Realistic atomistic structure of amorphous silicon from machine-learning-driven molecular dynamics

Amorphous silicon (a-Si) is a widely studied noncrystalline material, and yet the subtle details of its atomistic structure are still unclear. Here, we show that accurate structural models of a-Si can be obtained using a machine-learning-based interatomic potential. Our best a-Si network is obtained by simulated cooling from the melt at a rate of 1011 K/s (that is, on the 10 ns time scale), contains less than 2% defects, and agrees with experiments regarding excess energies, diffraction data, and 29Si NMR chemical shifts. We show that this level of quality is impossible to achieve with faster quench simulations. We then generate a 4096-atom system that correctly reproduces the magnitude of the first sharp diffraction peak (FSDP) in the structure factor, achieving the closest agreement with experiments to date. Our study demonstrates the broader impact of machine-learning potentials for elucidating structures and properties of technologically important amorphous materials

Social fit of coral reef governance varies among individuals

Improved natural resource governance is critical for the effective conservation of ecosystems, and the well-being of societies that depend on them. Understanding the social fit of institutional arrangements in different contexts can help guide the design of effective environmental governance. This empirical study assessed individual-level variation in institutional acceptance of coral reef governance among 652 respondents in 12 fishing and tourism-oriented communities in the Wider Caribbean. High institutional acceptance was strongly associated with perceptions of community cohesiveness, underlining the potential contribution of civil society to effective governance processes. Institutional acceptance was also influenced by reef use, awareness of rules, perceived trends in reef fish populations, education, and contextual community-level factors. Understanding what influences diverse perceptions of coral reef governance among individuals can help to assess the likelihood of support for conservation measures. This study highlights how knowledge of institutional acceptance can inform the design of more targeted interventions that enhance the social fit of conservation governance to local contexts and diverse resource users

Expanding narratives of governance constraints to improve coral reef conservation

The widespread degradation of coral reefs is often attributed to local to global failures of governance. To understand and address the failures of reef governance it is critical to understand the perceptions of diverse policymakers and practitioners about the challenges they face in achieving their goals. Examining the discourse of policymakers and practitioners can reveal the extent to which these perceptions capture the full spectrum of potential governance challenges, including those related to management, institutional structures and processes, the values and principles underpinning governance, and the social and environmental context. This study examined the governance challenges perceived by 110 policymakers and practitioners across multiple sectors, scales and contexts in four countries of the Wider Caribbean Region. Thematic qualitative analysis informed by theories of interactive governance and governability found that perceived challenges were broadly consistent across countries, but differed by sector (V = 0.819, F(6, 60) = 1.502, p = 0.01) and by level (community compared to national; V = 0.194, F(1, 10) = 2.178, p = 0.026). The findings show that management inputs and outputs, challenges relating to the socio-economic context, issues of leadership and power, and stakeholder engagement were common themes. In contrast, few respondents discussed challenges relating to the ecological context, governance processes, or the values and principles underpinning governance. We argue that examining perceptions can inform both efforts to improve governance and to assess the appropriateness of particular management tools under context-specific governance constraints. Furthermore, expanding the narratives of governance challenges to encompass the subtle values and images underpinning governance, and the scale of the challenges faced, can help to identify a wider set of opportunities for change. This article is protected by copyright. All rights reserved

Digital clinical communication for families and caregivers of children or young people with short- or long-term conditions : rapid review

Background The communication relationship between parents of children or young people with health conditions and health professionals is an important part of treatment, but it is unclear how far the use of digital clinical communication tools may affect this relationship. Objective The objective of our study was to describe, assess the feasibility of, and explore the impact of digital clinical communication between families or caregivers and health professionals. Methods We searched the literature using 5 electronic databases. We considered all types of study design published in the English language from January 2009 to August 2015. The population of interest included families and caregivers of children and young people aged less than 26 years with any type of health condition. The intervention was any technology permitting 2-way communication. Results We included 31 articles. The main designs were randomized controlled trials (RCTs; n=10), cross-sectional studies (n=9), pre- and postintervention uncontrolled (pre/post) studies (n=7), and qualitative interview studies (n=2); 6 had mixed-methods designs. In the majority of cases, we considered the quality rating to be fair. Many different types of health condition were represented. A breadth of digital communication tools were included: videoconferencing or videoconsultation (n=14), and Web messaging or emails (n=12). Health care professionals were mainly therapists or cognitive behavioral therapists (n=10), physicians (n=8), and nurses (n=6). Studies were very heterogeneous in terms of outcomes. Interventions were mainly evaluated using satisfaction or acceptance, or outcomes relating to feasibility. Clinical outcomes were rarely used. The RCTs showed that digital clinical communication had no impact in comparison with standard care. Uncontrolled pre/post studies showed good rates of satisfaction or acceptance. Some economic studies suggested that digital clinical communication may save costs. Conclusions This rapid review showed an emerging body of literature on the use of digital clinical communication to improve families’ and caregivers’ involvement in the health management of children or young people. Further research with appropriate study designs and longer-term outcome measures should be encouraged. Trial Registration: PROSPERO CRD42016035467; http://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD 42016 035467(Archived by WebCite at http://www.webcitation.org/6vpgZU1FU

