Developing a model of distributed sensemaking: a case study of military analysis

In this paper, we examine the role of representational artefacts in sensemaking. Embodied within representational media, such as maps, charts and lists, are a number of affordances, which can furnish sensemakers with the ability to perform tasks that may be difficult to do inside the head. Presented here is a study of sensemaking in action. We conducted a study of military intelligence analysts carrying out a training exercise, the analysis of which focuses on the use of external task-specific representations. We present a discussion of the findings of our study in the form of a model of distributed sensemaking. Our model concentrates on the interaction of information and various representational artefacts, leading to the generation of insights and a situation picture. We also introduce a number of levels of description for examining the properties and affordances offered by representational artefacts and their role in the sensemaking process

The Immediate Effects of Kinesio Taping Versus Thoracic Manipulation in Subjects with Mechanical Neck Pain: A Pilot Study

Title: The Immediate Effects of Kinesio Taping Versus Thoracic Manipulation in Subjects with Mechanical Neck Pain: A Pilot Study. Authors: Brynn A. Blickenstaff, SPT1; Jenae L. Perman, SPT1; Ashley N. Rojan, ATC, AT/L, SPT1; Dr. Robert E. Boyles, PT, DSc, OCS, FAAOMPT1. Affiliation(s): 1. Physical Therapy Program, University of Puget Sound. Purpose: The purpose of this study was to compare the short-term effects of thoracic spine thrust manipulation and exercise (TSM-EX), cervical spine Kinesio Taping and exercise (KT-EX), and exercise only in subjects with mechanical neck pain (MNP). Subjects: Eleven participants who met all eligibility criteria with complaints of MNP were included in the study. Materials & Methods: Following self-reported outcome measures were used: the Numeric Pain Rating Scale (NPRS), the Neck Disability Index (NDI), and the Global Rating of Change (GRC). Participants were randomly assigned to one of three groups: TSM-EX (n=6), KT-EX (n=2), or HEP alone (n=3). All participants were treated once weekly for 2 weeks, with a follow-up visit on the third week for a total of 3 visits. Results: KT-EX and TSM-EX showed a trend of decreased NDI and NPRS scores each week. The exercise group showed a decrease in NDI and NPRS scores between baseline and week 1. All groups showed improvement in symptoms on the GRC all weeks except week 2 for the exercise group, which on average remained the same. Conclusions: This pilot study demonstrates the need to further investigate the effects of Kinesio Taping compared to thoracic manipulation in patients with MNP. We are unable to report significant differences due to the low power of this study. However, KT-EX and TSM-EX groups demonstrated superior results in all outcome measures compared to the control group

The Immediate Effects of Kinesio Taping Versus Thoracic Manipulation in Subjects with Mechanical Neck Pain: A Pilot Study

Title: The Immediate Effects of Kinesio Taping Versus Thoracic Manipulation in Subjects with Mechanical Neck Pain: A Pilot Study. Authors: Brynn A. Blickenstaff, SPT1; Jenae L. Perman, SPT1; Ashley N. Rojan, ATC, AT/L, SPT1; Dr. Robert E. Boyles, PT, DSc, OCS, FAAOMPT1. Affiliation(s): 1. Physical Therapy Program, University of Puget Sound. Purpose: The purpose of this study was to compare the short-term effects of thoracic spine thrust manipulation and exercise (TSM-EX), cervical spine Kinesio Taping and exercise (KT-EX), and exercise only in subjects with mechanical neck pain (MNP). Subjects: Eleven participants who met all eligibility criteria with complaints of MNP were included in the study. Materials & Methods: Following self-reported outcome measures were used: the Numeric Pain Rating Scale (NPRS), the Neck Disability Index (NDI), and the Global Rating of Change (GRC). Participants were randomly assigned to one of three groups: TSM-EX (n=6), KT-EX (n=2), or HEP alone (n=3). All participants were treated once weekly for 2 weeks, with a follow-up visit on the third week for a total of 3 visits. Results: KT-EX and TSM-EX showed a trend of decreased NDI and NPRS scores each week. The exercise group showed a decrease in NDI and NPRS scores between baseline and week 1. All groups showed improvement in symptoms on the GRC all weeks except week 2 for the exercise group, which on average remained the same. Conclusions: This pilot study demonstrates the need to further investigate the effects of Kinesio Taping compared to thoracic manipulation in patients with MNP. We are unable to report significant differences due to the low power of this study. However, KT-EX and TSM-EX groups demonstrated superior results in all outcome measures compared to the control group

Can vitamin D prevent acute respiratory infections?

Review of: Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.Can vitamin D prevent acute respiratory infections? A systematic review and meta-analysis says Yes, but the dosages used may not be what you'd expect. PRACTICE CHANGER: Reduce acute respiratory tract infections in those with significant vitamin D deficiency (circulating 25-hydroxyvitamin D levels < 10 ng/mL) with daily or weekly vitamin D supplementation--not bolus vitamin D treatment. STRENGTH OF RECOMMENDATION A: Based pm a systematic review and meta-analysis of 25 trials.Bob Marshall, MD, MPH, MISM, FAAFP; Nick Bennett, DO; Ashley Smith, MD; Robert Oh, MD, MPH, FAAFP; Jeffrey Burket, MD, MBA, FAAFP Madigan Family Medicine Residency, Gig Harbor, Was

Cerebral sparganosis in children: epidemiological, clinical and MR imaging characteristics

