Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment

Objective: We modeled design factors influencing the intent to use a university mental health service. Participants: Between November 2012 and October 2014, 909 undergraduates participated. Method: Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Results: Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. Conclusions: E-Mental Health options could engage students who may not wait for standard services.This project was supported by the Jack Laidlaw Chair in Patient-Centered Health Care and a grant from the Canadian Health Services Research Foundation

The NOD2-Smoking Interaction in Crohn's Disease is likely Specific to the 1007fs Mutation and may be Explained by Age at Diagnosis:A Meta-Analysis and Case-Only Study

Background: NOD2 and smoking are risk factors for Crohn's disease. We meta-analyzed NOD2-smoking interactions in Crohn's disease (Phase 1), then explored the effect of age at diagnosis on NOD2-smoking interactions (Phase 2). Methods: Phase 1: MEDLINE and EMBASE were searched for studies (n = 18) providing data on NOD2 and smoking in Crohn's disease. NOD2-smoking interactions were estimated using odds ratios (ORs) and 95% confidence intervals (CIs) calculated using random effects models. Phase 2: A case-only study compared the proportion of smokers and carriers of the 1007 fs variant across ages at diagnosis (≤16, 17–40, >40 years). Findings: Phase 1: Having ever smoked was less common among carriers of the 1007 fs variant of NOD2 (OR 0.74, 95%CI:0.66–0.83). There was no interaction between smoking and the G908R (OR 0.96, 95%CI:0.82–1.13) or the R702W variant (OR 0.89, 95%CI:0.76–1.05). Phase 2: The proportion of patients (n = 627) carrying the 1007 fs variant decreased with age at diagnosis (≤16 years: 15%; 17–40: 12%; >40: 3%; p = 0.003). Smoking was more common in older patients (≤16 years: 4%; 17–40: 48%; >40: 71%; p < 0.001). Interpretation: The negative NOD2-smoking interaction in Crohn's disease is specific to the 1007 fs variant. However, opposing rates of this variant and smoking across age at diagnosis may explain this negative interaction

Salt marsh ecosystem restructuring enhances elevation resilience and carbon storage during accelerating relative sea-level rise

Salt marshes respond to sea-level rise through a series of complex and dynamic bio-physical feedbacks. In this study, we found that sea-level rise triggered salt marsh habitat restructuring, with the associated vegetation changes enhancing salt marsh elevation resilience. A continuous record of marsh elevation relative to sea level that includes reconstruction of high-resolution, sub-decadal, marsh elevation over the past century, coupled with a lower-resolution 1500-year record, revealed that relative sea-level rose 1.5 ± 0.4 m, following local glacial isostatic adjustment (1.2 mm/yr). As sea-level rise has rapidly accelerated, the high marsh zone dropped 11 cm within the tidal frame since 1932, leading to greater inundation and a shift to flood- and salt-tolerant low marsh species. Once the marsh platform fell to the elevation favored by low-marsh Spartina alterniflora, the elevation stabilized relative to sea level. Currently low marsh accretion keeps pace with sea-level rise, while present day high marsh zones that have not transitioned to low marsh have a vertical accretion deficit. Greater biomass productivity, and an expanding subsurface accommodation space favorable for salt marsh organic matter preservation, provide a positive feed-back between sea-level rise and marsh platform elevation. Carbon storage was 46 ± 28 g C/m2/yr from 550 to 1800 CE, increasing to 129 ± 50 g C/m2/yr in the last decade. Enhanced carbon storage is controlled by vertical accretion rates, rather than soil carbon density, and is a direct response to anthropogenic eustatic sea-level rise, ultimately providing a negative feedback on climate warming

Key questions in marine mammal bioenergetics

This work was funded by the Marine Mammal Commission (MMC19-173). The Office of Naval Research funded the bioenergetic workshop (N000142012392) that provided support for this work.Bioenergetic approaches are increasingly used to understand how marine mammal populations could be affected by a changing and disturbed aquatic environment. There remain considerable gaps in our knowledge of marine mammal bioenergetics, which hinder the application of bioenergetic studies to inform policy decisions. We conducted a priority-setting exercise to identify high-priority unanswered questions in marine mammal bioenergetics, with an emphasis on questions relevant to conservation and management. Electronic communication and a virtual workshop were used to solicit and collate potential research questions from the marine mammal bioenergetic community. From a final list of 39 questions, 11 were identified as ‘key’ questions because they received votes from at least 50% of survey participants. Key questions included those related to energy intake (prey landscapes, exposure to human activities) and expenditure (field metabolic rate, exposure to human activities, lactation, time-activity budgets), energy allocation priorities, metrics of body condition and relationships with survival and reproductive success and extrapolation of data from one species to another. Existing tools to address key questions include labelled water, animal-borne sensors, mark-resight data from long-term research programs, environmental DNA and unmanned vehicles. Further validation of existing approaches and development of new methodologies are needed to comprehensively address some key questions, particularly for cetaceans. The identification of these key questions can provide a guiding framework to set research priorities, which ultimately may yield more accurate information to inform policies and better conserve marine mammal populations.Publisher PDFPeer reviewe

