Test Excavations of a Stone Foundation at Ayr Mount Historic Site, Hillsborough, North Carolina

Technical Report No. 28, Research Laboratories of Archaeology, University of North Carolina at Chapel Hill. Reports in this series present the findings of archaeological surveys and test excavations completed by the RLA between 1983 and present

Attitudes Toward Anger Management Scale: Development and Initial Validation

This article describes the development and preliminary validation of the Attitudes Toward Anger Management Scale (ATAMS), a self-report measure of attitudes toward anger management services. Undergraduate volunteers (N = 415) completed an initial version of the instrument. Principal components analysis yielded a two-factor solution. Convergent and incremental validities were supported

A search for rapidly pulsating hot subdwarf stars in the GALEX survey

NASA's Galaxy Evolution Explorer (GALEX) provided near- and far-UV observations for approximately 77 percent of the sky over a ten-year period; however, the data reduction pipeline initially only released single NUV and FUV images to the community. The recently released Python module gPhoton changes this, allowing calibrated time-series aperture photometry to be extracted easily from the raw GALEX data set. Here we use gPhoton to generate light curves for all hot subdwarf B (sdB) stars that were observed by GALEX, with the intention of identifying short-period, p-mode pulsations. We find that the spacecraft's short visit durations, uneven gaps between visits, and dither pattern make the detection of hot subdwarf pulsations difficult. Nonetheless, we detect UV variations in four previously known pulsating targets and report their UV pulsation amplitudes and frequencies. Additionally, we find that several other sdB targets not previously known to vary show promising signals in their periodograms. Using optical follow-up photometry with the Skynet Robotic Telescope Network, we confirm p-mode pulsations in one of these targets, LAMOST J082517.99+113106.3, and report it as the most recent addition to the sdBVr class of variable stars.Comment: 11 Pages, 8 Figures, Accepted for publication in the Astrophysical Journa

The Remains of the Fray: Nascent Colonialism and Heterogeneous Hybridity

Investigations at the Native American site complex of Stark Farms in Mississippi, USA, have yielded numerous examples of metal artifacts of European origin. Our study suggests that they derive from contact between the AD 1540–1541 winter encampment of the Spanish Hernando de Soto expedition and the local Indigenous polity. The artifacts display a wide range of modifications, uses, and depositional contexts congruent with hybrid practices. We argue that the early colonial setting of Stark Farms requires a different perspective on cultural mixing than is often applied in studies of European colonialism. This is highlighted by the strongly improvisational nature of the modification of the metal objects, embodying a political climate in which European incursions were precarious and in which hybridity and power were heterogeneous and fluid

Assessing Risk of Future Suicidality in Emergency Department Patients

Background. Emergency Departments (ED) are the first line of evaluation for patients at risk and in crisis, with or without overt suicidality (ideation, attempts). Currently employed triage and assessments methods miss some of the individuals who subsequently become suicidal. The Convergent Functional Information for Suicidality (CFI-S) 22 item checklist of risk factors, that does not ask directly about suicidal ideation, has demonstrated good predictive ability for suicidality in previous studies in psychiatric outpatients, but has not been tested in the real world-setting of emergency departments (EDs). Methods. We administered CFI-S prospectively to a convenience sample of consecutive ED patients. Median administration time was 3 minutes. Patients were also asked at triage about suicidal thoughts or intentions per standard ED suicide clinical screening (SCS), and the treating ED physician was asked to fill a physician gestalt visual analog scale (VAS) for likelihood of future suicidality spectrum events (SSE) (ideation, preparatory acts, attempts, completed suicide). We performed structured chart review and telephone follow-up at 6 months post index visit. Results. The median time to complete the CFI-S was three minutes (1st to 3rd quartile 3–6 minutes). Of the 338 patients enrolled, 45 (13.3%) were positive on the initial SCS, and 32 (9.5%) experienced a SSE in the 6 months follow-up. Overall, across genders, SCS had a modest diagnostic discrimination for future SSE (ROC AUC 0.63,). The physician VAS was better (AUC 0.76 CI 0.66–0.85), and the CFI-S was slightly higher (AUC 0.81, CI 0.76–0.87). The top CFI-S differentiating items were psychiatric illness, perceived uselessness, and social isolation. The top CFI-S items were family history of suicide, age, and past history of suicidal acts. Conclusions. Using CFI-S, or some of its items, in busy EDs may help improve the detection of patients at high risk for future suicidality

