Slip inversion along inner fore-arc faults, eastern Tohoku, Japan

The kinematics of deformation in the overriding plate of convergent margins may vary across timescales ranging from a single seismic cycle to many millions of years. In Northeast Japan, a network of active faults has accommodated contraction across the arc since the Pliocene, but several faults located along the inner fore arc experienced extensional aftershocks following the 2011 Tohoku-oki earthquake, opposite that predicted from the geologic record. This observation suggests that fore-arc faults may be favorable for stress triggering and slip inversion, but the geometry and deformation history of these fault systems are poorly constrained. Here we document the Neogene kinematics and subsurface geometry of three prominent fore-arc faults in Tohoku, Japan. Geologic mapping and dating of growth strata provide evidence for a 5.6–2.2 Ma initiation of Plio-Quaternary contraction along the Oritsume, Noheji, and Futaba Faults and an earlier phase of Miocene extension from 25 to 15 Ma along the Oritsume and Futaba Faults associated with the opening of the Sea of Japan. Kinematic modeling indicates that these faults have listric geometries, with ramps that dip ~40–65°W and sole into subhorizontal detachments at 6–10 km depth. These fault systems can experience both normal and thrust sense slip if they are mechanically weak relative to the surrounding crust. We suggest that the inversion history of Northeast Japan primed the fore arc with a network of weak faults mechanically and geometrically favorable for slip inversion over geologic timescales and in response to secular variations in stress state associated with the megathrust seismic cycle.Funding was provided by a grant from the National Science Foundation Tectonics Program grant EAR-0809939 to D.M.F. and E.K., Geologic Society of America Graduate Research Grants, and the P.D. Krynine Memorial Fund. The authors thank Gaku Kimura, Kyoko Tonegawa, Hiroko Watanabe, Jun Kameda, and Asuka Yamaguchi for scientific and logistical support, and Kristin Morell for comments on early versions of the manuscript. We also thank Yuzuru Yamamoto and Kohtaro Ujiie for their detailed reviews and suggestions for improvement to the manuscript. The authors acknowledge the use of the Move Software Suite granted by Midland Valley's Academic Software Initiative. Geologic, structural, stratigraphic, and chronologic data used herein are accessible in manuscript figures, and in the citations therein. Input geologic data for trishear kinematic modeling can be accessed in Table 1 and in the supporting information. (EAR-0809939 - National Science Foundation Tectonics Program grant; Geologic Society of America Graduate Research Grants; P.D. Krynine Memorial Fund

"We are everything to everyone": a systematic review of factors influencing the accountability relationships of Aboriginal and Torres Strait Islander health workers (AHWs) in the Australian health system

Background: Health policy in Australia positions Aboriginal and Torres Strait Islander Health Workers (AHWs) as central to improving Aboriginal and Torres Strait Islander peoples' health, with high expectations of their contribution to closing the gap between Indigenous and non-Indigenous health outcomes. Understanding how AHWs' governance and accountability relationships influence their ability to address such health inequities has policy, programme and ethical significance. We sought to map the evidence of AHWs' experiences of accountability in the Australian health system. Methods: We followed an adapted qualitative systematic review process to map evidence on accountability relations in the published literature. We sought empirical studies or first-person accounts describing AHWs' experiences of working in government or Aboriginal community-controlled services anywhere in Australia. Findings were organised according to van Belle and Mayhew's four dimensions of accountability – social, political, provider and organisational. Results: Of 27 included studies, none had a primary focus on AHW governance or AHWs' accountability relationships. Nonetheless, selected articles provided some insight into AHWs' experiences of accountability across van Belle and Mayhew's four dimensions. In the social dimension, AHWs' sense of connection and belonging to community was reflected in the importance placed on AHWs' cultural brokerage and advocacy functions. But social and cultural obligations overlapped and sometimes clashed with organisational and provider-related accountabilities. AHWs described having to straddle cultural obligations (e.g. related to gender, age and kinship) alongside the expectations of non-Indigenous colleagues and supervisors which were underpinned by 'Western' models of clinical governance and management. Lack of role-clarity stemming from weakly constituted (state-based) career structures was linked to a system-wide misunderstanding of AHWs' roles and responsibilities – particularly the cultural components – acting as a barrier to AHWs working to their full capacity for the benefit of patients, broader society and their own professional satisfaction. Conclusions: In literature spanning different geographies, service domains and several decades, this review found evidence of complexity in AHWs’ accountability relationships that both affects individual and team performance. However, theoretically informed and systematic investigation of accountability relationships and related issues, including the power dynamics that underpin AHW governance and performance in often diverse settings, remains limited and more work in this area is required

An evidence map of the effect of Tai Chi on health outcomes.

