Watershed Outreach Professionals' Behavior Change Practices, Challenges, and Needs: Insights and Recommendations for the Chesapeake Bay Trust

This project was conducted in collaboration with a Maryland non-profit grant-making organization, the Chesapeake Bay Trust (CBT). The goal of the project was to determine how to assist local organizations in implementing environmental outreach programs (EOPs) that foster environmentally responsible behaviors (ERB) within the Chesapeake Bay Watershed. Based on findings from a review of conservation psychology literature, interviews with outreach program leaders, and observations of EOPs, the team designed and administered a survey to the CBT grant applicants (n=108, r=55%). The survey determined the EOP practices, challenges, and needs of these organizations. Survey results demonstrated that the majority of respondents’ organizations seek to motivate individuals to protect the Bay (97%) and that their EOPs have behavioral objectives (62%). Respondents reported that they motivate people in variety of ways, such as raising awareness (91 %). Their EOPs, however, also demonstrated misperceptions about how to achieve behavior change, for example suggesting that raising awareness will lead to ERB. Responses further revealed that many organizations are incorporating behavior change strategies and outreach best practices, such as targeting audiences (76%) and conducting internal evaluations (78%). Respondents, however, face challenges in implementing EOPs including: recruiting audiences not already environmentally motivated (53%); intentionally using behavior change strategies (52%); and developing EOPs with limited resources (48%). Finally, respondents felt their EOPs would most benefit from increased collaboration with other organizations (73%), opportunities to learn more about evaluation (63%), and training in how to incorporate academic research on ERB (53%). These survey results, as well as interview, observation, grant review, and presentation findings, led to the development of recommendations for the CBT and other funders interested in supporting EOPs to motivate ERB. Recommendations focused on facilitating effective program design include, addressing behavior change misconceptions, offering opportunities to learn more about behavior change, and developing outreach best practices skills, such as audience targeting and assessment. The recommendations also focus on ways to ensure that the needs of under-resourced grantees are met by encouraging collaboration and providing user-friendly, Bay-specific resources, such as the Rapid Assessment tool and guide to Strategies for Motivating Watershed Behavior created by the team.Master of ScienceNatural Resources and EnvironmentUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/90869/1/Watershed Outreach Professionals' Behavior Change Practices, Challenges, and Needs[1].pd

Acute carpal tunnel syndrome: early nerve decompression and surgical stabilization for bony wrist trauma

Background We undertook this study to investigate the outcomes of surgical treatment for acute carpal tunnel syndrome following our protocol for concurrent nerve decompression and skeletal stabilization for bony wrist trauma to be undertaken within 48-hours. Methods We identified all patients treated at our trauma centre following this protocol between 1 January 2014 and 31 December 2019. All patients were clinically reviewed at least 12 months following surgery and assessed using the Brief Michigan Hand Outcomes Questionnaire (bMHQ), the Boston Carpal Tunnel Questionnaire (BCTQ) and sensory assessment with Semmes-Weinstein monofilament testing. Results The study group was made up of 35 patients. Thirty-three patients were treated within 36-hours. Patients treated with our unit protocol for early surgery comprising nerve decompression and bony stabilization within 36-hours, report excellent outcomes at medium term follow up. Conclusions We propose that nerve decompression and bony surgical stabilization should be undertaken as soon as practically possible once the diagnosis is made. This is emergent treatment to protect and preserve nerve function. In our experience, the vast majority of patients were treated within 24-hours however where a short period of observation was required excellent results were generally achieved where treatment was completed within 36-hours

Dielectric Replica Measurement : A New Technique for Obtaining the Complex Permittivity of Irregularly Shaped Objects

Dielectric measurements provide valuable information about the properties of materials, and could be used to classify and identify the source of objects in fields such as archaeology. Current methods of identification are all partly destructive, so an innovative electromagnetic method developed by the authors, based on resonant cavity perturbation (RCP), provides an attractive, non-destructive alternative. A problem with traditional RCP is that the changes in frequency and Q-factor vary with the object's shape; however, we overcome this by creating a replica of the object, from a material whose dielectric properties are known. Then, by combining three separate perturbations with orthogonal field directions, due firstly to the object and then to its replica, we eliminate the shape dependency, and thus determine the object's dielectric constant and loss factor. After developing the theory of this novel DRM technique, we demonstrate the principle using a set of geometric shapes made in both polytetrafluoroethylene and a 3D printed material. Further measurements then enable second-order terms to be included in the model, improving its accuracy. Finally, DRM is shown to be capable of distinguishing two irregularly shaped objects of different materials. Potential applications of DRM include determining the provenance of pottery, glasses and flints, and distinguishing ivory from bone. These would be of interest to customs and environmental agencies, as well as museum curators and archaeologists

Does Human Predation Risk Affect Harvest Susceptibility of White-Tailed Deer During Hunting Season?

