A modeling study of heterogeneity and surface water-groundwater interactions in the Thomas Brook catchment, Annapolis Valley (Nova Scotia, Canada)

A modelling study of the impacts of subsurface\ud heterogeneity on the hydrologic response of a small catchment\ud is reported. The study is focused in particular on the\ud hydraulic connection and interactions between surface water\ud and groundwater. A coupled (1-D surface/3-D subsurface)\ud numerical model is used to investigate, for a range of scenarios,\ud the spatio-temporal patterns of response variables such\ud as return flow, recharge, groundwater levels, surface saturation,\ud and streamflow. Eight scenarios of increasing geological\ud complexity are simulated for an 8 km2 catchment in\ud the Annapolis Valley (eastern Canada), introducing at each\ud step more realistic representations of the geological strata\ud and corresponding hydraulic properties. In a ninth scenario\ud the effects of snow accumulation and snowmelt are also considered.\ud The results show that response variables and significant\ud features of the catchment (e.g. springs) can be adequately\ud reproduced using a representation of the geology and\ud model parameter values that are based on targeted fieldwork\ud and existing databases, and that reflect to a sufficient degree\ud the geological and hydrological complexity of the study area.\ud The hydraulic conductivity values of the thin surficial sediment\ud cover (especially till) and of the basalts in the upstream\ud reaches emerge as key elements of the basin’s heterogeneity\ud for properly capturing the overall catchment response

Patient-defined meaningfulness within chronic pain rehabilitation: A concept analysis

Background: As the problem of chronic pain grows worldwide, rehabilitation is critical to improved patient well-being. There is thus a need for rehabilitation-focused research. It appears that outcomes are improved when patients perceive the rehabilitation process to be meaningful. However, there is no empirical evidence determining how this would be achieved. An important first step is to identify and describe the concept of meaningfulness as it is used in the chronic pain rehabilitation literature. Objective: This paper reports the findings of a structured concept analysis to define meaningfulness from the patient perspective in chronic pain rehabilitation. Methodology: In consultation with a medical librarian, a search strategy was developed and articles retrieved. The Walker and Avant concept analysis method was used to analyze the data, identify the defining attributes of meaningfulness, develop contrary, borderline, and model cases, and identify its antecedents and consequences. Results: The search revealed extensive use of the terms ‘meaningfulness’ and ‘meaningful’ within the chronic pain rehabilitation literature from the healthcare provider and system perspective. However, only ten articles met the inclusion criteria, and used the terms meaningful or meaningfulness from the patients’ perspective. Given the paucity of relevant studies, it was not possible to retrieve a clear definition of meaningfulness specific to the context of chronic pain rehabilitation, nor to identify specific outcome measures used to confirm whether rehabilitation is meaningful for people with chronic pain. Conclusions: There is a worrisome gap in the chronic pain rehabilitation literature regarding the application of the concept of ‘meaningfulness’ as perceived by the patient. This study lays the foundation to further the conceptual clarity required for rigorous research to determine potential benefits of personally meaningful chronic pain rehabilitation. Further work is required to define and operationalize the concept, develop valid assessment tools, and build the evidence base regarding relationships between patient-defined meaningfulness and positive outcomes in rehabilitation

Organizations’ choices when implementing an Early Intensive Behavioral Intervention program (EIBI).

The organizations’ characteristics and choices are essential components of an action plan that favors quality program implementation, a prelude to effectiveness, especially in natural environment. The objectives of this study are to describe the choices made by rehabilitation centers (CRDITED) in the context of a universal community based on Early Intensive Behavioral Intervention program (EIBI) for 2 to 5 year-old children with autism spectrum disorder (ASD) in Québec (Canada). Based on a theoretical evaluation model, a questionnaire was filled out by 15 CRDITEDs, covering the large majority of the Quebec territory but also the Quebec population. Results show a great diversity between the different CRDITEDs. Factors that impact implementation quality are identified. Absence of evidence-based implementation practices and the diversity of the approaches to EIBI are discussed

