1,933 research outputs found

    The Chelsea Critical Care Physical Assessment Tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study.

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    Objective To develop a scoring system to measure physical morbidity in critical care – the Chelsea Critical Care Physical Assessment Tool (CPAx). Method The development process was iterative involving content validity indices (CVI), a focus group and an observational study of 33 patients to test construct validity against the Medical Research Council score for muscle strength, peak cough flow, Australian Therapy Outcome Measures score, Glasgow Coma Scale score, Bloomsbury sedation score, Sequential Organ Failure Assessment score, Short Form 36 (SF-36) score, days of mechanical ventilation and inter-rater reliability. Participants Trauma and general critical care patients from two London teaching hospitals. Results Users of the CPAx felt that it possessed content validity, giving a final CVI of 1.00 (P < 0.05). Construct validation data showed moderate to strong significant correlations between the CPAx score and all secondary measures, apart from the mental component of the SF-36 which demonstrated weak correlation with the CPAx score (r = 0.024, P = 0.720). Reliability testing showed internal consistency of α = 0.798 and inter-rater reliability of κ = 0.988 (95% confidence interval 0.791 to 1.000) between five raters. Conclusion This pilot work supports proof of concept of the CPAx as a measure of physical morbidity in the critical care population, and is a cogent argument for further investigation of the scoring system

    Assessing the behavioural trajectories of terrorists: The role of psychological resilience

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    Within studies critically examining terrorist behaviour, the examination of mental health has largely focused on the relationship with the movement towards terrorist involvement. The impact of engagement in terrorism upon mental health has rarely been studied. However, recent research has shown that there is an association between terrorist engagement and the occurrence of mental health problems across the spectrum of terrorist involvement. This work therefore expands on previous research, and disaggregates three discrete stages of terrorist involvement; pre-engagement, engagement, and disengagement, to critically examine the role of psychological resilience on mental health. To determine whether psychological resilience protects against the negative psychological repercussions of terrorist involvement, we undertake cluster analyses. Results indicate that there is a subset of actors who demonstrate psychological resilience, and appear to maintain their mental health despite their experiences during involvement in terrorism

    Towards Load-Deformation Models for Screw-Fastened Cold-Formed Steel-to-Steel Shear Connections

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    This paper summarizes results from an experimental program considering single-fastened cold-formed steel-to-steel shear connections. Fastener motion (displacement and tilting angle) and bearing deformation occurring on the connecting members at the fastener location were captured using an automated, optical non-contact measurement procedure. The results are used to relate cold-formed steel-to-steel shear connection load-deformation response to tilting and bearing response. A general steel-to-steel single shear fastener load-deformation equation is also proposed and demonstrated

    Media(ted) fabrications: How the science-media symbiosis helped ‘sell’ cord banking

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    This paper considers the problematic role of the science–media symbiosis in the dissemination of misleading and emotionally manipulative information regarding services offered by CordBank, New Zealand's only umbilical cord blood banking facility. As this case study illustrates, the growing reliance of health and science reporters on the knowledge capital of medical specialists, biogenetic researchers, and scientists potentially enhances the ability of ‘expert’ sources to set the agenda for media representations of emerging medical and scientific developments, and may undermine the editorial independence of journalists and editors, many of whom in this case failed to critically evaluate deeply problematic claims regarding the current and future benefits of cord banking. Heavy reliance on established media frames of anecdotal personalization and technoboosterism also reinforced a proscience journalistic culture in which claims by key sources were uncritically reiterated and amplified, with journalistic assessments of the value of cord banking emphasizing potential benefits for individual consumers. It is argued that use of these media frames potentially detracts from due consideration of the broader social, ethical, legal, and health implications of emerging biomedical developments, along with the professional, personal, and increasingly also financial interests at stake in their public promotion, given the growing commercialization of biogenetic technologies

    Application of satellite precipitation data to analyse and model arbovirus activity in the tropics

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    Background: Murray Valley encephalitis virus (MVEV) is a mosquito-borne Flavivirus (Flaviviridae: Flavivirus) which isclosely related to Japanese encephalitis virus, West Nile virus and St. Louis encephalitis virus. MVEV is enzootic innorthern Australia and Papua New Guinea and epizootic in other parts of Australia. Activity of MVEV in WesternAustralia (WA) is monitored by detection of seroconversions in flocks of sentinel chickens at selected sample sitesthroughout WA.Rainfall is a major environmental factor influencing MVEV activity. Utilising data on rainfall and seroconversions,statistical relationships between MVEV occurrence and rainfall can be determined. These relationships can be usedto predict MVEV activity which, in turn, provides the general public with important information about diseasetransmission risk. Since ground measurements of rainfall are sparse and irregularly distributed, especially in northWA where rainfall is spatially and temporally highly variable, alternative data sources such as remote sensing (RS)data represent an attractive alternative to ground measurements. However, a number of competing alternatives areavailable and careful evaluation is essential to determine the most appropriate product for a given problem.Results: The Tropical Rainfall Measurement Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA) 3B42product was chosen from a range of RS rainfall products to develop rainfall-based predictor variables and buildlogistic regression models for the prediction of MVEV activity in the Kimberley and Pilbara regions of WA. Twomodels employing monthly time-lagged rainfall variables showed the strongest discriminatory ability of 0.74 and0.80 as measured by the Receiver Operating Characteristics area under the curve (ROC AUC).Conclusions: TMPA data provide a state-of-the-art data source for the development of rainfall-based predictivemodels for Flavivirus activity in tropical WA. Compared to ground measurements these data have the advantage ofbeing collected spatially regularly, irrespective of remoteness. We found that increases in monthly rainfall andmonthly number of days above average rainfall increased the risk of MVEV activity in the Pilbara at a time-lag oftwo months. Increases in monthly rainfall and monthly number of days above average rainfall increased the risk ofMVEV activity in the Kimberley at a lag of three months.I

