, L.; Jiang, J. H.

2017-12-01

Recent studies show that the Hadley Circulation undergoes complicated structure changes under global warming (e.g., Su et al., 2014; Lau and Kim 2015; Byrne and Schneider 2016; Su et al., 2017)). Accompanied by the widening of the descent zone, a narrowing of the ascending branch of the Hadley Circulation is simulated in most climate models. The magnitude of the tightening of Hadley ascent (THA) in the models is found to be highly correlated with the decrease of tropical high cloud fraction, which is a major contributor to the inter-model spread of the longwave radiative cooling rate and the global-mean precipitation change per degree of surface warming (Su et al. 2017). While the THA is a common feature in the models, its observational evidence is limited. We have examined a number of reanalyses and satellite datasets to identify the indicators of the THA in terms of large-scale winds, water vapor, cloud and precipitation changes in the past decades. The robustness of the THA in the observations and the differences between various datasets will be presented.

Skin pigmentation provides evidence of convergent melanism in extinct marine reptiles.

PubMed

Lindgren, Johan; Sjövall, Peter; Carney, Ryan M; Uvdal, Per; Gren, Johan A; Dyke, Gareth; Schultz, Bo Pagh; Shawkey, Matthew D; Barnes, Kenneth R; Polcyn, Michael J

2014-02-27

Throughout the animal kingdom, adaptive colouration serves critical functions ranging from inconspicuous camouflage to ostentatious sexual display, and can provide important information about the environment and biology of a particular organism. The most ubiquitous and abundant pigment, melanin, also has a diverse range of non-visual roles, including thermoregulation in ectotherms. However, little is known about the functional evolution of this important biochrome through deep time, owing to our limited ability to unambiguously identify traces of it in the fossil record. Here we present direct chemical evidence of pigmentation in fossilized skin, from three distantly related marine reptiles: a leatherback turtle, a mosasaur and an ichthyosaur. We demonstrate that dark traces of soft tissue in these fossils are dominated by molecularly preserved eumelanin, in intimate association with fossilized melanosomes. In addition, we suggest that contrary to the countershading of many pelagic animals, at least some ichthyosaurs were uniformly dark-coloured in life. Our analyses expand current knowledge of pigmentation in fossil integument beyond that of feathers, allowing for the reconstruction of colour over much greater ranges of extinct taxa and anatomy. In turn, our results provide evidence of convergent melanism in three disparate lineages of secondarily aquatic tetrapods. Based on extant marine analogues, we propose that the benefits of thermoregulation and/or crypsis are likely to have contributed to this melanisation, with the former having implications for the ability of each group to exploit cold environments.

Observational Evidence For The Comet-Like Heliosphere

NASA Astrophysics Data System (ADS)

Bzowski, M.; Czechowski, A.; Funsten, H. O.; Grygorczuk, J.; Heerikhuisen, J.; Kubiak, M. A.; Moebius, E.; McComas, D. J.; Schwadron, N.; Sokol, J. M.; Swaczyna, P.; Zirnstein, E.

2017-12-01

The shape of the heliosphere is a subject of ongoing debate. The traditional comet-like image has recently been challenged by ideas of croissant- or bubble-like forms. Here we seek to resolve this debate by confronting available observational evidence with global modeling. Several MHD models of a comet-like heliosphere were used to simulate the radius and center of the IBEX Ribbon to fit the direction and intensity of the interstellar magnetic field (ISMF). These models assumed the secondary ENA emission mechanism, which was recently strengthened due to direct measurement of the distance to the Ribbon source most likely just beyond the heliopause. The same mechanism explains the dependence of the Ribbon center position on energy due to the latitudinal structure of solar wind. The obtained ISMF vector agrees among these models and is consistent with the draped IMF measured by Voyager. Independently, we have shown by modeling that the Warm Breeze discovered by IBEX is naturally created in the outer heliosheath due to charge-exchange between interstellar He+ ions and He atoms. Now we simulate the Warm Breeze for various directions and intensities of the local IMF and we find that the simulation results are in best agreement with IBEX observations for the IMF vector obtained from the above-mentioned Ribbon analyses and Voyager measurements. These arguments, along with the co-planarity of the inflow directions of interstellar neutral H, He, O, and the Warm Breeze, directions of the Ribbon center and ISMF, as well as measurements of the plasma flow directions in the IHS by Voyager 2 indicate the existence of a common plane of approximate mirror symmetry of the heliosphere, defined by the directions of ISMF and the Sun's motion through the local interstellar medium. This suggests that the global structure of the outer heliosphere mostly results from the conditions in the local interstellar medium and the Sun's velocity. This evidence, obtained from very different

Coordinated vigilance provides evidence for direct reciprocity in coral reef fishes.

PubMed

Brandl, Simon J; Bellwood, David R

2015-09-25

Reciprocity is frequently assumed to require complex cognitive abilities. Therefore, it has been argued that reciprocity may be restricted to animals that can meet these demands. Here, we provide evidence for the potential presence of direct reciprocity in teleost fishes. We demonstrate that in pairs of coral reef rabbitfishes (f. Siganidae), one fish frequently assumes an upright vigilance position in the water column, while the partner forages in small crevices in the reef substratum. Both behaviours are strongly coordinated and partners regularly alternate their positions, resulting in a balanced distribution of foraging activity. Compared to solitary individuals, fishes in pairs exhibit longer vigilance bouts, suggesting that the help provided to the partner is costly. In turn, fishes in pairs take more consecutive bites and penetrate deeper into crevices than solitary individuals, suggesting that the safety provided by a vigilant partner may outweigh initial costs by increasing foraging efficiency. Thus, the described system appears to meet all of the requirements for direct reciprocity. We argue that the nature of rabbitfish pairs provides favourable conditions for the establishment of direct reciprocity, as continuous interaction with the same partner, simultaneous needs, interdependence, and communication relax the cognitive demands of reciprocal cooperation.

A note on the observational evidence for the existence of event horizons in astrophysical black hole candidates.

PubMed

Bambi, Cosimo

2013-01-01

Black holes have the peculiar and intriguing property of having an event horizon, a one-way membrane causally separating their internal region from the rest of the Universe. Today, astrophysical observations provide some evidence for the existence of event horizons in astrophysical black hole candidates. In this short paper, I compare the constraint we can infer from the nonobservation of electromagnetic radiation from the putative surface of these objects with the bound coming from the ergoregion instability, pointing out the respective assumptions and limitations.

Nanodiamonds do not provide unique evidence for a Younger Dryas impact

PubMed Central

Tian, H.; Schryvers, D.; Claeys, Ph.

2011-01-01

Microstructural, δ13C isotope and C/N ratio investigations were conducted on excavated material from the black Younger Dryas boundary in Lommel, Belgium, aiming for a characterisation of the carbon content and structures. Cubic diamond nanoparticles are found in large numbers. The larger ones with diameters around or above 10 nm often exhibit single or multiple twins. The smaller ones around 5 nm in diameter are mostly defect-free. Also larger flake-like particles, around 100 nm in lateral dimension, with a cubic diamond structure are observed as well as large carbon onion structures. The combination of these characteristics does not yield unique evidence for an exogenic impact related to the investigated layer. PMID:21173270

An observational study of frequency of provider hand contacts in child care facilities in North Carolina and South Carolina.

PubMed

Fraser, Angela; Wohlgenant, Kelly; Cates, Sheryl; Chen, Xi; Jaykus, Lee-Ann; Li, You; Chapman, Benjamin

2015-02-01

Children enrolled in child care are 2.3-3.5 times more likely to experience acute gastrointestinal illness than children cared for in their own homes. The purpose of this study was to determine the frequency surfaces were touched by child care providers to identify surfaces that should be cleaned and sanitized. Observation data from a convenience sample of 37 child care facilities in North Carolina and South Carolina were analyzed. Trained data collectors used iPods (Apple, Cupertino, CA) to record hand touch events of 1 child care provider for 45 minutes in up to 2 classrooms in each facility. Across the 37 facilities, 10,134 hand contacts were observed in 51 classrooms. Most (4,536) were contacts with porous surfaces, with an average of 88.9 events per classroom observation. The most frequently touched porous surface was children's clothing. The most frequently touched nonporous surface was food contact surfaces (18.6 contacts/observation). Surfaces commonly identified as high-touch surfaces (ie, light switches, handrails, doorknobs) were touched the least. General cleaning and sanitizing guidelines should include detailed procedures for cleaning and sanitizing high-touch surfaces (ie, clothes, furniture, soft toys). Guidelines are available for nonporous surfaces but not for porous surfaces (eg, clothing, carpeting). Additional research is needed to inform the development of evidence-based practices to effectively treat porous surfaces. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Observational Evidence for Mixing and Dust Condensation in Core-Collapse Supernovae

NASA Technical Reports Server (NTRS)

Wooden, Diane; Young, Richard E. (Technical Monitor)

1997-01-01

Recent findings of isotopic anomalies of Ca-44 (the decay product of Ti-44) and the enhanced ratio of Si-28/Si-30 in SiC grains X, TiC subgrains, and graphite dust grains within primitive meteorites provides strong evidence that these presolar grains came from core-collapse supernovae. The chemical composition of the presolar grains requires macroscopic mixing of newly nucleo-synthesized elements from explosive silicon burning at the innermost zone of the ejects to higher velocities where C exists and where C/O > 1 in either the outer edge of the oxygen zone or in the He-C zone. To date, the only core-collapse supernova observed to form dust is the brightest supernova of the past four centuries, SN1987A in the Large Magellanic Cloud. Observations of SN1987A confirm large scale macroscopic mixing occurs in the explosions of massive stars. Rayleigh-Taylor instabilities macroscopically mix most of the ejects into regions which are still chemically homogeneous and which cool with different time scales. Only small clumps in the ejects are microscopically mixed. Observations show that dust condensed in the ejects of SN1987A after approx.500 days in the Fe-rich gas. Neither silicates nor SiC grains were seen in the dust emission spectrum of SN1987A. SN1987A, the Rosetta Stone of core-collapse supernovae, shows that while the mixing required to explain presolar grains occurs, the rapid cooling of the Fe zone and the sustained high temperatures of the O-Si, O-C, and He-C zones favor the formation of iron-rich rather than oxygen- or carbon-rich grains.

Observational evidence for Alfven waves in the solar atmosphere (Invited)

NASA Astrophysics Data System (ADS)

De Pontieu, B.

2013-12-01

Alfven waves have long been suspected of playing an important role in both heating the corona and accelerating the solar wind. Recently, more and more observational evidence for the presence of such waves has been reported in both the corona and the lower solar atmosphere. I will review observations of the properties and presence of Alfven waves from CoMP, Hinode, AIA and ground-based telescopes in both coronal lines and the lower solar atmosphere. I will discuss our current understanding of the importance of these waves for the energy balance of the corona. I will also present initial results of the Interface Region Imaging Spectrograph (IRIS) which was launched in June 2013 and obtains images and spectra in both the far and near ultraviolet.

Evidence for ground-ice occurrence on asteroid Vesta using Dawn bistatic radar observations

NASA Astrophysics Data System (ADS)

Palmer, E. M.; Heggy, E.; Kofman, W. W.

2017-12-01

From 2011 to 2012, the Dawn spacecraft orbited asteroid Vesta, the first of its two targets in the asteroid belt, and conducted the first bistatic radar (BSR) experiment at a small-body, during which Dawn's high-gain communications antenna is used to transmit radar waves that scatter from Vesta's surface toward Earth at high incidence angles just before and after occultation of the spacecraft behind the asteroid. Among the 14 observed mid-latitude forward-scatter reflections, the radar cross section ranges from 84 ± 8 km2 (near Saturnalia Fossae) to 3,588 ± 200 km2 (northwest of Caparronia crater), implying substantial spatial variation in centimeter- to decimeter-scale surface roughness. The compared distributions of surface roughness and subsurface hydrogen concentration [H]—measured using data from Dawn's BSR experiment and Gamma Ray and Neutron Spectrometer (GRaND), respectively—reveal the occurrence of heightened subsurface [H] with smoother terrains that cover tens of square kilometers. Furthermore, unlike on the Moon, we observe no correlation between surface roughness and surface ages on Vesta—whether the latter is derived from lunar or asteroid-flux chronology [Williams et al., 2014]—suggesting that cratering processes alone are insufficient to explain Vesta's surface texture at centimeter-to-decimeter scales. Dawn's BSR observations support the hypothesis of transient melting, runoff and recrystallization of potential ground-ice deposits, which are postulated to flow along fractures after an impact, and provide a mechanism for the smoothing of otherwise rough, fragmented impact ejecta. Potential ground-ice presence within Vesta's subsurface was first proposed by Scully et al. [2014], who identified geomorphological evidence for transient water flow along several of Vesta's crater walls using Dawn Framing Camera images. While airless, differentiated bodies such as Vesta and the Moon are thought to have depleted their initial volatile content

Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence.

PubMed

Stockings, Emily; Zagic, Dino; Campbell, Gabrielle; Weier, Megan; Hall, Wayne D; Nielsen, Suzanne; Herkes, Geoffrey K; Farrell, Michael; Degenhardt, Louisa

2018-07-01

Review evidence for cannabinoids as adjunctive treatments for treatment-resistant epilepsy. Systematic search of Medline, Embase and PsycINFO was conducted in October 2017. Outcomes were: 50%+ seizure reduction, complete seizure freedom; improved quality of life (QoL). Tolerability/safety were assessed by study withdrawals, adverse events (AEs) and serious adverse events (SAEs). Analyses were conducted in Stata V.15.0. 36 studies were identified: 6 randomised controlled trials (RCTs), 30 observational studies. Mean age of participants was 16.1 years (range 0.5-55 years). Cannabidiol (CBD) 20 mg/kg/day was more effective than placebo at reducing seizure frequency by 50%+(relative risk (RR) 1.74, 95% CI 1.24 to 2.43, 2 RCTs, 291 patients, low Grades of Recommendation, Assessment, Development and Evaluation (GRADE) rating). The number needed to treat for one person using CBD to experience 50%+ seizure reduction was 8 (95% CI 6 to 17). CBD was more effective than placebo at achieving complete seizure freedom (RR 6.17, 95% CI 1.50 to 25.32, 3 RCTs, 306 patients, low GRADE rating), and improving QoL (RR 1.73, 95% CI 1.33 to 2.26), however increased risk of AEs (RR 1.24, 95% CI 1.13 to 1.36) and SAEs (RR 2.55, 95% CI 1.48 to 4.38). Pooled across 17 observational studies, 48.5% (95% CI 39.0% to 58.1%) of patients reported 50%+ reductions in seizures; in 14 observational studies 8.5% (95% CI 3.8% to 14.5%) were seizure-free. Twelve observational studies reported improved QoL (55.8%, 95% CI 40.5 to 70.6); 50.6% (95% CI 31.7 to 69.4) AEs and 2.2% (95% CI 0 to 7.9) SAEs. Pharmaceutical-grade CBD as adjuvant treatment in paediatric-onset drug-resistant epilepsy may reduce seizure frequency. Existing RCT evidence is mostly in paediatric samples with rare and severe epilepsy syndromes; RCTs examining other syndromes and cannabinoids are needed. CRD42017055412. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

Clinical evidence supporting pharmacogenomic biomarker testing provided in US Food and Drug Administration drug labels.

PubMed

Wang, Bo; Canestaro, William J; Choudhry, Niteesh K

2014-12-01

Genetic biomarkers that predict a drug's efficacy or likelihood of toxicity are assuming increasingly important roles in the personalization of pharmacotherapy, but concern exists that evidence that links use of some biomarkers to clinical benefit is insufficient. Nevertheless, information about the use of biomarkers appears in the labels of many prescription drugs, which may add confusion to the clinical decision-making process. To evaluate the evidence that supports pharmacogenomic biomarker testing in drug labels and how frequently testing is recommended. Publicly available US Food and Drug Administration databases. We identified drug labels that described the use of a biomarker and evaluated whether the label contained or referenced convincing evidence of its clinical validity (ie, the ability to predict phenotype) and clinical utility (ie, the ability to improve clinical outcomes) using guidelines published by the Evaluation of Genomic Applications in Practice and Prevention Working Group. We graded the completeness of the citation of supporting studies and determined whether the label recommended incorporation of biomarker test results in therapeutic decision making. Of the 119 drug-biomarker combinations, only 43 (36.1%) had labels that provided convincing clinical validity evidence, whereas 18 (15.1%) provided convincing evidence of clinical utility. Sixty-one labels (51.3%) made recommendations about how clinical decisions should be based on the results of a biomarker test; 36 (30.3%) of these contained convincing clinical utility data. A full description of supporting studies was included in 13 labels (10.9%). Fewer than one-sixth of drug labels contained or referenced convincing evidence of clinical utility of biomarker testing, whereas more than half made recommendations based on biomarker test results. It may be premature to include biomarker testing recommendations in drug labels when convincing data that link testing to patient outcomes do not exist.

Evidence for CO in Jupiter's atmosphere from airborne spectroscopic observations at 5 microns

NASA Technical Reports Server (NTRS)

Larson, H. P.; Fink, U.; Treffers, R. R.

1978-01-01

High-altitude (12.4 km) spectra of Jupiter recorded at the Kuiper Airborne Observatory are analyzed for the presence of CO absorption lines. A line-by-line comparison of Jupiter's spectrum with that of carbon monoxide is presented, as well as a correlation analysis that includes the influence of other gases present in Jupiter's atmosphere (CH4, NH3, H2O, PH3, and GeH4). The resulting evidence points strongly to the presence of carbon monoxide in Jupiter's atmosphere, thus strengthening Beer's evidence for it. Possible explanations for the existence and observability of Jovian CO, including convection from hotter, deeper layers or decomposition of organic molecules, are explored. A recent suggestion that the Jovian CO is restricted to stratospheric levels is not supported by the observations.

Evidence of Plumes on Europa from far-ultraviolet observations with HST

NASA Astrophysics Data System (ADS)

Sparks, William B.; McGrath, Melissa; Schmidt, Britney; Bergeron, Eddie; Hand, Kevin; Spencer, John; Cracraft, Misty; Deustua, Susana

2018-01-01

Evidence for plumes of water emerging from the icy surface of Europa has been found by the Hubble Space Telescope (HST) using two different UV observing techniques. Roth et al. (2014) found line emission from the dissociation products of water. Sparks et al. (2016, 2017) found evidence for off-limb continuum absorption as Europa transited Jupiter. We describe the transit method which obtains far ultraviolet images of Europa as it passes in front of the smooth face of Jupiter, seeking off-limb absorption patches that may be due to plumes on Europa. This approach exploits the time resolution, sensitivity and spatial resolution of HST, coupled to the high cross-sections for molecules of interest at these wavelengths. We show that a well-localized plume candidate appears more than once, and that it is at the same position as a nighttime thermal anomaly seen by the Galileo spacecraft, the warmest point on the observed Europa nightside. The favored interpretation of the thermal anomaly is a modification to the local thermal inertia, which could be causally related to plume activity. Future plans for additional work in this area are described.

Near infrared observations of S155. evidence of induced star formation?

NASA Astrophysics Data System (ADS)

Hunt, L. K.; Lisi, F.; Felli, M.; Tofani, G.

At the interface of the giant molecular cloud Cepheus OB3, S155 represents one of the most interesting examples of bright rim produced by the ionization of a nearby O-star. The interaction between the ionized HII region S155 and the hot molecular core Cepheus B may constitute the ideal site for new stars, according to the sequential star-formation theory. Past observations of molecular lines have shown the evidence of a hot spot in the cloud core, probably a compact region associated to a young stellar object. New J,H,K images recently obtained with the ARNICA array at the TIRGO telescope give evidence of stars with strong near-infrared excess, which must represent the newest generation of young stars.

Observing functional actions affects semantic processing of tools: evidence of a motor-to-semantic priming.

PubMed

De Bellis, Francesco; Ferrara, Antonia; Errico, Domenico; Panico, Francesco; Sagliano, Laura; Conson, Massimiliano; Trojano, Luigi

2016-01-01

Recent evidence shows that activation of motor information can favor identification of related tools, thus suggesting a strict link between motor and conceptual knowledge in cognitive representation of tools. However, the involvement of motor information in further semantic processing has not been elucidated. In three experiments, we aimed to ascertain whether motor information provided by observation of actions could affect processing of conceptual knowledge about tools. In Experiment 1, healthy participants judged whether pairs of tools evoking different functional handgrips had the same function. In Experiment 2 participants judged whether tools were paired with appropriate recipients. Finally, in Experiment 3 we again required functional judgments as in Experiment 1, but also included in the set of stimuli pairs of objects having different function and similar functional handgrips. In all experiments, pictures displaying either functional grasping (aimed to use tools) or structural grasping (just aimed to move tools independently from their use) were presented before each stimulus pair. The results demonstrated that, in comparison with structural grasping, observing functional grasping facilitates judgments about tools' function when objects did not imply the same functional manipulation (Experiment 1), whereas worsened such judgments when objects shared functional grasp (Experiment 3). Instead, action observation did not affect judgments concerning tool-recipient associations (Experiment 2). Our findings support a task-dependent influence of motor information on high-order conceptual tasks and provide further insights into how motor and conceptual processing about tools can interact.

A Review of Online Evidence-based Practice Point-of-Care Information Summary Providers

PubMed Central

Liberati, Alessandro; Moschetti, Ivan; Tagliabue, Ludovica; Moja, Lorenzo

2010-01-01

Background Busy clinicians need easy access to evidence-based information to inform their clinical practice. Publishers and organizations have designed specific tools to meet doctors’ needs at the point of care. Objective The aim of this study was to describe online point-of-care summaries and evaluate their breadth, content development, and editorial policy against their claims of being “evidence-based.” Methods We searched Medline, Google, librarian association websites, and information conference proceedings from January to December 2008. We included English Web-based point-of-care summaries designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, evidence-based information to clinicians. Two investigators independently extracted data on the general characteristics and content presentation of summaries. We assessed and ranked point-of-care products according to: (1) coverage (volume) of medical conditions, (2) editorial quality, and (3) evidence-based methodology. We explored how these factors were associated. Results We retrieved 30 eligible summaries. Of these products, 18 met our inclusion criteria and were qualitatively described, and 16 provided sufficient data for quantitative evaluation. The median volume of medical conditions covered was 80.6% (interquartile range, 68.9% - 84.2%) and varied for the different products. Similarly, differences emerged for editorial policy (median 8.0, interquartile range 5.8 - 10.3) and evidence-based methodology scores (median 10.0, interquartile range 1.0 - 12.8) on a 15-point scale. None of these dimensions turned out to be significantly associated with the other dimensions (editorial quality and volume, Spearman rank correlation r = -0.001, P = .99; evidence-based methodology and volume, r = -0.19, P = .48; editorial and evidence-based methodology, r = 0.43, P =.09). Conclusions Publishers are moving to develop point-of-care summary products. Some of these have better profiles than

VA Residential Provider Perceptions of Dissuading Factors to the Use of Two Evidence-Based PTSD Treatments

PubMed Central

Cook, Joan M.; Dinnen, Stephanie; Simiola, Vanessa; Thompson, Richard; Schnurr, Paula P.

2014-01-01

Providers (N = 198) from 38 Department of Veterans Affairs residential posttraumatic stress disorder treatment programs across the United States completed qualitative interviews regarding implementation of 2 evidence-based treatments: prolonged exposure and cognitive processing therapy. As part of this investigation, providers were asked how they decide which patients are appropriate for these treatments. Many indicated that they did not perceive any patient factors that dissuade their use of either evidence-based treatment. However, 3 broad categories emerged surrounding reasons that patients were perceived to be less suitable candidates for the treatments: the presence of psychiatric comorbidities, cognitive limitations, and low levels of patient motivation. Interestingly, providers’ perceived reasons for limited or nonuse of a treatment did not correspond entirely to those espoused by treatment developers. Possible solutions to address provider concerns, including educational and motivational interventions, are noted. PMID:25309031

Simulations of VLBI observations of a geodetic satellite providing co-location in space

NASA Astrophysics Data System (ADS)

Anderson, James M.; Beyerle, Georg; Glaser, Susanne; Liu, Li; Männel, Benjamin; Nilsson, Tobias; Heinkelmann, Robert; Schuh, Harald

2018-02-01

We performed Monte Carlo simulations of very-long-baseline interferometry (VLBI) observations of Earth-orbiting satellites incorporating co-located space-geodetic instruments in order to study how well the VLBI frame and the spacecraft frame can be tied using such measurements. We simulated observations of spacecraft by VLBI observations, time-of-flight (TOF) measurements using a time-encoded signal in the spacecraft transmission, similar in concept to precise point positioning, and differential VLBI (D-VLBI) observations using angularly nearby quasar calibrators to compare their relative performance. We used the proposed European Geodetic Reference Antenna in Space (E-GRASP) mission as an initial test case for our software. We found that the standard VLBI technique is limited, in part, by the present lack of knowledge of the absolute offset of VLBI time to Coordinated Universal Time at the level of microseconds. TOF measurements are better able to overcome this problem and provide frame ties with uncertainties in translation and scale nearly a factor of three smaller than those yielded from VLBI measurements. If the absolute time offset issue can be resolved by external means, the VLBI results can be significantly improved and can come close to providing 1 mm accuracy in the frame tie parameters. D-VLBI observations with optimum performance assumptions provide roughly a factor of two higher uncertainties for the E-GRASP orbit. We additionally simulated how station and spacecraft position offsets affect the frame tie performance.

Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: a mixed-methods approach.

PubMed

Eaton, Linda H; Meins, Alexa R; Mitchell, Pamela H; Voss, Joachim; Doorenbos, Ardith Z

2015-03-01

To describe evidence-based practice (EBP) beliefs and behaviors of nurses who provide cancer pain management. Descriptive, cross-sectional with a mixed-methods approach. Two inpatient oncology units in the Pacific Northwest. 40 RNs.
 Data collected by interviews and web-based surveys. EBP beliefs, EBP implementation, evidence-based pain management. Nurses agreed with the positive aspects of EBP and their implementation ability, although implementation level was low. They were satisfied with their pain management practices. Oncology nursing certification was associated with innovativeness, and innovativeness was associated with EBP beliefs. Themes identified were (a) limited definition of EBP, (b) varied evidence-based pain management decision making, (c) limited identification of evidence-based pain management practices, and (d) integration of nonpharmacologic interventions into patient care. Nurses' low level of EBP implementation in the context of pain management was explained by their trust that standards of care and medical orders were evidence-based. Nurses' EBP beliefs and behaviors should be considered when developing strategies for sustaining evidence-based pain management practices. Implementation of the EBP process by nurses may not be realistic in the inpatient setting; therefore, hospital pain management policies need to be evidence-based and reinforced with nurses.

Evidence Accumulator or Decision Threshold – Which Cortical Mechanism are We Observing?

PubMed Central

Simen, Patrick

2012-01-01

Most psychological models of perceptual decision making are of the accumulation-to-threshold variety. The neural basis of accumulation in parietal and prefrontal cortex is therefore a topic of great interest in neuroscience. In contrast, threshold mechanisms have received less attention, and their neural basis has usually been sought in subcortical structures. Here I analyze a model of a decision threshold that can be implemented in the same cortical areas as evidence accumulators, and whose behavior bears on two open questions in decision neuroscience: (1) When ramping activity is observed in a brain region during decision making, does it reflect evidence accumulation? (2) Are changes in speed-accuracy tradeoffs and response biases more likely to be achieved by changes in thresholds, or in accumulation rates and starting points? The analysis suggests that task-modulated ramping activity, by itself, is weak evidence that a brain area mediates evidence accumulation as opposed to threshold readout; and that signs of modulated accumulation are as likely to indicate threshold adaptation as adaptation of starting points and accumulation rates. These conclusions imply that how thresholds are modeled can dramatically impact accumulator-based interpretations of this data. PMID:22737136

Deteriorating water clarity in shallow waters: Evidence from long term MODIS and in-situ observations

NASA Astrophysics Data System (ADS)

Shi, Kun; Zhang, Yunlin; Zhu, Guangwei; Qin, Boqiang; Pan, Delu

2018-06-01

Water clarity (Secchi disk depth: SDD), as a proxy of water transparency, provides important information on the light availability to the water or lake ecosystem. Shallow lakes have been experienced dramatic environmental and climatic change. This study demonstrated using combination of long-term MODIS and in-situ measurements to track the dynamics of SDD with these environmental and climate changes in shallow water environments. We selected a typical turbid shallow Lake Taihu as our case study. Based on MODIS-Aqua data, an empirical model for estimating SDD was developed and validated. Subsequently, we employed the proposed model to derive the spatial and temporal SDD distribution patterns of Lake Taihu from 2003 to 2015. Combining MODIS-derived SDD time series of 2003-2015 and long-term in-situ SDD observations dated back to 1993, we elucidated SDD long-term variation trends and driving mechanism. Deteriorating water clarity from the long-term SDD observations indicated that Lake Taihu became more and more turbid and water quality was decreasing. Increasing in cyanobacterial bloom area, as a result of decreasing in wind speed and eutrophication, may partially be responsible for the decreasing trend. A predicted future decrease in the wind speed in Lake Taihu region could enhance the formation of cyanobacterial blooms and consequently lead to a further decrease in water clarity. This study suggested that coupling remote sensing monitoring and long-term in-situ observations could provide robust evidence and new insights to elucidate long-term dynamics in aquatic ecosystem evolution.

Adoption of Evidence-Based Practices Among Substance Abuse Treatment Providers*

PubMed Central

Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph

2009-01-01

This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals’ readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area. PMID:18724657

Long tree-ring chronologies provide evidence of recent tree growth decrease in a Central African tropical forest.

PubMed

Battipaglia, Giovanna; Zalloni, Enrica; Castaldi, Simona; Marzaioli, Fabio; Cazzolla-Gatti, Roberto; Lasserre, Bruno; Tognetti, Roberto; Marchetti, Marco; Valentini, Riccardo

2015-01-01

It is still unclear whether the exponential rise of atmospheric CO2 concentration has produced a fertilization effect on tropical forests, thus incrementing their growth rate, in the last two centuries. As many factors affect tree growth patterns, short -term studies might be influenced by the confounding effect of several interacting environmental variables on plant growth. Long-term analyses of tree growth can elucidate long-term trends of plant growth response to dominant drivers. The study of annual rings, applied to long tree-ring chronologies in tropical forest trees enables such analysis. Long-term tree-ring chronologies of three widespread African species were measured in Central Africa to analyze the growth of trees over the last two centuries. Growth trends were correlated to changes in global atmospheric CO2 concentration and local variations in the main climatic drivers, temperature and rainfall. Our results provided no evidence for a fertilization effect of CO2 on tree growth. On the contrary, an overall growth decline was observed for all three species in the last century, which appears to be significantly correlated to the increase in local temperature. These findings provide additional support to the global observations of a slowing down of C sequestration in the trunks of forest trees in recent decades. Data indicate that the CO2 increase alone has not been sufficient to obtain a tree growth increase in tropical trees. The effect of other changing environmental factors, like temperature, may have overridden the fertilization effect of CO2.

Long Tree-Ring Chronologies Provide Evidence of Recent Tree Growth Decrease in a Central African Tropical Forest

PubMed Central

Battipaglia, Giovanna; Zalloni, Enrica; Castaldi, Simona; Marzaioli, Fabio; Cazzolla- Gatti, Roberto; Lasserre, Bruno; Tognetti, Roberto; Marchetti, Marco; Valentini, Riccardo

2015-01-01

It is still unclear whether the exponential rise of atmospheric CO2 concentration has produced a fertilization effect on tropical forests, thus incrementing their growth rate, in the last two centuries. As many factors affect tree growth patterns, short -term studies might be influenced by the confounding effect of several interacting environmental variables on plant growth. Long-term analyses of tree growth can elucidate long-term trends of plant growth response to dominant drivers. The study of annual rings, applied to long tree-ring chronologies in tropical forest trees enables such analysis. Long-term tree-ring chronologies of three widespread African species were measured in Central Africa to analyze the growth of trees over the last two centuries. Growth trends were correlated to changes in global atmospheric CO2 concentration and local variations in the main climatic drivers, temperature and rainfall. Our results provided no evidence for a fertilization effect of CO2 on tree growth. On the contrary, an overall growth decline was observed for all three species in the last century, which appears to be significantly correlated to the increase in local temperature. These findings provide additional support to the global observations of a slowing down of C sequestration in the trunks of forest trees in recent decades. Data indicate that the CO2 increase alone has not been sufficient to obtain a tree growth increase in tropical trees. The effect of other changing environmental factors, like temperature, may have overridden the fertilization effect of CO2. PMID:25806946

A bias-adjusted evidence synthesis of RCT and observational data: the case of total hip replacement.

PubMed

Schnell-Inderst, Petra; Iglesias, Cynthia P; Arvandi, Marjan; Ciani, Oriana; Matteucci Gothe, Raffaella; Peters, Jaime; Blom, Ashley W; Taylor, Rod S; Siebert, Uwe

2017-02-01

Evaluation of clinical effectiveness of medical devices differs in some aspects from the evaluation of pharmaceuticals. One of the main challenges identified is lack of robust evidence and a will to make use of experimental and observational studies (OSs) in quantitative evidence synthesis accounting for internal and external biases. Using a case study of total hip replacement to compare the risk of revision of cemented and uncemented implant fixation modalities, we pooled treatment effect estimates from OS and RCTs, and simplified existing methods for bias-adjusted evidence synthesis to enhance practical application. We performed an elicitation exercise using methodological and clinical experts to determine the strength of beliefs about the magnitude of internal and external bias affecting estimates of treatment effect. We incorporated the bias-adjusted treatment effects into a generalized evidence synthesis, calculating both frequentist and Bayesian statistical models. We estimated relative risks as summary effect estimates with 95% confidence/credibility intervals to capture uncertainty. When we compared alternative approaches to synthesizing evidence, we found that the pooled effect size strongly depended on the inclusion of observational data as well as on the use bias-adjusted estimates. We demonstrated the feasibility of using observational studies in meta-analyses to complement RCTs and incorporate evidence from a wider spectrum of clinically relevant studies and healthcare settings. To ensure internal validity, OS data require sufficient correction for confounding and selection bias, either through study design and primary analysis, or by applying post-hoc bias adjustments to the results. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

Long-term monitoring data provide evidence of declining species richness in a river valued for biodiversity conservation

USGS Publications Warehouse

Freeman, Mary C.; Hagler, Megan M.; Bumpers, Phillip M.; Wheeler, Kit; Wengerd, Seth J.; Freeman, Byron J.

2017-01-01

and observations identified contaminants, nutrient loading, or changes in benthic habitat as possible causes for fish species declines in the Conasauga River. Our analysis provides baseline information that could be used to assess effectiveness of future management actions in the Conasauga or Etowah rivers, and illustrates the use of dynamic occupancy models to evaluate evidence of faunal decline from time-series data.

Diagnosing dehydration? Blend evidence with clinical observations.

PubMed

Armstrong, Lawrence E; Kavouras, Stavros A; Walsh, Neil P; Roberts, William O

2016-11-01

The purpose of the review is to provide recommendations to improve clinical decision-making based on the strengths and weaknesses of commonly used hydration biomarkers and clinical assessment methods. There is widespread consensus regarding treatment, but not the diagnosis of dehydration. Even though it is generally accepted that a proper clinical diagnosis of dehydration can only be made biochemically rather than relying upon clinical signs and symptoms, no gold standard biochemical hydration index exists. Other than clinical biomarkers in blood (i.e., osmolality and blood urea nitrogen/creatinine) and in urine (i.e., osmolality and specific gravity), blood pressure assessment and clinical symptoms in the eye (i.e., tear production and palpitating pressure) and the mouth (i.e., thirst and mucous wetness) can provide important information for diagnosing dehydration. We conclude that clinical observations based on a combination of history, physical examination, laboratory values, and clinician experience remain the best approach to the diagnosis of dehydration.

Observations of a Two-Stage Solar Eruptive Event (SEE): Evidence for Secondary Heating

NASA Technical Reports Server (NTRS)

Su, Yang; Dennis, Brian R.; Holman, Gordon D.; Wang, Tongjiang; Chamberlin, Phillip C.; Savage, Sabrina; Veronig, Astrid

2012-01-01

We present RHESSI, SDO/AIA, SOHO/LASCO, STEREO, and GOES observations of a partially occulted solar eruptive event (SEE) that occurred at the South-West limb on 8 March, 2011. The GOES X-ray light curve shows two peaks separated by almost two hours that we interpret as two stages of a single event associated with the delayed eruption of a CME. A hot flux rope formed during the first stage and continued expanding and rising throughout the event. The speed of the flux rope decreased from approx.120 to 14 km/s during the decay phase of the first stage and increased again during the second stage to become the CME with a speed of approx.516 km/s. RHESSI and GOES data analyses show that the plasma temperature reached over 20 MK in the first stage, then decreased to approx.10 MK and increased to 15 MK in the second stage. This event provides clear evidence for a secondary heating phase. The enhanced EUV and X-ray emission came from the high corona ( approx.60 arcsec above the limb) in the second stage, approx.40 arcsec higher than the site of the initial flare emission. STEREO-A on-disk observations indicate that the post-flare loops during this stage were of larger scale sizes and spatially distinct from those in the first stage.

Simultaneous Extreme-Ultraviolet Explorer and Optical Observations of Ad Leonis: Evidence for Large Coronal Loops and the Neupert Effect in Stellar Flares

NASA Technical Reports Server (NTRS)

Hawley, Suzanne L.; Fisher, George H.; Simon, Theodore; Cully, Scott L.; Deustua, Susana E.; Jablonski, Marek; Johns-Krull, Christopher; Pettersen, Bjorn R.; Smith, Verne; Spiesman, William J.;

The disagreement between the ideal observer and human observers in hardware and software imaging system optimization: theoretical explanations and evidence

NASA Astrophysics Data System (ADS)

He, Xin

2017-03-01

The ideal observer is widely used in imaging system optimization. One practical question remains open: do the ideal and human observers have the same preference in system optimization and evaluation? Based on the ideal observer's mathematical properties proposed by Barrett et. al. and the empirical properties of human observers investigated by Myers et. al., I attempt to pursue the general rules regarding the applicability of the ideal observer in system optimization. Particularly, in software optimization, the ideal observer pursues data conservation while humans pursue data presentation or perception. In hardware optimization, the ideal observer pursues a system with the maximum total information, while humans pursue a system with the maximum selected (e.g., certain frequency bands) information. These different objectives may result in different system optimizations between human and the ideal observers. Thus, an ideal observer optimized system is not necessarily optimal for humans. I cite empirical evidence in search and detection tasks, in hardware and software evaluation, in X-ray CT, pinhole imaging, as well as emission computed tomography to corroborate the claims. (Disclaimer: the views expressed in this work do not necessarily represent those of the FDA)

Little Evidence Exists To Support The Expectation That Providers Would Consolidate To Enter New Payment Models.

PubMed

Neprash, Hannah T; Chernew, Michael E; McWilliams, J Michael

2017-02-01

Provider consolidation has been associated with higher health care prices and spending. The prevailing wisdom is that payment reform will accelerate consolidation, especially between physicians and hospitals and among physician groups, as providers position themselves to bear financial risk for the full continuum of patient care. Drawing on data from a number of sources from 2008 onward, we examined the relationship between Medicare's accountable care organization (ACO) programs and provider consolidation. We found that consolidation was under way in the period 2008-10, before the Affordable Care Act (ACA) established the ACO programs. While the number of hospital mergers and the size of specialty-oriented physician groups increased after the ACA was passed, we found minimal evidence that consolidation was associated with ACO penetration at the market level or with physicians' participation in ACOs within markets. We conclude that payment reform has been associated with little acceleration in consolidation in addition to trends already under way, but there is evidence of potential defensive consolidation in response to new payment models. Project HOPE—The People-to-People Health Foundation, Inc.

PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes

PubMed Central

Eddy, Sarah L.; Converse, Mercedes; Wenderoth, Mary Pat

2015-01-01

There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both clarifies the research-supported elements of best practices for instructor implementation of active learning in the classroom setting and measures instructors’ alignment with these practices. We describe how we reviewed the discipline-based education research literature to identify best practices in active learning for adult learners in the classroom and used these results to develop an observation tool (Practical Observation Rubric To Assess Active Learning, or PORTAAL) that documents the extent to which instructors incorporate these practices into their classrooms. We then use PORTAAL to explore the classroom practices of 25 introductory biology instructors who employ some form of active learning. Overall, PORTAAL documents how well aligned classrooms are with research-supported best practices for active learning and provides specific feedback and guidance to instructors to allow them to identify what they do well and what could be improved. PMID:26033871

Long-Term Empirical and Observational Evidence of Practical Helicoverpa zea Resistance to Cotton With Pyramided Bt Toxins.

PubMed

Reisig, Dominic D; Huseth, Anders S; Bacheler, Jack S; Aghaee, Mohammad-Amir; Braswell, Lewis; Burrack, Hannah J; Flanders, Kathy; Greene, Jeremy K; Herbert, D Ames; Jacobson, Alana; Paula-Moraes, Silvana V; Roberts, Phillip; Taylor, Sally V

2018-04-16

Evidence of practical resistance of Helicoverpa zea (Boddie) (Lepidoptera: Noctuidae) to Bt cotton in the United States is debatable, supported with occasional reports of boll damage in the field. Our objective was to provide both empirical and long-term observational evidence of practical resistance by linking both in-season and end-of-season measurements of H. zea damage to pyramided Bt cotton bolls and to provide Cry1Ac diet-based bioassay data in support of these damage estimates. In-season boll damage from H. zea was highly correlated to end-of-season damaged bolls. Across North Carolina, Bt cotton fields with end-of-season bolls damaged by H. zea increased during 2016 compared to previous years. Elevated damage was coupled with an increase in field sprays targeting H. zea during 2016, but not related to an increase in H. zea abundance. Bioassay data indicated that there was a range of Cry1Ac susceptibility across the southeastern United States. Given the range of susceptibility to Cry1Ac across the southeastern United States, it is probable that resistant populations are common. Since H. zea is resistant to cotton expressing pyramided Cry toxins, the adoption of new cotton varieties expressing Vip3Aa will be rapid. Efforts should be made to delay resistance of H. zea to the Vip3Aa toxin to avoid foliar insecticide use.

Observational Study Designs for Comparative Effectiveness Research: An Alternative Approach to Close Evidence Gaps in Head-and-Neck Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goulart, Bernardo H.L., E-mail: bhg@uw.edu; University of Washington, Seattle, Washington; Ramsey, Scott D.

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H and N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H and N RCTs, which limits the validity of their results to the broader H and N cancer patient population seenmore » in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H and N cancer, including treatment comparisons for rare types of H and N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H and N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H and N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design.« less

Observational study designs for comparative effectiveness research: an alternative approach to close evidence gaps in head-and-neck cancer.

PubMed

Goulart, Bernardo H L; Ramsey, Scott D; Parvathaneni, Upendra

2014-01-01

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H&N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H&N RCTs, which limits the validity of their results to the broader H&N cancer patient population seen in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H&N cancer, including treatment comparisons for rare types of H&N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H&N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H&N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design. Copyright © 2014 Elsevier Inc. All rights reserved.

Use of acetaminophen and risk of endometrial cancer: evidence from observational studies.

PubMed

Ding, Yuan-Yuan; Yao, Peng; Verma, Surya; Han, Zhen-Kai; Hong, Tao; Zhu, Yong-Qiang; Li, Hong-Xi

2017-05-23

Previous meta-analyses suggested that aspirin was associated with reduced risk of endometrial cancer. However, there has been no study comprehensively summarize the evidence of acetaminophen use and risk of endometrial cancer from observational studies. We systematically searched electronic databases (PubMed , EMBASE, Web of Science, and Cochrane Library) for relevant cohort or case-control studies up to February 28, 2017. Two independent authors performed the eligibility evaluation and data extraction. All differences were resolved by discussion. A random-effects model was applied to estimate summary relative risks (RRs) with 95% CIs. All statistical tests were two-sided. Seven observational studies including four prospective cohort studies and three case-control studies with 3874 endometrial cancer cases were included for final analysis. Compared with never use acetaminophen, ever use this drug was not associated with risk of endometrial cancer (summarized RR = 1.02; 95% CI: 0.93-1.13, I2 = 0%). Similar null association was also observed when compared the highest category of frequency/duration with never use acetaminophen (summarized RR = 0.88; 95% CI: 0.70-1.11, I2 = 15.2%). Additionally, the finding was robust in the subgroup analyses stratified by study characteristics and adjustment for potential confounders and risk factors. There was no evidence of publication bias by a visual inspection of a funnel plot and formal statistical tests. In summary, the present meta-analysis reveals no association between acetaminophen use and risk of endometrial cancer. More large scale prospective cohort studies are warranted to confirm our findings and carry out the dose-response analysis of aforementioned association.

Observational learning without a model is influenced by the observer's possibility to act: evidence from the Simon task.

PubMed

Iani, Cristina; Rubichi, Sandro; Ferraro, Luca; Nicoletti, Roberto; Gallese, Vittorio

2013-07-01

We assessed whether observational learning in perceptual-motor tasks is affected by the visibility of an action producing perceived environmental effects and by the observer's possibility to act during observation. To this end, we conducted three experiments in which participants were required to observe a spatial compatibility task in which only the effects of computer-generated responses were visible before executing a Simon task. In Experiment 1, we compared the effects of a passively observed practice with either a spatially compatible or incompatible stimulus-response (S-R) association. In Experiment 2, during the observed spatially incompatible practice participants were prevented from potentially acting, either because a plexiglas barrier separated the participant from the response device rendering it out of reach; or because the participant's hands were tied; or the device affording a response was absent. In Experiment 3, the plexiglas presented an opening that could allow the participant to potentially reach and interact with it. As when the practice is physically performed, we found an elimination of the Simon effect following a spatially incompatible observed practice, suggesting that participants learned an incompatible S-R association by observing and transferred this knowledge to the subsequent Simon task. No evidence of transfer of learning was found when, during passive observation, the participant's hands were tied, or a barrier prevented him/her from potentially interacting with the device, or no response device was present. Differently, a transfer-of-learning effect was observed when the barrier presented an opening. These results suggest that learning can derive from the mere observation of action effects, even when an action is not visible, as long as the observer has the potential to act. Copyright © 2013 Elsevier B.V. All rights reserved.

Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts.

PubMed

Maclean, Johanna Catherine; Saloner, Brendan

2018-01-01

We examine the impact of the 2006 Massachusetts healthcare reform on substance use disorder (SUD) treatment facilities' provision of care. We test the impact of the reform on treatment quantity and access. We couple data on the near universe of specialty SUD treatment providers in the USA with a synthetic control method approach. We find little evidence that the reform lead to changes in treatment quantity or access. Reform effects were similar among for-profit and non-profit facilities. In an extension, we show that the reform altered the setting in which treatment is received, the number of offered services, and the number of programs for special populations. These findings may be useful in predicting the implications of major health insurance expansions on the provision of SUD treatment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Mental Health Providers' Decision-Making Around the Implementation of Evidence-Based Treatment for PTSD.

PubMed

Osei-Bonsu, Princess E; Bolton, Rendelle E; Wiltsey Stirman, Shannon; Eisen, Susan V; Herz, Lawrence; Pellowe, Maura E

2017-04-01

It is estimated that <15% of veterans with posttraumatic stress disorder (PTSD) have engaged in two evidence-based psychotherapies highly recommended by VA-cognitive processing therapy (CPT) and prolonged exposure (PE). CPT and PE guidelines specify which patients are appropriate, but research suggests that providers may be more selective than the guidelines. In addition, PTSD clinical guidelines encourage "shared decision-making," but there is little research on what processes providers use to make decisions about CPT/PE. Sixteen licensed psychologists and social workers from two VA medical centers working with ≥1 patient with PTSD were interviewed about patient factors considered and decision-making processes for CPT/PE use. Qualitative analyses revealed that patient readiness and comorbid conditions influenced decisions to use or refer patients with PTSD for CPT/PE. Providers reported mentally derived and instances of patient-involved decision-making around CPT/PE use. Continued efforts to assist providers in making informed and collaborative decisions about CPT/PE use are discussed.

Provider Perspectives on Evidence-Based HIV Prevention Interventions: Barriers and Facilitators to Implementation

PubMed Central

Dickson-Gomez, Julia

2011-01-01

Abstract Since the beginning of the HIV/AIDS epidemic, community-based organizations (CBOs) have been key players in combating this disease through grassroots prevention programs and close ties to at-risk populations. Increasingly, both funding agencies and public health institutions require that CBOs implement evidence-based HIV prevention interventions, most of which are researcher developed. However, after completing training for these evidence-based interventions (EBIs), agencies may either abandon plans to implement them or significantly modify the intervention. Based on 22 semistructured interviews with HIV prevention service providers, this article explores the barriers and facilitators to dissemination and implementation of EBIs included in the Centers for Disease Control and Prevention's (CDC) Diffusion of Effective Behavioral Interventions (DEBI) program. Results suggest that there is a tension between the need to implement interventions with fidelity and the lack of guidance on how to adapt the interventions for their constituencies and organizational contexts. Findings suggest the need for HIV prevention intervention development and dissemination that integrate community partners in all phases of research and dissemination. PMID:21323564

Mirror neuron system and observational learning: behavioral and neurophysiological evidence.

PubMed

Lago-Rodriguez, Angel; Lopez-Alonso, Virginia; Fernández-del-Olmo, Miguel

2013-07-01

Three experiments were performed to study observational learning using behavioral, perceptual, and neurophysiological data. Experiment 1 investigated whether observing an execution model, during physical practice of a transitive task that only presented one execution strategy, led to performance improvements compared with physical practice alone. Experiment 2 investigated whether performing an observational learning protocol improves subjects' action perception. In experiment 3 we evaluated whether the type of practice performed determined the activation of the Mirror Neuron System during action observation. Results showed that, compared with physical practice, observing an execution model during a task that only showed one execution strategy does not provide behavioral benefits. However, an observational learning protocol allows subjects to predict more precisely the outcome of the learned task. Finally, intersperse observation of an execution model with physical practice results in changes of primary motor cortex activity during the observation of the motor pattern previously practiced, whereas modulations in the connectivity between primary and non primary motor areas (PMv-M1; PPC-M1) were not affected by the practice protocol performed by the observer. Copyright © 2013 Elsevier B.V. All rights reserved.

Evidence Synthesis for Knowledge Exchange: Balancing Responsiveness and Quality in Providing Evidence for Policy and Practice

ERIC Educational Resources Information Center

Morton, Sarah; Seditas, Karen

2018-01-01

Barriers to using research in practice are well documented. This paper describes an innovative process developed by the Centre for Research on Families and Relationships to address these barriers. We supported people to define what they needed to know; how existing evidence could help; and how to use evidence in practice. An action-focused…

New Observational Evidence of Flash Mixing on the White Dwarf Cooling Curve

NASA Technical Reports Server (NTRS)

Brown, T. M.; Lanz, T.; Sweigart, A. V.; Cracraft, Misty; Hubeny, Ivan; Landsman, W. B.

2011-01-01

Blue hook stars are a class of subluminous extreme horizontal branch stars that were discovered in UV images of the massive globular clusters w Cen and NGC 2808. These stars occupy a region of the HR diagram that is unexplained by canonical stellar evolution theory. Using new theoretical evolutionary and atmospheric models, we have shown that the blue hook stars are very likely the progeny of stars that undergo extensive internal mixing during a late helium-core flash on the white dwarf cooling curve. This "flash mixing" produces hotter-than-normal EHB stars with atmospheres significantly enhanced in helium and carbon. The larger bolometric correction, combined with the decrease in hydrogen opacity, makes these stars appear sub luminous in the optical and UV. Flash mixing is more likely to occur in stars born with a high helium abundance, due to their lower mass at the main sequence turnoff. For this reason, the phenomenon is more common in those massive globular clusters that show evidence for secondary populations enhanced in helium. However, a high helium abundance does not, by itself, explain the presence of blue hook stars in massive globular clusters. Here, we present new observational evidence for flash mixing, using recent HST observations. These include UV color-magnitude diagrams of six massive globular clusters and far-UV spectroscopy of hot subdwarfs in one of these clusters (NGC 2808).

The importance of distinguishing information from evidence/observations when formulating propositions.

PubMed

Hicks, T; Biedermann, A; de Koeijer, J A; Taroni, F; Champod, C; Evett, I W

2015-12-01

The value of forensic results crucially depends on the propositions and the information under which they are evaluated. For example, if a full single DNA profile for a contemporary marker system matching the profile of Mr A is assessed, given the propositions that the DNA came from Mr A and given it came from an unknown person, the strength of evidence can be overwhelming (e.g., in the order of a billion). In contrast, if we assess the same result given that the DNA came from Mr A and given it came from his twin brother (i.e., a person with the same DNA profile), the strength of evidence will be 1, and therefore neutral, unhelpful and irrelevant(1) to the case at hand. While this understanding is probably uncontroversial and obvious to most, if not all practitioners dealing with DNA evidence, the practical precept of not specifying an alternative source with the same characteristics as the one considered under the first proposition may be much less clear in other circumstances. During discussions with colleagues and trainees, cases have come to our attention where forensic scientists have difficulty with the formulation of propositions. It is particularly common to observe that results (e.g., observations) are included in the propositions, whereas-as argued throughout this note-they should not be. A typical example could be a case where a shoe-mark with a logo and the general pattern characteristics of a Nike Air Jordan shoe is found at the scene of a crime. A Nike Air Jordan shoe is then seized at Mr A's house and control prints of this shoe compared to the mark. The results (e.g., a trace with this general pattern and acquired characteristics corresponding to the sole of Mr A's shoe) are then evaluated given the propositions 'The mark was left by Mr A's Nike Air Jordan shoe-sole' and 'The mark was left by an unknown Nike Air Jordan shoe'. As a consequence, the footwear examiner will not evaluate part of the observations (i.e., the mark presents the general

Evidence for -Gz Adaptation Observed with Wearable Biosensors During High Performance Jet Flight.

