Crisis Anticipation

This study builds on two qualitative studies, one by Smith (1988) and one by Rew (1988a) which investigate the characteristics of crisis anticipation as defined by critical care nurses. A convenience sample of critical care nurses from three Midwestern hospitals was shown a random ordered list of thirty characteristics of crisis anticipation identified in the Smith (1988) and Rew (1988a) studies. The nurses scored each characteristic on importance to the concept of crisis anticipation. Nurses were divided into two groups by experience level, and group scores for each characteristic were developed using the Fehring (1986) technique. Group scores were compared to each other and to the ranked list developed from the Smith (1988) and Rew (1988a) results. Results showed essentially no significant difference between groups in this study. Comparison of group scores to the original list supported those characteristics as major and minor characteristics of the concept of crisis anticipation

Embarrassment as a Key Emotion in Young People Talking About Sexual Health

This paper highlights embarrassment as one of the often-ignored emotions of young people when it comes to discussing issues around sexual health. There have been many sexual health studies on knowledge, attitudes and behaviour of young people over the past two decades, but emotional aspects have been largely ignored, despite a growing literature in the sociology of emotion. A qualitative approach was adopted in the form of focus group discussions, which included questions on sex education, sexual health campaigns and formal and informal sources of sexual health information and advice. Focus groups were conducted in secondary schools in and around Edinburgh and Aberdeen as part of a four-year evaluation study of a Scottish Demonstration Project on young people's sexual health: 'Healthy Respect'. We conclude that is it important for policy makers and sexual health promoters to understand young people's notions of embarrassment. Not only are there elements of sex education that (some) young people perceive as embarrassing, they also sense embarrassment in those people providing them with sex education. Young people reported that both professionals (e.g. teachers and doctors) and their parents could be embarrassed about raising the topic of sexual health. Moreover, as one of the goals of sex education is to ensure an open and non-embarrassing attitude towards sex and sexuality, there is still a major gap between the aspirations of health educators and policy makers and the ways that young people experience such education.Sexual Health Services, Adolescence, School, Scotland, Emotion, Qualitative Research, Sex Education, Parents, Focus Groups, Relationships

Investigation of Anaplasma marginale Seroprevalence in a Traditionally Managed Large California Beef Herd.

Recent observations by stakeholders suggested that ecosystem changes may be driving an increased incidence of bovine erythrocytic anaplasmosis, resulting in a reemerging cattle disease in California. The objective of this prospective cohort study was to estimate the incidence of Anaplasma marginale infection using seroconversion in a northern California beef cattle herd. A total of 143 Black Angus cattle (106 prebreeding heifers and 37 cows) were enrolled in the study. Serum samples were collected to determine Anaplasma marginale seroprevalence using a commercially available competitive enzyme-linked immunosorbent assay test kit. Repeat sampling was performed in seronegative animals to determine the incidence density rate from March through September (2013). Seroprevalence of heifers was significantly lower than that of cows at the beginning of the study (P < 0.001) but not at study completion (P = 0.075). Incidence density rate of Anaplasma marginale infection was 8.17 (95% confidence interval: 6.04, 10.81) cases per 1000 cow-days during the study period. Study cattle became Anaplasma marginale seropositive and likely carriers protected from severe clinical disease that might have occurred had they been first infected as mature adults. No evidence was found within this herd to suggest increased risk for clinical bovine erythrocytic anaplasmosis

Factors associated with Self-reported First Sexual Intercourse in Scottish Adolescents

Background: There is continuing concern about high pregnancy rates and increasing numbers of sexually transmitted infections being detected in Scottish adolescents. Consistent evidence about factors associated with risky sexual behaviours, including early first sexual intercourse, may help to identify adolescents at risk and help improve interventions. This study aimed to provide detailed analysis of the evidence of the associations between individual factors and early sexual intercourse using cross-sectional questionnaire data from 4,379 Scottish adolescents who participated in a sexual health intervention evaluation. Findings: Multivariate secondary analysis showed that aspects of family and school life such as decreasing parental monitoring (OR 1.45, 95% CI 1.24–1.70) and decreasing enjoyment of school (OR 2.55, 95% CI 2.15–3.03) were associated with reporting previous sexual intercourse. Furthermore, females were more likely to report previous sexual intercourse than males (OR 1.48, 95% CI 1.14–1.91). Several factors commonly used to inform sexual health intervention design, such as socioeconomic status, self-esteem and religion, were not independently associated. Conclusion: These results contribute to the evidence base for the association of several factors with early initiation of sexual activity. The findings suggest that interventions aiming to delay first intercourse may need to consider targeting aspects of individuals' connection to their school and family. Furthermore, the results do not support the need to consider socio-economic background, religion or self-esteem of the individuals in intervention design

