Use of Visual Symbols To Promote Communication between Health Care Providers and Receivers.

With the aging population in Japan, an increasing number of people place a higher value on health. For the adults, encounters with health-care providers are expected to be opportunities to learn about health. However, the one-sidedness of the communication at the encounter prevents both health-care providers and receivers from getting meaningful interactive feedback. In this study, we tried to solve the problem of one-sided communication by visualizing health-related feelings and concepts for both parties involved in the communication. Three visualization prototypes were developed to (a) visualize basic sensation and feelings accompanying illness using symptomatic symbols,(b) visualize a holistic concept of wellness using a face graph, and (c) visualize multidimensionality of health by using two-dimensional mapping. To develop and further improve these prototypes, we considered the people-s needs and adopted the research strategy of learning from people by sharing the process of problem solving. Three prototypes were announced at various professional meetings, and people were invited to participate in the process of problem-solving. Severa1 groups were interested in this project and assisted by improvement and triangulation of the prototypes. The resuIts indicated that the strategy was effective in improving the understanding of health-related concerns in typical situations.Paper presented at the 1992 Annual Meeting of the American Educational Research Association(AERA), San Francisco, April 19-24, 199

Use of SWATH mass spectrometry for quantitative proteomic investigation of Shewanella oneidensis MR-1 biofilms grown on graphite cloth electrodes

Quantitative proteomics from low biomass, biofilm samples is not well documented. In this study we show successful use of SWATH-MS for quantitative proteomic analysis of a microbial electrochemically active biofilm. Shewanella oneidensis MR-1 was grown on carbon cloth electrodes under continuous anodic electrochemical polarizations in a bioelectrochemical system (BES). Using lactate as the electron donor, anodes serving as terminal microbial electron acceptors were operated at three different electrode potentials (+0.71 V, +0.21 V & -0.19V vs. SHE) and the development of catalytic activity was monitored by measuring the current traces over time. Once maximum current was reached (usually within 21-29 h) the electrochemical systems were shut off and biofilm proteins were extracted from the electrodes for proteomic assessment. SWATH-MS analysis identified 704 proteins, and quantitative comparison was made of those associated with tricarboxcylic acid (TCA) cycle. Metabolic differences detected between the biofilms suggested a branching of the S. oneidensis TCA cycle when grown at the different electrode potentials. In addition, the higher abundance of enzymes involved in the TCA cycle at higher potential indicates an increase in metabolic activity, which is expected given the assumed higher energy gains. This study demonstrates high numbers of identifications on BES biofilm samples can be achieved in comparison to what is currently reported. This is most likely due to the minimal preparation steps required for SWATH-MS. (C) 2014 Elsevier GmbH. All rights reserved

Physician antipsychotic overprescribing letters and cognitive, behavioral, and physical health outcomes among people with dementia: a secondary analysis of a randomized clinical trial

Importance Antipsychotics, such as quetiapine, are frequently prescribed to people with dementia to address behavioral symptoms but can also cause harm in this population. Objective To determine whether warning letters to high prescribers of quetiapine can successfully reduce its use among patients with dementia and to investigate the impacts on patients’ health outcomes. Design, Setting, and Participants This is a secondary analysis of a randomized clinical trial of overprescribing letters that began in April 2015 and included the highest-volume primary care physician (PCP) prescribers of quetiapine in original Medicare. Outcomes of patients with dementia were analyzed in repeated 90-day cross-sections through December 2018. Analyses were conducted from September 2021 to February 2024. Interventions PCPs were randomized to a placebo letter or 3 overprescribing warning letters stating that their prescribing of quetiapine was high and under review by Medicare. Main Outcomes and Measures The primary outcome of this analysis was patients’ total quetiapine use in days per 90-day period (the original trial primary outcome was total quetiapine prescribing by study PCPs). Prespecified secondary outcomes included measures of cognitive function and behavioral symptoms from nursing home assessments, indicators of depression from screening questionnaires in assessments and diagnoses in claims, metabolic diagnoses derived from assessments and claims, indicators of use of the hospital and other health care services, and death. Outcomes were analyzed separately for patients living in nursing homes and in the community. Results Of the 5055 study PCPs, 2528 were randomized to the placebo letter, and 2527 were randomized to the 3 warning letters. A total of 84 881 patients with dementia living in nursing homes and 261 288 community-dwelling patients with dementia were attributed to these PCPs. There were 92 874 baseline patients (mean [SD] age, 81.5 [10.5] years; 64 242 female [69.2%]). The intervention reduced quetiapine use among both nursing home patients (adjusted difference, –0.7 days; 95% CI, −1.3 to −0.1 days; P = .02) and community-dwelling patients (adjusted difference, −1.5 days; 95% CI, −1.8 to −1.1 days; P < .001). There were no detected adverse effects on cognitive function (cognitive function scale adjusted difference, 0.01; 95% CI, −0.01 to 0.03; P = .19), behavioral symptoms (agitated or reactive behavior adjusted difference, −0.2%; 95% CI −1.2% to 0.8% percentage points; P = .72), depression, metabolic diagnoses, or more severe outcomes, including hospitalization and death. Conclusions and Relevance This study found that overprescribing warning letters to PCPs safely reduced quetiapine prescribing to their patients with dementia. This intervention and others like it may be useful for future efforts to promote guideline-concordant care

Chapter 16 - Cross-cutting investment and finance issues

This is the first time an assessment report by the Intergovernmental Panel on Climate Change (IPCC) contains a chapter dedicated to investment and finance to address climate change. This reflects the growing awareness of the relevance of these issues for the design of efficient and effective climate policies