PubMed

Rice, G Merrill; Snider, Dallas; Moore, Jeffrey L; Lavan, J Timothy; Folga, Rich; VanBrunt, Thomas B

2016-12-01

Few studies have evaluated physiological responses to high acceleration forces during actual flight and to our knowledge no normative data has been acquired by technologies such as wearable biosensors during high performance jet aircraft operations. In-flight physiological data from an FDA cleared portable triaxial accelerometer and bio-sensor were observed from five active duty F-18 pilots of the Naval Flight Demonstration Squadron (Blue Angels). Of the five pilots, three were formation pilots who flew lower G profiles and two were solo pilots who flew higher G profiles. Physiological parameters monitored were heart rate, respiratory rate, temperature, caloric expenditure, and duration of exposure to levels of acceleration. Evaluated were 25 practice demonstration flights; 9 flights were excluded secondary to incomplete or inaccurate physiological data. We observed no significant bradycardia during a total of 189 maneuvers which met inclusion criteria for push-pull events (PPE) or isolated -Gz exposures. Further analysis of 73 PPE revealed an overall significant rise in HR following the PPE, where mean heart rate was 106 (95% CI, 100:112) at the beginning of the push and 129 (95% CI, 123:135) following the pull. A majority of the flights monitored provided reliable physiological data. Initial data suggests, contrary to currently held aeromedical doctrine, maneuvers such as the "push-pull" do not evoke vasovagal based bradycardic responses in aerobatic pilots. Possible explanations for these findings are sympathetic nervous system activation through adaptation and/or sustained isometric resistance from control inputs, both of which are areas of future research for our team.Rice GM, Snider D, Moore JL, Lavan JT, Folga R, VanBrunt TB. Evidence for -Gz adaptation observed with wearable biosensors during high performance jet flight. Aerosp Med Hum Perform. 2016; 87(12):996-1003.

Doctors or mid-level providers for abortion.

PubMed

Barnard, Sharmani; Kim, Caron; Park, Min Hae; Ngo, Thoai D

2015-07-27

out in India, Sweden and Nepal. The studies included women with gestational ages up to 14 weeks for surgical abortion and nine weeks for medical abortion.Risk of selection bias was considered to be low in the three RCTs, unclear in four observational studies and high in one observational study. Concealment bias was considered to be low in the three RCTs and high in all five observational studies. Although none of the eight studies performed blinding of the participants to the provider type, we considered the performance bias to be low as this is part of the intervention. Detection bias was considered to be high in all eight studies as none of the eight studies preformed blinding of the outcome assessment. Attrition bias was low in seven studies and high in one, with over 20% attrition. We considered six studies to have unclear risk of selective reporting bias as their protocols had not been published. The remaining two studies had published their protocols. Few other sources of bias were found.Based on an analysis of three cohort studies, the risk of surgical abortion failure was significantly higher when provided by mid-level providers than when procedures were administered by doctors (RR 2.25, 95% CI 1.38 to 3.68), however the quality of evidence for this outcome was deemed to be very low. For surgical abortion procedures, we found no significant differences in the risk of complications between mid-level providers and doctors (RR 0.99, 95% CI 0.17 to 5.70 from RCTs; RR 1.38, 95% CI 0.70 to 2.72 from observational studies). When we combined the data for failure and complications for surgical abortion we found no significant differences between mid-level providers and doctors in both the observational study analysis (RR 1.36, 95% CI 0.86 to 2.14) and the RCT analysis (RR 3.07, 95% CI 0.16 to 59.08). The quality of evidence of the outcome for RCT studies was considered to be low and for observational studies very low. For medical abortion procedures the risk of failure

Evidence of the Solar EUV Hot Channel as a Magnetic Flux Rope from Remote-sensing and In Situ Observations

NASA Astrophysics Data System (ADS)

SONG, H. Q.; CHEN, Y.; ZHANG, J.; CHENG, X.; Wang, B.; HU, Q.; LI, G.; WANG, Y. M.

2015-07-01

Hot channels (HCs), high-temperature erupting structures in the lower corona of the Sun, have been proposed as a proxy of magnetic flux ropes (MFRs) since their initial discovery. However, it is difficult to provide definitive proof given the fact that there is no direct measurement of the magnetic field in the corona. An alternative method is to use the magnetic field measurement in the solar wind from in situ instruments. On 2012 July 12, an HC was observed prior to and during a coronal mass ejection (CME) by the Atmospheric Imaging Assembly high-temperature images. The HC is invisible in the EUVI low-temperature images, which only show the cooler leading front (LF). However, both the LF and an ejecta can be observed in the coronagraphic images. These are consistent with the high temperature and high density of the HC and support that the ejecta is the erupted HC. Meanwhile, the associated CME shock was identified ahead of the ejecta and the sheath through the COR2 images, and the corresponding ICME was detected by the Advanced Composition Explorer, showing the shock, sheath, and magnetic cloud (MC) sequentially, which agrees with the coronagraphic observations. Further, the MC average Fe charge state is elevated, containing a relatively low-ionization-state center and a high-ionization-state shell, consistent with the preexisting HC observation and its growth through magnetic reconnection. All of these observations support that the MC detected near the Earth is the counterpart of the erupted HC in the corona for this event. The study provides strong observational evidence of the HC as an MFR.

Evidence of the Solar EUV Hot Channel as a Magnetic Flux Rope from Remote-sensing and in situ Observations

NASA Astrophysics Data System (ADS)

Song, H.

2015-12-01

Hot channels (HCs), high-temperature erupting structures in the lower corona of the Sun, have been proposed as a proxy of magnetic flux ropes (MFRs) since their initial discovery. However, it is difficult to provide definitive proof given the fact that there is no direct measurement of the magnetic field in the corona. An alternative method is to use the magnetic field measurement in the solar wind from in situ instruments. On 2012 July 12, an HC was observed prior to and during a coronal mass ejection (CME) by the Atmospheric Imaging Assembly high-temperature images. The HC is invisible in the EUVI low-temperature images, which only show the cooler leading front (LF). However, both the LF and an ejecta can be observed in the coronagraphic images. These are consistent with the high temperature and high density of the HC and support that the ejecta is the erupted HC. Meanwhile, the associated CME shock was identified ahead of the ejecta and the sheath through the COR2 images, and the corresponding ICME was detected by the Advanced Composition Explorer, showing the shock, sheath, and magnetic cloud (MC) sequentially, which agrees with the coronagraphic observations. Further, the MC average Fe charge state is elevated, containing a relatively low-ionization-state center and a high-ionization-state shell, consistent with the preexisting HC observation and its growth through magnetic reconnection. All of these observations support that the MC detected near the Earth is the counterpart of the erupted HC in the corona for this event. The study provides strong observational evidence of the HC as an MFR.

The ISI Classroom Observation System: Examining the Literacy Instruction Provided to Individual Students

ERIC Educational Resources Information Center

Connor, Carol McDonald; Morrison, Frederick J.; Fishman, Barry J.; Ponitz, Claire Cameron; Glasney, Stephanie; Underwood, Phyllis S.; Piasta, Shayne B.; Crowe, Elizabeth Coyne; Schatschneider, Christopher

2009-01-01

The Individualizing Student Instruction (ISI) classroom observation and coding system is designed to provide a detailed picture of the classroom environment at the level of the individual student. Using a multidimensional conceptualization of the classroom environment, foundational elements (teacher warmth and responsiveness to students, classroom…

Osteoporosis therapies: evidence from health-care databases and observational population studies.

PubMed

Silverman, Stuart L

2010-11-01

Osteoporosis is a well-recognized disease with severe consequences if left untreated. Randomized controlled trials are the most rigorous method for determining the efficacy and safety of therapies. Nevertheless, randomized controlled trials underrepresent the real-world patient population and are costly in both time and money. Modern technology has enabled researchers to use information gathered from large health-care or medical-claims databases to assess the practical utilization of available therapies in appropriate patients. Observational database studies lack randomization but, if carefully designed and successfully completed, can provide valuable information that complements results obtained from randomized controlled trials and extends our knowledge to real-world clinical patients. Randomized controlled trials comparing fracture outcomes among osteoporosis therapies are difficult to perform. In this regard, large observational database studies could be useful in identifying clinically important differences among therapeutic options. Database studies can also provide important information with regard to osteoporosis prevalence, health economics, and compliance and persistence with treatment. This article describes the strengths and limitations of both randomized controlled trials and observational database studies, discusses considerations for observational study design, and reviews a wealth of information generated by database studies in the field of osteoporosis.

Observational Evidence of Shallow Origins for the Magnetic Fields of Solar Cycles - a review

NASA Astrophysics Data System (ADS)

Martin, Sara F.

2018-05-01

Observational evidence for the origin of active region magnetic fields has been sought from published information on extended solar cycles, statistical distributions of active regions and ephemeral regions, helioseismology results, positional relationships to supergranules, and fine-scale magnetic structure of active regions and their sunspots during their growth. Statistical distributions of areas of ephemeral and active regions blend together to reveal a single power law. The shape of the size distribution in latitude of all active regions is independent of time during the solar cycle, yielding further evidence that active regions of all sizes belong to the same population. Elementary bipoles, identified also by other names, appear to be the building blocks of active regions; sunspots form from elementary bipoles and are therefore deduced to develop from the photosphere downward, consistent with helioseismic detection of downflows to 3-4 Mm below sunspots as well as long-observed downflows from chromospheric/coronal arch filaments into sunspots from their earliest appearance. Time-distance helioseismology has been effective in revealing flows related to sunspots to depths of 20 Mm. Ring diagram analysis shows a statistically significant preference for upflows to precede major active region emergence and downflows after flux emergence but both are often observed together or sometimes not detected. From deep-focus helioseismic techniques for seeking magnetic flux below the photosphere prior major active regions, there is evidence of acoustic travel-time perturbation signatures rising in the limited range of depths of 42-75 Mm but these have not been verified or found at more shallow depths by helioseismic holographic techniques. The development of active regions from clusters of elementary bipoles appears to be the same irrespective of how much flux an active region eventually develops. This property would be consistent with the magnetic fields of large active

Observational Evidence for a Dark Side to NGC 5128's Globular Cluster System

NASA Astrophysics Data System (ADS)

Taylor, Matthew A.; Puzia, Thomas H.; Gomez, Matias; Woodley, Kristin A.

2015-05-01

We present a study of the dynamical properties of 125 compact stellar systems (CSSs) in the nearby giant elliptical galaxy NGC 5128, using high-resolution spectra (R ≈ 26, 000) obtained with Very Large Telescope/FLAMES. Our results provide evidence for a new type of star cluster, based on the CSS dynamical mass scaling relations. All radial velocity (vr) and line-of-sight velocity dispersion (σlos) measurements are performed with the penalized pixel fitting (ppxf ) technique, which provided σppxf estimates for 115 targets. The σppxf estimates are corrected to the 2D projected half-light radii, σ1/2, as well as the cluster cores, σ0, accounting for observational/aperture effects and are combined with structural parameters, from high spatial resolution imaging, in order to derive total dynamical masses ({{M}dyn}) for 112 members of NGC 5128’s star cluster system. In total, 89 CSSs have dynamical masses measured for the first time along with the corresponding dynamical mass-to-light ratios (\\Upsilon Vdyn). We find two distinct sequences in the \\Upsilon Vdyn-{{M}dyn} plane, which are well approximated by power laws of the forms \\Upsilon Vdyn\\propto Mdyn0.33+/- 0.04 and \\Upsilon Vdyn\\propto Mdyn0.79+/- 0.04. The shallower sequence corresponds to the very bright tail of the globular cluster luminosity function (GCLF), while the steeper relation appears to be populated by a distinct group of objects that require significant dark gravitating components such as central massive black holes and/or exotically concentrated dark matter distributions. This result would suggest that the formation and evolution of these CSSs are markedly different from the “classical” globular clusters in NGC 5128 and the Local Group, despite the fact that these clusters have luminosities similar to the GCLF turnover magnitude. We include a thorough discussion of myriad factors potentially influencing our measurements. Based on observations collected under program 081.D-0651 (PI

Evidence-Based Practices: Providing Guidance for Early Childhood Practitioners

ERIC Educational Resources Information Center

Farley, Kristin S.; Brock, Matthew E.; Winterbottom, Christian

2018-01-01

Early childhood education represents a pivotal opportunity to improve the developmental trajectories of young children, and evidence-based practices (EBPs) are scientifically proven to improve these outcomes. Furthermore, federal law mandates that early childhood practitioners implement EBPs. However, because EBP has not been clearly defined in…

Hindsight Bias and Outcome-Consistent Thoughts when Observing and Making Service Provider Decisions

ERIC Educational Resources Information Center

Louie, Therese A.

2005-01-01

Two studies examined the relationship between hindsight bias and corresponding open-ended thoughts for decisions in a service provider setting. Perspectives of those observing and making decisions were examined. In study 1, business students who learned the results of a financial advisor's stock purchase showed the traditional hindsight effect…

OBSERVATIONAL EVIDENCE OF BACK REACTION ON THE SOLAR SURFACE ASSOCIATED WITH CORONAL MAGNETIC RESTRUCTURING IN SOLAR ERUPTIONS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang Haimin; Liu Chang, E-mail: haimin.wang@njit.ed, E-mail: chang.liu@njit.ed

2010-06-20

Most models of solar eruptions assume that coronal field lines are anchored in the dense photosphere and thus the photospheric magnetic fields would not have rapid, irreversible changes associated with eruptions resulted from the coronal magnetic reconnection. Motivated by the recent work of Hudson et al. on quantitatively evaluating the back reaction due to energy release from the coronal fields, in this Letter we synthesize our previous studies and present analysis of new events about flare-related changes of photospheric magnetic fields. For the 11 X-class flares where vector magnetograms are available, we always find an increase of transverse field atmore » the polarity inversion line (PIL) although only four events had measurements with 1 minute temporal resolution. We also discuss 18 events with 1 minute cadence line-of-sight magnetogram observation, which all show prominent changes of magnetic flux contained in the flaring {delta} spot region. Except in one case, the observed limbward flux increases while diskward flux decreases rapidly and irreversibly after flares. This observational evidence provides support, either directly or indirectly, for the theory and prediction of Hudson et al. that the photospheric magnetic fields must respond to coronal field restructuring and turn to a more horizontal state near the PIL after eruptions.« less

Quantifying the AGN-driven outflows in ULIRGs (QUADROS) II: evidence for compact outflow regions from HST [OIII] imaging observations

NASA Astrophysics Data System (ADS)

Tadhunter, C.; Zaurín, J. Rodríguez; Rose, M.; Spence, R. A. W.; Batcheldor, D.; Berg, M. A.; Ramos Almeida, C.; Spoon, H. W. W.; Sparks, W.; Chiaberge, M.

2018-05-01

The true importance of the warm, AGN-driven outflows for the evolution of galaxies remains uncertain. Measurements of the radial extents of the outflows are key for quantifying their masses and kinetic powers, and also establishing whether the AGN outflows are galaxy-wide. Therefore, as part of a larger project to investigate the significance of warm, AGN-driven outflows in the most rapidly evolving galaxies in the local universe, here we present deep Hubble Space Telescope (HST) narrow-band [OIII]λ5007 observations of a complete sample of 8 nearby ULIRGs with optical AGN nuclei. Combined with the complementary information provided by our ground-based spectroscopy, the HST images show that the warm gas outflows are relatively compact for most of the objects in the sample: in three objects the outflow regions are barely resolved at the resolution of HST (0.065 < R[OIII] < 0.12 kpc); in a further four cases the outflows are spatially resolved but with flux weighted mean radii in the range 0.65 < R[OIII] < 1.2 kpc; and in only one object (Mrk273) is there clear evidence for a more extended outflow, with a maximum extent of R[OIII] ˜ 5 kpc. Overall, our observations show little evidence for the galaxy-wide outflows predicted by some models of AGN feedback.

The PERSIAN Cohort: Providing the Evidence Needed for Healthcare Reform.

PubMed

Eghtesad, Sareh; Mohammadi, Zahra; Shayanrad, Amaneh; Faramarzi, Elnaz; Joukar, Farahnaz; Hamzeh, Behrooz; Farjam, Mojtaba; Zare Sakhvidi, Mohammad Javad; Miri-Monjar, Mohammadreza; Moosazadeh, Mahmood; Hakimi, Hamid; Rahimi Kazerooni, Salar; Cheraghian, Bahman; Ahmadi, Ali; Nejatizadeh, Azim; Mohebbi, Iraj; Pourfarzi, Farhad; Roozafzai, Farzin; Motamed-Gorji, Nazgol; Montazeri, Seyed Ali; Masoudi, Sahar; Amin-Esmaeili, Masoumeh; Danaie, Navid; Mirhafez, Seyed Reza; Hashemi, Hasan; Poustchi, Hossein; Malekzadeh, Reza

2017-11-01

In the past, communicable diseases caused the highest mortality in Iran. Improvements in socioeconomic status and living standards including access to safe drinking water, along with the inception of Health Houses in the 1980s, have changed disease patterns, decreasing the spread of and deaths from infectious and communicable diseases. The incidence and prevalence of non-communicable diseases (NCD), however, have now increased in Iran, accounting for nearly 80% of deaths and disabilities. Without interventions, NCD are predicted to impose a substantial human and economic burden in the next 2 decades. However, Iran's health system is not equipped with the necessary policies to combat this growth and must refocus and reform. Therefore, in the year 2013, the Ministry of Health and Medical Education funded a well-designed nationwide cohort study-Prospective Epidemiological Research Studies in IrAN (PERSIAN)-in order to assess the burden of NCD and investigate the risk factors associated with them in the different ethnicities and geographical areas of Iran. The PERSIAN Cohort, which aims to include 200000 participants, has 4 components: Adult (main), Birth, Youth and Elderly, which are being carried out in 22 different regions of Iran. Having an enormous dataset along with a biobank of blood, urine, hair and nail samples, the PERSIAN Cohort will serve as an important infrastructure for future implementation research and will provide the evidence needed for new healthcare policies in order to better control, manage and prevent NCD. Copyright © 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

Association between dietary nitrate and nitrite intake and sitespecific cancer risk: evidence from observational studies.

PubMed

Xie, Li; Mo, Miao; Jia, Hui-Xun; Liang, Fei; Yuan, Jing; Zhu, Ji

2016-08-30

Epidemiological studies have reported inconsistent findings on the association between dietary nitrate and nitrite intake and cancer risk. We performed a meta-analysis of epidemiological studies to summarize available evidence on the association between dietary nitrate and nitrite intake and cancer risk from published prospective and case-control studies. PubMed database was searched to identify eligible publications through April 30th, 2016. Study-specific relative risks (RRs) with corresponding 95% confidence interval (CI) from individual studies were pooled by using random- or fixed- model, and heterogeneity and publication bias analyses were conducted. Data from 62 observational studies, 49 studies for nitrates and 51 studies for nitrites, including a total of 60,627 cancer cases were analyzed. Comparing the highest vs. lowest levels, dietary nitrate intake was inversely associated with gastric cancer risk (RR = 0.78; 95%CI = 0.67-0.91) with moderate heterogeneity (I2 = 42.3%). In contrast, dietary nitrite intake was positively associated with adult glioma and thyroid cancer risk with pooled RR of 1.21 (95%CI = 1.03-1.42) and 1.52 (95%CI = 1.12-2.05), respectively. No significant associations were found between dietary nitrate/nitrite and cancers of the breast, bladder, colorectal, esophagus, renal cell, non-Hodgkin lymphoma, ovarian, and pancreas. The present meta-analysis provided modest evidence that positive associations of dietary nitrate and negative associations of dietary nitrite with certain cancers.

Contracting with private providers for primary care services: evidence from urban China.

PubMed

Wang, Yan; Eggleston, Karen; Yu, Zhenjie; Zhang, Qiong

2013-01-17

Controversy surrounds the role of the private sector in health service delivery, including primary care and population health services. China's recent health reforms call for non-discrimination against private providers and emphasize strengthening primary care, but formal contracting-out initiatives remain few, and the associated empirical evidence is very limited. This paper presents a case study of contracting with private providers for urban primary and preventive health services in Shandong Province, China. The case study draws on three primary sources of data: administrative records; a household survey of over 1600 community residents in Weifang and City Y; and a provider survey of over 1000 staff at community health stations (CHS) in both Weifang and City Y. We supplement the quantitative data with one-on-one, in-depth interviews with key informants, including local officials in charge of public health and government finance.We find significant differences in patient mix: Residents in the communities served by private community health stations are of lower socioeconomic status (more likely to be uninsured and to report poor health), compared to residents in communities served by a government-owned CHS. Analysis of a household survey of 1013 residents shows that they are more willing to do a routine health exam at their neighborhood CHS if they are of low socioeconomic status (as measured either by education or income). Government and private community health stations in Weifang did not statistically differ in their performance on contracted dimensions, after controlling for size and other CHS characteristics. In contrast, the comparison City Y had lower performance and a large gap between public and private providers. We discuss why these patterns arose and what policymakers and residents considered to be the main issues and concerns regarding primary care services.

Contracting with private providers for primary care services: evidence from urban China

PubMed Central

2013-01-01

Controversy surrounds the role of the private sector in health service delivery, including primary care and population health services. China’s recent health reforms call for non-discrimination against private providers and emphasize strengthening primary care, but formal contracting-out initiatives remain few, and the associated empirical evidence is very limited. This paper presents a case study of contracting with private providers for urban primary and preventive health services in Shandong Province, China. The case study draws on three primary sources of data: administrative records; a household survey of over 1600 community residents in Weifang and City Y; and a provider survey of over 1000 staff at community health stations (CHS) in both Weifang and City Y. We supplement the quantitative data with one-on-one, in-depth interviews with key informants, including local officials in charge of public health and government finance. We find significant differences in patient mix: Residents in the communities served by private community health stations are of lower socioeconomic status (more likely to be uninsured and to report poor health), compared to residents in communities served by a government-owned CHS. Analysis of a household survey of 1013 residents shows that they are more willing to do a routine health exam at their neighborhood CHS if they are of low socioeconomic status (as measured either by education or income). Government and private community health stations in Weifang did not statistically differ in their performance on contracted dimensions, after controlling for size and other CHS characteristics. In contrast, the comparison City Y had lower performance and a large gap between public and private providers. We discuss why these patterns arose and what policymakers and residents considered to be the main issues and concerns regarding primary care services. PMID:23327666

Providing reviews of evidence to COPD patients: controlled prospective 12-month trial.

PubMed

Harris, M; Smith, B J; Veale, A J; Esterman, A; Frith, P A; Selim, P

2009-01-01

The aim of this study was to evaluate a novel patient-held manual designed to reduce the evidence-practice gap in chronic obstructive pulmonary disease (COPD). The intervention manual contained summaries of research evidence. It was developed using current best practice for patient information materials and designed to cause discussion of evidence between patient and doctor. A controlled before-and-after study was employed in two similar but geographically separate regions of metropolitan Adelaide, South Australia. Participants had moderate to severe COPD, with 249 included at baseline and 201 completing the study. Evidence-based COPD management was measured using an indicator with three components: rates of influenza vaccination, bone density testing, and pulmonary rehabilitation. A survey of behavioral steps leading to practice change was conducted with the trial. Analysis, by median split of socioeconomic disadvantage, showed significant difference between study arms for only one component of the indicator of evidence-based practice, enrollment in pulmonary rehabilitation and only for the most socioeconomically disadvantaged stratum. For both socioeconomic strata, more intervention participants than control participants reported remembering being given the information material, reading part or all, and finding it very or quite helpful. Other significant differences were restricted to the stratum of greatest socioeconomic disadvantage: reading all of the material, learning from it, referring back, and talking to a doctor about a topic from the material. Above 90% of all participants who received the manual reported reading from it, 42% reported discussing topics with a doctor, but only 10% reported treatment change attributable to the manual. We have found that people with COPD will read an evidence manual developed using current best practice. However, the study demonstrated improvement for only one of the three components of an indicator of evidence

The principal-agent problems in health care: evidence from prescribing patterns of private providers in Vietnam.

PubMed

Nguyen, Ha

2011-07-01

The principal-agent problem in health care asserts that providers, being the imperfect agents of patients, will act to maximize their profits at the expense of the patients' interests. This problem applies especially where professional regulations are lacking and incentives exist to directly link providers' actions to their profits, such as a fee-for-service payment system. The current analysis tests for the existence of the principal-agent problem in the private health market in Vietnam by examining the prescribing patterns of private providers. I show that: (1) private providers were able to induce demand by prescribing more drugs than public providers for a similar illness and patient profile; (2) private providers were significantly more likely to prescribe injection drugs to gain trust among the patients; and (3) patients' education as a source of information and empowerment has enabled them to mitigate the demand inducement by the providers. The hypotheses are supported with evidence from the Vietnam National Health Survey 2001-02, the first and, so far, only comprehensive health survey in the country.

Evidence of 3-D Reconnection at Null Point from the Observations of Circular Flares and Homologous Jets

NASA Astrophysics Data System (ADS)

Wang, Haimin; Liu, C.

2012-05-01

In recent studies by Pariat, Antiochos and DeVore (2009, 2010), fan-separatrix topology and magnetic reconnection at the null-point were simulated and found to produce homologous jets. This motivates us to search for axisymmetric magnetic structure and associated flaring/jetting activity. Using high-resolution ( 0.15" per pixel) and high-cadence ( 15 s) H-alpha center/offband observations obtained from the recently digitized films of Big Bear Solar Observatory, we were able to identify five large circular flares with associated surges. All the events exhibit a central parasite magnetic field surrounded by opposite polarity, forming a circular polarity inversion line (PIL). Consequently, a compact flare kernel at the center is surrounded by a circular ribbon, and together with the upward ejecting dark surge, these seem to depict a dome-like magnetic structure. Very interestingly, (1) the circular ribbon brightens sequentially rather than simultaneously, (2) the central compact flare kernel shows obvious motion, and (3) a remote elongated, co-temporal flare ribbon at a region with the same polarity as the central parasite site is seen in the series of four homologous events on 1991 March 17 and 18. The remote ribbon is 120" away from the jet location. Moreover, magnetic reconnection across the circular PIL is evident from the magnetic flux cancellation. These rarely observed homologous surges with circular as well as central and remote flare ribbons provide valuable evidence concerning the dynamics of magnetic reconnection in a null-point topology. This study is dedicated to Professor Hal Zirin, the founder of Big Bear Solar Observatory, who passed away on January 3, 2012.

Adherence to a Mediterranean-style diet and incident fractures: pooled analysis of observational evidence.

PubMed

Kunutsor, Setor K; Laukkanen, Jari A; Whitehouse, Michael R; Blom, Ashley W

2018-06-01

The Mediterranean diet is associated with decreased morbidity and mortality from various chronic diseases. Adherence to a Mediterranean-style diet has been suggested to have protective effects on bone health and decreases the incidence of bone fractures, but the evidence is not clear. We conducted a systematic review and meta-analysis of available observational studies to quantify the association between adherence to a Mediterranean-style diet, as assessed by the Mediterranean Diet Score (MDS), and the risk of fractures in the general population. Relevant studies were identified in a literature search of MEDLINE, EMBASE, Web of Science, and reference lists of relevant studies to October 2016. Relative risks (RRS) with 95% confidence intervals (CIs) were aggregated using random-effects models. Five observational studies with data on 353,076 non-overlapping participants and 33,576 total fractures (including 6,881 hip fractures) were included. The pooled fully adjusted RR (95% CI) for hip fractures per 2-point increment in adherence to the MDS was 0.82 (0.71-0.96). Adherence to the MDS was not associated with the risk of any or total fractures based on pooled analysis of only two studies. Limited observational evidence supports a beneficial effect of adherence to a Mediterranean-style diet on the incidence of hip fractures. Well-designed intervention studies are needed to elucidate the relationship between adherence to a Mediterranean-style diet and the risk of adverse bone health outcomes such as fractures.

Does Breastfeeding Protect Against Childhood Obesity? Moving Beyond Observational Evidence.

PubMed

Woo, Jessica G; Martin, Lisa J

2015-06-01

Human milk is the optimal feeding choice for infants, as it dynamically provides the nutrients, immunity support, and other bioactive factors needed for infants at specific stages during development. Observational studies and several meta-analyses have suggested that breastfeeding is protective against development of obesity in childhood and beyond. However, these findings are not without significant controversy. This review includes an overview of observational findings to date, then focuses on three specific pathways that connect human milk and infant physiology: maternal obesity, microbiome development in the infant, and the development of taste preference and diet quality. Each of these pathways involves complex interactions between mother and infant, includes both biologic and non-biologic factors, and may have both direct and indirect effects on obesity risk in the offspring. This type of integrated approach to examining breastfeeding and childhood obesity is necessary to advance research in this area beyond observational findings.

Subliminal stimuli modulate somatosensory perception rhythmically and provide evidence for discrete perception

PubMed Central

Baumgarten, Thomas J.; Königs, Sara; Schnitzler, Alfons; Lange, Joachim

2017-01-01

Despite being experienced as continuous, there is an ongoing debate if perception is an intrinsically discrete process, with incoming sensory information treated as a succession of single perceptual cycles. Here, we provide causal evidence that somatosensory perception is composed of discrete perceptual cycles. We used in humans an electrotactile temporal discrimination task preceded by a subliminal (i.e., below perceptual threshold) stimulus. Although not consciously perceived, subliminal stimuli are known to elicit neuronal activity in early sensory areas and modulate the phase of ongoing neuronal oscillations. We hypothesized that the subliminal stimulus indirectly, but systematically modulates the ongoing oscillatory phase in S1, thereby rhythmically shaping perception. The present results confirm that, without being consciously perceived, the subliminal stimulus critically influenced perception in the discrimination task. Importantly, perception was modulated rhythmically, in cycles corresponding to the beta-band (13–18 Hz). This can be compellingly explained by a model of discrete perceptual cycles. PMID:28276493

Subliminal stimuli modulate somatosensory perception rhythmically and provide evidence for discrete perception.

PubMed

Baumgarten, Thomas J; Königs, Sara; Schnitzler, Alfons; Lange, Joachim

2017-03-09

Despite being experienced as continuous, there is an ongoing debate if perception is an intrinsically discrete process, with incoming sensory information treated as a succession of single perceptual cycles. Here, we provide causal evidence that somatosensory perception is composed of discrete perceptual cycles. We used in humans an electrotactile temporal discrimination task preceded by a subliminal (i.e., below perceptual threshold) stimulus. Although not consciously perceived, subliminal stimuli are known to elicit neuronal activity in early sensory areas and modulate the phase of ongoing neuronal oscillations. We hypothesized that the subliminal stimulus indirectly, but systematically modulates the ongoing oscillatory phase in S1, thereby rhythmically shaping perception. The present results confirm that, without being consciously perceived, the subliminal stimulus critically influenced perception in the discrimination task. Importantly, perception was modulated rhythmically, in cycles corresponding to the beta-band (13-18 Hz). This can be compellingly explained by a model of discrete perceptual cycles.

Wasted research when systematic reviews fail to provide a complete and up-to-date evidence synthesis: the example of lung cancer.

PubMed

Créquit, Perrine; Trinquart, Ludovic; Yavchitz, Amélie; Ravaud, Philippe

2016-01-20

Multiple treatments are frequently available for a given condition, and clinicians and patients need a comprehensive, up-to-date synthesis of evidence for all competing treatments. We aimed to quantify the waste of research related to the failure of systematic reviews to provide a complete and up-to-date evidence synthesis over time. We performed a series of systematic overviews and networks of randomized trials assessing the gap between evidence covered by systematic reviews and available trials of second-line treatments for advanced non-small cell lung cancer. We searched the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, EMBASE, and other resources sequentially by year from 2009 to March 2, 2015. We sequentially compared the amount of evidence missing from systematic reviews to the randomized evidence available for inclusion each year. We constructed cumulative networks of randomized evidence over time and evaluated the proportion of trials, patients, treatments, and treatment comparisons not covered by systematic reviews on December 31 each year from 2009 to 2015. We identified 77 trials (28,636 patients) assessing 47 treatments with 54 comparisons and 29 systematic reviews (13 published after 2013). From 2009 to 2015, the evidence covered by existing systematic reviews was consistently incomplete: 45 % to 70 % of trials; 30 % to 58 % of patients; 40 % to 66 % of treatments; and 38 % to 71 % of comparisons were missing. In the cumulative networks of randomized evidence, 10 % to 17 % of treatment comparisons were partially covered by systematic reviews and 55 % to 85 % were partially or not covered. We illustrate how systematic reviews of a given condition provide a fragmented, out-of-date panorama of the evidence for all treatments. This waste of research might be reduced by the development of live cumulative network meta-analyses.

Creation of a Tool for Assessing Knowledge in Evidence-Based Decision-Making in Practicing Health Care Providers.

PubMed

Spurr, Kathy; Dechman, Gail; Lackie, Kelly; Gilbert, Robert

2016-01-01

Evidence-based decision-making (EBDM) is the process health care providers (HCPs) use to identify and appraise potential evidence. It supports the integration of best research evidence with clinical expertise and patient values into the decision-making process for patient care. Competence in this process is essential to delivery of optimal care. There is no objective tool that assesses EBDM across HCP groups. This research aimed to develop a content valid tool to assess knowledge of the principles of evidence-based medicine and the EBDM process, for use with all HCPs. A Delphi process was used in the creation of the tool. Pilot testing established its content validity with the added benefit of evaluating HCPs' knowledge of EBDM. Descriptive statistics and multivariate mixed models were used to evaluate individual survey responses in total, as well as within each EBDM component. The tool consisted of 26 multiple-choice questions. A total of 12,884 HCPs in Nova Scotia were invited to participate in the web-based validation study, yielding 818 (6.3%) participants, 471 of whom completed all questions. The mean overall score was 68%. Knowledge in one component, integration of evidence with clinical expertise and patient preferences, was identified as needing development across all HCPs surveyed. A content valid tool for assessing HCP EBDM knowledge was created and can be used to support the development of continuing education programs to enhance EBDM competency.

Large-scale adverse effects related to treatment evidence standardization (LAERTES): an open scalable system for linking pharmacovigilance evidence sources with clinical data.

PubMed

2017-03-07

Integrating multiple sources of pharmacovigilance evidence has the potential to advance the science of safety signal detection and evaluation. In this regard, there is a need for more research on how to integrate multiple disparate evidence sources while making the evidence computable from a knowledge representation perspective (i.e., semantic enrichment). Existing frameworks suggest well-promising outcomes for such integration but employ a rather limited number of sources. In particular, none have been specifically designed to support both regulatory and clinical use cases, nor have any been designed to add new resources and use cases through an open architecture. This paper discusses the architecture and functionality of a system called Large-scale Adverse Effects Related to Treatment Evidence Standardization (LAERTES) that aims to address these shortcomings. LAERTES provides a standardized, open, and scalable architecture for linking evidence sources relevant to the association of drugs with health outcomes of interest (HOIs). Standard terminologies are used to represent different entities. For example, drugs and HOIs are represented in RxNorm and Systematized Nomenclature of Medicine -- Clinical Terms respectively. At the time of this writing, six evidence sources have been loaded into the LAERTES evidence base and are accessible through prototype evidence exploration user interface and a set of Web application programming interface services. This system operates within a larger software stack provided by the Observational Health Data Sciences and Informatics clinical research framework, including the relational Common Data Model for observational patient data created by the Observational Medical Outcomes Partnership. Elements of the Linked Data paradigm facilitate the systematic and scalable integration of relevant evidence sources. The prototype LAERTES system provides useful functionality while creating opportunities for further research. Future work will

Association between dietary nitrate and nitrite intake and site-specific cancer risk: evidence from observational studies

PubMed Central

Jia, Hui-Xun; Liang, Fei; Yuan, Jing; Zhu, Ji

2016-01-01

Epidemiological studies have reported inconsistent findings on the association between dietary nitrate and nitrite intake and cancer risk. We performed a meta-analysis of epidemiological studies to summarize available evidence on the association between dietary nitrate and nitrite intake and cancer risk from published prospective and case-control studies. PubMed database was searched to identify eligible publications through April 30th, 2016. Study-specific relative risks (RRs) with corresponding 95% confidence interval (CI) from individual studies were pooled by using random- or fixed- model, and heterogeneity and publication bias analyses were conducted. Data from 62 observational studies, 49 studies for nitrates and 51 studies for nitrites, including a total of 60,627 cancer cases were analyzed. Comparing the highest vs. lowest levels, dietary nitrate intake was inversely associated with gastric cancer risk (RR = 0.78; 95%CI = 0.67-0.91) with moderate heterogeneity (I2 = 42.3%). In contrast, dietary nitrite intake was positively associated with adult glioma and thyroid cancer risk with pooled RR of 1.21 (95%CI = 1.03-1.42) and 1.52 (95%CI = 1.12-2.05), respectively. No significant associations were found between dietary nitrate/nitrite and cancers of the breast, bladder, colorectal, esophagus, renal cell, non-Hodgkin lymphoma, ovarian, and pancreas. The present meta-analysis provided modest evidence that positive associations of dietary nitrate and negative associations of dietary nitrite with certain cancers. PMID:27486968

Providing Opportunities to Learn in Home-Based Child Care Settings: Observations of Learning Contexts and Behavior

ERIC Educational Resources Information Center

Rusby, Julie C.; Crowley, Ryann; Jones, Laura B.; Smolkowski, Keith

2017-01-01

Research Findings: This observation study investigated the prevalence and correlates of learning contexts provided to preschool-age children in 133 registered child care homes in below-average-income neighborhoods in the U.S. Pacific Northwest. On average, 30% of the observed proportion of time was spent in structured teacher-led activities, 51%…

Directly observed daily mouth care provided to care home residents in one area of Kent, UK.

PubMed

Zander, A; Boniface, D

2017-03-01

To gather accurate data on the daily mouth care provided in care homes including tooth brushing, oral health assessment, and recording of care provided. Direct observation and notes review. Both nursing and 'regular' care homes. 365 Residents living in 16 care homes and their carers underwent observation, notes review or data collection in some form. Provision of mouth morning care. Of 161 residents observed, most (93, 58%) did not have their teeth/dentures brushed. If performed, brushing was often carried out by the resident themselves (36 cases, 53%), rather than by a carer (32 cases, 44%). Carers used a toothbrush to clean inside a resident's mouth in just 7 cases (4.3% of all personal care routines observed). Smaller care homes were no more likely to brush residents teeth than larger care homes, and nursing homes were no more likely to brush teeth than other care homes. Of the 309 sets of notes available for review, 41 (13%) contained a dedicated oral health needs assessment, and 109 (35%) contained a daily oral care chart in some form. Mouth care was often recorded inaccurately (15% of cases). This is the first observational study in the UK to assess oral care actually provided to residents by carers in care homes. The findings reveal a substantially different picture of daily mouth care than was previously understood and suggest that many of the nation's care home residents may not be receiving adequate, or any, oral health care. Copyright© 2017 Dennis Barber Ltd

Evidence for Type Ia Supernova Diversity from Ultraviolet Observations with the Hubble Space Telescope

NASA Technical Reports Server (NTRS)

Wang, Xiaofeng; Wang, Lifan; Filippenko, Alexei; Baron, Eddie; Kromer, Markus; Jack, Dennis; Zhang, Tianmeng; Aldering, Greg; Antilogus, Pierre; Arnett, W. David;

PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes.

PubMed

Eddy, Sarah L; Converse, Mercedes; Wenderoth, Mary Pat

2015-01-01

There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both clarifies the research-supported elements of best practices for instructor implementation of active learning in the classroom setting and measures instructors' alignment with these practices. We describe how we reviewed the discipline-based education research literature to identify best practices in active learning for adult learners in the classroom and used these results to develop an observation tool (Practical Observation Rubric To Assess Active Learning, or PORTAAL) that documents the extent to which instructors incorporate these practices into their classrooms. We then use PORTAAL to explore the classroom practices of 25 introductory biology instructors who employ some form of active learning. Overall, PORTAAL documents how well aligned classrooms are with research-supported best practices for active learning and provides specific feedback and guidance to instructors to allow them to identify what they do well and what could be improved. © 2015 S. L. Eddy et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

International Observe the Moon Night: Providing Opportunities for the Public to Engage in Lunar Observation

NASA Astrophysics Data System (ADS)

Hsu, B. C.; Bleacher, L.; Day, B. H.; Daou, D.; Jones, A. P.; Mitchell, B.; Shaner, A. J.; Shipp, S. S.

2010-12-01

International Observe the Moon Night (InOMN) is designed to engage lunar science and education communities, our partner networks, amateur astronomers, space enthusiasts, and the general public in annual lunar observation campaigns that share the excitement of lunar science and exploration. InOMN enables the public to maintain its curiosity about the Moon and gain a better understanding of the Moon's formation, its evolution, and its place in the sky. For 2010, members of the public were encouraged to host their own InOMN events. InOMN hosts such as astronomy clubs, museums, schools, or other groups could find helpful resources and share information about InOMN events they organized on the InOMN website (http://observethemoonnight.org). Images, feedback, and lessons learned from the 2010 InOMN event will be shared in order to encourage increased planning and hosting of InOMN events in 2011. From various interpretations of the lunar “face,” early pictograms of the Moon’s phases, or to the use of the lunar cycle for festivals or harvests, the Moon has an undeniable influence on human civilization. We have chosen the 2011 InOMN theme to provide an opportunity for individuals to share their personal or cultural connections to the Moon. For 2011, the InOMN website will include a ‘lunar bulletin board’ where InOMN participants can post pictures and share stories of what the Moon means to them. The 2011 InOMN contest will encourage people to submit their works of art, poems, short stories, or music about the Moon all centered around the theme “What does the Moon mean to you?” As with the winners of previous contests, winning entries will be incorporated into the following year’s InOMN advertisements and events.

Archaeal phylogenomics provides evidence in support of a methanogenic origin of the Archaea and a thaumarchaeal origin for the eukaryotes.

PubMed

Kelly, S; Wickstead, B; Gull, K

2011-04-07

We have developed a machine-learning approach to identify 3537 discrete orthologue protein sequence groups distributed across all available archaeal genomes. We show that treating these orthologue groups as binary detection/non-detection data is sufficient to capture the majority of archaeal phylogeny. We subsequently use the sequence data from these groups to infer a method and substitution-model-independent phylogeny. By holding this phylogeny constrained and interrogating the intersection of this large dataset with both the Eukarya and the Bacteria using Bayesian and maximum-likelihood approaches, we propose and provide evidence for a methanogenic origin of the Archaea. By the same criteria, we also provide evidence in support of an origin for Eukarya either within or as sisters to the Thaumarchaea.

Archaeal phylogenomics provides evidence in support of a methanogenic origin of the Archaea and a thaumarchaeal origin for the eukaryotes

PubMed Central

Kelly, S.; Wickstead, B.; Gull, K.

2011-01-01

We have developed a machine-learning approach to identify 3537 discrete orthologue protein sequence groups distributed across all available archaeal genomes. We show that treating these orthologue groups as binary detection/non-detection data is sufficient to capture the majority of archaeal phylogeny. We subsequently use the sequence data from these groups to infer a method and substitution-model-independent phylogeny. By holding this phylogeny constrained and interrogating the intersection of this large dataset with both the Eukarya and the Bacteria using Bayesian and maximum-likelihood approaches, we propose and provide evidence for a methanogenic origin of the Archaea. By the same criteria, we also provide evidence in support of an origin for Eukarya either within or as sisters to the Thaumarchaea. PMID:20880885

Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers.

PubMed

Prochazka, Allan V; Lundahl, Kristy; Pearson, Wesley; Oboler, Sylvia K; Anderson, Robert J

2005-06-27

Current evidence does not support an annual screening physical examination for asymptomatic adults, but little is known about primary care provider (PCP) attitudes and practices regarding an annual physical examination. We conducted a postal survey (32 items) of attitudes and practices regarding the annual physical examination (in asymptomatic patients 18 years or older) of a random sample of PCPs (specializing in internal medicine, family practice, and obstetrics/gynecology) from 3 geographic areas (Boston, Mass; Denver, Colo; and San Diego, Calif). Respondents included 783 (47%) of 1679 PCPs. Overall, 430 (65%) of 664 agreed that an annual physical examination is necessary. Three hundred ninety-three (55%) of 712 disagreed with the statement that national organizations do not recommend an annual physical examination, and 641 (88%) of 726 perform such examinations. Most PCPs agreed that an annual physical examination provides time to counsel patients about preventive health services (696/739 [94%]), improves patient-physician relationships (693/737 [94%]), and is desired by most patients (572/737 [78%]). Most also believe that an annual physical examination improves detection of subclinical illness (545/738 [74%]) and is of proven value (461/736 [63%]). Many believed that tests should be part of an annual physical examination, including mammography (44%), a lipid panel (48%), urinalysis (44%), testing of blood glucose level (46%), and complete blood cell count (39%). Despite contrary evidence, most PCPs believe an annual physical examination detects subclinical illness, and many report performing unproven screening laboratory tests. Primary care providers do not appear to accept recommendations that annual physical examinations be abandoned in favor of a more selective approach to preventing health problems.

Cryptococcosis Serotypes Impact Outcome and Provide Evidence of Cryptococcus neoformans Speciation.

PubMed

Desnos-Ollivier, Marie; Patel, Sweta; Raoux-Barbot, Dorothée; Heitman, Joseph; Dromer, Françoise

2015-06-09

Cryptococcus neoformans is a human opportunistic fungal pathogen causing severe disseminated meningoencephalitis, mostly in patients with cellular immune defects. This species is divided into three serotypes: A, D, and the AD hybrid. Our objectives were to compare population structures of serotype A and D clinical isolates and to assess whether infections with AD hybrids differ from infections with the other serotypes. For this purpose, we analyzed 483 isolates and the corresponding clinical data from 234 patients enrolled during the CryptoA/D study or the nationwide survey on cryptococcosis in France. Isolates were characterized in terms of ploidy, serotype, mating type, and genotype, utilizing flow cytometry, serotype- and mating type-specific PCR amplifications, and multilocus sequence typing (MLST) methods. Our results suggest that C. neoformans serotypes A and D have different routes of multiplication (primarily clonal expansion versus recombination events for serotype A and serotype D, respectively) and important genomic differences. Cryptococcosis includes a high proportion of proven or probable infections (21.5%) due to a mixture of genotypes, serotypes, and/or ploidies. Multivariate analysis showed that parameters independently associated with failure to achieve cerebrospinal fluid (CSF) sterilization by week 2 were a high serum antigen titer, the lack of flucytosine during induction therapy, and the occurrence of mixed infection, while infections caused by AD hybrids were more likely to be associated with CSF sterilization. Our study provides additional evidence for the possible speciation of C. neoformans var. neoformans and grubii and highlights the importance of careful characterization of causative isolates. Cryptococcus neoformans is an environmental fungus causing severe disease, estimated to be responsible for 600,000 deaths per year worldwide. This species is divided into serotypes A and D and an AD hybrid, and these could be considered two

Sampling of sea ducks for influenza A viruses in Alaska during winter provides lack of evidence for epidemiological peak of infection.

USGS Publications Warehouse

Ramey, Andy M.; Reeves, Andrew B.; Poulson, Rebecca L.; Wasley, Jeff; Esler, Daniel N.; Stalknecht, David E.

2015-01-01

Sampling of sea ducks for influenza A viruses in Alaska during winter provided no evidence for an epidemiologic peak of infection. Isolates were recovered, however, that provide information on viral diversity and dispersal that may not be realized through sampling efforts focused on other avian taxa.

Aural exostoses (surfer's ear) provide vital fossil evidence of an aquatic phase in Man's early evolution.

PubMed

Rhys Evans, P H; Cameron, M

2017-11-01

For over a century, otolaryngologists have recognised the condition of aural exostoses, but their significance and aetiology remains obscure, although they tend to be associated with frequent swimming and cold water immersion of the auditory canal. The fact that this condition is usually bilateral is predictable since both ears are immersed in water. However, why do exostoses only grow in swimmers and why do they grow in the deep bony meatus at two or three constant sites? Furthermore, from an evolutionary point of view, what is or was the purpose and function of these rather incongruous protrusions? In recent decades, paleoanthropological evidence has challenged ideas about early hominid evolution. In 1992 the senior author suggested that aural exostoses were evolved in early hominid Man for protection of the delicate tympanic membrane during swimming and diving by narrowing the ear canal in a similar fashion to other semiaquatic species. We now provide evidence for this theory and propose an aetiological explanation for the formation of exostoses.

Expanding the Evidence Base: Comparing Randomized Controlled Trials and Observational Studies of Statins.

PubMed

Atar, Dan; Ong, Seleen; Lansberg, Peter J

2015-01-01

It is widely accepted that randomized controlled trials (RCTs) are the gold standard for demonstrating the efficacy of a given therapy (results under ideal conditions). Observational studies, on the other hand, can complement this by demonstrating effectiveness (results under real-world conditions). To examine the role that observational studies can play in complementing data from RCTs, we reviewed published studies for statins, a class of drugs that have been widely used to reduce the risk of cardiovascular (CV) events by lowering low-density lipoprotein cholesterol levels. RCTs have consistently demonstrated the benefits of statin treatment in terms of CV risk reduction and have demonstrated that more intensive statin therapy has incremental benefits over less intensive treatment. Observational studies of statin use in 'real-world' populations have served to augment the evidence base generated from statin RCTs in preselected populations of patients who are often at high CV risk and have led to similar safety and efficacy findings. They have also raised questions about factors affecting medication adherence, under-treatment, switching between statins, and failure to reach low-density lipoprotein cholesterol target levels, questions for which the answers could lead to improved patient care.

Observational Evidence for Desert Amplification Using Multiple Satellite Datasets.

PubMed

Wei, Nan; Zhou, Liming; Dai, Yongjiu; Xia, Geng; Hua, Wenjian

2017-05-17

Desert amplification identified in recent studies has large uncertainties due to data paucity over remote deserts. Here we present observational evidence using multiple satellite-derived datasets that desert amplification is a real large-scale pattern of warming mode in near surface and low-tropospheric temperatures. Trend analyses of three long-term temperature products consistently confirm that near-surface warming is generally strongest over the driest climate regions and this spatial pattern of warming maximizes near the surface, gradually decays with height, and disappears in the upper troposphere. Short-term anomaly analyses show a strong spatial and temporal coupling of changes in temperatures, water vapor and downward longwave radiation (DLR), indicating that the large increase in DLR drives primarily near surface warming and is tightly associated with increasing water vapor over deserts. Atmospheric soundings of temperature and water vapor anomalies support the results of the long-term temperature trend analysis and suggest that desert amplification is due to comparable warming and moistening effects of the troposphere. Likely, desert amplification results from the strongest water vapor feedbacks near the surface over the driest deserts, where the air is very sensitive to changes in water vapor and thus efficient in enhancing the longwave greenhouse effect in a warming climate.

Providing for the Future: Providers' Views on Apprenticeship Reform

ERIC Educational Resources Information Center

McCrone, Tami; Sims, David; Gladding, Cath

2016-01-01

Apprenticeships are currently undergoing reform in England. Funding mechanisms and the content of Apprenticeship programmes are being restructured. NFER and the Association of Employment and Learning Providers (AELP) have carried out a joint research project to inform future policy and practice with evidence on how providers of Apprenticeships are…

Cytoplasmic-genetic male sterility gene provides direct evidence for some hybrid rice recently evolving into weedy rice

PubMed Central

Zhang, Jingxu; Lu, Zuomei; Dai, Weimin; Song, Xiaoling; Peng, Yufa; Valverde, Bernal E.; Qiang, Sheng

2015-01-01

Weedy rice infests paddy fields worldwide at an alarmingly increasing rate. There is substantial evidence indicating that many weedy rice forms originated from or are closely related to cultivated rice. There is suspicion that the outbreak of weedy rice in China may be related to widely grown hybrid rice due to its heterosis and the diversity of its progeny, but this notion remains unsupported by direct evidence. We screened weedy rice accessions by both genetic and molecular marker tests for the cytoplasmic male sterility (CMS) genes (Wild abortive, WA, and Boro type, BT) most widely used in the production of indica and japonica three-line hybrid rice as a diagnostic trait of direct parenthood. Sixteen weedy rice accessions of the 358 tested (4.5%) contained the CMS-WA gene; none contained the CMS-BT gene. These 16 accessions represent weedy rices recently evolved from maternal hybrid rice derivatives, given the primarily maternal inheritance of this trait. Our results provide key direct evidence that hybrid rice can be involved in the evolution of some weedy rice accessions, but is not a primary factor in the recent outbreak of weedy rice in China. PMID:26012494

Cytoplasmic-genetic male sterility gene provides direct evidence for some hybrid rice recently evolving into weedy rice.

