What topics should we teach the parents of admitted neonates in the newborn care unit in the resource-limited setting - a Delphi study

BACKGROUND: In resource-limited settings, such as Rwanda, health care profession (HCP) to neonate ratios are low, and therefore caregivers play a significant role in providing care for their admitted neonates. To provide such Family Integrated Care, caregivers need knowledge, skills, and confidence. The objective of this study was to identify consensus from key stakeholders regarding the priority topics for a "parental neonatal curriculum." METHODS: A three-round Delphi-study was conducted. During Round-1, face-to-face interviews were undertaken and responses coded and categorized into themes. In Round-2, participants were presented with Round-1 feedback and asked to provide additional topics in respective themes. In Round-3, respondents were asked to rank the importance of these items using a 9-point Likert scale. RESULTS: Ten, 36 and 40 stakeholders participated in Rounds-1, - 2 and - 3 respectively, including parents, midwives, nurses and physicians. Twenty and 37 education topics were identified in Rounds-1 and -2 respectively. In Round-3 47 of the 57 presented outcomes met pre-defined criteria for inclusion in the "parental neonatal curriculum." CONCLUSION: We describe a "parental neonatal curriculum," formed using robust consensus methods, describing the core topics required to educate parents of neonates admitted to a newborn care unit. The curriculum has been developed in Rwanda and is relevant to other resource-limited settings

Declining Public Awareness of Heart Attack Warning Symptoms in the Years Following an Australian Public Awareness Campaign: A Cross-Sectional Study

Background: The National Heart Foundation of Australia's (NHFA) Warning Signs campaign ran between 2010 and 2013. This study examines trends in Australian adults’ ability to name heart attack symptoms during the campaign and in the years following. Methods: Using the NHFA's HeartWatch data (quarterly online surveys) for adults aged 30–59 years, we conducted an adjusted piecewise regression analysis comparing trends in the ability to name symptoms during the campaign period plus one year lag (2010–2014) to the post-campaign period (2015–2020) Results: Over the study period, there were 101,936 Australian adults surveyed. Symptom awareness was high or increased during the campaign period. However, there was a significant downward trend in each year following the campaign period for most symptoms (e.g., chest pain: adjusted odds ratio [AOR] =0.91, 95%CI: 0.56–0.80; arm pain: AOR=0.92, 95%CI: 0.90–0.94). Conversely, the inability to name any heart attack symptom increased in each year following the campaign (3.7% in 2010 to 19.9% in 2020; AOR=1.13, 95%CI: 1.10–1.15); these respondents were more likely to be younger, male, have less than 12 years of education, identify as Aboriginal and/or Torres Strait Islander Peoples, speak a language other than English at home and have no cardiovascular risk factors. Conclusion: Awareness of heart attack symptoms has decreased in the years since the Warning Signs campaign in Australia, with 1 in 5 adults currently unable to name a single heart attack symptom. New approaches are needed to promote and sustain this knowledge, and to ensure people act appropriately and promptly if symptoms occur

Interstellar Carbon in Translucent Sightlines

We report interstellar C II column densities or upper limits determined from weak absorption of the 2325.4029 A intersystem transition observed in six translucent sightlines with STIS. The sightlines sample a wide range of interstellar characteristics including total-to-selective extinction, R_{V} = 2.6 - 5.1; average hydrogen density along the sightline, = 3 - 14 cm^{-3}; and fraction of H in molecular form, 0 - 40%. Four of the sightlines, those toward HD 37021, HD 37061, HD 147888 and HD 207198, have interstellar gas-phase abundances that are consistent with the diffuse sightline ratio of 161 +/- 17 carbon atoms in the gas per million hydrogen nuclei. We note that while it has a gas-phase carbon abundance that is consistent with the other sightlines, a large fraction of the C II toward HD 37061 is in an excited state. The sightline toward HD 152590 has a measured interstellar gas-phase carbon abundance that is well above the diffuse sightline average; the column density of C in this sightline may be overestimated due to noise structure in the data. Toward HD 27778 we find a 3 sigma abundance upper limit of <108 C atoms in the gas per million H, a substantially enhanced depletion of C as compared to the diffuse sightline value. The interstellar characteristics toward HD 27778 are otherwise not extreme among the sample except for an unusually large abundance of CO molecules in the gas.Comment: Accepted for publication in the Astrophysical Journa