Self-Swabbing for Virological Confirmation of Influenza-Like Illness Among an Internet-Based Cohort in the UK During the 2014-2015 Flu Season: Pilot Study.

BACKGROUND: Routine influenza surveillance, based on laboratory confirmation of viral infection, often fails to estimate the true burden of influenza-like illness (ILI) in the community because those with ILI often manage their own symptoms without visiting a health professional. Internet-based surveillance can complement this traditional surveillance by measuring symptoms and health behavior of a population with minimal time delay. Flusurvey, the UK's largest crowd-sourced platform for surveillance of influenza, collects routine data on more than 6000 voluntary participants and offers real-time estimates of ILI circulation. However, one criticism of this method of surveillance is that it is only able to assess ILI, rather than virologically confirmed influenza. OBJECTIVE: We designed a pilot study to see if it was feasible to ask individuals from the Flusurvey platform to perform a self-swabbing task and to assess whether they were able to collect samples with a suitable viral content to detect an influenza virus in the laboratory. METHODS: Virological swabbing kits were sent to pilot study participants, who then monitored their ILI symptoms over the influenza season (2014-2015) through the Flusurvey platform. If they reported ILI, they were asked to undertake self-swabbing and return the swabs to a Public Health England laboratory for multiplex respiratory virus polymerase chain reaction testing. RESULTS: A total of 700 swab kits were distributed at the start of the study; from these, 66 participants met the definition for ILI and were asked to return samples. In all, 51 samples were received in the laboratory, 18 of which tested positive for a viral cause of ILI (35%). CONCLUSIONS: This demonstrated proof of concept that it is possible to apply self-swabbing for virological laboratory testing to an online cohort study. This pilot does not have significant numbers to validate whether Flusurvey surveillance accurately reflects influenza infection in the community, but highlights that the methodology is feasible. Self-swabbing could be expanded to larger online surveillance activities, such as during the initial stages of a pandemic, to understand community transmission or to better assess interseasonal activity

Effect of Menstrual Cycle Phase and Hormonal Contraceptives on Resting Metabolic Rate and Body Composition

The cyclical changes in sex hormones across the menstrual cycle (MC) are associated with various biological changes that may alter resting metabolic rate (RMR) and body composition estimates. Hormonal contraceptive (HC) use must also be considered given their impact on endogenous sex hormone concentrations and synchronous exogenous profiles. The purpose of this study was to determine if RMR and dual-energy X-ray absorptiometry body composition estimates change across the MC and differ compared with HC users. This was accomplished during a 5-week training camp involving naturally cycling athletes (n = 11) and HC users (n = 7 subdermal progestin implant, n = 4 combined monophasic oral contraceptive pill, n = 1 injection) from the National Rugby League Indigenous Women's Academy. MC phase was retrospectively confirmed via serum estradiol and progesterone concentrations and a positive ovulation test. HC users had serum estradiol and progesterone concentrations assessed at the time point of testing. Results were analyzed using general linear mixed model. There was no effect of MC phase on absolute RMR (p = .877), relative RMR (p = .957), or dual-energy X-ray absorptiometry body composition estimates (p > .05). There was no effect of HC use on absolute RMR (p = .069), relative RMR (p = .679), or fat mass estimates (p = .766), but HC users had a greater fat-free mass and lean body mass than naturally cycling athletes (p = .028). Our findings suggest that RMR and dual-energy X-ray absorptiometry body composition estimates do not significantly differ due to changes in sex hormones in a group of athletes, and measurements can be compared between MC phases or with HC usage without variations in sex hormones causing additional noise

Human factors and data logging processes with the use of advanced technology for adults with type 1 diabetes (T1DM): A systematic integrative review

