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Diversifying the simplified landscape of corn and soybeans in the Midwest is an emerging priority in both the public and private sectors to reap a suite of climate, social, agronomic, and economic benefits. However, little research has documented the perspectives of farmers, the primary stakeholders in diversification efforts. This preliminary report uses newly collected survey data (n = 725) from farmers in the states of Illinois, Indiana, and Iowa to provide descriptive statistics and tests to understand what farmers in the region think about agricultural diversification, including their perspectives on its benefits, barriers, and opportunities. For the purposes of the study, we define diversification as extended rotations, perennials, horticulture, grazed livestock, and agroforestry practices. We find that a majority or plurality of farmers in the sample believe that diversified systems are superior to non-diversified systems at achieving a range of environmental, agronomic, and economic goals, although many farmers are still forming opinions. Farmers believe that primarily economic barriers stand in the way of diversification, including the lack of affordable land, low short-term returns on investment, and lack of labor. Farmers identified key opportunities to increase diversification through developing processing capacity for local meat and specialty crops, increasing demand for diversified products, and providing more information on returns on investment of diversified systems. Different interventions, however, may be needed to support farmers who are already diversified compared to non-diversified farmers. Building on these initial results, future studies using these data will develop more detailed analyses and recommendations for policymakers, the private sector, and agricultural organizations to support diversification.
Australian children fall short of national dietary guidelines with only 63 % consuming adequate fruit and 10 % enough vegetables. Before school care operates as part of Out of School Hours Care (OSHC) services and provides opportunities to address poor dietary habits in children. The aim of this study was to describe the food and beverages provided in before school care and to explore how service-level factors influence food provision.
Design:
A cross-sectional study was conducted in OSHC services. Services had their before school care visited twice between March and June 2021. Direct observation was used to capture food and beverage provision and child and staff behaviour during breakfast. Interviews with staff collected information on service characteristics. Foods were categorised using the Australian Dietary Guidelines, and frequencies were calculated. Fisher’s exact test was used to compare food provision with service characteristics.
Setting:
The before school care of OSHC services in New South Wales, Australia.
Participants:
Twenty-five OSHC services.
Results:
Fruit was provided on 22 % (n 11) of days and vegetables on 12 % (n 6). Services with nutrition policies containing specific language on food provision (i.e. measurable) were more likely to provide fruit compared with those with policies using non-specific language (P= 0·027). Services that reported receiving training in healthy eating provided more vegetables than those who had not received training (P= 0·037).
Conclusions:
Before school care can be supported to improve food provision through staff professional development and advocating to regulatory bodies for increased specificity requirements in the nutrition policies of service providers.
We review some of the processes leading to dispersion and mixing in porous media, exploring the differences between the travel time distribution of fluid particles within a pore throat and between pore throats of different size within the porous layer. A recent paper of Liu et al. (2024) has combined a model of these travel time distributions with a continuous time random walk to quantify the dispersion as a function of the Peclet number. We describe some further problems relating to dispersive mixing of tracer which may be amenable to this approach, including dispersion caused by macroscopic lenses of different permeability, dispersion of tracer which partitions between the fluid and matrix and the effects of buoyancy on mixing.
To improve early intervention and personalise treatment for individuals early on the psychosis continuum, a greater understanding of symptom dynamics is required. We address this by identifying and evaluating the movement between empirically derived attenuated psychotic symptomatic substates—clusters of symptoms that occur within individuals over time.
Methods
Data came from a 90-day daily diary study evaluating attenuated psychotic and affective symptoms. The sample included 96 individuals aged 18–35 on the psychosis continuum, divided into four subgroups of increasing severity based on their psychometric risk of psychosis, with the fourth meeting ultra-high risk (UHR) criteria. A multilevel hidden Markov modelling (HMM) approach was used to characterise and determine the probability of switching between symptomatic substates. Individual substate trajectories and time spent in each substate were subsequently assessed.
Results
Four substates of increasing psychopathological severity were identified: (1) low-grade affective symptoms with negligible psychotic symptoms; (2) low levels of nonbizarre ideas with moderate affective symptoms; (3) low levels of nonbizarre ideas and unusual thought content, with moderate affective symptoms; and (4) moderate levels of nonbizarre ideas, unusual thought content, and affective symptoms. Perceptual disturbances predominantly occurred within the third and fourth substates. UHR individuals had a reduced probability of switching out of the two most severe substates.