Large carnivores are considered a primary source of mortality for many ungulate populations, but harvest by hunters is the primary means of population management. However, research is needed to evaluate how human predation risk influences observability (a surrogate to harvest susceptibility) of ungulates. We determined how hunting intensity and duration influence observation rates of white-tailed deer (Odocoileus virginianus) and how deer behavior (i.e., movement rate and resource selection) affects observation rates. We sampled 37 adult (≥2 yr) male deer at 2 levels of risk (i.e., low-risk = 1 hunter/101 ha; and high-risk = 1 hunter/30 ha) during 3 exposure periods (i.e., first, second, and third weekend of hunting) on a 1,861-ha property in Oklahoma, USA, during the 2008 and 2009 rifle deer-seasons. Observation rates (collared deer/hunter-hr/day) were greatest during the first weekend in both the low- and high-risk treatments, but declined each weekend thereafter in both treatments. Immediately prior to hunter observation, movement rate of observed collared deer was greater than that of unobserved collared deer, but only when hunting risk was high. Greater movement rates of deer in the high-risk treatment also led to a greater probability of observation. Hunters also had a greater probability of observing collared deer at higher elevations. Overall, deer modified their behavior to avoid detection by hunters. These results can be used to explain decreased observation rates to hunters and to modify harvest rates by altering timing and intensity of human predation risk during the recreational hunting season to help achieve population management goals through harvest

Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

<b>Background</b> Patient 'enablement' is a term closely aligned with 'empowerment' and its measurement in a general practice consultation has been operationalised in the widely used patient enablement instrument (PEI), a patient-rated measure of consultation outcome. However, there is limited knowledge regarding the factors that influence enablement, particularly the effect of socio-economic deprivation. The aim of the study is to assess the factors influencing patient enablement in GP consultations in areas of high and low deprivation.<p></p> <b>Methods</b> A questionnaire study was carried out on 3,044 patients attending 26 GPs (16 in areas of high socio-economic deprivation and 10 in low deprivation areas, in the west of Scotland). Patient expectation (confidence that the doctor would be able to help) was recorded prior to the consultation. PEI, GP empathy (measured by the CARE Measure), and a range of other measures and variables were recorded after the consultation. Data analysis employed multi-level modelling and multivariate analyses with the PEI as the dependant variable.<p></p> <b>Results</b> Although numerous variables showed a univariate association with patient enablement, only four factors were independently predictive after multilevel multivariate analysis; patients with multimorbidity of 3 or more long-term conditions (reflecting poor chronic general health), and those consulting about a long-standing problem had reduced enablement scores in both affluent and deprived areas. In deprived areas, emotional distress (GHQ-caseness) had an additional negative effect on enablement. Perceived GP empathy had a positive effect on enablement in both affluent and deprived areas. Maximal patient enablement was never found with low empathy.<p></p> <b>Conclusions</b> Although other factors influence patient enablement, the patients' perceptions of the doctors' empathy is of key importance in patient enablement in general practice consultations in both high and low deprivation settings

