A mixed methods study examining the barriers and facilitators to research utilization and evidence-based practice in adult weight management

Background Obesity is a disease with many associated comorbidities and its prevalence in the U.S. continues to increase despite the majority of people with obesity attempting weight loss. Dietitians are responsible for using evidence-based practice to mitigate the effects of obesity, however, differences in practice philosophies, opinion leaders, misinformation, a sense of competence, and the complexity of nutrition research have been identified as barriers to implementing practice guidelines into daily practice. It is unclear how dietitians strike a balance between empirical evidence, anecdotal evidence, and patient-centered practice. Aims The primary aim of this mixed-methods study was to identify the barriers and facilitators of research utilization and evidence-based practice in adult weight management. The secondary aim was to identify how dietitians gather information about obesity and/or adult weight management as well as to understand what factors influence how they discern whether to adopt a new practice strategy. Theory A combination of Social Cognitive Theory and Diffusion of Innovations Theory provided a framework to understanding the barriers and facilitators to the adoption of various practice innovations in the field of obesity management. Methods The validated BARRIERS survey was disseminated to dietitians working at least part-time with people with obesity. Survey also contained additional miscellaneous questions regarding information gathering preferences and use of best practices. Semi-structured interviews were conducted to understand current obesity practices utilizing thematic analysis of the interviews. Results Survey data identified that Setting items (M = 23.89, SD = 6.83) were the greatest perceived barrier within the BARRIERS survey items. Years of experience were found to decrease the perception of Setting items with 0-5 years (M = 25.01, SD = 6.39) and 6-11 years for Setting was (M = 25.00, SD = 6.29) compared to 32 or more years (M = 20.60, SD = 6.38) indicating that years of experience help decrease the perception of Setting barriers. Qualitative results identified that time, degree of training, and reliance on opinion leaders are the greatest barrier to research utilization, implementation of best practices, and gathering information from refereed sources. Conclusion Dietitians report limited time resources derived from a number of factors and are compounded by limited training in statistical analysis and a sense of competence which leads to a reliance on opinion leaders to place research findings into context on their behalf. Dietitians should be cautious of reliance upon others in gathering information as misinformation may be a significant factor. Continuing education requirements and the use of podcasts are a significant contributor of increasing reliance on opinion leaders for daily practice guidance

The Massachusetts Volunteers : Two Step

https://digitalcommons.library.umaine.edu/mmb-ps/2354/thumbnail.jp

Weak Lensing Peaks in Simulated Light-Cones: Investigating the Coupling between Dark Matter and Dark Energy

In this paper, we study the statistical properties of weak lensing peaks in light-cones generated from cosmological simulations. In order to assess the prospects of such observable as a cosmological probe, we consider simulations that include interacting Dark Energy (hereafter DE) models with coupling term between DE and Dark Matter. Cosmological models that produce a larger population of massive clusters have more numerous high signal-to-noise peaks; among models with comparable numbers of clusters those with more concentrated haloes produce more peaks. The most extreme model under investigation shows a difference in peak counts of about $20\%$ with respect to the reference $\mathrm{\Lambda}$CDM model. We find that peak statistics can be used to distinguish a coupling DE model from a reference one with the same power spectrum normalisation. The differences in the expansion history and the growth rate of structure formation are reflected in their halo counts, non-linear scale features and, through them, in the properties of the lensing peaks. For a source redshift distribution consistent with the expectations of future space-based wide field surveys, we find that typically seventy percent of the cluster population contributes to weak-lensing peaks with signal-to-noise ratios larger than two, and that the fraction of clusters in peaks approaches one-hundred percent for haloes with redshift z$\leq$0.5. Our analysis demonstrates that peak statistics are an important tool for disentangling DE models by accurately tracing the structure formation processes as a function of the cosmic time.Comment: accepted in MNRAS, figures improved and text update