PubMed

Zhang, Jingxu; Lu, Zuomei; Dai, Weimin; Song, Xiaoling; Peng, Yufa; Valverde, Bernal E; Qiang, Sheng

2015-05-27

Weedy rice infests paddy fields worldwide at an alarmingly increasing rate. There is substantial evidence indicating that many weedy rice forms originated from or are closely related to cultivated rice. There is suspicion that the outbreak of weedy rice in China may be related to widely grown hybrid rice due to its heterosis and the diversity of its progeny, but this notion remains unsupported by direct evidence. We screened weedy rice accessions by both genetic and molecular marker tests for the cytoplasmic male sterility (CMS) genes (Wild abortive, WA, and Boro type, BT) most widely used in the production of indica and japonica three-line hybrid rice as a diagnostic trait of direct parenthood. Sixteen weedy rice accessions of the 358 tested (4.5%) contained the CMS-WA gene; none contained the CMS-BT gene. These 16 accessions represent weedy rices recently evolved from maternal hybrid rice derivatives, given the primarily maternal inheritance of this trait. Our results provide key direct evidence that hybrid rice can be involved in the evolution of some weedy rice accessions, but is not a primary factor in the recent outbreak of weedy rice in China.

Impact of an online medical internet site on knowledge and practice of health care providers: a mixed methods study of the Spinal Cord Injury Rehabilitation Evidence project.

PubMed

Eng, Janice J; Noonan, Vanessa K; Townson, Andrea F; Higgins, Caroline E; Rogers, Jess; Wolfe, Dalton L

2014-12-23

It is not known whether ongoing access to a broad-based Internet knowledge resource can influence the practice of health care providers. We undertook a study to evaluate the impact of a Web-based knowledge resource on increasing access to evidence and facilitating best practice of health care providers. The objective of this study was to evaluate (1) the impact of the Spinal Cord Injury Rehabilitation Evidence (SCIRE) project on access to information for health care providers and researchers and (2) how SCIRE influenced health care providers' management of clients. A 4-part mixed methods evaluation was undertaken: (1) monitoring website traffic and utilization using Google Analytics, (2) online survey of users who accessed the SCIRE website, (3) online survey of targeted end-users, that is, rehabilitation health care providers known to work with spinal cord injury (SCI) clients, as well as researchers, and (4) focus groups with health care providers who had previously accessed SCIRE. The online format allowed the content for a relatively specialized field to have far reach (eg, 26 countries and over 6500 users per month). The website survey and targeted end-user survey confirmed that health care providers, as well as researchers perceived that the website increased their access to SCI evidence. Access to SCIRE not only improved knowledge of SCI evidence but helped inform changes to the health providers' clinical practice and improved their confidence in treating SCI clients. The SCIRE information directly influenced the health providers' clinical decision making, in terms of choice of intervention, equipment needs, or assessment tool. A Web-based knowledge resource may be a relatively inexpensive method to increase access to evidence-based information, increase knowledge of the evidence, inform changes to the health providers' practice, and influence their clinical decision making.

Reconstruction of the feeding apparatus in Postgaardi mariagerensis provides evidence for character evolution within the Symbiontida (Euglenozoa).

PubMed

Yubuki, Naoji; Simpson, Alastair G B; Leander, Brian S

2013-01-01

Microbial eukaryotes living in low oxygen environments often have novel physiological and morphological features that facilitate symbiotic relationships with bacteria and other means for acquiring nutrients. Comparative studies of these features provide evidence for phylogenetic relationships and evolutionary history. Postgaardi mariagerensis, for instance, is a euglenozoan that lives in low oxygen environments and is enveloped by episymbiotic bacteria. The general ultrastructure of P. mariagerensis was described more than a decade ago and no further studies have been carried out since, mainly because these cells are difficult to obtain. Postgaardi lacks the diagnostic features found in other major euglenozoan lineages (e.g., pellicle strips and kinetoplast-like mitochondrial inclusions) and no molecular data are available, so the phylogenetic position of this genus within the Euglenozoa remains unclear. We re-examined and reconstructed the ultrastructural organization of the feeding apparatus in Postgaardi by serial sectioning an existing block of resin-embedded cells. Postgaardi possesses distinctive finger-like projections within the feeding apparatus; this system has only been found in one other highly distinctive flagellate, namely the symbiontid Calkinsia. Detailed comparisons of the cytoskeleton in Postgaardi and in two symbiontids, Calkinsia and Bihospites, provided new evidence for phylogenetic relationships and character evolution in all three genera. Copyright © 2012 Elsevier GmbH. All rights reserved.

Observer Use of Standardized Observation Protocols in Consequential Observation Systems

ERIC Educational Resources Information Center

Bell, Courtney A.; Yi, Qi; Jones, Nathan D.; Lewis, Jennifer M.; McLeod, Monica; Liu, Shuangshuang

2014-01-01

Evidence from a handful of large-scale studies suggests that although observers can be trained to score reliably using observation protocols, there are concerns related to initial training and calibration activities designed to keep observers scoring accurately over time (e.g., Bell, et al, 2012; BMGF, 2012). Studies offer little insight into how…

Evidence of a global magma ocean in Io's interior.

PubMed

Khurana, Krishan K; Jia, Xianzhe; Kivelson, Margaret G; Nimmo, Francis; Schubert, Gerald; Russell, Christopher T

2011-06-03

Extensive volcanism and high-temperature lavas hint at a global magma reservoir in Io, but no direct evidence has been available. We exploited Jupiter's rotating magnetic field as a sounding signal and show that the magnetometer data collected by the Galileo spacecraft near Io provide evidence of electromagnetic induction from a global conducting layer. We demonstrate that a completely solid mantle provides insufficient response to explain the magnetometer observations, but a global subsurface magma layer with a thickness of over 50 kilometers and a rock melt fraction of 20% or more is fully consistent with the observations. We also place a stronger upper limit of about 110 nanoteslas (surface equatorial field) on the dynamo dipolar field generated inside Io.

Is Provider Secure Messaging Associated With Patient Messaging Behavior? Evidence From the US Army.

PubMed

Wolcott, Vickee; Agarwal, Ritu; Nelson, D Alan

2017-04-06

Secure messaging with health care providers offers the promise of improved patient-provider relationships, potentially facilitating outcome improvements. But, will patients use messaging technology in the manner envisioned by policy-makers if their providers do not actively use it? We hypothesized that the level and type of secure messaging usage by providers might be associated with messaging initiation by their patients. The study employed a dataset of health care and secure messaging records of more than 81,000 US Army soldiers and nearly 3000 clinicians with access to a patient portal system. We used a negative binomial regression model on over 25 million observations to determine the adjusted association between provider-initiated and provider-response messaging and subsequent messaging by their patients in this population over a 4-year period. Prior provider-initiated and response messaging levels were associated with new patient messaging when controlling for the patient's health care utilization and diagnoses, with the strongest association for high provider-response messaging level. Patients whose providers were highly responsive to the messages of other patients initiated 334% more secure messages (P<.001) than patients with providers who did not personally respond to other patients' messages. Our results indicate that provider messaging usage levels and types thereof predict their patients' subsequent communication behavior. The findings suggest the need for more study into the factors associated with provider messaging to fully understand the mechanisms of this relationship. ©Vickee Wolcott, Ritu Agarwal, D. Alan Nelson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.04.2017.

Study design and hierarchy of evidence for surgical decision making.

PubMed

Sprague, Sheila; McKay, Paula; Thoma, Achilleas

2008-04-01

This article provides a historical overview of the hierarchy of evidence for surgical decision making and discusses key study designs in the hierarchy of evidence. This encompasses meta-analyses, randomized controlled trials, and observational studies, including cohort and case-controlled studies, case series and case reports, and basic science studies. This article also reviews the principles and importance of evidence-based plastic surgery and describes several systems to rate the strength of the scientific evidence.

Observations of a Newly "Captured" Magnetosheath Field Line: Evidence for "Double Reconnection"

NASA Technical Reports Server (NTRS)

Chandler, Michael O.; Avanov, Levon A.; Craven, Paul D.; Mozer, Forrest S.; Moore, Thomas E.

2007-01-01

We have begun an investigation of the nature of the low-latitude boundary layer in the mid-altitude cusp region using data from the Polar spacecraft. This region has been routinely sampled for about three months each year for the periods 1999-2001 and 2004-2006. The low-to-mid-energy ion instruments frequently observed dense, magnetosheath-like plasma deep (in terms of distance from the magnetopause and in invariant latitude) in the magnetosphere. One such case, taken during a period of northward interplanetary magnetic field (IMF), shows magnetosheath ions within the magnetosphere with velocity distributions resulting from two separate merging sites along the same field lines. Cold ionospheric ions were also observed counterstreaming along the field lines, evidence that these field lines were closed. These results are consistent with the hypothesis that double merging can produce closed field .lines populated by solar wind plasma. Through the use of individual cases such as this and statistical studies of a broader database we seek to understand the morphology of the LLBL as it projects from the sub-solar region into the cusp. We will present preliminary results of our ongoing study.

Placoderm Assemblage from the Tetrapod-Bearing Locality of Strud (Belgium, Upper Famennian) Provides Evidence for a Fish Nursery

PubMed Central

Clément, Gaël; Daeschler, Edward B.; Dupret, Vincent

2016-01-01

The placoderm fauna of the upper Famennian tetrapod-bearing locality of Strud, Belgium, includes the antiarch Grossilepis rikiki, the arthrodire groenlandaspidid Turrisaspis strudensis and the phyllolepidid Phyllolepis undulata. Based on morphological and morphometric evidence, the placoderm specimens from Strud are predominantly recognised as immature specimens and this locality as representing a placoderm nursery. The Strud depositional environment corresponds to a channel in an alluvial plain, and the presence of a nursery in such environment could have provided nutrients and protection to the placoderm offspring. This represents one of the earliest pieces of evidence for this sort of habitat partitioning in vertebrate history, with adults living more distantly from the nursery and using the nursery only to spawn or give live birth. PMID:27552196

Development of Innovative Technology to Provide Low-Cost Surface Atmospheric Observations in Data Sparse Regions

NASA Astrophysics Data System (ADS)

Kucera, Paul; Steinson, Martin

2017-04-01

Accurate and reliable real-time monitoring and dissemination of observations of surface weather conditions is critical for a variety of societal applications. Applications that provide local and regional information about temperature, precipitation, moisture, and winds, for example, are important for agriculture, water resource monitoring, health, and monitoring of hazard weather conditions. In many regions of the World, surface weather stations are sparsely located and/or of poor quality. Existing stations have often been sited incorrectly, not well-maintained, and have limited communications established at the site for real-time monitoring. The University Corporation for Atmospheric Research (UCAR)/National Center for Atmospheric Research (NCAR), with support from USAID, has started an initiative to develop and deploy low-cost weather instrumentation in sparsely observed regions of the world. The project is focused on improving weather observations for environmental monitoring and early warning alert systems on a regional to global scale. Instrumentation that has been developed use innovative new technologies such as 3D printers, Raspberry Pi computing systems, and wireless communications. The goal of the project is to make the weather station designs, software, and processing tools an open community resource. The weather stations can be built locally by agencies, through educational institutions, and residential communities as a citizen effort to augment existing networks to improve detection of natural hazards for disaster risk reduction. The presentation will provide an overview of the open source weather station technology and evaluation of sensor observations for the initial networks that have been deployed in Africa.

Evidence for higher-than-average air temperatures after the 8.2 ka event provided by a Central European δ18O record

NASA Astrophysics Data System (ADS)

Andersen, Nils; Lauterbach, Stefan; Erlenkeuser, Helmut; Danielopol, Dan L.; Namiotko, Tadeusz; Hüls, Matthias; Belmecheri, Soumaya; Dulski, Peter; Nantke, Carla; Meyer, Hanno; Chapligin, Bernhard; von Grafenstein, Ulrich; Brauer, Achim

2017-09-01

The so-called 8.2 ka event represents one of the most prominent cold climate anomalies during the Holocene warm period. Accordingly, several studies have addressed its trigger mechanisms, absolute dating and regional characteristics so far. However, knowledge about subsequent climate recovery is still limited although this might be essential for the understanding of rapid climatic changes. Here we present a new sub-decadally resolved and precisely dated oxygen isotope (δ18O) record for the interval between 7.7 and 8.7 ka BP (103 calendar years before AD 1950), derived from the calcareous valves of benthic ostracods preserved in the varved lake sediments of pre-Alpine Mondsee (Austria). Besides a clear reflection of the 8.2 ka event, showing a good agreement in timing, duration and magnitude with other regional stable isotope records, the high-resolution Mondsee lake sediment record provides evidence for a 75-year-long interval of higher-than-average δ18O values directly after the 8.2 ka event, possibly reflecting increased air temperatures in Central Europe. This observation is consistent with evidence from other proxy records in the North Atlantic realm, thus most probably reflecting a hemispheric-scale climate signal rather than a local phenomenon. As a possible trigger we suggest an enhanced resumption of the Atlantic meridional overturning circulation (AMOC), supporting assumptions from climate model simulations.

Pervasive faint Fe XIX emission from a solar active region observed with EUNIS-13: Evidence for nanoflare heating

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brosius, Jeffrey W.; Daw, Adrian N.; Rabin, D. M., E-mail: Jeffrey.W.Brosius@nasa.gov

2014-08-01

We present spatially resolved EUV spectroscopic measurements of pervasive, faint Fe XIX 592.2 Å line emission in an active region observed during the 2013 April 23 flight of the Extreme Ultraviolet Normal Incidence Spectrograph (EUNIS-13) sounding rocket instrument. With cooled detectors, high sensitivity, and high spectral resolution, EUNIS-13 resolves the lines of Fe XIX at 592.2 Å (formed at temperature T ≈ 8.9 MK) and Fe XII at 592.6 Å (T ≈ 1.6 MK). The Fe XIX line emission, observed over an area in excess of 4920 arcsec{sup 2} (2.58 × 10{sup 9} km{sup 2}, more than 60% of themore » active region), provides strong evidence for the nanoflare heating model of the solar corona. No GOES events occurred in the region less than 2 hr before the rocket flight, but a microflare was observed north and east of the region with RHESSI and EUNIS during the flight. The absence of significant upward velocities anywhere in the region, particularly the microflare, indicates that the pervasive Fe XIX emission is not propelled outward from the microflare site, but is most likely attributed to localized heating (not necessarily due to reconnection) consistent with the nanoflare heating model of the solar corona. Assuming ionization equilibrium we estimate Fe XIX/Fe XII emission measure ratios of ∼0.076 just outside the AR core and ∼0.59 in the core.« less

The Dominance Behavioral System and Psychopathology: Evidence from Self-Report, Observational, and Biological Studies

PubMed Central

Johnson, Sheri L.; Leedom, Liane J.; Muhtadie, Luma

2012-01-01

The dominance behavioral system (DBS) can be conceptualized as a biologically-based system which guides dominance motivation, dominant and subordinate behavior, and responsivity to perceptions of power and subordination. A growing body of research suggests that problems with the DBS are evident across a broad range of psychopathologies. We begin by describing psychological, social, and biological correlates of the dominance behavioral system (DBS). Extensive research suggests that externalizing disorders, mania-proneness, and narcissistic traits are related to heightened dominance motivation and behaviors. Mania and narcissistic traits also appear related to inflated self-perceptions of power. Anxiety and depression are related to subordination and submissiveness, as well as a desire to avoid subordination. Models of the DBS have received support from research with humans and animals; from self-report, observational, and biological methods; and using naturalistic and experimental paradigms. Limitations of available research include the relative lack of longitudinal studies using multiple measures of the DBS and the absence of relevant studies using diagnosed samples to study narcissistic personality disorder and bipolar disorder. We provide suggestions for future research on the DBS and psychopathology, including investigations of whether the DBS can be used to differentiate specific disorder outcomes; the need for more sophisticated biological research; and the value of longitudinal dynamical research. Implications of using the DBS as a tool in clinical assessment and treatment are discussed. PMID:22506751

Observational evidences of viscoelastic behaviour at low strain

NASA Astrophysics Data System (ADS)

Daminelli, Rosastella; Marcellini, Alberto; Tento, Alberto

2014-05-01

Theoretical formulations of inhomogeneous waves in low-loss media have been suggested by a number of researchers due to the important role played by anelasticity in changing the characteristics of seismic waves. The Homogeneous Isotropic Linear Viscoelastic Model (HILV) introduced by Borcherdt (2009) is particularly promising because of its mathematical simplicity and the handiness to test the model in real seismograms. We showed that the seismograms of the explosion of a 2nd World War bomb found in Milan recorded by a seismic station at 2 km epicentral distance, exhibit a clear elliptical prograde P wave particle motion (Marcellini and Tento, 2011) as predicted by HILV. We observed a similar P wave prograde elliptical motion analysing a ML 4.8 earthquake occurred on July 17, 2011 in the Po Valley at a 48 km epicentral distance from a seismic station located at Palazzo Te, Mantova (Daminelli et al., 2013). In both cases the stations were situated on the deep quaternary sediments of the Po Valley. Based on measured Vp and Vs and the amplitude of the recorded motion, the strain at the station sites was estimated to be 10-6, 10-7. In this paper we extend the analysis of the previously mentioned seismograms to check the feasibility of HILV application to other types of waves that are particularly relevant in fields such as the engineering seismology. We focus on the S waves (as it is well known HILV predicts the split of S in S type I and S type II) of the seismograms of the earthquake recorded in Mantova and on the Rayleigh waves of the explosion recorded in Milan. The results show that observational evidences of HILV are not as clear as for P waves, probably because of noise or superposition of converted waves. However, once established the validity of HILV by P waves (that is very simple), the whole seismograms can be interpreted following HILV, confirming the relevancy of anelasticity also at low strain. Borcherdt, R.D. (2009) 'Viscoelastic Waves in Layered Media

Childcare Providers' Use of Practices to Promote Young Children's Social-Emotional Competence

ERIC Educational Resources Information Center

Steed, Elizabeth A.; Roach, Andrew T.

2017-01-01

Findings are presented regarding childcare providers' use of evidence-based strategies to promote preschoolers' social-emotional competence in 38 urban childcare classrooms. Descriptive results from classroom observations and childcare teachers' interviews indicated that in the absence of training, childcare teaching staff implemented few of these…

An XMM-Newton Observation of 4U1755-33 in Quiescence: Evidence for a Fossil X-Ray Jet

NASA Technical Reports Server (NTRS)

Angelini, Lorella; White, Nicholas E.

2003-01-01

We report an XMM-Newton observation of the Low mass X-ray Binary (LMXB) and black hole candidate 4U1755-33. This source had been a bright persistent source for at least 25 yrs, but in 1995 entered an extended quiescent phase. 4U1755-33 was not detected with an upper limit to the 2-10 keV luminosity of 5 x 10(exp 31) d(sup 2) (sub 4kpc) ergs per second (where d(sub 4kpc) is the distance in units of 4 kpc) - consistent with the luminosity of other black hole candidates in a quiescent state. An unexpected result is the discovery of a narrow 7 arc min long X-ray jet centered on the position of 4Ul755-33. The spectrum of the jet is similar to that of jets observed from other galactic and extragalactic sources, and may have been ejected from 4Ul755-33 when it was bright. Jets are a feature of accreting black holes, and the detection of a fossil jet provides additional evidence supporting the black hole candidacy of 4U1755-33. The spectral properties of three bright serendipitous sources in the field are reported and it is suggested these are background active galactic nuclei sources.

Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online

PubMed Central

Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

2015-01-01

Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence

Fibers under fire: suggestions for improving their use to provide forensic evidence.

PubMed

Grieve, M C; Wiggins, K G

2001-07-01

The current emphasis on DNA technology in forensic science has led many to believe that trace evidence examinations, including fibers, may be of little value. Reasons are given here to show that this is an erroneous assumption. In the face of this situation, fibers examiners have been challenged to consider ways in which they can improve the services they offer to the Criminal Justice System not only by increasing the efficiency of the examinations, but also by expressing the evidential value of the findings in a clearer way. The separate stages within fibers casework from evidence collection to report writing are critically examined. Suggestions are made on how improvements may be achieved. Areas where particular progress can be made include improving communication and exchange of information between the investigator and the scientist and streamlining analysis by using the latest equipment in conjunction with effective case management. In addition, ways of making better use of existing data pertaining to fiber frequencies, accumulating new data by using the resources of working groups, and improving training procedures with respect to evidence interpretation are discussed.

Provider cost analysis supports results-based contracting out of maternal and newborn health services: an evidence-based policy perspective.

PubMed

Hatcher, Peter; Shaikh, Shiraz; Fazli, Hassan; Zaidi, Shehla; Riaz, Atif

2014-11-13

There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services. This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical and Newborn Care (BEmONC) services provided in one RHC and six Comprehensive Emergency Obstetrical and Newborn Care (CEmONC) services in the other. Data were collected using staff interviews and record review to compile resource inputs and service volumes, and analyzed using the CORE Plus tool. Unit costs are based on actual costs of MNH services and are calculated for actual volumes in 2011 and for volumes projected to meet need with optimal resource inputs. The unit costs per service for actual 2011 volumes at the BEmONC RHC were antenatal care (ANC) visit USD$ 18.78, normal delivery US$ 84.61, newborn care US$ 16.86 and a postnatal care (PNC) visit US$ 13.86; and at the CEmONC RHC were ANC visit US$ 45.50, Normal Delivery US$ 148.43, assisted delivery US$ 167.43, C-section US$ 183.34, Newborn Care US$ 41.07, and PNC visit US$ 27.34. The unit costs for the projected volumes needed were lower due to optimal utilization of resources. The percentage distribution of expenditures at both RHCs was largest for salaries of technical staff, followed by salaries of administrative staff, and then operating costs, medicines, medical and diagnostic supplies. The unit costs of MNH services at the two contracted out government rural facilities remain higher than is optimal, primarily due to underutilization. Provider cost analysis

Microscale spatial analysis provides evidence for adhesive monopolization of dietary nutrients by specific intestinal bacteria

PubMed Central

Takada, Toshihiko; Nagata, Yuriko; Kado, Shoichi; Kushiro, Akira

2017-01-01

Each species of intestinal bacteria requires a nutritional source to maintain its population in the intestine. Dietary factors are considered to be major nutrients; however, evidence directly explaining the in situ utilization of dietary factors is limited. Microscale bacterial distribution would provide clues to understand bacterial lifestyle and nutrient utilization. However, the detailed bacterial localization around dietary factors in the intestine remains uninvestigated. Therefore, we explored microscale habitats in the murine intestine by using histology and fluorescent in situ hybridization, focusing on dietary factors. This approach successfully revealed several types of bacterial colonization. In particular, bifidobacterial colonization and adhesion on granular starch was frequently and commonly observed in the jejunum and distal colon. To identify the bacterial composition of areas around starch granules and areas without starch, laser microdissection and next-generation sequencing-based 16S rRNA microbial profiling was performed. It was found that Bifidobacteriaceae were significantly enriched by 4.7 fold in peri-starch areas compared to ex-starch areas. This family solely consisted of Bifidobacterium pseudolongum. In contrast, there was no significant enrichment among the other major families. This murine intestinal B. pseudolongum had starch-degrading activity, confirmed by isolation from the mouse feces and in vitro analysis. Collectively, our results demonstrate the significance of starch granules as a major habitat and potential nutritional niche for murine intestinal B. pseudolongum. Moreover, our results suggest that colonizing bifidobacteria effectively utilize starch from the closest location and maintain the location. This may be a bacterial strategy to monopolize solid dietary nutrients. We believe that our analytical approach could possibly be applied to other nutritional factors, and can be a powerful tool to investigate in vivo

Microscale spatial analysis provides evidence for adhesive monopolization of dietary nutrients by specific intestinal bacteria.

PubMed

Nagara, Yusuke; Takada, Toshihiko; Nagata, Yuriko; Kado, Shoichi; Kushiro, Akira

2017-01-01

Each species of intestinal bacteria requires a nutritional source to maintain its population in the intestine. Dietary factors are considered to be major nutrients; however, evidence directly explaining the in situ utilization of dietary factors is limited. Microscale bacterial distribution would provide clues to understand bacterial lifestyle and nutrient utilization. However, the detailed bacterial localization around dietary factors in the intestine remains uninvestigated. Therefore, we explored microscale habitats in the murine intestine by using histology and fluorescent in situ hybridization, focusing on dietary factors. This approach successfully revealed several types of bacterial colonization. In particular, bifidobacterial colonization and adhesion on granular starch was frequently and commonly observed in the jejunum and distal colon. To identify the bacterial composition of areas around starch granules and areas without starch, laser microdissection and next-generation sequencing-based 16S rRNA microbial profiling was performed. It was found that Bifidobacteriaceae were significantly enriched by 4.7 fold in peri-starch areas compared to ex-starch areas. This family solely consisted of Bifidobacterium pseudolongum. In contrast, there was no significant enrichment among the other major families. This murine intestinal B. pseudolongum had starch-degrading activity, confirmed by isolation from the mouse feces and in vitro analysis. Collectively, our results demonstrate the significance of starch granules as a major habitat and potential nutritional niche for murine intestinal B. pseudolongum. Moreover, our results suggest that colonizing bifidobacteria effectively utilize starch from the closest location and maintain the location. This may be a bacterial strategy to monopolize solid dietary nutrients. We believe that our analytical approach could possibly be applied to other nutritional factors, and can be a powerful tool to investigate in vivo

Adaptation and validation of the Evidence-Based Practice Belief and Implementation scales for French-speaking Swiss nurses and allied healthcare providers.

PubMed

Verloo, Henk; Desmedt, Mario; Morin, Diane

2017-09-01

To evaluate two psychometric properties of the French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales, namely their internal consistency and construct validity. The Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales developed by Melnyk et al. are recognised as valid, reliable instruments in English. However, no psychometric validation for their French versions existed. Secondary analysis of a cross sectional survey. Source data came from a cross-sectional descriptive study sample of 382 nurses and other allied healthcare providers. Cronbach's alpha was used to evaluate internal consistency, and principal axis factor analysis and varimax rotation were computed to determine construct validity. The French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales showed excellent reliability, with Cronbach's alphas close to the scores established by Melnyk et al.'s original versions. Principal axis factor analysis showed medium-to-high factor loading scores without obtaining collinearity. Principal axis factor analysis with varimax rotation of the 16-item Evidence-Based Practice Beliefs scale resulted in a four-factor loading structure. Principal axis factor analysis with varimax rotation of the 17-item Evidence-Based Practice Implementation scale revealed a two-factor loading structure. Further research should attempt to understand why the French Evidence-Based Practice Implementation scale showed a two-factor loading structure but Melnyk et al.'s original has only one. The French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales can both be considered valid and reliable instruments for measuring Evidence-Based Practice beliefs and implementation. The results suggest that the French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales are valid and reliable and can therefore be used to

Impact of an Online Medical Internet Site on Knowledge and Practice of Health Care Providers: A Mixed Methods Study of the Spinal Cord Injury Rehabilitation Evidence Project

PubMed Central

Noonan, Vanessa K; Townson, Andrea F; Higgins, Caroline E; Rogers, Jess; Wolfe, Dalton L

2014-01-01

Background It is not known whether ongoing access to a broad-based Internet knowledge resource can influence the practice of health care providers. We undertook a study to evaluate the impact of a Web-based knowledge resource on increasing access to evidence and facilitating best practice of health care providers. Objective The objective of this study was to evaluate (1) the impact of the Spinal Cord Injury Rehabilitation Evidence (SCIRE) project on access to information for health care providers and researchers and (2) how SCIRE influenced health care providers' management of clients. Methods A 4-part mixed methods evaluation was undertaken: (1) monitoring website traffic and utilization using Google Analytics, (2) online survey of users who accessed the SCIRE website, (3) online survey of targeted end-users, that is, rehabilitation health care providers known to work with spinal cord injury (SCI) clients, as well as researchers, and (4) focus groups with health care providers who had previously accessed SCIRE. Results The online format allowed the content for a relatively specialized field to have far reach (eg, 26 countries and over 6500 users per month). The website survey and targeted end-user survey confirmed that health care providers, as well as researchers perceived that the website increased their access to SCI evidence. Access to SCIRE not only improved knowledge of SCI evidence but helped inform changes to the health providers’ clinical practice and improved their confidence in treating SCI clients. The SCIRE information directly influenced the health providers’ clinical decision making, in terms of choice of intervention, equipment needs, or assessment tool. Conclusions A Web-based knowledge resource may be a relatively inexpensive method to increase access to evidence-based information, increase knowledge of the evidence, inform changes to the health providers’ practice, and influence their clinical decision making. PMID:25537167

Gamma-Ray Observations of Supernova Remnants

NASA Astrophysics Data System (ADS)

Buckley, James

2000-04-01

Despite the growing evidence for shock acceleration of electrons in supernova remnants (SNR), there is still no direct evidence pointing unambiguously to SNR as sources of cosmic-ray nuclei. Observations of nonthermal synchrotron emission in the limbs of a number of shell-type SNR (SN1006, Tycho, Cas A, IC443, RCW86, and Kepler) provide convincing evidence for acceleration of electrons to energies greater than 10 TeV (Allen 1999). The CANGAROO group has now reported significant VHE gamma-ray emission from SN1006 (Tanimori et al. 1998) and RXJ1713-3946, and the HEGRA group has reported preliminary evidence for TeV emission from Cas A (Pülhofer et al. 1999); all of these measurements are consistent with the expected level of inverse-Compton emission in these objects. Following the predictions of an observable π^0-decay signal from nearby SNRs (e.g., Drury, Aharonian and Volk 1994) the discovery of >100 MeV emission from the direction of a number of SNR by the EGRET experiment (Esposito et al. 1996) and possible evidence for a π^0 component (Gaisser, Protheroe and Stanev 1996) led to some initial optimism that evidence for a SNR origin of cosmic-ray nuclei had been obtained. However, 200 GeV to 100 TeV measurements revealed no significant emission implying either a significantly steeper source spectrum than the canonical ~ E-2.1, a spectral cutoff below the knee energy in these sources, or that a re-interpretation of the EGRET results was required. I will discuss these results, as well as the considerable promise of future gamma-ray experiments to determine the sources of galactic cosmic-ray nuclei and to provide quantitative information about the acceleration mechanisms.

An evidence synthesis of the international knowledge base for new care models to inform and mobilise knowledge for multispecialty community providers (MCPs).

PubMed

Turner, Alison; Mulla, Abeda; Booth, Andrew; Aldridge, Shiona; Stevens, Sharon; Battye, Fraser; Spilsbury, Peter

2016-10-01

NHS England's Five Year Forward View (NHS England, Five Year Forward View, 2014) formally introduced a strategy for new models of care driven by simultaneous pressures to contain costs, improve care and deliver services closer to home through integrated models. This synthesis focuses on a multispecialty community provider (MCP) model. This new model of care seeks to overcome the limitations in current models of care, often based around single condition-focused pathways, in contrast to patient-focused delivery (Royal College of General Practitioners, The 2022 GP: compendium of evidence, 2012) which offers greater continuity of care in recognition of complex needs and multimorbidity. The synthesis, an innovative combination of best fit framework synthesis and realist synthesis, will develop a "blueprint" which articulates how and why MCP models work, to inform design of future iterations of the MCP model. A systematic search will be conducted to identify research and practice-derived evidence to achieve a balance that captures the historical legacy of MCP models but focuses on contemporary evidence. Sources will include bibliographic databases including MEDLINE, PreMEDLINE, CINAHL, Embase, HMIC and Cochrane Library; and grey literature sources. The Best Fit synthesis methodology will be combined with a synthesis following realist principles which are particularly suited to exploring what works, when, for whom and in what circumstances. The aim of this synthesis is to provide decision makers in health and social care with a practical evidence base relating to the multispecialty community provider (MCP) model of care. PROSPERO CRD42016039552 .

Does the sedimentology of the Chelmsford formation provide evidence for a meteorite impact origin of the Sudbury structure?

NASA Technical Reports Server (NTRS)

Long, D. G. F.

1992-01-01

The post-'event' fill of the Paleoproterozoic Sudbury Basin consists of at least 600 m of deep-water mudrocks of the Onwatin Formation, overlain by 850 m of lithic-arkosic muddy sandstones in the Chelmsford Formation. While mudstones of the Onwatin reflect deposition in a deep-water, anoxic setting, there is no clear evidence of local breccias, conglomerates, or sand bodies to support the concept that the basin was protected by the steep walls of an impact crater. Carbonates in the basal, Vermillion Member are of sedimentary exhalitive origin and were not derived from a shallow marine shelf. Turbidites in the Chelmsford Formation show no evidence of centripetal fill as might be expected from a restricted, circular basin. They appear to have been emplaced by predominantly southwesterly flowing turbidity currents, which showed little to no deflection along the depositional axis of an elongate foreland basin that developed in front of the rising Penokean mountain chain. While the presence of minor sandstone-filled fractures in parts of the Chelmsford Formation suggests the presence of north- or south-directed paleoslopes, no evidence is seen to support the existence of subbasins or a central uplift within the Sudbury Basin. While tilt-corrected paleocurrent orientations are ambiguous, due to postdepositional shortening of strata during cleavage development, strain correction of the observations makes little difference to the net, south-southwest-directed paleoflow.

Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

PubMed

Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

2012-02-01

Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

Objectively Optimized Observation Direction System Providing Situational Awareness for a Sensor Web

NASA Astrophysics Data System (ADS)

Aulov, O.; Lary, D. J.

2010-12-01

There is great utility in having a flexible and automated objective observation direction system for the decadal survey missions and beyond. Such a system allows us to optimize the observations made by suite of sensors to address specific goals from long term monitoring to rapid response. We have developed such a prototype using a network of communicating software elements to control a heterogeneous network of sensor systems, which can have multiple modes and flexible viewing geometries. Our system makes sensor systems intelligent and situationally aware. Together they form a sensor web of multiple sensors working together and capable of automated target selection, i.e. the sensors “know” where they are, what they are able to observe, what targets and with what priorities they should observe. This system is implemented in three components. The first component is a Sensor Web simulator. The Sensor Web simulator describes the capabilities and locations of each sensor as a function of time, whether they are orbital, sub-orbital, or ground based. The simulator has been implemented using AGIs Satellite Tool Kit (STK). STK makes it easy to analyze and visualize optimal solutions for complex space scenarios, and perform complex analysis of land, sea, air, space assets, and shares results in one integrated solution. The second component is target scheduler that was implemented with STK Scheduler. STK Scheduler is powered by a scheduling engine that finds better solutions in a shorter amount of time than traditional heuristic algorithms. The global search algorithm within this engine is based on neural network technology that is capable of finding solutions to larger and more complex problems and maximizing the value of limited resources. The third component is a modeling and data assimilation system. It provides situational awareness by supplying the time evolution of uncertainty and information content metrics that are used to tell us what we need to observe and the

Creating and synthesizing evidence with decision makers in mind: integrating evidence from clinical trials and other study designs.

PubMed

Atkins, David

2007-10-01

Randomized controlled trials (RCTs) remain the accepted "gold standard" for determining the efficacy of new drugs or medical procedures. Randomized trials alone, however, cannot provide all the relevant information decision makers need to determine the relative risks and benefits when choosing the best treatment of individual patients or weighing the implications of particular policies affecting medical therapies. To demonstrate the limitations of RCTs in providing the information needed by medical decision makers, and to show how information from observational studies can supplement evidence from RCTs. Qualitative description of the limitations of RCTs in providing the information needed by medical decision makers, and demonstration of how evidence from additional sources can aid in decision making, using the examples of deciding whether a 60-year-old woman with mildly elevated blood pressure should take daily low-dose aspirin, and whether a hospital network should implement carotid artery surgery for asymptomatic patients. Even the most rigorously designed RCTs leave many questions central to medical decision making unanswered. Research using cohort and case-control designs, disease and intervention registries, and outcomes studies based on administrative data can all shed light on who is most likely to benefit from the treatment, and what the important tradeoffs are. This suggests the need to revise the traditional evidence hierarchy, whereby evidence progresses linearly from basic research to rigorous RCTs. This revised hierarchy recognizes that other research designs can provide important evidence to strengthen our understanding of how to apply research findings in practice.

Preparing for fieldwork: Students' perceptions of their readiness to provide evidence-based practice.

PubMed

Evenson, Mary E

2013-01-01

The purpose of this study was to explore students' perceptions of their confidence to use research evidence to complete a client case analysis assignment in preparation for participation in fieldwork and future practice. A convenience sample of 42 entry-level occupational therapy Masters students, included 41 females and one male, ages 24 to 35. A quasi-experimental pretest-posttest design was used. Students participated in a problem-based learning approach supported by educational technology. Measures included a pre- and post-semester confidence survey, a post-semester satisfaction survey, and an assignment rubric. Based on paired t-tests and Wilcoxin Signed Ranks Tests, statistically significant differences in pre- and post-test scores were noted for all 18 items on the confidence survey (p< 0.001). Significant increases in students' confidence were noted for verbal and written communication of descriptive, assessment, and intervention evidence, along with increased confidence to effectively use assessment evidence. Results suggest that problem-based learning methods were significantly associated with students' perceptions of their confidence to use research evidence to analyze a client case. These results cannot necessarily be generalized due to the limitations of using non-standardized measures with a convenience sample, without a control group, within the context of a single course as part of one academic program curriculum.

X-ray Observations of Cosmic Ray Acceleration

NASA Technical Reports Server (NTRS)

Petre, Robert

2012-01-01

Since the discovery of cosmic rays, detection of their sources has remained elusive. A major breakthrough has come through the identification of synchrotron X-rays from the shocks of supernova remnants through imaging and spectroscopic observations by the most recent generation of X-ray observatories. This radiation is most likely produced by electrons accelerated to relativistic energy, and thus has offered the first, albeit indirect, observational evidence that diffusive shock acceleration in supernova remnants produces cosmic rays to TeV energies, possibly as high as the "knee" in the cosmic ray spectrum. X-ray observations have provided information about the maximum energy to which these shOCks accelerate electrons, as well as indirect evidence of proton acceleration. Shock morphologies measured in X-rays have indicated that a substantial fraction of the shock energy can be diverted into particle acceleration. This presentation will summarize what we have learned about cosmic ray acceleration from X-ray observations of supernova remnants over the past two decades.

Evidence-based practice implementation: the impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice.

PubMed

Aarons, Gregory A; Sommerfeld, David H; Walrath-Greene, Christine M

2009-12-31

The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.

Prevalence of gambling-related harm provides evidence for the prevention paradox.

PubMed

Browne, Matthew; Rockloff, Matthew J

2018-05-23

Background The prevention paradox (PP) describes a situation in which a greater number of cases of a disease-state come from low-risk members of a population, because they are more prevalent than high-risk members. Past research has provided only tangential and disputed evidence to support the application of the PP to gambling-related harm. Aims To assess whether the PP applies to gambling, the prevalence of a large set (72) of diverse harmful consequences from gambling was examined across four risk categories for problem gambling, including no-risk, low-risk, moderate-risk, and problem-gambling. Methods Respondents who had gambled on non-lottery forms in the past 6 months completed an online survey (N = 1,524, 49.4% male). The data were weighted to the known prevalence of gambling problems in the Victorian community. Results The prevalence of gambling harms, including severe harms, was generally higher in the combined categories of lower risk categories compared to the high-risk problem-gambling category. There were some notable exceptions, however, for some severe and rare harms. Nevertheless, the majority of harms in the 72-item list, including serious harms such as needing temporary accommodation, emergency welfare assistance, experiencing separation or end of a relationship, loss of a job, needing to sell personal items, and experiencing domestic violence from gambling, were more commonly associated with lower risk gamblers. Conclusion Many significant harms are concentrated outside the ranks of gamblers with a severe mental health condition, which supports a public-health approach to ameliorating gambling-related harm.

Observations of circumstellar carbon monoxide and evidence for multiple ejections in red giants

NASA Technical Reports Server (NTRS)

Bernat, A. P.

1981-01-01

Observations of the fundamental 4.6 micron band of CO in nine red giants are presented. A common feature is multiple absorption lines which are identified as products of separate components or shells. Column densities are derived; the relative values should be free of the uncertainties inherent in determining the absolute scale. These column densities are well fitted by single excitation temperatures for each absorption component; these excitation temperatures are identified with the local kinetic temperatures. There is no correlation of CO column density with either gas or dust column density nor of the expansion velocity of the component with its distance from the star. The evidence is reviewed, and it is concluded that mass loss from red giants is most likely episodic in nature.

Balancing the Evidence: How to Reconcile the Results of Observational Studies vs. Randomized Clinical Trials in Dialysis.

PubMed

Shen, Jenny I; Lum, Erik L; Chang, Tara I

2016-09-01

Because large randomized clinical trials (RCTs) in dialysis have been relatively scarce, evidence-based dialysis care has depended heavily on the results of observational studies. However, when results from RCTs appear to contradict the findings of observational studies, nephrologists are left to wonder which type of study they should believe. In this editorial, we explore the key differences between observational studies and RCTs in the context of such seemingly conflicting studies in dialysis. Confounding is the major limitation of observational studies, whereas low statistical power and problems with external validity are more likely to limit the findings of RCTs. Differences in the specification of the population, exposure, and outcomes can also contribute to different results among RCTs and observational studies. Rigorous methods are required regardless of what type of study is conducted, and readers should not automatically assume that one type of study design is superior to the other. Ultimately, dialysis care requires both well-designed, well-conducted observational studies and RCTs to move the field forward. © 2016 Wiley Periodicals, Inc.

Balancing the Evidence: How to Reconcile the Results of Observational Studies vs. Randomized Clinical Trials in Dialysis

PubMed Central

Shen, Jenny I.; Lum, Erik L.; Chang, Tara I.

2016-01-01

Because large randomized clinical trials (RCTs) in dialysis have been relatively scarce, evidence-based dialysis care has depended heavily on the results of observational studies. However, when results from RCTs appear to contradict the findings of observational studies, nephrologists are left to wonder which type of study they should believe. In this editorial we explore the key differences between observational studies and RCTs in the context of such seemingly conflicting studies in dialysis. Confounding is the major limitation of observational studies, while low statistical power and problems with external validity are more likely to limit the findings of RCTs. Differences in the specification of the population, exposure, and outcomes can also contribute to different results among RCTs and observational studies. Rigorous methods are required regardless of what type of study is conducted, and readers should not automatically assume that one type of study design is superior to the other. Ultimately, dialysis care requires both well-designed, well-conducted observational studies and RCTs to move the field forward. PMID:27207819

Observational evidence of European summer weather patterns predictable from spring

NASA Astrophysics Data System (ADS)

Ossó, Albert; Sutton, Rowan; Shaffrey, Len; Dong, Buwen

2018-01-01

Forecasts of summer weather patterns months in advance would be of great value for a wide range of applications. However, seasonal dynamical model forecasts for European summers have very little skill, particularly for rainfall. It has not been clear whether this low skill reflects inherent unpredictability of summer weather or, alternatively, is a consequence of weaknesses in current forecast systems. Here we analyze atmosphere and ocean observations and identify evidence that a specific pattern of summertime atmospheric circulation––the summer East Atlantic (SEA) pattern––is predictable from the previous spring. An index of North Atlantic sea-surface temperatures in March–April can predict the SEA pattern in July–August with a cross-validated correlation skill above 0.6. Our analyses show that the sea-surface temperatures influence atmospheric circulation and the position of the jet stream over the North Atlantic. The SEA pattern has a particularly strong influence on rainfall in the British Isles, which we find can also be predicted months ahead with a significant skill of 0.56. Our results have immediate application to empirical forecasts of summer rainfall for the United Kingdom, Ireland, and northern France and also suggest that current dynamical model forecast systems have large potential for improvement.

Observer Comments Provided at the Peer Consultation Workshop (Appendix E)

EPA Pesticide Factsheets

The peer consultation workshop included three observer comment periods, one on the first day of the workshop and two on the second day of the workshop. This appendix includes verbatim transcripts (to the extent that specific remarks were audible from recordings) of the observer comments, in the order the comments were given.

Mixed Methods for Implementation Research: Application to Evidence-Based Practice Implementation and Staff Turnover in Community Based Organizations Providing Child Welfare Services

PubMed Central

Aarons, Gregory A.; Fettes, Danielle L.; Sommerfeld, David H.; Palinkas, Lawrence

2013-01-01

Many public sector services systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well-suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This paper describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. We integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research. PMID:22146861

Copernicus observations of Betelgeuse and Antares

NASA Technical Reports Server (NTRS)

Bernat, A. P.; Lambert, D. L.

1976-01-01

The Mg II h and k lines were observed strongly in emission by Copernicus scans of the M supergiants alpha Ori and alpha Sco. The striking symmetry in the k line as contrasted with the symmetric h line, as observed previously was confirmed. Estimates of absolute chromospheric fluxes were obtained. Measured values for the widths of the h and k lines do not follow a Wilson-Bappu relationship. Upper limits determined for other chromospheric lines of alpha Ori tend to exclude the existence of extensive and/or hot regions surrounding this supergiant. Observed weakening by fluorescence of the Fe L 4307 A line is good evidence that the Mn I and Fe I resonance transitions overlying the Mg II k-line profile are responsible for the strong asymmetry of this line in the two stars. However, quantitative study shows that the absorption provided by the cool circumstellar shells is insufficient to provide the observed asymmetry. Additional absorption may be provided by a cool turbulent region at the top of the chromosphere.

Observational Evidence for Small-Scale Mixture of Weak and Strong Fields in the Quiet Sun

NASA Astrophysics Data System (ADS)

Socas-Navarro, H.; Lites, B. W.

2004-11-01

Three different maps of the quiet Sun, observed with the Advanced Stokes Polarimeter (ASP) and the Diffraction-Limited Stokes Polarimeter (DLSP), show evidence of strong (~=1700 G) and weak (<500 G) fields coexisting within the resolution element at both network and internetwork locations. The angular resolution of the observations is of 1" (ASP) and 0.6" (DLSP). Even at the higher DLSP resolution, a significant fraction of the network magnetic patches harbor a mixture of strong and weak fields. Internetwork elements that exhibit kG fields when analyzed with a single-component atmosphere are also shown to harbor considerable amounts of weak fields. Only those patches for which a single-component analysis yields weak fields do not show this mixture of field strengths. Finally, there is a larger fractional area of weak fields in the convective upflows than in the downflows.

NuSTAR Observations of the Black Hole GS 1354-645: Evidence of Rapid Black Hole Spin

NASA Astrophysics Data System (ADS)

El-Batal, A. M.; Miller, J. M.; Reynolds, M. T.; Boggs, S. E.; Chistensen, F. E.; Craig, W. W.; Fuerst, F.; Hailey, C. J.; Harrison, F. A.; Stern, D. K.; Tomsick, J.; Walton, D. J.; Zhang, W. W.

2016-07-01

We present the results of a NuSTAR study of the dynamically confirmed stellar-mass black hole GS 1354-645. The source was observed during its 2015 “hard” state outburst; we concentrate on spectra from two relatively bright phases. In the higher-flux observation, the broadband NuSTAR spectra reveal a clear, strong disk reflection spectrum, blurred by a degree that requires a black hole spin of a={cJ}/{{GM}}2≥slant 0.98 (1σ statistical limits only). The fits also require a high inclination: θ ≃ 75{(2)}\\circ . Strong “dips” are sometimes observed in the X-ray light curves of sources viewed at such an angle; these are absent, perhaps indicating that dips correspond to flared disk structures that only manifest at higher accretion rates. In the lower flux observation, there is evidence of radial truncation of the thin accretion disk. We discuss these results in the context of spin in stellar-mass black holes, and inner accretion flow geometries at moderate accretion rates.

NuSTAR Observations of the Black Hole GS 1354-645: Evidence of Rapid Black Hole Spin

NASA Technical Reports Server (NTRS)

El-Batal, A. M.; Miller, J. M.; Reynolds, M. T.; Boggs, S. E.; Christensen, F. E.; Craig, W. W.; Fuerst, F.; Hailey, C. J.; Harrison, F. A.; Stern, D. K.;

Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

ERIC Educational Resources Information Center

DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

2012-01-01

Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

Psychosocial interventions in opiate substitution treatment services: does the evidence provide a case for optimism or nihilism?

PubMed

Day, Ed; Mitcheson, Luke

2017-08-01

Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond 'routine counselling'. We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice. The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions. © 2017 Society for the Study of Addiction.

Comparisons of aerosol optical depth provided by seviri satellite observations and CAMx air quality modelling

NASA Astrophysics Data System (ADS)

Fernandes, A.; Riffler, M.; Ferreira, J.; Wunderle, S.; Borrego, C.; Tchepel, O.

2015-04-01

Satellite data provide high spatial coverage and characterization of atmospheric components for vertical column. Additionally, the use of air pollution modelling in combination with satellite data opens the challenging perspective to analyse the contribution of different pollution sources and transport processes. The main objective of this work is to study the AOD over Portugal using satellite observations in combination with air pollution modelling. For this purpose, satellite data provided by Spinning Enhanced Visible and Infra-Red Imager (SEVIRI) on-board the geostationary Meteosat-9 satellite on AOD at 550 nm and modelling results from the Chemical Transport Model (CAMx - Comprehensive Air quality Model) were analysed. The study period was May 2011 and the aim was to analyse the spatial variations of AOD over Portugal. In this study, a multi-temporal technique to retrieve AOD over land from SEVIRI was used. The proposed method takes advantage of SEVIRI's high temporal resolution of 15 minutes and high spatial resolution. CAMx provides the size distribution of each aerosol constituent among a number of fixed size sections. For post processing, CAMx output species per size bin have been grouped into total particulate sulphate (PSO4), total primary and secondary organic aerosols (POA + SOA), total primary elemental carbon (PEC) and primary inert material per size bin (CRST1 to CRST_4) to be used in AOD quantification. The AOD was calculated by integration of aerosol extinction coefficient (Qext) on the vertical column. The results were analysed in terms of temporal and spatial variations. The analysis points out that the implemented methodology provides a good spatial agreement between modelling results and satellite observation for dust outbreak studied (10th -17th of May 2011). A correlation coefficient of r=0.79 was found between the two datasets. This work provides relevant background to start the integration of these two different types of the data in order

Global Warming: Evidence from Satellite Observations

NASA Technical Reports Server (NTRS)

Prabhakara, C.; Iacovazzi, R.; Yoo, J.-M.; Dalu, G.; Einaudi, Franco (Technical Monitor)

2000-01-01

Observations made in Channel 2 (53.74 GHz) of the Microwave Sounding Unit (MSU) radiometer, flown onboard sequential, sun-synchronous, polar-orbiting NOAA (National Oceanic and Atmospheric Administration) operational satellites, indicate that the mean temperature of the atmosphere over the globe increased during the period 1980 to 1999. In this study, we have minimized systematic errors in the time series introduced by satellite orbital drift in an objective manner. This is done with the help of the onboard warm-blackbody temperature, which is used in the calibration of the MSU radiometer. The corrected MSU Channel 2 observations of the NOAA satellite series reveal that the vertically-weighted global-mean temperature of the atmosphere, with a peak weight near the mid troposphere, warmed at the rate of 0.13 +/- 0.05 K/decade during 1980 to 1999. The global warming deduced from conventional meteorological data that have been corrected for urbanization effects agrees reasonably with this satellite-deduced result.

Global Warming: Evidence from Satellite Observations

NASA Technical Reports Server (NTRS)

Prabhakara, C.; Iacovazzi, R., Jr.; Yoo, J.-M.

2001-01-01

Observations made in Channel 2 (53.74 GHz) of the Microwave Sounding Unit (MSU) radiometer, flown on-board sequential, sun-synchronous, polar orbiting NOAA operational satellites, indicate that the mean temperature of the atmosphere over the globe increased during the period 1980 to 1999. In this study we have minimized systematic errors in the time series introduced by the satellite orbital drift in an objective manner. This is done with the help the onboard warm black body temperature, which is used in the calibration of the MSU radiometer. The corrected MSU Channel 2 observations of the NOAA satellite series reveal that the vertically weighted global mean temperature of the atmosphere, with a peak weight near the mid-troposphere, warmed at the rate of 0.13 K per decade (with an uncertainty of 0.05 K per decade) during 1980 to 1999. The global warming deduced from conventional meteorological data that have been corrected for urbanization effects agrees reasonably with this satellite deuced result.

Providers' knowledge of diagnosis and treatment of tuberculosis using vignettes: evidence from rural Bihar, India

PubMed Central

Mohanan, Manoj; Goldhaber-Fiebert, Jeremy D; Giardili, Soledad; Vera-Hernández, Marcos

2016-01-01

Background Almost 25% of all new cases of tuberculosis (TB) worldwide are in India, where drug resistance and low quality of care remain key challenges. Methods We conducted an observational, cross-sectional study of healthcare providers' knowledge of diagnosis and treatment of TB in rural Bihar, India, from June to September 2012. Using data from vignette-based interviews with 395 most commonly visited healthcare providers in study areas, we scored providers' knowledge and used multivariable regression models to examine their relationship to providers' characteristics. Findings 80% of 395 providers had no formal medical qualifications. Overall, providers demonstrated low levels of knowledge: 64.9% (95% CI 59.8% to 69.8%) diagnosed correctly, and 21.7% (CI 16.8% to 27.1%) recommended correct treatment. Providers seldom asked diagnostic questions such as fever (31.4%, CI 26.8% to 36.2%) and bloody sputum (11.1%, CI 8.2% to 14.7%), or results from sputum microscopy (20.0%, CI: 16.2% to 24.3%). After controlling for whether providers treat TB, MBBS providers were not significantly different, from unqualified providers or those with alternative medical qualifications, on knowledge score or offering correct treatment. MBBS providers were, however, more likely to recommend referrals relative to complementary medicine and unqualified providers (23.2 and 37.7 percentage points, respectively). Interpretation Healthcare providers in rural areas in Bihar, India, have low levels of knowledge regarding TB diagnosis and treatment. Our findings highlight the need for policies to improve training, incentives, task shifting and regulation to improve knowledge and performance of existing providers. Further, more research is needed on the incentives providers face and the role of information on quality to help patients select providers who offer higher quality care. PMID:28588984

Is Tertiary Education Expansion Observable in Private Returns to Education? (Evidence for Middle and Eastern European Countries)

ERIC Educational Resources Information Center

Štefánik, Miroslav; Horvát, Peter

2015-01-01

This article provides evidence about differences in the recent tertiary education expansion in Austria, Germany, the Czech Republic, Poland and Slovakia. Focusing on these differences, we have examined private returns to tertiary education acquired before and after the tertiary education expansion. We compare these returns as follows: Austria with…

Observational evidence of aging processes in comets

NASA Astrophysics Data System (ADS)

Meech, Karen J.

