Factors associated with the incidence and severity of neonatal abstinence syndrome in infants born to opioid dependent mothers

Indiana University-Purdue University Indianapolis (IUPUI)Neonatal abstinence syndrome (NAS), the constellation of withdrawal symptoms experienced by neonates exposed to opioids prenatally, is an epidemic affecting an estimated 23,580 infants each year with an annual cost of $720 million. The purpose of this study was to examine factors associated with the incidence and severity of NAS as measured by the need for initiation of neonatal medication, peak medication dose, hospital length of stay (LOS), and hospital costs among newborns born to opioiddependent mothers. A retrospective review of medical records was conducted with two convenience samples: 204 infants born to mothers who used opioids during pregnancy; and 121 of these infants who required treatment with morphine to control symptoms of NAS. Data from April 2011 to September 2017 were collected from medical records of a large Midwestern hospital. Exploratory analysis and descriptive statistics were performed. Associations between independent variables and outcomes were examined using correlations, chi-square, t-tests, analyses of variance, and linear regression. Of the 204 neonates who were exposed to opioids prenatally, 121 (59%) developed symptoms of NAS requiring treatment with morphine. Neonates requiring morphine had significantly higher gestational ages than those who did not (37.7 vs 36.4 weeks; p = < .001) and their mothers were present at the neonates’ bedside a lower proportion of their total hospital stay (mean = 0.5684 of days vs 0.7384 of days; p = < .001). Compared to maternal use of buprenorphine, maternal methadone use was associated with higher peak morphine doses needed to control the neonate’s withdrawal symptoms (0.089 mg/kg versus 0.054 mg/kg; p = .023), and with longer hospital length of stay when compared to maternal use of buprenorphine and other opioid analgesics (34.2 vs. 20.8 vs. 22.5 days, respectively; p=0.02). Higher visitation time from the primary caregiver was correlated with lower hospital LOS (r = -0.421; p = < .001). Future research is needed to examine these relationships prospectively in a larger and more diverse sample. An effective response to the epidemics of opioid use during pregnancy and the incidence of NAS requires ongoing coordinated research and intervention in clinical care, public health, and health policy.2019-11-0

Effects of Exercise and a Brief Education Intervention on Social Physique Anxiety in College Students

Body image concerns that create anxiety in social settings [social physique anxiety (SPA)] has shown to influence behaviors of college women (Crawford & Eklund, 1994). There have been attempts to lower SPA among college students by utilizing physical activity or administrating an education or cognitive-behavioral intervention to decrease SPA (Bane, 1996; ODea and Abraham, 1999; Zabinski, Calfas, Gehrman, Wilfley, & Sallis, 2001.) Interventions take time and time in todays society is limited. Brief or time-limited interventions have shown to be beneficial, and ultra-brief therapy (treatments with six or fewer sessions) has shown to be beneficial to a substantial amount of clients (Shapiro, 2003). The purpose of this study was to examine the effects an exercise-only intervention (EO) and a brief education plus exercise intervention (BEE) would have on SPA among male and female college students. The hypothesis was that the BEE group would decrease SPA more than the EO group. The research question was whether there would be a significant decrease in SPA at three weeks and at six weeks. At the completion of the study there were 213 participants who had completed all three administrations of the 7-item Social Physique Anxiety Scale and who missed two or fewer physical activity classes and/or one or fewer education handouts. Participants were male (n = 60) and female (n = 153) college volunteers (ages 18-22 years) from a Effects of Exercise 2 southeastern university, currently enrolled in beginner aerobics (n = 95), aerobic cross-training (n = 4), jogging (n = 53), and health (n = 61) classes. Participants were assigned into one of the following groups: EO (n = 69), BEE (n = 83), and control (n = 61). Paired t-tests were run to observe if there was a time effect in SPA. There was not a significant difference in SPA from administration one (week zero) to week three (p = .503). There was a significant decrease in SPA from week three to week six (p = .021). A three-way ANOVA (3 X 2 X 3) with repeated measures on the last factor was utilized to observe whether there was an interaction across time among the three groups and if there was a gender interaction. The alpha level was set at .05. There was a violation in sphericity so the Greenhouse-Geisser adjustment was used. There was not a significant interaction between group, gender, and SPA (p = .162). There was an interaction between SPA and group (p = .022). The BEE group showed a significant decrease in SPA. The EO and control groups showed no significant changes in SPA. There was not a significant interaction between gender and SPA (p = .078). There was no group and gender interaction (p = .385). There was a main effect for gender (p = .001). The results from this study demonstrated that a brief educational plus exercise intervention, with duration longer than three weeks, may decrease SPA among male and female college students