Conclusions
Findings suggest that individuals reporting unusual thought content, rather than nonbizarre ideas in isolation, may exhibit symptom dynamics with greater psychopathological severity. Individuals at a higher risk of psychosis exhibited persistently severe symptom dynamics, indicating a potential reduction in psychological flexibility.
If being asked to give to charity stimulates an emotional response, like empathy, that makes giving difficult to resist, a natural self-control mechanism might be to avoid being asked in the first place. We replicate a result from a field experiment that points to the role of empathy in giving. We conduct an experiment in a large superstore in which we solicit donations to charity and randomly allow shoppers the opportunity to avoid solicitation by using the other door. We find the rate of avoidance by store entrants to be 8.9 %. However, we also find that the avoidance effect disappears in very cold weather, suggesting that avoidance behavior is sensitive to its cost.
This study sought to assess undergraduate students’ knowledge and attitudes surrounding perceived self-efficacy and threats in various common emergencies in communities of higher education.
Methods
Self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, obligation to respond, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond were investigated through 3 representative scenarios via a web-based survey.
Results
Among 970 respondents, approximately 60% reported their university had adequately prepared them for various emergencies while 84% reported the university should provide such training. Respondents with high self-efficacy were significantly more likely than those with low self-efficacy to be willing to respond in whatever capacity needed across all scenarios.
Conclusions
There is a gap between perceived student preparedness for emergencies and training received. Students with high self-efficacy were the most likely to be willing to respond, which may be useful for future training initiatives.
Medicines routinely funded for use in Wales undergo health technology appraisal by the All Wales Medicines Strategy Group (AWMSG) or the National Institute for Health and Care Excellence (NICE). This includes pediatric license extensions (PLE) notwithstanding any existing advice in adults. A review of the PLE process was conducted with the aim of providing faster access to children’s medicines in Wales.
Methods
Data were collected for PLE appraisals of medicines previously approved for adults by the AWMSG or NICE that subsequently went through the original PLE process between January 2010 and December 2020, or a simplified PLE process between January 2021 and March 2023. Data were analyzed using descriptive statistics and a two-tailed t-test (unequal variance) to test the null hypothesis that the difference between the two means was zero. An alpha of less than 0.05 was considered significant. Feedback was obtained from relevant stakeholders including the Association of the British Pharmaceutical Industry (Wales) and the Royal College of Paediatrics and Child Health.
Results
The AWMSG issued positive recommendations for all PLE appraisals included in the data collected, and these were endorsed by the Welsh Government. Appraisals that went through the original PLE process (n=56) took a mean 229.8 days (standard deviation 55.6), whereas those that went through the simplified PLE process (n=15) took a mean 102.6 days (standard deviation 48.1; p < 0.0001). The rapid access to children’s medicines was welcomed by the Association of the British Pharmaceutical Industry and the Royal College of Paediatrics and Child Health.
Conclusions
Review of the 2020 and 2023 PLE processes facilitated faster access to clinically effective and cost-effective medicines for children in Wales. In March 2023, the AWMSG and the Welsh Government reviewed these results and agreed that because all PLE medicines were approved for use within Wales irrespective of the process used, the AWMSG would no longer be required to routinely appraise PLEs.
We develop a simple model which describes the repeated injection and extraction of hydrogen in a permeable water-saturated rock which has the form of an anticline. We demonstrate that the flow is controlled by the dimensionless ratio of the square of the buoyancy speed to the product of the two-dimensional volume injection rate and the injection–extraction frequency, and we explore the cases in which this ratio is large and small. Over the first few cycles, the volume of hydrogen in the system gradually builds up since during the extraction phase, some of the water eventually reaches the extraction well, and in our model the system ceases to extract fluid for the remainder of this extraction phase. After many cycles, there is sufficient hydrogen in the system that a quasi-equilibrium state develops in which the mass of fluid injected matches the mass extracted over the course of a cycle. We show that in this equilibrium, the ratio between the mass of gas remaining in the aquifer at the end of the extraction phase, known as the cushion gas, to the mass of gas injected, known as the working gas, decreases if either the flow rate or frequency of the cycles decrease or the buoyancy speed increases, leading to more efficient storage.