1991-10-01

Emphasis was on searching for systematic differences among two groups of comets: periodic comets which spend most of their time in the vicinity of the inner Solar System and the new comets which are believed to be passing through the inner Solar System for the first time. Such differences are expected, but have never been observed, in part because there has never been a systematic observational program aimed at addressing this question. Understanding possible physical and compositional differences between these two groups will lead to a better understanding of the cometary formation conditions in the early Solar System. The employed method studies the activity in the comets as a function of distance by obtaining charge coupled device (CCD) observations of the comets at frequent intervals on both the pre- and post-perihelion legs of their orbits in order to ascertain the distances at the onset and turn-off of activity through comparison with sublimation models.

OBSERVATIONAL SIGNATURES OF CONVECTIVELY DRIVEN WAVES IN MASSIVE STARS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aerts, C.; Rogers, T. M.

We demonstrate observational evidence for the occurrence of convectively driven internal gravity waves (IGWs) in young massive O-type stars observed with high-precision CoRoT space photometry. This evidence results from a comparison between velocity spectra based on two-dimensional hydrodynamical simulations of IGWs in a differentially rotating massive star and the observed spectra. We also show that the velocity spectra caused by IGWs may lead to detectable line-profile variability and explain the occurrence of macroturbulence in the observed line profiles of OB stars. Our findings provide predictions that can readily be tested by including a sample of bright, slowly and rapidly rotatingmore » OB-type stars in the scientific program of the K2 mission accompanied by high-precision spectroscopy and their confrontation with multi-dimensional hydrodynamic simulations of IGWs for various masses and ages.« less

Evaluating and Using Observational Evidence: The Contrasting Views of Policy Makers and Epidemiologists.

PubMed

O'Donoughue Jenkins, Lily; Kelly, Paul M; Cherbuin, Nicolas; Anstey, Kaarin J

2016-01-01

Currently, little is known about the types of evidence used by policy makers. This study aimed to investigate how policy makers in the health domain use and evaluate evidence and how this differs from academic epidemiologists. By having a better understanding of how policy makers select, evaluate, and use evidence, academics can tailor the way in which that evidence is produced, potentially leading to more effective knowledge translation. An exploratory mixed-methods study design was used. Quantitative measures were collected via an anonymous online survey ( n  = 28), with sampling from three health-related government and non-government organizations. Semi-structured interviews with policy makers ( n  = 20) and epidemiologists ( n  = 6) were conducted to gather qualitative data. Policy makers indicated systematic reviews were the preferred research resource (19%), followed closely by qualitative research (16%). Neither policy makers nor epidemiologists used grading instruments to evaluate evidence. In the web survey, policy makers reported that consistency and strength of evidence (93%), the quality of data (93%), bias in the evidence (79%), and recency of evidence (79%) were the most important factors taken into consideration when evaluating the available evidence. The same results were found in the qualitative interviews. Epidemiologists focused on the methodology used in the study. The most cited barriers to using robust evidence, according to policy makers, were political considerations (60%), time limitations (55%), funding (50%), and research not being applicable to current policies (50%). The policy maker's investigation did not report a systematic approach to evaluating evidence. Although there was some overlap between what policy makers and epidemiologists identified as high-quality evidence, there was also some important differences. This suggests that the best scientific evidence may not routinely be used in the development of policy. In

Association Between Cannabis and Psychosis: Epidemiologic Evidence.

PubMed

Gage, Suzanne H; Hickman, Matthew; Zammit, Stanley

2016-04-01

Associations between cannabis use and psychotic outcomes are consistently reported, but establishing causality from observational designs can be problematic. We review the evidence from longitudinal studies that have examined this relationship and discuss the epidemiologic evidence for and against interpreting the findings as causal. We also review the evidence identifying groups at particularly high risk of developing psychosis from using cannabis. Overall, evidence from epidemiologic studies provides strong enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders. However, further studies are required to determine the magnitude of this effect, to determine the effect of different strains of cannabis on risk, and to identify high-risk groups particularly susceptible to the effects of cannabis on psychosis. We also discuss complementary epidemiologic methods that can help address these questions. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

PubMed

Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

2011-11-01

Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

50 CFR 679.52 - Observer provider permitting and responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... samples from the observer's deployment by the completion of the electronic vessel and/or processor survey(s); (ii) Complete NMFS electronic vessel and/or processor surveys before performing other jobs or... or experimental fishing as defined in § 600.10 of this chapter. (2) Must not have a direct financial...

50 CFR 679.52 - Observer provider permitting and responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... samples from the observer's deployment by the completion of the electronic vessel and/or processor survey(s); (ii) Complete NMFS electronic vessel and/or processor surveys before performing other jobs or... or experimental fishing as defined in § 600.10 of this chapter. (2) Must not have a direct financial...

New horned dinosaurs from Utah provide evidence for intracontinental dinosaur endemism.

PubMed

Sampson, Scott D; Loewen, Mark A; Farke, Andrew A; Roberts, Eric M; Forster, Catherine A; Smith, Joshua A; Titus, Alan L

2010-09-22

During much of the Late Cretaceous, a shallow, epeiric sea divided North America into eastern and western landmasses. The western landmass, known as Laramidia, although diminutive in size, witnessed a major evolutionary radiation of dinosaurs. Other than hadrosaurs (duck-billed dinosaurs), the most common dinosaurs were ceratopsids (large-bodied horned dinosaurs), currently known only from Laramidia and Asia. Remarkably, previous studies have postulated the occurrence of latitudinally arrayed dinosaur "provinces," or "biomes," on Laramidia. Yet this hypothesis has been challenged on multiple fronts and has remained poorly tested. Here we describe two new, co-occurring ceratopsids from the Upper Cretaceous Kaiparowits Formation of Utah that provide the strongest support to date for the dinosaur provincialism hypothesis. Both pertain to the clade of ceratopsids known as Chasmosaurinae, dramatically increasing representation of this group from the southern portion of the Western Interior Basin of North America. Utahceratops gettyi gen. et sp. nov.-characterized by short, rounded, laterally projecting supraorbital horncores and an elongate frill with a deep median embayment-is recovered as the sister taxon to Pentaceratops sternbergii from the late Campanian of New Mexico. Kosmoceratops richardsoni gen. et sp. nov.-characterized by elongate, laterally projecting supraorbital horncores and a short, broad frill adorned with ten well developed hooks-has the most ornate skull of any known dinosaur and is closely allied to Chasmosaurus irvinensis from the late Campanian of Alberta. Considered in unison, the phylogenetic, stratigraphic, and biogeographic evidence documents distinct, co-occurring chasmosaurine taxa north and south on the diminutive landmass of Laramidia. The famous Triceratops and all other, more nested chasmosaurines are postulated as descendants of forms previously restricted to the southern portion of Laramidia. Results further suggest the presence of

Provider payment in community-based health insurance schemes in developing countries: a systematic review

PubMed Central

Robyn, Paul Jacob; Sauerborn, Rainer; Bärnighausen, Till

2013-01-01

Objectives Community-based health insurance (CBI) is a common mechanism to generate financial resources for health care in developing countries. We review for the first time provider payment methods used in CBI in developing countries and their impact on CBI performance. Methods We conducted a systematic review of the literature on provider payment methods used by CBI in developing countries published up to January 2010. Results Information on provider payment was available for a total of 32 CBI schemes in 34 reviewed publications: 17 schemes in South Asia, 10 in sub-Saharan Africa, 4 in East Asia and 1 in Latin America. Various types of provider payment were applied by the CBI schemes: 17 used fee-for-service, 12 used salaries, 9 applied a coverage ceiling, 7 used capitation and 6 applied a co-insurance. The evidence suggests that provider payment impacts CBI performance through provider participation and support for CBI, population enrolment and patient satisfaction with CBI, quantity and quality of services provided and provider and patient retention. Lack of provider participation in designing and choosing a CBI payment method can lead to reduced provider support for the scheme. Conclusion CBI schemes in developing countries have used a wide range of provider payment methods. The existing evidence suggests that payment methods are a key determinant of CBI performance and sustainability, but the strength of this evidence is limited since it is largely based on observational studies rather than on trials or on quasi-experimental research. According to the evidence, provider payment can affect provider participation, satisfaction and retention in CBI; the quantity and quality of services provided to CBI patients; patient demand of CBI services; and population enrollment, risk pooling and financial sustainability of CBI. CBI schemes should carefully consider how their current payment methods influence their performance, how changes in the methods could improve

Provider payment in community-based health insurance schemes in developing countries: a systematic review.

PubMed

Robyn, Paul Jacob; Sauerborn, Rainer; Bärnighausen, Till

2013-03-01

Community-based health insurance (CBI) is a common mechanism to generate financial resources for health care in developing countries. We review for the first time provider payment methods used in CBI in developing countries and their impact on CBI performance. We conducted a systematic review of the literature on provider payment methods used by CBI in developing countries published up to January 2010. Information on provider payment was available for a total of 32 CBI schemes in 34 reviewed publications: 17 schemes in South Asia, 10 in sub-Saharan Africa, 4 in East Asia and 1 in Latin America. Various types of provider payment were applied by the CBI schemes: 17 used fee-for-service, 12 used salaries, 9 applied a coverage ceiling, 7 used capitation and 6 applied a co-insurance. The evidence suggests that provider payment impacts CBI performance through provider participation and support for CBI, population enrolment and patient satisfaction with CBI, quantity and quality of services provided and provider and patient retention. Lack of provider participation in designing and choosing a CBI payment method can lead to reduced provider support for the scheme. CBI schemes in developing countries have used a wide range of provider payment methods. The existing evidence suggests that payment methods are a key determinant of CBI performance and sustainability, but the strength of this evidence is limited since it is largely based on observational studies rather than on trials or on quasi-experimental research. According to the evidence, provider payment can affect provider participation, satisfaction and retention in CBI; the quantity and quality of services provided to CBI patients; patient demand of CBI services; and population enrollment, risk pooling and financial sustainability of CBI. CBI schemes should carefully consider how their current payment methods influence their performance, how changes in the methods could improve performance, and how such effects could be

The oldest known communal latrines provide evidence of gregarism in Triassic megaherbivores

PubMed Central

Fiorelli, Lucas E.; Ezcurra, Martín D.; Hechenleitner, E. Martín; Argañaraz, Eloisa; Taborda, Jeremías R. A.; Trotteyn, M. Jimena; von Baczko, M. Belén; Desojo, Julia B.

2013-01-01

Defecation in communal latrines is a common behaviour of extant mammals widely distributed among megaherbivores. This behaviour has key social functions with important biological and ecological implications. Herbivore communal latrines are only documented among mammals and their fossil record is exceptionally restricted to the late Cenozoic. Here we report the discovery of several massive coprolite associations in the Middle-Late Triassic of the Chañares Formation, Argentina, which represent fossil communal latrines based on a high areal density, small areal extension and taphonomic attributes. Several lines of evidence (size, morphology, abundance and coprofabrics) and their association with kannemeyeriiform dicynodonts indicate that these large synapsids produced the communal latrines and had a gregarious behaviour comparable to that of extant megaherbivores. This is the first evidence of megaherbivore communal latrines in non-mammal vertebrates, indicating that this mammal-type behaviour was present in distant relatives of mammals, and predates its previous oldest record by 220 Mya. PMID:24287957

Combining evidence using likelihood ratios in writer verification

NASA Astrophysics Data System (ADS)

Srihari, Sargur; Kovalenko, Dimitry; Tang, Yi; Ball, Gregory

2013-01-01

Forensic identification is the task of determining whether or not observed evidence arose from a known source. It involves determining a likelihood ratio (LR) - the ratio of the joint probability of the evidence and source under the identification hypothesis (that the evidence came from the source) and under the exclusion hypothesis (that the evidence did not arise from the source). In LR- based decision methods, particularly handwriting comparison, a variable number of input evidences is used. A decision based on many pieces of evidence can result in nearly the same LR as one based on few pieces of evidence. We consider methods for distinguishing between such situations. One of these is to provide confidence intervals together with the decisions and another is to combine the inputs using weights. We propose a new method that generalizes the Bayesian approach and uses an explicitly defined discount function. Empirical evaluation with several data sets including synthetically generated ones and handwriting comparison shows greater flexibility of the proposed method.

Observation of the ankle and evidence for a high-energy break in the cosmic ray spectrum

NASA Astrophysics Data System (ADS)

Abbasi, R.; Abuzayyad, T.; Amman, J.; Archbold, G.; Atkins, R.; Bellido, J.; Belov, K.; Belz, J.; Benzvi, S.; Bergman, D.

2005-07-01

We have measured the cosmic ray spectrum at energies above $10^{17}$ eV using the two air fluorescence detectors of the High Resolution Fly's Eye experiment operating in monocular mode. We describe the detector, PMT and atmospheric calibrations, and the analysis techniques for the two detectors. We fit the spectrum to models describing galactic and extragalactic sources. Our measured spectrum gives an observation of a feature known as the ``ankle'' near $3\\times 10^{18}$ eV, and strong evidence for a suppression near $6\\times 10^{19}$ eV.

Cancer prevention by green tea: evidence from epidemiologic studies.

PubMed

Yuan, Jian-Min

2013-12-01

In contrast to the consistent results of an inhibitory effect of green tea extracts and tea polyphenols on the development and growth of carcinogen-induced tumors in experimental animal models, results from human studies are mixed. Both observational and intervention studies have provided evidence in support of a protective role of green tea intake in the development of oral-digestive tract cancer or an inhibitory role of oral supplementation of green tea extract on a precancerous lesion of oral cavity. Evidence in support of green tea intake against the development of liver cancer risk is limited and inconsistent. An inverse association between green tea intake and lung cancer risk has been observed among never smokers but not among smokers. Although observational studies do not support a beneficial role of tea intake against the development of prostate cancer, several phase 2 clinical trials have shown an inhibitory effect of green tea extract against the progression of prostate premalignant lesions to malignant tumors. Prospective epidemiologic studies so far have not provided evidence for a protective effect of green tea consumption on breast cancer development. Current data neither confirm nor refute a definitive cancer-preventive role of green tea intake. Large randomized intervention trials on the efficacy of green tea polyphenols or extracts are required before a recommendation for green tea consumption for cancer prevention should be made.

Decentralization strategies and provider incentives in healthcare: evidence from the english national health service.

PubMed

Mannion, Russell; Goddard, Maria; Kuhn, Michael; Bate, Angela

2005-01-01

performance ratings. We also found evidence that the objectives of providers may differ from those of both the central government and local purchasers. There is, therefore, a risk that granting greater autonomy will allow providers to pursue their own objectives which, whilst not self-serving, may still jeopardize the achievement of strategic goals. It is apparent that the design and implementation features of decentralizing policies such as earned autonomy require careful attention if an optimal balance is to be struck between central oversight and local autonomy in the delivery of healthcare.

Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

PubMed

White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

2017-10-20

To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

Evidence for Abnormal H α Variability During Near-transit Observations of HD 189733 b

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cauley, P. Wilson; Redfield, Seth; Jensen, Adam G., E-mail: pcauley@wesleyan.edu

2017-04-01

Changes in levels of stellar activity can mimic absorption signatures in transmission spectra from circumplanetary material. Thus, it is critical to understand the frequency and magnitude of these changes in order to attribute any particular signal to the circumplanetary environment. We present short-cadence, high-resolution out-of-transit H α spectra for the hot Jupiter host HD 189733 in order to establish the frequency and magnitude of intrinsic stellar variations in the H α line core. We find that changes in the line core strength similar to those observed immediately pre- and post-transit in two independent data sets are uncommon. This suggests thatmore » the observed near-transit signatures are either due to absorption of circumplanetary material or they occur preferentially in time, very near planetary transits. In either case, the evidence for abnormal H α variability is strengthened, though the short-cadence out-of-transit data do not argue for circumplanetary absorption versus stellar activity caused by a star–planet interaction. Further out-of-transit monitoring at higher signal-to-noise would be useful to more strictly constrain the frequency of the near-transit changes in the H α line core.« less

Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

PubMed

Ramsey, Alex T; van den Berk-Clark, Carissa

2015-05-12

Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The

The Healthcare Improvement Scotland evidence note rapid review process: providing timely, reliable evidence to inform imperative decisions on healthcare.

PubMed

McIntosh, Heather M; Calvert, Julie; Macpherson, Karen J; Thompson, Lorna

2016-06-01

Rapid review has become widely adopted by health technology assessment agencies in response to demand for evidence-based information to support imperative decisions. Concern about the credibility of rapid reviews and the reliability of their findings has prompted a call for wider publication of their methods. In publishing this overview of the accredited rapid review process developed by Healthcare Improvement Scotland, we aim to raise awareness of our methods and advance the discourse on best practice. Healthcare Improvement Scotland produces rapid reviews called evidence notes using a process that has achieved external accreditation through the National Institute for Health and Care Excellence. Key components include a structured approach to topic selection, initial scoping, considered stakeholder involvement, streamlined systematic review, internal quality assurance, external peer review and updating. The process was introduced in 2010 and continues to be refined over time in response to user feedback and operational experience. Decision-makers value the responsiveness of the process and perceive it as being a credible source of unbiased evidence-based information supporting advice for NHSScotland. Many agencies undertaking rapid reviews are striving to balance efficiency with methodological rigour. We agree that there is a need for methodological guidance and that it should be informed by better understanding of current approaches and the consequences of different approaches to streamlining systematic review methods. Greater transparency in the reporting of rapid review methods is essential to enable that to happen.

Translating research into practice: the role of provider-based research networks in the diffusion of an evidence-based colon cancer treatment innovation.

PubMed

Carpenter, William R; Meyer, Anne-Marie; Wu, Yang; Qaqish, Bahjat; Sanoff, Hanna K; Goldberg, Richard M; Weiner, Bryan J

2012-08-01

Provider-based research networks (PBRNs)--collaborative research partnerships between academic centers and community-based practitioners--are a promising model for accelerating the translation of research into practice; however, empirical evidence of accelerated translation is limited. Oxaliplatin in adjuvant combination chemotherapy is an innovation with clinical trial-proven survival benefit compared with prior therapies. The goal of this study is to examine the diffusion of oxaliplatin into community practice, and whether affiliation with the National Cancer Institute's (NCI's) Community Clinical Oncology Program (CCOP)--a nationwide cancer-focused PBRN--is associated with accelerated innovation adoption. This retrospective observational study used linked Surveillance, Epidemiology, and End Results-Medicare and NCI CCOP data to examine Medicare participants with stage III colon cancer initiating treatment in 2003 through 2006, the years surrounding oxaliplatin's Food and Drug Administration approval. A fixed-effects analysis examined chemotherapy use among patients treated outside academic centers at CCOP-affiliated practices compared with non-CCOP practices. Two-group modeling controlled for multiple levels of clustering, year of chemotherapy initiation, tumor characteristics, patient age, race, comorbidity, Medicaid dual-eligibility status, and education. Of 4055 community patients, 35% received 5-fluoruracil, 20% received oxaliplatin, 7% received another chemotherapy, and 38% received no chemotherapy. Twenty-five percent of CCOP patients received oxaliplatin, compared with 19% of non-CCOP patients. In multivariable analysis, CCOP exposure was associated with higher odds of receiving guideline-concordant treatment in general, and oxaliplatin specifically. These findings contribute to a growing set of evidence linking PBRNs with a greater probability of receiving treatment innovations and high-quality cancer care, with implications for clinical and research

Provider report of the existence of detection and care of perinatal depression: quantitative evidence from public obstetric units in Mexico.

PubMed

Castro, Filipa de; Place, Jean Marie; Allen-Leigh, Betania; Rivera-Rivera, Leonor; Billings, Deborah

2016-08-01

To provide evidence on perinatal mental healthcare in Mexico. Descriptive and bivariate analyses of data from a cross-sectional probabilistic survey of 211 public obstetric units. Over half (64.0%) of units offer mental healthcare; fewer offer perinatal depression (PND) detection (37.1%) and care (40.3%). More units had protocols/guidelines for PND detection and for care, respectively, in Mexico City-Mexico state (76.7%; 78.1%) than in Southern (26.5%; 36.4%), Northern (27.3%; 28.1%) and Central Mexico (50.0%; 52.7%). Protocols and provider training in PND, implementation of brief screening tools and psychosocial interventions delivered by non-clinical personnel are needed.

Healthcare Provider Type and Switch to Biologics in Psoriasis: Evidence from Real-World Practice.

PubMed

Calara, Paul S; Norlin, Jenny M; Althin, Rikard; Carlsson, Katarina Steen; Schmitt-Egenolf, Marcus

2016-04-01

Previous research indicates an uneven uptake of biologics in patients with moderate-to-severe psoriasis in Sweden. Therefore, it is essential to scrutinise variations in treatment patterns. The aim of this study was to evaluate the extent to which the uptake of biologics for psoriasis differs between types of healthcare provider. Three types of provider were identified within 52 units participating in the Swedish National Registry for Systemic Psoriasis Treatment (PsoReg): university hospitals, non-university hospitals and individual practices. Biologics-naïve patients (n = 3165) were included in analyses to investigate the probability of switch to biologics. The numbers of patients fulfilling the criteria for moderate-to-severe psoriasis [Psoriasis Area and Severity Index (PASI) ≥10 and Dermatology Life Quality Index (DLQI) ≥10] among patients who switched to biologics and patients who did not switch were reported. A logistic regression model was used to calculate how healthcare provider type influenced the probability of switch to biologics whilst adjusting for patient characteristics and disease severity. During registration, 16% of patients switched to biologics while 84% remained on conventional systemic treatment. In 7% of patients, the criteria PASI ≥10 and DLQI ≥10 was fulfilled at their last visit without switching to biologics, whereas in 10% of patients the criteria was not fulfilled prior to switch. After controlling for patient characteristics and disease severity, small or no difference in the probability of switch was observed between provider types. Disease severity does not explain the decision to switch or not to switch to biologics for a disproportionate number of patients. There seems to be an uneven uptake of biologics in Swedish clinical practice, but the type of healthcare provider cannot explain this variation. More research is needed on what factors influence the prescription of biologics.

Identifying Evidence-Based Educational Practices: Which Research Designs Provide Findings That Can Influence Social Change?

ERIC Educational Resources Information Center

Schirmer, Barbara R.; Lockman, Alison S.; Schirmer, Todd N.

2016-01-01

We conducted this conceptual study to determine if the Institute of Education Sciences/National Science Foundation pipeline of evidence guidelines could be applied as a protocol that researchers could follow in establishing evidence of effective instructional practices. To do this, we compared these guidelines, new drug development process, and…

First observational evidence for the connection between the meteoric activity and occurrence of equatorial counter electrojet

NASA Astrophysics Data System (ADS)

Vineeth, C.; Mridula, N.; Muralikrishna, P.; Kumar, K. K.; Pant, T. K.

2016-09-01

This paper presents the first direct observational evidence for the possible role of meteoric activity in the generation of the equatorial Counter Electrojets (CEJ), an enigmatic daytime electrodynamical process over the geomagnetic equatorial upper atmosphere. The investigation carried out using the data from Proton Precession Magnetometer and Meteor Wind Radar over a geomagnetic dip equatorial station, Trivandrum (8.5°N, 77°E, 0.5°N dip lat.) in India, revealed that the occurrence of the afternoon CEJ events during a month is directly proportional to the average monthly meteor counts over this location. The observation is found to be very consistent during the considered period of study, i.e the years 2006 and 2007. The study vindicates that the meteor showers play a major role in setting up the background condition conducive for the generation of CEJ by reducing the strength of the upward polarization field.

Basic nursing care: The most provided, the least evidence based - A discussion paper.

PubMed

Zwakhalen, Sandra M G; Hamers, Jan P H; Metzelthin, Silke F; Ettema, Roelof; Heinen, Maud; de Man-Van Ginkel, Janneke M; Vermeulen, Hester; Huisman-de Waal, Getty; Schuurmans, Marieke J

2018-06-01

To describe and discuss the "Basic Care Revisited" (BCR) research programme, a collaborative initiative that contributes to evidence-based basic nursing care and raises awareness about the importance of basic nursing care activities. While basic nursing care serves nearly all people at some point in their lifetime, it is poorly informed by evidence. There is a need to prioritise and evaluate basic nursing care activities to improve patient outcomes and improve the quality of care. Discussion paper METHOD: The discussion presented in this paper is based on nursing literature and theory and supported by the authors' clinical and research experiences. We present the developmental process and content of a research programme called "Basic Care Revisited" (BCR) as a solution to move forward and improve basic nursing care. To prioritise basic nursing care, we propose a research programme entitled "Basic Care Revisited" that aims to create awareness and expand knowledge on evidence-based basic nursing care by addressing four basic nursing care themes (bathing and dressing, communication, mobility, and nutrition) in different settings. The paper discusses a pathway to create a sustainable and productive research collaborative on basic nursing care and addresses issues to build research capacity. Revaluation of these important nursing activities will not only positively influence patient outcomes, but also have an impact on staff outcomes and organisational outcomes. © 2018 John Wiley & Sons Ltd.

Patent foramen ovale closure and medical treatments for secondary stroke prevention: a systematic review of observational and randomized evidence.

PubMed

Kitsios, Georgios D; Dahabreh, Issa J; Abu Dabrh, Abd Moain; Thaler, David E; Kent, David M

2012-02-01

Patients discovered to have a patent foramen ovale in the setting of a cryptogenic stroke may be treated with percutaneous closure, antiplatelet therapy, or anticoagulants. A recent randomized trial (CLOSURE I) did not detect any benefit of closure over medical treatment alone; the optimal medical therapy is also unknown. We synthesized the available evidence on secondary stroke prevention in patients with patent foramen ovale and cryptogenic stroke. A MEDLINE search was performed for finding longitudinal studies investigating medical treatment or closure, meta-analysis of incidence rates (IR), and IR ratios of recurrent cerebrovascular events. Fifty-two single-arm studies and 7 comparative nonrandomized studies and the CLOSURE I trial were reviewed. The summary IR of recurrent stroke was 0.36 events (95% confidence interval [CI], 0.24-0.56) per 100 person-years with closure versus 2.53 events (95% CI, 1.91-3.35) per 100 person-years with medical therapy. In comparative observational studies, closure was superior to medical therapy (IR ratio=0.19; 95% CI, 0.07-0.54). The IR for the closure arm of the CLOSURE I trial was higher than the summary estimate from observational studies; there was no significant benefit of closure over medical treatment (P=0.002 comparing efficacy estimates between observational studies and the trial). Observational and randomized data (9 studies) comparing medical therapies were consistent and suggested that anticoagulants are superior to antiplatelets for preventing stroke recurrence (IR ratio=0.42; 95% CI, 0.18-0.98). Although further randomized trial data are needed to precisely determine the effects of closure on stroke recurrence, the results of CLOSURE I challenge the credibility of a substantial body of observational evidence strongly favoring mechanical closure over medical therapy.

Evidence-based financial management.

PubMed

Finkler, Steven A; Henley, Richard J; Ward, David M

2003-10-01

Like the practice of evidence-based medicine, evidence-based financial management can be used by providers to improve results. The concept provides a framework that managers and researchers can use to help direct efforts in gathering and using evidence to support management decisions in health care.

Serum uric acid levels and multiple health outcomes: umbrella review of evidence from observational studies, randomised controlled trials, and Mendelian randomisation studies.

PubMed

Li, Xue; Meng, Xiangrui; Timofeeva, Maria; Tzoulaki, Ioanna; Tsilidis, Konstantinos K; Ioannidis, John PA; Campbell, Harry; Theodoratou, Evropi

2017-06-07

Objective  To map the diverse health outcomes associated with serum uric acid (SUA) levels. Design  Umbrella review. Data sources  Medline, Embase, Cochrane Database of Systematic Reviews, and screening of citations and references. Eligibility criteria  Systematic reviews and meta-analyses of observational studies that examined associations between SUA level and health outcomes, meta-analyses of randomised controlled trials that investigated health outcomes related to SUA lowering treatment, and Mendelian randomisation studies that explored the causal associations of SUA level with health outcomes. Results  57 articles reporting 15 systematic reviews and144 meta-analyses of observational studies (76 unique outcomes), 8 articles reporting 31 meta-analyses of randomised controlled trials (20 unique outcomes), and 36 articles reporting 107 Mendelian randomisation studies (56 unique outcomes) met the eligibility criteria. Across all three study types, 136 unique health outcomes were reported. 16 unique outcomes in meta-analyses of observational studies had P<10 -6 , 8 unique outcomes in meta-analyses of randomised controlled trials had P<0.001, and 4 unique outcomes in Mendelian randomisation studies had P<0.01. Large between study heterogeneity was common (80% and 45% in meta-analyses of observational studies and of randomised controlled trials, respectively). 42 (55%) meta-analyses of observational studies and 7 (35%) meta-analyses of randomised controlled trials showed evidence of small study effects or excess significance bias. No associations from meta-analyses of observational studies were classified as convincing; five associations were classified as highly suggestive (increased risk of heart failure, hypertension, impaired fasting glucose or diabetes, chronic kidney disease, coronary heart disease mortality with high SUA levels). Only one outcome from randomised controlled trials (decreased risk of nephrolithiasis recurrence with SUA lowering treatment

The Practice of Using Evidence in Kindergarten: The Role of Purposeful Observation

ERIC Educational Resources Information Center

Monteira, Sabela F.; Jiménez-Aleixandre, María Pilar

2016-01-01

This article examines kindergarten children's (5-6 years old) engagement in scientific practices, with a focus on generating and using evidence to support claims, during a 5-month project about snails. The research questions are as follows: (1) what meanings do kindergarteners construct for what constitutes evidence? How are those meanings…

Alfven Waves observed in Polar Jets

NASA Astrophysics Data System (ADS)

Cirtain, J.

2007-12-01

Data collected on X-ray jets during a polar coronal hole observation campaign has revealed that some events have two distinct velocity components, one near the Alfv\\acute{e}n speed (~ 800 km sec-1) and the other near the sound speed (200 km sec-1). Previous reports indicate the incidence of jet formation to be only a few per day, with average radial speeds of 200 km sec-1. With the X-Ray Telescope (XRT) we detect an average of 10 events per hour. These jets are approximately 2 × 103 - 2 × 104 km wide and than 1 × 105 km long. The jet lifetimes range from 100 - 2500 secs. A large percentage of these jets are associated with small footpoint flares (1). The large number of events, coupled with the high velocities of the apparent outflows, indicate that these jets may contribute significantly to the high-speed solar wind from coronal holes. These observations provide unique and important evidence for the generation of Alfvén waves during reconnection and are possibly the first evidence of Alfv´n wave observations driving the high speed solar wind.

Benchmarking Controlled Trial--a novel concept covering all observational effectiveness studies.

PubMed

Malmivaara, Antti

2015-06-01

The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals.

Benchmarking Controlled Trial—a novel concept covering all observational effectiveness studies

PubMed Central

Malmivaara, Antti

2015-01-01

Abstract The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals. PMID:25965700

How Many Classroom Observations Are Sufficient? Empirical Findings in the Context of a Longitudinal Study

ERIC Educational Resources Information Center

Shih, Jeffrey C.; Ing, Marsha; Tarr, James E.

2013-01-01

One method to investigate classroom quality is for a person to observe what is happening in the classroom. However, this method raises practical and technical concerns such as how many observations to collect, when to collect these observations and who should collect these observations. The purpose of this study is to provide empirical evidence to…

Diverse convergent evidence in the genetic analysis of complex disease: coordinating omic, informatic, and experimental evidence to better identify and validate risk factors

PubMed Central

2014-01-01

In omic research, such as genome wide association studies, researchers seek to repeat their results in other datasets to reduce false positive findings and thus provide evidence for the existence of true associations. Unfortunately this standard validation approach cannot completely eliminate false positive conclusions, and it can also mask many true associations that might otherwise advance our understanding of pathology. These issues beg the question: How can we increase the amount of knowledge gained from high throughput genetic data? To address this challenge, we present an approach that complements standard statistical validation methods by drawing attention to both potential false negative and false positive conclusions, as well as providing broad information for directing future research. The Diverse Convergent Evidence approach (DiCE) we propose integrates information from multiple sources (omics, informatics, and laboratory experiments) to estimate the strength of the available corroborating evidence supporting a given association. This process is designed to yield an evidence metric that has utility when etiologic heterogeneity, variable risk factor frequencies, and a variety of observational data imperfections might lead to false conclusions. We provide proof of principle examples in which DiCE identified strong evidence for associations that have established biological importance, when standard validation methods alone did not provide support. If used as an adjunct to standard validation methods this approach can leverage multiple distinct data types to improve genetic risk factor discovery/validation, promote effective science communication, and guide future research directions. PMID:25071867

Global QBO in circulation and ozone. Part 1: Reexamination of observational evidence

NASA Technical Reports Server (NTRS)

Tung, K. K.; Yang, H.

1994-01-01

Observational evidence for a global quasi-biennial oscillation (QBO) pattern is reviewed. In particular, the presence of an extratropical, as well as an equatorial, component of the QBO signal in column ozone is established. It is found that the ozone interannual variability is such that as one moves away from the Tropics, the frequency spectrum of the anomaly changes from one that is dominated by the equatorial QBO frequency of 1/30 mo to a two-peak spectrum around the two frequencies: 1/30 mo and 1/20 mo. Instead of treating the 1/20 mo frequency as a separate phenomenon to be filtered away in extracting the QBO in the extratropics, as was previously done, the authors argue that both peaks are integral parts of the extratropical QBO phenomenon. The 1/20 mo frequency happens to be the difference combination of the QBO frequency 1/30 mo and the annual frequency 1/12 mo. Therefore, it can represent the result of the QBO modulating an annual cycle. The authors suggest that previous methods of extracting the extratropical QBO signal severely underestimated the contribution of the QBO to the interannual variability of ozone when data are filtered to pass only the component with the period of equatorial QBO. Further, it is argued that the transport of equatorial QBO ozone anomaly by a non-QBO circulation can at most account for 6-8 Dobson units (DU) of the observed interannual variability of column ozone in the extratropics. The remaining variability (up to 20 DU) probably cannot be produced without an anomaly in the transporting circulation in the extratropics.

Global QBO in circulation and ozone. Part 1: Reexamination of observational evidence

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tung, K.K.; Yang, H.

1994-10-01

Observational evidence for a global quasi-biennial oscillation (QBO) pattern is reviewed. In particular, the presence of an extratropical, as well as an equatorial, component of the QBO signal in column ozone is established. It is found that the ozone interannual variability is such that as one moves away from the Tropics, the frequency spectrum of the anomaly changes from one that is dominated by the equatorial QBO frequency of 1/30 mo to a two-peak spectrum around the two frequencies: 1/30 mo and 1/20 mo. Instead of treating the 1/20 mo frequency as a separate phenomenon to be filtered away inmore » extracting the QBO in the extratropics, as was previously done, the authors argue that both peaks are integral parts of the extratropical QBO phenomenon. The 1/20 mo frequency happens to be the difference combination of the QBO frequency 1/30 mo and the annual frequency 1/12 mo. Therefore, it can represent the result of the QBO modulating an annual cycle. The authors suggest that previous methods of extracting the extratropical QBO signal severely underestimated the contribution of the QBO to the interannual variability of ozone when data are filtered to pass only the component with the period of equatorial QBO. Further, it is argued that the transport of equatorial QBO ozone anomaly by a non-QBO circulation can at most account for 6-8 Dobson units (DU) of the observed interannual variability of column ozone in the extratropics. The remaining variability (up to 20 DU) probably cannot be produced without an anomaly in the transporting circulation in the extratropics.« less

Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers systematic reviews of provider assessment and feedback and provider incentives.

PubMed

Sabatino, Susan A; Habarta, Nancy; Baron, Roy C; Coates, Ralph J; Rimer, Barbara K; Kerner, Jon; Coughlin, Steven S; Kalra, Geetika P; Chattopadhyay, Sajal

2008-07-01

Most major medical organizations recommend routine screening for breast, cervical, and colorectal cancers. Screening can lead to early detection of these cancers, resulting in reduced mortality. Yet not all people who should be screened are screened, either regularly or, in some cases, ever. This report presents results of systematic reviews of effectiveness, applicability, economic efficiency, barriers to implementation, and other harms or benefits of two provider-directed intervention approaches to increase screening for breast, cervical, and colorectal cancers. These approaches, provider assessment and feedback, and provider incentives encourage providers to deliver screening services at appropriate intervals. Evidence in these reviews indicates that provider assessment and feedback interventions can effectively increase screening by mammography, Pap test, and fecal occult blood test. Health plans, healthcare systems, and cancer control coalitions should consider such evidence-based findings when implementing interventions to increase screening use. Evidence was insufficient to determine the effectiveness of provider incentives in increasing use of any of these tests. Specific areas for further research are suggested in this report, including the need for additional research to determine whether provider incentives are effective in increasing use of any of these screening tests, and whether assessment and feedback interventions are effective in increasing other tests for colorectal cancer (i.e., flexible sigmoidoscopy, colonoscopy, or double-contrast barium enema).

Autonomic nervous system correlates in movement observation and motor imagery

PubMed Central

Collet, C.; Di Rienzo, F.; El Hoyek, N.; Guillot, A.

2013-01-01

The purpose of the current article is to provide a comprehensive overview of the literature offering a better understanding of the autonomic nervous system (ANS) correlates in motor imagery (MI) and movement observation. These are two high brain functions involving sensori-motor coupling, mediated by memory systems. How observing or mentally rehearsing a movement affect ANS activity has not been extensively investigated. The links between cognitive functions and ANS responses are not so obvious. We will first describe the organization of the ANS whose main purposes are controlling vital functions by maintaining the homeostasis of the organism and providing adaptive responses when changes occur either in the external or internal milieu. We will then review how scientific knowledge evolved, thus integrating recent findings related to ANS functioning, and show how these are linked to mental functions. In turn, we will describe how movement observation or MI may elicit physiological responses at the peripheral level of the autonomic effectors, thus eliciting autonomic correlates to cognitive activity. Key features of this paper are to draw a step-by step progression from the understanding of ANS physiology to its relationships with high mental processes such as movement observation or MI. We will further provide evidence that mental processes are co-programmed both at the somatic and autonomic levels of the central nervous system (CNS). We will thus detail how peripheral physiological responses may be analyzed to provide objective evidence that MI is actually performed. The main perspective is thus to consider that, during movement observation and MI, ANS activity is an objective witness of mental processes. PMID:23908623

Training early childcare providers in evidence-based nutrition strategies can help improve nutrition policies and practices of early childcare centres serving racially and ethnically diverse children from low-income families.

PubMed

Hollar, T Lucas; Cook, Nicole; Natale, Ruby; Quinn, David; Phillips, Teina; DeLucca, Michael

2018-05-01

We evaluated the extent to which providing training and technical assistance to early childcare centre (ECC) directors, faculty and staff in the implementation of evidence-based nutrition strategies improved the nutrition contexts, policies and practices of ECC serving racially and ethnically diverse, low-income children in Broward County, Florida, USA. The nutrition strategies targeted snack and beverage policies and practices, consistent with Caring for Our Children National Standards. We used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to observe ECC as part of a one-group pre-test/post-test evaluation design. ECC located within areas of high rates of poverty, diabetes, minority representation and unhealthy food index in Broward County, Florida, USA. Eighteen ECC enrolled, mean 112·9 (sd 53·4) children aged 2-5 years; 12·3 (sd 7·2) staff members; and 10·2 (sd 4·6) children per staff member at each centre. We found significant improvements in centres' overall nutrition contexts, as measured by total EPAO nutrition scores (P=0·01). ECC made specific significant gains within written nutrition policies (P=0·03) and nutrition training and education (P=0·01). Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas.

Bayesian evidences for dark energy models in light of current observational data

NASA Astrophysics Data System (ADS)

Lonappan, Anto. I.; Kumar, Sumit; Ruchika; Dinda, Bikash R.; Sen, Anjan A.

2018-02-01

We do a comprehensive study of the Bayesian evidences for a large number of dark energy models using a combination of latest cosmological data from SNIa, CMB, BAO, strong lensing time delay, growth measurements, measurements of Hubble parameter at different redshifts and measurements of angular diameter distance by Megamaser Cosmology Project. We consider a variety of scalar field models with different potentials as well as different parametrizations for the dark energy equation of state. Among 21 models that we consider in our study, we do not find strong evidences in favor of any evolving dark energy model compared to Λ CDM . For the evolving dark energy models, we show that purely nonphantom models have much better evidences compared to those models that allow both phantom and nonphantom behaviors. Canonical scalar field with exponential and tachyon field with square potential have highest evidences among all the models considered in this work. We also show that a combination of low redshift measurements decisively favors an accelerating Λ CDM model compared to a nonaccelerating power law model.

Eating under observation: a systematic review and meta-analysis of the effect that heightened awareness of observation has on laboratory measured energy intake.

PubMed

Robinson, Eric; Hardman, Charlotte A; Halford, Jason C G; Jones, Andrew

2015-08-01

Laboratory paradigms are commonly used to study human energy intake. However, the extent to which participants believe their eating behavior is being measured may affect energy intake and is a methodologic factor that has received little consideration. Our main objective was to examine available evidence for the effect that heightened awareness of observation has on energy intake in a laboratory setting. We systematically reviewed laboratory studies that allowed for experimental examination of the effect that heightened awareness of observation has on energy intake. From these experimental studies we combined effect estimates using inverse variance meta-analysis, calculating the standardized mean difference (SMD) in energy intake between heightened-awareness and control conditions and qualitatively synthesized potential moderators of this effect. Nine studies, providing 22 comparisons, were eligible for inclusion. These studies largely sampled young women and examined the energy intake of energy-dense snack foods. Evidence indicated that heightened awareness of observation was associated with reduced energy intake when compared with the control condition (random-effects SMD: 0.45; 95% CI: 0.25, 0.66; P < 0.0001). We found little evidence that the type of experimental manipulation used to heighten awareness moderated the overall effect. The available evidence to date suggests that heightened awareness of observation reduces energy intake in a laboratory setting. These findings suggest that laboratory studies should attempt to minimize the degree to which participants are aware that their eating behavior is being measured. © 2015 American Society for Nutrition.

Understanding the roles of faith-based health-care providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfaction.

PubMed

Olivier, Jill; Tsimpo, Clarence; Gemignani, Regina; Shojo, Mari; Coulombe, Harold; Dimmock, Frank; Nguyen, Minh Cong; Hines, Harrison; Mills, Edward J; Dieleman, Joseph L; Haakenstad, Annie; Wodon, Quentin

2015-10-31

At a time when many countries might not achieve the health targets of the Millennium Development Goals and the post-2015 agenda for sustainable development is being negotiated, the contribution of faith-based health-care providers is potentially crucial. For better partnership to be achieved and for health systems to be strengthened by the alignment of faith-based health-providers with national systems and priorities, improved information is needed at all levels. Comparisons of basic factors (such as magnitude, reach to poor people, cost to patients, modes of financing, and satisfaction of patients with the services received) within faith-based health-providers and national systems show some differences. As the first report in the Series on faith-based health care, we review a broad body of published work and introduce some empirical evidence on the role of faith-based health-care providers, with a focus on Christian faith-based health providers in sub-Saharan Africa (on which the most detailed documentation has been gathered). The restricted and diverse evidence reported supports the idea that faith-based health providers continue to play a part in health provision, especially in fragile health systems, and the subsequent reports in this Series review controversies in faith-based health care and recommendations for how public and faith sectors might collaborate more effectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

Observations of ebb flows on tidal flats: Evidence of dewatering?

NASA Astrophysics Data System (ADS)

Rinehimer, J. P.; Thomson, J. M.; Chickadel, C.

2010-12-01

Incised channels are a common morphological feature of tidal flats. When the flats are inundated, flows are generally forced by the tidally varying sea surface height. During low tide, however, these channels continue to drain throughout flat exposure even without an upstream source of water. While the role of porewater is generally overlooked due to the low permeability of marine muds, it remains the only potential source of flows through the channels during low tide. In situ and remotely sensed observations (Figure 1) at an incised channel on a tidal flat in Willapa Bay from Spring 2010 indicate that dewatering of the flats may be driving these low tide flows. High resolution Aquadopp ADCP velocity profiles are combined with observations from tower-based infrared (IR) video to produce a complete time series of surface velocity measurements throughout low tide. The IR video observations provide a measurement of surface currents even when the channel depth is below the blanking distance of the ADCP (10 cm). As the depth within the channel drops from 50 cm to 10 cm surface velocities increase from 10 cm/s to 60 cm/s even as the tide level drops below the channel flanks and the flats are dry. As the drainage continues, the temperature of the flow rises throughout low tide, mirroring temperatures within the sediment bed on the tidal flat. Drainage salinity falls despite the lack of any freshwater input to the flat indicating that less saline porewater may be the source. The likely source of the drainage water is from the channel flanks where time-lapse video shows slumping and compaction of channel sediments. Velocity profiles, in situ temperatures, and IR observations also are consistent with the presence of fluid muds and a hyperpycnal, density driven outflow at the channel mouth highlighting a possible pathway for sediment delivery from the flats to the main distributary channels of the bay. Figure 1: Time series of tidal flat channel velocities and temperatures

Market Share Matters: Evidence Of Insurer And Provider Bargaining Over Prices.

PubMed

Roberts, Eric T; Chernew, Michael E; McWilliams, J Michael

2017-01-01

Proposed mergers among large US health insurers and growing consolidation among providers have renewed concerns about the effects of market concentration on commercial health care prices. Using multipayer claims for physician services provided in office settings, we estimated that-within the same provider groups-insurers with market shares of 15 percent or more (average: 24.5 percent), for example, negotiated prices for office visits that were 21 percent lower than prices negotiated by insurers with shares of less than 5 percent. Analyses stratified by provider market share suggested that insurers require greater market shares to negotiate lower prices from large provider groups than they do when negotiating with smaller provider groups. For example, office visit prices for small practices were $88, $72, and $70, for insurers with market shares of <5 percent, ≥5 to <15 percent, and ≥15 percent, respectively, whereas prices for large provider groups were $97, $86, and $76, exhibiting a continued decrease across higher insurer-market-share categories. These results suggest that mergers of health insurers could lower the prices paid to providers, particularly providers large enough to obtain higher prices from insurers with modest market shares. Continued monitoring will be important for determining the net effects of the countervailing trends of insurer and provider consolidation on the affordability of health care. Project HOPE—The People-to-People Health Foundation, Inc.

A New Rock Strength Criterion from Microcracking Mechanisms Which Provides Theoretical Evidence of Hybrid Failure

NASA Astrophysics Data System (ADS)

Zhu, Qi-Zhi

2017-02-01

A proper criterion describing when material fails is essential for deep understanding and constitutive modeling of rock damage and failure by microcracking. Physically, such a criterion should be the global effect of local mechanical response and microstructure evolution inside the material. This paper aims at deriving a new mechanisms-based failure criterion for brittle rocks, based on micromechanical unilateral damage-friction coupling analyses rather than on the basic results from the classical linear elastic fracture mechanics. The failure functions respectively describing three failure modes (purely tensile mode, tensile-shear mode as well as compressive-shear mode) are achieved in a unified upscaling framework and illustrated in the Mohr plane and also in the plane of principal stresses. The strength envelope is proved to be continuous and smooth with a compressive to tensile strength ratio dependent on material properties. Comparisons with experimental data are finally carried out. By this work, we also provide a theoretical evidence on the hybrid failure and the smooth transition from tensile failure to compressive-shear failure.

Research utilization among children's mental health providers.

PubMed

Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean

2008-04-09

Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

Evaluation of Two Observational Assessment Systems for Children's Development and Learning

ERIC Educational Resources Information Center

Kim, Do-Hong; Smith, JaneDiane

2010-01-01

This study provided preliminary evidence for the reliability and validity of "Teaching Strategies GOLD", a recently developed observational system for assessing young children's development and learning. The measurement properties of "Teaching Strategies GOLD" were compared with those of an older instrument, "The Creative…

ASCA Observations of "Type 2" LINERs Evidence for a Stellar Source of Ionization

NASA Technical Reports Server (NTRS)

Terashima, Yuichi; Ho, Luis C.; Ptak, Andrew F.; Mushotzky, Richard F.; Serlemitsos, Peter J.; Yaqoob, Tahir; Kunieda, Hideyo

1999-01-01

We present ASCA observations of LINERs without broad H.alpha emission in their optical spectra. The sample of "type 2" LINERs consists of NGC 404, 4111, 4192, 4457, and 4569. We have detected X-ray emission from all the objects except for NGC 404; among the detected objects are two so-called transition objects (NGC 4192 and NGC 4569), which have been postulated to be composite nuclei having both an H II region and a LINER component. The images of NGC 4111 and NGC 4569 in the soft (0.5-2 keV) and hard (2-7 keV) X-ray bands are extended on scales of several kpc. The X-ray spectra of NGC 4111, NGC 4457 and NGC 4569 are well fitted by a two-component model that consists of soft thermal emission with kT approximately 0.65 keV and a hard component represented by a power law (photon index approximately 2) or by thermal bremsstrahlung emission (kT approximately several keV). The extended hard X-rays probably come from discrete sources, while the soft emission most likely originates from hot gas produced by active star formation in the host galaxy. We have found no clear evidence for the presence of active galactic nuclei (AGNs) in the sample. Using black hole masses estimated from host galaxy bulge luminosities, we obtain an upper limit on the implied Eddington ratios less than 5 x 10(exp -5). If an AGN component is the primary ionization source of the optical emission lines, then it must be heavily obscured with a column density significantly larger than 10(exp 23)/sq cm, since the observed X-ray luminosity is insufficient to drive the luminosities of the optical emission lines. Alternatively, the optical emission could be ionized by a population of exceptionally hot stars. This interpretation is consistent with the small [O I] lambda6300/H.alpha ratios observed in these sources, the ultraviolet spectral characteristics in the cases where such information exists, and the X-ray results reported here. We also analyze the X-ray properties of NGC 4117, a low

Distinctive Protein Signatures Provide Molecular Markers and Evidence for the Monophyletic Nature of the Deinococcus-Thermus Phylum

PubMed Central

Griffiths, Emma; Gupta, Radhey S.

2004-01-01

The Deinococcus-Thermus group of species is currently recognized as a distinct phylum solely on the basis of their branching in 16S rRNA trees. No unique biochemical or molecular characteristics that can distinguish this group from all other bacteria are known at present. In this work, we describe eight conserved indels (viz., inserts or deletions) in seven widely distributed proteins that are distinctive characteristics of the Deinococcus-Thermus phylum but are not found in any other group of bacteria. The identified signatures include a 7-amino-acid (aa) insert in threonyl-tRNA synthetase, 1- and 3-aa inserts in the RNA polymerase β′ subunit, a 5-aa deletion in signal recognition particle (Ffh/SR54), a 2-aa insert in major sigma factor 70 (σ70), a 2-aa insert in seryl-tRNA synthetase (SerRS), a 1-aa insert in ribosomal protein L1, and a 2-aa insert in UvrA homologs. By using PCR primers for conserved regions, fragments of these genes were amplified from a number of Deinococcus-Thermus species, and all such fragments (except SerRS in Deinococcus proteolyticus) were found to contain the indicated signatures. The presence of these signatures in various species from all three known genera within this phylum, viz., Deinococcus, Thermus, and Meiothermus, provide evidence that they are likely distinctive characteristics of the entire phylum which were introduced in a common ancestor of this group. The signature in SerRS, which is absent in D. proteolyticus, was likely introduced after the branching of this species. Phylogenetic studies as well as the nature of the inserts in some of these proteins (viz., σ70 and SerRS) also support a sister group relationship between the Thermus and the Meiothermus genera. The identified signatures provide strong evidence for the monophyletic nature of the Deinococcus-Thermus phylum. These molecular markers should prove very useful in the identification of new species related to this group. PMID:15126471

Clinical Knowledge from Observational Studies: Everything You Wanted to Know but Were Afraid to Ask.

PubMed

Gershon, Andrea S; Jafarzadeh, S Reza; Wilson, Kevin C; Walkey, Allan J

2018-05-07

Well-done randomized trials provide accurate estimates of treatment effect by producing groups that are similar on all measures except for the intervention of interest. However, inferences of efficacy in tightly-controlled experimental settings may not translate into similar effectiveness in real-world settings. Observational studies generally enable inferences over a wider range of patient characteristics and evaluation of a broader range of outcomes over a longer period than randomized trials. However, clinicians are often reluctant to incorporate the findings of observational studies into clinical practice. Reason for uncertainty regarding observational studies include a lack of familiarity with observational research methods, occasional disagreements between results of observational studies and randomized trials, the perceived risk of spurious results from systematic bias, and prior teaching that randomized trials are the most reliable source of medical evidence. We propose that a better understanding of observational research will enhance clinicians' ability to distinguish reliable observational studies from those that are subjected to biases and, therefore, provide more confidence to apply observational research results into clinical practice when appropriate. Herein, we explain why observational studies may be perceived as less conclusive than randomized trials, address situations in which observational research and randomized trials produced different findings, and provide information on observational study design so that quality can be evaluated. We conclude that observational research is a valuable source of medical evidence and that clinical action is strongest when supported by both high quality observational studies and randomized trials.