BackgroundThis evidence map describes the volume and focus of Tai Chi research reporting health outcomes. Originally developed as a martial art, Tai Chi is typically taught as a series of slow, low-impact movements that integrate the breath, mind, and physical activity to achieve greater awareness and a sense of well-being.MethodsThe evidence map is based on a systematic review of systematic reviews. We searched 11 electronic databases from inception to February 2014, screened reviews of reviews, and consulted with topic experts. We used a bubble plot to graphically display clinical topics, literature size, number of reviews, and a broad estimate of effectiveness.ResultsThe map is based on 107 systematic reviews. Two thirds of the reviews were published in the last five years. The topics with the largest number of published randomized controlled trials (RCTs) were general health benefits (51 RCTs), psychological well-being (37 RCTs), interventions for older adults (31 RCTs), balance (27 RCTs), hypertension (18 RCTs), fall prevention (15 RCTs), and cognitive performance (11 RCTs). The map identified a number of areas with evidence of a potentially positive treatment effect on patient outcomes, including Tai Chi for hypertension, fall prevention outside of institutions, cognitive performance, osteoarthritis, depression, chronic obstructive pulmonary disease, pain, balance confidence, and muscle strength. However, identified reviews cautioned that firm conclusions cannot be drawn due to methodological limitations in the original studies and/or an insufficient number of existing research studies.ConclusionsTai Chi has been applied in diverse clinical areas, and for a number of these, systematic reviews have indicated promising results. The evidence map provides a visual overview of Tai Chi research volume and content.Systematic review registrationPROSPERO CRD42014009907

Through the Looking Glass: An Autoethnographic View of the Perceptions of Race and Institutional Support in the Tenure Process

This autoethnography study reflects on the experiences of three assistant professors of different races of the tenure process at a large public research university. The study was framed by social cognitive career theory (SCCT), which is often used to describe career interest and career choice in a variety of professional domains, considering cognitive - personal, environmental, and experiential factors (Lent, 2005; Tang, Pan, & Newmeyer, 2008). Despite the commonality of the journey through the tenure process, everyone’s path looks different. Isolation, collegial relationships, and for some, unusually high service commitments and family responsibilities, whether because of gender or race, have provided a back drop for the lives of women in academe and have, in large part, defined their experiences on the tenure track. The results of the reflections of our experiences identify that environmental variables are important to the success of tenure seeking faculty

Cancer survivors treated with platinum-based chemotherapy affected by ototoxicity and the impact on quality of life: a narrative synthesis systematic review

© 2019, © 2019 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society. Objective: To identify any change in quality of life (QoL) caused by chemotherapy-induced toxicities, such as hearing loss and tinnitus, to provide information in order to improve services and aid clinicians in their decision-making. Design: This systematic review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. The search terms were cancer, platinum-based chemotherapy, ototoxicity and “quality of life”. Titles and abstracts, followed by full texts, were screened by two independent researchers. The relevant data were extracted and quality analysis was performed using the NIH Quality Assessment Tool. Study sample: About 308 titles and abstracts were screened, and 27 full-text articles were screened. Ten articles representing 11 studies were included in the review. Study design included cross-sectional studies, randomised control trials and longitudinal studies. Results: Diagnostic criteria consisted of audiograms, questionnaires and patient complaints. The study quality ranged from 21.43% to 85.71%. Overall results found that those treated with cisplatin had more hearing loss and tinnitus than those treated with other therapies. Furthermore, those with hearing loss and tinnitus were more likely to have a lower QoL. Conclusions: There is an urgent need to standardise diagnostics when investigating ototoxicity and its effect on QoL, particularly for research into risk factors, prevention and management

"'Academic' is a dirty word": intended impact pathways of an emerging academic health centre in tropical regional Australia

