Alien Registration- Cole, Alison (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/22976/thumbnail.jp

Spatial and Temporal Mapping of Distributed Precipitation, Surface and Groundwater Stable Isotopes Enables Insights into Hydrologic Processes Operating at a Catchment Scale

Isotopic analyses of d18O and d2H of water through the hydrologic cycle have allowed hydrologists to make better interpretations related to climate and relationships between precipitation, surface water, and groundwater. In this study 394 precipitation samples 1917 surface water samples and 1405 groundwater samples across Massachusetts was used to create an isoscape for each respective water. All samples have been collected by volunteers throughout Massachusetts. A state meteoric water line: d2H = 7.7*d18O + 9.8, surface water line: d2H = 5.7*d18O – 4.2, and groundwater line: d2H = 6.5*d18O + 2.9 was created for the state of Massachusetts. The d18O isoscape for each of the above-mentioned waters shows an isotopic separation along an east-west topographic gradient where isotopes were enriched in the eastern portion of Massachusetts and depleted in the western portion of Massachusetts. Precipitation, surface water, and groundwater show unique isotopic variability. The isotopic variability of precipitation is primarily due to seasonality, moisture source and differences in topography across Massachusetts. The d18O and d2H isotopic variability of surface water is due to a biasing of precipitation as well an enrichment due to an open water system as the surface water dataset correlates with surface water type and precipitation isotopic values. The d18O and d2H isotopic variability of groundwater is due to the dampening of surface water and precipitation because of hydrogeologic processes and the biasing of surface waters that have gone through open water isotopic variability

Alien Registration- Cole, Alison (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/22976/thumbnail.jp

Can you identify violent extremists using a screening checklist and open-source intelligence alone?

Checklist-based screening instruments have a role in the assessment of mentally disordered and criminal offenders, but their value for screening for vulnerability to violent extremism remains moot. This study examined the effectiveness of using the Identifying Vulnerable People (IVP) guidance to identify serious violence in persons convicted or killed in the process of committing a violent-extremist offense using open-source intelligence (i.e., publicly available archival material). Of 182 specific participants identified, specific offense data was available for 157 individuals. Blind kappas for individual items of the 16-item IVP guidance ranged from 0.67 to 1.00. IVP guidance was more reliable when applied to conventional terrorist groups, but missing information significantly reduced reliability. Weighting items thought more central to violent extremism (death rhetoric, extremist group membership, contact with recruiters, advanced paramilitary training, overseas combat) did not improve reliability or prediction. Although the total unweighted IVP score predicted some acts of violence, test effectiveness statistics suggested IVP guidance was most effective as a negative predictor of grave outcomes, and best applicable to conventional ideological violent extremists who came to this position through typical “terrorist” trajec- tories. Results suggest the IVP guidance has potential value as an initial screening tool, but must be applied appropriately to persons of interest, is strongly dependent on the integrity and completeness of information, and does not supercede human-led risk assessment of the case and acute risk states

Fabric of Memory: A Multimedia Synthesis of The History of Cockatoo Island

Fabric of Memory is a creative exploration of the history of Cockatoo Island. This practice-based research project thesis comprises a written dissertation and an artistic multimedia work. The written dissertation explores the concept of identity and connection to site as a poetic idiom in multimedia composition. I will explore how my research into cultural and historical perspectives of the island has informed my creative response to the site. In documenting the creation of this composition, I hope to offer new insights into sonic exploration, multimodal artistic expression, and strategies to engage with place. Fabric of Memory comprises a long-form multimedia composition that explores four eras of Cockatoo Island. The Pre-European-Indigenous era, colonial era, Industrial and my personal experience of living surrounded by a working shipyard as an island resident for eighteen years. Each composition shares a consistent conceptual approach of reconnection to place and identity via the inclusion of site sound as a component of the work. The multimodal composition aims to create an audience experience that opens new possibilities and dialogue around history, culture, and our place in the material landscape. An important outcome is to produce a strategy for other historical sites. A context of composition, sound design, and multimedia for other places to create content and improve audience engagement with the lands on which they live. I propose the concept of an ‘empathic bridge’ as a model to enhance audience engagement with the site

Understanding the national performance of flood forecasting models to guide incident management and investment