Issues concerning centralized versus decentralized power deployment

The results of a study of proposed lunar base architectures to identify issues concerning centralized and decentralized power system deployment options are presented. The power system consists of the energy producing system (power plant), the power conditioning components used to convert the generated power into the form desired for transmission, the transmission lines that conduct this power from the power sources to the loads, and the primary power conditioning hardware located at the user end. Three power system architectures, centralized, hybrid, and decentralized, were evaluated during the course of this study. Candidate power sources were characterized with respect to mass and radiator area. Two electrical models were created for each architecture to identify the preferred method of power transmission, dc or ac. Each model allowed the transmission voltage level to be varied at assess the impact on power system mass. The ac power system models also permitted the transmission line configurations and placements to determine the best conductor construction and installation location. Key parameters used to evaluate each configuration were power source and power conditioning component efficiencies, masses, and radiator areas; transmission line masses and operating temperatures; and total system mass

Support Vector Machine classification of strong gravitational lenses

The imminent advent of very large-scale optical sky surveys, such as Euclid and LSST, makes it important to find efficient ways of discovering rare objects such as strong gravitational lens systems, where a background object is multiply gravitationally imaged by a foreground mass. As well as finding the lens systems, it is important to reject false positives due to intrinsic structure in galaxies, and much work is in progress with machine learning algorithms such as neural networks in order to achieve both these aims. We present and discuss a Support Vector Machine (SVM) algorithm which makes use of a Gabor filterbank in order to provide learning criteria for separation of lenses and non-lenses, and demonstrate using blind challenges that under certain circumstances it is a particularly efficient algorithm for rejecting false positives. We compare the SVM engine with a large-scale human examination of 100000 simulated lenses in a challenge dataset, and also apply the SVM method to survey images from the Kilo-Degree Survey.Comment: Accepted by MNRA

Optical Lenses for Atomic Beams

Superpositions of paraxial laser beam modes to generate atom-optical lenses based on the optical dipole force are investigated theoretically. Thin, wide, parabolic, cylindrical and circular atom lenses with numerical apertures much greater than those reported in the literature to date can be synthesized. This superposition approach promises to make high quality atom beam imaging and nano-deposition feasible.Comment: 10 figure

Pinning an Ion with an Intracavity Optical Lattice

We report one-dimensional pinning of a single ion by an optical lattice. The lattice potential is produced by a standing-wave cavity along the rf-field-free axis of a linear Paul trap. The ion's localization is detected by measuring its fluorescence when excited by standing-wave fields with the same period, but different spatial phases. The experiments agree with an analytical model of the localization process, which we test against numerical simulations. For the best localization achieved, the ion's average coupling to the cavity field is enhanced from 50% to 81(3)% of its maximum possible value, and we infer that the ion is bound in a lattice well with over 97% probability.Comment: 5 pages, 4 figures; Text edited for clarity, results unchange

The effects of host age and spatial location on bacterial community composition in the English Oak tree (Quercus robur).

Published onlineJOURNAL ARTICLEThis is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.Drivers of bacterial community assemblages associated with plants are diverse and include biotic factors, such as competitors and host traits, and abiotic factors, including environmental conditions and dispersal mechanisms. We examine the roles of spatial distribution and host size, as an approximation for age, in shaping the microbiome associated with Quercus robur woody tissue using culture-independent 16S rRNA gene amplicon sequencing. In addition to providing a baseline survey of the Q. robur microbiome, we screened for the pathogen of acute oak decline. Our results suggest that age is a predictor of bacterial community composition, demonstrating a surprising negative correlation between tree age and alpha diversity. We find no signature of dispersal limitation within the Wytham Woods plot sampled. Together, these results provide evidence for niche-based hypotheses of community assembly and the importance of tree age in bacterial community structure, as well as highlighting that caution must be applied when diagnosing dysbiosis in a long-lived plant host. This article is protected by copyright. All rights reserved.This work was supported by a Royal Society Research Grant (to CJEM and BK). SM was funded by a studentship at the University of Exeter, BK by a NERC independent research fellowship (NE/K00879X/1), and CJEM by a Royal Society Fellowship. The authors thank Dr. Rob Jackson at the University of Reading for providing an isolate of Brenneria, Dr. Keith Kirby for providing data on tree age and size and Dr. Konrad Paskiewicz as well as the faculty and participants of the NERC-funded population genomics workshop for training in bioinformatics analyses. The 18-ha Long-Term Forest Monitoring Plot is a collaborative project between the University of Oxford, the Centre for Ecology and Hydrology, and the Smithsonian Institution CTFS Forest-GEO (HSBC Climate Partnership)