The pairs training effect in unfamiliar face matching

A wealth of studies have shown that humans are remarkably poor at determining whether two face images show the same person or not (face matching). Given the prevalence of photo-ID, and the fact that people employed to check photo-ID are typically unfamiliar with the person pictured, there is a need to improve unfamiliar face matching accuracy. One method of improvement is to have participants complete the task in a pair, which results in subsequent improvements in the low performer (“the pairs training effect”). Here, we sought to replicate the original finding, to test the longevity of the pairs training effect, and to shed light on the potential underlying mechanisms. In two experiments, we replicated the pairs training effect and showed it is maintained after a delay (Experiment 1). We found no differences between high and low performers in confidence (Experiment 1) or response times (Experiment 2), and the content of the pairs’ discussions (Experiment 2) did not explain the results. The pairs training effect in unfamiliar face matching is robust, but the mechanisms underlying the effects remain as yet unexplained

Improving face morph detection with the pairs training effect

It is becoming increasingly common for face morphs (weighted combinations of two people's photographs) to be submitted for inclusion in an official document, such as a passport. These images may sufficiently resemble both individuals that they can be used by either person in a ‘fraudulently obtained genuine’ document. Problematically, people are poor at detecting face morphs and there is limited evidence that this can be improved. Here, we tested whether the ‘pairs training effect’ (working in pairs, which we know improves unfamiliar face matching) can improve face morph detection. We found morph detection was more accurate when working in a pair. Further, the lower performer in the pair maintained this benefit when completing the task again individually. We conclude that the pairs training effect translates to face morph detection, and these findings have important implications for improving the detection of face morphs at the initial application stage

First urology simulation boot camp in the United Kingdom

Objective: Simulation is now firmly established in modern surgical training and is applicable not only to acquiring surgical skills but also to non-surgical skills and professionalism. A 5-day intensive Urology Simulation Boot Camp was run to teach emergency procedural skills, clinical reasoning, and communication skills using clinical scenario simulations, endoscopic and laparoscopic trainers. This paper reports the educational value of this first urology boot camp. Subjects and methods: Sixteen urology UK trainees completed pre-course questionnaires on their operative experience and confidence level in common urological procedures. The course included seven modules covering basic scrotal procedures, laparoscopic skills, ureteroscopy, transurethral resection of the prostate and bladder tumour, green light laser prostatectomy, familiarisation with common endoscopic equipment, bladder washout to remove clots, bladder botox injection, setting up urodynamics. Emergency urological conditions were managed using scenarios on SimMan®. The main focus of the course was hands-on training using animal models, bench-top models and virtual reality simulators. Post-course assessment and feedback on the course structure and utility of knowledge gained together with a global outcome score was collected. Results: Overall all the sections of feedback received score of over 4.5/5, with the hands-on training on simulators getting the best score 4.8/5. When trainees were asked “The training has equipped me with enhanced knowledge, understanding and skills,” the average score was 4.9/5.0. The vast majority of participants felt they would recommend the boot camp to future junior trainees. Conclusion: This first UK Urology Simulation Boot Camp has demonstrated feasibility and effectiveness in enhancing trainee’s experience. Given these positive feedbacks there is a good reason to expect that future courses will improve the overall skills of a new urology trainee

FUSE Measurements of Far Ultraviolet Extinction. I. Galactic Sight Lines

We present extinction curves that include data down to far ultraviolet wavelengths (FUV; 1050 - 1200 A) for nine Galactic sight lines. The FUV extinction was measured using data from the Far Ultraviolet Spectroscopic Explorer. The sight lines were chosen for their unusual extinction properties in the infrared through the ultraviolet; that they probe a wide range of dust environments is evidenced by the large spread in their measured ratios of total-to-selective extinction, R_V = 2.43 - 3.81. We find that extrapolation of the Fitzpatrick & Massa relationship from the ultraviolet appears to be a good predictor of the FUV extinction behavior. We find that predictions of the FUV extinction based upon the Cardelli, Clayton & Mathis (CCM) dependence on R_V give mixed results. For the seven extinction curves well represented by CCM in the infrared through ultraviolet, the FUV extinction is well predicted in three sight lines, over-predicted in two sight lines, and under-predicted in 2 sight lines. A Maximum Entropy Method analysis using a simple three component grain model shows that seven of the nine sight lines in the study require a larger fraction of grain materials to be in dust when FUV extinction is included in the models. Most of the added grain material is in the form of small (radii < 200 A) grains.Comment: Accepted for publication in the Astrophysical Journal. 31 pages with 7 figure

Short-term psychosocial outcomes of adding a non-contrast abdominal computed tomography (CT) scan to the thoracic CT within lung cancer screening.

