CHANGES IN ARCTIC CLIMATE AND CENTRAL U.S. WEATHER PATTERNS Is There a Link?

Earlier snowmelt, decreasing soil moisture, decreased corn yields, increasing extreme precipitation events—these are some of the weather effects currently observed in the central United States that might well have their origin in the rapidly warming Arctic. These and other implications of Arctic warming were among the topics discussed at a fall 2015 workshop, Implications of a Changing Arctic on Water Resources and Agriculture in the Central U.S (Wilhite and Morrow 2016). The United States assumed chairmanship of the Arctic Council in April 2015, making the workshop topic timely. Given the importance of the Midwest and Great Plains region as a breadbasket of the world, the goal of the workshop was to explore how changing Arctic weather patterns may affect agriculture, water resources, and other sectors. The workshop provided an opportunity to identify possible adaptation and mitigation measures in response to these changes in severe weather patterns and extreme climate events, as well as to ascertain future research needs and to discuss how management decisions and policy options may need to be altered in the region in response to a changing climate

Smoking among Lao medical doctors: challenges and opportunities for tobacco control

BACKGROUND: Smoking is an increasing threat to health in low-income and middle-income countries and doctors are recognised as important role models in anti-smoking campaigns. OBJECTIVES: The study aimed to identify the smoking prevalence of medical doctors in Laos, their tobacco-related knowledge and attitudes, and their involvement in and capacity for tobacco prevention and control efforts. METHODS: This was a cross-sectional national survey by a researcher-administered, face-to-face questionnaire implemented at provincial health facilities throughout the central (including national capital), northern and southern regions of Laos in 2007. Both descriptive and inferential statistics were used. RESULTS: Of the 855 participants surveyed, 9.2% were current smokers and 18.4% were ex-smokers; smoking was least common in the central region (p<0.05) and far more prevalent in males (17.3% vs 0.4%; p<0.001). Smoking was concentrated among older doctors (p <0.001). Over 84% of current smokers wanted to quit, and 74.7% had made a recent serious attempt to do so. Doctors had excellent knowledge and positive attitudes to tobacco control, although smokers were relatively less knowledgeable and positive on some items. While 78% of doctors were engaged in cessation support, just 24% had been trained to do so, and a mere 8.8% considered themselves 'well prepared'. CONCLUSION: The willingness of doctors to take up their tobacco control role and the lower smoking rates among younger respondents offers an important window of opportunity to consolidate their knowledge, attitudes, skills and enthusiasm as cessation advocates and supports

A cultural models approach to osteoporosis prevention and treatment

This article identifies cultural models of osteoporosis, as shared by community-dwelling older women in southeastern Australia, and compares these with cultural knowledge conveyed through social marketing. Cultural models are mental constructs about specific domains in everyday life, such as health and illness, which are shared within a community. We applied domain analyses to data obtained from in-depth interviews and stakeholder-identified print materials. The response domains identified from our case studies made up the shared cultural model &ldquo;Osteoporosis has low salience,&rdquo; particularly when ranked against other threats to health. The cultural knowledge reflected in the print materials supported a cultural model of low salience. Cultural cues embedded in social marketing messages on osteoporosis may be internalized and motivating in unintended ways. Identifying and understanding cultural models of osteoporosis within a community may provide valuable insights to inform the development of targeted health messages.<br /

Barriers and enablers to becoming and staying open defecation free in remote Timor-Leste

The barriers and enablers to becoming and staying open-defecation-free (ODF) following interventions which include Community-Led Total Sanitation (CLTS) are not well documented for remote communities in Manufahi District, Timor-Leste. This case study sought to address this gap in knowledge through a thematic analysis of interviews (which took place in 2014) with 21 participants affiliated with two communities which underwent the WaterAid program between 2012 and 2013. Whilst the cost and effort of constructing toilets was cited as a significant barrier, competing priorities for resources is likely to be more important. Trust in the implementing organisation as well as being able to acquire the household’s preferred toilet are important enablers to becoming and staying ODF. There is a perception among participants that vulnerable households face specific challenges to becoming and staying ODF. Including vulnerable households, especially those with people with disabilities, in both interventions and research remains challenging

Getting It on Record: Issues and Strategies for Ethnographic Practice in Recording Studios

The recording studio has been somewhat neglected as a site for ethnographic fieldwork in the field of ethno-musicology and, moreover, the majority of published studies tend to overlook the specific concerns faced by the researcher within these contexts. Music recording studios can be places of creativity, artistry, and collaboration, but they often also involve challenging, intimidating, and fractious relations. Given that recording studios are, first and foremost, concerned with documenting musicians’ performances, we discuss the concerns of getting studio interactions “on record” in terms of access, social relations, and methods of data collection. This article reflects on some of the issues we faced when conducting our fieldwork within British music recording facilities and makes suggestions based on strategies that we employed to address these issues

Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2)

OBJECTIVES: We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS), considering new evidence and topic areas that were not previously addressed. DESIGN: International consensus conference series involving 52 multidisciplinary international content experts in PARDS and four methodology experts from 15 countries, using consensus conference methodology, and implementation science. SETTING: Not applicable. PATIENTS: Patients with or at risk for PARDS. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eleven subgroups conducted systematic or scoping reviews addressing 11 topic areas: 1) definition, incidence, and epidemiology; 2) pathobiology, severity, and risk stratification; 3) ventilatory support; 4) pulmonary-specific ancillary treatment; 5) nonpulmonary treatment; 6) monitoring; 7) noninvasive respiratory support; 8) extracorporeal support; 9) morbidity and long-term outcomes; 10) clinical informatics and data science; and 11) resource-limited settings. The search included MEDLINE, EMBASE, and CINAHL Complete (EBSCOhost) and was updated in March 2022. Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to summarize evidence and develop the recommendations, which were discussed and voted on by all PALICC-2 experts. There were 146 recommendations and statements, including: 34 recommendations for clinical practice; 112 consensus-based statements with 18 on PARDS definition, 55 on good practice, seven on policy, and 32 on research. All recommendations and statements had agreement greater than 80%. CONCLUSIONS: PALICC-2 recommendations and consensus-based statements should facilitate the implementation and adherence to the best clinical practice in patients with PARDS. These results will also inform the development of future programs of research that are crucially needed to provide stronger evidence to guide the pediatric critical care teams managing these patients.</p