Comparison of three methods for diabetes screening in a rural clinic in Honduras

Objective. To evaluate two alternatives to the fasting plasma glucose (FPG) test for diabetes screening in Latin America. Methods. Eight hundred adults without diabetes were recruited in a primary care clinic in Honduras. An equation-based screening formula, incorporating a random capillary glucose test and other risk factors, was used for initial screening. All patients with a screening-based probability of diabetes > 20%, plus one-fifth of those with a probability < 20%, were asked to return for FPG and point-of-care hemoglobin A1c (POC-A1c) tests. An FPG ≥ 126 milligrams per deciliter and a POC-A1c ≥ 6.5% were used as gold standards to assess the performance of the screening equation. The association between the POC-A1c and the FPG tests was examined as were patient factors associated with failure to return for follow-up and variation in diabetes risk across subgroups. Results. The screening equation had excellent test characteristics compared with FPG and POC-A1c. Using the FPG gold standard, the POC-A1c had a sensitivity of 77.8% and a specificity of 84.9%. With an A1c cutoff of 7%, POC-A1c specificity increased to 96.2%. Thirty-four percent of patients asked to return for follow-up testing failed to do so. Those who failed to return were more likely to be men and to have hypertension. Conclusions. Both the screening equation and POC-A1c are reasonable alternatives to an FPG test for identifying patients with diabetes. Given the barriers to currently recommended screening procedures, these options could have important public health benefits in Latin America

Investigating Use of a Parent Report Tool to Measure Vocabulary Development in Deaf Greek-speaking Children with Cochlear Implants

Objective: There are very few measures of language development in spoken Greek that can be used with young deaf children. This study investigated the use of Cyprus Lexical List (CYLEX), a receptive and expressive vocabulary assessment based on parent report that has recently been adapted to Standard Greek, to measure the vocabulary development of deaf Greek-speaking children with cochlear implants. Design: A Standard Greek version of CYLEX was used to collect data on receptive and expressive vocabulary development from parents of thirteen deaf children with cochlear implants aged between 21 and 71 months. These data were compared with data collected previously from typically developing hearing Greek-speaking children. Results: Use of the test by parents of deaf children was found to be reliable. No correlation was found between children's vocabulary scores and chronological age. A positive correlation was however found between children's post-implant age and expressive vocabulary. The vocabulary skills of implanted children with a mean post-implant age of 20 months were not significantly different from those of typically developing hearing children of similar chronological age. Conclusion: CYLEX is a reliable and useful tool for exploring vocabulary development with this clinical group. Findings confirm the results of other studies in indicating that the vocabulary size of implanted pre-school-aged deaf children is related to the amount of time that children have used their implant, rather than chronological age

Addressing climate change with behavioral science:A global intervention tournament in 63 countries

Effectively reducing climate change requires marked, global behavior change. However, it is unclear which strategies are most likely to motivate people to change their climate beliefs and behaviors. Here, we tested 11 expert-crowdsourced interventions on four climate mitigation outcomes: beliefs, policy support, information sharing intention, and an effortful tree-planting behavioral task. Across 59,440 participants from 63 countries, the interventions' effectiveness was small, largely limited to nonclimate skeptics, and differed across outcomes: Beliefs were strengthened mostly by decreasing psychological distance (by 2.3%), policy support by writing a letter to a future-generation member (2.6%), information sharing by negative emotion induction (12.1%), and no intervention increased the more effortful behavior-several interventions even reduced tree planting. Last, the effects of each intervention differed depending on people's initial climate beliefs. These findings suggest that the impact of behavioral climate interventions varies across audiences and target behaviors.</p

Addressing climate change with behavioral science:A global intervention tournament in 63 countries

Effectively reducing climate change requires marked, global behavior change. However, it is unclear which strategies are most likely to motivate people to change their climate beliefs and behaviors. Here, we tested 11 expert-crowdsourced interventions on four climate mitigation outcomes: beliefs, policy support, information sharing intention, and an effortful tree-planting behavioral task. Across 59,440 participants from 63 countries, the interventions' effectiveness was small, largely limited to nonclimate skeptics, and differed across outcomes: Beliefs were strengthened mostly by decreasing psychological distance (by 2.3%), policy support by writing a letter to a future-generation member (2.6%), information sharing by negative emotion induction (12.1%), and no intervention increased the more effortful behavior-several interventions even reduced tree planting. Last, the effects of each intervention differed depending on people's initial climate beliefs. These findings suggest that the impact of behavioral climate interventions varies across audiences and target behaviors.</p

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

New Data on the Late Cretaceous Flora of the New Siberia Island, New Siberian Islands

Abstract: A new collection of plant fossils from the Derevyannye Gory Formation of the New Siberia Island collected in 2016 was studied. Thirty species of fossil plants attributed to liverworts, ferns, ginkgoaleans, conifers, and angiosperms were identified and illustrated; 16 of these species were not previously encountered among the New Siberian flora. A new angiosperm species Dalembia (?) gracilis Herman was described. New Siberian flora is characterized by a moderately rich systematic composition, by the predominance of conifers and angiosperms, by the dominance of the large-leaved platanoids and the species of the genus Trochodendroides among angiosperms, by the predominance of dentate-margined angiosperms, by the rarity of entire-margined forms, and by the total absence of cycadaleans and bennettitaleans. The age of the New Siberian flora corresponds to the Turonian–Coniacian interval; most likely, the flora should be dated to the Turonian. Plants of the New Siberian flora experienced a warm-temperate humid climate with warm summer, mild frost-free winter, and insignificant seasonality in precipitation. © 2019, Pleiades Publishing, Ltd