The performance of 2D and 3D tsunami evacuation maps: A case study for Seaside, Oregon

Tsunami evacuation maps are intended to inform the public about the geographic extent of the hazard and where to evacuate, but these maps can be difficult to interpret for people unfamiliar with cartographic semiology. This study focuses on the performance of tsunami evacuation maps and how the tsunami hazard is represented cartographically, as at-risk communities must be able to act quickly, and effectively understand tsunami maps to remain aware of the hazard and adequately evacuate. This study investigated the use of static three-dimensional (3D) perspective maps and travel time to safety representation (shown using point markers and choropleth symbology), as alternative ways to help mitigate tsunami disaster. The performance of, and preference for, static 3D tsunami evacuation maps were compared to conventional two-dimensional (2D) evacuation maps using a user survey and a set of test maps for the area of Seaside, Oregon. Each participant was given either a 2D or 3D map showing travel times as either point markers or choropleth symbology, and asked to complete a series of tasks concerning terrain and positional judgment, and evacuation travel time estimation. Participants were also shown all four maps and asked to determine which map was best for completing the tasks mentioned above. There were 84 survey respondents, and the results indicated that the 3D maps were preferred, overall. 3D maps performed best for judging terrain but showed no difference in performance when judging position. There was no difference in performance between 3D maps using choropleth symbology and 2D maps using point markers when estimating travel times. The results indicate that 3D maps perform the same or better than 2D maps and are preferred, suggesting the use of 3D maps for tsunami evacuation planning and education

The Barbero-Immirzi Parameter as a Scalar Field: K-Inflation from Loop Quantum Gravity?

We consider a loop-quantum gravity inspired modification of general relativity, where the Holst action is generalized by making the Barbero-Immirzi (BI) parameter a scalar field, whose value could be dynamically determined. The modified theory leads to a non-zero torsion tensor that corrects the field equations through quadratic first-derivatives of the BI field. Such a correction is equivalent to general relativity in the presence of a scalar field with non-trivial kinetic energy. This stress-energy of this field is automatically covariantly conserved by its own dynamical equations of motion, thus satisfying the strong equivalence principle. Every general relativistic solution remains a solution to the modified theory for any constant value of the BI field. For arbitrary time-varying BI fields, a study of cosmological solutions reduces the scalar field stress-energy to that of a pressureless perfect fluid in a comoving reference frame, forcing the scale factor dynamics to be equivalent to those of a stiff equation of state. Upon ultraviolet completion, this model could provide a natural mechanism for k-inflation, where the role of the inflaton is played by the BI field and inflation is driven by its non-trivial kinetic energy instead of a potential.Comment: Phys. Rev. D78, 064070 (2008

Singularity Avoidance of Charged Black Holes in Loop Quantum Gravity

Based on spherically symmetric reduction of loop quantum gravity, quantization of the portion interior to the horizon of a Reissner-Nordstr\"{o}m black hole is studied. Classical phase space variables of all regions of such a black hole are calculated for the physical case $M^2> Q^2$. This calculation suggests a candidate for a classically unbounded function of which all divergent components of the curvature scalar are composed. The corresponding quantum operator is constructed and is shown explicitly to possess a bounded operator. Comparison of the obtained result with the one for the Swcharzschild case shows that the upper bound of the curvature operator of a charged black hole reduces to that of Schwarzschild at the limit $Q \rightarrow 0$. This local avoidance of singularity together with non-singular evolution equation indicates the role quantum geometry can play in treating classical singularity of such black holes.Comment: To be appeared in International Journal of Theoretical Physic

Need for Early Interventions in the Prevention of Pediatric Overweight: A Review and Upcoming Directions

Childhood obesity is currently one of the most prevailing and challenging public health issues among industrialized countries and of international priority. The global prevalence of obesity poses such a serious concern that the World Health Organization (WHO) has described it as a “global epidemic.” Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns, dietary habits, and parental feeding practices are established. Obesity prevention evidence points to specific dietary factors, such as the promotion of breastfeeding and appropriate introduction of nutritious complementary foods, but also calls for attention to parental feeding practices, awareness of appropriate responses to infant hunger and satiety cues, physical activity/inactivity behaviors, infant sleep duration, and family meals. Interventions that begin at birth, targeting multiple factors related to healthy growth, have not been adequately studied. Due to the overwhelming importance and global significance of excess weight within pediatric populations, this narrative review was undertaken to summarize factors associated with overweight and obesity among infants and toddlers, with focus on potentially modifiable risk factors beginning at birth, and to address the need for early intervention prevention

