Factors associated with poor self-reported health within the UK military and comparisons with the general population: a cohort study

Objective: To investigate the self-rated health of the UK military and explore factors associated with poor self-rated health. Compare self-rated health of the military to the general population. / Design: A cohort study. / Participants: A total of 7626 serving and ex-serving UK military personnel, aged between 25 and 49; 19,452,300 civilians from England and Wales. / Setting: United Kingdom (military), England and Wales (civilians). / Main outcome measures: Self rated health for both populations. Additional data for the military sample included measures of symptoms of common mental disorder (General Health Questionnaire-12), probable post-traumatic stress disorder (post-traumatic stress disorder checklist Civilian Version), alcohol use (Alcohol Use Disorders Identification Test), smoking behaviour, history of self-harm and body mass index. / Results: In the military sample, poor self-rated health was significantly associated with: common mental disorders and post-traumatic stress disorder symptomology, a history of self-harm, being obese, older age (ages 35–49) and current smoking status. However, the majority of military personnel report good health, with levels of poor self-rated health (13%) not significantly different to those reported by the general population (12.1%). / Conclusions: Self-rated health appears to relate to aspects of both physical and psychological health. The link between poor self-rated health and psychological ill-health emphasises the need for military support services to continue addressing mental health problems

Maintaining credibility when communicating uncertainty: The role of communication format

Research into risk communication has commonly highlighted the disparity between the meaning intended by the communicator and what is understood by the recipient. Such miscommunications will have implications for perceived trust and expertise of the communicator, but it is not known whether this differs according to the communication format. We examined the effect of using verbal, numerical and mixed communication formats on perceptions of credibility and correctness, as well as whether they influenced a decision to evacuate, both before and after an ‘erroneous’ prediction (i.e. an ‘unlikely’ event occurs, or a ‘likely’ event does not occur). We observed no effect of communication format on any of the measures pre-outcome, but found the numerical format was perceived as less incorrect, as well as more credible than the other formats after an ‘erroneous’ prediction, but only when low probability expressions were used. Our findings suggest numbers should be used in consequential risk communications

Understanding ‘Unlikely (20% Likelihood)’ or ‘20% Likelihood (Unlikely)’ Outcomes: The Robustness of the Extremity Effect

Calls to communicate uncertainty using mixed, verbal‐numerical formats (‘unlikely [0–33%]’) have stemmed from research comparing mixed with solely verbal communications. Research using the new ‘which outcome’ approach to investigate understanding of verbal probability expressions suggests, however, that mixed formats might convey disadvantages compared with purely numerical communications. When asked to indicate an outcome that is ‘unlikely’, participants have been shown to often indicate outcomes with a value exceeding the maximum value shown, equivalent to a 0% probability —an ‘extremity effect’. Recognising the potential consequences of communication recipients expecting an ‘unlikely’ event to never occur, we extend the ‘which outcome’ work across four experiments, using verbal, numerical, and verbal‐numerical communication formats, as well as a previously unconsidered numerical‐verbal format. We examine how robust the effect is in the context of consequential outcomes and over non‐normal distributions. We also investigate whether participants are aware of the inconsistency in their responses from a traditional ‘how likely’ and ‘which outcome’ task. We replicate and extend previous findings, with preference for extreme outcomes (including above maximum values) observed in both verbal and verbal‐numerical formats. Our results suggest caution in blanket usage of recently recommended verbal‐numerical formats for the communication of uncertainty

Dynamic variation of supernatant quality in a dairy shed waste stabilisation pond system

An intensive monitoring program of a standard two-stage dairy shed waste stabilisation pond system was undertaken to determine the incidence and extent of spatial and temporal variation of basic physio-chemical parameters, and to shed light on the longer term dynamic nature of in-pond conditions. The anaerobicâfacultative pond system, located in a remote rural area, treats wastewater from the hosing down and hydraulic flushing of the milking parlour and holding yard at the farm dairy shed. A number of multi-parameter water quality field monitoring probes were permanently deployed at various locations within the two ponds to enable continuous measurement of temperature, pH, conductivity and dissolved oxygen. In addition, profiling of the supernatant of both ponds was undertaken at different times of the year to examine vertical variation of the same parameters. Continuous monitoring revealed spatial homogeneity in EC and pH levels in the upper metre of both ponds. Physio-chemical parameters also appear to change uniformly across the ponds in response to external stimuli such as rainfall. Neither pond, however, exhibits homogeneity down the profile of the supernatant. Seasonal stratification is prevalent in the facultative pond suggesting poor vertical mixing, while the anaerobic pond is notably affected by sludge accumulation. A long-term pattern of rising conductivity in both ponds indicated accumulation of dissolved salt species in the system due to recirculation of reclaimed effluent for hydraulic flushing of the dairy shed. In the facultative pond, diurnal fluctuations in dissolved oxygen, oxidation-reduction potential and turbidity during warmer months of the year closely followed temperature swings. The extensive data collected in this study provides a detailed picture of the physio-chemical dynamics of two-stage stabilisation pond systems treating dairy shed wastewater

