The critical role of second-order normative beliefs in predicting energy conservation

This is the author accepted manuscript. The final version is available from Springer Nature via the DOI in this recordSustaining large-scale public goods requires individuals to make environmentally friendly decisions today to benefit future generations. Recent research suggests that second-order normative beliefs are more powerful predictors of behaviour than first-order personal beliefs. We explored the role that second-order normative beliefs—the belief that community members think that saving energy helps the environment—play in curbing energy use. We first analysed a data set of 211 independent, randomized controlled trials conducted in 27 US states by Opower, a company that uses comparative information about energy consumption to reduce household energy usage (pooled N = 16,198,595). Building off the finding that the energy savings varied between 0.81% and 2.55% across states, we matched this energy use data with a survey that we conducted of over 2,000 individuals in those same states on their first-order personal and second-order normative beliefs. We found that second-order normative beliefs predicted energy savings but first-order personal beliefs did not. A subsequent pre-registered experiment provides causal evidence for the role of second-order normative beliefs in predicting energy conservation above first-order personal beliefs. Our results suggest that second-order normative beliefs play a critical role in promoting energy conservation and have important implications for policymakers concerned with curbing the detrimental consequences of climate change

Crassostrea Ariakensis In Chesapeake Bay: Growth, Disease And Mortality In Shallow Subtidal Environments

In April 2004, triploid native (Crassostrea virginica) and nonnative (Crassostrea ariakensis) oysters were deployed in cages at four sites along a salinity gradient in Chesapeake Bay. In Maryland, the lowest salinity site was located in the Severn River and two low to mid-salinity sites were located in the Choptank and Patuxent Rivers. The highest salinity site was located in the York River in Virginia. Growth, disease acquisition, and mortality were measured in the deployed oysters through August 2006. Although ANOVA revealed that the nonnative oysters were significantly larger at the end of the experiment than the native oysters at all sites, the differences were much greater at the Virginia site (59 mm) than in Maryland waters (9-23 mm). With the exception of C. ariakensis in the Severn River, Perkinsus marinus infected both species at all sites. Prevalences and weighted prevalences in both species remained relatively low throughout the experiment, but native oysters consistently acquired higher prevalences and weighted prevalences than C. ariakensis by August 2006. With the exception of several mortality-inducing events including winter freezing and hypoxic exposure, mortality was generally low in both species. No disease-related mortality was suspected in either species given the low weighted prevalences observed. In the York River, where a substantial natural spatfall occurred in 2004, more native spat were found on C. ariakensis than on C. virginica. To our knowledge, this is the first comparison of triploid C. ariakensis to triploid C. virginica conducted in the field. Because we did not observe substantial disease-related mortality, it is too soon to draw conclusions regarding the disease tolerance of C. ariakensis in the field or its viability as a replacement for the native species

Self-Affirmation Improves Problem-Solving under Stress

High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings. © 2013 Creswell et al

Health care's response to climate change: a carbon footprint assessment of the NHS in England

Background: Climate change threatens to undermine the past 50 years of gains in public health. In response, the National Health Service (NHS) in England has been working since 2008 to quantify and reduce its carbon footprint. This Article presents the latest update to its greenhouse gas accounting, identifying interventions for mitigation efforts and describing an approach applicable to other health systems across the world. Methods: A hybrid model was used to quantify emissions within Scopes 1, 2, and 3 of the Greenhouse Gas Protocol, as well as patient and visitor travel emissions, from 1990 to 2019. This approach complements the broad coverage of top-down economic modelling with the high accuracy of bottom-up data wherever available. Available data were backcasted or forecasted to cover all years. To enable the identification of measures to reduce carbon emissions, results were disaggregated by organisation type. Findings: In 2019, the health service's emissions totalled 25 megatonnes of carbon dioxide equivalent, a reduction of 26% since 1990, and a decrease of 64% in the emissions per inpatient finished admission episode. Of the 2019 footprint, 62% came from the supply chain, 24% from the direct delivery of care, 10% from staff commute and patient and visitor travel, and 4% from private health and care services commissioned by the NHS. Interpretation: This work represents the longest and most comprehensive accounting of national health-care emissions globally, and underscores the importance of incorporating bottom-up data to improve the accuracy of top-down modelling and enabling detailed monitoring of progress as health systems act to reduce emissions. Funding: Wellcome Trust

Female Sex Worker Social Networks and STI/HIV Prevention in South China

Reducing harm associated with selling and purchasing sex is an important public health priority in China, yet there are few examples of sustainable, successful programs to promote sexual health among female sex workers. The limited civil society and scope of nongovernmental organizations circumscribe the local capacity of female sex workers to collectively organize, advocate for their rights, and implement STI/HIV prevention programs. The purpose of this study was to examine social networks among low-income female sex workers in South China to determine their potential for sexual health promotion.Semi-structured interviews with 34 low-income female sex workers and 28 health outreach members were used to examine how social relationships affected condom use and negotiation, STI/HIV testing and health-seeking behaviors, and dealing with violent clients. These data suggested that sex worker's laoxiang (hometown social connections) were more powerful than relationships between women selling sex at the same venue in establishing the terms and risk of commercial sex. Female sex workers from the same hometown often migrated to the city with their laoxiang and these social connections fulfilled many of the functions of nongovernmental organizations, including collective mobilization, condom promotion, violence mitigation, and promotion of health-seeking behaviors. Outreach members observed that sex workers accompanied by their laoxiang were often more willing to accept STI/HIV testing and trust local sexual health services.Organizing STI/HIV prevention services around an explicitly defined laoxiang social network may provide a strong foundation for sex worker health programs. Further research on dyadic interpersonal relationships between female sex workers, group dynamics and norm establishment, and the social network characteristics are needed