Relative Brain and Brain Part Sizes Provide Only Limited Evidence that Machiavellian Behaviour in Cleaner Wrasse Is Cognitively Demanding

PubMed Central

Chojnacka, Dominika; Isler, Karin; Barski, Jaroslaw Jerzy; Bshary, Redouan

2015-01-01

It is currently widely accepted that the complexity of a species’ social life is a major determinant of its brain complexity, as predicted by the social brain hypothesis. However, it remains a challenge to explain what social complexity exactly is and what the best corresponding measures of brain anatomy are. Absolute and relative size of the brain and of the neocortex have often been used as a proxy to predict cognitive performance. Here, we apply the logic of the social brain hypothesis to marine cleaning mutualism involving the genus Labroides. These wrasses remove ectoparasites from ‘client’ reef fish. Conflict occurs as wrasse prefer client mucus over ectoparasites, where mucus feeding constitutes cheating. As a result of this conflict, cleaner wrasse show remarkable Machiavellian-like behaviour. Using own data as well as available data from the literature, we investigated whether the general brain anatomy of Labroides provides any indication that their Machiavellian behaviour is associated with a more complex brain. Neither data set provided evidence for an increased encephalisation index compared to other wrasse species. Published data on relative sizes of brain parts in 25 species of the order Perciformes suggests that only the diencephalon is relatively enlarged in Labroides dimidiatus. This part contains various nuclei of the social decision making network. In conclusion, gross brain anatomy yields little evidence for the hypothesis that strategic behaviour in cleaning selects for larger brains, while future research should focus on more detailed aspects like the sizes of specific nuclei as well as their cryoarchitectonic structure and connectivity. PMID:26263490

Relative Brain and Brain Part Sizes Provide Only Limited Evidence that Machiavellian Behaviour in Cleaner Wrasse Is Cognitively Demanding.

PubMed

Chojnacka, Dominika; Isler, Karin; Barski, Jaroslaw Jerzy; Bshary, Redouan

2015-01-01

It is currently widely accepted that the complexity of a species' social life is a major determinant of its brain complexity, as predicted by the social brain hypothesis. However, it remains a challenge to explain what social complexity exactly is and what the best corresponding measures of brain anatomy are. Absolute and relative size of the brain and of the neocortex have often been used as a proxy to predict cognitive performance. Here, we apply the logic of the social brain hypothesis to marine cleaning mutualism involving the genus Labroides. These wrasses remove ectoparasites from 'client' reef fish. Conflict occurs as wrasse prefer client mucus over ectoparasites, where mucus feeding constitutes cheating. As a result of this conflict, cleaner wrasse show remarkable Machiavellian-like behaviour. Using own data as well as available data from the literature, we investigated whether the general brain anatomy of Labroides provides any indication that their Machiavellian behaviour is associated with a more complex brain. Neither data set provided evidence for an increased encephalisation index compared to other wrasse species. Published data on relative sizes of brain parts in 25 species of the order Perciformes suggests that only the diencephalon is relatively enlarged in Labroides dimidiatus. This part contains various nuclei of the social decision making network. In conclusion, gross brain anatomy yields little evidence for the hypothesis that strategic behaviour in cleaning selects for larger brains, while future research should focus on more detailed aspects like the sizes of specific nuclei as well as their cryoarchitectonic structure and connectivity.

The equivalence of a human observer and an ideal observer in binary diagnostic tasks

NASA Astrophysics Data System (ADS)

He, Xin; Samuelson, Frank; Gallas, Brandon D.; Sahiner, Berkman; Myers, Kyle

2013-03-01

The Ideal Observer (IO) is "ideal" for given data populations. In the image perception process, as the raw images are degraded by factors such as display and eye optics, there is an equivalent IO (EIO). The EIO uses the statistical information that exits the perception/cognitive degradations as the data. We assume a human observer who received sufficient training, e.g., radiologists, and hypothesize that such a human observer can be modeled as if he is an EIO. To measure the likelihood ratio (LR) distributions of an EIO, we formalize experimental design principles that encourage rationality based on von Neumann and Morgenstern's (vNM) axioms. We present examples to show that many observer study design refinements, although motivated by empirical principles explicitly, implicitly encourage rationality. Our hypothesis is supported by a recent review paper on ROC curve convexity by Pesce, Metz, and Berbaum. We also provide additional evidence based on a collection of observer studies in medical imaging. EIO theory shows that the "sub-optimal" performance of a human observer can be mathematically formalized in the form of an IO, and measured through rationality encouragement.

Beliefs, Knowledge, Implementation, and Integration of Evidence-Based Practice Among Primary Health Care Providers: Protocol for a Scoping Review.

PubMed

Pereira, Filipa; Salvi, Mireille; Verloo, Henk

2017-08-01

The adoption of evidence-based practice (EBP) is promoted because it is widely recognized for improving the quality and safety of health care for patients, and reducing avoidable costs. Providers of primary care face numerous challenges to ensuring the effectiveness of their daily practices. Primary health care is defined as: the entry level into a health care services system, providing a first point of contact for all new needs and problems; patient-focused (not disease-oriented) care over time; care for all but the most uncommon or unusual conditions; and coordination or integration of care, regardless of where or by whom that care is delivered. Primary health care is the principal means by which to approach the main goal of any health care services system: optimization of health status. This review aims to scope publications examining beliefs, knowledge, implementation, and integration of EBPs among primary health care providers (HCPs). We will conduct a systematic scoping review of published articles in the following electronic databases, from their start dates until March 31, 2017: Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed (from 1946), Embase (from 1947), Cumulative Index to Nursing and Allied Health Literature (CINAHL; from 1937), the Cochrane Central Register of Controlled Trials (CENTRAL; from 1992), PsycINFO (from 1806), Web of Science (from 1900), Joanna Briggs Institute (JBI) database (from 1998), Database of Abstracts of Reviews of Effects (DARE; from 1996), Trip medical database (from 1997), and relevant professional scientific journals (from their start dates). We will use the predefined search terms of, "evidence-based practice" and, "primary health care" combined with other terms, such as, "beliefs", "knowledge", "implementation", and "integration". We will also conduct a hand search of the bibliographies of all relevant articles and a search for unpublished studies using Google Scholar, ProQuest, Mednar, and World

Evidence-based librarianship: searching for the needed EBL evidence.

PubMed

Eldredge, J D

2000-01-01

This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

Evidence for online processing during causal learning.

PubMed

Liu, Pei-Pei; Luhmann, Christian C

2015-03-01

Many models of learning describe both the end product of learning (e.g., causal judgments) and the cognitive mechanisms that unfold on a trial-by-trial basis. However, the methods employed in the literature typically provide only indirect evidence about the unfolding cognitive processes. Here, we utilized a simultaneous secondary task to measure cognitive processing during a straightforward causal-learning task. The results from three experiments demonstrated that covariation information is not subject to uniform cognitive processing. Instead, we observed systematic variation in the processing dedicated to individual pieces of covariation information. In particular, observations that are inconsistent with previously presented covariation information appear to elicit greater cognitive processing than do observations that are consistent with previously presented covariation information. In addition, the degree of cognitive processing appears to be driven by learning per se, rather than by nonlearning processes such as memory and attention. Overall, these findings suggest that monitoring learning processes at a finer level may provide useful psychological insights into the nature of learning.

The Relative Influence of Goal and Kinematics on Corticospinal Excitability Depends on the Information Provided to the Observer

PubMed Central

Mc Cabe, Sofía I.; Villalta, Jorge Ignacio; Saunier, Ghislain; Grafton, Scott T.; Della-Maggiore, Valeria

2015-01-01

Viewing a person perform an action activates the observer's motor system. Whether this phenomenon reflects the action's kinematics or its final goal remains a matter of debate. One alternative to this apparent controversy is that the relative influence of goal and kinematics depends on the information available to the observer. Here, we addressed this possibility. For this purpose, we measured corticospinal excitability (CSE) while subjects viewed 3 different grasping actions with 2 goals: a large and a small object. Actions were directed to the large object, the small object, or corrected online in which case the goal switched during the movement. We first determined the kinematics and dynamics of the 3 actions during execution. This information was used in 2 other experiments to measure CSE while observers viewed videos of the same actions. CSE was recorded prior to movement onset and at 3 time points during the observed action. To discern between goal and kinematics, information about the goal was manipulated across experiments. We found that the goal influenced CSE only when its identity was known before movement onset. In contrast, a kinematic modulation of CSE was observed whether or not information regarding the goal was provided. PMID:24591524

Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence.

PubMed

Javadi, D; Feldhaus, I; Mancuso, A; Ghaffar, A

2017-01-01

This paper seeks to review the available evidence to determine whether a systems approach is employed in the implementation and evaluation of task shifting for mental health using lay providers in low- and middle-income countries, and to highlight system-wide effects of task-shifting strategies in order to better inform efforts to strength community mental health systems. Pubmed, CINAHL, and Cochrane Library databases were searched. Articles were screened by two independent reviewers with a third reviewer resolving discrepancies. Two stages of screens were done to ensure sensitivity. Studies were analysed using the World Health Organization's building blocks framework with the addition of a community building block, and systems thinking characteristics to determine the extent to which system-wide effects had been considered. Thirty studies were included. Almost all studies displayed positive findings on mental health using task shifting. One study showed no effect. No studies explicitly employed systems thinking tools, but some demonstrated systems thinking characteristics, such as exploring various stakeholder perspectives, capturing unintended consequences, and looking across sectors for system-wide impact. Twenty-five of the 30 studies captured elements other than the most directly relevant building blocks of service delivery and health workforce. There is a lack of systematic approaches to exploring complexity in the evaluation of task-shifting interventions. Systems thinking tools should support evidence-informed decision making for a more complete understanding of community-based systems strengthening interventions for mental health.

The Leadville Mine Drainage Tunnel Catastrophe: A Case Study of How Isotope Geochemistry Provided Forensic Evidence to Inform Policy Decisions

NASA Astrophysics Data System (ADS)

Williams, M. W.; Wireman, M.; Liu, F.; Gertson, J.

2008-12-01

A state of emergency was declared in February 2008 because of fears that a blocked drainage tunnel in the Leadville mining district of Colorado could cause a catastrophic flood. An estimated 1 billion gallons of metals-laden water poses an eminent threat to the city of Leadville and the headwaters of the Arkansas river. Within days of the declaration of a state of emergency, Governor Ritter and Senator Salazer of Colorado, along with a host of other local and statewide politicians, visited the site and emphasized the need to develop a fast yet safe mitigation plan. Here we provide information from a case study that illustrates how a suite of isotopic and hydrologic tools enables identification of critical, site-specific variables essential in developing a science plan to guide targeted remediation of the Leadville drainage tunnel. The isotopic tools, including both stable and radiogenic isotopes, provided clear and compelling evidence of water sources and flowpaths in an area that has undergone extensive perturbations, including the drilling of more than 2,000 mine shafts. This forensic evidence was the key information in developing a plan to plug the drainage tunnel several hundred feet underground, divert a major source of polluted water from reaching the collapsed tunnel and piping it to an existing treatment plant, and guidance on where to place pumps in additional mine shafts, and the drilling of new wells to pump water in case the plugging of the tunnel caused water to pool up and raise the water table to dangerous heights. This particular case of forensic hydrology using isotopic tools not only provides the scientific basis for an operational plan to defuse a life- and property-threatening situation, it also provides the basis for decommissioning an existing water treatment plant, which will result in savings of over 1 million annually in operational costs. Decommissioning the existing water treatment plant will pay for the tunnel mitigation within several

Beliefs and implementation of evidence-based practice among nurses and allied healthcare providers in the Valais hospital, Switzerland.

PubMed

Verloo, Henk; Desmedt, Mario; Morin, Diane

2017-02-01

Evidence-based practice (EBP) is upheld as a means for patients to receive the most efficient care in a given context. Despite the available evidence and positive beliefs about it, implementing EBP as standard daily practice still faces many obstacles. This study investigated the beliefs about and implementation of EBP among nurses and allied healthcare providers (AHP) in 9 acute care hospitals in the canton of Valais, Switzerland. A cross-sectional descriptive survey was conducted. The target population was composed of 1899 nurses and 126 AHPs. Beliefs about and implementation of EBP were measured using EBP-Beliefs and EBP-Implementation scales of Melnyk et al. The initial sample consisted in 491 participants (overall response rate 24.2%): 421 nurses (22.4% response rate) and 78 AHPs (61.9% response rate). The final sample, composed only of those who declared previous exposure to EBP, included 391 participants (329 nurses and 62 AHPs). Overall, participants had positive attitudes towards EBP and were willing to increase their knowledge to guide practice. However, they acknowledged poor implementation of EBP in daily practice. A significantly higher level of EBP implementation was declared by those formally trained in it (P = 0.006) and by those occupying more senior professional functions (P = 0.004). EBP-Belief scores predicted 13% of the variance in the EBP-Implementation scores (R 2  = 0.13). EBP is poorly implemented despite positive beliefs about it. Continuing education and support on EBP would help to ensure that patients receive the best available care based on high-quality evidence, patient needs, clinical expertise, and a fair distribution of healthcare resources. This study's results will be used to guide institutional strategy to increase the use of EBP in daily practice. © 2016 John Wiley & Sons, Ltd.

Alienating evidence based medicine vs. innovative medical device marketing: a report on the evidence debate at a Wounds conference.

PubMed

Madden, Mary

2012-06-01

Wound care management is one of the largest segments of the UK medical technology sector with a turnover exceeding £1bn in 2009 (BIS, 2010). Using data derived from participant observation, this article examines the antagonistic relationship expressed by wound care clinicians towards evidence based medicine in the context of the 2010 United Kingdom (UK) Wounds UK conference/trade show, where evidence based medicine is positioned in opposition to clinical knowledge, as an obstacle to innovation and as a remover of solutions rather than a provider of them. The article is written in the context of the trend towards increasing marketization and privatization in the UK National Health Service (NHS). Copyright © 2012 Elsevier Ltd. All rights reserved.

Brokering the Evidence-Practice Gap: A Strategy for Moving Evidence Into Clinical Practice.

PubMed

Segre, Lisa S; Trusty, Stephanie; Gullickson, Renee; Chuffo Davila, Rebecca; O'Hara, Michael W

2018-05-08

Moving novel, evidence-based interventions into broad community use is challenging. This column describes how a midlevel public health administrator acted in the role of broker to link university-based researchers with maternal health clinical staff to successfully implement an innovative, evidence-based maternal depression treatment. Program evaluation assessed adoption, implementation, reach, and effectiveness. In reflecting on this partnership, the broker provided critical elements of access, credibility, and accountability. A partnership between service providers and research teams provides one strategy to disseminate evidence-based practices among those served by public-health programs.

Can high quality overcome consumer resistance to restricted provider access? Evidence from a health plan choice experiment.

PubMed

Harris, Katherine M

2002-06-01

To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents "extremely satisfied with results of care" had the greatest impact on plan choice while the proportion of network doctors "affiliated with university medical centers" had the least. Other consumer and expert assessed measures had more comparable effects. Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of

Can High Quality Overcome Consumer Resistance to Restricted Provider Access? Evidence from a Health Plan Choice Experiment

PubMed Central

Harris, Katherine M

2002-01-01

Objective To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. Data Sources and Setting A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. Study Design An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. Principal Findings The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents “extremely satisfied with results of care” had the greatest impact on plan choice while the proportion of network doctors “affiliated with university medical centers” had the least. Other consumer and expert assessed measures had more comparable effects. Conclusions Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high

Evidence of leopard predation on bonobos (Pan paniscus).

PubMed

D'Amour, Danielle E; Hohmann, Gottfried; Fruth, Barbara

2006-01-01

Current models of social organization assume that predation is one of the major forces that promotes group living in diurnal primates. As large body size renders some protection against predators, gregariousness of great apes and other large primate species is usually related to other parameters. The low frequency of observed cases of nonhuman predation on great apes seems to support this assumption. However, recent efforts to study potential predator species have increasingly accumulated direct and indirect evidence of predation by leopards (Panthera pardus) on chimpanzees and gorillas. The following report provides the first evidence of predation by a leopard on bonobos (Pan paniscus). Copyright 2006 S. Karger AG, Basel.

Providers of antenatal care services in Ghana: evidence from Ghana demographic and health surveys 1988-2014.

PubMed

Dickson, Kwamena Sekyi; Darteh, Eugene Kofuor Maafo; Kumi-Kyereme, Akwasi

2017-03-14

Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014. The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services. The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses. To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour

Evidence for acoustic communication among bottom foraging humpback whales

PubMed Central

Parks, Susan E.; Cusano, Dana A.; Stimpert, Alison K.; Weinrich, Mason T.; Friedlaender, Ari S.; Wiley, David N.

2014-01-01

Humpback whales (Megaptera novaeangliae), a mysticete with a cosmopolitan distribution, demonstrate marked behavioural plasticity. Recent studies show evidence of social learning in the transmission of specific population level traits ranging from complex singing to stereotyped prey capturing behaviour. Humpback whales have been observed to employ group foraging techniques, however details on how individuals coordinate behaviour in these groups is challenging to obtain. This study investigates the role of a novel broadband patterned pulsed sound produced by humpback whales engaged in bottom-feeding behaviours, referred to here as a ‘paired burst' sound. Data collected from 56 archival acoustic tag deployments were investigated to determine the functional significance of these signals. Paired burst sound production was associated exclusively with bottom feeding under low-light conditions, predominantly with evidence of associated conspecifics nearby suggesting that the sound likely serves either as a communicative signal to conspecifics, a signal to affect prey behaviour, or possibly both. This study provides additional evidence for individual variation and phenotypic plasticity of foraging behaviours in humpback whales and provides important evidence for the use of acoustic signals among foraging individuals in this species. PMID:25512188

Evidence for acoustic communication among bottom foraging humpback whales.

PubMed

Parks, Susan E; Cusano, Dana A; Stimpert, Alison K; Weinrich, Mason T; Friedlaender, Ari S; Wiley, David N

2014-12-16

Humpback whales (Megaptera novaeangliae), a mysticete with a cosmopolitan distribution, demonstrate marked behavioural plasticity. Recent studies show evidence of social learning in the transmission of specific population level traits ranging from complex singing to stereotyped prey capturing behaviour. Humpback whales have been observed to employ group foraging techniques, however details on how individuals coordinate behaviour in these groups is challenging to obtain. This study investigates the role of a novel broadband patterned pulsed sound produced by humpback whales engaged in bottom-feeding behaviours, referred to here as a 'paired burst' sound. Data collected from 56 archival acoustic tag deployments were investigated to determine the functional significance of these signals. Paired burst sound production was associated exclusively with bottom feeding under low-light conditions, predominantly with evidence of associated conspecifics nearby suggesting that the sound likely serves either as a communicative signal to conspecifics, a signal to affect prey behaviour, or possibly both. This study provides additional evidence for individual variation and phenotypic plasticity of foraging behaviours in humpback whales and provides important evidence for the use of acoustic signals among foraging individuals in this species.

Geochemical signatures of benthic foraminifera shells from a heat-polluted shallow marine environment provide field evidence for growth and calcification under extreme warmth

NASA Astrophysics Data System (ADS)

Titelboim, Danna; Sadekov, Aleksey; Almogi-Labin, Ahuva; Herut, Barak; Kucera, Michal; Schmidt, Christiane; Hyams-Kaphzan, Orit; Abramovich, Sigal

2017-04-01

Shallow marine calcifiers play an important role as marine ecosystem engineers and in the global carbon cycle. Understanding their response to warming is essential to evaluate the fate of marine ecosystems under global change scenarios. So far, most data on thermal tolerance of marine calcifiers have been obtained by manipulative laboratory experiments. Such experiments provide valuable physiological data, but it remains unclear to what degree these observations apply to natural ecosystems. A rare opportunity to test the effect of warming acting on ecosystem-relevant scales is by investigation of heat-polluted coastal areas. Here we study growth and calcification in benthic foraminifera that inhabit a thermally polluted coastal area in Israel, where they are exposed to temperature elevated by 6˚ C above the natural seasonal temperature range and reaching up to ˜42˚ C in summer. Several species of benthic foraminifera have been previously shown to persist throughout the year in the heat-polluted area, allowing us to examine in natural conditions the thermal limits of growth and calcification under extreme temperatures as they are expected to prevail in the future. Live specimens of two known heat tolerant species Lachlanella sp. 1 and Pararotalia calcariformata were collected over a period of one year from two stations, representing thermally polluted and undisturbed (control) shallow hard bottom habitats. Single-chamber element ratios of these specimens were obtained using laser ablation and the Mg/Ca of the last chambers (grown closest to the time of collection) were used to calculate calcification temperatures. Our results provide the first direct field evidence that these foraminifera species not only persist extreme warm temperatures but continue to grow and calcify. Species-specific Mg/Ca thermometry indicates that P. calcariformata precipitate their shells at temperatures as high as 40˚ C and Lachlanella sp. 1 at least up to 36˚ C. Instead, both species

Applications of Satellite Observations of Tropospheric Composition

NASA Astrophysics Data System (ADS)

Monks, Paul S.; Beirle, Steffen

A striking feature of the field of tropospheric composition is the sheer number of chemical species that have been detected and measured with satellite instruments. The measurements have found application both in atmospheric chemistry itself, providing evidence, for example, of unexpected cryochemistry in the Arctic regions, and also in environmental monitoring with, for example, the observed growth in NO2 emissions over eastern Asia. Chapter 8 gives an overview of the utility of satellite observations for measuring tropospheric composition, dealing with each of the many compounds seen in detail. A comprehensive compound by compound table of the many studies performed is a most useful feature.

Gamma Ray Pulsars: Multiwavelength Observations

NASA Technical Reports Server (NTRS)

Thompson, David J.

2004-01-01

High-energy gamma rays are a valuable tool for studying particle acceleration and radiation in the magnetospheres of energetic pulsars. The seven or more pulsars seen by instruments on the Compton Gamma Ray Observatory (CGRO) show that: the light curves usually have double-peak structures (suggesting a broad cone of emission); gamma rays are frequently the dominant component of the radiated power; and all the spectra show evidence of a high-energy turnover. For all the known gamma-ray pulsars, multiwavelength observations and theoretical models based on such observations offer the prospect of gaining a broad understanding of these rotating neutron stars. The Gamma-ray Large Area Space Telescope (GLAST), now in planning for a launch in 2006, will provide a major advance in sensitivity, energy range, and sky coverage.

Development and testing of a DVT risk assessment tool: providing evidence of validity and reliability.

PubMed

McCaffrey, Ruth; Bishop, Mary; Adonis-Rizzo, Marie; Williamson, Ellen; McPherson, Melanie; Cruikshank, Alice; Carrier, Vicki Jo; Sands, Simone; Pigano, Diane; Girard, Patricia; Lauzon, Cathy

2007-01-01

Hospital-acquired deep vein thrombosis (DVT) and pulmonary embolisms (PE) are preventable problems that can increase mortality. Early assessment and recognition of risk as well as initiating appropriate prevention measures can prevent DVT or PE. The purpose of this research project was to develop a DVT risk assessment tool and test the tool for validity and reliability. Three phases were undertaken in developing and testing the JFK Medical Center DVT risk assessment tool. Investigation and clarification of risk and predisposing factors for DVT were identified from the literature, expert nursing knowledge, and medical staff input. Second, item development and weighting were undertaken. Third, parametric testing for content validity measured the differences in mean assessment tool scores between a group of patients who developed DVT in the hospital and a demographically similar group who did not develop DVT. Interrater reliability was measured by having three different nurses score each patient and compare the differences in scores among the three. The DVT group had significantly higher scores on the JFK DVT assessment scale than did those who did not experience DVT. Interrater reliability showed a strong correlation among the scores of the three nurses (.98). Providing a valid and reliable tool for measuring the risk for DVT or PE in hospitalized patients will enable nurses to intervene early in patients at risk. Basing DVT risk assessment on the evidence provided in this study will assist nurses in becoming more confident in recognizing the necessity for interventions in hospitalized patients and decreasing risk. Nurses can now evaluate patients at risk for DVT or PE using the JFK Medial Center's risk assessment tool.

Tip of the Tongue States Increase Under Evaluative Observation.

PubMed

James, Lori E; Schmank, Christopher J; Castro, Nichol; Buchanan, Tony W

2018-02-01

We tested the frequent assumption that the difficulty of word retrieval increases when a speaker is being observed and evaluated. We modified the Trier Social Stress Test (TSST) so that participants believed that its evaluative observation components continued throughout the duration of a subsequent word retrieval task, and measured participants' reported tip of the tongue (TOT) states. Participants in this TSST condition experienced more TOTs than participants in a comparable, placebo TSST condition in which there was no suggestion of evaluative observation. This experiment provides initial evidence confirming the assumption that evaluative observation by a third party can be disruptive to word retrieval. We interpret our findings by proposing an extension to a well-supported theoretical model of TOTs.

Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

PubMed

Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

2017-07-14

Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

Teacher Interviews, Student Interviews, and Classroom Observations in Combinatorics: Four Analyses

ERIC Educational Resources Information Center

Caddle, Mary C.

2012-01-01

This research consists of teacher interviews, student interviews, and classroom observations, all based around the mathematical content area of combinatorics. Combinatorics is a part of discrete mathematics concerning the ordering and grouping of distinct elements. The data are used in four separate analyses. The first provides evidence that…

RNA sequencing provides evidence for functional variability between naturally co-existing Alteromonas macleodii lineages.

PubMed

Kimes, Nikole E; López-Pérez, Mario; Ausó, Eva; Ghai, Rohit; Rodriguez-Valera, Francisco

2014-10-26

Alteromonas macleodii is a ubiquitous gammaproteobacterium shown to play a biogeochemical role in marine environments. Two A. macleodii strains (AltDE and AltDE1) isolated from the same sample (i.e., the same place at the same time) show considerable genomic differences. In this study, we investigate the transcriptional response of these two strains to varying growth conditions in order to investigate differences in their ability to adapt to varying environmental parameters. RNA sequencing revealed transcriptional changes between all growth conditions examined (e.g., temperature and medium) as well as differences between the two A. macleodii strains within a given condition. The main inter-strain differences were more marked in the adaptation to grow on minimal medium with glucose and, even more so, under starvation. These differences suggested that AltDE1 may have an advantage over AltDE when glucose is the major carbon source, and co-culture experiments confirmed this advantage. Additional differences were observed between the two strains in the expression of ncRNAs and phage-related genes, as well as motility. This study shows that the genomic diversity observed in closely related strains of A. macleodii from a single environment result in different transcriptional responses to changing environmental parameters. This data provides additional support for the idea that greater diversity at the strain level of a microbial community could enhance the community's ability to adapt to environmental shifts.

Genome-Wide Meta-Analysis of Myopia and Hyperopia Provides Evidence for Replication of 11 Loci

PubMed Central

Simpson, Claire L.; Wojciechowski, Robert; Oexle, Konrad; Murgia, Federico; Portas, Laura; Li, Xiaohui; Verhoeven, Virginie J. M.; Vitart, Veronique; Schache, Maria; Hosseini, S. Mohsen; Hysi, Pirro G.; Raffel, Leslie J.; Cotch, Mary Frances; Chew, Emily; Klein, Barbara E. K.; Klein, Ronald; Wong, Tien Yin; van Duijn, Cornelia M.; Mitchell, Paul; Saw, Seang Mei; Fossarello, Maurizio; Wang, Jie Jin; Polašek, Ozren; Campbell, Harry; Rudan, Igor; Oostra, Ben A.; Uitterlinden, André G.; Hofman, Albert; Rivadeneira, Fernando; Amin, Najaf; Karssen, Lennart C.; Vingerling, Johannes R.; Döring, Angela; Bettecken, Thomas; Bencic, Goran; Gieger, Christian; Wichmann, H.-Erich; Wilson, James F.; Venturini, Cristina; Fleck, Brian; Cumberland, Phillippa M.; Rahi, Jugnoo S.; Hammond, Chris J.; Hayward, Caroline; Wright, Alan F.; Paterson, Andrew D.; Baird, Paul N.; Klaver, Caroline C. W.; Rotter, Jerome I.; Pirastu, Mario; Meitinger, Thomas; Bailey-Wilson, Joan E.; Stambolian, Dwight

2014-01-01

Refractive error (RE) is a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and its axial length that causes object images to be focused off the retina. The two major subtypes of RE are myopia (nearsightedness) and hyperopia (farsightedness), which represent opposite ends of the distribution of the quantitative measure of spherical refraction. We performed a fixed effects meta-analysis of genome-wide association results of myopia and hyperopia from 9 studies of European-derived populations: AREDS, KORA, FES, OGP-Talana, MESA, RSI, RSII, RSIII and ERF. One genome-wide significant region was observed for myopia, corresponding to a previously identified myopia locus on 8q12 (p = 1.25×10−8), which has been reported by Kiefer et al. as significantly associated with myopia age at onset and Verhoeven et al. as significantly associated to mean spherical-equivalent (MSE) refractive error. We observed two genome-wide significant associations with hyperopia. These regions overlapped with loci on 15q14 (minimum p value = 9.11×10−11) and 8q12 (minimum p value 1.82×10−11) previously reported for MSE and myopia age at onset. We also used an intermarker linkage- disequilibrium-based method for calculating the effective number of tests in targeted regional replication analyses. We analyzed myopia (which represents the closest phenotype in our data to the one used by Kiefer et al.) and showed replication of 10 additional loci associated with myopia previously reported by Kiefer et al. This is the first replication of these loci using myopia as the trait under analysis. “Replication-level” association was also seen between hyperopia and 12 of Kiefer et al.'s published loci. For the loci that show evidence of association to both myopia and hyperopia, the estimated effect of the risk alleles were in opposite directions for the two traits. This suggests that these loci are important contributors to variation of

Genome-wide meta-analysis of myopia and hyperopia provides evidence for replication of 11 loci.

PubMed

Simpson, Claire L; Wojciechowski, Robert; Oexle, Konrad; Murgia, Federico; Portas, Laura; Li, Xiaohui; Verhoeven, Virginie J M; Vitart, Veronique; Schache, Maria; Hosseini, S Mohsen; Hysi, Pirro G; Raffel, Leslie J; Cotch, Mary Frances; Chew, Emily; Klein, Barbara E K; Klein, Ronald; Wong, Tien Yin; van Duijn, Cornelia M; Mitchell, Paul; Saw, Seang Mei; Fossarello, Maurizio; Wang, Jie Jin; Polašek, Ozren; Campbell, Harry; Rudan, Igor; Oostra, Ben A; Uitterlinden, André G; Hofman, Albert; Rivadeneira, Fernando; Amin, Najaf; Karssen, Lennart C; Vingerling, Johannes R; Döring, Angela; Bettecken, Thomas; Bencic, Goran; Gieger, Christian; Wichmann, H-Erich; Wilson, James F; Venturini, Cristina; Fleck, Brian; Cumberland, Phillippa M; Rahi, Jugnoo S; Hammond, Chris J; Hayward, Caroline; Wright, Alan F; Paterson, Andrew D; Baird, Paul N; Klaver, Caroline C W; Rotter, Jerome I; Pirastu, Mario; Meitinger, Thomas; Bailey-Wilson, Joan E; Stambolian, Dwight

2014-01-01

Refractive error (RE) is a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and its axial length that causes object images to be focused off the retina. The two major subtypes of RE are myopia (nearsightedness) and hyperopia (farsightedness), which represent opposite ends of the distribution of the quantitative measure of spherical refraction. We performed a fixed effects meta-analysis of genome-wide association results of myopia and hyperopia from 9 studies of European-derived populations: AREDS, KORA, FES, OGP-Talana, MESA, RSI, RSII, RSIII and ERF. One genome-wide significant region was observed for myopia, corresponding to a previously identified myopia locus on 8q12 (p = 1.25×10(-8)), which has been reported by Kiefer et al. as significantly associated with myopia age at onset and Verhoeven et al. as significantly associated to mean spherical-equivalent (MSE) refractive error. We observed two genome-wide significant associations with hyperopia. These regions overlapped with loci on 15q14 (minimum p value = 9.11×10(-11)) and 8q12 (minimum p value 1.82×10(-11)) previously reported for MSE and myopia age at onset. We also used an intermarker linkage- disequilibrium-based method for calculating the effective number of tests in targeted regional replication analyses. We analyzed myopia (which represents the closest phenotype in our data to the one used by Kiefer et al.) and showed replication of 10 additional loci associated with myopia previously reported by Kiefer et al. This is the first replication of these loci using myopia as the trait under analysis. "Replication-level" association was also seen between hyperopia and 12 of Kiefer et al.'s published loci. For the loci that show evidence of association to both myopia and hyperopia, the estimated effect of the risk alleles were in opposite directions for the two traits. This suggests that these loci are important contributors to variation of refractive

Evidence & Gap Maps: A tool for promoting evidence informed policy and strategic research agendas.

PubMed

Snilstveit, Birte; Vojtkova, Martina; Bhavsar, Ami; Stevenson, Jennifer; Gaarder, Marie

2016-11-01

A range of organizations are engaged in the production of evidence on the effects of health, social, and economic development programs on human welfare outcomes. However, evidence is often scattered around different databases, web sites, and the gray literature and is often presented in inaccessible formats. Lack of overview of the evidence in a specific field can be a barrier to the use of existing research and prevent efficient use of limited resources for new research. Evidence & Gap Maps (EGMs) aim to address these issues and complement existing synthesis and mapping approaches. EGMs are a new addition to the tools available to support evidence-informed policymaking. To provide an accessible resource for researchers, commissioners, and decision makers, EGMs provide thematic collections of evidence structured around a framework which schematically represents the types of interventions and outcomes of relevance to a particular sector. By mapping the existing evidence using this framework, EGMs provide a visual overview of what we know and do not know about the effects of different programs. They make existing evidence available, and by providing links to user-friendly summaries of relevant studies, EGMs can facilitate the use of existing evidence for decision making. They identify key "gaps" where little or no evidence from impact evaluations and systematic reviews is available and can be a valuable resource to inform a strategic approach to building the evidence base in a particular sector. The article will introduce readers to the concept and methods of EGMs and present a demonstration of the EGM tool using existing examples. Copyright © 2016 Elsevier Inc. All rights reserved.

Asynchronous threat awareness by observer trials using crowd simulation

NASA Astrophysics Data System (ADS)

Dunau, Patrick; Huber, Samuel; Stein, Karin U.; Wellig, Peter

2016-10-01

The last few years showed that a high risk of asynchronous threats is given in every day life. Especially in large crowds a high probability of asynchronous attacks is evident. High observational abilities to detect threats are desirable. Consequently highly trained security and observation personal is needed. This paper evaluates the effectiveness of a training methodology to enhance performance of observation personnel engaging in a specific target identification task. For this purpose a crowd simulation video is utilized. The study first provides a measurement of the base performance before the training sessions. Furthermore a training procedure will be performed. Base performance will then be compared to the after training performance in order to look for a training effect. A thorough evaluation of both the training sessions as well as the overall performance will be done in this paper. A specific hypotheses based metric is used. Results will be discussed in order to provide guidelines for the design of training for observational tasks.

Satellite Observation of El Nino Effects on Amazon Forest Phenology and Productivity

NASA Technical Reports Server (NTRS)

Asner, Gregory P.; Townsend, Alan R.; Braswell, Bobby H.

2000-01-01

Climate variability may affect the functioning of Amazon moist tropical forests, and recent modeling analyses suggest that the carbon dynamics of the region vary interannually in response to precipitation and temperature anomalies. However, due to persistent orbital and atmospheric artifacts in the satellite record, remote sensing observations have not provided quantitative evidence that climate variation affects Amazon forest phenology or productivity, We developed a method to minimize and quantify non-biological artifacts in NOAA AVHRR satellite data, providing a record of estimated forest phenological variation from 1982-1993. The seasonal Normalized Difference Vegetation Index (NDVI) amplitude (a proxy for phenology) increased throughout much of the basin during El Nino periods when rainfall was anomalously low. Wetter La Nina episodes brought consistently smaller NDVI amplitudes. Using radiative transfer and terrestrial biogeochemical models driven by these satellite data, we estimate that canopy-energy absorption and net primary production of Amazon forests varied interannually by as much as 21% and 18%, respectively. These results provide large-scale observational evidence for interannual sensitivity to El Nino of plant phenology and carbon flux in Amazon forests.

Observational and numerical evidence for ocean frontogenesis inducing submesoscale processes and impacting biochemistry

NASA Astrophysics Data System (ADS)

Claret, M.; Ruiz, S.; Pascual, A.; Olita, A.; Mahadevan, A.; Tovar, A.; Troupin, C.; Tintore, J.; Capet, A.

2016-02-01

We present the results of ALBOREX, a multi-platform and multi-disciplinary experiment completed in May 2014 as a part of PERSEUS EU funded project. This unique process-oriented experiment in the eastern Alboran Sea (Western Mediterranean) examined mesoscale and submesoscale dynamics at an intense front. The field campaign, conducted during 8 days, included 25 drifters, 2 gliders, 3 Argo floats and one ship (66 CTDs and 500 biochemical samples). The drifters followed coherently an anticyclonic gyre. ADCP data showed consistent patterns with currents up to 1 m/s in the southern part of the domain and Rossby numbers up to 1.5 suggesting significant ageostrophic motion. We show observational evidence for mesoscale frontogenesis produced by the confluence of (fresh) Atlantic Water and the resident (more saline) Mediterranean Water. This confluence resulted in lateral density gradients of the order of 1 kg/m3 in 10 km and associated vertical velocities of about ±20 m/day, diagnosed using the QG Omega equation. However, the vertical velocity is likely underestimated due to unresolved submesoscale processes (<10 km), which are induced by intense mesoscale frontogenesis. In order to assess the role of these submesoscale processes in the frontal vertical transport, a high-resolution Process Ocean Model Study is initialized with hydrographic data (0.5-1 km resolution) from underwater gliders. Numerical results show that observed lateral buoyancy gradients are large enough to trigger submesoscale mixed layer instabilities. The coupling between mesoscale and submesoscale phenomena can explain remarkable subduction events of chlorophyll and oxygen captured by ocean gliders, as well as local increases of primary production.

Observational Evidence of Impacts of Aerosols on Seasonal-to-Interannual Variability of the Asian Monsoon

NASA Technical Reports Server (NTRS)

Lau, K.-M.; Kim, K.-M.; Hsu, N. C.

2006-01-01

Observational evidences are presented showing that the Indian subcontinent and surrounding regions are subject to heavy loading of absorbing aerosols (dust and black carbon), with strong seasonality closely linked to the monsoon annual rainfall cycle. Increased loading of absorbing aerosols over the Indo-Gangetic Plain in April-May is associated with a) increased heating of the upper troposphere over the Tibetan Plateau, b) an advance of the monsoon rainy season, and c) subsequent enhancement of monsoon rainfall over the South Asia subcontinent, and reduction over East Asia. Also presented are radiative transfer calculations showing how differential solar absorption by aerosols over bright surface (desert or snow cover land) compared to dark surface (vegetated land and ocean), may be instrumental in triggering an aerosol-monsoon large-scale circulation and water cycle feedback, consistent with the elevated heat pump hypothesis (Lau et al. 2006).

Multisensory decisions provide support for probabilistic number representations.

PubMed

Kanitscheider, Ingmar; Brown, Amanda; Pouget, Alexandre; Churchland, Anne K

2015-06-01

A large body of evidence suggests that an approximate number sense allows humans to estimate numerosity in sensory scenes. This ability is widely observed in humans, including those without formal mathematical training. Despite this, many outstanding questions remain about the nature of the numerosity representation in the brain. Specifically, it is not known whether approximate numbers are represented as scalar estimates of numerosity or, alternatively, as probability distributions over numerosity. In the present study, we used a multisensory decision task to distinguish these possibilities. We trained human subjects to decide whether a test stimulus had a larger or smaller numerosity compared with a fixed reference. Depending on the trial, the numerosity was presented as either a sequence of visual flashes or a sequence of auditory tones, or both. To test for a probabilistic representation, we varied the reliability of the stimulus by adding noise to the visual stimuli. In accordance with a probabilistic representation, we observed a significant improvement in multisensory compared with unisensory trials. Furthermore, a trial-by-trial analysis revealed that although individual subjects showed strategic differences in how they leveraged auditory and visual information, all subjects exploited the reliability of unisensory cues. An alternative, nonprobabilistic model, in which subjects combined cues without regard for reliability, was not able to account for these trial-by-trial choices. These findings provide evidence that the brain relies on a probabilistic representation for numerosity decisions. Copyright © 2015 the American Physiological Society.

Gene alterations at Drosophila inversion breakpoints provide prima facie evidence for natural selection as an explanation for rapid chromosomal evolution.

PubMed

Guillén, Yolanda; Ruiz, Alfredo

2012-02-01

Chromosomal inversions have been pervasive during the evolution of the genus Drosophila, but there is significant variation between lineages in the rate of rearrangement fixation. D. mojavensis, an ecological specialist adapted to a cactophilic niche under extreme desert conditions, is a chromosomally derived species with ten fixed inversions, five of them not present in any other species. In order to explore the causes of the rapid chromosomal evolution in D. mojavensis, we identified and characterized all breakpoints of seven inversions fixed in chromosome 2, the most dynamic one. One of the inversions presents unequivocal evidence for its generation by ectopic recombination between transposon copies and another two harbor inverted duplications of non-repetitive DNA at the two breakpoints and were likely generated by staggered single-strand breaks and repair by non-homologous end joining. Four out of 14 breakpoints lay in the intergenic region between preexisting duplicated genes, suggesting an adaptive advantage of separating previously tightly linked duplicates. Four out of 14 breakpoints are associated with transposed genes, suggesting these breakpoints are fragile regions. Finally two inversions contain novel genes at their breakpoints and another three show alterations of genes at breakpoints with potential adaptive significance. D. mojavensis chromosomal inversions were generated by multiple mechanisms, an observation that does not provide support for increased mutation rate as explanation for rapid chromosomal evolution. On the other hand, we have found a number of gene alterations at the breakpoints with putative adaptive consequences that directly point to natural selection as the cause of D. mojavensis rapid chromosomal evolution.

Gene alterations at Drosophila inversion breakpoints provide prima facie evidence for natural selection as an explanation for rapid chromosomal evolution

PubMed Central

2012-01-01

Background Chromosomal inversions have been pervasive during the evolution of the genus Drosophila, but there is significant variation between lineages in the rate of rearrangement fixation. D. mojavensis, an ecological specialist adapted to a cactophilic niche under extreme desert conditions, is a chromosomally derived species with ten fixed inversions, five of them not present in any other species. Results In order to explore the causes of the rapid chromosomal evolution in D. mojavensis, we identified and characterized all breakpoints of seven inversions fixed in chromosome 2, the most dynamic one. One of the inversions presents unequivocal evidence for its generation by ectopic recombination between transposon copies and another two harbor inverted duplications of non-repetitive DNA at the two breakpoints and were likely generated by staggered single-strand breaks and repair by non-homologous end joining. Four out of 14 breakpoints lay in the intergenic region between preexisting duplicated genes, suggesting an adaptive advantage of separating previously tightly linked duplicates. Four out of 14 breakpoints are associated with transposed genes, suggesting these breakpoints are fragile regions. Finally two inversions contain novel genes at their breakpoints and another three show alterations of genes at breakpoints with potential adaptive significance. Conclusions D. mojavensis chromosomal inversions were generated by multiple mechanisms, an observation that does not provide support for increased mutation rate as explanation for rapid chromosomal evolution. On the other hand, we have found a number of gene alterations at the breakpoints with putative adaptive consequences that directly point to natural selection as the cause of D. mojavensis rapid chromosomal evolution. PMID:22296923

Ulysses radio and plasma wave observations in the Jupiter environment

NASA Technical Reports Server (NTRS)

Stone, R. G.; Pedersen, B. M.; Harvey, C. C.; Canu, P.; Cornilleau-Wehrlin, N.; Desch, M. D.; De Villedary, C.; Fainberg, J.; Farrell, W. M.; Goetz, K.

1992-01-01

The Unified Radio and Plasma Wave (URAP) experiment has produced new observations of the Jupiter environment, owing to the unique capabilities of the instrument and the traversal of high Jovian latitudes. Broad-band continuum radio emission from Jupiter and in situ plasma waves have proved valuable in delineating the magnetospheric boundaries. Simultaneous measurements of electric and magnetic wave fields have yielded new evidence of whistler-mode radiation within the magnetosphere. Observations of auroral-like hiss provided evidence of a Jovian cusp. The source direction and polarization capabilities of URAP have demonstrated that the outer region of the Io plasma torus supported at least five separate radio sources that reoccurred during successive rotations with a measurable corotation lag. Thermal noise measurements of the Io torus densities yielded values in the densest portion that are similar to models suggested on the basis of Voyager observations of 13 years ago. The URAP measurements also suggest complex beaming and polarization characteristics of Jovian radio components. In addition, a new class of kilometer-wavelength striated Jovian bursts has been observed.

From Evidence Based Medicine to Medicine Based Evidence.

PubMed

Horwitz, Ralph I; Hayes-Conroy, Allison; Caricchio, Roberto; Singer, Burton H

2017-11-01

Evidence based medicine, using randomized controlled trials and meta-analyses as the major tools and sources of evidence about average results for heterogeneous groups of patients, developed as a reaction against poorly designed observational treatment research and physician reliance on personal experience with other patients as a guide to decision-making about a patient at hand. However, these tools do not answer the clinician's question: "Will a given therapeutic regimen help my patient at a given point in her/his clinical course?" We introduce fine-grained profiling of the patient at hand, accompanied by comparative evidence of responses from approximate matches to this patient on whom a contemplated treatment has/has not been administered. This represents medicine based evidence that is tuned to decision-making for the particular patient. Copyright © 2017 Elsevier Inc. All rights reserved.

Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence.

PubMed

Schenk, Katie D

2009-07-01

Children affected by HIV in their families and communities face multiple risks to their health, education and psychosocial wellbeing. Community interventions for children who have been orphaned or rendered vulnerable take many forms, including educational assistance, home-based care, legal protection and psychosocial support. Despite a recent influx of funding for programme implementation, there exists little evidence to inform policymakers about whether their investments are improving the lives of vulnerable children and meeting key benchmarks including the Millennium Development Goals. This paper reviews the current evidence base on evaluations of community interventions for orphans and vulnerable children (OVC) in high HIV-prevalence African settings, focusing on studies' methodologies. Sources reviewed include published research studies and evidence from the unpublished programmatic "grey literature" located through database and internet searches. A total of 21 studies, varying in scope and generalisability, were identified. Interventions reviewed address children's wellbeing through various strategies within their communities. Evaluation methodologies reflect quantitative and qualitative approaches, including surveys (with and without baseline or comparison data), costing studies, focus groups, interviews, case studies, and participatory review techniques. Varied study methodologies reflect diverse research questions, various intervention types, and the challenges associated with evaluating complex interventions; highlighting the need to broaden the research paradigm in order to build the evidence base by including quasi-experimental and process evaluation approaches, and seeking further insights through participatory qualitative methodologies and costing studies. Although findings overall indicate the value of community interventions in effecting measurable improvements in child and family wellbeing, the quality and rigour of evidence is varied. A strategic

Evidence for recombination in scorpion mitochondrial DNA (Scorpiones: Buthidae).

PubMed

Gantenbein, Benjamin; Fet, Victor; Gantenbein-Ritter, Iris A; Balloux, François

2005-04-07

There has been very little undisputed evidence for recombination in animal mitochondrial DNA (mtDNA) provided so far. Previous unpublished results suggestive of mtDNA recombination in the scorpion family Buthidae, together with cytological evidence for a unique mechanism of mitochondrial fusion in that family, prompted us to investigate this group in more details. First, we sequenced the complete mtDNA genome of Mesobuthus gibbosus, and chose two genes opposing each other (16S and coxI). We then sequenced 150 individuals from the natural populations of four species of Buthidae (Old World genera Buthus and Mesobuthus). We observed strong evidence for widespread recombination through highly significant negative correlations between linkage disequilibrium and physical distance in three out of four species. The evidence is further confirmed when using five other tests for recombination and by the presence of a high amount of homoplasy in phylogenetic trees.

No evidence of decreased risk of colorectal adenomas with white meat, poultry, and fish intake: a meta-analysis of observational studies.

PubMed

Xu, Bin; Sun, Jing; Sun, Yunwei; Huang, Liya; Tang, Yuming; Yuan, Yaozong

2013-04-01

Observational studies on the association between white meat (including fish and poultry) intake and the risk of colorectal adenoma (CRA), the precursor of colorectal cancer, have reported mixed results. To provide a quantitative assessment of this association, we summarized the evidence from observational studies. Relevant studies published on or before April 30, 2012 were identified from MEDLINE and EMBASE. Summary effect size estimates with 95% confidence intervals (CIs) were calculated with a random-effects model. Between-study heterogeneity was assessed using the Cochran Q and I(2) statistics. A total of 23 publications from 21 independent studies (16 case-control and 5 cohort studies) were included in this meta-analysis. Based on high versus low analysis, the summary effect size estimate of CRA was 0.96 (95% CI, 0.84-1.09) for white meat intake, 0.98 (95% CI, 0.80-1.19) for fish intake, and 0.98 (95% CI, 0.80-1.18) for poultry intake. Subgroup analyses revealed that the null associations of CRA with intake of white meat (fish/poultry) were independent of geographic locations, study design, type of food frequency questionnaire, number of cases, and adjustments for confounders, such as body mass index, use of nonsteroidal anti-inflammatory drugs, dietary energy intake, smoking, and physical activity. Intake of white meat (fish/poultry) is not associated with the risk of CRA. Copyright © 2013 Elsevier Inc. All rights reserved.

Earth observations during Space Shuttle mission STS-28 - 8-13 August 1989

NASA Technical Reports Server (NTRS)

Whitehead, Victor S.; Helfert, M. R.; Lulla, K. P.; Amsbury, D. L.; Runco, S. K.

1990-01-01

An overview of the STS-28 earth observation is provided with attention given to meteorology, oceanographic phenomena, and human activity such as urban environments and related land uses. Environmental observations discussed include evidence of a monsoon, vegetation changes such as deforestation, and water pollution and eutrophication of major rivers. Particular attention is paid to atmospheric palls in both the Northern and Southern Hemispheres. Discussion of geological observations focuses on the Mount St. Helens volcano and the little-recognized landform type, the immense illuvial cone. Observation techniques include use of color infrared film and two types of polarization observations.

Online Patient-Provider E-cigarette Consultations: Perceptions of Safety and Harm.

PubMed

Brown-Johnson, Cati G; Burbank, Andrea; Daza, Eric J; Wassmann, Arianna; Chieng, Amy; Rutledge, Geoffrey W; Prochaska, Judith J

2016-12-01

E-cigarettes are popular and unregulated. Patient-provider communications concerning e-cigarettes were characterized to identify patient concerns, provider advice and attitudes, and research needs. An observational study of online patient-provider communications was conducted January 2011-June 2015 from a network providing free medical advice, and analyzed July 2014-May 2016. Patient and provider themes, and provider attitudes toward e-cigarettes (positive, negative, or neutral) were coded qualitatively. Provider attitudes were analyzed with cumulative logit modeling to account for clustering. Patient satisfaction with provider responses was expressed via a Thank function. An increase in e-cigarette-related questions was observed over time. Patient questions (N=512) primarily concerned specific side effects and harms (34%); general safety (27%); e-cigarettes as quit aids (19%); comparison of e-cigarette harms relative to combusted tobacco (18%); use with pre-existing medical conditions (18%); and nicotine-free e-cigarettes (14%). Half of provider responses discussed e-cigarettes as a harm reduction option (48%); 26% discussed them as quit aids. Overall, 47% of providers' responses represented a negative attitude toward e-cigarettes; 33% were neutral (contradictory or non-committal); and 20% were positive. Attitudes did not differ statistically by medical specialty; provider responses positive toward e-cigarettes received significantly more Thanks. Examination of online patient-provider communications provides insight into consumer health experience with emerging alternative tobacco products. Patient concerns largely related to harms and safety, and patients preferred provider responses positively inclined toward e-cigarettes. Lacking conclusive evidence of e-cigarette safety or efficacy, healthcare providers encouraged smoking cessation and recommended first-line cessation treatment approaches. Copyright © 2016 American Journal of Preventive Medicine. Published by

The Impact of Ocean Observations in Seasonal Climate Prediction

NASA Technical Reports Server (NTRS)

Rienecker, Michele; Keppenne, Christian; Kovach, Robin; Marshak, Jelena

2010-01-01

The ocean provides the most significant memory for the climate system. Hence, a critical element in climate forecasting with coupled models is the initialization of the ocean with states from an ocean data assimilation system. Remotely-sensed ocean surface fields (e.g., sea surface topography, SST, winds) are now available for extensive periods and have been used to constrain ocean models to provide a record of climate variations. Since the ocean is virtually opaque to electromagnetic radiation, the assimilation of these satellite data is essential to extracting the maximum information content. More recently, the Argo drifters have provided unprecedented sampling of the subsurface temperature and salinity. Although the duration of this observation set has been too short to provide solid statistical evidence of its impact, there are indications that Argo improves the forecast skill of coupled systems. This presentation will address the impact these different observations have had on seasonal climate predictions with the GMAO's coupled model.

