Objective and subjective personality characteristics of medical students

The present study viewed personality characteristics of medical students using both objective (i.e., a valid and reliable psychological instrument) and subjective methods (i.e., medical students\u27 self-ratings of how they viewed themselves and how they believed others viewed them). The 16 Personality Factor Questionnaire (16PF, 5th Edition) and a researcher developed instrument, the Subjective Rating Form (SRF), were utilized in this study. Significant differences were found in 16PF scores from entry to medical school (Time 1) to exit from medical school (Time 2). Significant differences were also observed when SRF scores were compared between Self at Time 1 (retrospectively), Self at Time 2, and self-ratings made from the perspective of Other. Most striking were differences between 16PF and SRF scores when compared with each other, at both Time 1 and Time 2. This last group of findings translated into differences between the actual and perceived self (i.e., real vs. ideal). The implications of such differences are discussed

The use of tracking tunnels to monitor the activity of small mammals in habitats associated with the northern wheatear (Oenanthe oenanthe)

Nest predation is the main cause of nest mortality among birds and is thought to be the main reason for breeding failure amongst northern wheatears (Oenanthe oenanthe) in Swedish farmland habitats. Previous studies suggest that small mammalian predators and snakes are important nest predators for wheatears. However, other factors behind nest predation among wheatears have not been thoroughly studied. Here I used ink tracking tunnels (with a piece of meat as bait) to monitor the activity of small mammals in relation to landscape elements (such as linear, forest edge, open area, tall vegetation and stone piles) and land-use types (pastures, crop fields and ungrazed grasslands) in wheatear breeding territories. I also investigated whether the activity of the mammals changed over time using four survey periods (each period represents the time when collecting tracks from tunnels). The two first survey periods took place during the peak of incubation for wheatears and the last two during the peak of nestling provisioning. Footprint tracks from the tunnels revealed that small mammals (shrews, mice, rats, weasels, stoats and cats), birds, lizards, insects and amphibians visited the tunnels. The activity of small mammals increased over time so that the highest tracking rates occurred when wheatears were feeding nestlings. The proportion of tunnels with tracks varied according to landscape features, with the highest percentage of tracks found in forest edges (35.5 %) and the lowest in stone piles (17.6 %). However, in stone piles the proportion of tunnels with tracks of small mammals was dependent on land-use type. Whereas mammal prints were generally rare in stone piles located in pastures (12% of all mammal tracks in pasture) they were much more frequent in crop fields (33 % of all mammal tracks in crop): possibly because stone piles offer the only available predator refuge in crop fields. The increase of mammal activity between the four survey periods differed between land-use categories with a greater increase in grasslands than in pastures and crop fields. Tunnels with tracks of mammals were positively correlated with the amount of local shrub coverage and tall vegetation. No connection was found between proportion of mammal tracks and breeding success for the northern wheatear. This study suggests that there are temporal and spatial variation in small mammal activity and demonstrates the value of using tracking tunnels in a Swedish farmland landscape to increase the knowledge of predator movements. However, further studies with long-term data on small mammal activity are needed for to draw conclusions about mammal activity and breeding success for the northern wheatear

Rahvusvahelise õiguse probleeme seoses metsavendlusega Nõukogude Liidu poolt okupeeritud ja annekteeritud Eestis ning teistes Balti riikides

https://www.ester.ee/record=b5505531*es

Investigating the impact of the diseases of despair in Appalachia

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose. Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64. Results: Over the past two decades, the mortality rate due to diseases of despair has been increasing across the United States, but the gap has widened between the Appalachian Region and the rest of the nation. In 2017, the combined diseases of despair mortality rate was 45% higher in the Appalachian Region than the non-Appalachian United States. When looking at just overdose mortality, this disparity grows to 65% higher in the Appalachian Region. Within the Appalachian region disparities are most notable in the Central and North Central Appalachian subregions, among males, and among individuals age 45 to 54. Discussion: These findings document the scale and scope of the problem in Appalachia and highlight the need for additional research and discussion in terms of effective interventions, policies, and strategies to address these diseases of despair. Over the past two decades, mortality from overdose, suicide, and alcoholic liver diseases/cirrhosis has increased across the United States, but the disparity between Appalachia and the non-Appalachian U.S. continues to grow

Tracking the Impact of Diseases of Despair in Appalachia—2015 to 2018

Introduction: This study provides an update on mortality due to diseases of despair within the Appalachian Region, comparing 2015 to 2018. Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Analyses are based on National Vital Statistics System (NVSS) mortality data for individuals aged 15-64. Results: Between 2015 and 2017, the diseases of despair mortality rate increased in both Appalachia and the non-Appalachian U.S., and the disparity grew between Appalachia and the rest of the county. In 2018, the disease of despair mortality rate declined by 8 percent in Appalachia, marking the first decline for the Region since 2012. Diseases of despair continue to impact the working-age population, and while males experience a higher burden of mortality due to diseases of despair, the disparity between Appalachia and the rest of the United States is greater for females. Overdose mortality rates in Appalachia increased between 2015 and 2017, followed by a decline in 2018. During this same time frame, suicide also increased notably within the Appalachian region, and the disparity between Appalachia and the non-Appalachian U.S. increased by 50 percent. Implications: These findings document that the diseases of despair continue to have a greater impact in the Appalachian Region than in the rest of the United States. While the declining trends between 2017 and 2018 are promising, data has shown that these rates are likely to increase again, particularly as a result of the COVID-19 pandemic