Incidental chest radiographic findings in adult patients with acute cough

PURPOSE Imaging may produce unexpected or incidental findings with consequences for patients and ordering of future investigations. Chest radiography in patients with acute cough is among the most common reasons for imaging in primary care, but data on associated incidental findings are lacking. We set out to describe the type and prevalence of incidental chest radiography findings in primary care patients with acute cough. METHODS We report on data from a cross-sectional study in 16 European primary care networks on 3,105 patients with acute cough, all of whom were undergoing chest radiography as part of a research study workup. Apart from assessment for specified signs of pneumonia and acute bronchitis, local radiologists were asked to evaluate any additional finding on the radiographs. For the 2,823 participants with good-quality chest radiographs, these findings were categorized according to clinical relevance based on previous research evidence and analyzed for type and prevalence by network, sex, age, and smoking status. RESULTS Incidental findings were reported in 19% of all participants, and ranged from 0% to 25% by primary care network, with the network being an independent contributor (P < .001). Of all participants 3% had clinically relevant incidental findings. Suspected nodules and shadows were reported in 1.8%. Incidental findings were more common is older participants and smokers (P < .001). CONCLUSIONS Clinically relevant incidental findings on chest radiographs in primary care adult patients with acute cough are uncommon, and prevalence varies by setting

VizWiz

The lack of access to visual information like text labels, icons,and colors can cause frustration and decrease independence for blind people. Current access technology uses automatic approaches to address some problems in this space, but the technology is error-prone, limited in scope, and quite expensive. In this paper, we introduce VizWiz, a talking application for mobile phones that offers a new alternative to answering visual questions in nearly real-time—asking multiple people on the web. To support answering questions quickly, we introduce a general approach for intelligently recruiting human workers in advance called quikTurkit so that workers are available when new questions arrive. A field deployment with 11 blind participants illustrates that blind people can effectively use VizWiz to cheaply answer questions in their everyday lives, highlighting issues that automatic approaches will need to address to be useful. Finally, we illustrate the potential of using VizWiz as part of the participatory design of advanced tools by using it to build and evaluate VizWiz::LocateIt, an interactive mobile tool that helps blind people solve general visual search problems

The Effects of ELDRS at Ultra-Low Dose Rates

We present results on the effects on ELDRS at dose rates of 10, 5, 1, and 0.5 mrad(Si)/s for a variety of radiation hardened and commercial devices. We observed low dose rate enhancement below 10 mrad(Si)/s in several different parts. The magnitudes of the dose rate effects vary. The TL750L, a commercial voltage regulator, showed dose rate dependence in the functional failures, with initial failures occurring after 10 krad(Si) for the parts irradiated at 0.5 mrad(Si)/s. The RH1021 showed an increase in low dose rate enhancement by 2x at 5 mrad(Si)/s relative to 8 mrad(Si)/s and high dose rate, and parametric failure after 100 krad(Si). Additionally the ELDRS-free devices, such as the LM158 and LM117, showed evidence of dose rate sensitivity in parametric degradations. Several other parts also displayed dose rate enhancement, with relatively lower degradations up to approx.15 to 20 krad(Si). The magnitudes of the dose rate enhancement will likely increase in significance at higher total dose levels

Illness perception and related behaviour in lower respiratory tract infections—a European study

Background. Lower respiratory tract infection (LRTI) is a common presentation in primary care, but little is known about associated patients’ illness perception and related behaviour. Objective. To describe illness perceptions and related behaviour in patients with LRTI visiting their general practitioner (GP) and identify differences between European regions and types of health care system. Methods. Adult patients presenting with acute cough were included. GPs recorded co morbidities and clinical findings. Patients filled out a diary for up to 4 weeks on their symptoms, illness perception and related behaviour. The chi-square test was used to compare proportions between groups and the Mann-Whitney U or Kruskal Wallis tests were used to compare means. Results. Three thousand one hundred six patients from 12 European countries were included. Eighty-one per cent (n = 2530) of the patients completed the diary. Patients were feeling unwell for a mean of 9 (SD 8) days prior to consulting. More than half experienced impairment of normal or social activities for at least 1 week and were absent from work/school for a mean of 4 (SD 5) days. On average patients felt recovered 2 weeks after visiting their GP, but 21% (n = 539) of the patients did not feel recovered after 4 weeks. Twenty-seven per cent (n = 691) reported feeling anxious or depressed, and 28% (n = 702) re-consulted their GP at some point during the illness episode. Reported illness duration and days absent from work/school differed between countries and regions (North-West versus South-East), but there was little difference in reported illness course and related behaviour between health care systems (direct access versus gate-keeping). Conclusion. Illness course, perception and related behaviour in LRTI differ considerably between countries. These finding should be taken into account when developing International guidelines for LRTI and interventions for setting realistic expectations about illness course