Pollutant dispersion in a developing valley cold-air pool

Pollutants are trapped and accumulate within cold-air pools, thereby affecting air quality. A numerical model is used to quantify the role of cold-air-pooling processes in the dispersion of air pollution in a developing cold-air pool within an alpine valley under decoupled stable conditions. Results indicate that the negatively buoyant downslope flows transport and mix pollutants into the valley to depths that depend on the temperature deficit of the flow and the ambient temperature structure inside the valley. Along the slopes, pollutants are generally entrained above the cold-air pool and detrained within the cold-air pool, largely above the ground-based inversion layer. The ability of the cold-air pool to dilute pollutants is quantified. The analysis shows that the downslope flows fill the valley with air from above, which is then largely trapped within the cold-air pool, and that dilution depends on where the pollutants are emitted with respect to the positions of the top of the ground-based inversion layer and cold-air pool, and on the slope wind speeds. Over the lower part of the slopes, the cold-air-pool-averaged concentrations are proportional to the slope wind speeds where the pollutants are emitted, and diminish as the cold-air pool deepens. Pollutants emitted within the ground-based inversion layer are largely trapped there. Pollutants emitted farther up the slopes detrain within the cold-air pool above the ground-based inversion layer, although some fraction, increasing with distance from the top of the slopes, penetrates into the ground-based inversion layer.Peer reviewe

Potential implications of differential preservation of testate amoeba shells for paleoenvironmental reconstruction in peatlands

Testate amoebae are now commonly used in paleoenvironmental studies but little is known of their taphonomy. There is some experimental evidence for differential preservation of some testate amoeba shell types over others, but it is unclear what, if any impact this has on palaeoenvironmental reconstruction. To investigate this issue we looked at palaeoecological evidence for the preservation of different shell types. We then investigated the possible impact of selective preservation on quantitative palaeoenvironmental inference. We first used existing palaeoecological data sets to assess the vertical patterns of relative abundance in four testate amoeba shell types: (1) shells made of secreted biosilica plates (idiosomes, e.g. Euglypha), (2) idiosomes with thick organic coating (Assulina), (3) proteinaceous shells (e.g. Hyalosphenia), (4) shells built from recycled organic or mineral particles (xenosomes) (e.g. Difflugia, Centropyxis). In three diagrams a clear pattern of decay was only observed for the idiosome type. In order to assess the implications of differential preservation of testate amoeba taxa for paleoenvironmental reconstruction we then carried out simulations using three existing transfer functions and a wide range of scenarios, downweighting different test categories to represent the impact of selective test decomposition. Simulation results showed that downweighting generally reduced overall model performance. However downweighting a shell type only produced a consistent directional bias in inferred water table depth where that shell type is both dominant and shows a clear preference along the ecological gradient. Applying a scenario derived from previous experimental work did not lead to significant difference in inferred water table. Our results show that differential shell preservation has little impact on paleohydrological reconstruction from Sphagnum-dominated peatlands. By contrast, for the minerotrophic peatlands data-set loss of idiosome tests leads to consistent underestimation of water table depth. However there are few studies from fens and it is possible that idiosome tests are not always dominant, and/or that differential decomposition is less marked than in Sphagnum peatlands. Further work is clearly needed to assess the potential of testate amoebae for paleoecological studies of minerotrophic peatlands

Casting for a sovereign role:Socialising an aspirant state in the Scottish independence referendum

This article examines international reactions to Scotland’s 2014 bid for independence as an instance of socialisation of an aspirant state, what we term ‘pre-socialisation’. Building on and contributing to research on state socialisation and role theory, this study proposes a nexus between roles and sovereignty. This nexus has three components: sovereignty itself is a role casted for by an actor; the sovereign role is entangled with the substantive foreign policy roles the actor might play; and the sovereign role implicates the substantive foreign policy roles of other actors. The Scottish debate on independence provides an effective laboratory to develop and explore these theoretical dimensions of pre-socialisation, revealing the contested value and meaning of sovereignty, the possible roles that an independent Scotland could play, and the projected implications for the role of the UK and other international actors. Our analysis of the Scottish case can provide insights for other cases of pre-socialisation and is more empirically significant following the UK’s 2016 referendum to leave the European Union.PostprintPeer reviewe

Personal investment in Japan and the U.S.A.: A study of worker motivation,

The Inventory of Personal Investment (IPI) was administered to 522 Japanese and 746 American workers to compare their work motivation and self-concepts. Eleven subscales were formed based on the IPI model and were found through factor analysis to be appropriate for the samples in both countries. Discriminant analyses of scale scores by subjects' nationality, gender, occupational strata, and age are reported. Findings included: (1) Japanese and American workers sampled emphasized different aspects of meaning as they perceive work and self, (2) Japanese and American women sampled exhibited similar profiles to one another, as did the two male subsamples, and (3) motivational profiles for various age groupings differed between the two samples. The results are related to previous research on Japanese and American workers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30299/1/0000701.pd

Long-term performance of a plant microbial fuel cell with Spartina anglica

The plant microbial fuel cell is a sustainable and renewable way of electricity production. The plant is integrated in the anode of the microbial fuel cell which consists of a bed of graphite granules. In the anode, organic compounds deposited by plant roots are oxidized by electrochemically active bacteria. In this research, salt marsh species Spartina anglica generated current for up to 119 days in a plant microbial fuel cell. Maximum power production was 100 mW m−2 geometric anode area, highest reported power output for a plant microbial fuel cell. Cathode overpotential was the main potential loss in the period of oxygen reduction due to slow oxygen reduction kinetics at the cathode. Ferricyanide reduction improved the kinetics at the cathode and increased current generation with a maximum of 254%. In the period of ferricyanide reduction, the main potential loss was transport loss. This research shows potential application of microbial fuel cell technology in salt marshes for bio-energy production with the plant microbial fuel cell