Perceptions of a short animated film on adverse childhood experiences: a mixed methods evaluation

OBJECTIVES: An evaluation of a short animated film on adverse childhood experiences (ACEs) to explore attitudes and sentiment towards the film including, for a subsample of professionals, associations between attitudes and personal experience of ACEs. DESIGN: Mixed-method exploratory design. SETTING: Professionals and the general public. PARTICIPANTS: A short online survey with 239 professionals. Interaction and user sentiment towards with the film on social media (Twitter, YouTube). PRIMARY AND SECONDARY OUTCOME MEASURES: Survey: participants’ attitudes towards the film including feelings invoked, learning gained and ACE count prevalence. Twitter user and YouTube viewer sentiment (positive, negative or neutral) and interaction (likes, retweets or comments) with the film. RESULTS: Attitudes to the film were positive: 94.1% and 93.7%, respectively, agreed that it provided a helpful explanation of ACEs and trusted that the film was credible. Of those who reported ACE exposure, 88.9% agreed that those with ACEs would benefit from watching the film. Despite 50.6% reporting that the film had made them feel sad or upset, the majority (66.4%) reported they found the film hopeful or encouraging. Across 358 publicly available tweets from 313 users, 39.1% of tweets expressed positive sentiment, with only 1.4% negative (59.5% neutral). However, there was no association between tweet sentiment and interaction. Thirteen YouTube versions of the film received 171 812 views, 97.3% (n=889/914) ratings were positive (ie, ‘thumbs up’). CONCLUSIONS: Despite being emotionally arousing, many professionals reflected positive impacts of the film including a perceived increased ability to discuss ACEs. Public sentiment demonstrated a positive reaction to and acceptability of the film. Understanding the professional and public response to materials developed to increase ACE awareness, such as the film explored here, is important given the growing number of international movements which seek to increase ACE awareness, prevent ACEs and mitigate their lifelong negative effects

Estimation of the linear mixed integrated Ornstein-Uhlenbeck model.

The linear mixed model with an added integrated Ornstein-Uhlenbeck (IOU) process (linear mixed IOU model) allows for serial correlation and estimation of the degree of derivative tracking. It is rarely used, partly due to the lack of available software. We implemented the linear mixed IOU model in Stata and using simulations we assessed the feasibility of fitting the model by restricted maximum likelihood when applied to balanced and unbalanced data. We compared different (1) optimization algorithms, (2) parameterizations of the IOU process, (3) data structures and (4) random-effects structures. Fitting the model was practical and feasible when applied to large and moderately sized balanced datasets (20,000 and 500 observations), and large unbalanced datasets with (non-informative) dropout and intermittent missingness. Analysis of a real dataset showed that the linear mixed IOU model was a better fit to the data than the standard linear mixed model (i.e. independent within-subject errors with constant variance)

Setup and Execution Of the Blindfolded Code Training Exercise

Miscommunication is the most common cause of preventable patient harm in medicine. Currently, there is limited knowledge of innovative techniques to improve resident physician communication and leadership strategies in high-acuity situations. The blindfolded code training exercise removes visual stimuli from the team leader, forcing the team leader to effectively utilize closed-loop communication. The simple act of blindfolding the team leader creates a learning environment where the leader must utilize a conceptual framework and critical thinking strategies to organize the team and manage the resuscitation. An advantage to this teaching technique is that it does not require any special simulation equipment, making it a low-cost approach. The blindfolded code training exercise can be applied to the management of any critically ill patient where the primary objective is to focus on developing communication skills in acute resuscitations. The purpose of the description of the blindfolded code training exercise is to provide guidance on how to perform this innovative teaching technique to force effective closed-loop communication

Asteroid Belts in Debris Disk Twins: VEGA and FOMALHAUT

Vega and Fomalhaut, are similar in terms of mass, ages, and global debris disk properties; therefore, they are often referred as "debris disk twins". We present Spitzer 10-35 um spectroscopic data centered at both stars, and identify warm, unresolved excess emission in the close vicinity of Vega for the first time. The properties of the warm excess in Vega are further characterized with ancillary photometry in the mid infrared and resolved images in the far-infrared and submillimeter wavelengths. The Vega warm excess shares many similar properties with the one found around Fomalhaut. The emission shortward of ~30 um from both warm components is well described as a blackbody emission of ~170 K. Interestingly, two other systems, eps Eri and HR 8799, also show such an unresolved warm dust using the same approach. These warm components may be analogous to the solar system's zodiacal dust cloud, but of far greater. The dust temperature and tentative detections in the submillimeter suggest the warm excess arises from dust associated with a planetesimal ring located near the water-frost line and presumably created by processes occurring at similar locations in other debris systems as well. We also review the properties of the 2 um hot excess around Vega and Fomalhaut, showing that the dust responsible for the hot excess is not spatially associated with the dust we detected in the warm belt. We suggest it may arise from hot nano grains trapped in the magnetic field of the star. Finally, the separation between the warm and cold belt is rather large with an orbital ratio >~10 in all four systems. In light of the current upper limits on the masses of planetary objects and the large gap, we discuss the possible implications for their underlying planetary architecture, and suggest that multiple, low-mass planets likely reside between the two belts in Vega and Fomalhaut.Comment: 14 pages, accepted for publication in Ap