Postnatal Depressive Symptoms Among Mothers and Fathers of Infants Born Preterm: Prevalence and Impacts on Children's Early Cognitive Function

OBJECTIVE: Preterm birth is associated with lower cognitive functioning. One potential pathway is postnatal parental depression. The authors assessed depressive symptoms in mothers and fathers after preterm birth, and identified the impacts of both prematurity and parental depressive symptoms on children's early cognitive function. METHOD: Data were from the nationally representative Early Childhood Longitudinal Study, Birth Cohort (n = 5350). Depressive symptoms at 9 months were assessed by the Center for Epidemiologic Studies Depression Scale (CESD) and children's cognitive function at 24 months by the Bayley Short Form, Research Edition. Weighted generalized estimating equation models examined the extent to which preterm birth, and mothers' and fathers' postnatal depressive symptoms impacted children's cognitive function at 24 months, and whether the association between preterm birth and 24-month cognitive function was mediated by parental depressive symptoms. RESULTS: At 9 months, fathers of very preterm (<32 weeks gestation) and moderate/late preterm (32-37 weeks gestation) infants had higher CESD scores than fathers of term-born (≥37 weeks gestation) infants (p value = .02); preterm birth was not associated with maternal depressive symptoms. In multivariable analyses, preterm birth was associated with lower cognitive function at 24 months; this association was unaffected by adjustment for parental depressive symptoms. Fathers', but not mothers', postnatal depressive symptoms predicted lower cognitive function in the fully adjusted model (β = -0.11, 95% confidence interval, -0.18 to -0.03). CONCLUSION: Fathers of preterm infants have more postnatal depressive symptomology than fathers of term-born infants. Fathers' depressive symptoms also negatively impact children's early cognitive function. The national findings support early identification and treatment of fathers of preterm infants with depressive symptoms

Gestational weight gain and child adiposity at age 3 years

OBJECTIVE The purpose of this study was to examine the associations of gestational weight gain with child adiposity. STUDY DESIGN Using multivariable regression, we studied associations of total gestational weight gain and weight gain according to 1990 Institute of Medicine guidelines with child outcomes among 1044 mother-child pairs in Project Viva. RESULTS Greater weight gain was associated with higher child body mass index z-score (0.13 units per 5 kg [95% CI, 0.08, 0.19]), sum of subscapular and triceps skinfold thicknesses (0.26 mm [95% CI, 0.02, 0.51]), and systolic blood pressure (0.60 mm Hg [95% CI, 0.06, 1.13]). Compared with inadequate weight gain (0.17 units [95% CI, 0.01, 0.33]), women with adequate or excessive weight gain had children with higher body mass index z-scores (0.47 [95% CI, 0.37, 0.57] and 0.52 [95% CI, 0.44, 0.61], respectively) and risk of overweight (odds ratios, 3.77 [95% CI: 1.38, 10.27] and 4.35 [95% CI: 1.69, 11.24]). CONCLUSION New recommendations for gestational weight gain may be required in this era of epidemic obesity

Nutrition provider confidence in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study

Objective: The multi-sector, multi-level Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study resulted in improvements in obesity risk factors among children age 2-4 years enrolled in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC). The goal of this study was to examine whether the MA-CORD intervention increased WIC provider confidence in their ability to identify childhood obesity and obesity-related behaviors. Methods: As part of the MA-CORD intervention conducted from 2012 to 2015, we implemented WIC practice changes focused on childhood obesity prevention within two Massachusetts communities. We examined changes in provider confidence to assess childhood obesity risk factors and practice frequency among WIC practices located in MA-CORD intervention communities over a 3-year period, compared to non-intervention sites. We measured provider confidence on a continuous scale using questions previously developed to assess provider and parent confidence to make weight-related behavior change (range 0 to 24). Results: There were 205 providers at baseline and 165 at follow-up. WIC providers at intervention sites reported greater confidence in their ability to identify childhood obesity and obesity-related behaviors compared to the usual care sites (β = 1.01, standard error = 0.13). These findings persisted after adjusting for provider gender, years in practice, highest education level, and WIC position. Conclusions: The MA-CORD intervention was associated with increased WIC provider confidence to assess children's obesity risk. Interventions that increase confidence in assessing obesity-related behaviors may have salutary effects within WIC programs that serve low-income families