Background Cerebral sparganosis in children is an extremely rare disease of central nervous system, and caused by a tapeworm larva from the genus of Spirometra. In this study, we discussed and summarized epidemiological, clinical and MR imaging characteristics of eighteen children with cerebral sparganosis for a better diagnosis and treatment of the disease. Methods Eighteen children with cerebral sparganosis verified by pathology, serological tests and MR presentations were retrospectively investigated, and the epidemiologic and clinical characteristics of the disease were studied. Results Twenty-seven lesions were found in the eighteen children. Twelve lesions in twelve patients were solitary while the lesions in the rest six patients were multiple and asymmetrical. The positions of the lesions were: seven in frontal, eleven in parietal, four in temporal and two in occipital lobes, one in basal ganglia, one in cerebella hemisphere and one in pons. The lesions were presented as slight hypointensity on T1-weighted images but moderate hyperintensity on T2-weighted images with perilesional brain parenchyma edema. Enhanced MR scans by using Gadopentetic Acid Dimeglumine Salt were performed in the patients, and the images demonstrated abnormal enhancements with the patterns of a peripheral ring, or a tortuous beaded, or a serpiginous tubular shape. Follow-up MR scans were preformed for eight patients, and three out of the eight cases exposed migrations and changes in shapes of the lesion areas. Conclusions The MR presentations in our study in general were similar to those in previous studies. However serpiginous tubular and comma-shaped enhancements of lesions have not been previously reported. The enhanced MR imaging and follow-up MR scans with the positive results from serological tests are the most important methods for the clinical diagnosis of cerebral sparganosis in children

First-time, mild diverticulitis: Antibiotics or watchful waiting?

Review of: Daniels L, Ünlü Ç, de Korte N, et al, for the Dutch Diverticular Disease (3D) Collaborative Study Group. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg. 2017;104:52-61.First-time, mild diverticulitis: antibiotics or watchful waiting? Don't jump to antibiotic Tx for mild, uncomplicated diverticulitis, a recent RCT says. Observation may be just as effective. Practice changer: For mild, computed tomography-proven acute diverticulitis, consider observation only instead of antibiotic therapy. Stength of recommendation: B: Based on a single randomized controlled trial.Bob Marshall, MD, MPH, MISM, FAAFP; Shailendra Prasad, MBBS, MPH; Mary Alice Noel, MD; Jeffrey Burket, MD, FAAFP; Michael Arnold, DO, FAAFP; Benjamin Arthur, MD; Nick Bennett, DO; Ashley Smith, MD ; Madigan Family Medicine Residency, Gig Harbor, Wash (Drs. Marshall, Noel, Burket, Arnold, Arthur, Bennett, Smith); University of Minnesota Family Medicine and Community Health, Minneapolis (Dr. Prasad

Sheep Updates 2003 - Plenaries

This session covers eight papers from different authors:1. Biosecurity in the sheep industry will improve production and profits Ashley Mercy, Department of Agriculture, Western Australia 2. Easy care sheep David Scobie, AgResearch, PO Box 60 Lincoln, 8152, New Zealand 3. Targeting the market’s requirements - live sheep exports Neil Buchanan, Manager Animal Health Operations, Primary Industries & Resources, South Australia 4. Setting flock breeding objectives Kevin Bell, Sheep Management and Production Consultants, Kojonup WA 5. Future feeding of sheep in Western Australia John Milton and Graeme Martin, The University of Western Australia 6. Recipe for getting back into Sheep Bob Hall, JRL Hall and Co., Darkan 7. Wool producer experiences with individual animal management Maurie Stephen, Wool Producer, Armidale NSW 8. The history of future sheep worm management Dr Rob Woodgate, Department of Agriculture, Western Australi

Supplemental oxygen : more isn't always better

Review of: Chu DK, Kim LH, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet. 2018;391:1693-1705.Supplemental oxygen: more isn't always better. A recent study says that in certain populations supplemental oxygen above certain levels can increase mortality. PRACTICE CHANGER Do not use liberal oxygen therapy (SpO2> 96%) in acutely ill adults, as it is associated with increased all-cause mortality. STRENGTH OF RECOMMENDATION A: Based on a systematic review and meta-analysis of 25 randomized controlled trials.Ashley Smith, MD; Bob Marshall, MD, MPH, MISM, FAAFP; Nick Bennett, DO; Benjamin Arthur, MD; Michael Dickman, DO; Madigan Army Medical Center, Joint Base Lewis-McChord, Was

Dredging fundamentally reshapes the ecological significance of 3D terrain features for fish in estuarine seascapes

Context: Landscape modification alters the condition of ecosystems and the structure of terrain, with widespread impacts on biodiversity and ecosystem functioning. Seafloor dredging impacts a diversity of flora and fauna in many coastal landscapes, and these processes also transform three-dimensional terrain features. The potential ecological significance of these terrain changes in urban seascapes has, however, not been investigated. Objectives: We examined the effects of terrain variation on fish assemblages in 29 estuaries in eastern Australia, and tested whether dredging changes how fish associate with terrain features. Methods: We surveyed fish assemblages with baited remote underwater video stations and quantified terrain variation with nine complementary metrics (e.g. depth, aspect, curvature, slope, roughness), extracted from bathymetry maps created with multi-beam sonar. Results: Fish diversity and abundance were strongly linked to seafloor terrain in both natural and dredged estuaries, and were highest in shallow waters and near features with high curvature. Dredging, however, significantly altered the terrain of dredged estuaries and transformed the significance of terrain features for fish assemblages. Abundance and diversity switched from being correlated with lower roughness and steeper slopes in natural estuaries to being linked to features with higher roughness and gentler slopes in dredged estuaries. Conclusions: Contrasting fish-terrain relationships highlight previously unrecognised ecological impacts of dredging, but indicate that plasticity in terrain use might be characteristic of assemblages in urban landscapes. Incorporating terrain features into spatial conservation planning might help to improve management outcomes, but we suggest that different approaches would be needed in natural and modified landscapes