Maternal Exposure to Occupational Solvents and Childhood Leukemia

Many organic solvents are considered probable carcinogens. We carried out a population-based case–control study including 790 incident cases of childhood acute lymphoblastic leukemia and as many healthy controls, matched on age and sex. Maternal occupational exposure to solvents before and during pregnancy was estimated using the expert method, which involves chemists coding each individual’s job for specific contaminants. Home exposure to solvents was also evaluated. The frequency of exposure to specific agents or mixtures was generally low. Results were generally similar for the period ranging from 2 years before pregnancy up to birth and for the pregnancy period alone. For the former period, the odds ratio (OR), adjusted for maternal age and sex, for any exposure to all solvents together was 1.11 [95% confidence interval (CI), 0.88–1.40]. Increased risks were observed for specific exposures, such as to 1,1,1-trichloroethane (OR = 7.55; 95% CI, 0.92–61.97), toluene (OR = 1.88; 95% CI, 1.01–3.47), and mineral spirits (OR = 1.82; 95% CI, 1.05–3.14). There were stronger indications of moderately increased risks associated with exposure to alkanes (C5–C17; OR = 1.78; 95% CI, 1.11–2.86) and mononuclear aromatic hydrocarbons (OR = 1.64; 95% CI, 1.12–2.41). Risk did not increase with increasing exposure, except for alkanes, where a significant trend (p = 0.04) was observed. Home exposure was not associated with increased risk. Using an elaborate exposure coding method, this study shows that maternal exposure to solvents in the workplace does not seem to play a major role in childhood leukemia

The enhanced cognitive interview: expressions of uncertainty, motivation and its relation with report accuracy

The Enhanced Cognitive Interview (ECI) is one of the most widely studied and used methods to interview witnesses. However, ECI research has mainly focused on increasing report size and somewhat overlooked how to improve and evaluate report accuracy. No study evaluated if witnesses’ spontaneous expressions of uncertainty are accurate metacognitive judgments, nor if witnesses’ motivation during the interview affects report accuracy. This study examined how witnesses’ judgments of recall ‘uncertainty’ and their motivation perception could relate to report accuracy. Forty-four psychology students watched a mock robbery video recording and were interviewed 48 hours later with either the Portuguese version of the ECI or a Structured Interview (SI). Afterward, participants’ motivation was assessed and items of information were classified as ‘certainties’ or ‘uncertainties’. Results suggest that our ECI protocol was effective, since participants interviewed with the ECI produced more information without compromising accuracy. ‘Uncertainties’ were less accurate than ‘certainties’, and their exclusion raised overall, ECI, and SI, accuracy. More motivated participants had better recall accuracy. Accounting for witnesses’ motivation and spontaneous verbal expressions of uncertainty may be effective and time-saving procedures to increase accuracy. These are key points that professionals and researchers should consider

Competency drivers to support implementation of early intensive behavioral intervention in large-scale community-based services: Perspectives of caseworkers and organization representatives

Implementing evidence-based practices in “real-world” settings poses significant challenges. Organizations involved must address this issue by providing supportive infrastructures. Among the elements to consider are competency drivers, which refer to the selection, training, and supervision of caseworkers. The purpose of this study was to describe the perspectives of caseworkers and representatives on competency drivers that organizations put in place to support the implementation of early intensive behavioral intervention (EIBI) in large-scale community-based services. The sample consisted of 109 caseworkers and 23 organization representatives who completed questionnaires. Results demonstrated that respondents consider clinical support and training as key elements in EIBI implementation. However, despite recognizing these factors, respondents reported considerable variability in practices. It appears necessary to better define and plan the implementation of these competency drivers with a view to improving EIBI implementation

Reference values for an index of fetal aortic isthmus blood flow during the second half of pregnancy

ABSTRACT Objective During fetal life, the parallel position of the two cardiac ventricles confers a special status to the aortic isthmus. Flow through the isthmus reflects the balance between the performances of the two ventricles and their respective peripheral impedances. This study proposes a fetal aortic isthmus flow velocity index and its reference values defined on the basis of gestational age (GA). Methods Video recordings of 111 normal fetuses from 18 to 39 weeks of gestation were retrospectively reviewed. An isthmus flow velocity index (IFI) was calculated as follows: IFI = (systoli