Obesity Prevalence and Dietary Intake of Antioxidants in Native American Adolescents

Antioxidants are well known for possessing anti-inflammatory properties, which can reduce the risk of chronic disease and obesity. However, very little research has been done to examine antioxidant intake among adolescent minority populations such as Native American adolescents. Our study examined the significance of antioxidant intake among Native American adolescents at an urban residential high school in Southern California. Our study population consisted of 183 male and female Native American adolescents, 14-18 years of age, representing 43 tribes from across the United States. Students' primary source of meals was provided by the school food service. Based on the BMI calculations, the rate of obesity within our population was 38% for males and 40% for females, more than two-fold the national rate indicated by NHANESIII data. We used the Harvard School of Public Health Youth/Adolescent Questionnaire (HSPH YAQ), a semi-quantitative food frequency questionnaire, to examine antioxidant nutrient intake and evaluate the differences in the intake between normal and obese weight students. Statistical analysis of the results showed that intakes of vitamins C, E, and lycopene were the antioxidant nutrients found to be significantly different between normal and obese weight students and intakes of these nutrients were found to be higher among normal weight students (p-values = 0.02451, 0.00847, and 0.04928, respectively). These results suggest that dietary intake of antioxidants could be increased among Native American adolescents. Further research is needed to confirm our findings and identify effective ways for school food service to incorporate antioxidant rich foods into school menus

The effects on clinical trial activity of direct funding and taxation policy interventions made by government: A systematic review

Context Governments have attempted to increase clinical trial activity in their jurisdictions using a range of methods including targeted direct funding and industry tax rebates. The effectiveness of the different approaches employed is unclear. Objective To systematically review the effects of direct government financing interventions by allowing companies to reduce their tax payable on clinical trial activity. Data sources Pub Med, Scopus, Sage, ProQuest, Google Scholar and Google were searched up to the 11th of April 2022. In addition, the reference lists of all potentially eligible documents were hand searched to identify additional reports. Following feedback from co-authors, information on a small number of additional interventions were specifically sought out and included. Data extraction Summary information about potentially eligible reports were reviewed independently by two researchers, followed by extraction of data into a structured spreadsheet for eligible studies. The primary outcomes of interest were the number of clinical trials and the expenditure on clinical trials but data about other evaluations were also collected. Results There were 1694 potentially eligible reports that were reviewed. Full text assessments were done for 304, and 30 reports that provided data on 43 interventions were included- 29 that deployed targeted direct funding and 14 that provided tax rebates or exemptions. There were data describing effects on a primary outcome for 25/41 of the interventions. The most common types of interventions were direct funding to researchers via special granting mechanisms and tax offsets to companies and research organisations. All 25 of the studies for which data were available reported a positive impact on numbers and/or expenditure on clinical trials though the robustness of evaluations was limited for many. Estimates of the magnitude of effects of interventions were reported inconsistently, varied substantially, and could not be synthesised quantitatively, though targeted direct funding interventions appeared to be associated with more immediate impact on clinical trial activity. Conclusion There is a high likelihood that governments can increase clinical trial activity with either direct or indirect fiscal mechanisms. Direct funding may provide a more immediate and tangible return on investment than tax rebates

New development: strategic user orientation in public services delivery—the missing link in the strategic trinity?

This paper explores the application of strategic planning and management to Public Service Organisations (PSOs). It argues that the impact of these approaches has been limited by the absence of an underlying strategic orientation that would provide a value-base upon which to embed these approaches within PSOs. It argues further for such an orientation to privelege the need for public services to add value to the lives of citizens and service users and not to focus solely upon internal measures of efficiency and performance

Anticipating Stream Ecosystem Responses to Climate Change: Toward Predictions That Incorporate Effects via Land–Water Linkages

Climate change (CC) is projected to increase the frequency and severity of natural disturbances (wildfires, insect outbreaks, and debris flows) and shift distributions of terrestrial ecosystems on a global basis. Although such terrestrial changes may affect stream ecosystems, they have not been incorporated into predictions of stream responses to CC. Here, we introduce a conceptual framework to evaluate to what extent responses of streams to CC will be driven by not only changes in thermal and hydrologic regimes, but also alterations of terrestrial processes. We focused on forested water-sheds of western North America because this region is projected to experience CC-induced alteration of terrestrial processes. This provided a backdrop for investigating interactive effects of climate and terrestrial responses on streams. Because stream responses to terrestrial processes have been well-studied in contexts largely independent of CC research, we synthesized this knowledge to demonstrate how CC-induced alterations of terrestrial ecosystems may affect streams. Our synthesis indicated that altered terrestrial processes will change terrestrial–aquatic linkages and autotrophic production, potentially yielding greater sensitivity of streams to CC than would be expected based on shifts in temperature and precipitation regime alone. Despite uncertainties that currently constrain predictions regarding stream responses to these additional pathways of change, this synthesis highlighted broader effects of CC that require additional research. Based on widespread evidence that CC is linked to changing terrestrial processes, we conclude that accurate predictions of CC effects on streams may be coupled to the accuracy of predictions for long-term changes in terrestrial ecosystems

