Outcomes of an Evidence-Based, Data Driven-Model Fieldwork Experience for Occupational Therapy Students

Over the past decade, there has been an increased emphasis on evidence-based practice (EBP) and the use of outcome measurement in clinical practice, however, the implementation of evidence into practice remains challenging and irregular. During fieldwork, students often experience a disconnect between the emphasis on EBP in the classroom and lack of use in the clinic. Recognizing the need to develop high-quality, evidence-based and data-driven models of practice for student training, we partnered with local fieldwork educators to develop an innovative program that guides students and simultaneously trains fieldwork educators (FWE) in the use of a systematic data driven decision making (DDDM) process to infuse evidence into practice. Using a pre-post quasi-experimental design, we evaluated the impact of this program on students’ perceived knowledge and skills in use of EBP and DDDM. A focus group with participating fieldwork educators captured their knowledge and attitudes in the use of EBP and DDDM in their clinical sites. Eleven FWEs and twenty four students participated. Results revealed significant change in students’ knowledge and skill in use of EBP and DDDM. FWEs reported the program clarified the role of occupational therapy, enhanced communication, and validated the value of occupational therapy in their clinical site. This program serves as a model for training students to implement evidence and data driven approaches in clinical practice, thus bridging the gap between classroom and clinic

Future Implications of Emerging Disruptive Technologies on Weapons of Mass Destruction

This report asks the questions: What are the future implications of Emerging Disruptive Technologies (EDTs) on the future of Weapons of Mass Destruction (WMD) warfare? How might EDTs increase the lethality and effectiveness of WMDs in kinetic warfare in 2040? How can civic leaders and public servants prepare for and mitigate projected threats? Problem  In the coming decade, state and non-state adversaries will use EDTs to attack systems and populations that may initiate and accelerate existing geopolitical conflict escalation. EDTs are expected to be used both in the initial attack or escalation as well as a part of the detection and decision-making process. Due to the speed of EDTs, expected confusion, and common lack of human oversight, attacks will also be incorrectly attributed, which has the capacity to escalate rapid geopolitical conflict to global military conflict, and ultimately, to the use of nuclear WMDs. The use of EDTs in the shadow of nuclear WMDs is also expected to create an existential threat to possible adversaries, pushing them to “lower the bar” of acceptability for using nuclear WMDs. EDTs will enable and embolden insider threats, both willing and unknowing, to effect geopolitical conflict on a global scale. In addition, the combination of multiple EDTs when used together for attacks will create WMD effects on populations and governments. Furthermore, EDTs will be used by adversaries to target and destabilize critical infrastructure systems, such as food, energy, and transportation, etc. that will have a broader effect on populations and governments. EDTs will enable adversaries to perpetrate a long-game attack, where the effect and attribution of the attack may not be detected for an extended period -- if ever. Solution  To combat these future threats, organizations will need to conduct research and intelligence gathering paired with exploratory research and development to better understand the state of EDTs and their potential impacts. With this information, organizations will need to conduct collaborative “wargaming” and planning to explore a range of possible and potential threats of EDTs. The knowledge gained from all of these activities will inform future training and best practices to prepare for and address these threats. Organizations will also need to increase their investments in EDT related domains, necessitating countries to not only change how they fight, but also evolve their thinking about deterrence. Expanded regulation, policy making, and political solidarity among members will take on an increasingly more significant and expanded role. Broader government, military, and civilian cooperation will be needed to disrupt and mitigate some of these future threats in conjunction with broader public awareness. All of these actions will place a higher value on cooperation and shared resiliency among NATO members

Access to and Use of Technology for Health: Comparisons Between Appalachian Kentuckians and the General U.S. Population

Introduction: Technology may increase the availability of health information and enable health promoting behaviors. However, lack of access to and use of technology may also exacerbate disparities, particularly in rural communities with limited Internet access. Purpose: The purpose of this study was to compare Internet access, device ownership, and use of technology for health between Appalachian Kentuckians and the general U.S. population. Methods: Findings from the 2017 Assessing the Health Status of Kentucky (ASK) survey were compared to national estimates from the Health Information National Trends Survey (HINTS) 5, Cycle 1 (2017), with a particular focus on degree of rurality. ASK and HINTS respondent sociodemographics, Internet access, and use of technology for health were assessed using weighted percentages; chi-square P-values were calculated based on weighted counts. Results: Over 80% of both populations reported accessing the Internet. However, Appalachian Kentuckians across all geographic strata were significantly less likely to access the Internet through broadband, cellular networks, and Wi-Fi. The U.S. population reported greater electronic device ownership rates. Appalachian Kentuckians were significantly more likely to search for cancer information online compared to national estimates. The majority of both populations reported not having health apps on their smartphones or tablets. Appalachian Kentuckians reported significantly lower rates of using electronic media to exchange information with health professionals. Implications: Ensuring high-speed Internet access among Appalachian Kentuckians could help this population leverage available technology to overcome barriers to care and reduce health disparities – for example, by enabling the use of health-related apps or electronic means to remotely communicate with providers. Such technologies have the potential to improve the health of medically underserved populations and deserve further attention

The p−p-sphere and the geometric substratum of power law probability distributions

Links between power law probability distributions and marginal distributions of uniform laws on $p$-spheres in $\mathbb{R}^{n}$ show that a mathematical derivation of the Boltzmann-Gibbs distribution necessarily passes through power law ones. Results are also given that link parameters $p$ and $n$ to the value of the non-extensivity parameter $q$ that characterizes these power laws in the context of non-extensive statistics.Comment: 10 page