The preparation of routine flood guidance statements and formulation of incident management strategies requires national operating agencies to have a firm understanding of the performance of flood forecasting models. Studies of flood forecasting model performance are commonly evaluated on a groupedcatchment or local basis and can lack the analytical consistency required for integration into coherent national assessments. Here, the first nationally consistent analysis of flood forecasting model performance across England and Wales is presented. Application of the assessment framework, accounting for regional and model-type differences, yields a national overview of relative forecasting capability for models in current operational use. To achieve extensive site coverage, information from many existing local performance studies are pooled into a single structure for analysis under a national framework. The performance information spanning a variety of local models is also compared against the area-wide national G2G (Grid-to-Grid) distributed model. An integrated national assessment gives an evidence base of model performance useful for guiding strategic planning and investment in flood forecasting models. A concise single-page Performance Summary has been created for each site model that contains performance statistics, forecast hydrographs and catchment properties to aid operational use. A prototype web portal has been developed to make information on forecasting model performance more accessible and understandable for end-users

Woman-centred care and integrated electronic medical records within Australian maternity settings: Point prevalence audit and observational study

Objective: Transition to paperless records brings new challenges to midwifery practice across the continuum of woman-centred care. There is limited and conflicting evidence on the relative benefits of electronic medical records in maternity settings. This article aims to inform the use of integrative electronic medical records within the maternity services’ environment with attention to the midwife-woman relationship. Design: This descriptive two-part study includes 1) an audit of electronic records in the early period following implementation (2-time points); and 2) an observational study to observe midwives’ practice relating to electronic record use. Setting: Two regional tertiary public hospitals Participants: Midwives providing care for childbearing women across antenatal, intrapartum and postnatal areas. Findings: 400 integrated electronic medical records were audited for completeness. Most fields had high levels of complete data in the correct location. However, between time 1 (T1) and time 2 (T2), persistent missing data (foetal heart rate documented 30 minutely T1 36%; T2 42%), and incomplete or incorrectly located data (pathology results T1:63%; T2 54%; perineal repair T1 60%; T2 46%) were identified. Observationally, midwives were actively engaged with the integrative electronic medical record between 23% to 68% (median 46%; IQR 16) of the time. Conclusion: Midwives spent a significant amount of time completing documentation during clinical episodes of care. Largely, this documentation was found to be accurate, yet exceptions to data completeness, precision and location remained, indicating some concerns with software usability. Implications for practice: Time-intensive monitoring and documentation may hinder woman-centred midwifery care

Acceptable Noise Levels for Typical Outdoor Leisure Activities

Throughout the Appalachian Mountain chain, entrepreneurs have capitalized on the outdoor sporting experience.  Both summer and winter sports such as fly fishing, hiking, skiing and snowboarding are very popular. One popular emerging activity is skeet, trap, and sporting clays shooting.  Major tourist enterprises are developing this opportunity for both tourists and the local residents.  To meet the increasing demand, ranges are being constructed throughout the region from Alabama to Maine.  Within North Carolina that are approximately 12 ranges, with an additional 10 in east Tennessee. Although these activities have had few opponents, sporting clays establishments have received an insignificant number of complaints that the noise level is above the noxious level.  A research experiment was designed to test noise levels at one sporting clays course situated near a vacation resort. The first phase of this experiment determined that the noise levels at the source from 12 and 20 gauge shotguns were insignificant. The allowable rounds used are the standard reduced load target load. At the source there was a significant difference between trap (85.85 dBA) and skeet (74.95 dBA). At the closest guest location (second phase) 333 samples were taken between August 2015 and March 2016.  The noise level averaged 53.7 dBA (σ = 7.43dBA). During the third phase (January to March 2016) 44 samples were obtained at the main resort lodging site.  At Site 2 the noise level averaged 31.9 dBA (σ = 5.45).  The fourth and final phase of this study was to determine the noise levels at the closest guest location for each of the 12 sporting clays stations.  Ninety-six samples (8 per station) were collected in October 2016. The average noise level was 53.0 dBA (σ 4.19 dBA). An analysis at the statistical confidence level of 97.5% was conducted.  First all stations were analyzed in a pairwise comparison analysis.  Stations that were not significantly different from one another were combined.  Thus the 12 stations were reduced to three combined stations.  The analysis determined that the noise level from stations 1 through 5 (48.9dBA, σ =1.50 dBA) was significantly lower than from the other stations.  Next loudest was the combinations of stations 6, 7, 10, and 11 (54.1 dBA, σ = 1.69). The last loudest combination was stations 8, 9, and 12 (58.6 dBA, σ = 1.50 dDA).  Thus there was a difference of 9.7 dBA between the lowest and the loudest station.  Since every 5 dBA difference equates to 2 to 3 times louder, depending on frequency, the loudest station is approximately 4 to 6 times louder that the lowest noise level.  However, all stations are below the OSHA Standard.  With an annoyance level (60.0 dBA) for the guest activity, the gunshots are less than the nuisance level and significantly less than the permissible level. The few complaints about the noise levels are not supported by the noise level data. A logical conclusion is that the objection is the act of shooting and not the noise level of the shotgun’s sharp or impact report. Potential solutions might be to examine stations 8, 9, and 12 and considering possible relocation, orientation, or emplacement of a thick tree barrier to absorb the reports. Regression analysis was used to develop a highly significant model to predict noise levels with the variables collected. However, this will not solve the complaints from those who object to reports under any circumstance