Factors Influencing Physicians’ Screening Behavior for Liver Cancer Among High-risk Patients

BACKGROUND: Little is known about physicians’ screening patterns for liver cancer despite its rising incidence. OBJECTIVE: Describe physician factors associated with liver cancer screening. DESIGN: Mailed survey. PARTICIPANTS: Physicians practicing in family practice, internal medicine, gastroenterology, or nephrology in 3 northern California counties in 2004. MEASUREMENTS: Sociodemographic and practice measures, liver cancer knowledge, attitudes, and self-reported screening behaviors. RESULTS: The response rate was 61.8% (N = 459). Gastroenterologists (100%) were more likely than Internists (88.4%), family practitioners (84.2%), or nephrologists (75.0%) to screen for liver cancer in high-risk patients (p = 0.016). In multivariate analysis, screeners were more likely than nonscreeners to think that screening for liver cancer reduced mortality (odds ratio [OR] 1.60, CI 1.09–2.34) and that not screening was a malpractice risk (OR 1.88, CI 1.29–2.75). Screeners were more likely than nonscreeners to order any screening test if it was a quality of care measure (OR 4.39, CI 1.79–10.81). CONCLUSIONS: Despite debate about screening efficacy, many physicians screen for liver cancer. Their screening behavior is influenced by malpractice and quality control concerns. More research is needed to develop better screening tests for liver cancer, to evaluate their effectiveness, and to understand how physicians behave when there is insufficient evidence

Mucosal atrophy in collagenous colitis: a case report

<p>Abstract</p> <p>Background</p> <p>Mucosal atrophy as a potential cause of impaired colonic compliance has not yet been described as a complication in Collagenous Colitis (CC).</p> <p>Case presentation</p> <p>We present a 51-year-old female patient with a 20-year history of diarrhea and diagnosed with CC ten years prior to her presentation. We reviewed reports from three colonoscopies performed after the diagnosis. Overall 12 biopsies obtained in the last two colonoscopies were re-analyzed by two pathologists blinded to the aim of the study. Besides the typical histological findings of CC, the endoscopic appearance was normal, and no histological signs of atrophy were found during the first colonoscopy. Surprisingly, the second and third colonoscopy revealed a region of advanced segmental mucosal atrophy in the cecum with the mucosal height normalizing toward the transverse colon. This pattern of atrophy was inversely related to the pattern of sub-epithelial collagen deposition, which increased toward the rectum.</p> <p>Conclusion</p> <p>If no chance occurrence, our observation supports the idea that additional factors, probably luminal in nature, may be co-responsible for the mucosal atrophy in this case. Thus, mucosal atrophy in the proximal colon appears to be a new candidate among the growing list of rare complications associated with long standing CC.</p

Comparative Effectiveness of Stereo-EEG versus Subdural Grids in Epilepsy Surgery

OBJECTIVE: To compare the outcomes of subdural electrode (SDE) implantations versus stereo-electroencephalography (SEEG), the two predominant methods of intracranial EEG (iEEG) performed in difficult to localize drug-resistant focal epilepsy. METHODS: The Surgical Therapies Commission of the International League Against Epilepsy created an international registry of iEEG patients implanted between 2005-2019 with ≥ 1 year follow-up. We used propensity score matching to control exposure selection bias and generate comparable cohorts. Study endpoints: 1) likelihood of resection after iEEG; 2) seizure-freedom at last follow-up; and 3) complications (composite of either post-operative infection, symptomatic intracranial hemorrhage, or permanent neurologic deficit). RESULTS: Ten study sites from seven countries and three continents contributed 2,012 patients, including 1,468 (73%) eligible for analysis (526 SDE, 942 SEEG) of whom 988 (67%) underwent subsequent resection. Propensity score matching improved covariate balance between exposure groups for all analyses. Propensity-matched patients who underwent SDE had higher odds of subsequent resective surgery (odds ratio OR = 1.4, 95% CI 1.05 - 1.84), and higher odds of complications (OR=2.24, 95% CI 1.34-3.74; unadjusted: 9.6% after SDE vs. 3.3% after SEEG). Odds of seizure-freedom in propensity-matched resected patients were 1.66 times higher (95% CI 1.21, 2.26) for SEEG compared to SDE (unadjusted: 55% seizure-free after SEEG-guided resections vs. 41% after SDE) INTERPRETATION: Compared to SEEG, SDE evaluations are more likely to lead to brain surgery in patients with drug-resistant epilepsy, but have more surgical complications and lower probability of seizure-freedom. This comparative-effectiveness study provides the highest feasible evidence level to guide decisions on iEEG. This article is protected by copyright. All rights reserved

Coextensive space: virtual reality and the developing relationship between the body, the digital and physical space

Virtual Reality (VR) has traditionally required external sensors placed around a designated play space. In contrast, more recent wired and wireless systems, such as the Oculus Rift S (released in March 2019) and the Oculus Quest (released in May 2019) use cameras located on the outside of these devices to monitor their physical position. Users can now mark out a physical space that is then digitally tracked within their display. Once a play space has been established, users are alerted if they come close to breaching this boundary by the visual inclusion of a grid. Should this threshold be breached, the headset display shifts to an image of the surrounding concrete environment. We contend that physical space is increasingly being incorporated into the digital space of VR in a manner that meaningfully differs from older systems. We build our argument in the following way. First, the article explores how theories surrounding VR have implicated only a limited relationship with physical space. Second, the article introduces the concept of coextensive space as a way of understanding the developing relationship between the physical, digital and concrete reality enacted by current VR systems