We explore the interaction of natural convection and mechanical ventilation in a room where fresh air is supplied at low level and stale air is extracted at high level. Turbulent buoyant plumes rising from heat sources interact with this upward airflow and establish a steady-state stratification with a warm upper layer above a layer of the cold supply air. Adapting the volume balance model used in natural ventilation (Linden et al., J. Fluid Mech., vol. 212, 1990, pp. 309–335) leads to the prediction that the upper layer will vent from the room when the ventilation volume flux exceeds the volume flux in the plumes at the ceiling. However, our new laboratory experiments establish that there is still a stable two-layer stratification beyond this point of critical ventilation. Motivated by our observations, we propose that the kinetic energy flux supplied by the plume leads to turbulent mixing in the upper layer. We propose a new model of this mixing which is consistent with our experiments in both the over- and under-ventilated regimes. This has important implications for air recirculation in buildings with large ventilation flows, particularly hospital operating theatres and clean rooms.
Considering Roman art as a cumulative process could help resolve a small iconographical problem. Cubiculum N in the burial hypogeum under the Via Dino Compagni in Rome (c.350–75 ce) features a series of figure scenes referencing the exploits of the mythological hero Hercules. One of these scenes, presently entitled Hercules Slaying an Unknown Enemy, has no direct equivalent in extant Roman art and so has proved difficult to identify. This article suggests that Hercules’ battle with Cacus is most likely the incident referred to here. This is because Antonine medallions and coins, and third-century Roman sarcophagi, use imagery associated with the Cacus story that collectively could have contributed to the design of the Unknown Enemy panel. Further, identifying the defeated enemy as Cacus fits in with, and indeed helps to clarify, programmatic themes and associations already established in the other figure scenes in this funerary chamber.
Few studies have examined the genetic population structure of vector-borne microparasites in wildlife, making it unclear how much these systems can reveal about the movement of their associated hosts. This study examined the complex host–vector–microbe interactions in a system of bats, wingless ectoparasitic bat flies (Nycteribiidae), vector-borne microparasitic bacteria (Bartonella) and bacterial endosymbionts of flies (Enterobacterales) across an island chain in the Gulf of Guinea, West Africa. Limited population structure was found in bat flies and Enterobacterales symbionts compared to that of their hosts. Significant isolation by distance was observed in the dissimilarity of Bartonella communities detected in flies from sampled populations of Eidolon helvum bats. These patterns indicate that, while genetic dispersal of bats between islands is limited, some non-reproductive movements may lead to the dispersal of ectoparasites and associated microbes. This study deepens our knowledge of the phylogeography of African fruit bats, their ectoparasites and associated bacteria. The results presented could inform models of pathogen transmission in these bat populations and increase our theoretical understanding of community ecology in host–microbe systems.
Can the experience of being ostracized – ignored and excluded – lead to people being more open to extremism? In this chapter we review the theoretical basis and experimental evidence for such a connection. According to the temporal need-threat model (Williams, 2009), ostracism is a painful experience that threatens fundamental social needs. Extreme groups have the potential to be powerful sources of inclusion and could therefore address these needs, thereby making them especially attractive to recent targets of ostracism. We also identify a set of factors that is theoretically likely to affect this link and review evidence for the opposite causal path: People are especially likely to ostracize others who belong to extreme groups. Together, this suggests a possible negative cycle in which ostracism may push people toward extreme groups, on which they become more reliant as social contacts outside the group further ostracize them.
Through a combination of laboratory experiments and theoretical models, we investigate the interaction of a mean upwelling through a closed basin with a vertical buoyancy flux. The fluid is mixed by a horizontally oscillating rake, which either traverses the whole basin or which oscillates just near one vertical boundary. We first review the steady state and demonstrate that, in both mixing regimes, the vertical density profile across the basin is controlled by the steady-state balance between the upward advective and diffusive fluxes of salinity as described by the classical model introduced by Munk (Deep-Sea Res., vol. 13, issue 4, 1966, pp. 707–730). However, with boundary mixing, we show that both the upwelling and the buoyancy transport are localised to the mixing zone near the boundary, and the interior fluid is stagnant. We then develop a model to describe the transient evolution of the system if there is either a discrete increase or gradual decrease to the buoyancy flux. In the boundary mixing case, the change in the buoyancy flux at the lower boundary leads to a change in the buoyancy of the fluid in the boundary mixing region, and this induces a transient, buoyancy-driven flow in the boundary region in addition to the steady upwelling. In turn, an equal and opposite vertical flow develops in the interior, and this leads to a change in the density stratification of the interior fluid as the system adjusts to a new equilibrium. However, in our experiments, there is no vertical mixing in the interior and interior fluid may upwell or downwell dependent on the change to the buoyancy forcing. We discuss the implications of our results for the transport and mixing in the deep ocean, and the associated interpretation of field experiments.