    Priorizando portafolios de inversión en Agricultura Sostenible Adaptada al Clima (ASAC) en Guatemala

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    El Corredor Seco en Centroamérica ha sido afectado por la recurrencia de graves sequías en los últimos dos años, que afectan especialmente la producción de maíz y frijol, amenazando la seguridad alimentaria y nutricional de aproximadamente 2.5 millones de personas en la región. Más del 50% de la población afectada practica agricultura de subsistencia y se encuentran en las zonas central, no-reste y noroeste de Guatemala. En estas regiones, la sequía prolongada en 2014 dio lugar a pérdidas de alrededor del 70% en la cosecha de frijol (equivalentes a 70.000 toneladas) y 80% en maíz (200.000 toneladas), en comparación con los rendimientos de 2013. Estas pérdidas fueron avaluadas en US$ 58 millones y han tenido consecuencias importantes sobre las reservas de alimentos locales y regionales, la nutrición y la salud de las personas, así como el acceso al agua potable. Se ha estimado que alrededor de 275,000 familias se han visto afectadas por la falta de lluvias en el Corredor Seco de Guatemala durante el 2014 (UNOCHA, 2014). Estos acontecimientos han puesto de relieve la necesidad urgente de estrategias a corto plazo que pueden ayudar a las familias afectadas, pero a su vez de una visión de mediano y largo plazo que ayude a incrementar la resiliencia de los productores a eventos climáticos extremos e inesperados. La visión tendría que incorporar variables climáticas (tales como los cambios en los patrones de lluvia) en la planificación agrícola y otras intervenciones de desarrollo, dado que el sector agropecuario es uno de los mayores contribuyentes a la economía del país

    A guideline for the formation of sub-national climate-smart agriculture alliances in Tanzania

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    About the guideline: This document summarizes recommendations on best practices on how to form and operationalize of sustainable sub-national Climate Smart Agriculture (CSA) alliances for CSA actors in Tanzania. These are based on the experience and recommendations of existing District CSA Alliances and views from selected CSA actors in the country. It seeks to support ongoing efforts in the country to promote the adoption of CSA practices and technologies

    Mycobacterium bovis: A model pathogen at the interface of livestock, wildlife, and humans

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    Complex and dynamic interactions involving domestic animals, wildlife, and humans create environments favorable to the emergence of new diseases, or reemergence of diseases in new host species. Today, reservoirs of Mycobacterium bovis, the causative agent of tuberculosis in animals, and sometimes humans, exist in a range of countries and wild animal populations. Free-ranging populations of white-tailed deer in the US, brushtail possum in New Zealand, badger in the Republic of Ireland and the United Kingdom, and wild boar in Spain exemplify established reservoirs of M. bovis. Establishment of these reservoirs is the result of factors such as spillover from livestock, translocation of wildlife, supplemental feeding of wildlife, and wildlife population densities beyond normal habitat carrying capacities. As many countries attempt to eradicate M. bovis from livestock, efforts are impeded by spillback from wildlife reservoirs. It will not be possible to eradicate this important zoonosis from livestock unless transmission between wildlife and domestic animals is halted. Such an endeavor will require a collaborative effort between agricultural, wildlife, environmental, and political interests.Peer Reviewe

    A data-driven classification of outcome behaviors in those who cause concern to British public figures

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    Fixated individuals pose a significant threat to public figures. Previous research compares individuals labeled ‘approachers’ to those labeled ‘communicators.’ Typically, such studies compare a number of risk factors among the two groups to identify significant differences. This has impactful implications for the threat assessment and management of the pathologically fixated. The present study builds upon this established body of work by considering if more nuance can be disaggregated from a universe of cases referred to the Fixated Threat Assessment Center (FTAC). FTAC is a joint police and mental health unit in the U.K. which applies a public health approach to managing the pathologically fixated. The present study takes a deductive approach to detect profiles of cases from the data. First, we use cluster analysis to detect unmeasured subgroups of concerning behavior in the case files of 2,118 referrals to FTAC. We identify 5 patterns of concerning behavior: incoherent offline communicators, incoherent online communicators, angry/abusive communicators, concerning approachers, and problematic approachers. Second, we examine the rate of diagnosed mental disorder, the nature of concerns evoked, and case management actions taken among each of the five profiles identified. We conclude by highlighting how our results could inform triaging large volumes of cases, the allocation of limited resources, and more generally, how the success of the FTAC model has relevance across the management of grievance-fueled violence in general. (PsycInfo Database Record (c) 2021 APA, all rights reserved
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