Chemical variations observed on Aeolis Mons in Gale Crater, Mars

NASA Astrophysics Data System (ADS)

Frydenvang, Jens; Gasda, Patrick J.; Thompson, Lucy; Hurowitz, Joel; Grotzinger, John P.; Blaney, Diana L.; Gellert, Ralf; Wiens, Roger; Vasavada, Ashwin R.; MSL Science Team

2016-10-01

The extraordinarily extensive exposure of hematite-, clay-, sulfate-bearing stratigraphic layers in the lower part of Aeolis Mons was the primary reason Gale Crater was selected as the landing site for the Mars Science Laboratory rover, Curiosity. 753 martian solar days (sols) after the Curiosity rover landed in Gale Crater in August 2012, and after driving more than 9 km, the Curiosity rover arrived at the first exposure of the Murray formation, the basal layer of Aeolis Mons. The Murray formation is a thinly laminated lacustrine mudstone showing stratification down to the millimeter scale. This supports the idea that the stratigraphic layers of Aeolis Mons are sedimentary, and likely deposited in a series of long-lived lakes extending into the early Hesperian time, as recently described by Grotzinger et al. (Science, vol. 350, 2015). The chemical variations observed throughout the Murray formation by the ChemCam and APXS instruments in the 600+ sols since first arriving at Aeolis Mons will be presented. While Murray remains thinly laminated throughout the 30+ vertical meters of stratigraphy explored, large chemical variations are observed. The most extreme variations arise from likely co-located detrital and diagenetic silica enrichments in Murray. Remarkably, an associated diagenetic silica enrichment is also observed in the unconformably overlying eolian sandstone of the Stimson formation in that location. The detrital enrichment provides evidence of how the source region chemistry varied as the sedimentary layers of Aeolis Mons were deposited. Conversely, the diagenetic enrichment observed across both the Murray and Stimson formations provides compelling evidence for the presence of subsurface fluids in Gale Crater, thousands to millions of years after the crater lakes disappeared. This evidence of liquid water greatly extends the timescale in which Gale Crater might have been habitable.

Surface of Venus - Evidence of diverse landforms from radar observations

NASA Technical Reports Server (NTRS)

Malin, M. C.; Saunders, R. S.

1977-01-01

Radar images seem to indicate that some regions of Venus have remained little altered since a period of intense bombardment similar to that recorded by the many large impact craters on the moon. On the other hand, there is evidence in other regions that Venus has been a geologically active planet, forming diverse landforms, and perhaps rivaling the earth in the breadth of features portrayed on its surface

The Evidence-Based Manifesto for School Librarians

ERIC Educational Resources Information Center

Todd, Ross

2008-01-01

School Library Journal's 2007 Leadership Summit, "Where's the Evidence? Understanding the Impact of School Libraries," focused on the topic of evidence-based practice. Evidence-based school librarianship is a systematic approach that engages research-derived evidence, school librarian-observed evidence, and user-reported evidence in the processes…

A century of ocean warming on Florida Keys coral reefs: historic in situ observations

USGS Publications Warehouse

Kuffner, Ilsa B.; Lidz, Barbara H.; Hudson, J. Harold; Anderson, Jeffery S.

2015-01-01

There is strong evidence that global climate change over the last several decades has caused shifts in species distributions, species extinctions, and alterations in the functioning of ecosystems. However, because of high variability on short (i.e., diurnal, seasonal, and annual) timescales as well as the recency of a comprehensive instrumental record, it is difficult to detect or provide evidence for long-term, site-specific trends in ocean temperature. Here we analyze five in situ datasets from Florida Keys coral reef habitats, including historic measurements taken by lighthouse keepers, to provide three independent lines of evidence supporting approximately 0.8 °C of warming in sea surface temperature (SST) over the last century. Results indicate that the warming observed in the records between 1878 and 2012 can be fully accounted for by the warming observed in recent decades (from 1975 to 2007), documented using in situ thermographs on a mid-shore patch reef. The magnitude of warming revealed here is similar to that found in other SST datasets from the region and to that observed in global mean surface temperature. The geologic context and significance of recent ocean warming to coral growth and population dynamics are discussed, as is the future prognosis for the Florida reef tract.

Evidence for Precise Calendrical Observations in the 17th Century at the `Bruchhauser Steine', Olsberg, Northrhine-Westphalia, Germany

NASA Astrophysics Data System (ADS)

Steinrücken, B.

The `Bruchhauser Steine', four large rocks of volcanic origin in southern Westphalia, form perfect foresights for calendrical observations from the surrounding country. The ancient walls and embankments on the `Istenberg' with the rocks as cornerstones were built 500 BC. In the landscape are placed shrines with images of Christian saints, erected in the late 17th and the early 18th century. The positions of these shrines can be interpreted as observing sites with respect to the stones. The foresights reach several degrees to the sky, so variations in the astronomical refraction are strongly suppressed. The most impressive observing site with a shrine of 1699 (8o31'13'' E, 51o18'49'' N) is exactly at the position to observe the summer solstice sunrise at the topmost rock, the `Feldstein'. The solstice sun rises between two stones and grazes the Feldstein at 6:20 CEST. Today the sun is obstructed 2'-3' by the stone. Taking into account the slight variation of the obliquity of the ecliptic of 2' since 1699 the grazing procedure at the time of erection was perfect, without any obstruction of the suns disc. Similar shrines are placed at positions to observe the sunrise on May 1st in the identical manner (8o29'39'' E, 51o18'41'' N) and the lunar declination minimum on the meridian (8o32'44'' E, 51o20'33'' N). Some evidence indicates a prehistoric origin of this calendrical system.

Fossil Fishes from China Provide First Evidence of Dermal Pelvic Girdles in Osteichthyans

PubMed Central

Zhu, Min; Yu, Xiaobo; Choo, Brian; Qu, Qingming; Jia, Liantao; Zhao, Wenjin; Qiao, Tuo; Lu, Jing

2012-01-01

Background The pectoral and pelvic girdles support paired fins and limbs, and have transformed significantly in the diversification of gnathostomes or jawed vertebrates (including osteichthyans, chondrichthyans, acanthodians and placoderms). For instance, changes in the pectoral and pelvic girdles accompanied the transition of fins to limbs as some osteichthyans (a clade that contains the vast majority of vertebrates – bony fishes and tetrapods) ventured from aquatic to terrestrial environments. The fossil record shows that the pectoral girdles of early osteichthyans (e.g., Lophosteus, Andreolepis, Psarolepis and Guiyu) retained part of the primitive gnathostome pectoral girdle condition with spines and/or other dermal components. However, very little is known about the condition of the pelvic girdle in the earliest osteichthyans. Living osteichthyans, like chondrichthyans (cartilaginous fishes), have exclusively endoskeletal pelvic girdles, while dermal pelvic girdle components (plates and/or spines) have so far been found only in some extinct placoderms and acanthodians. Consequently, whether the pectoral and pelvic girdles are primitively similar in osteichthyans cannot be adequately evaluated, and phylogeny-based inferences regarding the primitive pelvic girdle condition in osteichthyans cannot be tested against available fossil evidence. Methodology/Principal Findings Here we report the first discovery of spine-bearing dermal pelvic girdles in early osteichthyans, based on a new articulated specimen of Guiyu oneiros from the Late Ludlow (Silurian) Kuanti Formation, Yunnan, as well as a re-examination of the previously described holotype. We also describe disarticulated pelvic girdles of Psarolepis romeri from the Lochkovian (Early Devonian) Xitun Formation, Yunnan, which resemble the previously reported pectoral girdles in having integrated dermal and endoskeletal components with polybasal fin articulation. Conclusions/Significance The new findings reveal

Toward More Evidence-Based Practice

PubMed Central

Hotelling, Barbara A.

2005-01-01

Childbirth educators are responsible for providing expectant parents with evidence-based information. In this column, the author suggests resources where educators can find evidence-based research for best practices. Additionally, the author describes techniques for childbirth educators to use in presenting research-based information in their classes. A sample of Web sites and books that offer evidence-based resources for expectant parents is provided. PMID:17273422

Metaproteomics Provides Functional Insight into Activated Sludge Wastewater Treatment

PubMed Central

Wilmes, Paul; Wexler, Margaret; Bond, Philip L.

2008-01-01

Background Through identification of highly expressed proteins from a mixed culture activated sludge system this study provides functional evidence of microbial transformations important for enhanced biological phosphorus removal (EBPR). Methodology/Principal Findings A laboratory-scale sequencing batch reactor was successfully operated for different levels of EBPR, removing around 25, 40 and 55 mg/l P. The microbial communities were dominated by the uncultured polyphosphate-accumulating organism “Candidatus Accumulibacter phosphatis”. When EBPR failed, the sludge was dominated by tetrad-forming α-Proteobacteria. Representative and reproducible 2D gel protein separations were obtained for all sludge samples. 638 protein spots were matched across gels generated from the phosphate removing sludges. 111 of these were excised and 46 proteins were identified using recently available sludge metagenomic sequences. Many of these closely match proteins from “Candidatus Accumulibacter phosphatis” and could be directly linked to the EBPR process. They included enzymes involved in energy generation, polyhydroxyalkanoate synthesis, glycolysis, gluconeogenesis, glycogen synthesis, glyoxylate/TCA cycle, fatty acid β oxidation, fatty acid synthesis and phosphate transport. Several proteins involved in cellular stress response were detected. Conclusions/Significance Importantly, this study provides direct evidence linking the metabolic activities of “Accumulibacter” to the chemical transformations observed in EBPR. Finally, the results are discussed in relation to current EBPR metabolic models. PMID:18392150

Observational evidence for enhanced magnetic activity of superflare stars.

PubMed

Karoff, Christoffer; Knudsen, Mads Faurschou; De Cat, Peter; Bonanno, Alfio; Fogtmann-Schulz, Alexandra; Fu, Jianning; Frasca, Antonio; Inceoglu, Fadil; Olsen, Jesper; Zhang, Yong; Hou, Yonghui; Wang, Yuefei; Shi, Jianrong; Zhang, Wei

2016-03-24

Superflares are large explosive events on stellar surfaces one to six orders-of-magnitude larger than the largest flares observed on the Sun throughout the space age. Due to the huge amount of energy released in these superflares, it has been speculated if the underlying mechanism is the same as for solar flares, which are caused by magnetic reconnection in the solar corona. Here, we analyse observations made with the LAMOST telescope of 5,648 solar-like stars, including 48 superflare stars. These observations show that superflare stars are generally characterized by larger chromospheric emissions than other stars, including the Sun. However, superflare stars with activity levels lower than, or comparable to, the Sun do exist, suggesting that solar flares and superflares most likely share the same origin. The very large ensemble of solar-like stars included in this study enables detailed and robust estimates of the relation between chromospheric activity and the occurrence of superflares.

Observational evidence for enhanced magnetic activity of superflare stars

PubMed Central

Karoff, Christoffer; Knudsen, Mads Faurschou; De Cat, Peter; Bonanno, Alfio; Fogtmann-Schulz, Alexandra; Fu, Jianning; Frasca, Antonio; Inceoglu, Fadil; Olsen, Jesper; Zhang, Yong; Hou, Yonghui; Wang, Yuefei; Shi, Jianrong; Zhang, Wei

2016-01-01

Superflares are large explosive events on stellar surfaces one to six orders-of-magnitude larger than the largest flares observed on the Sun throughout the space age. Due to the huge amount of energy released in these superflares, it has been speculated if the underlying mechanism is the same as for solar flares, which are caused by magnetic reconnection in the solar corona. Here, we analyse observations made with the LAMOST telescope of 5,648 solar-like stars, including 48 superflare stars. These observations show that superflare stars are generally characterized by larger chromospheric emissions than other stars, including the Sun. However, superflare stars with activity levels lower than, or comparable to, the Sun do exist, suggesting that solar flares and superflares most likely share the same origin. The very large ensemble of solar-like stars included in this study enables detailed and robust estimates of the relation between chromospheric activity and the occurrence of superflares. PMID:27009381

Evidence against observational spatial memory for cache locations of conspecifics in marsh tits Poecile palustris.

PubMed

Urhan, A Utku; Emilsson, Ellen; Brodin, Anders

2017-01-01

Many species in the family Paridae, such as marsh tits Poecile palustris , are large-scale scatter hoarders of food that make cryptic caches and disperse these in large year-round territories. The perhaps most well-known species in the family, the great tit Parus major , does not store food itself but is skilled in stealing caches from the other species. We have previously demonstrated that great tits are able to memorise positions of caches they have observed marsh tits make and later return and steal the food. As great tits are explorative in nature and unusually good learners, it is possible that such "memorisation of caches from a distance" is a unique ability of theirs. The other possibility is that this ability is general in the parid family. Here, we tested marsh tits in the same experimental set-up as where we previously have tested great tits. We allowed caged marsh tits to observe a caching conspecific in a specially designed indoor arena. After a retention interval of 1 or 24 h, we allowed the observer to enter the arena and search for the caches. The marsh tits showed no evidence of such observational memorization ability, and we believe that such ability is more useful for a non-hoarding species. Why should a marsh tit that memorises hundreds of their own caches in the field bother with the difficult task of memorising other individuals' caches? We argue that the close-up memorisation procedure that marsh tits use at their own caches may be a different type of observational learning than memorisation of caches made by others. For example, the latter must be done from a distance and hence may require the ability to adopt an allocentric perspective, i.e. the ability to visualise the cache from the hoarder's perspective. Members of the Paridae family are known to possess foraging techniques that are cognitively advanced. Previously, we have demonstrated that a non-hoarding parid species, the great tit P. major , is able to memorise positions of caches

From evidence to action

PubMed Central

Verheyen, Cees CPM; Kerkhoffs, Gino M; Bhandari, Mohit; Schünemann, Holger J

2009-01-01

ABSTRACT Good guidelines will help us to take evidence into practice. In a survey among Dutch orthopedic surgeons, development and use of evidence-based guidelines was perceived as one of the best ways of moving from opinion-based to evidence-based orthopedic practice. The increasing number of guidelines means that knowing how to make a critical appraisal of guidelines is now a key part of every surgeon’s life. This is particularly true because guidelines use varying systems to judge the quality of evidence and the strength of recommendations. In this manuscript we discuss what a guideline is, where we can find guidelines, how to evaluate the quality of guidelines, and finally provide an example on the different steps of guideline development. Thus, we show that good guidelines are a summary of the best available evidence and that they provide a graded recommendation to help surgeons in evidence-based practice. PMID:19234892

Microtubules provide directional information for core PCP function

PubMed Central

Matis, Maja; Russler-Germain, David A; Hu, Qie; Tomlin, Claire J; Axelrod, Jeffrey D

2014-01-01

Planar cell polarity (PCP) signaling controls the polarization of cells within the plane of an epithelium. Two molecular modules composed of Fat(Ft)/Dachsous(Ds)/Four-jointed(Fj) and a ‘PCP-core’ including Frizzled(Fz) and Dishevelled(Dsh) contribute to polarization of individual cells. How polarity is globally coordinated with tissue axes is unresolved. Consistent with previous results, we find that the Ft/Ds/Fj-module has an effect on a MT-cytoskeleton. Here, we provide evidence for the model that the Ft/Ds/Fj-module provides directional information to the core-module through this MT organizing function. We show Ft/Ds/Fj-dependent initial polarization of the apical MT-cytoskeleton prior to global alignment of the core-module, reveal that the anchoring of apical non-centrosomal MTs at apical junctions is polarized, observe that directional trafficking of vesicles containing Dsh depends on Ft, and demonstrate the feasibility of this model by mathematical simulation. Together, these results support the hypothesis that Ft/Ds/Fj provides a signal to orient core PCP function via MT polarization. DOI: http://dx.doi.org/10.7554/eLife.02893.001 PMID:25124458

Transdisciplinary collaboration and endorsement of pharmacological and psychosocial evidence-based practices by medical and psychosocial substance abuse treatment providers in the United States.

PubMed

Pinto, Rogério M; Spector, Anya Y; Yu, Gary; Campbell, Aimee N C

To examine the relative contribution of providers' professional affiliation (medical vs. non-medical), involvement in research, and training needs for associations with endorsement of the following evidence-based practices (EBPs): (1) pharmacological - buprenorphine treatment and (2) psychosocial - Cognitive Behavioural Therapy (CBT). Secondary analysis from a 2008 survey of a national sample ( n = 571) of substance abuse treatment providers (medical, social workers, psychologists and counsellors) affiliated with the United States National Institute on Drug Abuse's National Drug Abuse Treatment Clinical Trials Network. Multivariate linear regression models to analyze cross-sectional survey data. Results demonstrated that medical providers and providers with previous research involvement more strongly endorsed the effectiveness of buprenorphine over CBT. Compared to medical providers, psychosocial providers more strongly endorsed CBT. There was a positive association between needing training in rapport with patients and endorsement of buprenorphine and a negative association with CBT. There was a positive association between needing training in behavioural management and needs assessment and endorsement of CBT. Results underscore the importance of providers' involvement in research and the need for training medical and non-medical providers in practice areas that can purposely enhance their use of pharmacological and psychosocial EBPs.

Assessing Spectral Evidence of Aqueous Activity in Two Putative Martian Paleolakes

NASA Technical Reports Server (NTRS)

Roush, Ted L.; Marzo, Giuseppe A.; Fonti, Sergio; Orofino, Vicenzo; Blanco, Armando; Gross, Christoph; Wendt, Lorenz

2011-01-01

We evaluate the evidence for the presence of mineral spectral signatures indicative of the past presence of water at two putative paleolakes on Mars using observations by the Mars Reconnaissance Orbiter (MRO) Compact Reconnaissance Image Spectrometer for Mars (CRISM). CRISM spectra of both sites are consistent with laboratory spectra of Mg-rich phyllosilicates. Our analysis represents the first detailed evaluation of these locations. The spatial occurrence and association with topographic features within the craters is distinctly different for the two sites. The occurrence of these minerals supports the conclusion that water was once active in the areas sampled by these craters. The distribution of the phyllosilicates in Luqa does not provide distinctive evidence for the presence of a previous standing body of water and is consistent with either impact emplacement or post-impact alteration. For Cankuzo, the phyllosilicate distribution provides evidence of a layer in the crater wall indicative of aqueous activity, but does not require a paleolake.

The final Galileo SSI observations of Io: Orbits G28-I33

USGS Publications Warehouse

Turtle, E.P.; Keszthelyi, L.P.; McEwen, A.S.; Radebaugh, J.; Milazzo, M.; Simonelli, D.P.; Geissler, P.; Williams, D.A.; Perry, J.; Jaeger, W.L.; Klaasen, K.P.; Breneman, H.H.; Denk, T.; Phillips, C.B.

2004-01-01

We present the observations of Io acquired by the Solid State Imaging (SSI) experiment during the Galileo Millennium Mission (GMM) and the strategy we used to plan the exploration of Io. Despite Galileo's tight restrictions on data volume and downlink capability and several spacecraft and camera anomalies due to the intense radiation close to Jupiter, there were many successful SSI observations during GMM. Four giant, high-latitude plumes, including the largest plume ever observed on Io, were documented over a period of eight months; only faint evidence of such plumes had been seen since the Voyager 2 encounter, despite monitoring by Galileo during the previous five years. Moreover, the source of one of the plumes was Tvashtar Catena, demonstrating that a single site can exhibit remarkably diverse eruption styles - from a curtain of lava fountains, to extensive surface flows, and finally a ??? 400 km high plume - over a relatively short period of time (??? 13 months between orbits 125 and G29). Despite this substantial activity, no evidence of any truly new volcanic center was seen during the six years of Galileo observations. The recent observations also revealed details of mass wasting processes acting on Io. Slumping and landsliding dominate and occur in close proximity to each other, demonstrating spatial variation in material properties over distances of several kilometers. However, despite the ubiquitous evidence for mass wasting, the rate of volcanic resurfacing seems to dominate; the floors of paterae in proximity to mountains are generally free of debris. Finally, the highest resolution observations obtained during Galileo's final encounters with Io provided further evidence for a wide diversity of surface processes at work on Io. ?? 2003 Elsevier Inc. All rights reserved.

Evidence of redshifts in the average solar line profiles of C IV and Si IV from OSO-8 observations

NASA Technical Reports Server (NTRS)

Roussel-Dupre, D.; Shine, R. A.

1982-01-01

Line profiles of C IV and Si V obtained by the Colorado spectrometer on OSO-8 are presented. It is shown that the mean profiles are redshifted with a magnitude varying from 6-20 km/s, and with a mean of 12 km/s. An apparent average downflow of material in the 50,000-100,000 K temperature range is measured. The redshifts are observed in the line center positions of spatially and temporally averaged profiles and are measured either relative to chromospheric Si I lines or from a comparison of sun center and limb profiles. The observations of 6-20 km/s redshifts place constraints on the mechanisms that dominate EUV line emission since it requires a strong weighting of the emission in regions of downward moving material, and since there is little evidence for corresponding upward moving materials in these lines.

Cusp observation at Saturn's high-latitude magnetosphere by the Cassini spacecraft.

PubMed

Jasinski, J M; Arridge, C S; Lamy, L; Leisner, J S; Thomsen, M F; Mitchell, D G; Coates, A J; Radioti, A; Jones, G H; Roussos, E; Krupp, N; Grodent, D; Dougherty, M K; Waite, J H

2014-03-16

We report on the first analysis of magnetospheric cusp observations at Saturn by multiple in situ instruments onboard the Cassini spacecraft. Using this we infer the process of reconnection was occurring at Saturn's magnetopause. This agrees with remote observations that showed the associated auroral signatures of reconnection. Cassini crossed the northern cusp around noon local time along a poleward trajectory. The spacecraft observed ion energy-latitude dispersions-a characteristic signature of the terrestrial cusp. This ion dispersion is "stepped," which shows that the reconnection is pulsed. The ion energy-pitch angle dispersions suggest that the field-aligned distance from the cusp to the reconnection site varies between ∼27 and 51 R S . An intensification of lower frequencies of the Saturn kilometric radiation emissions suggests the prior arrival of a solar wind shock front, compressing the magnetosphere and providing more favorable conditions for magnetopause reconnection. We observe evidence for reconnection in the cusp plasma at SaturnWe present evidence that the reconnection process can be pulsed at SaturnSaturn's cusp shows similar characteristics to the terrestrial cusp.

Assessing mental health clinicians' intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale.

PubMed

Williams, Nathaniel J

2016-05-05

Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians' EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians' intentions to adopt EBTs. The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed. Findings support the EBTI's factor structure (χ (2) = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians' observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p < .05), self-reported EBT adoption at a 12-month follow-up (R (2) = .17, p < .001), and self-reported use of EBTs with clients at a 12-month follow-up (R (2) = .25, p < .001). Discriminant validity evidence was provided by small associations with clinicians' concurrently measured psychological work climate perceptions of functionality (R (2) = .06, p < .05), engagement (R (2) = .06, p < .05), and stress (R (2) = .00, ns). The EBTI is a practical and theoretically grounded measure of mental health clinicians' EBT intentions. Scores on the EBTI provide a basis for valid inferences regarding mental health clinicians' intentions to adopt EBTs. Discussion focuses on research and practice applications.

Towards Trustable Digital Evidence with PKIDEV: PKI Based Digital Evidence Verification Model

NASA Astrophysics Data System (ADS)

Uzunay, Yusuf; Incebacak, Davut; Bicakci, Kemal

How to Capture and Preserve Digital Evidence Securely? For the investigation and prosecution of criminal activities that involve computers, digital evidence collected in the crime scene has a vital importance. On one side, it is a very challenging task for forensics professionals to collect them without any loss or damage. On the other, there is the second problem of providing the integrity and authenticity in order to achieve legal acceptance in a court of law. By conceiving digital evidence simply as one instance of digital data, it is evident that modern cryptography offers elegant solutions for this second problem. However, to our knowledge, there is not any previous work proposing a systematic model having a holistic view to address all the related security problems in this particular case of digital evidence verification. In this paper, we present PKIDEV (Public Key Infrastructure based Digital Evidence Verification model) as an integrated solution to provide security for the process of capturing and preserving digital evidence. PKIDEV employs, inter alia, cryptographic techniques like digital signatures and secure time-stamping as well as latest technologies such as GPS and EDGE. In our study, we also identify the problems public-key cryptography brings when it is applied to the verification of digital evidence.

Multi-color interferometric observations of Mira stars

NASA Technical Reports Server (NTRS)

Mennesson, B.; Creech-Eakman, M.; Thompson, B. B.; Foresto, V. Coude du; Merand, A.; Ridgway, S.; Perrin, G.

2002-01-01

Interferometric observations in the atmospheric windows of the near infrared (1 to 4 microns) can be efficiently used to probe the chemical composition of Miras atmosphere and provide direct measurements of extended gas layers around these stars. This is illustrated by recent Miras observations carried out with the FLUOR instrument of the IOTA interferometer (Mennesson et al. 2002, and Perrin et al. proceedings of this conference) and with the PTI test-bed (Thompson 2002, Thompson et al. 2002). These visibility measurements show evidence for continuum emission from very extended ( 2-3 stellar radii) semi-transparent gaseous atmospheric layers, and large apparent diameter changes with pulsation phase. Interestingly these observations are consistent with the extended molecular gas layers (H20, CO ...) already inferred around some of these objects from IS0 and high resolution ground-based FTS infrared spectra.

Landsat-based Earth Observations and Crowd-sourced Data Provide Near Real-time Monitoring of Chimpanzee Habitat

NASA Astrophysics Data System (ADS)

Nackoney, J.; Pintea, L.; Jantz, S.; Hansen, M.

2015-12-01

The endangered chimpanzee (Pan troglodytes) is threatened by habitat loss from resource extraction and land conversion, as well as hunting, disease and the illegal pet trade. It has been estimated that more than 70% of chimpanzee's tropical forest habitats in Africa are now threatened by land use change. Recent developments in remote sensing and cloud computing enable the use of satellite observations to provide a synoptic view of chimpanzee habitats at finer spatial and temporal resolutions that are locally relevant and consistent across the entire species' range. We present a practical Decision Support System to be used by the Jane Goodall Institute and partners to annually monitor and forecast chimpanzee habitat health in Africa. The system integrates Earth observations from 30-meter resolution Landsat data with a species-specific habitat model and a model forecasting future land use change, enhanced by crowd-sourced field data collected by local communities and rangers using the Open Data Kit app and Android mobile smartphones and tablets. While coarser-scale and static chimpanzee habitat models have been previously developed, this project is the first to develop a dynamic monitoring system updated annually via Earth observations data that will systematically monitor threats and changes in habitat over time. Since the chimpanzee is an important keystone, flagship and umbrella species, an annual chimpanzee habitat health index would support conservation goals of other species within its large 2.5 million sq. km range and could be an important indicator of overall ecosystem health of tropical forests in Africa.

Distant Healing Intention Therapies: An Overview of the Scientific Evidence

PubMed Central

Schlitz, Marilyn; Baur, Christopher

2015-01-01

This article provides a broad overview of “distant healing intention” (DHI) therapies, ie, intentional healing modalities claimed to transcend the usual constraints of distance through space or time. We provide a summary of previous reviews and meta-analyses that have explored a diverse array of DHI modalities, outcome measures, and experimental protocols. While some significant experimental effects have been observed, the evidence to date does not yet provide confidence in its clinical efficacy. The purported “nonlocal” nature of DHI raises significant methodological and theoretical challenges. We recommend several avenues for improving future research. PMID:26665044

Juno‐UVS approach observations of Jupiter's auroras

PubMed Central

Versteeg, M. H.; Greathouse, T. K.; Hue, V.; Davis, M. W.; Gérard, J.‐C.; Grodent, D. C.; Bonfond, B.; Nichols, J. D.; Wilson, R. J.; Hospodarsky, G. B.; Bolton, S. J.; Levin, S. M.; Connerney, J. E. P.; Adriani, A.; Kurth, W. S.; Mauk, B. H.; Valek, P.; McComas, D. J.; Orton, G. S.; Bagenal, F.

2017-01-01

Abstract Juno ultraviolet spectrograph (UVS) observations of Jupiter's aurora obtained during approach are presented. Prior to the bow shock crossing on 24 June 2016, the Juno approach provided a rare opportunity to correlate local solar wind conditions with Jovian auroral emissions. Some of Jupiter's auroral emissions are expected to be controlled or modified by local solar wind conditions. Here we compare synoptic Juno‐UVS observations of Jupiter's auroral emissions, acquired during 3–29 June 2016, with in situ solar wind observations, and related Jupiter observations from Earth. Four large auroral brightening events are evident in the synoptic data, in which the total emitted auroral power increases by a factor of 3–4 for a few hours. Only one of these brightening events correlates well with large transient increases in solar wind ram pressure. The brightening events which are not associated with the solar wind generally have a risetime of ~2 h and a decay time of ~5 h. PMID:28989207

Juno-UVS approach observations of Jupiter's auroras

NASA Astrophysics Data System (ADS)

Gladstone, G. R.; Versteeg, M. H.; Greathouse, T. K.; Hue, V.; Davis, M. W.; Gérard, J.-C.; Grodent, D. C.; Bonfond, B.; Nichols, J. D.; Wilson, R. J.; Hospodarsky, G. B.; Bolton, S. J.; Levin, S. M.; Connerney, J. E. P.; Adriani, A.; Kurth, W. S.; Mauk, B. H.; Valek, P.; McComas, D. J.; Orton, G. S.; Bagenal, F.

2017-08-01

Juno ultraviolet spectrograph (UVS) observations of Jupiter's aurora obtained during approach are presented. Prior to the bow shock crossing on 24 June 2016, the Juno approach provided a rare opportunity to correlate local solar wind conditions with Jovian auroral emissions. Some of Jupiter's auroral emissions are expected to be controlled or modified by local solar wind conditions. Here we compare synoptic Juno-UVS observations of Jupiter's auroral emissions, acquired during 3-29 June 2016, with in situ solar wind observations, and related Jupiter observations from Earth. Four large auroral brightening events are evident in the synoptic data, in which the total emitted auroral power increases by a factor of 3-4 for a few hours. Only one of these brightening events correlates well with large transient increases in solar wind ram pressure. The brightening events which are not associated with the solar wind generally have a risetime of 2 h and a decay time of 5 h.

Juno-UVS approach observations of Jupiter's auroras.

PubMed

Gladstone, G R; Versteeg, M H; Greathouse, T K; Hue, V; Davis, M W; Gérard, J-C; Grodent, D C; Bonfond, B; Nichols, J D; Wilson, R J; Hospodarsky, G B; Bolton, S J; Levin, S M; Connerney, J E P; Adriani, A; Kurth, W S; Mauk, B H; Valek, P; McComas, D J; Orton, G S; Bagenal, F

2017-08-16

Juno ultraviolet spectrograph (UVS) observations of Jupiter's aurora obtained during approach are presented. Prior to the bow shock crossing on 24 June 2016, the Juno approach provided a rare opportunity to correlate local solar wind conditions with Jovian auroral emissions. Some of Jupiter's auroral emissions are expected to be controlled or modified by local solar wind conditions. Here we compare synoptic Juno-UVS observations of Jupiter's auroral emissions, acquired during 3-29 June 2016, with in situ solar wind observations, and related Jupiter observations from Earth. Four large auroral brightening events are evident in the synoptic data, in which the total emitted auroral power increases by a factor of 3-4 for a few hours. Only one of these brightening events correlates well with large transient increases in solar wind ram pressure. The brightening events which are not associated with the solar wind generally have a risetime of ~2 h and a decay time of ~5 h.

Observations and Laboratory Data of Planetary Organics

NASA Technical Reports Server (NTRS)

Roush, Ted L.

2002-01-01

Many efforts are underway to search for evidence of prebiotic materials in the outer solar system. Current and planned Mars missions obtain remote sensing observations that can be used to address the potential presence of prebiotic materials. Additional missions to, and continuing earth-based observations of, more distant solar system objects will also provide remote sensing observations that can be used to address the potential presence of prebiotic materials. I will present an overview of on-going observations, associated laboratory investigations of candidate materials, and theoretical modeling of observational data. In the past the room temperature reflectance spectra of many residues created from HC-bearing gases and solids have been reported. The results of an investigation of what effect temperatures more representative of outer solar system surfaces (50-140K) have on the reflectance spectra of these residues, and the associated interpretations, will be presented. The relatively organic-rich Tagish Lake Meteorite has been suggested as a spectral analog for Dtype asteroids. Using a new approach that relies upon iterative use of Hapke theory and Kraniers-Kronig analysis the optical constants of TLM were estimated. The approach and results of the analysis will be presented. Use of optical constants in scattering theories, such as the Hapke theory, provide the ability to determine quantitative estimates of the relative abundances and grain sizes of candidate surface components. This approach has been applied to interpret the reflectance spectra of several outer solar system surfaces. A summary will be provided describing the results of such modeling efforts.

Do Preferences for Job Attributes Provide Evidence of "Hierarchy of Needs"?

ERIC Educational Resources Information Center

Baslevent, Cem; Kirmanoglu, Hasan

2013-01-01

We examine whether employees' preferences for various job attributes are associated with their individual characteristics in ways that are in line with "hierarchy of needs" theories. Using data from the fifth round of the European Social Survey, we observe the influence of socio-demographic and dispositional characteristics as well as…

[Evidence and Evidence Gaps - an Introduction].

PubMed

Dreier, G; Löhler, J

2016-04-01

Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

Using Certification to Promote Uptake of Real-World Evidence by Payers.

PubMed

Segal, Jodi B; Kallich, Joel D; Oppenheim, Emma R; Garrison, Louis P; Iqbal, Sheikh Usman; Kessler, Marla; Alexander, G Caleb

2016-03-01

Most randomized controlled trials are unable to generate information about a product's real-world effectiveness. Therefore, payers use real-world evidence (RWE) generated in observational studies to make decisions regarding formulary inclusion and coverage. While some payers generate their own RWE, most cautiously rely on RWE produced by manufacturers who have a strong financial interest in obtaining coverage for their products. We propose a process by which an independent body would certify observational studies as generating valid and unbiased estimates of the effectiveness of the intervention under consideration. This proposed process includes (a) establishing transparent criteria for assessment, (b) implementing a process for receipt and review of observational study protocols from interested parties, (c) reviewing the submitted protocol and requesting any necessary revisions, (d) reviewing the study results, (e) assigning a certification status to the submitted evidence, and (f) communicating the certification status to all who seek to use this evidence for decision making. Accrediting organizations such as the National Center for Quality Assurance and the Joint Commission have comparable goals of providing assurance about quality to those who look to their accreditation results. Although we recognize potential barriers, including a slowing of evidence generation and costs, we anticipate that processes can be streamlined, such as when familiar methods or familiar datasets are used. The financial backing for such activities remains uncertain, as does identification of organizations that might serve this certification function. We suggest that the rigor and transparency that will be required with such a process, and the unassailable evidence that it will produce, will be valuable to decision makers.

Rényi entropies and observables.

PubMed

Lesche, Bernhard

2004-01-01

Evidence is given that Rényi entropies of macroscopic thermodynamic systems defined on the bases of probabilities of microstates cannot be related to observables. The notion of observable is clarified.

Using perceptions as evidence to improve conservation and environmental management.

PubMed

Bennett, Nathan James

2016-06-01

The conservation community is increasingly focusing on the monitoring and evaluation of management, governance, ecological, and social considerations as part of a broader move toward adaptive management and evidence-based conservation. Evidence is any information that can be used to come to a conclusion and support a judgment or, in this case, to make decisions that will improve conservation policies, actions, and outcomes. Perceptions are one type of information that is often dismissed as anecdotal by those arguing for evidence-based conservation. In this paper, I clarify the contributions of research on perceptions of conservation to improving adaptive and evidence-based conservation. Studies of the perceptions of local people can provide important insights into observations, understandings and interpretations of the social impacts, and ecological outcomes of conservation; the legitimacy of conservation governance; and the social acceptability of environmental management. Perceptions of these factors contribute to positive or negative local evaluations of conservation initiatives. It is positive perceptions, not just objective scientific evidence of effectiveness, that ultimately ensure the support of local constituents thus enabling the long-term success of conservation. Research on perceptions can inform courses of action to improve conservation and governance at scales ranging from individual initiatives to national and international policies. Better incorporation of evidence from across the social and natural sciences and integration of a plurality of methods into monitoring and evaluation will provide a more complete picture on which to base conservation decisions and environmental management. © 2016 Society for Conservation Biology.

Observational evidence of planetary wave influences on ozone enhancements over upper troposphere North Africa

NASA Astrophysics Data System (ADS)

Mengistu Tsidu, Gizaw; Ture, Kassahun; Sivakumar, V.

2013-07-01

MOZAIC instrument measured enhanced ozone on two occasions in February, 1996 and 1997 at cruise altitude over North Africa. The cause and source of ozone enhancements over the region are investigated using additional reanalysis data from ERA-Interim. The ERA-Interim reprocessed GOME ozone indicated existence of enhancement as well. Both observational data revealed that the increase in ozone has wider latitudinal coverage extending from North Europe upto North Africa. The geopotential heights and zonal wind from ERA-Interim have indicated existence of planetary-scale flow that allowed meridional airmass exchanges between subtropics and higher latitudes. The presence of troughs-ridge pattern are attributable to large amplitude waves of zonal wavenumber 1-5 propagating eastward in the winter hemisphere westerly current as determined from Hayashi spectra as well as local fractional variance spectra determined from Multitaper Method-Singular Value Decomposition (MTM-SVD) spectral method. MTM-SVD is also used to understand the role of these waves on ozone enhancement and variability during the observation period in a mechanistic approach. A joint analysis of driving field, such as wind and potential vorticity (PV) for which only signals of the dominant zonal wavenumbers of prevailing planetary waves are retained, has revealed strong linkage between wave activity and ozone enhancement over the region at a temporal cycle of 5.8 days. One of these features is the displacement of the polar vortex southward during the enhancements, allowing strong airmass, energy and momentum exchanges. Evidence of cutoff laws that are formed within the deep trough, characteristics of Rossby wave breaking, is also seen in the ozone horizontal distribution at different pressure levels during the events. The reconstruction of signals with the cycle of 5.8 days has shown that the time and strength of enhancement depend on the circulation patterns dictated by planetary-scale flow relative to the

No evidence for involvement of SDHD in neuroblastoma pathogenesis

PubMed Central

De Preter, Katleen; Vandesompele, Jo; Hoebeeck, Jasmien; Vandenbroecke, Caroline; Smet, Jöel; Nuyts, Annick; Laureys, Geneviève; Combaret, Valérie; Van Roy, Nadine; Roels, Frank; Van Coster, Rudy; Praet, Marleen; De Paepe, Anne; Speleman, Frank

2004-01-01

Background Deletions in the long arm of chromosome 11 are observed in a subgroup of advanced stage neuroblastomas with poor outcome. The deleted region harbours the tumour suppressor gene SDHD that is frequently mutated in paraganglioma and pheochromocytoma, which are, like neuroblastoma, tumours originating from the neural crest. In this study, we sought for evidence for involvement of SDHD in neuroblastoma. Methods SDHD was investigated on the genome, transcriptome and proteome level using mutation screening, methylation specific PCR, real-time quantitative PCR based homozygous deletion screening and mRNA expression profiling, immunoblotting, functional protein analysis and ultrastructural imaging of the mitochondria. Results Analysis at the genomic level of 67 tumour samples and 37 cell lines revealed at least 2 bona-fide mutations in cell lines without allelic loss at 11q23: a 4bp-deletion causing skip of exon 3 resulting in a premature stop codon in cell line N206, and a Y93C mutation in cell line NMB located in a region affected by germline SDHD mutations causing hereditary paraganglioma. No evidence for hypermethylation of the SDHD promotor region was observed, nor could we detect homozygous deletions. Interestingly, SDHD mRNA expression was significantly reduced in SDHD mutated cell lines and cell lines with 11q allelic loss as compared to both cell lines without 11q allelic loss and normal foetal neuroblast cells. However, protein analyses and assessment of mitochondrial morphology presently do not provide clues as to the possible effect of reduced SDHD expression on the neuroblastoma tumour phenotype. Conclusions Our study provides no indications for 2-hit involvement of SDHD in the pathogenesis of neuroblastoma. Also, although a haplo-insufficient mechanism for SDHD involvement in advanced stage neuroblastoma could be considered, the present data do not provide consistent evidence for this hypothesis. PMID:15331017

Direct geoelectrical evidence of mass transfer at the laboratory scale

NASA Astrophysics Data System (ADS)

Swanson, Ryan D.; Singha, Kamini; Day-Lewis, Frederick D.; Binley, Andrew; Keating, Kristina; Haggerty, Roy

2012-10-01

Previous field-scale experimental data and numerical modeling suggest that the dual-domain mass transfer (DDMT) of electrolytic tracers has an observable geoelectrical signature. Here we present controlled laboratory experiments confirming the electrical signature of DDMT and demonstrate the use of time-lapse electrical measurements in conjunction with concentration measurements to estimate the parameters controlling DDMT, i.e., the mobile and immobile porosity and rate at which solute exchanges between mobile and immobile domains. We conducted column tracer tests on unconsolidated quartz sand and a material with a high secondary porosity: the zeolite clinoptilolite. During NaCl tracer tests we collected nearly colocated bulk direct-current electrical conductivity (σb) and fluid conductivity (σf) measurements. Our results for the zeolite show (1) extensive tailing and (2) a hysteretic relation between σf and σb, thus providing evidence of mass transfer not observed within the quartz sand. To identify best-fit parameters and evaluate parameter sensitivity, we performed over 2700 simulations of σf, varying the immobile and mobile domain and mass transfer rate. We emphasized the fit to late-time tailing by minimizing the Box-Cox power transformed root-mean square error between the observed and simulated σf. Low-field proton nuclear magnetic resonance (NMR) measurements provide an independent quantification of the volumes of the mobile and immobile domains. The best-fit parameters based on σf match the NMR measurements of the immobile and mobile domain porosities and provide the first direct electrical evidence for DDMT. Our results underscore the potential of using electrical measurements for DDMT parameter inference.

Direct geoelectrical evidence of mass transfer at the laboratory scale

USGS Publications Warehouse

Swanson, Ryan D.; Singha, Kamini; Day-Lewis, Frederick D.; Binley, Andrew; Keating, Kristina; Haggerty, Roy

2012-01-01

Previous field-scale experimental data and numerical modeling suggest that the dual-domain mass transfer (DDMT) of electrolytic tracers has an observable geoelectrical signature. Here we present controlled laboratory experiments confirming the electrical signature of DDMT and demonstrate the use of time-lapse electrical measurements in conjunction with concentration measurements to estimate the parameters controlling DDMT, i.e., the mobile and immobile porosity and rate at which solute exchanges between mobile and immobile domains. We conducted column tracer tests on unconsolidated quartz sand and a material with a high secondary porosity: the zeolite clinoptilolite. During NaCl tracer tests we collected nearly colocated bulk direct-current electrical conductivity (σb) and fluid conductivity (σf) measurements. Our results for the zeolite show (1) extensive tailing and (2) a hysteretic relation between σf and σb, thus providing evidence of mass transfer not observed within the quartz sand. To identify best-fit parameters and evaluate parameter sensitivity, we performed over 2700 simulations of σf, varying the immobile and mobile domain and mass transfer rate. We emphasized the fit to late-time tailing by minimizing the Box-Cox power transformed root-mean square error between the observed and simulated σf. Low-field proton nuclear magnetic resonance (NMR) measurements provide an independent quantification of the volumes of the mobile and immobile domains. The best-fit parameters based on σf match the NMR measurements of the immobile and mobile domain porosities and provide the first direct electrical evidence for DDMT. Our results underscore the potential of using electrical measurements for DDMT parameter inference.

Experimental observation of Lorenz chaos in the Quincke rotor dynamics.

PubMed

Peters, François; Lobry, Laurent; Lemaire, Elisabeth

2005-03-01

In this paper, we report experimental evidence of Lorenz chaos for the Quincke rotor dynamics. We study the angular motion of an insulating cylinder immersed in slightly conducting oil and submitted to a direct current electric field. The simple equations which describe the dynamics of the rotor are shown to be equivalent to the Lorenz equations. In particular, we observe two bifurcations in our experimental system. Above a critical value of the electric field, the cylinder rotates at a constant rate. At a second bifurcation, the system becomes chaotic. The characteristic shape of the experimental first return map provides strong evidence for Lorenz-type chaos.

Experimental observation of Lorenz chaos in the Quincke rotor dynamics

NASA Astrophysics Data System (ADS)

Peters, François; Lobry, Laurent; Lemaire, Elisabeth

2005-03-01

In this paper, we report experimental evidence of Lorenz chaos for the Quincke rotor dynamics. We study the angular motion of an insulating cylinder immersed in slightly conducting oil and submitted to a direct current electric field. The simple equations which describe the dynamics of the rotor are shown to be equivalent to the Lorenz equations. In particular, we observe two bifurcations in our experimental system. Above a critical value of the electric field, the cylinder rotates at a constant rate. At a second bifurcation, the system becomes chaotic. The characteristic shape of the experimental first return map provides strong evidence for Lorenz-type chaos.

Opioid prescribing by multiple providers in Medicare: retrospective observational study of insurance claims

PubMed Central

Goldman, Dana; Weaver, Lesley; Karaca-Mandic, Pinar

2014-01-01

Objectives To estimate the frequency and characteristics of opioid prescribing by multiple providers in Medicare and the association with hospital admissions related to opioid use. Design Retrospective cohort study. Setting Database of prescription drugs and medical claims in 20% random sample of Medicare beneficiaries in 2010. Participants 1 808 355 Medicare beneficiaries who filled at least one prescription for an opioid from a pharmacy in 2010. Main outcome measures Proportion of beneficiaries who filled opioid prescriptions from multiple providers; proportion of these prescriptions that were concurrently supplied; adjusted rates of hospital admissions related to opioid use associated with multiple provider prescribing. Results Among 1 208 100 beneficiaries with an opioid prescription, 418 530 (34.6%) filled prescriptions from two providers, 171 420 (14.2%) from three providers, and 143 344 (11.9%) from four or more providers. Among beneficiaries with four or more opioid providers, 110 671 (77.2%) received concurrent opioid prescriptions from multiple providers, and the dominant provider prescribed less than half of the mean total prescriptions per beneficiary (7.9/15.2 prescriptions). Multiple provider prescribing was highest among beneficiaries who were also prescribed stimulants, non-narcotic analgesics, and central nervous system, neuromuscular, and antineoplastic drugs. Hospital admissions related to opioid use increased with multiple provider prescribing: the annual unadjusted rate of admission was 1.63% (95% confidence interval 1.58 to 1.67%) for beneficiaries with one provider, 2.08% (2.03% to 2.14%) for two providers, 2.87% (2.77% to 2.97%) for three providers, and 4.83% (4.70% to 4.96%) for four or more providers. Results were similar after covariate adjustment. Conclusions Concurrent opioid prescribing by multiple providers is common in Medicare patients and is associated with higher rates of hospital admission related to opioid use

Impact of Postapproval Evidence Generation on the Biopharmaceutical Industry.

PubMed

Milne, Christopher-Paul; Cohen, Joshua P; Felix, Abigail; Chakravarthy, Ranjana

2015-08-01

Meeting marketplace demands for proving the value of new products requires more data than the industry has routinely produced. These data include evidence from comparative effectiveness research (CER), including randomized, controlled trials; pragmatic clinical trials; observational studies; and meta-analyses. We designed and conducted a survey to examine the industry's perceptions on new data requirements regarding CER evidence, the acceptability of postapproval study types, payer-specific issues related to CER, communication of data being generated postapproval, and methods used for facilitating postapproval evidence generation. CER is being used by payers for most types of postapproval decisions. Randomized, controlled trials were indicated as the most acceptable form of evidence. At the same time, there was support for the utility of other types of studies, such as pragmatic clinical trials and observational studies. Respondents indicated the use of multiple formats for communicating postapproval data with many different stakeholders including regulators, payers, providers, and patients. Risk-sharing agreements with payers were unanimously supported by respondents with regard to certain products with unclear clinical and economic outcomes at launch. In these instances, conditional reimbursement through coverage with evidence development was considered a constructive option. The Food and Drug Administration's initiative called Regulatory Science was considered by the respondents as having the most impact on streamlining the generation of postapproval research-related evidence. The biopharmaceutical industry is faced with a broad and complex set of challenges related to evidence generation for postapproval decisions by a variety of health care system stakeholders. Uncertainty remains as to how the industry and payers use postapproval studies to guide decision making with regard to pricing and reimbursement status. Correspondingly, there is uncertainty regarding

Seeing the World through Another Person's Eyes: Simulating Selective Attention via Action Observation

ERIC Educational Resources Information Center

Frischen, Alexandra; Loach, Daniel; Tipper, Steven P.

2009-01-01

Selective attention is usually considered an egocentric mechanism, biasing sensory information based on its behavioural relevance to oneself. This study provides evidence for an equivalent allocentric mechanism that allows passive observers to selectively attend to information from the perspective of another person. In a negative priming task,…

Evidence-based assessment in pediatric psychology: family measures.

PubMed

Alderfer, Melissa A; Fiese, Barbara H; Gold, Jeffrey I; Cutuli, J J; Holmbeck, Grayson N; Goldbeck, Lutz; Chambers, Christine T; Abad, Mona; Spetter, Dante; Patterson, Joän

2008-10-01

To provide a review of the evidence base of family measures relevant to pediatric psychology. Twenty-nine family measures were selected based upon endorsement by Division 54 listserv members, expert judgment, and literature review. Spanning observational and self-report methods, the measures fell into three broad assessment categories: Family functioning, Dyadic family relationships, and Family functioning in the context of childhood chronic health conditions. Measures were categorized as: "Well-established", "Approaching well-established", or "Promising." Nineteen measures met "well-established" criteria and the remaining ten were "approaching well-established." "Well-established" measures were documented for each of the broad assessment categories named above. Many measures deemed "well-established" in the general population are proving to be reliable and useful in pediatric samples. More evidence of the validity of family measures is needed in this context. This review should prove helpful to clinicians and researchers as they strive to make evidence-based decisions regarding family measures.

Rainfall intensity and groundwater recharge: evidence from ground-based observations in East Africa (Invited)

NASA Astrophysics Data System (ADS)

Taylor, R. G.; Owor, M.; Kaponda, A.

2013-12-01

Global greenhouse-gas emissions serve to warm Africa more rapidly than the rest of the world. The intensification of precipitation that is associated with this warming, strongly influences terrestrial water budgets. This shift toward fewer but heavier rainfall events is expected to lead to more frequent and intense floods as well as more variable and lower soil moisture. However, its impact on groundwater recharge is unclear and in dispute. We review evidence from long (1 to 5 decades) time series of groundwater levels recorded in deeply weathered crystalline rock aquifers systems underlying land surfaces of low relief in Uganda and Tanzania. Borehole hydrographs consistently demonstrate a non-linear relationship between rainfall and recharge wherein heavy rainfalls exceeding a threshold contribute disproportionately to the recharge flux. Rapid responses observed in groundwater levels to rainfall events attest further to the importance of preferential pathways in enabling rain-fed recharge via soil macro-pores. Our results suggest that, in these environments, increased use of groundwater to offset periods of low surface flow and to supplement soil moisture through irrigation may prove a logical strategy to enhance regional water and food security.

Observation intervention: time for an overview.

PubMed

Kettles, A M; Addo, M A

2009-11-01

This paper aims to illustrate the nature and extent of research and development work related to observation practice over the last 28 years. It aims to show both local Scottish work and the National picture, how there is still a lack of research evidence despite all the work that has taken place and what needs to be performed to explore observation practice for the future. It is not intended to be a literature review in the traditional sense. Observation has not been studied enough to know the continuing ever-changing picture of what goes on in the reality of practice. There are now studies examining observation but none of these are 'gold standard' randomized controlled trials; some are quantitative and some are qualitative audit or guidelines all based at a lower level in research evidence terms. The time has come to take the evidence base to the next level through evaluative research.

Observational Learning without a Model Is Influenced by the Observer's Possibility to Act: Evidence from the Simon Task

ERIC Educational Resources Information Center

Iani, Cristina; Rubichi, Sandro; Ferraro, Luca; Nicoletti, Roberto; Gallese, Vittorio

2013-01-01

We assessed whether observational learning in perceptual-motor tasks is affected by the visibility of an action producing perceived environmental effects and by the observer's possibility to act during observation. To this end, we conducted three experiments in which participants were required to observe a spatial compatibility task in which only…

Vitamin K status and vascular calcification: evidence from observational and clinical studies.

PubMed

Shea, M Kyla; Holden, Rachel M

2012-03-01

Vascular calcification occurs when calcium accumulates in the intima (associated with atherosclerosis) and/or media layers of the vessel wall. Coronary artery calcification (CAC) reflects the calcium burden within the intima and media of the coronary arteries. In population-based studies, CAC independently predicts cardiovascular disease (CVD) and mortality. A preventive role for vitamin K in vascular calcification has been proposed based on its role in activating matrix Gla protein (MGP), a calcification inhibitor that is expressed in vascular tissue. Although animal and in vitro data support this role of vitamin K, overall data from human studies are inconsistent. The majority of population-based studies have relied on vitamin K intake to measure status. Phylloquinone is the primary dietary form of vitamin K and available supplementation trials, albeit limited, suggest phylloquinone supplementation is relevant to CAC. Yet observational studies have found higher dietary menaquinone, but not phylloquinone, to be associated with less calcification. Vascular calcification is highly prevalent in certain patient populations, especially in those with chronic kidney disease (CKD), and it is plausible vitamin K may contribute to reducing vascular calcification in patients at higher risk. Subclinical vitamin K deficiency has been reported in CKD patients, but studies linking vitamin K status to calcification outcomes in CKD are needed to clarify whether or not improving vitamin K status is associated with improved vascular health in CKD. This review summarizes the available evidence of vitamin K and vascular calcification in population-based studies and clinic-based studies, with a specific focus on CKD patients.