Background: The Tropical Australian Academic Health Centre (TAAHC) is being established in northern Queensland across a vast rural geography. The study aim is to identify intended impact pathways and beneficiaries of TAAHC as well as experienced and anticipated challenges. Methodology: The study is an empirical case study nested within a comparative multi‐case study on academic health centres (AHCs). Data were collected from documents, observation, and interviews with 24 health system and university stakeholders. Intended impact pathways were identified abductively from analysis of aspirations and challenges. Results: Aspirations of TAAHC reflect an ultimate aim to improve the health of the northern Queensland population. Challenges were trust and communication, understanding value and return on investment, health system receptiveness to building a research culture, prioritising and influencing the research agenda, and structure of the health system. Discussion: The study identifies three interdependent transitions that comprise the main intended impact pathway in TAAHC. Stakeholders expected TAAHC to effect health systems change and improvement rather than drive discovery‐oriented academic research associated with AHCs elsewhere. Conclusion: The findings contribute to the empirical evidence base on the role of AHCs internationally and to ongoing initiatives to establish and resource AHCs in Australia

Implementation of an Interprofessional Medication Therapy Management Experience

Objective. To measure the impact of an interprofessional experience (IPE) in medication therapy management (MTM) on students' attitudes and skills regarding interprofessional collaboration (IPC). Methods. This interprofessional MTM experience spanned three weeks, with health science students (medicine, nursing, nutrition, and pharmacy) meeting once weekly. The IPE facilitated interprofessional student collaboration via small-group sessions to conduct MTM consultations for patients with complex chronic conditions. Student learning and attitudinal changes were evaluated by comparing pre- and post-IPE survey responses and a qualitative summary of the students' clinical recommendations. Efficacy of student groups was measured via patient satisfaction surveys and was reported by frequency of response. Results. Twenty-seven students participated in the program and 22 completed both pre- and post-IPE surveys (81% response rate). The survey included open-ended and Likert-type items assessing students' attitudes and skills regarding the IPE as well as their reactions to the experience. Significant changes were observed for two attitudinal items regarding interprofessional teams: maintaining enthusiasm/interest and responsiveness to patients' emotional and financial needs. Patient-reported satisfaction and students' complex clinical recommendations provided further evidence of student learning. Conclusion. This novel IPE in MTM promoted interprofessional collaboration and education in this unique patient care area. Students' attitudes toward and skills in interprofessional collaboration improved, and the patients who received care reported positive experiences. Many health professions programs face challenges in meeting IPE requirements. The results of our study may provide the impetus for other institutions to develop similar programs to meet this urgent need.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

The population health role of academic health centres: a multiple-case exploratory study in Australia and England

Background: Academic health centres (AHCs) are organisations that aim to mobilise knowledge into practice by improving the responsiveness of health systems to emerging evidence. This study aims to explore the population health role of AHCs in Australia and England, where AHCs represent novel organisational forms. Methods: A multiple-case study design using qualitative methods was used to explore population health goals and activities in four discrete AHCs in both countries during 2017 and 2018. Data from 85 interviews with AHC leaders, clinicians and researchers, direct observation, and documentation were analysed within and across the cases. Results: Comparison across cases produced four cross-case themes: health care rather than population health; incremental rather than major health system change; different conceptions of “translation” and “innovation”; and unclear pathways to impact. The ability of the AHCs to define and enact a population health role was hindered during the study period by gaps in knowledge mobilisation strategies at a health system and policy level, the biomedical orientation of government designation schemes for AHCs in Australia and England, and competing expectations of the sovereign partner organisations in AHCs against a backdrop of limited operational resources. Discussion: The study identifies several institutional elements that are likely to be needed for AHCs in Australia and England to deliver on both internal and external expectations of their population health role

Emerging Regulatory Experiments in Permit Process Coordination for Endangered Species and Aquatic Resources in California

The interconnected relationship between California’s wetlands and endangered species has spurred recent efforts to coordinate endangered species permitting under federal and state endangered species laws with freshwater aquatic resource permits under the federal Clean Water Act and analogous state laws. The University of California, Irvine School of Law Center for Land, Environment, and Natural Resources surveyed these emerging permit coordination efforts among several proposed and existing California Habitat Conservation Plans/Natural Community Conservation Plans. This Article explores these nascent initiatives, including the coordinating tools they have tested, the anticipated benefits, and the already observed challenges. Preliminary evidence suggests that clearer guidance from federal agency headquarters, building on recent Presidential interagency initiatives in infrastructure permitting, would likely provide the best opportunity to promote beneficial permit coordination while minimizing potential drawbacks