Moisture performance of sealed attics in the mixed-humid climate

Oak Ridge National Laboratory studied 8 homes in the mixed-humid climate, 4 with vented attics and 4 with sealed attics. ORNL wanted to understand the moisture performance of the sealed attic and how it affected the interior environment. We found that the attic and interior of sealed attic homes were more humid than the attic and interior observed in vented attic homes. This is due to the lack of ventilation in the sealed attic. Historically attics have been vented to dehumidify the attic and interior of the home. A sealed attic design greatly reduces the venting potential and thus this drying pathway and can cause elevated interior moisture over a vented attic home. Despite the elevated attic and interior moisture in the sealed attic homes, so far no mold or material degradation has been found. The roof sheathing moisture content has stayed below 20%, indicating low potential for material degradation. Also the relative humidity at the roof sheathing has stayed within the ASHRAE 160 design criteria except for a short time during the 2011/2012 winter. This was due to a combination of the sealed attic design (minimal venting to the outside) and the duct work not being operated in the attic which usually provides a dehumidification pathway. It was also found that when the humidity was controlled using the HVAC system, it resulted in 7% more cooling energy consumption. In the mixed-humid climate this reduces the cost effectiveness of the sealed attic design as a solution for bringing ducts into a semi-conditioned space. Because of this we are recommending the other alternatives be used to bringing ducts into the conditioned space in both new construction and retrofit work in the mixed-humid climate

Training Mid-Level Providers to Treat Severe Non-Communicable Diseases in Neno, Malawi through PEN-Plus Strategies.

Background: Non-communicable diseases (NCDs) are a leading cause of worldwide morbidity and mortality, yet access to care in lower-income countries is limited. Rural communities, where poverty levels are high, feel the greatest burden. In Malawi, as elsewhere in the African region, it is particularly challenging for patients in rural districts to obtain care for locally endemic and severe NCDs such as type 1 diabetes, rheumatic heart disease, and sickle cell disease. The Package of Essential NCD Interventions - Plus (PEN-Plus) is a strategy to decentralize care for these severe conditions by enabling local clinicians at intermediate-care facilities to provide services otherwise available only through specialty clinics at central hospitals. Objectives: The primary objective of this study was to evaluate the impact of training mid-level providers to treat severe and chronic NCDs in newly established PEN-Plus clinics in Neno, Malawi. Methods: Our team developed a logic model to describe the anticipated impacts of the intervention on provider knowledge, patient recruitment, and care provision. We applied a retrospective review of routinely collected clinical and administrative data to assess changes along these hypothesized pathways. Findings: Didactic trainings improved provider test scores immediately following training (25-point improvement; p < 0.01), with demonstrated retention of knowledge after 6 months (21-point improvement, p < 0.01). Over 350 patients were enrolled in the first 18 months of program initiation. The PEN-Plus clinic led to significant improvement in the provision of medications and testing across a range of services. Conclusion: Mid-level providers can be successfully trained to treat severe NCDs with physician-guided education, mentorship, and supervision. The PEN-Plus clinic improved patient enrollment, the quality of clinical care and access to essential medications and laboratory supplies. These lessons learned can guide decentralization of NCD care to district hospitals in Malawi and expansion of PEN-Plus services in the African region

Methods for Evaluating the Content, Usability, and Efficacy of Commercial Mobile Health Apps

Commercial mobile apps for health behavior change are flourishing in the marketplace, but little evidence exists to support their use. This paper summarizes methods for evaluating the content, usability, and efficacy of commercially available health apps. Content analyses can be used to compare app features with clinical guidelines, evidence-based protocols, and behavior change techniques. Usability testing can establish how well an app functions and serves its intended purpose for a target population. Observational studies can explore the association between use and clinical and behavioral outcomes. Finally, efficacy testing can establish whether a commercial app impacts an outcome of interest via a variety of study designs, including randomized trials, multiphase optimization studies, and N-of-1 studies. Evidence in all these forms would increase adoption of commercial apps in clinical practice, inform the development of the next generation of apps, and ultimately increase the impact of commercial apps. Boudreaux, Rajani S Sadasivam, Sean P Mullen, Jennifer L Carey, Rashelle B Hayes, Eric Y Ding, Gary G Bennett, Sherry L Pagoto. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 18.12.2017