The ASCA PV phase observation of FO Aquarii

NASA Technical Reports Server (NTRS)

Mukai, Koji; Ishida, Manabu; Osborne, Julian P.

1994-01-01

We report on a approximately 1-day Advanced Satellite for Cosmology and Astrophysics (ASCA) observation of the intermediate polar FO Aquarii. We find two distinctive spectral components, one unabsorbed and the other strongly absorbed; the observed 2-10 keV flux severely underestimates the total system luminosity, due to this strong absorption intrinsic to the binary. The absorbed component is dominant in terms of luminosity, and its light curve is simple. The unabsorbed component accounts for approximately 2% of the luminosity, and shows a much more complicated light curve. As the dominant component predominantly shows a sinusoidal modulation at the white dwarf spin period, it provides a strong evidence for a partial accretion disk in the system.

Dementia revealed: novel chromosome 6 locus for late-onset Alzheimer disease provides genetic evidence for folate-pathway abnormalities.

PubMed

Naj, Adam C; Beecham, Gary W; Martin, Eden R; Gallins, Paul J; Powell, Eric H; Konidari, Ioanna; Whitehead, Patrice L; Cai, Guiqing; Haroutunian, Vahram; Scott, William K; Vance, Jeffery M; Slifer, Michael A; Gwirtsman, Harry E; Gilbert, John R; Haines, Jonathan L; Buxbaum, Joseph D; Pericak-Vance, Margaret A

2010-09-23

Genome-wide association studies (GWAS) of late-onset Alzheimer disease (LOAD) have consistently observed strong evidence of association with polymorphisms in APOE. However, until recently, variants at few other loci with statistically significant associations have replicated across studies. The present study combines data on 483,399 single nucleotide polymorphisms (SNPs) from a previously reported GWAS of 492 LOAD cases and 496 controls and from an independent set of 439 LOAD cases and 608 controls to strengthen power to identify novel genetic association signals. Associations exceeding the experiment-wide significance threshold (alpha=1.03x10(-7)) were replicated in an additional 1,338 cases and 2,003 controls. As expected, these analyses unequivocally confirmed APOE's risk effect (rs2075650, P=1.9x10(-36)). Additionally, the SNP rs11754661 at 151.2 Mb of chromosome 6q25.1 in the gene MTHFD1L (which encodes the methylenetetrahydrofolate dehydrogenase (NADP+ dependent) 1-like protein) was significantly associated with LOAD (P=4.70x10(-8); Bonferroni-corrected P=0.022). Subsequent genotyping of SNPs in high linkage disequilibrium (r2>0.8) with rs11754661 identified statistically significant associations in multiple SNPs (rs803424, P=0.016; rs2073067, P=0.03; rs2072064, P=0.035), reducing the likelihood of association due to genotyping error. In the replication case-control set, we observed an association of rs11754661 in the same direction as the previous association at P=0.002 (P=1.90x10(-10) in combined analysis of discovery and replication sets), with associations of similar statistical significance at several adjacent SNPs (rs17349743, P=0.005; rs803422, P=0.004). In summary, we observed and replicated a novel statistically significant association in MTHFD1L, a gene involved in the tetrahydrofolate synthesis pathway. This finding is noteworthy, as MTHFD1L may play a role in the generation of methionine from homocysteine and influence homocysteine

Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study.

PubMed

Schroeder, Mary C; Chapman, Cole G; Nattinger, Matthew C; Halfdanarson, Thorvardur R; Abu-Hejleh, Taher; Tien, Yu-Yu; Brooks, John M

2016-07-18

An aging population, with its associated rise in cancer incidence and strain on the oncology workforce, will continue to motivate patients, healthcare providers and policy makers to better understand the existing and growing challenges of access to chemotherapy. Administrative data, and SEER-Medicare data in particular, have been used to assess patterns of healthcare utilization because of its rich information regarding patients, their treatments, and their providers. To create measures of geographic access to chemotherapy, patients and oncologists must first be identified. Others have noted that identifying chemotherapy providers from Medicare claims is not always straightforward, as providers may report multiple or incorrect specialties and/or practice in multiple locations. Although previous studies have found that specialty codes alone fail to identify all oncologists, none have assessed whether various methods of identifying chemotherapy providers and their locations affect estimates of geographic access to care. SEER-Medicare data was used to identify patients, physicians, and chemotherapy use in this population-based observational study. We compared two measures of geographic access to chemotherapy, local area density and distance to nearest provider, across two definitions of chemotherapy provider (identified by specialty codes or billing codes) and two definitions of chemotherapy service location (where chemotherapy services were proven to be or possibly available) using descriptive statistics. Access measures were mapped for three representative registries. In our sample, 57.2 % of physicians who submitted chemotherapy claims reported a specialty of hematology/oncology or medical oncology. These physicians were associated with 91.0 % of the chemotherapy claims. When providers were identified through billing codes instead of specialty codes, an additional 50.0 % of beneficiaries (from 23.8 % to 35.7 %) resided in the same ZIP code as a chemotherapy

Weak interspecific interactions in a sagebrush steppe? Conflicting evidence from observations and experiments.

PubMed

Adler, Peter B; Kleinhesselink, Andrew; Giles, Hooker; Taylor, J Bret; Teller, Brittany; Ellner, Stephen P

2018-04-28

Stable coexistence requires intraspecific limitations to be stronger than interspecific limitations. The greater the difference between intra- and interspecific limitations, the more stable the coexistence, and the weaker the competitive release any species should experience following removal of competitors. We conducted a removal experiment to test whether a previously estimated model, showing surprisingly weak interspecific competition for four dominant species in a sagebrush steppe, accurately predicts competitive release. Our treatments were 1) removal of all perennial grasses and 2) removal of the dominant shrub, Artemisia tripartita. We regressed survival, growth and recruitment on the locations, sizes, and species identities of neighboring plants, along with an indicator variable for removal treatment. If our "baseline" regression model, which accounts for local plant-plant interactions, accurately explains the observed responses to removals, then the removal coefficient should be non-significant. For survival, the removal coefficients were never significantly different from zero, and only A. tripartita showed a (negative) response to removals at the recruitment stage. For growth, the removal treatment effect was significant and positive for two species, Poa secunda and Pseudoroegneria spicata, indicating that the baseline model underestimated interspecific competition. For all three grass species, population models based on the vital rate regressions that included removal effects projected 1.4 to 3-fold increases in equilibrium population size relative to the baseline model (no removal effects). However, we found no evidence of higher response to removal in quadrats with higher pretreatment cover of A. tripartita, or by plants experiencing higher pre-treatment crowding by A. tripartita, raising questions about the mechanisms driving the positive response to removal. While our results show the value of combining observations with a simple removal experiment

Sequence analysis, identification of evolutionary conserved motifs and expression analysis of murine tcof1 provide further evidence for a potential function for the gene and its human homologue, TCOF1.

PubMed

Dixon, J; Hovanes, K; Shiang, R; Dixon, M J

1997-05-01

The gene mutated in Treacher Collins syndrome, an autosomal dominant disorder of facial development, has recently been cloned. While the function of the predicted protein, Treacle, is unknown, it has been shown to share a number of features with the highly phosphorylated nucleolar phosphoproteins, which play a role in nucleolar-cytoplasmic transport. In the current study, the murine homologue of the Treacher Collins syndrome gene has been isolated and shown to encode a low complexity, serine/alanine-rich protein of 133 kDa. Interspecies comparison indicates that the proteins display 61.5% identity, with the level of conservation being greatest in the regions of acidic/basic amino acid repeats and nuclear localization signals. These features are shared with the nucleolar phosphoproteins. Confirmation that the gene isolated in the current study is orthologous with the Treacher Collins syndrome gene was provided by the demonstration that it mapped to central mouse chromosome 18 in a conserved syntenic region with human chromosome 5q21-q33. Expression analysis in the mouse indicated that the gene was expressed in a wide variety of embryonic and adult tissues. Peak levels of expression in the developing embryo were observed at the edges of the neural folds immediately prior to fusion, and also in the developing branchial arches at the times of critical morphogenetic events. These observations support a role for the gene in the development of the craniofacial complex and provide further evidence that the gene encodes a protein which may be involved in nucleolar-cytoplasmic transport.

Wind Observations of Wave Heating and/or Particle Energization at Supercritical Interplanetary Shocks

NASA Technical Reports Server (NTRS)

Wilson, Lynn Bruce, III; Szabo, Adam; Koval, Andriy; Cattell, Cynthia A.; Kellogg, Paul J.; Goetz, Keith; Breneman, Aaron; Kersten, Kris; Kasper, Justin C.; Pulupa, Marc

2011-01-01

We present the first observations at supercritical interplanetary shocks of large amplitude (> 100 mV/m pk-pk) solitary waves, approx.30 mV/m pk-pk waves exhibiting characteristics consistent with electron Bernstein waves, and > 20 nT pk-pk electromagnetic lower hybrid-like waves, with simultaneous evidence for wave heating and particle energization. The solitary waves and the Bernstein-like waves were likely due to instabilities driven by the free energy provided by reflected ions [Wilson III et al., 2010]. They were associated with strong particle heating in both the electrons and ions. We also show a case example of parallel electron energization and perpendicular ion heating due to a electromagnetic lower hybrid-like wave. Both studies provide the first experimental evidence of wave heating and/or particle energization at interplanetary shocks. Our experimental results, together with the results of recent Vlasov [Petkaki and Freeman, 2008] and PIC [Matsukyo and Scholer, 2006] simulations using realistic mass ratios provide new evidence to suggest that the importance of wave-particle dissipation at shocks may be greater than previously thought.

MID-INFRARED SPECTROSCOPIC OBSERVATIONS OF THE DUST-FORMING CLASSICAL NOVA V2676 OPH

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kawakita, Hideyo; Arai, Akira; Shinnaka, Yoshiharu

2017-02-01

The dust-forming nova V2676 Oph is unique in that it was the first nova to provide evidence of C{sub 2} and CN molecules during its near-maximum phase and evidence of CO molecules during its early decline phase. Observations of this nova have revealed the slow evolution of its lightcurves and have also shown low isotopic ratios of carbon ({sup 12}C/{sup 13}C) and nitrogen ({sup 14}N/{sup 15}N) in its envelope. These behaviors indicate that the white dwarf (WD) star hosting V2676 Oph is a CO-rich WD rather than an ONe-rich WD (typically larger in mass than the former). We performed mid-infraredmore » spectroscopic and photometric observations of V2676 Oph in 2013 and 2014 (respectively 452 and 782 days after its discovery). No significant [Ne ii] emission at 12.8 μ m was detected at either epoch. These provided evidence for a CO-rich WD star hosting V2676 Oph. Both carbon-rich and oxygen-rich grains were detected in addition to an unidentified infrared feature at 11.4 μ m originating from polycyclic aromatic hydrocarbon molecules or hydrogenated amorphous carbon grains in the envelope of V2676 Oph.« less

Observational evidence of dust evolution in galactic extinction curves

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cecchi-Pestellini, Cesare; Casu, Silvia; Mulas, Giacomo

Although structural and optical properties of hydrogenated amorphous carbons are known to respond to varying physical conditions, most conventional extinction models are basically curve fits with modest predictive power. We compare an evolutionary model of the physical properties of carbonaceous grain mantles with their determination by homogeneously fitting observationally derived Galactic extinction curves with the same physically well-defined dust model. We find that a large sample of observed Galactic extinction curves are compatible with the evolutionary scenario underlying such a model, requiring physical conditions fully consistent with standard density, temperature, radiation field intensity, and average age of diffuse interstellar clouds.more » Hence, through the study of interstellar extinction we may, in principle, understand the evolutionary history of the diffuse interstellar clouds.« less

Frontal Midline Theta Reflects Anxiety and Cognitive Control: Meta-Analytic Evidence

PubMed Central

Cavanagh, James F.; Shackman, Alexander J.

2014-01-01

Evidence from imaging and anatomical studies suggests that the midcingulate cortex (MCC) is a dynamic hub lying at the interface of affect and cognition. In particular, this neural system appears to integrate information about conflict and punishment in order to optimize behavior in the face of action-outcome uncertainty. In a series of meta-analyses, we show how recent human electrophysiological research provides compelling evidence that frontal-midline theta signals reflecting MCC activity are moderated by anxiety and predict adaptive behavioral adjustments. These findings underscore the importance of frontal theta activity to a broad spectrum of control operations. We argue that frontal-midline theta provides a neurophysiologically plausible mechanism for optimally adjusting behavior to uncertainty, a hallmark of situations that elicit anxiety and demand cognitive control. These observations compel a new perspective on the mechanisms guiding motivated learning and behavior and provide a framework for understanding the role of the MCC in temperament and psychopathology. PMID:24787485

How evidence from observing attending physicians links to a competency-based framework.

PubMed

Bacchus, Maria; Ward, David R; de Grood, Jill; Lemaire, Jane B

2017-06-01

Competency-based medical education frameworks are often founded on a combination of existing research, educational principles and expert consensus. Our objective was to examine how components of the attending physician role, as determined by observing preceptors during their real-world work, link to the CanMEDS Physician Competency Framework. This is a sub-study of a broader study exploring the role of the attending physician by observing these doctors during their working day. The parent study revealed three overarching elements of the role that emerged from 14 themes and 123 sub-themes: (i) Competence, defined as the execution of traditional physician competencies; (ii) Context, defined as the environment in which the role is carried out, and (iii) Conduct, defined as the manner of acting, or behaviours and attitudes in the role that helped to negotiate the complex environment. In this sub-study, each sub-theme, or 'role-related component', was mapped to the competencies described in the CanMEDS 2005 and 2015 frameworks. Many role-related components from the Competence element were represented in the 2015 CanMEDS framework. No role-related components from the Context element were represented. Some role-related components from the Conduct element were represented. These Conduct role-related components were better represented in the 2015 CanMEDS framework than in the 2005 framework. This study shows how the real-world work of attending physicians links to the CanMEDS framework and provides empirical data identifying disconnects between espoused and observed behaviours. There is a conceptual gap where the contextual influences of physicians' work and the competencies required to adjust to these influences are missing from the framework. These concepts should be incorporated into learning both broadly, such as through an emphasis on context within curriculum development for the workplace (e.g. entrustable professional activities), and explicitly, through the

Observation of the Top Quark

DOE R&D Accomplishments Database

Kim, S. B.

1995-08-01

Top quark production is observed in{bar p}p collisions at{radical}s= 1.8 TeV at the Fermilab Tevatron. The Collider Detector at Fermilab (CDF) and D{O} observe signals consistent with t{bar t} to WWb{bar b}, but inconsistent with the background prediction by 4.8{sigma} (CDF), 4.6a (D{O}). Additional evidence for the top quark Is provided by a peak in the reconstructed mass distribution. The kinematic properties of the excess events are consistent with the top quark decay. They measure the top quark mass to be 176{plus_minus}8(stat.){plus_minus}10(sys.) GeV/c{sup 2} (CDF), 199{sub -21}{sup+19}(stat.){plus_minus}22(sys.) GeV/c{sup 2} (D{O}), and the t{bar t} production cross section to be 6.8{sub -2.4}{sup+3.6}pb (CDF), 6.4{plus_minus}2.2 pb (D{O}).

Synonyms Provide Semantic Preview Benefit in English

PubMed Central

Schotter, Elizabeth R.

2013-01-01

While orthographic and phonological preview benefits in reading are uncontroversial (see Schotter, Angele, & Rayner, 2012 for a review), researchers have debated the existence of semantic preview benefit with positive evidence in Chinese and German, but no support in English. Two experiments, using the gazecontingent boundary paradigm (Rayner, 1975), show that semantic preview benefit can be observed in English when the preview and target are synonyms (share the same or highly similar meaning, e.g., curlers-rollers). However, no semantic preview benefit was observed for semantic associates (e.g., curlers-styling). These different preview conditions represent different degrees to which the meaning of the sentence changes when the preview is replaced by the target. When this continuous variable (determined by a norming procedure) was used as the predictor in the analyses, there was a significant relationship between it and all reading time measures, suggesting that similarity in meaning between what is accessed parafoveally and what is processed foveally may be an important influence on the presence of semantic preview benefit. Why synonyms provide semantic preview benefit in reading English is discussed in relation to (1) previous failures to find semantic preview benefit in English and (2) the fact that semantic preview benefit is observed in other languages even for non-synonymous words. Semantic preview benefit is argued to depend on several factors—attentional resources, depth of orthography, and degree of similarity between preview and target. PMID:24347813

Electroencephalogram evidence for the activation of human mirror neuron system during the observation of intransitive shadow and line drawing actions☆

PubMed Central

Zhu, Huaping; Sun, Yaoru; Wang, Fang

2013-01-01

Previous studies have demonstrated that hand shadows may activate the motor cortex associated with the mirror neuron system in human brain. However, there is no evidence of activity of the human mirror neuron system during the observation of intransitive movements by shadows and line drawings of hands. This study examined the suppression of electroencephalography mu waves (8–13 Hz) induced by observation of stimuli in 18 healthy students. Three stimuli were used: real hand actions, hand shadow actions and actions made by line drawings of hands. The results showed significant desynchronization of the mu rhythm (“mu suppression”) across the sensorimotor cortex (recorded at C3, Cz and C4), the frontal cortex (recorded at F3, Fz and F4) and the central and right posterior parietal cortex (recorded at Pz and P4) under all three conditions. Our experimental findings suggest that the observation of “impoverished hand actions”, such as intransitive movements of shadows and line drawings of hands, is able to activate widespread cortical areas related to the putative human mirror neuron system. PMID:25206595

Direct observation limits on antimatter gravitation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fischler, Mark; Lykken, Joe; Roberts, Tom

2008-06-01

The proposed Antihydrogen Gravity experiment at Fermilab (P981) will directly measure the gravitational attraction g between antihydrogen and the Earth, with an accuracy of 1% or better. The following key question has been asked by the PAC: Is a possible 1% difference between g and g already ruled out by other evidence? This memo presents the key points of existing evidence, to answer whether such a difference is ruled out (a) on the basis of direct observational evidence; and/or (b) on the basis of indirect evidence, combined with reasoning based on strongly held theoretical assumptions. The bottom line is thatmore » there are no direct observations or measurements of gravitational asymmetry which address the antimatter sector. There is evidence which by indirect reasoning can be taken to rule out such a difference, but the analysis needed to draw that conclusion rests on models and assumptions which are in question for other reasons and are thus worth testing. There is no compelling evidence or theoretical reason to rule out such a difference at the 1% level.« less

Early atmospheric metal pollution provides evidence for Chalcolithic/Bronze Age mining and metallurgy in Southwestern Europe.

PubMed

Martínez Cortizas, Antonio; López-Merino, Lourdes; Bindler, Richard; Mighall, Tim; Kylander, Malin E

2016-03-01

Although archaeological research suggests that mining/metallurgy already started in the Chalcolithic (3rd millennium BC), the earliest atmospheric metal pollution in SW Europe has thus far been dated to ~3500-3200 cal.yr. BP in paleo-environmental archives. A low intensity, non-extensive mining/metallurgy and the lack of appropriately located archives may be responsible for this mismatch. We have analysed the older section (>2100 cal.yr. BP) of a peat record from La Molina (Asturias, Spain), a mire located in the proximity (35-100 km) of mines which were exploited in the Chalcolithic/Bronze Age, with the aim of assessing evidence of this early mining/metallurgy. Analyses included the determination of C as a proxy for organic matter content, lithogenic elements (Si, Al, Ti) as markers of mineral matter, and trace metals (Cr, Cu, Zn, Pb) and stable Pb isotopes as tracers of atmospheric metal pollution. From ~8000 to ~4980 cal.yr. BP the Pb composition is similar to that of the underlying sediments (Pb 15 ± 4 μg g(-1); (206)Pb/(207)Pb 1.204 ± 0.002). A sustained period of low (206)Pb/(207)Pb ratios occurred from ~4980 to ~2470 cal.yr. BP, which can be divided into four phases: Chalcolithic (~4980-3700 cal.yr. BP), (206)Pb/(207)Pb ratios decline to 1.175 and Pb/Al ratios increase; Early Bronze Age (~3700-3500 cal.yr. BP), (206)Pb/(207)Pb increase to 1.192 and metal/Al ratios remain stable; Late Bronze Age (~3500-2800 cal.yr. BP), (206)Pb/(207)Pb decline to their lowest values (1.167) while Pb/Al and Zn/Al increase; and Early Iron Age (~2800-2470 cal.yr. BP), (206)Pb/(207)Pb increase to 1.186, most metal/Al ratios decrease but Zn/Al shows a peak. At the beginning of the Late Iron Age, (206)Pb/(207)Pb ratios and metal enrichments show a rapid return to pre-anthropogenic values. These results provide evidence of regional/local atmospheric metal pollution triggered by the earliest phases of mining/metallurgy in the area, and reconcile paleo-environmental and

Comparing the performance of English mental health providers in achieving patient outcomes.

PubMed

Moran, Valerie; Jacobs, Rowena

2015-09-01

Evidence on provider payment systems that incorporate patient outcomes is limited for mental health care. In England, funding for mental health care services is changing to a prospective payment system with a future objective of linking some part of provider payment to outcomes. This research examines performance of mental health providers offering hospital and community services, in order to investigate if some are delivering better outcomes. Outcomes are measured using the Health of the Nation Outcome Scales (HoNOS) - a clinician-rated routine outcome measure (CROM) mandated for national use. We use data from the Mental Health Minimum Data Set (MHMDS) - a dataset on specialist mental health care with national coverage - for the years 2011/12 and 2012/13 with a final estimation sample of 305,960 observations with follow-up HoNOS scores. A hierarchical ordered probit model is used and outcomes are risk adjusted with independent variables reflecting demographic, need, severity and social indicators. A hierarchical linear model is also estimated with the follow-up total HoNOS score as the dependent variable and the baseline total HoNOS score included as a risk-adjuster. Provider performance is captured by a random effect that is quantified using Empirical Bayes methods. We find that worse outcomes are associated with severity and better outcomes with older age and social support. After adjusting outcomes for various risk factors, variations in performance are still evident across providers. This suggests that if the intention to link some element of provider payment to outcomes becomes a reality, some providers may gain financially whilst others may lose. The paper contributes to the limited literature on risk adjustment of outcomes and performance assessment of providers in mental health in the context of prospective activity-based payment systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

An integrative computational analysis provides evidence for FBN1-associated network deregulation in trisomy 21.

PubMed

Vilardell, Mireia; Civit, Sergi; Herwig, Ralf

2013-08-15

Although approximately 50% of Down Syndrome (DS) patients have heart abnormalities, they exhibit an overprotection against cardiac abnormalities related with the connective tissue, for example a lower risk of coronary artery disease. A recent study reported a case of a person affected by DS who carried mutations in FBN1, the gene causative for a connective tissue disorder called Marfan Syndrome (MFS). The fact that the person did not have any cardiac alterations suggested compensation effects due to DS. This observation is supported by a previous DS meta-analysis at the molecular level where we have found an overall upregulation of FBN1 (which is usually downregulated in MFS). Additionally, that result was cross-validated with independent expression data from DS heart tissue. The aim of this work is to elucidate the role of FBN1 in DS and to establish a molecular link to MFS and MFS-related syndromes using a computational approach. To reach that, we conducted different analytical approaches over two DS studies (our previous meta-analysis and independent expression data from DS heart tissue) and revealed expression alterations in the FBN1 interaction network, in FBN1 co-expressed genes and FBN1-related pathways. After merging the significant results from different datasets with a Bayesian approach, we prioritized 85 genes that were able to distinguish control from DS cases. We further found evidence for several of these genes (47%), such as FBN1, DCN, and COL1A2, being dysregulated in MFS and MFS-related diseases. Consequently, we further encourage the scientific community to take into account FBN1 and its related network for the study of DS cardiovascular characteristics.

Zika Virus Infection and Microcephaly: Evidence for a Causal Link.

PubMed

Wang, Jin-Na; Ling, Feng

2016-10-20

Zika virus (ZIKV) is a flavivirus related to the Dengue, yellow fever and West Nile viruses. Since the explosive outbreaks of ZIKV in Latin America in 2015, a sudden increase in the number of microcephaly cases has been observed in infants of women who were pregnant when they contracted the virus. The severity of this condition raises grave concerns, and extensive studies on the possible link between ZIKV infection and microcephaly have been conducted. There is substantial evidence suggesting that there is a causal link between ZIKV and microcephaly, however, future studies are warranted to solidify this association. To summarize the most recent evidence on this issue and provide perspectives for future studies, we reviewed the literature to identify existing evidence of the causal link between ZIKV infection and microcephaly within research related to the epidemics, laboratory diagnosis, and possible mechanisms.

ROSAT Pointed Observations of Cool Magnetic White Dwarfs

NASA Technical Reports Server (NTRS)

Musielak, Z. E.; Porter, J. G.; Davis, J. M.

1995-01-01

Observational evidence for the existence of a chromosphere on the cool magnetic white dwarf GD 356 has been reported. In addition, there has been theoretical speculations that cool magnetic white dwarfs may be sources of coronal X-ray emission. This emission, if it exists, would be distinct from the two types of X-ray emission (deep photospheric and shocked wind) that have already been observed from hot white dwarfs. We have used the PSPC instrument on ROSAT to observe three of the most prominent DA white dwarf candidates for coronal X-ray emission: GD 356, KUV 2316+123, and GD 90. The data show no significant emission for these stars. The derived upper limits for the X-ray luminosities provide constraints for a revision of current theories of the generation of nonradiative energy in white dwarfs.

Observational evidence for turbulent effects on total suspended matter within the Pearl River plume

NASA Astrophysics Data System (ADS)

Chunhua, Qiu; Danyi, Su; Huabin, Mao; Jiaxue, Wu; Yongsheng, Cui; Dongxiao, Wang

2017-12-01

We observed the structure of the Pearl River plume and its turbulent characteristics, and investigated the turbulent effect on total suspended matter (TSM) within its ;far-field; region, based on in situ and satellite data collected in June 2015. A significant northeastward plume was created under southern monsoonal conditions. The in situ data provided the width, depth, and velocity of the plume, as inferred by salinity. Weaker turbulence occurred at the front surface position than in the plume zone. Stronger turbulence induced greater turbidity in the bottom boundary layer; however, the surface mixed layer differed. By estimating the turbidity budget, we found the lateral fluxes term was the largest term in the plume, turbulent fluxes comprised the second largest term, and the settling terms comprised the smallest term. We quantified the turbulent mechanisms and found that stronger river discharge induced greater TSM turbidity. Tidal and buoyancy fluxes had minor regulatory effects on TSM. Our observations suggest that TSM in the ;far field; region originated from the Pearl River and the coastal region.

Educational Research for Professional Practice: More than Providing Evidence for Doing "x Rather than y" or Finding the "Size of the Effect of A on B"

ERIC Educational Resources Information Center

Rogers, Bev

2003-01-01

Educational research has been criticised by governments and practitioners. For some politicians and policy makers, there is a tendency to look for direct links between research and successful, effective and efficient practice. Research is needed to inform their evidence-based practice as policy makers, and to provide the kind of research teachers…

Gemini long-slit observations of luminous obscured quasars: Further evidence for an upper limit on the size of the narrow-line region

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hainline, Kevin N.; Hickox, Ryan C.; Greene, Jenny E.

2014-05-20

We examine the spatial extent of the narrow-line regions (NLRs) of a sample of 30 luminous obscured quasars at 0.4 < z < 0.7 observed with spatially resolved Gemini-N GMOS long-slit spectroscopy. Using the [O III] λ5007 emission feature, we estimate the size of the NLR using a cosmology-independent measurement: the radius where the surface brightness falls to 10{sup –15} erg s{sup –1} cm{sup –2} arcsec{sup –2}. We then explore the effects of atmospheric seeing on NLR size measurements and conclude that direct measurements of the NLR size from observed profiles are too large by 0.1-0.2 dex on average, asmore » compared to measurements made to best-fit Sérsic or Voigt profiles convolved with the seeing. These data, which span a full order of magnitude in IR luminosity (log (L {sub 8} {sub μm}/erg s{sup –1}) = 44.4-45.4), also provide strong evidence that there is a flattening of the relationship between NLR size and active galactic nucleus luminosity at a seeing-corrected size of ∼7 kpc. The objects in this sample have high luminosities which place them in a previously under-explored portion of the size-luminosity relationship. These results support the existence of a maximal size of the NLR around luminous quasars; beyond this size, there is either not enough gas or the gas is over-ionized and does not produce enough [O III] λ5007 emission.« less

Evidence-based neurosurgery

PubMed Central

Esene, Ignatius N.; Baeesa, Saleh S.; Ammar, Ahmed

2016-01-01

Medical evidence is obtainable from approaches, which might be descriptive, analytic and integrative and ranked into levels of evidence, graded according to quality and summarized into strengths of recommendation. Sources of evidence range from expert opinions through well-randomized control trials to meta-analyses. The conscientious, explicit, and judicious use of current best evidence in making decisions related to the care of individual patients defines the concept of evidence-based neurosurgery (EBN). We reviewed reference books of clinical epidemiology, evidence-based practice and other previously related articles addressing principles of evidence-based practice in neurosurgery. Based on existing theories and models and our cumulative years of experience and expertise conducting research and promoting EBN, we have synthesized and presented a holistic overview of the concept of EBN. We have also underscored the importance of clinical research and its relationship to EBN. Useful electronic resources are provided. The concept of critical appraisal is introduced. PMID:27356649

WEIGHT OF EVIDENCE IN ECOLOGICAL ASSESSMENT

EPA Science Inventory

This document provides guidance on methods for weighing ecological evidence using a a standard framework consisting of three steps: assemble evidence, weight evidence and weigh the body of evidence. Use of the methods will improve the consistency and reliability of WoE-based asse...

Synchrony and motor mimicking in chimpanzee observational learning

PubMed Central

Fuhrmann, Delia; Ravignani, Andrea; Marshall-Pescini, Sarah; Whiten, Andrew

2014-01-01

Cumulative tool-based culture underwrote our species' evolutionary success, and tool-based nut-cracking is one of the strongest candidates for cultural transmission in our closest relatives, chimpanzees. However the social learning processes that may explain both the similarities and differences between the species remain unclear. A previous study of nut-cracking by initially naïve chimpanzees suggested that a learning chimpanzee holding no hammer nevertheless replicated hammering actions it witnessed. This observation has potentially important implications for the nature of the social learning processes and underlying motor coding involved. In the present study, model and observer actions were quantified frame-by-frame and analysed with stringent statistical methods, demonstrating synchrony between the observer's and model's movements, cross-correlation of these movements above chance level and a unidirectional transmission process from model to observer. These results provide the first quantitative evidence for motor mimicking underlain by motor coding in apes, with implications for mirror neuron function. PMID:24923651

Synchrony and motor mimicking in chimpanzee observational learning.

PubMed

Fuhrmann, Delia; Ravignani, Andrea; Marshall-Pescini, Sarah; Whiten, Andrew

2014-06-13

Cumulative tool-based culture underwrote our species' evolutionary success, and tool-based nut-cracking is one of the strongest candidates for cultural transmission in our closest relatives, chimpanzees. However the social learning processes that may explain both the similarities and differences between the species remain unclear. A previous study of nut-cracking by initially naïve chimpanzees suggested that a learning chimpanzee holding no hammer nevertheless replicated hammering actions it witnessed. This observation has potentially important implications for the nature of the social learning processes and underlying motor coding involved. In the present study, model and observer actions were quantified frame-by-frame and analysed with stringent statistical methods, demonstrating synchrony between the observer's and model's movements, cross-correlation of these movements above chance level and a unidirectional transmission process from model to observer. These results provide the first quantitative evidence for motor mimicking underlain by motor coding in apes, with implications for mirror neuron function.

Observational evidence for the aerosol impact on ice cloud properties regulated by cloud/aerosol types

NASA Astrophysics Data System (ADS)

Zhao, B.; Gu, Y.; Liou, K. N.; Jiang, J. H.; Li, Q.; Liu, X.; Huang, L.; Wang, Y.; Su, H.

2016-12-01

The interactions between aerosols and ice clouds (consisting only of ice) represent one of the largest uncertainties in global radiative forcing from pre-industrial time to the present. The observational evidence for the aerosol impact on ice cloud properties has been quite limited and showed conflicting results, partly because previous observational studies did not consider the distinct features of different ice cloud and aerosol types. Using 9-year satellite observations, we find that, for ice clouds generated from deep convection, cloud thickness, cloud optical thickness (COT), and ice cloud fraction increase and decrease with small-to-moderate and high aerosol loadings, respectively. For in-situ formed ice clouds, however, the preceding cloud properties increase monotonically and more sharply with aerosol loadings. The case is more complicated for ice crystal effective radius (Rei). For both convection-generated and in-situ ice clouds, the responses of Rei to aerosol loadings are modulated by water vapor amount in conjunction with several other meteorological parameters, but the sensitivities of Rei to aerosols under the same water vapor amount differ remarkably between the two ice cloud types. As a result, overall Rei slightly increases with aerosol loading for convection-generated ice clouds, but decreases for in-situ ice clouds. When aerosols are decomposed into different types, an increase in the loading of smoke aerosols generally leads to a decrease in COT of convection-generated ice clouds, while the reverse is true for dust and anthropogenic pollution. In contrast, an increase in the loading of any aerosol type can significantly enhance COT of in-situ ice clouds. The modulation of the aerosol impacts by cloud/aerosol types is demonstrated and reproduced by simulations using the Weather Research and Forecasting (WRF) model. Adequate and accurate representations of the impact of different cloud/aerosol types in climate models are crucial for reducing the

Observational evidence for the aerosol impact on ice cloud properties regulated by cloud/aerosol types

NASA Astrophysics Data System (ADS)

Zhao, B.; Gu, Y.; Liou, K. N.; Jiang, J. H.; Li, Q.; Liu, X.; Huang, L.; Wang, Y.; Su, H.

2017-12-01

The interactions between aerosols and ice clouds (consisting only of ice) represent one of the largest uncertainties in global radiative forcing from pre-industrial time to the present. The observational evidence for the aerosol impact on ice cloud properties has been quite limited and showed conflicting results, partly because previous observational studies did not consider the distinct features of different ice cloud and aerosol types. Using 9-year satellite observations, we find that, for ice clouds generated from deep convection, cloud thickness, cloud optical thickness (COT), and ice cloud fraction increase and decrease with small-to-moderate and high aerosol loadings, respectively. For in-situ formed ice clouds, however, the preceding cloud properties increase monotonically and more sharply with aerosol loadings. The case is more complicated for ice crystal effective radius (Rei). For both convection-generated and in-situ ice clouds, the responses of Rei to aerosol loadings are modulated by water vapor amount in conjunction with several other meteorological parameters, but the sensitivities of Rei to aerosols under the same water vapor amount differ remarkably between the two ice cloud types. As a result, overall Rei slightly increases with aerosol loading for convection-generated ice clouds, but decreases for in-situ ice clouds. When aerosols are decomposed into different types, an increase in the loading of smoke aerosols generally leads to a decrease in COT of convection-generated ice clouds, while the reverse is true for dust and anthropogenic pollution. In contrast, an increase in the loading of any aerosol type can significantly enhance COT of in-situ ice clouds. The modulation of the aerosol impacts by cloud/aerosol types is demonstrated and reproduced by simulations using the Weather Research and Forecasting (WRF) model. Adequate and accurate representations of the impact of different cloud/aerosol types in climate models are crucial for reducing the

Gene Expression Profiles in Rice Developing Ovules Provided Evidence for the Role of Sporophytic Tissue in Female Gametophyte Development.

PubMed

Wu, Ya; Yang, Liyu; Cao, Aqin; Wang, Jianbo

2015-01-01

The development of ovule in rice (Oryza sativa) is vital during its life cycle. To gain more understanding of the molecular events associated with the ovule development, we used RNA sequencing approach to perform transcriptome-profiling analysis of the leaf and ovules at four developmental stages. In total, 25,401, 23,343, 23,647 and 23,806 genes were identified from the four developmental stages of the ovule, respectively. We identified a number of differently expressed genes (DEGs) from three adjacent stage comparisons, which may play crucial roles in ovule development. The DEGs were then conducted functional annotations and Kyoto encyclopedia of genes and genomes (KEGG) pathway analyses. Genes related to cellular component biogenesis, membrane-bounded organelles and reproductive regulation were identified to be highly expressed during the ovule development. Different expression levels of auxin-related and cytokinin-related genes were also identified at various stages, providing evidence for the role of sporophytic ovule tissue in female gametophyte development from the aspect of gene expression. Generally, an overall transcriptome analysis for rice ovule development has been conducted. These results increased our knowledge of the complex molecular and cellular events that occur during the development of rice ovule and provided foundation for further studies on rice ovule development.

Structures of parasite calreticulins provide insights into their flexibility and dual carbohydrate/peptide-binding properties.

PubMed

Moreau, Christophe; Cioci, Gianluca; Iannello, Marina; Laffly, Emmanuelle; Chouquet, Anne; Ferreira, Arturo; Thielens, Nicole M; Gaboriaud, Christine

2016-11-01

Calreticulin (CRT) is a multifaceted protein, initially discovered as an endoplasmic reticulum (ER) chaperone protein, that is essential in calcium metabolism. Various implications in cancer, early development and immunology have been discovered more recently for CRT, as well as its role as a dominant 'eat-me' prophagocytic signal. Intriguingly, cell-surface exposure/secretion of CRT is among the infective strategies used by parasites such as Trypanosoma cruzi , Entamoeba histolytica , Taenia solium , Leishmania donovani and Schistosoma mansoni . Because of the inherent flexibility of CRTs, their analysis by X-ray crystallography requires the design of recombinant constructs suitable for crystallization, and thus only the structures of two very similar mammalian CRT lectin domains are known. With the X-ray structures of two distant parasite CRTs, insights into species structural determinants that might be harnessed to fight against the parasites without affecting the functions of the host CRT are now provided. Moreover, although the hypothesis that CRT can exhibit both open and closed conformations has been proposed in relation to its chaperone function, only the open conformation has so far been observed in crystal structures. The first evidence is now provided of a complex conformational transition with the junction reoriented towards P-domain closure. SAXS experiments also provided additional information about the flexibility of T. cruzi CRT in solution, thus complementing crystallographic data on the open conformation. Finally, regarding the conserved lectin-domain structure and chaperone function, evidence is provided of its dual carbohydrate/protein specificity and a new scheme is proposed to interpret such unusual substrate-binding properties. These fascinating features are fully consistent with previous experimental observations, as discussed considering the broad spectrum of CRT sequence conservations and differences.

The relationship between trees and human health: evidence from the spread of the emerald ash borer

Treesearch

Geoffrey H. Donovan; David T. Butry; Yvonne L. Michael; Jeffrey P. Prestemon; Andrew M. Liebhold; Demetrios Gatziolis; Megan Y. Mao

2013-01-01

Background: Several recent studies have identified a relationship between the natural environment and improved health outcomes. However, for practical reasons, most have been observational, cross-sectional studies.Purpose: A natural experiment, which provides stronger evidence of causality, was used to...

Can Mindful Parenting Be Observed? Relations between Observational Ratings of Mother-Youth Interactions and Mothers’ Self-Report Mindful Parenting

PubMed Central

Duncan, Larissa G.; Coatsworth, J. Douglas; Gayles, Jochebed G.; Geier, Mary H.; Greenberg, Mark T.

2015-01-01

Research on mindful parenting, an extension of mindfulness to the interpersonal domain of parent-child relationships, has been limited by its reliance on self-report assessment. The current study is the first to examine whether observational indices of parent-youth interactions differentiate between high and low levels of self-reported mindful parenting. The Iowa Family Interaction Rating Scales (IFIRS) were used to code interactions between mothers and their 7th grade youth. Mothers drawn from the top and bottom quartiles (n = 375) of a larger distribution of self-reported interpersonal mindfulness in parenting (N = 804) represented clearly defined high and low mindful parenting groups. Discriminant function analysis (DFA) was used to analyze how well six composite IFIRS observational rating variables (e.g., parental warmth, consistent discipline) discriminated between high and low self-reports of mindful parenting. DFA results were cross-validated, with statistically significant canonical correlations found for both subsamples (p < .05). Subsequent independent samples t-tests revealed that group means were significantly different on all six IFIRS composite ratings. Confirmation of the relations between self-report mindful parenting and the observational ratings was also provided through hierarchical regression analyses conducted with a continuous predictor of mindful parenting using the full sample. Thus, the present study provides preliminary evidence for a link between self-reported mindful parenting and observed interactions between parents and youth. PMID:25844494

Obtaining evidence for use by healthcare payers on the success of chronic obstructive pulmonary disease management.

PubMed

Mapel, D; Pearson, M

2002-08-01

Healthcare payers make decisions on funding for treatments for diseases, such as chronic obstructive pulmonary disease (COPD), on a population level, so require evidence of treatment success in appropriate populations, using usual routine care as the comparison for alternative management approaches. Such health outcomes evidence can be obtained from a number of sources. The 'gold standard' method for obtaining evidence of treatment success is usually taken as the randomized controlled prospective clinical trial. Yet the value of such studies in providing evidence for decision-makers can be questioned due to the restricted entry criteria limiting the ability to generalize to real life populations, narrow focus on individual parameters, use of placebo for comparison rather than usual therapy and unrealistic intense monitoring of patients. Evidence obtained from retrospective and observational studies can supplement that from randomized clinical trials, providing that care is taken to guard against bias and confounders. However, very large numbers of patients must be investigated if small differences between drugs and treatment approaches are to be detected. Administrative databases from healthcare systems provide an opportunity to obtain observational data on large numbers of patients. Such databases have shown that high healthcare costs in patients with COPD are associated with co-morbid conditions and current smoking status. Analysis of an administrative database has also shown that elderly patients with COPD who received inhaled corticosteroids within 90 days of discharge from hospital had 24% fewer repeat hospitalizations for COPD and were 29% less likely to die during the 1-year follow-up period. In conclusion, there are a number of sources of meaningful evidence of the health outcomes arising from different therapeutic approaches that should be of value to healthcare payers making decisions on resource allocation.

Governance in Health - The Need for Exchange and Evidence Comment on "Governance, Government, and the Search for New Provider Models".

PubMed

Chanturidze, Tata; Obermann, Konrad

2016-05-17

Governance in health is cited as one of the key factors in balancing the concerns of the government and public sector with the interests of civil society/private players, but often remains poorly described and operationalized. Richard Saltman and Antonio Duran look at two aspects in the search for new provider models in a context of health markets signalling liberalisation: (i) the role of the government to balance public and private interests and responsibilities in delivering care through modernised governance arrangements, and (ii) the finding that operational complexities may hinder well-designed provider governance models, unless governance reflects country-specific realities. This commentary builds on the discussion by Saltman and Duran, and argues that the concept of governance needs to be clearly defined and operationalized in order to be helpful for policy debate as well as for the development of an applicable framework for performance improvement. It provides a working definition of governance and includes a reflection on the prevailing cultural norms in an organization or society upon which any governance needs to be build. It proposes to explore whether the "evidence-based governance" concept can be introduced to generate knowledge about innovative and effective governance models, and concludes that studies similar to the one by Saltman and Duran can inform this debate. © 2016 by Kerman University of Medical Sciences.

Microdam Impoundments Provide Suitable Habitat for Larvae of Malaria Vectors: An Observational Study in Western Kenya.

PubMed

McCann, Robert S; Gimnig, John E; Bayoh, M Nabie; Ombok, Maurice; Walker, Edward D

2018-05-04

Impoundments formed by microdams in rural areas of Africa are important sources of water for people, but they provide potential larval habitats for Anopheles (Diptera: Culicidae) mosquitoes that are vectors of malaria. To study this association, the perimeters of 31 microdam impoundments in western Kenya were sampled for Anopheles larvae in three zones (patches of floating and emergent vegetation, shorelines of open water, and aggregations of cattle hoofprints) across dry and rainy seasons. Of 3,169 larvae collected, most (86.8%) were collected in the rainy season. Of 2,403 larvae successfully reared to fourth instar or adult, nine species were identified; most (80.2%) were Anopheles arabiensis Patton, sampled from hoofprint zones in the rainy season. Other species collected were Anopheles coustani Laveran, Anopheles gambiae s.s. Giles, Anopheles funestus Giles, and Anopheles rivulorum Leeson, Anopheles pharoensis Theobald, Anopheles squamosus Theobald, Anopheles rufipes (Gough), and Anopheles ardensis (Theobald). Larvae of An. funestus were uncommon (1.5%) in both dry and rainy seasons and were confined to vegetated zones, suggesting that microdam impoundments are not primary habitats for this important vector species, although microdams may provide a dry season refuge habitat for malaria vectors, contributing to population persistence through the dry season. In this study, microdam impoundments clearly provided habitat for the malaria vector An. arabiensis in the rainy season, most of which was within the shallow apron side of the impoundments where people brought cattle for watering, resulting in compacted soil with aggregations of water-filled hoofprints. This observation suggests a potential conflict between public health concerns about malaria and people's need for stable and reliable sources of water.

Rectal cancer: An evidence-based update for primary care providers

PubMed Central

Gaertner, Wolfgang B; Kwaan, Mary R; Madoff, Robert D; Melton, Genevieve B

2015-01-01

Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage II and III rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize disease-free and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers. PMID:26167068

Observational evidence of EHP effects on the melting of snowpack over the Tibetan Plateau

NASA Astrophysics Data System (ADS)

Kim, M.; Lau, W. K.; Kim, K.; Lee, W.

2012-12-01

Observational evidences are presented showing that the Indo-Gangetic Plain (IGP) regions, bounded by the high altitude Himalayan mountains, are subject to heavy loading of absorbing aerosols, i.e., black carbon and dust, which can lead to widespread enhancement warming over the Tibetan Plateau and accelerated snowmelt in the western Tibetan Plateau (WTP) and Himalayas. The two pre-monsoon seasons of 2004 and 2005 were strikingly contrasting in terms of the aerosol loading over IGP. The warming of the TP in 2004 relative to 2005 was widespread, covering most of the WTP and Himalayas. This warming is closely linked to patterns of the snow melt. Consistent with the Elevated Heat Pump hypothesis, we find that increased loading of absorbing aerosols over IGP in the pre-monsoon season is associated with increased heating of the upper troposphere by dynamical feedback induced by aerosol heating, and enhances the rate of snowmelt over Himalayas and the WTP in April-May. Composite analysis with more contrasting years also shows that the heating of the troposphere by elevated dust and black carbon aerosols in the boreal sping can lead to widespread enhanced land-atmosphere warming, and accelated snow melt in the Himalayas and Tibetan Plateau.

Observational Evidence of EHP Effects on the Melting of Snowpack over the Tibetan Plateau

NASA Technical Reports Server (NTRS)

Kim, Maeng-Ki; Lau, William K. M.; Kim, Kyu-Myong; Lee, Woo-Seop

2012-01-01

Observational evidences are presented showing that the Indo-Gangetic Plain (IGP) regions, bounded by the high altitude Himalayan mountains, are subject to heavy loading of absorbing aerosols, i.e., black carbon and dust, which can lead to widespread enhancement warming over the Tibetan Plateau and accelerated snowmelt in the western Tibetan Plateau (WTP) and Himalayas. The two pre-monsoon seasons of 2004 and 2005 were strikingly contrasting in terms of the aerosol loading over IGP. The warming of the TP in 2004 relative to 2005 was widespread, covering most of the WTP and Himalayas. This warming is closely linked to patterns of the snow melt. Consistent with the Elevated Heat Pump hypothesis, we find that increased loading of absorbing aerosols over IGP in the pre-monsoon season is associated with increased heating of the upper troposphere by dynamical feedback induced by aerosol heating, and enhances the rate of snowmelt over Himalayas and the WTP in April-May. Composite analysis with more contrasting years also shows that the heating of the troposphere by elevated dust and black carbon aerosols in the boreal spring can lead to widespread enhanced land-atmosphere warming, and accelerated snow melt in the Himalayas and Tibetan Plateau.

Changes in extremes due to half a degree warming in observations and models

NASA Astrophysics Data System (ADS)

Fischer, E. M.; Schleussner, C. F.; Pfleiderer, P.

2017-12-01

Assessing the climate impacts of half-a-degree warming increments is high on the post-Paris science agenda. Discriminating those effects is particularly challenging for climate extremes such as heavy precipitation and heat extremes for which model uncertainties are generally large, and for which internal variability is so important that it can easily offset or strongly amplify the forced local changes induced by half a degree warming. Despite these challenges we provide evidence for large-scale changes in the intensity and frequency of climate extremes due to half a degree warming. We first assess the difference in extreme climate indicators in observational data for the 1960s and 1970s versus the recent past, two periods differ by half a degree. We identify distinct differences for the global and continental-scale occurrence of heat and heavy precipitation extremes. We show that those observed changes in heavy precipitation and heat extremes broadly agree with simulated historical differences and are informative for the projected differences between 1.5 and 2°C warming despite different radiative forcings. We therefore argue that evidence from the observational record can inform the debate about discernible climate impacts in the light of model uncertainty by providing a conservative estimate of the implications of 0.5°C warming. A limitation of using the observational record arises from potential non-linearities in the response of climate extremes to a certain level of warming. We test for potential non-linearities in the response of heat and heavy precipitation extremes in a large ensemble of transient climate simulations. We further quantify differences between a time-window approach in a coupled model large ensemble vs. time-slice experiments using prescribed SST experiments performed in the context of the HAPPI-MIP project. Thereby we provide different lines of evidence that half a degree warming leads to substantial changes in the expected occurrence of

Climate change: the evidence and our options.

PubMed

Thompson, Lonnie G

2010-01-01

Glaciers serve as early indicators of climate change. Over the last 35 years, our research team has recovered ice-core records of climatic and environmental variations from the polar regions and from low-latitude high-elevation ice fields from 16 countries. The ongoing widespread melting of high-elevation glaciers and ice caps, particularly in low to middle latitudes, provides some of the strongest evidence to date that a large-scale, pervasive, and, in some cases, rapid change in Earth's climate system is underway. This paper highlights observations of 20th and 21st century glacier shrinkage in the Andes, the Himalayas, and on Mount Kilimanjaro. Ice cores retrieved from shrinking glaciers around the world confirm their continuous existence for periods ranging from hundreds of years to multiple millennia, suggesting that climatological conditions that dominate those regions today are different from those under which these ice fields originally accumulated and have been sustained. The current warming is therefore unusual when viewed from the millennial perspective provided by multiple lines of proxy evidence and the 160-year record of direct temperature measurements. Despite all this evidence, plus the well-documented continual increase in atmospheric greenhouse gas concentrations, societies have taken little action to address this global-scale problem. Hence, the rate of global carbon dioxide emissions continues to accelerate. As a result of our inaction, we have three options: mitigation, adaptation, and suffering.

Climate Change: The Evidence and Our Options

PubMed Central

Thompson, Lonnie G

2010-01-01

Glaciers serve as early indicators of climate change. Over the last 35 years, our research team has recovered ice-core records of climatic and environmental variations from the polar regions and from low-latitude high-elevation ice fields from 16 countries. The ongoing widespread melting of high-elevation glaciers and ice caps, particularly in low to middle latitudes, provides some of the strongest evidence to date that a large-scale, pervasive, and, in some cases, rapid change in Earth's climate system is underway. This paper highlights observations of 20th and 21st century glacier shrinkage in the Andes, the Himalayas, and on Mount Kilimanjaro. Ice cores retrieved from shrinking glaciers around the world confirm their continuous existence for periods ranging from hundreds of years to multiple millennia, suggesting that climatological conditions that dominate those regions today are different from those under which these ice fields originally accumulated and have been sustained. The current warming is therefore unusual when viewed from the millennial perspective provided by multiple lines of proxy evidence and the 160-year record of direct temperature measurements. Despite all this evidence, plus the well-documented continual increase in atmospheric greenhouse gas concentrations, societies have taken little action to address this global-scale problem. Hence, the rate of global carbon dioxide emissions continues to accelerate. As a result of our inaction, we have three options: mitigation, adaptation, and suffering. PMID:22532707

Evidence accumulation detected in BOLD signal using slow perceptual decision making.

PubMed

Krueger, Paul M; van Vugt, Marieke K; Simen, Patrick; Nystrom, Leigh; Holmes, Philip; Cohen, Jonathan D

2017-04-01

We assessed whether evidence accumulation could be observed in the BOLD signal during perceptual decision making. This presents a challenge since the hemodynamic response is slow, while perceptual decisions are typically fast. Guided by theoretical predictions of the drift diffusion model, we slowed down decisions by penalizing participants for incorrect responses. Second, we distinguished BOLD activity related to stimulus detection (modeled using a boxcar) from activity related to integration (modeled using a ramp) by minimizing the collinearity of GLM regressors. This was achieved by dissecting a boxcar into its two most orthogonal components: an "up-ramp" and a "down-ramp." Third, we used a control condition in which stimuli and responses were similar to the experimental condition, but that did not engage evidence accumulation of the stimuli. The results revealed an absence of areas in parietal cortex that have been proposed to drive perceptual decision making but have recently come into question; and newly identified regions that are candidates for involvement in evidence accumulation. Previous fMRI studies have either used fast perceptual decision making, which precludes the measurement of evidence accumulation, or slowed down responses by gradually revealing stimuli. The latter approach confounds perceptual detection with evidence accumulation because accumulation is constrained by perceptual input. We slowed down the decision making process itself while leaving perceptual information intact. This provided a more sensitive and selective observation of brain regions associated with the evidence accumulation processes underlying perceptual decision making than previous methods. Copyright © 2017 Elsevier B.V. All rights reserved.