A new era for science-industry research collaboration – a view towards the future

Direct engagement of the fishing industry in the provision and co-creation of knowledge and data for research and management is increasingly prevalent. In both the North Atlantic and North Pacific, enhanced and targeted engagement is evident. More is needed. Science-Industry collaborative approaches to developing questions, collecting data, interpreting data, and sharing knowledge create opportunities for information transfer and improved understanding of ecosystem interactions, stock dynamics, economic incentives, and response to management. These collaborations require clear communication and awareness of objectives and outcomes. These initiatives also require careful attention to conditions and interactions that foster respect, trust, and communication. Respect is critical and entails acknowledging the respective skills and expertise of both scientists and fishers. Trust is needed to build confidence in the information developed and its use. Communication is essential to maintain relationships and leverage shared insights. To assess current trends and future opportunities related to this type of engagement, we convened a networking session of research scientists, industry scientists, industry leaders, and fishers at the Annual Science Meeting of the International Council for the Exploration of the Sea (ICES) to address the following questions: (1) What are scientific needs that could be addressed with industry-collected data or knowledge? And (2) How can science-industry collaboration be made sustainable? Here we identify opportunities and acknowledge challenges, outline necessary conditions for respectful and sustainable collaborative research, and highlight ways to promote stakeholder involvement in developing science. We address industry concerns and solicit industry advice. We also address challenges to scientists in ensuring standards for scientific data, conflict of interest, and applying information to advise management. The discussions in this session and subsequent correspondence have led to a set of guidelines and best practices that provide a framework to advance further collaboration between industry and research science. We identify opportunities for directed engagement. We also detail potential approaches to clarify expectations and develop avenues for iterative communication and engagement to sustain collaborative efforts over time. The intent is to improve and expand data streams and contextual understanding of ecosystem processes, stock assessment, and socio-economic dynamics to the benefits of science and industry alike

Evaluation of a fiberoptic-based system for measurement of optical properties in highly attenuating turbid media

BACKGROUND: Accurate measurements of the optical properties of biological tissue in the ultraviolet A and short visible wavelengths are needed to achieve a quantitative understanding of novel optical diagnostic devices. Currently, there is minimal information on optical property measurement approaches that are appropriate for in vivo measurements in highly absorbing and scattering tissues. We describe a novel fiberoptic-based reflectance system for measurement of optical properties in highly attenuating turbid media and provide an extensive in vitro evaluation of its accuracy. The influence of collecting reflectance at the illumination fiber on estimation accuracy is also investigated. METHODS: A neural network algorithm and reflectance distributions from Monte Carlo simulations were used to generate predictive models based on the two geometries. Absolute measurements of diffuse reflectance were enabled through calibration of the reflectance system. Spatially-resolved reflectance distributions were measured in tissue phantoms at 405 nm for absorption coefficients (μ(a)) from 1 to 25 cm(-1 )and reduced scattering coefficients ([Formula: see text]) from 5 to 25 cm(-1). These data and predictive models were used to estimate the optical properties of tissue-simulating phantoms. RESULTS: By comparing predicted and known optical properties, the average errors for μ(a )and [Formula: see text] were found to be 3.0% and 4.6%, respectively, for a linear probe approach. When bifurcated probe data was included and samples with μ(a )values less than 5 cm(-1 )were excluded, predictive errors for μ(a )and [Formula: see text] were further reduced to 1.8% and 3.5%. CONCLUSION: Improvements in system design have led to significant reductions in optical property estimation error. While the incorporation of a bifurcated illumination fiber shows promise for improving the accuracy of [Formula: see text] estimates, further study of this approach is needed to elucidate the source of discrepancies between measurements and simulation results at low μ(a )values