OBJECTIVES: To evaluate psychological, social, and financial outcomes amongst individuals undergoing a non-contrast abdominal computed tomography (CT) scan to screen for kidney cancer and other abdominal malignancies alongside the thoracic CT within lung cancer screening. SUBJECTS AND METHODS: The Yorkshire Kidney Screening Trial (YKST) is a feasibility study of adding a non-contrast abdominal CT scan to the thoracic CT within lung cancer screening. A total of 500 participants within the YKST, comprising all who had an abnormal CT scan and a random sample of one-third of those with a normal scan between 14/03/2022 and 24/08/2022 were sent a questionnaire at 3 and 6 months. Outcomes included the Psychological Consequences Questionnaire (PCQ), the short-form of the Spielberger State-Trait Anxiety Inventory, and the EuroQoL five Dimensions five Levels scale (EQ-5D-5L). Data were analysed using regression adjusting for participant age, sex, socioeconomic status, education, baseline quality of life (EQ-5D-5L), and ethnicity. RESULTS: A total of 380 (76%) participants returned questionnaires at 3 months and 328 (66%) at 6 months. There was no difference in any outcomes between participants with a normal scan and those with abnormal scans requiring no further action. Individuals requiring initial further investigations or referral had higher scores on the negative PCQ than those with normal scans at 3 months (standardised mean difference 0.28 sd, 95% confidence interval 0.01-0.54; P = 0.044). The difference was greater in those with anxiety or depression at baseline. No differences were seen at 6 months. CONCLUSION: Screening for kidney cancer and other abdominal malignancies using abdominal CT alongside the thoracic CT within lung cancer screening is unlikely to cause significant lasting psychosocial or financial harm to participants with incidental findings

Origin and evolution of the light nuclides

After a short historical (and highly subjective) introduction to the field, I discuss our current understanding of the origin and evolution of the light nuclides D, He-3, He-4, Li-6, Li-7, Be-9, B-10 and B-11. Despite considerable observational and theoretical progress, important uncertainties still persist for each and every one of those nuclides. The present-day abundance of D in the local interstellar medium is currently uncertain, making it difficult to infer the recent chemical evolution of the solar neighborhood. To account for the observed quasi-constancy of He-3 abundance from the Big Bang to our days, the stellar production of that nuclide must be negligible; however, the scarce observations of its abundance in planetary nebulae seem to contradict this idea. The observed Be and B evolution as primaries suggests that the source composition of cosmic rays has remained quasi-constant since the early days of the Galaxy, a suggestion with far reaching implications for the origin of cosmic rays; however, the main idea proposed to account for that constancy, namely that superbubbles are at the source of cosmic rays, encounters some serious difficulties. The best explanation for the mismatch between primordial Li and the observed "Spite-plateau" in halo stars appears to be depletion of Li in stellar envelopes, by some yet poorly understood mechanism. But this explanation impacts on the level of the recently discovered early ``Li-6 plateau'', which (if confirmed), seriously challenges current ideas of cosmic ray nucleosynthesis.Comment: 18 pages, 9 figs. Invited Review in "Symposium on the Composition of Matter", honoring Johannes Geiss on the occasion of his 80th birthday (Grindelwald, Switzerland, Sept. 2006), to be published in Space Science Series of ISS

Public attitudes towards the use of automatic facial recognition technology in criminal justice systems around the world

Automatic facial recognition technology (AFR) is increasingly used in criminal justice systems around the world, yet to date there has not been an international survey of public attitudes toward its use. In Study 1, we ran focus groups in the UK, Australia and China (countries at different stages of adopting AFR) and in Study 2 we collected data from over 3,000 participants in the UK, Australia and the USA using a questionnaire investigating attitudes towards AFR use in criminal justice systems. Our results showed that although overall participants were aligned in their attitudes and reasoning behind them, there were some key differences across countries. People in the USA were more accepting of tracking citizens, more accepting of private companies’ use of AFR, and less trusting of the police using AFR than people in the UK and Australia. Our results showed that support for the use of AFR depends greatly on what the technology is used for and who it is used by. We recommend vendors and users do more to explain AFR use, including details around accuracy and data protection. We also recommend that governments should set legal boundaries around the use of AFR in investigative and criminal justice settings