Addressing Adolescent Sexual Health Through an Educational Toolkit for Providers in Rural Alaska

Introduction. Adequately addressing an adolescent’s sexual health is essential during the child’s development yet, 33% of adolescents have health visits with no mention of sexual health. On average, primary care providers spend approximately thirty-six seconds discussing sexual health topics with adolescents despite recommendations for comprehensive education. Alaska Native youth face significant disparities regarding sexual and reproductive health care. Implementation and evaluation of a comprehensive educational toolkit regarding various sexual health topics for rural healthcare providers in Alaska revealed positive outcomes in discussing sexual health with an adolescent. Methods. Larrabee\u27s Model for Evidence-based Practice Change guided the development, implementation, and evaluation of an evidence-based sexual health toolkit. The evidence-based initiative targeted rural healthcare providers caring for Alaska Native adolescents. The toolkit was accessible on an organizational-led website for download called Iknowmine.org. A 34-item evaluation survey assessed the utility, accessibility, and overall impact of the toolkit. Results. Eight healthcare providers utilized the toolkit. Healthcare providers identified \u3e70% American Indian or Alaska Native adolescents as clients. Healthcare providers practiced in various specialties and represented each of the five geographical areas of Alaska. Healthcare providers found the most beneficial topics within the toolkit were answering adolescent questions and tips to create a confidential, youth-friendly environment (M = 4.4, SD = 0.98). After a review of the toolkit, there was a slight increase in a provider\u27s likelihood to initiate sexual health discussion with an adolescent and a statistically significant increase in a provider\u27s confidence in talking with youth about sexual health (p = .004). Healthcare providers prefer online resources available through a URL and share positive feedback on the aesthetics of the toolkit. Healthcare providers somewhat to strongly agree that the toolkit taught them something new, is easily accessible, and aids in sexual health care delivery. Discussion. The Adolescent Sexual Health Toolkit is a concisely formatted toolkit that includes evidence-based information for rural healthcare providers. The toolkit is easily accessible and is available on iknowmine.org and aids healthcare provider communication with adolescents about sexual health topics. Healthcare provider feedback addressed the need for sexual health resources, improved provider’s confidence in talking with adolescents, and shared eagerness to use evidence-based resources to improve practice

Natural fracture patterns at Swift Reservoir anticline, NW Montana : the influence of structural position and lithology from multiple observation scales

Acknowledgements We gratefully acknowledge constructive reviews by Amerigo Corradetti and an anonymous reviewer and thank Stefano Tavani for editorial handling. Adam J. Cawood is grateful to David Ferrill, Kevin Smart, and Paul Gillespie for helpful conversations about fracture patterns, although the data and interpretations shown here are of course the sole responsibility of the authors. This study was carried out as part of a University of Aberdeen doctoral programme supported by the Natural Environment Research Council (NERC) Centre for Doctoral Training in Oil and Gas. Additional funding for fieldwork was provided by the University of Aberdeen Fold–Thrust Research Group. Petroleum Experts (formerly Midland Valley Exploration) is acknowledged for allowing the academic use of Move 2016.1 software. Financial support This research has been supported by the Natural Environment Research Council (grant no. NE/M00578X/1).Peer reviewedPublisher PD

Fracture distribution on the Swift Reservoir Anticline, Montana : implications for structural and lithological controls on fracture intensity

Title of special publication: Folding and Fracturing of Rocks: 50 Years of Research since the Seminal Text Book of J. G. Ramsay This research was funded by Oil Search Ltd, Santos Ltd and InterOil, through the University of Aberdeen Fold-Thrust Research Group. Electron Microscopy was performed in the ACEMAC Facility at the University of Aberdeen with assistance from John Still. Joyce Neilson is thanked for advice on the use of ImageJ software. Midland Valley are thanked for the use of their Move software for field data collection and model building. We thank Alfred Lacazette and Stefano Tavani for reviewing the manuscript and providing constructive comments.Peer reviewedPostprin

Spatial variability of precipitation regimes over Turkey

Turkish annual precipitation regimes are analysed to provide large-scale perspective and redefine precipitation regions. Monthly total precipitation data are employed for 107 stations (1963–2002). Precipitation regime shape (seasonality) and magnitude (size) are classified using a novel multivariate methodology. Six shape and five magnitude classes are identified, which exhibit clear spatial structure. A composite (shape and magnitude) regime classification reveals dominant controls on spatial variability of precipitation. Intra-annual timing and magnitude of precipitation is highly variable due to seasonal shifts in Polar and Subtropical zones and physiographic factors. Nonetheless, the classification methodology is shown to be a powerful tool that identifies physically-interpretable precipitation regions: (1) coastal regimes for Marmara, coastal Aegean, Mediterranean and Black Sea; (2) transitional regimes in continental Aegean and Southeast Anatolia; and (3) inland regimes across central and Eastern Anatolia. This research has practical implications for understanding water resources, which are under ever growing pressure in Turkey

