Notes on Recent Cases

Notes on recent cases by D. M. Donahue, A. J. DeDario, J. S. Angelino, J. J. Canty, F. Earl Lamboley, Marc Wonderlin, and Albion M. Griffin

Piloting a shared decision-making clinician training intervention in maternity care in Australia: A mixed methods study

Problem: Implementation of woman-centred care in evidence-based maternity practice requires clinicians to be skilled in shared decision-making, yet there is limited training or research into such interventions. Background: Shared decision-making enables women to make informed decisions in partnership with clinicians where there are varied clinical options in relation to indications for and timing of planned birth. Aim: We aimed to develop a shared decision-making training intervention and evaluate its feasibility and acceptability to midwives and obstetricians. Methods: The intervention was co-designed by midwifery and medical clinician-researchers, and a consumer representative. Online training and demonstration videos were distributed to midwives and obstetricians in three Sydney hospitals, followed by two online workshops in 2021 and 2022 where participants practised shared decision-making in roleplaying scenarios tailored to timing of birth. Training was evaluated using post-workshop and post-training surveys and semi-structured qualitative interviews. Findings: The training workshop format, duration and content were well received. Barriers to the uptake of shared decision-making were time, paternalistic practices and fear of repercussions of centring women in the decision-making process. Discussion: The intervention enabled midwifery and medical colleagues to learn communication repertoires from each other in woman-centred discussions around timing of birth. Roleplay scenarios enabled participants to observe and provide feedback on their colleagues’ shared decision-making practices, while providing a space for collective reflection on ways to promote, and mitigate barriers to, its implementation in practice. Conclusion: Shared decision-making training supports maternity clinicians in developing skills that implement woman-centred care in the timing of planned birth

Constraints for the photolysis rate and the equilibrium constant of ClO-dimer from airborne and balloon-borne measurements of chlorine compounds

We analyze measurements of ClO across the terminator taken by the Airborne Submillimeter Radiometer (ASUR) in the activated vortices of the Arctic winters of 1995/1996, 1996/1997, and 1999/2000 to evaluate the plausibility of various determinations of the ClO-dimer photolysis cross section and the rate constant controlling the thermal equilibrium between ClO-dimer and ClO. We use measured ClO during sunlit conditions to estimate total active chlorine (ClOx). As the measurements suggest nearly full chlorine activation in winter 1999/2000, we compare ClOx estimates based on various photolysis frequencies of ClO-dimer with total available inorganic chlorine (Cly), estimated from an N2O-Cly correlation established by a balloon-borne MkIV interferometer measurement. Only ClO-dimer cross sections leading to the fastest photolysis frequencies in the literature (including the latest evaluation by the Jet Propulsion Laboratory) give ClOx mixing ratios that overlap with the estimated range of available Cly. Slower photolysis rates lead to ClOx values that are higher than available Cly. We use the ClOx calculated from sunlit ClO measurements to estimate ClO in darkness based on different equilibrium constants, and compare it with ASUR ClO measurements before sunrise at high solar zenith angles. Calculations with equilibrium constants published in recent evaluations of the Jet Propulsion Laboratory give good agreement with observed ClO mixing ratios. Equilibrium constants leading to a higher ClO/ClOx ratio in darkness yield ClO values that tend to exceed observed abundances. Perturbing the rates for the ClO + BrO reaction in a manner that increases OClO formation and decreases BrCl formation leads to lower ClO values calculated for twilight conditions after sunset, resulting in better agreement with ASUR measurements

Analysis of satellite-derived Arctic tropospheric BrO columns in conjunction with aircraft measurements during ARCTAS and ARCPAC

We derive tropospheric column BrO during the ARCTAS and ARCPAC field campaigns in spring 2008 using retrievals of total column BrO from the satellite UV nadir sensors OMI and GOME-2 using a radiative transfer model and stratospheric column BrO from a photochemical simulation. We conduct a comprehensive comparison of satellite-derived tropospheric BrO column to aircraft in-situ observations of BrO and related species. The aircraft profiles reveal that tropospheric BrO, when present during April 2008, was distributed over a broad range of altitudes rather than being confined to the planetary boundary layer (PBL). Perturbations to the total column resulting from tropospheric BrO are the same magnitude as perturbations due to longitudinal variations in the stratospheric component, so proper accounting of the stratospheric signal is essential for accurate determination of satellite-derived tropospheric BrO. We find reasonably good agreement between satellite-derived tropospheric BrO and columns found using aircraft in-situ BrO profiles, particularly when satellite radiances were obtained over bright surfaces (albedo \u3e0.7), for solar zenith angl

Beyond binary: (re)defining “gender” for 21st century disaster risk reduction research, policy, and practice