The personalised oncology paradigm remains challenging to deliver despite technological advances in genomics-based identification of actionable variants combined with the increasing focus of drug development on these specific targets. To ensure we continue to build concerted momentum to improve outcomes across all cancer types, financial, technological and operational barriers need to be addressed. For example, complete integration and certification of the ‘molecular tumour board’ into ‘standard of care’ ensures a unified clinical decision pathway that both counteracts fragmentation and is the cornerstone of evidence-based delivery inside and outside of a research setting. Generally, integrated delivery has been restricted to specific (common) cancer types either within major cancer centres or small regional networks. Here, we focus on solutions in real-world integration of genomics, pathology, surgery, oncological treatments, data from clinical source systems and analysis of whole-body imaging as digital data that can facilitate cost-effectiveness analysis, clinical trial recruitment, and outcome assessment. This urgent imperative for cancer also extends across the early diagnosis and adjuvant treatment interventions, individualised cancer vaccines, immune cell therapies, personalised synthetic lethal therapeutics and cancer screening and prevention. Oncology care systems worldwide require proactive step-changes in solutions that include inter-operative digital working that can solve patient centred challenges to ensure inclusive, quality, sustainable, fair and cost-effective adoption and efficient delivery. Here we highlight workforce, technical, clinical, regulatory and economic challenges that prevent the implementation of precision oncology at scale, and offer a systematic roadmap of integrated solutions for standard of care based on minimal essential digital tools. These include unified decision support tools, quality control, data flows within an ethical and legal data framework, training and certification, monitoring and feedback. Bridging the technical, operational, regulatory and economic gaps demands the joint actions from public and industry stakeholders across national and global boundaries.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
It is usual for humans to experience distress in the aftermath of emergencies, incidents, disasters, and disease outbreaks (EIDD). The manifestation, severity, and duration of the experiences that constitute distress depend on many intrinsic and extrinsic factors. Recent research has demonstrated that distress may be more ubiquitous than was previously thought, and that some interventions, even if well meaning, may not be helpful. Amelioration for most people comes with timely, proportionate, and targeted support and the passage of time. Validation of people’s experiences and minimising the medicalisation of distress are important in helping people to return to ordinary social functioning. This chapter looks at distress related to major events, including the scientific principles, impacts, and implications for intervention. The case study draws on the experience of three members of a pre-hospital team and how a challenging case affected them all.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
This chapter explores the moral dimensions of work in emergency and pre-hospital medicine, with an emphasis on protecting the workforce and maintaining optimal functioning of teams. It explores the concepts of moral distress and moral injury from the literature and as they apply to emergency and pre-hospital medicine, but also in the light of the COVID-19 pandemic. It includes reference to the experience of one helicopter emergency medical service (HEMS) organisation attempting to make changes to its culture.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
There is increasing awareness that working within the field of pre-hospital care can have psychosocial effects on clinicians. This chapter describes a systematic review of current knowledge of the psychosocial consequences of working in pre-hospital care. A considerable amount of research has been conducted, examining in particular whether practitioners develop burnout and psychiatric disorders, especially symptoms of post-traumatic stress and post-traumatic stress disorder (PTSD), as a result of their work. However, most studies did not fully assess whether practitioners developed clinically significant symptoms.. Instead, cross-sectional surveys and self-report questionnaires were used, which considerably overestimate the incidence of these problems. Perhaps the high scores on these questionnaires indicate that practitioners who work in pre-hospital care often suffer considerable stress and distress that can be the result of daily organisational and operational hassles, a high volume of work, lack of resources, and, less than has often been thought, attending unusual and high-profile incidents.
We explore ${\rm CO}_2$ injection into a layered permeable rock consisting of high permeability reservoir layers, separated by low permeability mudstone, and taking the shape of an anticline within a laterally extensive aquifer. We first show how the storage capacity of the formation depends on the capillary entry pressure of the inter-layer mudstone, so that ${\rm CO}_2$ cannot flow from one layer into the next. We then consider a formation composed of two layers, overlain by a cap rock. For injection into the lowest layer, we show that the injection rate, capillary entry pressure and buoyancy driven flux through the mudstone determine whether the lower or upper layer fills to the spill point first. We also show that at the end of the injection phase, ${\rm CO}_2$ may continue to flow from the lower to the upper layer. This implies that injection should be stopped once the injected volume matches the static capacity of the formation in order to prevent spilling after injection. We present a series of analogue experiments of a two layered system that illustrate some of the principles described by the model, and assess the implications of the results for field scale systems.