Developing Pandemic Comics for Youth Audiences

In spring 2020 our team received funding from the Rapid Response Research program of the National Science Foundation to develop comics that would help youth understand the COVID-19 pandemic. Our project built on a decade of expertise creating comics about the biology of viruses. In collaboration with virologists and artists, we developed three comic stories about COVID-19 during the pandemic and posted them on-line during the last half of 2020. The fictional narratives address fundamental issues in biology, virology, and network science, in order to help readers understand the complexities of living through a viral pandemic. The stories focus on three themes: the biology and social context of the COVID-19 virus; the relationship of wild animals, particularly bats, to the pandemic; and the impact of the pandemic on Tribal communities. We describe the challenges of comic development during the pandemic and the feedback from youth on whether the comics were appealing, interesting, and understandable. The stories were posted on worldofviruses.unl.edu and are published by the University of Nebraska Press as the book, C’RONA Pandemic Comics, with essays for youth about the virus and the pandemic

A critical narrative analysis of shared decision-making in acute, inpatient mental health care

Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients? care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place

Informed, Involved and Influential: The 3 I's model of Shared Decision Making in Mental Health Care

Collaboration between service users and mental health professionals is at the heart of values based practice and shared decision making. However, there has been limited analysis of the implications of these approaches within a healthcare context that involves depriving service users of their freedom. This article proposes a framework that aims to promote shared decision making which acknowledges, all participants must be Informed, Involved and Influential in the decision-making process. However, these are fluid; they refer to a sliding scale of influence that moves between these different positions depending on context, capacity and desire to influence

Estimated Ultraviolet Radiation Doses in Wetlands in Six National Parks

Ultraviolet-B radiation (UV-B, 280–320-nm wavelengths) doses were estimated for 1024 wetlands in six national parks: Acadia (Acadia), Glacier (Glacier), Great Smoky Mountains (Smoky), Olympic (Olympic), Rocky Mountain (Rocky), and Sequoia/ Kings Canyon (Sequoia). Estimates were made using ground-based UV-B data (Brewer spectrophotometers), solar radiation models, GIS tools, field characterization of vegetative features, and quantification of DOC concentration and spectral absorbance. UV-B dose estimates were made for the summer solstice, at a depth of 1 cm in each wetland. The mean dose across all wetlands and parks was 19.3 W-h m-2 (range of 3.4–32.1 W-h m-2). The mean dose was lowest in Acadia (13.7 W-h m-2) and highest in Rocky (24.4 W-h m-2). Doses were significantly different among all parks. These wetland doses correspond to UV-B flux of 125.0 µW cm-2 (range 21.4–194.7 µW cm)2) based on a day length, averaged among all parks, of 15.5 h. Dissolved organic carbon (DOC), a key determinant of water-column UV-B flux, ranged from 0.6 (analytical detection limit) to 36.7 mg C L-1 over all wetlands and parks, and reduced potential maximal UV-B doses at 1-cm depth by 1%–87 %. DOC concentration, as well as its effect on dose, was lowest in Sequoia and highest in Acadia (DOC was equivalent in Acadia, Glacier, and Rocky). Landscape reduction of potential maximal UV-B doses ranged from zero to 77% and was lowest in Sequoia. These regional differences in UV-B wetland dose illustrate the importance of considering all aspects of exposure in evaluating the potential impact of UV-B on aquatic organisms

Incremental value of the CT coronary calcium score for the prediction of coronary artery disease

Objectives:: To validate published prediction models for the presence of obstructive coronary artery disease (CAD) in patients with new onset stable typical or atypical angina pectoris and to assess the incremental value of the CT coronary calcium score (CTCS). Methods:: We searched the literature for clinical prediction rules for the diagnosis of obstructive CAD, defined as≥50% stenosis in at least one vessel on conventional coronary angiography. Significant variables were re-analysed in our dataset of 254 patients with logistic regression. CTCS was subsequently included in the models. The area under the receiver operating characteristic curve (AUC) was calculated to assess diagnostic performance. Results:: Re-analysing the variables used by Diamond & Forrester yielded an AUC of 0.798, which increased to 0.890 by adding CTCS. For Pryor, Morise 1994, Morise 1997 and Shaw the AUC increased from 0.838 to 0.901, 0.831 to 0.899, 0.840 to 0.898 and 0.833 to 0.899. CTCS significantly improved model performance in each model. Conclusions:: Validation demonstrated good diagnostic performance across all models. CTCS improves the prediction of the presence of obstructive CAD, independent of clinical predictors, and should be considered in its diagnostic work-up. © 2010 The Author(s)

Mirroring Opposition Threats

Hugo Chávez and his Bolivarian Movement came to power in 1999 promising to refound the Venezuelan state and restructure the polity in ways that would build “popular power” through the promotion of grassroots participation, organization, and mobilization. Once in office, the Bolivarian forces launched a series of initiatives to sponsor organization and mobilization among supporters, which ranged widely in their functions and strategic purpose. State-mobilized organizations can be seen as operating in three different arenas of politics: the local governance arena; the electoral arena; and the protest arena. From an ideological standpoint, the Bolivarian Movement was oriented toward sponsoring organizations that could operate in the first of these arenas, helping realize Chávez’s vision of constructing a “protagonistic democracy” by establishing vehicles for citizen participation in local governance. In the terminology of this volume, these activities are best seen as a form of “infrastructural mobilization,” working to solidify political support and achieve the government’s longer-term aims

Vegetarian eating

The philosophical literature may seem to be replete with arguments for vegetarianism based on harm to animals. However, these arguments turn out to be arguments for veganism, not vegetarianism. This chapter explores whether anything can be said for vegetarianism. Some reasons motivating vegetarianism seem to be very personal, and so not the sorts of things that could be the foundation of a moral argument. Meanwhile, though they may hold some weight, arguments about vegetarianism as a “middle way” between veganism and omnivorism are highly contingent. Both of these routes, then, may seem unsatisfying to the vegetarian. Could there be a principled case for vegetarianism? Tzachi Zamir is the one philosopher who has argued at length for vegetarianism over veganism, but a close examination of his arguments show that they are not as compelling as they first seem. A final option remains open: there may be potential for arguments critiquing the eating of animals’ flesh and/or their bodies that are independent of concerns about harms to animals in food production. Such arguments, which have been hinted at in animal ethics, offer a critique of meat consumption, but not, necessarily, of egg and dairy consumption. Perhaps, then, they could form the basis of a principled case for vegetarianism that does not immediately become a case for veganism. The consequences of such an argument, if one can be made, are not simple

Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine