Seasonal nitrate dynamics in an agriculturally influenced New Hampshire headwater stream

Nitrate (NO3-) uptake and denitrification in small headwater streams can have significant implications for downstream water quality. I measured seasonal NO3- uptake and longitudinal patterns in potential sediment denitrification in a New Hampshire agriculturally influenced stream during 2009. NO3- uptake was measured through short-term NO3- enrichments and potential denitrification was measured using the Chloramphenicol-amended acetylene-inhibition method. NO3 - was taken up in autumn but not in spring or summer. In autumn, on average 87% of the daily NO3- load was taken up and a maximum of 4% was removed via denitrification. Results suggest that, in this stream, carbon availability from leaf fall drives NO3 - uptake primarily via heterotrophic assimilation. This study helps to better characterize controls on NO3- uptake and denitrification in New England, where few such studies have been conducted on agricultural streams, and where seasons are pronounced

Visual Communications: An Analysis of University Students\u27 Perceptions of Rural America Based on Selected Photographs

Urban populations have been outgrowing rural populations since the 1920s. Studies exploring the shift in rural residents have noted items such as the job market, economy, and conveniences as factors of this change. However, few studies have been completed to examine mass media’s role in this trend. The purpose of this study was to explore college students’ perceptions about rural America, based on images selected from newspapers. This qualitative study consisted of five focus groups: two focus groups conducted at the 2009 Agricultural Communicators of Tomorrow’s (ACT) Professional Development Conference in Stillwater, Oklahoma (agricultural student focus), and three conducted at Texas A&M University (non-agricultural student focus). The focus groups followed Krueger’s (1998a, 1998b) method of questioning. Focus groups were recorded, and data was transcribed and analyzed. Common themes such as culture / values, efficiency / conservation, experience from environment, experience through observation, lack of technology, lack of accurate information, media impact / framing, occupation, proximity, relationship / ties, and stereotypes were found in both groups; however, the agricultural group indicated stronger ties to rural America. This study noted further research must be conducted to understand the total effects visual media has on rural America perceptions

Cognitive impairment negatively impacts allied health service uptake: Investigating the association between health and service use.

There is widespread concern about the potential impact on health and social care services of the ageing population and long-term health conditions, such as dementia. To effectively plan services it is important to understand current need and use and identify gaps in provision. Using data from the Cognitive Function and Ageing Study Wales (CFAS Wales), we used logistic regression to model the relationship between health (self-rated health, cognitive impairment, and activities of daily living), and the use of health and care services. CFAS Wales is a longitudinal cohort study of people aged 65 years and over, in two areas in Wales, UK, over-sampling those aged 75 years and over. Participants (n = 3593) answered a wide range of health and lifestyle questions and completed a variety of cognitive and physical health assessments. Data from 3153 people from wave 1 and 1968 people from wave 2 were analysed. As anticipated we found poorer health, on some indicators, predicted greater service use, including social care, hospital, general practitioner, and nursing services. However, cognitive impairment did not predict greater service use, except for social care. Controlling for age, sex, socio-economic status, social connection indices and area environment, conversely we found lower reported uptake of allied health services by people with cognitive impairment. Further analysis showed that people with a cognitive impairment were less likely to report having a sight-check or seeing a dentist in the previous year, a finding replicated in wave 2. These differences were not explained by transportation issues. In contrast, we did not find a significant difference in reported uptake of hearing checks or physiotherapist use, with mixed evidence of differences in chiropodist visits. Not accessing these preventative services may not only exacerbate existing conditions but have further downstream negative consequences for health and well-being in people who are cognitively impaired.Article written in collaboration with the CFAS WALES research team

Role of Foreign-Born Status on Suicide Mortality in Spain Between 2000 and 2019: An Age-Period-Cohort Analysis

Objectives: To examine recent age-period-cohort effects on suicide among foreign-born individuals, a particularly vulnerable sociodemographic group in Spain. Methods: Using 2000-2019 mortality data from Spain's National Institute of Statistics, we estimated age-period-cohort effects on suicide mortality, stratified by foreign-born status (native- vs. foreign-born) and, among the foreign-born, by Spanish citizenship status, a proxy for greater socioeconomic stability. Results: Annual suicide mortality rates were lower among foreign- than native-born individuals. There was heterogeneity in age-period-cohort effects between study groups. After 2010, suicide mortality increased markedly among the foreign-born-especially for female cohorts born around 1950, and slightly among native-born women-especially among female cohorts born after the 1960s. Among native-born men, suicide increased linearly with age and remained stable over time. Increases in suicide among the foreign-born were driven by increases among individuals without Spanish citizenship-especially among cohorts born after 1975. Conclusion: After 2010, suicide in Spain increased markedly among foreign-born individuals and slightly among native-born women, suggesting an association between the downstream effects of the 2008 economic recession and increases in suicide mortality among socioeconomically vulnerable populations.This work was supported by the National Institute of Mental Health (Grant number R01-MH121410) and the Instituto de Salud Carlos III (Grant number FIS PI19CIII/00037). The funders had no role in the conception, design, or execution of the study.S

Lake Michigan’s suitability for bigheaded carp: The importance of diet flexibility and subsurface habitat

As bighead (Hypophthalmichthys nobilis) and silver carp (Hypophthalmichthys molitrix)—collectively bigheaded carp (BHC)—arrive at Lake Michigan’s doorstep, questions remain as to whether there is sufficient food to support these invasive filter‐feeding fishes in the upper Laurentian Great Lakes. Previous studies suggest that suitable BHC habitat is limited to a few productive, nearshore areas. However, those studies did not consider the influence of BHC’s diet plasticity or the presence of spatially‐discrete subsurface prey resources. This study aimed to characterise Lake Michigan’s suitability for BHC and evaluate the importance of these considerations in habitat suitability assessments.We used simulated outputs of prey biomass (phytoplankton, zooplankton, and detritus) and water temperature from a three‐dimensional biophysical model of Lake Michigan to evaluate growth rate potential (GRP, quantitative index of habitat suitability) of adult BHC throughout the entire volume of the lake. Our GRP model applied a foraging model and a bioenergetics model to translate prey concentrations and water temperatures into habitat quality indexed by individual fish growth rate. We defined suitable habitat as habitats that can support GRP ≥ 0 g g−1 day−1. We developed six feeding scenarios to evaluate the impact of diet flexibility and subsurface prey resources on suitable habitat quantity. Scenarios were defined by the number of prey types the fish could consume and the depths at which they could feed (surface or whole water column).Consistent with previous studies, we found that habitats with the highest quality were concentrated near river mouths and in eutrophic areas of Green Bay. However, in contrast to previous studies, we found suitable offshore habitat for bighead carp owing to our added considerations of diet plasticity and subsurface prey resources. For silver carp, these considerations extended suitable habitat within Green Bay and in some tributary‐influenced nearshore areas, but offshore areas remained predominantly unsuitable in all feeding scenarios. Differences in simulated habitat suitability between these two species probably reflect differences in energy density and mass of the specific fishes we used in our model. However, reports of these two species in environments where they coexist indicate that bighead carp grow at faster rates than silver carp, as our model simulated.Our vertical analysis at Muskegon, MI, U.S.A. indicates that subsurface temperature and prey biomass are not only sufficient to support bighead carp growth but provide maximum habitat quality during late summer stratification.Overall, our study demonstrates that BHC are capable of surviving and growing in much larger areas of Lake Michigan than predicted by previous studies, and thus suggests that the risk of establishment is not sufficiently reduced by low plankton concentrations. Maps generated by our model identified the potential for cross‐lake migration corridors that may facilitate and accelerate lake‐wide movements. We believe these maps could be used to prioritise surveillance protocols by identifying areas to which BHC might spread upon entering the lake. More broadly, this research demonstrates how the physiology and trophic ecology of BHC contributes to their high invasive capacity and can permit their survival in novel environments.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151968/1/fwb13382_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151968/2/fwb13382.pd

Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure ulcers in high-risk patients: the PRESSURE 2 RCT

Background: Pressure ulcers (PUs) are a burden to patients, carers and health-care providers. Specialist mattresses minimise the intensity and duration of pressure on vulnerable skin sites in at-risk patients. Primary objective: Time to developing a new PU of category ≥ 2 in patients using an alternating pressure mattress (APM) compared with a high-specification foam mattress (HSFM). Design: A multicentre, Phase III, open, prospective, planned as an adaptive double-triangular group sequential, parallel-group, randomised controlled trial with an a priori sample size of 2954 participants. Randomisation used minimisation (incorporating a random element). Setting: The trial was set in 42 secondary and community inpatient facilities in the UK. Participants: Adult inpatients with evidence of acute illness and at a high risk of PU development. Interventions and follow-up: APM or HSFM – the treatment phase lasted a maximum of 60 days; the final 30 days were post-treatment follow-up. Main outcome measures: Time to event. Results: From August 2013 to November 2016, 2029 participants were randomised to receive either APM (n = 1016) or HSFM (n = 1013). Primary end point – 30-day final follow-up: of the 2029 participants in the intention-to-treat population, 160 (7.9%) developed a new PU of category ≥ 2. There was insufficient evidence of a difference between groups for time to new PU of category ≥ 2 [Fine and Gray model HR 0.76, 95% confidence interval (CI) 0.56 to 1.04; exact p-value of 0.0890 and 2% absolute difference]. Treatment phase sensitivity analysis: 132 (6.5%) participants developed a new PU of category ≥ 2 between randomisation and end of treatment phase. There was a statistically significant difference in the treatment phase time-to-event sensitivity analysis (Fine and Gray model HR 0.66, 95% CI 0.46 to 0.93; p = 0.0176 and 2.6% absolute difference). Secondary end points – 30-day final follow-up: new PUs of category ≥ 1 developed in 350 (17.2%) participants, with no evidence of a difference between mattress groups in time to PU development, (Fine and Gray model HR 0.83, 95% CI 0.67 to 1.02; p-value = 0.0733 and absolute difference 3.1%). New PUs of category ≥ 3 developed in 32 (1.6%) participants with insufficient evidence of a difference between mattress groups in time to PU development (Fine and Gray model HR 0.81, 95% CI 0.40 to 1.62; p = 0.5530 and absolute difference 0.4%). Of the 145 pre-existing PUs of category 2, 89 (61.4%) healed – there was insufficient evidence of a difference in time to healing (Fine and Gray model HR 1.12, 95% CI 0.74 to 1.68; p = 0.6122 and absolute difference 2.9%). Health economics – the within-trial and long-term analysis showed APM to be cost-effective compared with HSFM; however, the difference in costs models are small and the quality-adjusted life-year gains are very small. There were no safety concerns. Blinded photography substudy – the reliability of central blinded review compared with clinical assessment for PUs of category ≥ 2 was ‘very good’ (kappa statistic 0.82, prevalence- and bias-adjusted kappa 0.82). Quality-of-life substudy – the Pressure Ulcer Quality of Life – Prevention (PU-QoL-P) instrument meets the established criteria for reliability, construct validity and responsiveness. Limitations: A lower than anticipated event rate. Conclusions: In acutely ill inpatients who are bedfast/chairfast and/or have a category 1 PU and/or localised skin pain, APMs confer a small treatment phase benefit that is diminished over time. Overall, the APM patient compliance, very low PU incidence rate observed and small differences between mattresses indicate the need for improved indicators for targeting of APMs and individualised decision-making. Decisions should take into account skin status, patient preferences (movement ability and rehabilitation needs) and the presence of factors that may be potentially modifiable through APM allocation, including being completely immobile, having nutritional deficits, lacking capacity and/or having altered skin/category 1 PU. Future work: Explore the relationship between mental capacity, levels of independent movement, repositioning and PU development. Explore ‘what works for whom and in what circumstances’. Trial registration: Current Controlled Trials ISRCTN01151335. Funding: This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 52. See the NIHR Journals Library website for further project information

Enhancing audiology students’ understanding of person-centered care: insights from an multi-national virtual student conference

Objective: This project sought to investigate the impact of a multi-national peer learning initiative in facilitating a student-led conference on person-centred care (PCC). The primary objective was to assess students’ comprehension of PCC elements before and after engaging in the opportunity, with a concurrent evaluation of the efficacy of the opportunity. Design: A mixed-methods study protocol was followed. Following the conference, participants completed a four-part survey including (a) demographics, (b) retrospective pre-post Likert scale, (c) Likert rating of conference experience and (d) five open-ended questions. Study sample: One hundred and four participants (92.4% female) with a mean age of 21 years (0.07 SD) participated in the study. Results: A significant difference in awareness pre-post conference was demonstrated across all topics (WSR, p < 0.001) with participants satisfied with the conference. Qualitative analysis revealed three main themes: (a) application of PCC; (b) perspectives of PCC; and () barriers to PCC; with nine sub-themes. Conclusion: The conference was beneficial in enhancing students’ awareness of topics and principles of PCC. Innovative pedagogical approaches should be considered in order to enhance healthcare education allowing future clinicians to better meet the dynamic needs of their clients

Visible and near-infrared multispectral analysis of geochemically measured rock fragments at the Opportunity landing site in Meridiani Planum

We have used visible and near‐infrared Panoramic Camera (Pancam) spectral data acquired by the Opportunity rover to analyze 15 rock fragments at the Meridiani Planum landing site. These spectral results were then compared to geochemistry measurements made by the in situ instruments M&ouml;ssbauer (MB) and Alpha Particle X‐ray Spectrometer (APXS) to determine the feasibility of mineralogic characterization from Pancam data. Our results suggest that dust and alteration rinds coat many rock fragments, which limits our ability to adequately measure the mineralogy of some rocks from Pancam spectra relative to the different field of view and penetration depths of MB and APXS. Viewing and lighting geometry, along with sampling size, also complicate the spectral characterization of the rocks. Rock fragments with the same geochemistry of sulfate‐rich outcrops have similar spectra, although the sulfate‐rich composition cannot be ascertained based upon Pancam spectra alone. FeNi meteorites have spectral characteristics, particularly ferric oxide coatings, that generally differentiate them from other rocks at the landing site. Stony meteorites and impact fragments with unknown compositions have a diverse range of spectral properties and are not well constrained nor diagnostic in Pancam data. Bounce Rock, with its unique basalt composition, is easily differentiated in the Pancam data from all other rock types at Meridiani Planum. Our Pancam analyses of small pebbles adjacent to these 15 rock fragments suggests that other rock types may exist at the landing site but have not yet been geochemically measured

Establishing a core outcome set for peritoneal dialysis : report of the SONG-PD (standardized outcomes in nephrology-peritoneal dialysis) consensus workshop

Outcomes reported in randomized controlled trials in peritoneal dialysis (PD) are diverse, are measured inconsistently, and may not be important to patients, families, and clinicians. The Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative aims to establish a core outcome set for trials in PD based on the shared priorities of all stakeholders. We convened an international SONG-PD stakeholder consensus workshop in May 2018 in Vancouver, Canada. Nineteen patients/caregivers and 51 health professionals attended. Participants discussed core outcome domains and implementation in trials in PD. Four themes relating to the formation of core outcome domains were identified: life participation as a main goal of PD, impact of fatigue, empowerment for preparation and planning, and separation of contributing factors from core factors. Considerations for implementation were identified: standardizing patient-reported outcomes, requiring a validated and feasible measure, simplicity of binary outcomes, responsiveness to interventions, and using positive terminology. All stakeholders supported inclusion of PD-related infection, cardiovascular disease, mortality, technique survival, and life participation as the core outcome domains for PD