Observational evidence for volcanic impact on sea level and the global water cycle

PubMed Central

Grinsted, A.; Moore, J. C.; Jevrejeva, S.

2007-01-01

It has previously been noted that there are drops in global sea level (GSL) after some major volcanic eruptions. However, observational evidence has not been convincing because there is substantial variability in the global sea level record over periods similar to those at which we expect volcanoes to have an impact. To quantify the impact of volcanic eruptions we average monthly GSL data from 830 tide gauge records around five major volcanic eruptions. Surprisingly, we find that the initial response to a volcanic eruption is a significant rise in sea level of 9 ± 3 mm in the first year after the eruption. This rise is followed by a drop of 7 ± 3 mm in the period 2–3 years after the eruption relative to preeruption sea level. These results are statistically robust and no particular volcanic eruption or ocean region dominates the signature we find. Neither the drop nor especially the rise in GSL can be explained by models of lower oceanic heat content. We suggest that the mechanism is a transient disturbance of the water cycle with a delayed response of land river runoff relative to ocean evaporation and global precipitation that affects global sea level. The volcanic impact on the water cycle and sea levels is comparable in magnitude to that of a large El Niño–La Niña cycle, amounting to ≈5% of global land precipitation. PMID:18056644

Observational evidence for volcanic impact on sea level and the global water cycle.

PubMed

Grinsted, A; Moore, J C; Jevrejeva, S

2007-12-11

It has previously been noted that there are drops in global sea level (GSL) after some major volcanic eruptions. However, observational evidence has not been convincing because there is substantial variability in the global sea level record over periods similar to those at which we expect volcanoes to have an impact. To quantify the impact of volcanic eruptions we average monthly GSL data from 830 tide gauge records around five major volcanic eruptions. Surprisingly, we find that the initial response to a volcanic eruption is a significant rise in sea level of 9 +/- 3 mm in the first year after the eruption. This rise is followed by a drop of 7 +/- 3 mm in the period 2-3 years after the eruption relative to preeruption sea level. These results are statistically robust and no particular volcanic eruption or ocean region dominates the signature we find. Neither the drop nor especially the rise in GSL can be explained by models of lower oceanic heat content. We suggest that the mechanism is a transient disturbance of the water cycle with a delayed response of land river runoff relative to ocean evaporation and global precipitation that affects global sea level. The volcanic impact on the water cycle and sea levels is comparable in magnitude to that of a large El Niño-La Niña cycle, amounting to approximately 5% of global land precipitation.

The relationship between defecation and feeding in nestling birds: observational and experimental evidence.

PubMed

Quan, Rui-Chang; Li, Huan; Wang, Bo; Goodale, Eben

2015-01-01

Adult birds clean the nest by consuming or transporting feces, which is thought to be important in order to lower the levels of parasites, pathogens and predation at the nest. If nestlings were to defecate when parents were absent, however, feces could accumulate in the nest. To understand the mechanism by which nest sanitation is maintained, we studied the timing of defecation in nestling birds of common passerine species in southwest China. In 159 nests of 8 species at the nestling stage during 779 randomly timed observations, we never found fecal sacs present. Video recordings, totaling 455 h at five Pycnonotus jocosus nests in the field, showed almost all defecation after feedings, and only nestlings that were fed defecated. Six translocated P. jocosus nests were taken into captivity in order to manipulate the frequency of feeding. These nestlings defecated only after feeding, even when feeding intervals were extended to 60 and 120 min. The fecal sac weight also increased with extended feeding intervals, demonstrating a remarkable plasticity for nestlings to wait for feedings. The evidence allows two major conclusions: 1) defecation in the nest occurs at a time that ensures nest sanitation, stimulated by feeding, rather than there being a set time of gut processing between feeding and excretion; 2) the strong plasticity in the timing of defecation and the possibility of negative repercussions (if defecation occurs when parents are absent) are important mechanisms underlying the efficiency of the feeding-defecation system.

Observational evidence for thermal wave fronts in solar flares

NASA Technical Reports Server (NTRS)

Rust, D. M.; Simnett, G. M.; Smith, D. F.

1985-01-01

Images in 3.5-30 keV X-rays obtained during the first few minutes of seven solar flares show rapid motions. In each case X-ray emission first appeared at one end of a magnetic field structure, and then propagated along the field at a velocity between 800 and 1700 km/s. The observed X-ray structures were 45,000-230,000 km long. Simultaneous H-alpha images were available in three cases; they showed brightenings when the fast-moving fronts arrived at the chromosphere. The fast-moving fronts are interpreted as electron thermal conduction fronts since their velocities are consistent with conduction at the observed temperatures of 1-3 x 10 to the 7th K. The inferred conductive heat flux of up to 10-billion ergs/s sq cm accounts for most of the energy released in the flares, implying that the flares were primarily thermal phenomena.

Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.

PubMed

Marques, Luana; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi M; Wiltsey Stirman, Shannon

2016-08-01

This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The Sensitivity of Precocious Child Writers: More Evidence of the Double-Edged Sword

ERIC Educational Resources Information Center

Edmunds, Alan L.; Edmunds, Gail

2014-01-01

This article provides further evidence of the often observed sensitive nature displayed by children who are gifted. It also addresses the positive and negative effects that this sensitivity can have on these individuals. Earlier, the authors explored this concept through an analysis of the works and life experiences of Geoffrey, aged 9, a prolific…

Venus lives!. [evidence for active volcanoes

NASA Technical Reports Server (NTRS)

Wood, Charles A.; Francis, Peter W.

1988-01-01

Observational evidence which supports the contention that Venus is a volcanically and tectonically active planet is discussed. It is argued that, although there are no observations to date that would prove that Venus has been volcanically active during the last decade, planetological studies presented evidence for youthful volcanic mountains on Venus: the surface of the northern quarter of Venus is considered to be younger than 1 Gy, and some units are likely to be much younger. Because of the small sizes of likely volcanic manifestations and the long intervals expected between eruptions, it is unlikely that any direct evidence of eruptions will be detected with existing and planned spacecraft. It is suggested that future studies of the dynamics and the chemical mixing of the Venusian atmosphere might supply an unequivocal evidence for active volcanism on this planet.

Simultaneous Solar Maximum Mission (SMM) and very large array observations of solar active regions

NASA Technical Reports Server (NTRS)

Lang, K. R.

1986-01-01

The research deals mainly with Very Large Array and Solar Maximum Mission observations of the ubiquitous coronal loops that dominate the structure of the low corona. As illustrated, the observations of thermal cyclotron lines at microwave wavelengths provide a powerful new method of accurately specifying the coronal magnetic field strength. Processes are delineated that trigger solar eruptions from coronal loops, including preburst heating and the magnetic interaction of coronal loops. Evidence for coherent burst mechanisms is provided for both the Sun and nearby stars, while other observations suggest the presence of currents that may amplify the coronal magnetic field to unexpectedly high levels. The existence is reported of a new class of compact, variable moving sources in regions of apparently weak photospheric field.

Development of observational learning during school formation in jack mackerel Trachurus japonicus juveniles.

PubMed

Takahashi, Kohji; Masuda, Reiji; Yamashita, Yoh

2014-03-01

We assessed whether the development of observational learning in jack mackerel Trachurus japonicus juveniles corresponds with that of their schooling behaviour. Schooling behaviour was quantitatively analyzed by nearest neighbour distance and separation angle in two size classes of fish, 20-mm and 40-mm in body length. Observer and non-observer fish with matching sizes were conditioned to pellets by temporarily stopping aeration. Observer fish were provided with five observation trials of other individuals feeding near an air stone when aeration was stopped. After the observation trial, fish were conditioned to pellets with the stop of aeration, and then the learning process was evaluated by the increase in the association with the feeding area when aeration was stopped. In 20-mm fish, which were at an immature stage of schooling behaviour, there was no difference in the learning process between observer and non-observer fish. In contrast, 40-mm fish were confirmed to have a well-developed schooling behaviour, and the observer learnt the feeding area more efficiently than the non-observer. This study provides evidence that observational learning develops along with the development of the social interaction. Copyright © 2013 Elsevier B.V. All rights reserved.

Exploring the Symbiodinium rare biosphere provides evidence for symbiont switching in reef-building corals.

PubMed

Boulotte, Nadine M; Dalton, Steven J; Carroll, Andrew G; Harrison, Peter L; Putnam, Hollie M; Peplow, Lesa M; van Oppen, Madeleine Jh

2016-11-01

Reef-building corals possess a range of acclimatisation and adaptation mechanisms to respond to seawater temperature increases. In some corals, thermal tolerance increases through community composition changes of their dinoflagellate endosymbionts (Symbiodinium spp.), but this mechanism is believed to be limited to the Symbiodinium types already present in the coral tissue acquired during early life stages. Compelling evidence for symbiont switching, that is, the acquisition of novel Symbiodinium types from the environment, by adult coral colonies, is currently lacking. Using deep sequencing analysis of Symbiodinium rDNA internal transcribed spacer 2 (ITS2) PCR amplicons from two pocilloporid coral species, we show evidence consistent with de novo acquisition of Symbiodinium types from the environment by adult corals following two consecutive bleaching events. Most of these newly detected symbionts remained in the rare biosphere (background types occurring below 1% relative abundance), but one novel type reached a relative abundance of ~33%. Two de novo acquired Symbiodinium types belong to the thermally resistant clade D, suggesting that this switching may have been driven by consecutive thermal bleaching events. Our results are particularly important given the maternal mode of Symbiodinium transmission in the study species, which generally results in high symbiont specificity. These findings will cause a paradigm shift in our understanding of coral-Symbiodinium symbiosis flexibility and mechanisms of environmental acclimatisation in corals.

Exploring the Symbiodinium rare biosphere provides evidence for symbiont switching in reef-building corals

PubMed Central

Boulotte, Nadine M; Dalton, Steven J; Carroll, Andrew G; Harrison, Peter L; Putnam, Hollie M; Peplow, Lesa M; van Oppen, Madeleine JH

2016-01-01

Reef-building corals possess a range of acclimatisation and adaptation mechanisms to respond to seawater temperature increases. In some corals, thermal tolerance increases through community composition changes of their dinoflagellate endosymbionts (Symbiodinium spp.), but this mechanism is believed to be limited to the Symbiodinium types already present in the coral tissue acquired during early life stages. Compelling evidence for symbiont switching, that is, the acquisition of novel Symbiodinium types from the environment, by adult coral colonies, is currently lacking. Using deep sequencing analysis of Symbiodinium rDNA internal transcribed spacer 2 (ITS2) PCR amplicons from two pocilloporid coral species, we show evidence consistent with de novo acquisition of Symbiodinium types from the environment by adult corals following two consecutive bleaching events. Most of these newly detected symbionts remained in the rare biosphere (background types occurring below 1% relative abundance), but one novel type reached a relative abundance of ~33%. Two de novo acquired Symbiodinium types belong to the thermally resistant clade D, suggesting that this switching may have been driven by consecutive thermal bleaching events. Our results are particularly important given the maternal mode of Symbiodinium transmission in the study species, which generally results in high symbiont specificity. These findings will cause a paradigm shift in our understanding of coral-Symbiodinium symbiosis flexibility and mechanisms of environmental acclimatisation in corals. PMID:27093048

New Insight into the Solar System’s Transition Disk Phase Provided by the Metal-rich Carbonaceous Chondrite Isheyevo

NASA Astrophysics Data System (ADS)

Morris, Melissa A.; Garvie, Laurence A. J.; Knauth, L. Paul

2015-03-01

Many aspects of planet formation are controlled by the amount of gas remaining in the natal protoplanetary disks (PPDs). Infrared observations show that PPDs undergo a transition stage at several megayears, during which gas densities are reduced. Our Solar System would have experienced such a stage. However, there is currently no data that provides insight into this crucial time in our PPD’s evolution. We show that the Isheyevo meteorite contains the first definitive evidence for a transition disk stage in our Solar System. Isheyevo belongs to a class of metal-rich meteorites whose components have been dated at almost 5 Myr after formation of Ca, Al-rich inclusions, and exhibits unique sedimentary layers that imply formation through gentle sedimentation. We show that such layering can occur via the gentle sweep-up of material found in the impact plume resulting from the collision of two planetesimals. Such sweep-up requires gas densities consistent with observed transition disks (10-12-10-11 g cm-3). As such, Isheyevo presents the first evidence of our own transition disk and provides new constraints on the evolution of our solar nebula.

Competitive Dominance among Strains of Luminous Bacteria Provides an Unusual Form of Evidence for Parallel Evolution in Sepiolid Squid-Vibrio Symbioses

PubMed Central

Nishiguchi, Michele K.; Ruby, Edward G.; McFall-Ngai, Margaret J.

1998-01-01

One of the principal assumptions in symbiosis research is that associated partners have evolved in parallel. We report here experimental evidence for parallel speciation patterns among several partners of the sepiolid squid-luminous bacterial symbioses. Molecular phylogenies for 14 species of host squids were derived from sequences of both the nuclear internal transcribed spacer region and the mitochondrial cytochrome oxidase subunit I; the glyceraldehyde phosphate dehydrogenase locus was sequenced for phylogenetic determinations of 7 strains of bacterial symbionts. Comparisons of trees constructed for each of the three loci revealed a parallel phylogeny between the sepiolids and their respective symbionts. Because both the squids and their bacterial partners can be easily cultured independently in the laboratory, we were able to couple these phylogenetic analyses with experiments to examine the ability of the different symbiont strains to compete with each other during the colonization of one of the host species. Our results not only indicate a pronounced dominance of native symbiont strains over nonnative strains, but also reveal a hierarchy of symbiont competency that reflects the phylogenetic relationships of the partners. For the first time, molecular systematics has been coupled with experimental colonization assays to provide evidence for the existence of parallel speciation among a set of animal-bacterial associations. PMID:9726861

Testing spatial uniformity of the CR spectrum in the local ISM with γ-ray observations

NASA Astrophysics Data System (ADS)

Prokhorov, D. A.; Colafrancesco, S.

2018-05-01

Gamma-ray observations of nearby radio-line-emitting gas structures in the interstellar medium allow us to probe the spectrum of cosmic rays (CRs). In this paper, we analysed Fermi Large Area Telescope (LAT) γ-ray observations of three such structures located near each other to check if their CR spectra are compatible with that of the CR background or might provide evidence for a population of "fresh" CRs. We found that the shape of the γ-ray spectrum in the Aquarius HI shell is consistent with the previously published stacked γ-ray spectrum of the Gould Belt molecular clouds. We also found that assumptions on the diffuse Galactic γ-ray background affect the spectral shapes of CRs derived in the R Coronae Australis and ρ Ophiuchi molecular clouds in which spectral deviations had previously been suggested. These two facts provide evidence to support the hypothesis of uniformity of the shapes of cosmic ray spectra in the local Galaxy environment.

Chiropractic Observation and Analysis Study (COAST): providing an understanding of current chiropractic practice.

PubMed

French, Simon D; Charity, Melanie J; Forsdike, Kirsty; Gunn, Jane M; Polus, Barbara I; Walker, Bruce F; Chondros, Patty; Britt, Helena C

2013-11-18

COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.

45 CFR 79.34 - Evidence.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Evidence. 79.34 Section 79.34 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.34 Evidence. (a) The ALJ shall determine the admissibility of evidence. (b) Except as provided in this part, the...

Evidence-Based Reform in Education

ERIC Educational Resources Information Center

Slavin, Robert E.

2017-01-01

Education policies should support the use of programs and practices with strong evidence of effectiveness. The Every Student Succeeds Act (ESSA) contains evidence standards and incentives to use programs that meet them. This provides a great opportunity for evidence to play a stronger role in decisions about education programs and practices.…

6 CFR 13.34 - Evidence.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Evidence. 13.34 Section 13.34 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.34 Evidence. (a) The ALJ will determine the admissibility of evidence. (b) Except as provided in this part, the ALJ...

22 CFR 51.41 - Documentary evidence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Documentary evidence. 51.41 Section 51.41 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.41 Documentary evidence. The applicant must provide documentary evidence that he or she is a...

22 CFR 51.41 - Documentary evidence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Documentary evidence. 51.41 Section 51.41 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.41 Documentary evidence. The applicant must provide documentary evidence that he or she is a...

22 CFR 51.41 - Documentary evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Documentary evidence. 51.41 Section 51.41 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.41 Documentary evidence. The applicant must provide documentary evidence that he or she is a...

22 CFR 51.41 - Documentary evidence.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Documentary evidence. 51.41 Section 51.41 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.41 Documentary evidence. The applicant must provide documentary evidence that he or she is a...

22 CFR 51.41 - Documentary evidence.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Documentary evidence. 51.41 Section 51.41 Foreign Relations DEPARTMENT OF STATE NATIONALITY AND PASSPORTS PASSPORTS Evidence of U.S. Citizenship or Nationality § 51.41 Documentary evidence. The applicant must provide documentary evidence that he or she is a...

Evidence-based Assessment in Pediatric Psychology: Family Measures

PubMed Central

Fiese, Barbara H.; Gold, Jeffrey I.; Cutuli, J. J.; Holmbeck, Grayson N.; Goldbeck, Lutz; Chambers, Christine T.; Abad, Mona; Spetter, Dante; Patterson, Joän

2008-01-01

Objective To provide a review of the evidence base of family measures relevant to pediatric psychology. Method Twenty-nine family measures were selected based upon endorsement by Division 54 listserv members, expert judgment, and literature review. Spanning observational and self-report methods, the measures fell into three broad assessment categories: Family functioning, Dyadic family relationships, and Family functioning in the context of childhood chronic health conditions. Measures were categorized as: “Well-established”, “Approaching well-established”, or “Promising.” Results Nineteen measures met “well-established” criteria and the remaining ten were “approaching well-established.” “Well-established” measures were documented for each of the broad assessment categories named above. Conclusions Many measures deemed “well-established” in the general population are proving to be reliable and useful in pediatric samples. More evidence of the validity of family measures is needed in this context. This review should prove helpful to clinicians and researchers as they strive to make evidence-based decisions regarding family measures. PMID:17905801

Validity and feasibility of the EMG direct observation tool (EMG-DOT).

PubMed

Leep Hunderfund, Andrea N; Rubin, Devon I; Laughlin, Ruple S; Sorenson, Eric J; Watson, James C; Jones, Lyell K; Juul, Dorthea; Park, Yoon Soo

2016-04-26

To develop a new workplace-based EMG direct observation tool (EMG-DOT) and gather validity evidence supporting its use for assessing electrodiagnostic skills among postgraduate medical trainees. The EMG-DOT was developed by experts using an iterative process. Validity evidence from content, response process, internal structure, relations to other variables, and consequences of testing was collected during the 2013-2014 academic year. Of 3,412 studies performed by trainees during the study period, 299 (9%) were assessed using the EMG-DOT. Of these, 203 (68%) involved a physician rater and 96 (32%) involved a technician rater. The 14-item EMG-DOT had excellent internal-consistency reliability (Cronbach α 0.94). Correlations between individual items and criterion-referenced global ratings of performance ranged from 0.36 to 0.72 (all p < 0.001). Mean total scores increased from 70% to 80% over 4 months of the EMG rotation (p < 0.001) despite a corresponding significant increase in case complexity (0.21-0.74 on a 3-point rating scale; p < 0.001). Trainees reported that the observational assessment exercise improved their knowledge or skills in 82% of encounters (188/230) and that feedback generated by the EMG-DOT improved the quality of care provided to patients in 58% (133/230). Trainees were "satisfied" or "very satisfied" with the observational assessment exercise in 96% of encounters (234/243). This study provides validity evidence supporting the use of EMG-DOT scores to assess electrodiagnostic skills of residents and fellows. The EMG-DOT can be used to inform milestone-based assessments of trainee performance in neurology, child neurology, physical medicine and rehabilitation, neuromuscular, and clinical neurophysiology training programs. © 2016 American Academy of Neurology.

Experimental evidence for drought induced alternative stable states of soil moisture

NASA Astrophysics Data System (ADS)

Robinson, David. A.; Jones, Scott B.; Lebron, Inma; Reinsch, Sabine; Domínguez, María T.; Smith, Andrew R.; Jones, Davey L.; Marshall, Miles R.; Emmett, Bridget A.

2016-01-01

Ecosystems may exhibit alternative stable states (ASS) in response to environmental change. Modelling and observational data broadly support the theory of ASS, however evidence from manipulation experiments supporting this theory is limited. Here, we provide long-term manipulation and observation data supporting the existence of drought induced alternative stable soil moisture states (irreversible soil wetting) in upland Atlantic heath, dominated by Calluna vulgaris (L.) Hull. Manipulated repeated moderate summer drought, and intense natural summer drought both lowered resilience resulting in shifts in soil moisture dynamics. The repeated moderate summer drought decreased winter soil moisture retention by ~10%. However, intense summer drought, superimposed on the experiment, that began in 2003 and peaked in 2005 caused an unexpected erosion of resilience and a shift to an ASS; both for the experimental drought manipulation and control plots, impairing the soil from rewetting in winter. Measurements outside plots, with vegetation removal, showed no evidence of moisture shifts. Further independent evidence supports our findings from historical soil moisture monitoring at a long-term upland hydrological observatory. The results herald the need for a new paradigm regarding our understanding of soil structure, hydraulics and climate interaction.

Experimental evidence for drought induced alternative stable states of soil moisture

PubMed Central

Robinson, David. A.; Jones, Scott B.; Lebron, Inma; Reinsch, Sabine; Domínguez, María T.; Smith, Andrew R.; Jones, Davey L.; Marshall, Miles R.; Emmett, Bridget A.

2016-01-01

Ecosystems may exhibit alternative stable states (ASS) in response to environmental change. Modelling and observational data broadly support the theory of ASS, however evidence from manipulation experiments supporting this theory is limited. Here, we provide long-term manipulation and observation data supporting the existence of drought induced alternative stable soil moisture states (irreversible soil wetting) in upland Atlantic heath, dominated by Calluna vulgaris (L.) Hull. Manipulated repeated moderate summer drought, and intense natural summer drought both lowered resilience resulting in shifts in soil moisture dynamics. The repeated moderate summer drought decreased winter soil moisture retention by ~10%. However, intense summer drought, superimposed on the experiment, that began in 2003 and peaked in 2005 caused an unexpected erosion of resilience and a shift to an ASS; both for the experimental drought manipulation and control plots, impairing the soil from rewetting in winter. Measurements outside plots, with vegetation removal, showed no evidence of moisture shifts. Further independent evidence supports our findings from historical soil moisture monitoring at a long-term upland hydrological observatory. The results herald the need for a new paradigm regarding our understanding of soil structure, hydraulics and climate interaction. PMID:26804897

Methodological approaches to developing and establishing the body of evidence on post-marketing Chinese medicine safety.

PubMed

Liao, Xing; Robinson, Nicola

2013-07-01

Evidence based medicine demands the highest form of scientific evidence to demonstrate the efficacy and clinical effectiveness for any therapeutic intervention in order to provide best care. It is however accepted that in the absence of scientific evidence, personal experience and expert opinion together with professional judgement are critical. Obtaining evidence for drug safety, postmarketing surveillance (PMS) has focussed on follow up of observational cohorts exposed to a particular drug in order to estimate the incidence of adverse drug reactions (ADRs). Evidence on PMS of Chinese herbal products is still limited, in particular for herbal injections. The aim of this article is to suggest a new model of ascertaining the safety of Chinese medicine using a more comprehensive approach for collecting data. To collect safety data on the Chinese herbal injection, Kudiezi, a mixed methods approach is proposed using 18 hospital information systems to detect ADRs in order to prospectively observe 30,000 patients over 3 years. Evidence will also be collected using a questionnaire survey and through a sample of semi structured interviews. This information based on the expert opinion and the experience of clinicians will produce additional data on the frequency and types of side effects in clinical practice. Furthermore semi structured interviews with a random sample of patients receiving the injection will be carried out to ascertain any potential side effects missed. It is hoped that this comprehensive approach to data collection will accumulate wider evidence based on individual traditional Chinese medicine care and treatment and provide important feedback to the national data collection system to ensure completeness of ADR data recording, monitoring and any potential wider effects through developing improved ADR guidelines.

Coping style and depression influence the healing of diabetic foot ulcers: observational and mechanistic evidence.

PubMed

Vedhara, K; Miles, J N V; Wetherell, M A; Dawe, K; Searle, A; Tallon, D; Cullum, N; Day, A; Dayan, C; Drake, N; Price, P; Tarlton, J; Weinman, J; Campbell, R

2010-08-01

Experimental evidence suggests that the healing of diabetic foot ulcers is affected by psychosocial factors such as distress. We examined this proposal in a prospective study, in which we considered the role of psychological distress and coping style in the healing of diabetic foot ulcers over a 24 week period. We also explored the role of salivary cortisol and matrix metalloproteinases (MMPs) as potential mechanisms. For this prospective observational study we recruited 93 (68 men; mean age 60 years) patients with neuropathic or neuroischaemic diabetic foot ulcers from specialist podiatry clinics in secondary care. Clinical and demographic determinants of healing, psychological distress, coping, salivary cortisol and both MMP2 and MMP9 were assessed at baseline. Ulcers were assessed at baseline and at 6, 12 and 24 weeks post-baseline. The primary outcome was ulcer status at 24 weeks, i.e. healed vs not healed. After controlling for clinical and demographic determinants of healing, ulcer healing at 24 weeks was predicted by confrontation coping, but not by depression or anxiety. Patients with unhealed ulcers exhibited greater confrontation coping (model including depression: OR 0.809, 95% CI 0.704-0.929, p = 0.003; model including anxiety: OR 0.810, 95% CI 0.704-0.930, p = 0.003). However, change in ulcer size over the observation period was associated with depression only (p = 0.04, d = 0.31). Healed ulcers by 24 weeks were also associated with lower evening cortisol, higher precursor MMP2 and a greater cortisol awakening response. Confrontation coping and depression predict ulcer healing. Our preliminary enquiry into biological mechanisms suggests that cortisol and precursor MMP2 may underlie these relationships.

Evidence and Clinical Trials.

NASA Astrophysics Data System (ADS)

Goodman, Steven N.

1989-11-01

This dissertation explores the use of a mathematical measure of statistical evidence, the log likelihood ratio, in clinical trials. The methods and thinking behind the use of an evidential measure are contrasted with traditional methods of analyzing data, which depend primarily on a p-value as an estimate of the statistical strength of an observed data pattern. It is contended that neither the behavioral dictates of Neyman-Pearson hypothesis testing methods, nor the coherency dictates of Bayesian methods are realistic models on which to base inference. The use of the likelihood alone is applied to four aspects of trial design or conduct: the calculation of sample size, the monitoring of data, testing for the equivalence of two treatments, and meta-analysis--the combining of results from different trials. Finally, a more general model of statistical inference, using belief functions, is used to see if it is possible to separate the assessment of evidence from our background knowledge. It is shown that traditional and Bayesian methods can be modeled as two ends of a continuum of structured background knowledge, methods which summarize evidence at the point of maximum likelihood assuming no structure, and Bayesian methods assuming complete knowledge. Both schools are seen to be missing a concept of ignorance- -uncommitted belief. This concept provides the key to understanding the problem of sampling to a foregone conclusion and the role of frequency properties in statistical inference. The conclusion is that statistical evidence cannot be defined independently of background knowledge, and that frequency properties of an estimator are an indirect measure of uncommitted belief. Several likelihood summaries need to be used in clinical trials, with the quantitative disparity between summaries being an indirect measure of our ignorance. This conclusion is linked with parallel ideas in the philosophy of science and cognitive psychology.

Determinants and Developments of Employer Provided Training: Evidence from a Wage Compressed Environment

ERIC Educational Resources Information Center

Schone, Pal

2006-01-01

Using a representative employer-employee level dataset, this paper answers four questions: (1) What characterises employer provided training in Norway? (2) What characterises firms that invest heavily in employer provided training? (3) Is it the same firms that invest in employer provided all the time? (4) Has the level of employer provided…

Does Employer-Provided Health Insurance Constrain Labor Supply Adjustments to Health Shocks? New Evidence on Women Diagnosed with Breast Cancer

PubMed Central

Neumark, David; Barkowski, Scott

2013-01-01

Employment-contingent health insurance may create incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, comparing the labor supply responses to new breast cancer diagnoses of women dependent on their own employment for health insurance with the responses of women who are less dependent on their own employment for health insurance, because of actual or potential access to health insurance through their spouse’s employer. We find evidence that women who depend on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer. In the estimates that best control for unobservables associated with health insurance status, the hours reduction for women who continue to work is 8 to 11 percent smaller. Women’s subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior. PMID:23891911

On Whether People Have the Capacity to Make Observations of Mutually Excl usive Physical Phenomena Simultaneously

NASA Astrophysics Data System (ADS)

Snyder

1998-04-01

It has been shown by Einstein, Podolsky, and Rosen that in quantum mechanics two different wave functions can simultaneously characterize the same physical existent. This result means that one can make predictions regarding simultaneous, mutually exclusive features of a physical existent. It is important to ask whether people have the capacity to make observations of mutually exclusive phenomena simultaneously? Our everyday experience informs us that a human observer is capable of observing only one set of physical circumstances at a time. Evidence from psychology, though, indicates that people indeed have the capacity to make observations of mutually exclusive phenomena simultaneously, even though this capacity is not generally recognized. Working independently, Sigmund Freud and William James provided some of this evidence. How the nature of the quantum mechanical wave function is associated with the problem posed by Einstein, Podolsky, and Rosen, is addressed at the end of the paper.

Development of an observational measure of healthcare worker hand-hygiene behaviour: the hand-hygiene observation tool (HHOT).

PubMed

McAteer, J; Stone, S; Fuller, C; Charlett, A; Cookson, B; Slade, R; Michie, S

2008-03-01

Previous observational measures of healthcare worker (HCW) hand-hygiene behaviour (HHB) fail to provide adequate standard operating procedures (SOPs), accounts of inter-rater agreement testing or evidence of sensitivity to change. This study reports the development of an observational tool in a way that addresses these deficiencies. Observational categories were developed systematically, guided by a clinical guideline, previous measures and pilot hand-hygiene behaviour observations (HHOs). The measure, a simpler version of the Geneva tool, consists of HHOs (before and after low-risk, high-risk or unobserved contact), HHBs (soap, alcohol hand rub, no action, unknown), and type of HCW. Inter-observer agreement for each category was assessed by observation of 298 HHOs and HHBs by two independent observers on acute elderly and intensive care units. Raw agreement (%) and Kappa were 77% and 0.68 for HHB; 83% and 0.77 for HHO; and 90% and 0.77 for HCW. Inter-observer agreement for overall compliance of a group of HCWs was assessed by observation of 1191 HHOs and HHBs by two pairs of independent observers. Overall agreement was good (intraclass correlation coefficient = 0.79). Sensitivity to change was examined by autoregressive time-series modelling of longitudinal observations for 8 months on the intensive therapy unit during an Acinetobacter baumannii outbreak and subsequent strengthening of infection control measures. Sensitivity to change was demonstrated by a rise in compliance from 80 to 98% with an odds ratio of increased compliance of 7.00 (95% confidence interval: 4.02-12.2) P < 0.001.

Radiation inactivation method provides evidence that membrane-bound mitochondrial creatine kinase is an oligomer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Quemeneur, E.; Eichenberger, D.; Goldschmidt, D.

1988-06-30

Lyophilized suspensions of rabbit heart mitochondria have been irradiated with varying doses of gamma rays. Mitochondrial creatine kinase activity was inactivated exponentially with a radiation inactivation size of 352 or 377 kDa depending upon the initial medium. These values are in good agreement with the molecular mass previously deduced from by permeation experiments: 357 kDa. This is the first direct evidence showing that the native form of mitochondrial creatine kinase is associated to the inner membrane as an oligomer, very likely an octamer.

ASSOCIATION BETWEEN PAYMENT REFORM AND PROVIDER CONSOLIDATION

PubMed Central

Neprash, Hannah T.; Chernew, Michael E.; McWilliams, J. Michael

2017-01-01

Provider consolidation has been associated with higher health care prices and spending. Prevailing wisdom assumes that payment reform will accelerate consolidation, especially between physicians and hospitals and among physician groups, as providers position themselves to bear financial risk for the full continuum of patient care. Drawing from a number of data sources from 2008 onward, we examined the relationship between Medicare’s Accountable Care Organization (ACO) programs and provider consolidation. According to multiple measures, consolidation was underway in 2008–2010, before the Affordable Care Act (ACA) established the ACO programs. While the number of hospital mergers and specialty-oriented physician group size increased after the ACA, we found minimal evidence associating consolidation with ACO penetration at a market level or with ACO participation by physicians within markets. We conclude that payment reform has been associated with little acceleration in consolidation apart from trends already underway, but with some evidence of potential defensive consolidation in response to new payment models. PMID:28167725

Evidence-Based Medicine in Managed Care: A Survey of Current and Emerging Strategies

PubMed Central

Keckley, Paul H

2004-01-01

Background Evidence-based medicine is the “conscientious application of scientific best practice by clinicians in concert with patient understanding and values.”[1] Recent studies by the Institute of Medicine, RAND, and others have called attention to the gap between scientifically supported approaches to care and day-to-day practice by clinicians. Compounding the problem of non-adherence by providers, researchers have observed that patient compliance also falls short. As a result, avoidable costs from inappropriate variability in practice patterns coupled with patient noncompliance are a significant focus of managed care. Managed care plans play a key role in the selection of providers by consumers and in the design of benefits programs by employers. Avoidable costs from misuse, overuse, and under-use of care from clinicians is a strategic focus for health plans. The evidence upon which a plan makes coverage decisions and the incorporation of evidence in programs targeting providers, employers, and consumers was a focus of this study. Methodology A Delphi survey and 2-day interactive sessions with 128 clinical program directors and medical officers from 89 health plans were the primary methods used in this descriptive analysis. To test participant applications of evidence-based medicine in health plan medical management strategy, 3 conditions were used for illustrative purpose: managing rheumatoid arthritis, increasing remission in depression, and reducing heart disease among diabetics. Each provided a unique challenge to plans in terms of condition prevalence, strength of evidence, and cost. Key Findings Health plans incorporate evidence-based medicine in 5 areas overseen by medical management: (1) coverage decisions wherein improvements in pharmaceutical and therapeutic review processes are sought, (2) disease management efforts wherein increased attention to secondary prevention is desirable, (3) provider profiling wherein increased use of adherence

Evidence-Based Medicine in Facial Trauma.

PubMed

Dougherty, William M; Christophel, John Jared; Park, Stephen S

2017-11-01

This article provides the reader with a comprehensive review of high-level evidence-based medicine in facial trauma and highlights areas devoid of high-level evidence. The article is organized in the order one might approach a clinical problem: starting with the workup, followed by treatment considerations, operative decisions, and postoperative treatments. Individual injuries are discussed within each section, with an overview of the available high-level clinical evidence. This article not only provides a quick reference for the facial traumatologist, but also allows the reader to identify areas that lack high-level evidence, perhaps motivating future endeavors. Copyright © 2017 Elsevier Inc. All rights reserved.

Provider-patient adherence dialogue in HIV care: results of a multisite study.

PubMed

Laws, M Barton; Beach, Mary Catherine; Lee, Yoojin; Rogers, William H; Saha, Somnath; Korthuis, P Todd; Sharp, Victoria; Wilson, Ira B

2013-01-01

Few studies have analyzed physician-patient adherence dialogue about ARV treatment in detail. We comprehensively describe physician-patient visits in HIV care, focusing on ARV-related dialogue, using a system that assigns each utterance both a topic code and a speech act code. Observational study using audio recordings of routine outpatient visits by people with HIV at specialty clinics. Providers were 34 physicians and 11 non-M.D. practitioners. Of 415 patients, 66% were male, 59% African-American. 78% reported currently taking ARVs. About 10% of utterances concerned ARV treatment. Among those using ARVs, 15% had any adherence problem solving dialogue. ARV problem solving talk included significantly more directives and control parameter utterances by providers than other topics. Providers were verbally dominant, asked five times as many questions as patients, and made 21 times as many directive utterances. Providers asked few open questions, and rarely checked patients' understanding. Physicians respond to the challenges of caring for patients with HIV by adopting a somewhat physician-centered approach which is particularly evident in discussions about ARV adherence.

OBSERVATIONAL EVIDENCE AGAINST LONG-LIVED SPIRAL ARMS IN GALAXIES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foyle, K.; Rix, H.-W.; Walter, F.

2011-07-10

We test whether the spiral patterns apparent in many large disk galaxies should be thought of as dynamical features that are stationary in a corotating frame for {approx}> t{sub dyn}, as implied by the density wave approach for explaining spiral arms. If such spiral arms have enhanced star formation (SF), observational tracers for different stages of the SF sequence should show a spatial ordering, from upstream to downstream in the corotating frame: dense H I, CO, tracing molecular hydrogen gas, 24 {mu}m emission tracing enshrouded SF, and UV emission tracing unobscured young stars. We argue that such a spatial orderingmore » should be reflected in the angular cross-correlation (CC, in polar coordinates) using all azimuthal positions among pairs of these tracers; the peak of the CC should be offset from zero, in different directions inside and outside the corotation radius. Recent spiral SF simulations by Dobbs and Pringle show explicitly that for the case of a stationary spiral arm potential such angular offsets between gas and young stars of differing ages should be observable as cross-correlation offsets. We calculate the angular cross-correlations for different observational SF sequence tracers in 12 nearby spiral galaxies, drawing on a data set with high-quality maps of the neutral gas (H I, THINGS) and molecular gas (CO, HERACLES), along with 24 {mu}m emission (Spitzer, SINGS); we include FUV images (GALEX) and 3.6 {mu}m emission (Spitzer, IRAC) for some galaxies, tracing aging stars and longer timescales. In none of the resulting tracer cross-correlations for this sample do we find systematic angular offsets, which would be expected for a stationary dynamical spiral pattern of well-defined pattern speed. This result indicates that spiral density waves in their simplest form are not an important aspect of explaining spirals in large disk galaxies.« less

Determining a patient's comfort in inquiring about healthcare providers' hand-washing behavior.

PubMed

Clare, Camille A; Afzal, Omara; Knapp, Kenneth; Viola, Deborah

2013-06-01

To determine whether a patient's level of assertiveness and other factors influences her comfort level in asking her provider to wash his or her hands. In this pilot study, we developed a survey to gather cross-sectional information on a variety of factors that might explain patient willingness to ask her health-care provider to wash his or her hands. Three primary predictor variables are analyzed: (1) patient assertiveness; (2) patient familiarity with her healthcare provider; and (3) whether the patient has observed hand-washing behavior. Fifty patients participated from the Obstetrics and Gynecology Department of Metropolitan Hospital Center. Less assertive patients are much less likely than assertive patients to ask physicians to wash hands (25% versus 68%; Fisher's exact test P = 0.0427). Among the 3 assertiveness questions included in the survey, the ability to ask physicians questions during visits is most strongly indicative of willingness to ask about hand washing. Familiarity with the names of regular health-care providers has a statistically significant impact on willingness to ask about hand washing. Evidence suggests that observing hand washing behavior affects willingness to ask, but differences are not statistically significant. Results by socioeconomic status such as age, education, income, and race/ethnicity are inconclusive. A patient's level of assertiveness alone is not sufficient to determine her willingness to inquire about the hand-washing behavior of her provider. A high percentage of patients did not see their provider engaging in adequate hand washing behavior. If patients feel comfortable with their provider to inquire about their care and request hand-washing behavior, health outcomes are affected by reducing the rates of health care-associated infections.

Observational evidence of crystalline iron oxides on Mars

NASA Technical Reports Server (NTRS)

Bell, James F., III; Mccord, Thomas B.; Owensby, Pamela D.

1990-01-01

A series of new spectral observations of Mars was obtained at Mauna Kea Observatory in the 0.4-1.0-micron wavelength range during the extremely favorable 1988 opposition, which yielded new spectral reflectance and relative reflectance data for a number of distinct spots on the Martian surface at 500-600 km spatial resolution. The new spectra revealed absorptions at 0.62-0.72 micron and at 0.81-0.94 micron, both seen clearly for the first time. These absorption features are interpreted as Fe(3+) electronic transition bands that indicate the presence of crystalline ferric oxide or hydroxide minerals on the Martian surface.

Mercury radar imaging: evidence for polar ice.

PubMed

Slade, M A; Butler, B J; Muhleman, D O

1992-10-23

The first unambiguous full-disk radar mapping of Mercury at 3.5-centimeter wavelength, with the Goldstone 70-meter antenna transmitting and 26 antennas of the Very Large Array receiving, has provided evidence for the presence of polar ice. The radar experiments, conducted on 8 and 23 August 1991, were designed to image the half of Mercury not photographed by Mariner 10. The orbital geometry allowed viewing beyond the north pole of Mercury; a highly reflective region was clearly visible on the north pole during both experiments. This polar region has areas in which the circular polarization ratio (pt) was 1.0 to 1.4; values < approximately 0.1 are typical for terrestrial planets. Such high values of have hitherto been observed in radar observations only from icy regions of Mars and icy outer planet satellites.

Evidence for Evolution as Support for Big Bang

NASA Astrophysics Data System (ADS)

Gopal-Krishna

1997-12-01

With the exception of ZERO, the concept of BIG BANG is by far the most bizarre creation of the human mind. Three classical pillars of the Big Bang model of the origin of the universe are generally thought to be: (i) The abundances of the light elements; (ii) the microwave back-ground radiation; and (iii) the change with cosmic epoch in the average properties of galaxies (both active and non-active types). Evidence is also mounting for redshift dependence of the intergalactic medium, as discussed elsewhere in this volume in detail. In this contribution, I endeavour to highlight a selection of recent advances pertaining to the third category. The widely different levels of confidence in the claimed observational constraints in the field of cosmology can be guaged from the following excerpts from two leading astrophysicists: "I would bet odds of 10 to 1 on the validity of the general 'hot Big Bang' concept as a description of how our universe has evolved since it was around 1 sec. old" -M. Rees (1995), in 'Perspectives in Astrophysical Cosmology' CUP. "With the much more sensitive observations available today, no astrophysical property shows evidence of evolution, such as was claimed in the 1950s to disprove the Steady State theory" -F. Hoyle (1987), in 'Fifty years in cosmology', B. M. Birla Memorial Lecture, Hyderabad, India. The burgeoning multi-wavelength culture in astronomy has provided a tremendous boost to observational cosmology in recent years. We now proceed to illustrate this with a sequence of examples which reinforce the picture of an evolving universe. Also provided are some relevant details of the data used in these studies so that their scope can be independently judged by the readers.

Performance of new alternative providers of primary care services in England: an observational study

PubMed Central

Greaves, Felix; Laverty, Anthony A; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem

2015-01-01

Summary Objectives Health system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants – including private companies – have been allowed into the primary care market under ‘alternative provider of medical services’ contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice. Design Open cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type. Setting The English National Health Service. Participants All general practices open from 2008/2009 to 2012/2013. Main outcome measures Seventeen established quality indicators – covering clinical effectiveness, efficiency, access and patient experience. Results In total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p < 0.01 for all). Switching to a new alternative provider contract did not result in improved performance. Conclusions The introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new

Performance of new alternative providers of primary care services in England: an observational study.

PubMed

Greaves, Felix; Laverty, Anthony A; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem; Millett, Christopher

2015-05-01

Health system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants--including private companies--have been allowed into the primary care market under 'alternative provider of medical services' contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice. Open cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type. The English National Health Service. All general practices open from 2008/2009 to 2012/2013. Seventeen established quality indicators--covering clinical effectiveness, efficiency, access and patient experience. In total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p < 0.01 for all). Switching to a new alternative provider contract did not result in improved performance. The introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new entrants to clinical provider markets are performing to adequate standards and at least as well as

Immortal time bias in observational studies of time-to-event outcomes.

PubMed

Jones, Mark; Fowler, Robert

2016-12-01

The purpose of the study is to show, through simulation and example, the magnitude and direction of immortal time bias when an inappropriate analysis is used. We compare 4 methods of analysis for observational studies of time-to-event outcomes: logistic regression, standard Cox model, landmark analysis, and time-dependent Cox model using an example data set of patients critically ill with influenza and a simulation study. For the example data set, logistic regression, standard Cox model, and landmark analysis all showed some evidence that treatment with oseltamivir provides protection from mortality in patients critically ill with influenza. However, when the time-dependent nature of treatment exposure is taken account of using a time-dependent Cox model, there is no longer evidence of a protective effect of treatment. The simulation study showed that, under various scenarios, the time-dependent Cox model consistently provides unbiased treatment effect estimates, whereas standard Cox model leads to bias in favor of treatment. Logistic regression and landmark analysis may also lead to bias. To minimize the risk of immortal time bias in observational studies of survival outcomes, we strongly suggest time-dependent exposures be included as time-dependent variables in hazard-based analyses. Copyright © 2016 Elsevier Inc. All rights reserved.

Validity of therapist self-report ratings of fidelity to evidence-based practices for adolescent behavior problems: correspondence between therapists and observers.

PubMed

Hogue, Aaron; Dauber, Sarah; Lichvar, Emily; Bobek, Molly; Henderson, Craig E

2015-03-01

Developing therapist-report fidelity tools to support quality delivery of evidence-based practices in usual care is a top priority for implementation science. This study tested the reliability and accuracy of two groups of community therapists who reported on their use of family therapy (FT) and motivational interviewing/cognitive-behavioral therapy (MI/CBT) interventions during routine treatment of inner-city adolescents with conduct and substance use problems. Study cases (n = 45) were randomized into two conditions: (a) Routine Family Therapy (RFT), consisting of a single site that featured family therapy as its standard of care for behavioral treatment; or (b) Treatment As Usual (TAU), consisting of five sites that featured non-family approaches. Therapists and trained observational raters provided FT and MI/CBT adherence ratings on 157 sessions (104 RFT, 53 TAU). Overall therapist reliability was adequate for averaged FT ratings (ICC = .66) but almost non-existent for MI/CBT (ICC = .06); moreover, both RFT and TAU therapists were more reliable in reporting on FT than on MI/CBT. Both groups of therapists overestimated the extent to which they implemented FT and MI/CBT interventions. Results offer support for the feasibility of using existing therapist-report methods to anchor quality assurance procedures for FT interventions in real-world settings, though not for MI/CBT.

Remote radio observations of solar wind parameters upstream of planetary bow shocks

NASA Technical Reports Server (NTRS)

Macdowall, R. J.; Stone, R. G.; Gaffey, J. D., Jr.

1992-01-01

Radio emission is frequently produced at twice the electron plasma frequency 2fp in the foreshock region upstream of the terrestrial bow shock. Observations of this emission provide a remote diagnostic of solar wind parameters in the foreshock. Using ISEE-3 radio data, we present the first evidence that the radio intensity is proportional to the kinetic energy flux and to other parameters correlated with solar wind density. We provide a qualitative explanation of this intensity behavior and predict the detection of similar emission at Jupiter by the Ulysses spacecraft.

Corroborating evidence-based medicine.

PubMed

Mebius, Alexander

2014-12-01

Proponents of evidence-based medicine (EBM) have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. © 2014 John Wiley & Sons, Ltd.

δ15N Values in Crassostrea virginica Shells Provides Early Direct Evidence for Nitrogen Loading to Chesapeake Bay

NASA Astrophysics Data System (ADS)

Black, H. D.; Andrus, C. F. T.; Lambert, W. J.; Rick, T. C.; Gillikin, D. P.

2017-03-01

Crassostrea virginica is one of the most common estuarine bivalves in the United States’ east coast and is frequently found in archaeological sites and sub-fossil deposits. Although there have been several sclerochronological studies on stable carbon and oxygen isotopes in the shells of this species, less is known about δ15N values within their shells, which could be a useful paleoenvironmental proxy to assess estuarine nitrogen dynamics. Modern C. virginica samples were collected in Chesapeake Bay for comparison with archaeological shells from nearby sites ranging in age from ~100 to 3,200 years old. Left valves were sampled by milling the hinge area and the resulting powder was analyzed for %N and δ15N values. Comparison of δ15N values between C. virginica shells shows relatively constant values from ~1250 BC to ~1800 AD. After ~1800 AD, there are rapid increases in 15N enrichment in the shells, which continue to increase in value up to the modern shell values. The increase in δ15N values is evidence of early anthropogenic impact in Chesapeake Bay. These results corroborate the observation that coastal nitrogen pollution occurred earlier than the 19th century and support the use of oyster shell δ15N values as a useful environmental proxy.

Discourse analysis of an 'observation levels' nursing policy.

PubMed

Horsfall, J; Cleary, M

2000-11-01

The practice of special observation (or constant observation) is widely used in inpatient psychiatric facilities for the care of people who are suicidal. In this study, the policy of special observation was examined using a discourse analysis method to discern prevailing ideas and practices highlighted within the policy. After reading, studying and analysing the special observation nursing policy, the authors briefly describe the document and outline the terms and phrases prevalent within the document. These recurrent ideas are then organized into five categories: professional responsibilities, suicidality, the patient's immediate context, the patient's observable behaviour and the nursing checklist. In discussion of the policy document, the invisibility of the authors, target audience and patients is noted. The authors attempt to elicit evidence for the therapeutic nurse-patient relationship in the document. In the analysis of patient, nurse and doctor roles and responsibilities, it is evident that the policy document reinforces the traditional medical hierarchy of power relations. Some assumptions that underpin the document are postulated. Questions regarding the nature of risk assessment and the evidence base for the medical prescription of special observation are raised. As well as ideas and themes evident in the document, the absence of some relevant issues is explored. While the need for succinctness and clarity in policy documents is acknowledged, the fact that patient rights, therapeutic processes and ethical dilemmas are absent is deemed significant.

Does the Brief Observation of Social Communication Change help moving forward in measuring change in early autism intervention studies?

PubMed

Pijl, Mirjam Kj; Rommelse, Nanda Nj; Hendriks, Monica; De Korte, Manon Wp; Buitelaar, Jan K; Oosterling, Iris J

2018-02-01

The field of early autism research is in dire need of outcome measures that adequately reflect subtle changes in core autistic behaviors. This article compares the ability of a newly developed measure, the Brief Observation of Social Communication Change (BOSCC), and the Autism Diagnostic Observation Schedule (ADOS) to detect changes in core symptoms of autism in 44 toddlers. The results provide encouraging evidence for the Brief Observation of Social Communication Change as a candidate outcome measure, as reflected in sufficient inter- and intra-rater reliability, independency from other child characteristics, and sensitivity to capture change. Although the Brief Observation of Social Communication Change did not evidently outperform the Autism Diagnostic Observation Schedule on any of these quality criteria, the instrument may be better able to capture subtle, individual changes in core autistic symptoms. The promising findings warrant further study of this new instrument.

A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy.

PubMed

Trambert, Renee; Kowalski, Mildred Ortu; Wu, Betty; Mehta, Nimisha; Friedman, Paul

2017-10-01

Aromatherapy has been used to reduce anxiety in a variety of settings, but usefulness associated with breast biopsies has not been documented. This study was conducted in women undergoing image-guided breast biopsy. We explored the use of two different aromatherapy scents, compared to placebo, aimed at reducing anxiety with the intent of generating new knowledge. This was a randomized, placebo-controlled study of two different types of external aromatherapy tabs (lavender-sandalwood and orange-peppermint) compared with a matched placebo-control delivery system. Anxiety was self-reported before and after undergoing a breast biopsy using the Spielberger State Anxiety Inventory Scale. Eighty-seven women participated in this study. There was a statistically significant reduction in self-reported anxiety with the use of the lavender-sandalwood aromatherapy tab compared with the placebo group (p = .032). Aromatherapy tabs reduced anxiety during image-guided breast biopsy. The completion of the biopsy provided some relief from anxiety in all groups. The use of aromatherapy tabs offers an evidence-based nursing intervention to improve adaptation and reduce anxiety for women undergoing breast biopsy. Lavender-sandalwood aromatherapy reduced anxiety and promoted adaptation more than orange-peppermint aromatherapy or placebo. © 2017 Sigma Theta Tau International.

Mariner V: Plasma and Magnetic Fields Observed near Venus.

PubMed

Bridge, H S; Lazarus, A J; Snyder, C W; Smith, E J; Davis, L; Coleman, P J; Jones, D E

1967-12-29

Abrupt changes in the amplitude of the magnetic fluctuations, in the field strength, and in the plasma properties, were observed with Mariner V near Venus. They provide clear evidence for the presence of a bow shock around the planet, similar to, but much smaller than, that observed at Earth. The observations appear consistent with an interaction of the solar wind with the ionosphere of Venus. No planetary field could be detected, but a steady radial field and very low plasma density were found 10,000 to 20,000 kilometers behind Venus and 8,000 to 12,000 kilometers from the Sun-Venus line. These observations may be interpreted as relating to an expansion wave tending to fill the cavity produced by Venus in the solar wind. The upper limit to the magnetic dipole moment of Venus is estimated to be within a factor of 2 of 10(-3) items that of Earth.