The impact of psyllium gelation behaviour on in vitro colonic fermentation properties

Psyllium is a viscous, gel forming fibre with properties that have led it to be used for alleviating gastrointestinal discomfort. We have used previously identified fractions of psyllium with differing flow properties. Fraction 1 (F1) forms a non-gelling solution containing rhamnose. galactose, and arabinose. Fraction 2 (F2) forms a fluid-like gel containing mainly xylose and arabinose, Fraction 3 (F3) has almost identical monosaccharide and linkage composition to F2, but forms an insoluble, self-supporting gel. We performed in vitro batch fermentation experiments seeded with human stool. Metabolomics were performed using 1H NMR, and FISH with calcofluor white and direct red 23 were used to visualise the gels after in vitro fermentation of the fractions. The total amount of gas and short chain fatty acid produced was significantly higher for F1, compared to F2 and F3. F3 gas production was significantly lower than F2, but metabolite production between F2 and F3 did not differ. All fractions preferentially lead to the production of propionate instead of butyrate and were produced in the ratio of 58:35:7, 54:38:8, and 61:33:6 (acetate: propionate: butyrate) for F1, F2, and F3 respectively. Microscopy showed differences in how the fractions broke down and demonstrated the localisation of bacteria on the outer edge of each fraction. These results suggest that for these psyllium fractions the structure is a key factor that determines fermentability. Flow properties may play a role in gas production, suggesting directions for future investigation. Isolated fractions may have clinical benefit above that of unrefined psyllium powder aiding in the treatment of gastrointestinal discomfort

Best practices for constructing, preparing, and evaluating protein-ligand binding affinity benchmarks

Free energy calculations are rapidly becoming indispensable in structure-enabled drug discovery programs. As new methods, force fields, and implementations are developed, assessing their expected accuracy on real-world systems (benchmarking) becomes critical to provide users with an assessment of the accuracy expected when these methods are applied within their domain of applicability, and developers with a way to assess the expected impact of new methodologies. These assessments require construction of a benchmark - a set of well-prepared, high quality systems with corresponding experimental measurements designed to ensure the resulting calculations provide a realistic assessment of expected performance when these methods are deployed within their domains of applicability. To date, the community has not yet adopted a common standardized benchmark, and existing benchmark reports suffer from a myriad of issues, including poor data quality, limited statistical power, and statistically deficient analyses, all of which can conspire to produce benchmarks that are poorly predictive of real-world performance. Here, we address these issues by presenting guidelines for (1) curating experimental data to develop meaningful benchmark sets, (2) preparing benchmark inputs according to best practices to facilitate widespread adoption, and (3) analysis of the resulting predictions to enable statistically meaningful comparisons among methods and force fields

Pain and temperature processing in dementia: a clinical and neuroanatomical analysis

Symptoms suggesting altered processing of pain and temperature have been described in dementia diseases and may contribute importantly to clinical phenotypes, particularly in the frontotemporal lobar degeneration spectrum, but the basis for these symptoms has not been characterized in detail. Here we analysed pain and temperature symptoms using a semi-structured caregiver questionnaire recording altered behavioural responsiveness to pain or temperature for a cohort of patients with frontotemporal lobar degeneration (n = 58, 25 female, aged 52–84 years, representing the major clinical syndromes and representative pathogenic mutations in the C9orf72 and MAPT genes) and a comparison cohort of patients with amnestic Alzheimer’s disease (n = 20, eight female, aged 53–74 years). Neuroanatomical associations were assessed using blinded visual rating and voxel-based morphometry of patients’ brain magnetic resonance images. Certain syndromic signatures were identified: pain and temperature symptoms were particularly prevalent in behavioural variant frontotemporal dementia (71% of cases) and semantic dementia (65% of cases) and in association with C9orf72 mutations (6/6 cases), but also developed in Alzheimer’s disease (45% of cases) and progressive non-fluent aphasia (25% of cases). While altered temperature responsiveness was more common than altered pain responsiveness across syndromes, blunted responsiveness to pain and temperature was particularly associated with behavioural variant frontotemporal dementia (40% of symptomatic cases) and heightened responsiveness with semantic dementia (73% of symptomatic cases) and Alzheimer’s disease (78% of symptomatic cases). In the voxel-based morphometry analysis of the frontotemporal lobar degeneration cohort, pain and temperature symptoms were associated with grey matter loss in a right-lateralized network including insula (P < 0.05 corrected for multiple voxel-wise comparisons within the prespecified anatomical region of interest) and anterior temporal cortex (P < 0.001 uncorrected over whole brain) previously implicated in processing homeostatic signals. Pain and temperature symptoms accompanying C9orf72 mutations were specifically associated with posterior thalamic atrophy (P < 0.05 corrected for multiple voxel-wise comparisons within the prespecified anatomical region of interest). Together the findings suggest candidate cognitive and neuroanatomical bases for these salient but under-appreciated phenotypic features of the dementias, with wider implications for the homeostatic pathophysiology and clinical management of neurodegenerative diseases