The Differentiation of the Deciduous Forest of the Eastern United States

Author Institution: University of Cincinnat

Living near Main Streets and Respiratory Symptoms in Adults: The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults

The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA), conducted in 1991 (SAPALDIA 1) in eight areas among 9,651 randomly selected adults aged 18-60 years, reported associations among the prevalence of respiratory symptoms, nitrogen dioxide, and particles with an aerodynamic diameter of less than 10 μg/m3. Later, 8,047 subjects reenrolled in 2002 (SAPALDIA 2). The effects of individually assigned traffic exposures on reported respiratory symptoms were estimated, while controlling for socioeconomic and exposure- and health-related factors. The risk of attacks of breathlessness increased for all subjects by 13% (95% confidence interval: 3, 24) per 500-m increment in the length of main street segments within 200 m of the home and decreased in never smokers by 12% (95% confidence interval: 0, 22) per 100-m increment in distance from home to a main street. Living within 20 m of a main street increased the risks of regular phlegm by 15% (95% confidence interval: 0, 31) and wheezing with breathing problems by 34% (95% confidence interval: 0, 79) in never smokers. In 2002, the effects related to road distance were different from those in 1991, which could be due to changes in the traffic pollution mixture. These findings among a general population provide strong confirmation that living near busy streets leads to adverse respiratory health effect

Proportionate methods for evaluating a simple digital mental health tool

Background: Traditional evaluation methods are not keeping pace with rapid developments in mobile health. More flexible methodologies are needed to evaluate mHealth technologies, particularly simple, self-help tools. One approach is to combine a variety of methods and data to build a comprehensive picture of how a technology is used and its impact on users. Objective: This paper aims to demonstrate how analytical data and user feedback can be triangulated to provide a proportionate and practical approach to the evaluation of a mental wellbeing smartphone app (‘In Hand’). Methods: A three-part process was used to collect data: 1) app analytics; 2) an online user survey; and 3) interviews with users. Findings: Analytics showed that >50% of user sessions counted as ‘meaningful engagement’. User survey findings (N=108) revealed that In Hand was perceived to be helpful on several dimensions of mental wellbeing. Interviews (N=8) provided insight into how these self-reported positive effects were understood by users. Conclusions: This evaluation demonstrates how different methods can be combined to complete a real-world, naturalistic evaluation of a self-help digital tool and provide insights into how and why an app is used and its impact upon users’ wellbeing. Clinical implications: This triangulation approach to evaluation provides insight into how wellbeing apps are used and their perceived impact on users’ mental wellbeing. This approach is useful for mental healthcare professionals and commissioners who wish to recommend simple digital tools to their patients and evaluate their uptake, use and benefits

The Westerbork HI Survey of spiral and irregular galaxies III: HI observations of early-type disk galaxies

We present HI observations of 68 early-type disk galaxies from the WHISP survey. They have morphological types between S0 and Sab and absolute B-band magnitudes between -14 and -22. These galaxies form the massive, high surface-brightness extreme of the disk galaxy population, few of which have been imaged in HI before. The HI properties of the galaxies in our sample span a large range; the average values of M_HI/L_B and D_HI/D_25 are comparable to the ones found in later-type spirals, but the dispersions around the mean are larger. No significant differences are found between the S0/S0a and the Sa/Sab galaxies. Our early-type disk galaxies follow the same HI mass-diameter relation as later-type spiral galaxies, but their effective HI surface densities are slightly lower than those found in later-type systems. In some galaxies, distinct rings of HI emission coincide with regions of enhanced star formation, even though the average gas densities are far below the threshold of star formation derived by Kennicutt (1989). Apparently, additional mechanisms, as yet unknown, regulate star formation at low surface densities. Many of the galaxies in our sample have lopsided gas morphologies; in most cases this can be linked to recent or ongoing interactions or merger events. Asymmetries are rare in quiescent galaxies. Kinematic lopsidedness is rare, both in interacting and isolated systems. In the appendix, we present an atlas of the HI observations: for all galaxies we show HI surface density maps, global profiles, velocity fields and radial surface density profiles.Comment: 24 pages, 11 figures. Accepted for publication in A&A. A version with the full atlas can be downloaded from http://www.astro.rug.nl/~edo/WHISPIII.ps.gz (gzipped postscript, 9.3Mb

The addition of a goal-based motivational interview to standardised treatment as usual to reduce dropouts in a service for patients with personality disorder: a feasibility study

<p>Abstract</p> <p>Background</p> <p>Rates of non-completion of treatments for personality disorder are high and there are indications that those who do not complete treatment have worse outcomes than those who do. Improving both cost-efficiency and client welfare require attention to engaging people with personality disorder in treatment. A motivational interview, based on the Personal Concerns Inventory, may have the ability to enhance engagement and retention in therapy. Here, we report the protocol for a feasibility study for a randomised controlled trial (RCT).</p> <p>Methods</p> <p>All referrals accepted to the psychological service of Nottinghamshire Healthcare NHS Trust's outpatient service for people with personality disorder are eligible for inclusion. Consenting participants are randomised to receive the Personal Concerns Inventory interview plus treatment as usual or treatment as usual only. We aim to recruit 100 participants over 11/2 years. A randomised controlled trial will be considered feasible if <abbrgrp><abbr bid="B1">1</abbr></abbrgrp> the recruitment rate to the project is 54% of all referrals (95% CI 54-64), <abbrgrp><abbr bid="B2">2</abbr></abbrgrp> 80% of clients find the intervention acceptable in terms of its practicability and usefulness (95% CI 80-91), and <abbrgrp><abbr bid="B3">3</abbr></abbrgrp> 80% of therapists report finding the intervention helpful (95% CI 80-100). In a full-scale randomised controlled trial, the primary outcome measure will be completion of treatment i.e., entry into and completion of ≥ 75% of sessions offered. Therefore, information will be collected on recruitment rates, attendance at therapy sessions, and completion of treatment. The feasibility of examining the processes of engagement will be tested by assessing the value, coherence, and attainability of goals pre-treatment, and engagement in treatment. The costs associated with the intervention will be calculated, and the feasibility of calculating the cost-benefits of the intervention will be tested. The views of clients and therapists on the intervention, collected using semi-structured interviews, will be analysed using thematic analysis.</p> <p>Discussion</p> <p>The Personal Concerns Interview as a preparation for treatment of people with personality has the potential to maximise treatment uptake, reduce unfilled places in treatment programmes, and prevent group treatments faltering through non-attendance. Most importantly, it has the potential to improve patient outcomes, helping them to function better and reduce hospitalisation.</p> <p>Trial Registration</p> <p>ClinicalTrials.Gov.UK Identifier - NCT01132976</p