Discrepancies between ClinicalTrials.gov recruitment status and actual trial status: a cross-sectional analysis

To determine the accuracy of the recruitment status listed on ClinicalTrials.gov as compared with the actual trial status

The Simplest Government Heuristic of All: Citizens Infer that Governing Parties are Pro-European Union

Previous research documents that citizens apply a “coalition heuristic” to infer that governing coalition partners share more similar policies and ideologies than are implied by the statements in their election manifestos. We propose even simpler government-related heuristics citizens can apply to infer party positions on European integration: the current government heuristic that currently governing parties are more pro-Europe than opposition parties, and the long-term opposition heuristic that opposition parties that have never governed are less pro-Europe than opposition parties with previous governing experience. We report theoretical and empirical analyses of survey data from 24 European Union member states, which substantiate that citizens apply these heuristics, which have consequences for citizens’ policy beliefs and their party support. We also find evidence that citizens respond to policy as measured through election manifestos and expert surveys

Job-Related Burnout among Juvenile Probation Officers: Implications for Mental Health Stigma and Competency

The high demands and responsibilities of probation work, particularly with juvenile clients, may lead to burnout, which can negatively impact how probation officers work with clients, particularly individuals with behavioral health concerns. Yet, research examining burnout and related outcomes among juvenile probation officers (JPOs) is limited. We surveyed 246 JPOs in a Midwestern state to identify the prevalence, predictors, and potential outcomes of burnout. JPOs reported moderate levels of burnout; about 30% of the sample scored in the high range for emotional exhaustion and cynicism. Contrary to study hypotheses, there were no group-level differences in burnout scores across gender, race/ethnicity, age, or education. In regression models, burnout was predicted by being White (vs. minority), serving in an urban (vs. rural) county, dissatisfaction with department guidelines, job dissatisfaction, viewing job role as more treatment-oriented along the enforcement−treatment continuum, and turnover intention. JPOs with burnout were more likely to endorse mental health stigma and lack of mental health competency to address juvenile clients with behavioral health concerns. Findings suggest burnout prevention and intervention programs should be considered for JPOs to increase job satisfaction, limit job turnover, reduce burnout, and possibly increase effective practices for managing juvenile clients with behavioral health needs

Correlates of observer-rated active involvement in psychiatric treatment visits

Among people with serious mental illness, increased patient activation has been linked to a range of key recovery outcomes. To date, patient activation has been measured largely through self-report. The present study investigated correlates of a new tool that assesses active involvement through rating audio-recordings of treatment visits. The key domains of patient activation assessed in visits included: patients asking questions, discussing with providers instances of being active in managing illness outside the session, talking about goals, bringing up concerns, making evaluative statements about treatment, setting the agenda for the visit, and making requests about the course of treatment. The new coding scheme proved to be a feasible and reliable method for identifying multi-faceted behavioral indicators of patient activation. Contrary to our hypotheses, in a sample of 166 people diagnosed with severe mental illnesses, self-reported activation and observer-rated indices of activation were often not correlated or correlated in unexpected directions with the new behavioral measure of patient activation. This suggests the nature of patient activation may be complex and work is needed to understand how observer-rated and self-rated activation may predict differential recovery outcomes

Dual effects of fibroblast growth factor 21 on hepatic energy metabolism

The aim of this study was to investigate the mechanisms by which FGF21 affects hepatic integration of carbohydrate and fat metabolism in Siberian hamsters, a natural model of adiposity. Twelve aged matched adult male Siberian hamsters maintained in their long day fat state since birth were randomly assigned to one of two treatment groups and were continuously infused with either vehicle (saline; n=6) or recombinant human FGF21 protein (1 mg/kg/day; n=6) for 14 days. FGF21 administration caused a 40% suppression (P<0.05) of hepatic pyruvate dehydrogenase complex (PDC), the rate-limiting step in glucose oxidation, a 34% decrease (P<0.05) in hepatic acetylcarnitine accumulation, an index of reduced PDC flux, a 35% increase (P<0.05) in long-chain acylcarnitine content (an index of flux through β-oxidation) and a 47% reduction (P<0.05) in hepatic lipid content. These effects were underpinned by increased protein abundance of PD kinase-4 (a negative regulator of PDC), the phosphorylated (inhibited) form of acetyl-CoA carboxylase (ACC, a negative regulator of delivery of fatty acids into the mitochondria), and the transcriptional co-regulators of energy metabolism peroxisome proliferator activated receptor gamma co-activator alpha (PGC1 and sirtuin-1 (SIRT-1). These findings provide novel mechanistic basis to support the notion that FGF21 exerts profound metabolic benefits in the liver by modulating nutrient flux through both carbohydrate (mediated by a PDK4-mediated suppression of PDC activity) and fat (mediated by deactivation of ACC) metabolism, and therefore may be an attractive target for protection from increased hepatic lipid content and insulin resistance that frequently accompany obesity and diabetes

Short-term imaging follow-up of patients with concordant benign breast core needle biopsies: is it really worth it?