The cost of a primary care-based childhood obesity prevention intervention

Background: United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. Methods: High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children’s nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n = 192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. Results: The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95$64,522, $66,842]) and$12,192 (95% CI [$11,393,$13,174]). The mean costs for the intervention and usual care groups were $259 (95$255, $264]) and$63 (95% CI [$59,$69]) per child, respectively, for a incremental difference of $196 (95$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. Conclusions: High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions. Trial registration ClinicalTrials.gov Identifier: NCT00377767

Correlations among adiposity measures in school-aged children

BACKGROUND: Given that it is not feasible to use dual x-ray absorptiometry (DXA) or other reference methods to measure adiposity in all pediatric clinical and research settings, it is important to identify reasonable alternatives. Therefore, we sought to determine the extent to which other adiposity measures were correlated with DXA fat mass in school-aged children. METHODS: In 1110 children aged 6.5-10.9 years in the pre-birth cohort Project Viva, we calculated Spearman correlation coefficients between DXA (n=875) and other adiposity measures including body mass index (BMI), skinfold thickness, circumferences, and bioimpedance. We also computed correlations between lean body mass measures. RESULTS: 50.0% of the children were female and 36.5% were non-white. Mean (SD) BMI was 17.2 (3.1) and total fat mass by DXA was 7.5 (3.9) kg. DXA total fat mass was highly correlated with BMI (r(s)=0.83), bioimpedance total fat (r(s)=0.87), and sum of skinfolds (r(s)=0.90), and DXA trunk fat was highly correlated with waist circumference (r(s)=0.79). Correlations of BMI with other adiposity indices were high, e.g., with waist circumference (r(s)=0.86) and sum of subscapular plus triceps skinfolds (r(s)=0.79). DXA fat-free mass and bioimpedance fat-free mass were highly correlated (r(s)=0.94). CONCLUSIONS: In school-aged children, BMI, sum of skinfolds, and other adiposity measures were strongly correlated with DXA fat mass. Although these measurement methods have limitations, BMI and skinfolds are adequate surrogate measures of relative adiposity in children when DXA is not practical

Healthy Habits Happy Homes Scotland (4HS) feasibility study : translation of a home-based early childhood obesity prevention intervention evaluated using RE-AIM framework

Objective Healthy Habits, Happy Homes (4H) is a home-based, pre-school childhood obesity prevention intervention which demonstrated efficacy in North America which we translated to Scotland (4HS) by considering contextual factors and adapting study design. RE-AIM Framework was used to assess 1) extent to which development of 4HS intervention (including recruitment) was participatory and inclusive; 2) feasibility of translating a complex public health intervention from one setting to another; 3) extent to which translation was pragmatic and 4) fidelity of intervention to the principles of Motivational Interviewing (MI). Study design Feasibility testing, process evaluation and measurements of intervention fidelity were undertaken to evaluate the translation of 4H to an economically deprived area of Scotland (4HS). Methods 4HS study processes; participatory approach, recruitment methods, level of pragmatism were evaluated using the RE-AIM framework. Qualitative and quantitative measures identified key implementation features and functioning of 4HS intervention. Fidelity MI principles was determined through coding of audiotapes using Motivation Interviewing Treatment Integrity (MITI) code. Results Key facilitators for positive impact with families, included: inclusive recruitment methods, appropriate channels of communication and correspondence (Reach) with n ​= ​126 enquiries and n ​= ​26 (21%) families recruited. Positive links with local parents and community workers integral to the research process at n ​= ​9 meetings (Effectiveness). 61.5% of families lived in the most deprived data zone in Scotland, 23% were one parent families, thus awareness and consideration of local contextual factors (Adoption) and locally relevant materials were important. 4HS was feasible to deliver, pragmatic in nature and intervention demonstrated good fidelity to MI (Implementation). Conclusion Translation of 4H from North America to Scotland was successful. Future studies should consider implementation of 4HS approach within routine practice within the UK (practice based evidence) or through thoughtful evaluation in a future trial (evidence based practice)