Map My Trip: A Leap Motion Web App

Map My Trip is a travel application created using Leap Motion’s motion sensing technologies to allow you to search for hotels with just a few circles of your finger. Despite the initial objectives, the Leap Motion platform had not evolved to a point where the Web application support and support for this type of precision in a Web application was practical. We were able, however, to use the Map My Trip application to research the strengths, weaknesses, and opportunities of the Leap Motion Technology in comparison with other websites and current Web technologies

Self-reported psychopathy in the Middle East: a cross-national comparison across Egypt, Saudi Arabia, and the United States

Background: The construct of psychopathy is sparsely researched in the non-Western world, particularly in the Middle East. As such, the extent to which the psychopathy construct can be generalized to other cultures, including Middle Eastern Arab cultures, is largely unknown. Methods: The present study investigated the cross-cultural/national comparability of self-reported psychopathy in the United States (N = 786), Egypt (N = 296), and Saudi Arabia (N = 341). Results: A widely used psychopathy questionnaire demonstrated largely similar properties across the American and Middle Eastern samples and associations between Five Factor Model (FFM) personality and psychopathy were broadly consistent. Nevertheless, several notable cross-cultural differences emerged, particularly with regard to the internal consistencies of psychopathy dimensions and the correlates of Coldheartedness. Additionally, in contrast to most findings in Western cultures, associations between psychopathy and FFM personality varied consistently by gender in the Egyptian sample. Conclusions: These findings lend preliminary support to the construct validity of self-reported psychopathy in Arabic-speaking cultures, providing provisional evidence for the cross-cultural generalizability of certain core characteristics of psychopathy

Why Does My Model Fail? Contrastive Local Explanations for Retail Forecasting

In various business settings, there is an interest in using more complex machine learning techniques for sales forecasting. It is difficult to convince analysts, along with their superiors, to adopt these techniques since the models are considered to be "black boxes," even if they perform better than current models in use. We examine the impact of contrastive explanations about large errors on users' attitudes towards a "black-box'" model. We propose an algorithm, Monte Carlo Bounds for Reasonable Predictions. Given a large error, MC-BRP determines (1) feature values that would result in a reasonable prediction, and (2) general trends between each feature and the target, both based on Monte Carlo simulations. We evaluate on a real dataset with real users by conducting a user study with 75 participants to determine if explanations generated by MC-BRP help users understand why a prediction results in a large error, and if this promotes trust in an automatically-learned model. Our study shows that users are able to answer objective questions about the model's predictions with overall 81.1% accuracy when provided with these contrastive explanations. We show that users who saw MC-BRP explanations understand why the model makes large errors in predictions significantly more than users in the control group. We also conduct an in-depth analysis on the difference in attitudes between Practitioners and Researchers, and confirm that our results hold when conditioning on the users' background.Comment: To appear in ACM FAT* 202

Coccolithophore biodiversity controls carbonate export in the Southern Ocean

Southern Ocean waters are projected to undergo profound changes in their physical and chemical properties in the coming decades. Coccolithophore blooms in the Southern Ocean are thought to account for a major fraction of the global marine calcium carbonate (CaCO3) production and export to the deep sea. Therefore, changes in the composition and abundance of Southern Ocean coccolithophore populations are likely to alter the marine carbon cycle, with feedbacks to the rate of global climate change. However, the contribution of coccolithophores to CaCO3 export in the Southern Ocean is uncertain, particularly in the circumpolar subantarctic zone that represents about half of the areal extent of the Southern Ocean and where coccolithophores are most abundant. Here, we present measurements of annual CaCO3 flux and quantitatively partition them amongst coccolithophore species and heterotrophic calcifiers at two sites representative of a large portion of the subantarctic zone. We find that coccolithophores account for a major fraction of the annual CaCO3 export, with the highest contributions in waters with low algal biomass accumulations. Notably, our analysis reveals that although Emiliania huxleyi is an important vector for CaCO3 export to the deep sea, less abundant but larger species account for most of the annual coccolithophore CaCO3 flux. This observation contrasts with the generally accepted notion that high particulate inorganic carbon accumulations during the austral summer in the subantarctic Southern Ocean are mainly caused by E. huxleyi blooms. It appears likely that the climate-induced migration of oceanic fronts will initially result in the poleward expansion of large coccolithophore species increasing CaCO3 production. However, subantarctic coccolithophore populations will eventually diminish as acidification overwhelms those changes. Overall, our analysis emphasizes the need for species-centred studies to improve our ability to project future changes in phytoplankton communities and their influence on marine biogeochemical cycles.info:eu-repo/semantics/publishedVersio

What makes palliative care needs “complex”?:a multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

Background: Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods: Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results: Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions: Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input