Tolerance of high-intensity focused ultrasound ablation in patients with hepatocellular carcinoma

BACKGROUND: High-intensity focused ultrasound (HIFU) ablation is a relatively new, noninvasive way of ablation for treating hepatocellular carcinoma (HCC). Emerging evidence has shown that it is effective for the treatment of HCC, even in patients with poor liver function. There is currently no data on the safety limit of HIFU ablation in patients with cirrhosis. However, this information is vital for the selection of appropriate patients for the procedure. We analyzed HCC patients who had undergone HIFU ablation and determined the lower limit of liver function and other patient factors with which HCC patients can tolerate this treatment modality. METHODS: Preoperative variables of 100 patients who underwent HIFU ablation for HCC were analyzed to identify the risk factors in HIFU intolerance in terms of stress-induced complications. Factors that may contribute to postablation complications were compared. RESULTS: Thirteen (13 %) patients developed a total of 18 complications. Morbidity was mainly due to skin and subcutaneous tissue injuries (n = 9). Five patients had first-degree skin burn, one had second-degree skin burn, and three had third-degree skin burn. Four complications were grade 3a in the Clavien classification and 14 were below this grade. Univariate analysis showed that age (p = 0.022) was the only independent factor in HIFU intolerance. CONCLUSIONS: HIFU ablation is generally well tolerated in HCC patients with cirrhosis. It is safe for Child-Pugh A and B patients and selected Child-Pugh C patients. With this new modality, HCC patients who were deemed unsalvageable by other surgical means in the past because of simultaneous Child-Pugh B or C disease now have a new hope.published_or_final_versio

Rank-based poverty measures and poverty ordering with an application to Tunisia

Using the normative approach, we develop a class of poverty measures that is function of a weighting system. Each particular weighting function corresponds to a particular social judgment. This offers the decision-maker a large selection of social preferences functions, and he can choose the one that best represents his social judgment. We also develop new concepts of a-extended TIP curves. They are used to establish the conditions of the robust and unanimous poverty ranking of our measures. These conditions are in terms of second-and higher-degree TIP dominance. Finally, we provide an empirical illustration using Tunisian data on the 2005–2010 period.info:eu-repo/semantics/publishedVersio

Female Burying Beetles Benefit from Male Desertion: Sexual Conflict and Counter-Adaptation over Parental Investment

Sexual conflict drives the coevolution of sexually antagonistic traits, such that an adaptation in one sex selects an opposing coevolutionary response from the other. Although many adaptations and counteradaptations have been identified in sexual conflict over mating interactions, few are known for sexual conflict over parental investment. Here we investigate a possible coevolutionary sequence triggered by mate desertion in the burying beetle Nicrophorus vespilloides, where males commonly leave before their offspring reach independence. Rather than suffer fitness costs as a consequence, our data suggest that females rely on the male's absence to recoup some of the costs of larval care, presumably because they are then free to feed themselves on the carcass employed for breeding. Consequently, forcing males to stay until the larvae disperse reduces components of female fitness to a greater extent than caring for young singlehandedly. Therefore we suggest that females may have co-evolved to anticipate desertion by their partners so that they now benefit from the male's absence

Is nebulized saline a placebo in COPD?

BACKGROUND: Many trials of nebulized therapy have used nebulized saline as a "placebo". However, nebulized isotonic saline is sometimes used to assist sputum expectoration and relieve breathlessness in COPD patients. We designed this study to establish if nebulized saline had a placebo effect or a clinical effect. METHODS: 40 patients were studied following hospital admission for exacerbated COPD (mean FEV1 30% predicted). Patients were randomised to single-blind administration of either 4 mls of nebulized isotonic saline using an efficient nebulizer (active group n = 20) or an inefficient nebulizer (placebo group n = 20). Spirometry and subjective breathlessness scores (Modified Likert Scale) were measured before nebulized treatment and 10 minutes after treatment. RESULTS: There was no significant change in FEV1 after active or placebo nebulized saline treatment. Patients reported a 4% improvement in mean breathlessness score following placebo (Wilcoxon test; p = 0.37) compared with 23% improvement following active nebulized saline (p = 0.0001). 65% of patients given active nebulized saline but only 5% of the placebo group reported that mucus expectoration was easier after the treatment. CONCLUSIONS: This study lends support to the current use of nebulized saline to relieve breathlessness (possibly by facilitating sputum clearance) in COPD patients. Lung function was not affected. Nebulized saline can therefore be used as a placebo in bronchodilator studies involving COPD patients but it cannot be used as a placebo in trials assessing symptom relief