Delayed timing of breeding as a cost of reproduction

Timing of breeding is a trait with considerable individual variation, often closely linked to fitness because of seasonal declines in reproduction. The drivers of this variation have received much attention, but how reproductive costs may influence the timing of subsequent breeding has been largely unexplored. We examined a population of northern wheatears Oenanthe oenanthe to compare three groups of individuals that differed in their timing of breeding termination and reproductive effort to investigate how these factors may carry over to influence reproductive timing and reproductive output in the following season. Compared to females that bred successfully, females that put in less effort and terminated breeding early due to nest failure tended to arrive and breed earlier in year 2 (mean advancement = 2.2 and 3.3 d respectively). Females that spent potentially more effort and terminated breeding later due to production of a replacement clutch after nest failure, arrived later than other females in year 2. Reproductive output (number of fledglings) in year 2 differed between the three groups as a result of group-level differences in the timing of breeding in combination with the general seasonal decline in reproductive output. Our study shows that the main cost of reproduction was apparent in the timing of arrival and breeding in this migratory species. Hence, reproductive costs can arise through altered timing of breeding since future reproductive success (including adult survival) is often dependent on the timing of breeding in seasonal systems

Rural Appalachia Battling the Intersection of Two Crises: COVID-19 and Substance Use Disorders

During the COVID-19 pandemic, rural Appalachia is at great risk of unforeseen side effects including increased mortality from substance use disorders (SUDs). People living with SUDs are at increased risk for both exposure to and poor outcomes from COVID infection. The economic impacts of COVID-19 must also be considered. As rural Appalachia combats the substance use crisis amidst the COVID-19 pandemic, the geographic economic, health and social inequities within our region must be considered. As a national recovery is sought, we should reimagine federal policies that center the economic and public health of rural Appalachia addressing the two crises

The double disparity facing rural local health departments: A short report

Rural residents in the U.S. face significant health challenges, including higher rates of risky health behaviors and worse health outcomes than many other groups. Rural communities are also typically served by local health departments (LHDs) that have fewer human and financial resources than their suburban and urban peers. As a result of history and need, rural LHDs are more likely than urban LHDs to provide direct health services, which may result in limited resources for population-based activities. This review examines the double disparity facing rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities

Clinical Service Delivery along the Urban/Rural Continuum

Background: Engagement in the core public health functions and ten essential services remains the standard for measuring local health department (LHD) performance; their role as providers of clinical services remains uncertain, particularly in rural and underserved communities. Purpose: To examine the role of LHDs as clinical service providers and how this role varies among rural and nonrural communities. Methods: The 2013 National Association of County and City Health Officials (NACCHO) Profile was used to examine the geographic distribution of clinical service provision among LHDs. LHDs were coded as urban, large rural, or small rural based on Rural/Urban Commuting Area codes. Bivariate analysis for clinical services was conducted by rural/urban status. For each service, the proportions of LHDs that directly performed the service, contracted with other organizations to provide the service, or reported provision of the service by independent organizations in the community was compared. Results: Analyses show significant differences in patterns of clinical services offered, contracted, or provided by others, based on rurality. LHDs serving rural communities, especially large rural LHDs, tend to provide more direct services than urban LHDs. Among rural LHDs, larger rural LHDs provided a broader array of services and reported more community capacity for delivery than small rural LHDs- particularly maternal and child health services. Implications: There are capacity differences between large and small rural LHDs. Limited capacity within small rural LHDs may result in providing less services, regardless of the availability of other providers within their communities. These findings provide valuable information on clinical service provision among LHDs, particularly in rural and underserved communities

Local Health Department Clinical Service Delivery along the Urban/Rural Continuum

Background: Engagement in the core public health functions and ten essential services remains the standard for measuring local health department (LHD) performance; their role as providers of clinical services remains uncertain, particularly in rural and underserved communities. Purpose: To examine the role of LHDs as clinical service providers and how this role varies among rural and nonrural communities. Methods: The 2013 National Association of County and City Health Officials (NACCHO) Profile was used to examine the geographic distribution of clinical service provision among LHDs. LHDs were coded as urban, large rural, or small rural based on Rural/Urban Commuting Area codes. Bivariate analysis for clinical services was conducted by rural/urban status. For each service, the proportions of LHDs that directly performed the service, contracted with other organizations to provide the service, or reported provision of the service by independent organizations in the community was compared. Results: Analyses show significant differences in patterns of clinical services offered, contracted, or provided by others, based on rurality. LHDs serving rural communities, especially large rural LHDs, tend to provide more direct services than urban LHDs. Among rural LHDs, larger rural LHDs provided a broader array of services and reported more community capacity for delivery than small rural LHDs- particularly maternal and child health services. Implications: There are capacity differences between large and small rural LHDs. Limited capacity within small rural LHDs may result in providing less services, regardless of the availability of other providers within their communities. These findings provide valuable information on clinical service provision among LHDs, particularly in rural and underserved communities