Background: People with T1DM are confronted with self-management tasks and strategies to reduce risks of long-term complications against the risk of hypoglycemic events. The potential of advanced and evolving technology to address these issues involves consideration of psychological and behavioral constructs alongside the usability of devices. Access and uptake of advanced technology is further influenced by economic factors and health care provider capacity to support such interventions. Previous reviews have focused upon either clinical outcomes or descriptively scoped the literature or have synthesized studies on adults with children and young people where human factors are different. Objective: The objective of this review was to describe the relationship between human factors and adherence with technology for data logging processes in adults (> 18 years) with T1DM and to explore the factors which influence this association. Methods: A systematic literature review. Results: 18 studies were included in the review following a literature search using the PRISMA guidelines and a quality appraisal process. This included 3320 participants with a mean age of 42 years. Overall, adults felt more satisfied with their treatment on transition to advanced technology (insulin pump and CGM), the most significant contributing factor was when BG levels were consistently < 7.00mmol/l (P =.009). However, participants spent considerable time on their diabetes self-care. There was evidence that logging of data was positively correlated with increasing age with the use of an app that provided meaningful feedback (regression coefficient = 55.8 recordings/ year; P = 0.009). Furthermore, there were benefits of CGM use for older adults in mediating complexities and their fears of hypoglycemia with reported significant differences in well-being (P= .009). Qualitative studies within the review aimed to explore the use and uptake of technology within the context of everyday lives. Participants experienced ‘frustrations’ with CGM, CSII, calibration of devices and alarms. In addition, there were implications for ‘body image’ when carrying and using a device. This takes into account wide variations in individual use and interaction with technology across a continuum of sociocultural contexts. This has implications for the way in which future technologies are designed. Conclusions: Many of the quantitative studies in the review were limited by small sample sizes. This may make it difficult to generalize findings to other contexts. This is further limited by a sample that was predominantly Caucasian, well-controlled and engaged with their self-care. However, the use of critical appraisal frameworks has highlighted areas where research into human factors and data logging processes of individuals could be improved. This includes engaging people in the design of the technology, and further exploration of the way in which significant others impact on the behavior and attitude of the individual towards technology use

Exposure to, and searching for, information about suicide and self-harm on the Internet:Prevalence and predictors in a population based cohort of young adults

AbstractBackgroundThere is concern over the potential impact of the Internet on self-harm and suicidal behaviour, particularly in young people. However, little is known about the prevalence and patterns of suicide/self-harm related Internet use in the general population.MethodsCross sectional study of 3946 of the 8525 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) who were sent a self-report questionnaire including questions on suicide/self-harm related Internet use and self-harm history at age 21 years.ResultsSuicide/self-harm related Internet use was reported by 22.5% (886/3946) of participants; 11.9% (470/3946) had come across sites/chatrooms discussing self-harm or suicide, 8.2% (323/3946) had searched for information about self-harm, 7.5% (296/3946) had searched for information about suicide and 9.1% (357/3946) had used the Internet to discuss self-harm or suicidal feelings. Suicide/self-harm related Internet use was particularly prevalent amongst those who had harmed with suicidal intent (70%, 174/248), and was strongly associated with the presence of suicidal thoughts, suicidal plans, and history of self-harm. Sites offering help, advice, or support were accessed by a larger proportion of the sample (8.2%, 323/3946) than sites offering information on how to hurt or kill yourself (3.1%, 123/3946). Most individuals (81%) who had accessed these potentially harmful sites had also accessed help sites.Limitations(i) There were differences between questionnaire responders and non-responders which could lead to selection bias and (ii) the data were cross-sectional, and we cannot conclude that associations are causal.ConclusionsSuicide/self-harm related Internet use is common amongst young adults, particularly amongst those with suicidal thoughts and behaviour. Both harmful and helpful sites were accessed, highlighting that the Internet presents potential risks but also offers opportunities for suicide prevention

The HIKCUPS trial: a multi-site randomized controlled trial of a combined physical activity skill-development and dietary modification program in overweight and obese children

BACKGROUND: Childhood obesity is one of the most pressing health issues of our time. Key health organizations have recommended research be conducted on the effectiveness of well-designed interventions to combat childhood obesity that can be translated into a variety of settings. This paper describes the design and methods used in the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS) trial, an ongoing multi-site randomized controlled trial, in overweight/obese children comparing the efficacy of three interventions: 1) a parent-centered dietary modification program; 2) a child-centered physical activity skill-development program; and 3) a program combining both 1 and 2 above. METHODS/DESIGN: Each intervention consists of three components: i) 10-weekly face-to-face group sessions; ii) a weekly homework component, completed between each face-to-face session and iii) three telephone calls at monthly intervals following completion of the 10-week program. Details of the programs' methodological aspects of recruitment, randomization and statistical analyses are described here a priori. DISCUSSION: Importantly this paper describes how HIKCUPS addresses some of the short falls in the current literature pertaining to the efficacy of child obesity interventions. The HIKCUPS trial is funded by the National Medical Research Council, Australia