How prepared are UK medical graduates for practice? Final report from a programme of research commissioned by the General Medical Council

This programme of research aimed to understand the extent to which current UK medical graduates are prepared for practice. Commissioned by the General Medical Council, we conducted: (1) A Rapid Review of the literature between 2009 and 2013; (2) narrative interviews with a range of stakeholders; and (3) longitudinal audio-diaries with Foundation Year 1 doctors. The Rapid Review (RR) resulted in data from 81 manuscripts being extracted and mapped against a coding framework (including outcomes from Tomorrow's Doctors (2009) (TD09)). A narrative synthesis of the data was undertaken. Narrative interviews were conducted with 185 participants from 8 stakeholder groups: F1 trainees, newly registered trainee doctors, clinical educators, undergraduate and postgraduate deans and foundation programme directors, other healthcare professionals, employers, policy and government and patient and public representatives. Longitudinal audio-diaries were recorded by 26 F1 trainees over 4 months. The data were analysed thematically and mapped against TD09. Together these data shed light onto how preparedness for practice is conceptualised, measured, how prepared UK medical graduates are for practice, the effectiveness of transition interventions and the currently debated issue of bringing full registration forward to align with medical students’ graduation. Preparedness for practice was conceptualised as both a long- and short-term venture that included personal readiness as well as knowledge, skills and attitudes. It has mainly been researched using self-report measures of generalised incidents that have been shown to be problematic. In terms of transition interventions: assistantships were found to be valuable and efficacious for proactive students as team members, shadowing is effective when undertaken close to employment/setting of F1 post and induction is generally effective but of inconsistent quality. The August transition was highlighted in our interview and audio-diary data where F1s felt unprepared, particularly for the step-change in responsibility, workload, degree of multitasking and understanding where to go for help. Evidence of preparedness for specific tasks, skills and knowledge was contradictory: trainees are well prepared for some practical procedures but not others, reasonably well prepared for history taking and full physical examinations, but mostly unprepared for adopting an holistic understanding of the patient, involving patients in their care, safe and legal prescribing, diagnosing and managing complex clinical conditions and providing immediate care in medical emergencies. Evidence for preparedness for interactional and interpersonal aspects of practice was inconsistent with some studies in the RR suggesting graduates were prepared for team working and communicating with colleagues and patients, but other studies contradicting this. Interview and audio-diary data highlights concerns around F1s preparedness for communicating with angry or upset patients and relatives, breaking bad news, communicating with the wider team (including interprofessionally) and handover communication. There was some evidence in the RR to suggest that graduates were unprepared for dealing with error and safety incidents and lack an understanding of how the clinical environment works. Interview and audio-diary data backs this up, adding that F1s are also unprepared for understanding financial aspects of healthcare. In terms of being personally prepared, RR, interview and audio diary evidence is mixed around graduates’ preparedness for identifying their own limitations, but all data points to graduates’ difficulties in the domain of time management. In terms of personal and situational demographic factors, the RR found that gender did not typically predict perceptions of preparedness, but graduates from more recent cohorts, graduate entry students, graduates from problem based learning courses, UK educated graduates and graduates with an integrated degree reported feeling better prepared. The longitudinal audio-diaries provided insights into the preparedness journey for F1s. There seems to be a general development in the direction of trainees feeling more confident and competent as they gain more experience. However, these developments were not necessarily linear as challenging circumstances (e.g. new specialty, new colleagues, lack of staffing) sometimes made them feel unprepared for situations where they had previously indicated preparedness