The dominant discourse of gender focuses on the binary of woman/man, despite the known additional risks for diverse sexualities and gender minorities in disasters. Given the small but growing body of literature concerning gender minorities in disasters, this paper sets out to explore the place of sex and gender minorities in disasters and to examine whether a binary definition needs to be extended. A five-stage rapid review was undertaken following Arksey and O’Malley’s method. Peer-reviewed journal articles in English language were sought that included disaster and gender terms in the title, abstract, and/or body of the article published between January 2015 and March 2019. The search included MEDLINE and Scopus databases. Relevant information from the studies were charted in Microsoft Excel, and results were summarized using a descriptive analytical method. In total, 728 records were identified; 248 that did not meet the inclusion criteria were excluded and 166 duplicates were removed. A total of 315 records were sourced and their full text was reviewed. Of those, only 12 journal articles included content relative to more than two genders. We also recognized that sex and gender terms were used interchangeably with no clear differentiation between the two. We recommend that disaster scholars and practitioners adopt correct terminology and expand their definition of gender beyond the binary; utilize work on gender fluidity and diversity; and apply this to disaster research, policy, and practice. View Full-Tex

VerdictDB: Universalizing Approximate Query Processing

Despite 25 years of research in academia, approximate query processing (AQP) has had little industrial adoption. One of the major causes of this slow adoption is the reluctance of traditional vendors to make radical changes to their legacy codebases, and the preoccupation of newer vendors (e.g., SQL-on-Hadoop products) with implementing standard features. Additionally, the few AQP engines that are available are each tied to a specific platform and require users to completely abandon their existing databases---an unrealistic expectation given the infancy of the AQP technology. Therefore, we argue that a universal solution is needed: a database-agnostic approximation engine that will widen the reach of this emerging technology across various platforms. Our proposal, called VerdictDB, uses a middleware architecture that requires no changes to the backend database, and thus, can work with all off-the-shelf engines. Operating at the driver-level, VerdictDB intercepts analytical queries issued to the database and rewrites them into another query that, if executed by any standard relational engine, will yield sufficient information for computing an approximate answer. VerdictDB uses the returned result set to compute an approximate answer and error estimates, which are then passed on to the user or application. However, lack of access to the query execution layer introduces significant challenges in terms of generality, correctness, and efficiency. This paper shows how VerdictDB overcomes these challenges and delivers up to 171$\times$ speedup (18.45$\times$ on average) for a variety of existing engines, such as Impala, Spark SQL, and Amazon Redshift, while incurring less than 2.6% relative error. VerdictDB is open-sourced under Apache License.Comment: Extended technical report of the paper that appeared in Proceedings of the 2018 International Conference on Management of Data, pp. 1461-1476. ACM, 201

Assessing environmental pollution in birds: a new methodological approach for interpreting bioaccumulation of trace elements in feather shafts using geochemical sediment data

Environmental trace element composition can have an important impact on ecosystem and population health as well individual fitness. Therefore, carefully assessing bioaccumulation of trace elements is central to studies investigating the ecological impact of pollution. Colonial birds are important bioindicators since non-invasive sampling can easily be achieved through sampling of chick feathers, which controls for some confounding factors of variability (age and environmental heterogeneity). However, an additional confounding factor, external contamination (ExCo), which remains even after washing feathers, has frequently been overlooked in the literature. We developed a new method to reliably interpret bioaccumulation of 10 trace elements (As, Cd, Cr, Cu, Hg, Ni, Pb, Se, Sn and Zn) in feathers using chicks of a colonial species: the Greater Flamingo, Phoenicopterus roseus. First, only shafts were used to remove ExCo retained in vanes. Secondly, we applied a thorough washing procedure. Thirdly, we applied a new analytical method to control for ExCo, which assumes that ExCo is mainly due to adhered sediment particles and that the relative concentration of each trace element will be similar to the sediment geochemical composition of sampling sites. We validated this new methodology by comparing trace element composition and particle composition (by scanning electron microscopy and mass spectrometry) of washed and unwashed feathers. The washing procedure removed >99% of K indicating that most of the ExCo from salt was removed. Scanning electron microscopy and mass spectrometry revealed that some sediment particles remained after washing, especially clays which are likely to severely bias bioaccumulation interpretation. We successfully controlled for ExCo by calculating the ratio of ExCo due to sediment using the geochemical fingerprint of sediment samples. Our methodology leads to conservative estimates of bioaccumulation for As, Cd, Cr, Cu, Hg, Ni, Pb, Se, Sn and Zn. We have validated a new more reliable method of analysing trace element concentrations in feathers, which effectively controls for ExCo, if geochemical sediment data can be meaningfully compared to ExCo of feathers. We have demonstrated that overlooking ExCo leads to potentially erroneous conclusions, and we urge that the method applied in this study be considered in future studies.Peer Reviewe