Resolved Millimeter Observations of the HR 8799 Debris Disk

We present 1.3 millimeter observations of the debris disk surrounding the HR 8799 multi-planet system from the Submillimeter Array to complement archival ALMA observations that spatially filtered away the bulk of the emission. The image morphology at $3.8$ arcsecond (150 AU) resolution indicates an optically thin circumstellar belt, which we associate with a population of dust-producing planetesimals within the debris disk. The interferometric visibilities are fit well by an axisymmetric radial power-law model characterized by a broad width, $\Delta R/R\gtrsim 1$. The belt inclination and orientation parameters are consistent with the planet orbital parameters within the mutual uncertainties. The models constrain the radial location of the inner edge of the belt to $R_\text{in}= 104_{-12}^{+8}$ AU. In a simple scenario where the chaotic zone of the outermost planet b truncates the planetesimal distribution, this inner edge location translates into a constraint on the planet~b mass of $M_\text{pl} = 5.8_{-3.1}^{+7.9}$ M$_{\rm Jup}$. This mass estimate is consistent with infrared observations of the planet luminosity and standard hot-start evolutionary models, with the uncertainties allowing for a range of initial conditions. We also present new 9 millimeter observations of the debris disk from the Very Large Array and determine a millimeter spectral index of $2.41\pm0.17$. This value is typical of debris disks and indicates a power-law index of the grain size distribution $q=3.27\pm0.10$, close to predictions for a classical collisional cascade.Comment: 18 pages, 7 figures, accepted by Ap

Joint modelling rationale for chained equations.

BACKGROUND: Chained equations imputation is widely used in medical research. It uses a set of conditional models, so is more flexible than joint modelling imputation for the imputation of different types of variables (e.g. binary, ordinal or unordered categorical). However, chained equations imputation does not correspond to drawing from a joint distribution when the conditional models are incompatible. Concurrently with our work, other authors have shown the equivalence of the two imputation methods in finite samples. METHODS: Taking a different approach, we prove, in finite samples, sufficient conditions for chained equations and joint modelling to yield imputations from the same predictive distribution. Further, we apply this proof in four specific cases and conduct a simulation study which explores the consequences when the conditional models are compatible but the conditions otherwise are not satisfied. RESULTS: We provide an additional "non-informative margins" condition which, together with compatibility, is sufficient. We show that the non-informative margins condition is not satisfied, despite compatible conditional models, in a situation as simple as two continuous variables and one binary variable. Our simulation study demonstrates that as a consequence of this violation order effects can occur; that is, systematic differences depending upon the ordering of the variables in the chained equations algorithm. However, the order effects appear to be small, especially when associations between variables are weak. CONCLUSIONS: Since chained equations is typically used in medical research for datasets with different types of variables, researchers must be aware that order effects are likely to be ubiquitous, but our results suggest they may be small enough to be negligible

ALMA 1.3 Millimeter Map of the HD 95086 System

Planets and minor bodies such as asteroids, Kuiper-belt objects and comets are integral components of a planetary system. Interactions among them leave clues about the formation process of a planetary system. The signature of such interactions is most prominent through observations of its debris disk at millimeter wavelengths where emission is dominated by the population of large grains that stay close to their parent bodies. Here we present ALMA 1.3 mm observations of HD 95086, a young early-type star that hosts a directly imaged giant planet b and a massive debris disk with both asteroid- and Kuiper-belt analogs. The location of the Kuiper-belt analog is resolved for the first time. The system can be depicted as a broad ($\Delta R/R \sim$0.84), inclined (30\arcdeg$\pm$3\arcdeg) ring with millimeter emission peaked at 200$\pm$6 au from the star. The 1.3 mm disk emission is consistent with a broad disk with sharp boundaries from 106$\pm$6 to 320$\pm$20 au with a surface density distribution described by a power law with an index of --0.5$\pm$0.2. Our deep ALMA map also reveals a bright source located near the edge of the ring, whose brightness at 1.3 mm and potential spectral energy distribution are consistent with it being a luminous star-forming galaxy at high redshift. We set constraints on the orbital properties of planet b assuming co-planarity with the observed disk.Comment: accepted for publication in A

Thalamic Gap Junctions Control Local Neuronal Synchrony and Influence Macroscopic Oscillation Amplitude during EEG Alpha Rhythms

Although EEG alpha (α; 8–13 Hz) rhythms are often considered to reflect an “idling” brain state, numerous studies indicate that they are also related to many aspects of perception. Recently, we outlined a potential cellular substrate by which such aspects of perception might be linked to basic α rhythm mechanisms. This scheme relies on a specialized subset of rhythmically bursting thalamocortical (TC) neurons (high-threshold bursting cells) in the lateral geniculate nucleus (LGN) which are interconnected by gap junctions (GJs). By engaging GABAergic interneurons, that in turn inhibit conventional relay-mode TC neurons, these cells can lead to an effective temporal framing of thalamic relay-mode output. Although the role of GJs is pivotal in this scheme, evidence for their involvement in thalamic α rhythms has thus far mainly derived from experiments in in vitro slice preparations. In addition, direct anatomical evidence of neuronal GJs in the LGN is currently lacking. To address the first of these issues we tested the effects of the GJ inhibitors, carbenoxolone (CBX), and 18β-glycyrrhetinic acid (18β-GA), given directly to the LGN via reverse microdialysis, on spontaneous LGN and EEG α rhythms in behaving cats. We also examined the effect of CBX on α rhythm-related LGN unit activity. Indicative of a role for thalamic GJs in these activities, 18β-GA and CBX reversibly suppressed both LGN and EEG α rhythms, with CBX also decreasing neuronal synchrony. To address the second point, we used electron microscopy to obtain definitive ultrastructural evidence for the presence of GJs between neurons in the cat LGN. As interneurons show no phenotypic evidence of GJ coupling (i.e., dye-coupling and spikelets) we conclude that these GJs must belong to TC neurons. The potential significance of these findings for relating macroscopic changes in α rhythms to basic cellular processes is discussed