PURPOSEWomen with histologically proven concordant benign breast disease are often followed closely after biopsy for a period of two years, and they are considered to be at high-risk for cancer development. Our goal was to evaluate the utility of short-term (six-month) imaging follow-up and determine the incidence of breast cancer development in this population. METHODSRetrospective review of concordant benign breast pathology was performed in 558 patients who underwent multimodality breast core biopsy. A total of 339 patients (60.7%) with 393 biopsies qualified for the study. The six-, 12-, and 24-month incidence rates of breast cancer development were estimated with 95% confidence intervals (CI), using the exact method binomial proportions.RESULTSNo cancer was detected in 285 of 339 patients (84.1%) returning for the six-month follow-up. No cancer was detected in 271 of 339 patients (79.9%) returning for the 12-month follow-up. Among 207 follow-up exams (61.1%) performed at 24 months, three patients were detected to have cancer in the ipsilateral breast (1.45% [95% CI, 0.30%–4.18%]) and two patients were detected to have cancer in the contralateral breast (0.97% [95% CI, 0.12%–3.45%]). Subsequent patient biopsy rate was 30 of 339 (8.85%, [95% CI, 6.05%–12.39%]). Three ipsilateral biopsies occurred as a sole result of the six-month follow-up of 285 patients (1.05%, [95% CI, 0.22%–3.05%]). CONCLUSIONShort-term imaging follow-up did not contribute to improved breast cancer detection, as all subsequent cancers were detected on annual mammography. Annual diagnostic mammography after benign breast biopsy may be sufficient

New Perspectives on Transforming States' Health and Human Services: Practical Commentaries on the First Year of the Work Support Strategies Initiative

Millions of low-income working families in America today are struggling to make ends meet. While working hard, often in low-wage jobs, many of these families are living close to the edge of hardship and have little or no resources to fall back on in case of emergencies. Public benefit programs can make a huge difference in the well-being of these working families, providing help with food, child care, and health insurance expenses. These programs help families address immediate needs and weather short-term crises, such as repairing a car needed to get to work or dealing with an unexpected health problem. They can make it possible for families to hold onto their jobs in these emergencies, stabilizing employment and keeping families from falling further into poverty. Yet many families that are eligible for public benefit programs do not participate. Although the recession and its aftermath led to unprecedented increases in receipt of nutrition assistance through the federal Supplemental Nutrition Assistance Program (SNAP), the latest data (from 2010) show that only 65 percent of the eligible working poor are participating. Similarly, of all children eligible for public health insurance coverage through Medicaid or the Children's Health Insurance Program, only 86 percent are participating. The participation rate for public health insurance for parents is only 66 percent. And, these participation rates vary widely across states.The Work Support Strategies, or WSS, Initiative is motivated by the value public benefit programs can provide to working families and the belief that the states and localities administering these programs can improve how eligible families access and retain these benefits. In the first year of the demonstration, nine states took on the challenge of streamlining, integrating, and improving the provision of work support benefits through their SNAP, Medicaid, and child care programs (and, in some states, additional programs such as heating assistance and cash welfare). While most states hope their efforts will also reduce burden on caseworkers and administrative costs in these systems, all are motivated to improve the lives of the families they serve

Across borders: External factors and prior behaviour influence North Pacific albatross associations with fishing vessels

Understanding encounters between marine predators and fisheries across national borders and outside national jurisdictions offers new perspectives on unwanted interactions to inform ocean management and predator conservation. Although seabird–fisheries overlap has been documented at many scales, remote identification of vessel encounters has lagged because vessel movement data often are lacking. Here, we reveal albatrosses–fisheries associations throughout the North Pacific Ocean. We identified commercial fishing operations using Global Fishing Watch data and algorithms to detect fishing vessels. We compiled GPS tracks of adult black-footed Phoebastria nigripes and Laysan Phoebastria immutabilis albatrosses, and juvenile short-tailed albatrosses Phoebastria albatrus. We quantified albatrosses-vessel encounters based on the assumed distance that birds perceive a vessel (≤30 km), and associations when birds approached vessels (≤3 km). For each event we quantified bird behaviour, environmental conditions and vessel characteristics and then applied Boosted Regression Tree models to identify drivers and the duration of these associations. In regions of greater fishing effort short-tailed and Laysan albatrosses associated with fishing vessels more frequently. However, fishing method (e.g. longline, trawl) and flag nation did not influence association prevalence nor the duration short-tailed albatrosses attended fishing vessels. Laysan albatrosses were more likely to approach longer vessels. Black-footed albatrosses were the most likely to approach vessels (61.9%), but limited vessel encounters (n = 21) prevented evaluation of meaningful explanatory models for this species of high bycatch concern. Temporal variables (time of day and month) and bird behavioural state helped explain when short-tailed albatrosses were in close proximity to a vessel, but environmental conditions were more important for explaining interaction duration. Laysan albatrosses were more likely to associate with vessels while searching and during the last 60% (by time) of their trips. Our results provide specific species–fisheries insight regarding contributing factors of high-risk associations that could lead to bycatch of albatrosses within national waters and on the high seas. Policy implications. Given the availability of Global Fishing Watch data, our analysis can be applied to other marine predators—if tracking data are available—to identify spatio-temporal patterns, vessel specific attributes and predator behaviours associated with fishing vessel associations, thus enabling predictive modelling and targeted mitigation measures

Sustaining The Saco Estuary: Final Report 2015

This study focuses on the Saco estuary, the tidal portion of the Saco River, which drains the largest watershed in southern Maine. With headwaters in the White Mountains of New Hampshire, the watershed encompasses more than 4,400 km2, and provides clean healthy drinking water to over 100,000 people living and working in communities in southern Maine. When the study began in 2009, very little was known about the ecology of the Saco estuary. Researchers at the University of New England and the Wells National Estuarine Research Reserve employed the process of collaborative learning to bring together people who care about the estuary in order to identify their concerns. A Stewardship Network composed of people employed by municipal, state and federal governments, water supply organizations and businesses, volunteers from municipal boards making land use decisions, land trusts, property owners and representatives from other organizations that are uniquely focused on the region was formed. The Stewardship Network helped to define the project goals and objectives, and provided input and guidance over the five-year project. This report explains what the researchers discovered about the ecology of the estuary, along with what they learned about its social and economic components. This baseline assessment contributes to the long-term goal of restoring and sustaining the structure and function of the estuary, and supports the efforts of government, businesses and local organizations that value the estuary and depend upon the natural services it provides