Diffusion entropy and waiting time statistics of hard x-ray solar flares

We analyze the waiting time distribution of time distances $\tau$ between two nearest-neighbor flares. This analysis is based on the joint use of two distinct techniques. The first is the direct evaluation of the distribution function $\psi(\tau)$, or of the probability, $\Psi(tau)$, that no time distance smaller than a given $\tau$ is found. We adopt the paradigm of the inverse power law behavior, and we focus on the determination of the inverse power index $\mu$, without ruling out different asymptotic properties that might be revealed, at larger scales, with the help of richer statistics. The second technique, called Diffusion Entropy (DE) method, rests on the evaluation of the entropy of the diffusion process generated by the time series. The details of the diffusion process depend on three different walking rules, which determine the form and the time duration of the transition to the scaling regime, as well as the scaling parameter $\delta$. With the first two rules the information contained in the time series is transmitted, to a great extent, to the transition, as well as to the scaling regime. The same information is essentially conveyed, by using the third rules, into the scaling regime, which, in fact, emerges very quickly after a fast transition process. We show that the significant information hidden within the time series concerns memory induced by the solar cycle, as well as the power index $\mu$. The scaling parameter $\delta$ becomes a simple function of $\mu$, when memory is annihilated. Thus, the three walking rules yield a unique and precise value of $\mu$ if the memory is wisely taken under control, or cancelled by shuffling the data. All this makes compelling the conclusion that $\mu = 2.138 \pm 0.01$.Comment: 23 pages, 13 figure

The effects of government policies targeting ethics and governance processes on clinical trial activity and expenditure: a systematic review

Governments have attempted to increase clinical trial activity in their jurisdictions using a range of methods including simplifying the ethics review and governance process of clinical trials. This study’s objective was to systematically review the effects of government actions targeting ethics reviews or governance processes on clinical trial activity. The data sources of Pub Med, Scopus, Sage, ProQuest, Google, Google Scholar and reference lists were all searched between 9/8/20 and 6/9/20. From these sources, 1455 potentially eligible reports were reviewed and full text assessments were done for 295. Thirty-eight reports provided data on 45 interventions—13 targeting ethics review and 32 targeting governance processes—were included. There were data describing effects on a primary or secondary outcome (the number of clinical trials or expenditure on clinical trials) for 39/45 of the interventions. 23/39 (59%) reported positive effects, meaning a greater number of trials and/or expenditure on clinical trials (6/11 ethics, 17/28 governance), 7/39 (18%) reported null effects (4/11 ethics, 3/28 governance) and 9/39 (23%) reported adverse effects (1/13 ethics, 8/28 governance). Positive effects were attributable to interventions that better defined the scope of review, placed clear expectations on timelines or sought to achieve mutual acceptance of ethics review outcomes. Adverse effects were mostly caused by governance interventions that unintentionally added an extra layer of bureaucracy or were developed without full consideration of the broader clinical trial approval system. Governments have an opportunity to enhance clinical trial activity with interventions targeting ethics reviews and governance processes but must be aware that some interventions can have an adverse impact

Leading and recognizing public value

This article examines the relationship between leadership and public value, which is particularly challenging in a context of explicit contest and conflict. The theoretical framework is illustrated through a case study of policing rural crime. The study reveals that the police worked with multiple and competing publics rather than a single homogeneous public, and that part of their leadership role was to create and convene a public space in which different voices and divergent views could be expressed. The study notes that research needs to pay attention to the loss and displacement of public value, not solely its creation and recognition. The need to convene multiple publics required the police to lead, as part of a leadership constellation, and with political astuteness. The findings have wider relevance for other public services, and for studies of leadership and public value at the intersection between the state and civil society

A statistical analysis of X-ray variability in pre-main sequence objects of the Taurus Molecular Cloud

This work is part of a systematic X-ray survey of the Taurus star forming complex with XMM-Newton. We study the time series of all X-ray sources associated with Taurus members, to statistically characterize their X-ray variability, and compare the results to those for pre-main sequence stars in the Orion Nebula Cluster and to expectations arising from a model where all the X-ray emission is the result of a large number of stochastically occurring flares. We find that roughly half of the detected X-ray sources show variability above our sensitivity limit, and in ~ 26 % of the cases this variability is recognized as flares. Variability is more frequently detected at hard than at soft energies. The variability statistics of cTTS and wTTS are undistinguishable, suggesting a common (coronal) origin for their X-ray emission. We have for the first time applied a rigorous maximum likelihood method in the analysis of the number distribution of flare energies on pre-main sequence stars. In its differential form this distribution follows a power-law with index alpha = 2.4 +- 0.5, in the range typically observed on late-type stars and the Sun. The flare energy distribution is probably steep enough to explain the heating of stellar coronae by nano-flares (alpha > 2), albeit associated with a rather large uncertainty that leaves some doubt on this conclusion.Comment: accepted for publication in Astronomy & Astrophysics; to appear in a Special Section dedicated to the XMM-Newton Extended Survey of the Taurus Molecular Cloud (XEST

An Immersive Virtual Reality Curriculum for Pediatric Hematology Clinicians on Shared Decision-making for Hydroxyurea in Sickle Cell Anemia

Although hydroxyurea (HU) is an effective treatment for sickle cell anemia, uptake remains low. Shared decision-making (SDM) is a recommended strategy for HU initiation to elicit family preferences; however, clinicians lack SDM training. We implemented an immersive virtual reality (VR) curriculum at 8 pediatric institutions to train clinicians on SDM that included counseling virtual patients. Clinicians’ self-reported confidence significantly improved following the VR simulations on all communication skills assessed, including asking open-ended questions, eliciting specific concerns, and confirming understanding (Ps≤0.01 for all). VR may be an effective method for educating clinicians to engage in SDM for HU