First-principles method for high-QQ photonic crystal cavity mode calculations

We present a first-principles method to compute radiation properties of ultra-high quality factor photonic crystal cavities. Our Frequency-domain Approach for Radiation (FAR) can compute the far-field radiation pattern and quality factor of cavity modes $\sim 100$ times more rapidly than conventional finite-difference time domain calculations. It also provides a simple rule for engineering the cavity's far-field radiation pattern

Influence of the 2015–2016 El Niño on the record‑breaking mangrove dieback along northern Australia coast

This study investigates the underlying climate processes behind the largest recorded mangrove dieback event along the Gulf of Carpentaria coast in northern Australia in late 2015. Using satellite derived fractional canopy cover (FCC), variation of the mangrove canopies during recent decades are studied, including a severe dieback during 2015–2016. The relationship between mangrove FCC and climate conditions is examined with a focus on the possible role of the 2015–2016 El Niño in altering favorable conditions sustaining the mangroves. The mangrove FCC is shown to be coherent with the low-frequency component of sea level height (SLH) variation related to the El Niño Southern Oscillation (ENSO) cycle in the equatorial Pacific. The SLH drop associated with the 2015–2016 El Niño is identified to be the crucial factor leading to the dieback event. A stronger SLH drop occurred during austral autumn and winter, when the SLH anomalies were about 12% stronger than the previous very strong El Niño events. The persistent SLH drop occurred in the dry season of the year when SLH was seasonally at its lowest, so potentially exposed the mangroves to unprecedented hostile conditions. The influence of other key climate factors is also discussed, and a multiple linear regression model is developed to understand the combined role of the important climate variables on the mangrove FCC variation

40Ar/39Ar Ages of Carbonaceous Xenoliths in 2 HED Meteorites

The generally young K/Ar and 40Ar/39Ar ages of CM chondrites made us wonder whether carbonaceous xenoliths (CMX) entombed in HowarditeEucriteDiogenite (HED) meteorites might retain more radiogenic 40Ar than do free-range CM-chondrites. To find out, we selected two HED breccias with carbonaceous inclusions in order to compare the 40Ar/39Ar release patterns and ages of the inclusions with those of nearby HED material. Carbonaceous inclusions (CMXs) in two HED meteorites lost a greater fraction of radiogenic 40Ar than did surrounding host material, but a smaller fraction of it than did free-range CM-chondrites such as Murchison or more heavily altered ones. Importantly, however, the siting of the CMXs in HED matrix did not prevent the 40Ar loss of about 40 percent of the radiogenic 40Ar, even from phases that degas at high laboratory temperatures. We infer that carbonaceous asteroids with perihelia of 1 astronomical unit probably experience losses of at least this size. The usefulness of 40Ar/39Ar dating for samples returned from C-type asteroids may hinge, therefore, on identifying and analyzing separately small quantities of the most retentive phases of carbonaceous chondrites

Genome-wide association study of opioid cessation

The United States is experiencing an epidemic of opioid use disorder (OUD) and overdose-related deaths. However, the genetic basis for the ability to discontinue opioid use has not been investigated. We performed a genome-wide association study (GWAS) of opioid cessation (defined as abstinence from illicit opioids for \u3e1 year or \u3c6 months before the interview date) in 1130 African American (AA) and 2919 European ancestry (EA) participants recruited for genetic studies of substance use disorders and who met lifetime Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for OUD. Association tests performed separately within each ethnic group were combined by meta-analysis with results obtained from the Comorbidity and Trauma Study. Although there were no genome-wide significant associations, we found suggestive associations with nine independent loci, including three which are biologically relevant: rs4740988 i

ULTRAENDURANCE CYCLING IN A HOT ENVIRONMENT: THIRST, FLUID CONSUMPTION, AND WATER BALANCE

ABSTRACT Armstrong, LE, Johnson, EC, McKenzie, AL, Ellis, LA, and Williamson, KH. Ultraendurance cycling in a hot environment: thirst, fluid consumption, and water balance. J Strength Cond Res 29(4): 869-876, 2015-The purpose of this field investigation was to identify and clarify factors that may be used by strength and conditioning professionals to help athletes drink adequately but not excessively during endurance exercise. A universal method to accomplish this goal does not exist because the components of water balance (i.e., sweat rate, fluid consumed) are different for each athlete and endurance events differ greatly. Twenty-six male cyclists (mean 6 SD; age, 41 6 8 years; height, 177 6 7 cm; body mass, 81.85 6 8.95 kg) completed a summer 164-km road cycling event in 7.0 6 2.1 hours (range, 4.5-10.4 hours). Thirst ratings, fluid consumed, indices of hydration status, and body water balance (ingested fluid volume 2 [urine excreted + sweat loss]) were the primary outcome variables. Measurements were taken before the event, at designated aid stations on the course (52, 97, and 136 km), and at the finish line. Body water balance during exercise was not significantly correlated with exercise time on the course, height, body mass, or body mass index. Thirst ratings were not significantly correlated with any variable. We also observed a wide range of total sweat losses (4.9-12.7 L) and total fluid intakes (2.1-10.5 L) during this ultraendurance event. Therefore, we recommend that strength and conditioning professionals develop an individualized drinking plan for each athlete, by calculating sweat rate (milliliter per hour) on the basis of body mass change (in kilograms), during field simulations of competition