Spectral signatures of photosynthesis I: Review of Earth organisms

Why do plants reflect in the green and have a 'red edge' in the red, and should extrasolar photosynthesis be the same? We provide: 1) a brief review of how photosynthesis works; 2) an overview of the diversity of photosynthetic organisms, their light harvesting systems, and environmental ranges; 3) a synthesis of photosynthetic surface spectral signatures; 4) evolutionary rationales for photosynthetic surface reflectance spectra with regard to utilization of photon energy and the planetary light environment. Given the surface incident photon flux density spectrum and resonance transfer in light harvesting, we propose some rules with regard to where photosynthetic pigments will peak in absorbance: a) the wavelength of peak incident photon flux; b) the longest available wavelength for core antenna or reaction center pigments; and c) the shortest wavelengths within an atmospheric window for accessory pigments. That plants absorb less green light may not be an inefficient legacy of evolutionary history, but may actually satisfy the above criteria.Comment: 69 pages, 7 figures, forthcoming in Astrobiology March 200

Comparing neonatal morbidity and mortality estimates across specialty in periviable counseling

Objective To describe and compare estimates of neonatal morbidity and mortality communicated by neonatologists and obstetricians in simulated periviable counseling encounters. Methods A simulation-based study of 16 obstetricians (OBs) and 15 neonatologists counseling standardized patients portraying pregnant women with ruptured membranes at 23 weeks gestation. Two investigators tabulated all instances of numerically-described risk estimates across individuals and by specialty. Results Overall, 12/15 (80%) neonatologists utilized numeric estimates of survival; 6/16 (38%) OBs did. OBs frequently deferred the discussion of “exact numbers” to neonatologists. The twelve neonatologists provided 13 unique numeric estimates, ranging from 3% to 50% survival. Half of those neonatologists provided 2-3 different estimates in a single encounter. By comparison, six OBs provided 4 unique survival estimates (“50%”, “30-40%”, “1/3-1/2”, “<10%”). Only 2/15 (13%) neonatologists provided numeric estimates of survival without impairment. None of the neonatologists used the term ‘intact’ survival, while 5 OBs did. Three neonatologists gave numeric estimates of long-term disability and one OB did. Conclusion We found substantial variation in estimates and noteworthy omissions of discussions related to long-term morbidity. Across specialties, we noted inconsistencies in the use and meaning of terms like ‘intact survival.’ More tools and training are needed to improve the quality and consistency of periviable risk-communication

Midwives' competence : is it affected by working in a rural location?

Introduction: Rising health care costs and the need to consolidate expertise in tertiary services have led to the centralisation of services. In the UK, the result has been that many rural maternity units have become midwife-led. A key consideration is that midwives have the skills to competently and confidently provide maternity services in rural areas, which may be geographically isolated and where the midwife may only see a small number of pregnant women each year. Our objective was to compare the views of midwives in rural and urban settings, regarding their competence and confidence with respect to ‘competencies’ identified as being those which all professionals should have in order to provide effective and safe care for low-risk women. Method: This was a comparative questionnaire survey involving a stratified sample of remote and rural maternity units and an ad hoc comparison group of three urban maternity units in Scotland. Questionnaires were sent to 82 midwives working in remote and rural areas and 107 midwives working in urban hospitals with midwife-led units. Results: The response rate from midwives in rural settings was considerably higher (85%) than from midwives in the urban areas (60%). Although the proportion of midwives who reported that they were competent was broadly similar in the two groups, there were some significant differences regarding specific competencies. Midwives in the rural group were more likely to report competence for breech delivery (p = 0.001), while more urban midwives reported competence in skills such as intravenous fluid replacement (p <0.001) and initial and discharge examination of the newborn (p <0.001). Both groups reported facing barriers to continuing professional development; however, more of the rural group had attended an educational event within the last month (p <0.001). Lack of time was a greater barrier for urban midwives (p = 0.02), whereas distance to training was greater for rural midwives (p = 0.009). Lack of motivation or interest was significantly higher in urban units (p = 0.006). Conclusion: It is often assumed that midwives in rural areas where there are fewer deliveries, will be less competent and confident in their practice. Our exploratory study suggests that the issue of competence is far more complex and deserves further attention.NHS Education Scotlan

Spectral signatures of photosynthesis II: coevolution with other stars and the atmosphere on extrasolar worlds

As photosynthesis on Earth produces the primary signatures of life that can be detected astronomically at the global scale, a strong focus of the search for extrasolar life will be photosynthesis, particularly photosynthesis that has evolved with a different parent star. We take planetary atmospheric compositions simulated by Segura, et al. (2003, 2005) for Earth-like planets around observed F2V and K2V stars, modeled M1V and M5V stars, and around the active M4.5V star AD Leo; our scenarios use Earth's atmospheric composition as well as very low O2 content in case anoxygenic photosynthesis dominates. We calculate the incident spectral photon flux densities at the surface of the planet and under water. We identify bands of available photosynthetically relevant radiation and find that photosynthetic pigments on planets around F2V stars may peak in absorbance in the blue, K2V in the red-orange, and M stars in the NIR, in bands at 0.93-1.1 microns, 1.1-1.4 microns, 1.5-1.8 microns, and 1.8-2.5 microns. In addition, we calculate wavelength restrictions for underwater organisms and depths of water at which they would be protected from UV flares in the early life of M stars. We estimate the potential productivity for both surface and underwater photosynthesis, for both oxygenic and anoxygenic photosynthesis, and for hypothetical photosynthesis in which longer wavelength, multi-photosystem series are used.Comment: 59 pages, 4 figures, 4 tables, forthcoming in Astrobiology ~March 200