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Latent distance analysis provides a probability model for the non-perfect Guttman scale; the restricted latent distance structure is simpler to compute than the general structure. Since no sampling theory for latent structure analysis is available, the advantages of the general structure cannot be expressed formally. The two structures are compared in terms of their fit to fifteen sets of empirical data. The computation schemes used are summarized.
OBJECTIVES/GOALS: Contingency management (CM) procedures yield measurable reductions in cocaine use. This poster describes a trial aimed at using CM as a vehicle to show the biopsychosocial health benefits of reduced use, rather than total abstinence, the currently accepted metric for treatment efficacy. METHODS/STUDY POPULATION: In this 12-week, randomized controlled trial, CM was used to reduce cocaine use and evaluate associated improvements in cardiovascular, immune, and psychosocial well-being. Adults aged 18 and older who sought treatment for cocaine use (N=127) were randomized into three groups in a 1:1:1 ratio: High Value ($55) or Low Value ($13) CM incentives for cocaine-negative urine samples or a non-contingent control group. They completed outpatient sessions three days per week across the 12-week intervention period, totaling 36 clinic visits and four post-treatment follow-up visits. During each visit, participants provided observed urine samples and completed several assays of biopsychosocial health. RESULTS/ANTICIPATED RESULTS: Preliminary findings from generalized linear mixed effect modeling demonstrate the feasibility of the CM platform. Abstinence rates from cocaine use were significantly greater in the High Value group (47% negative; OR = 2.80; p = 0.01) relative to the Low Value (23% negative) and Control groups (24% negative;). In the planned primary analysis, the level of cocaine use reduction based on cocaine-negative urine samples will serve as the primary predictor of cardiovascular (e.g., endothelin-1 levels), immune (e.g., IL-10 levels) and psychosocial (e.g., Addiction Severity Index) outcomes using results from the fitted models. DISCUSSION/SIGNIFICANCE: This research will advance the field by prospectively and comprehensively demonstrating the beneficial effects of reduced cocaine use. These outcomes can, in turn, support the adoption of reduced cocaine use as a viable alternative endpoint in cocaine treatment trials.
The IntCal family of radiocarbon (14C) calibration curves is based on research spanning more than three decades. The IntCal group have collated the 14C and calendar age data (mostly derived from primary publications with other types of data and meta-data) and, since 2010, made them available for other sorts of analysis through an open-access database. This has ensured transparency in terms of the data used in the construction of the ratified calibration curves. As the IntCal database expands, work is underway to facilitate best practice for new data submissions, make more of the associated metadata available in a structured form, and help those wishing to process the data with programming languages such as R, Python, and MATLAB. The data and metadata are complex because of the range of different types of archives. A restructured interface, based on the “IntChron” open-access data model, includes tools which allow the data to be plotted and compared without the need for export. The intention is to include complementary information which can be used alongside the main 14C series to provide new insights into the global carbon cycle, as well as facilitating access to the data for other research applications. Overall, this work aims to streamline the generation of new calibration curves.
Understanding the relative longevity of different seed lots, perhaps of different species or genotypes, but also following production under different environments or using different cultivation methods, or following different post-harvest treatments, is relevant to anyone concerned with the retention of seed lot viability and vigour during storage. However, different scientists over the years have used different conditions to assess seed lot longevity, as well as different variables as the measure of ‘longevity.’ Here, we give some of the backgrounds to how two standard protocols, with an open and closed system respectively, were derived, and explain why we consider p50, defined as the time during storage when seed lot viability, as measured through a germination test, has declined to 50%, is a suitable longevity trait parameter.
Radiocarbon (14C) ages cannot provide absolutely dated chronologies for archaeological or paleoenvironmental studies directly but must be converted to calendar age equivalents using a calibration curve compensating for fluctuations in atmospheric 14C concentration. Although calibration curves are constructed from independently dated archives, they invariably require revision as new data become available and our understanding of the Earth system improves. In this volume the international 14C calibration curves for both the Northern and Southern Hemispheres, as well as for the ocean surface layer, have been updated to include a wealth of new data and extended to 55,000 cal BP. Based on tree rings, IntCal20 now extends as a fully atmospheric record to ca. 13,900 cal BP. For the older part of the timescale, IntCal20 comprises statistically integrated evidence from floating tree-ring chronologies, lacustrine and marine sediments, speleothems, and corals. We utilized improved evaluation of the timescales and location variable 14C offsets from the atmosphere (reservoir age, dead carbon fraction) for each dataset. New statistical methods have refined the structure of the calibration curves while maintaining a robust treatment of uncertainties in the 14C ages, the calendar ages and other corrections. The inclusion of modeled marine reservoir ages derived from a three-dimensional ocean circulation model has allowed us to apply more appropriate reservoir corrections to the marine 14C data rather than the previous use of constant regional offsets from the atmosphere. Here we provide an overview of the new and revised datasets and the associated methods used for the construction of the IntCal20 curve and explore potential regional offsets for tree-ring data. We discuss the main differences with respect to the previous calibration curve, IntCal13, and some of the implications for archaeology and geosciences ranging from the recent past to the time of the extinction of the Neanderthals.
There are no published estimates of the health state utility values (HSUVs) for a broad range of eating disorders (EDs). HSUVs are used in economic evaluations to determine quality-adjusted life years or as a measure of disorder burden. The main objective of the current study is to present HSUVs for a broad range of EDs based on DSM-5 diagnoses.
Methods
We used pooled data of two Health Omnibus Surveys (2015 and 2016) including representative samples of individuals aged 15 + years living in South Australia. HSUVs were derived from the SF-6D (based on the SF-12 health-related quality of life questionnaire) and analysed by ED classification, ED symptoms (frequency of binge-eating or distress associated to binge eating) and weight status. Multiple linear regression models, adjusted for socio-demographics, were used to test the differences of HSUVs across ED groups.
Results
Overall, 18% of the 5609 individuals met criteria for ED threshold and subthreshold. EDs were associated with HSUV decrements, especially if they were severe disorders (compared to non-ED), binge ED: −0.16 (95% CI −0.19 to −0.13), bulimia nervosa: −0.12, (95% CI −0.16 to −0.08). There was an inverse relationship between distress related binge eating and HSUVs. HSUVs were lower among people with overweight/obese compared to those with healthy weight regardless of ED diagnosis.
Conclusions
EDs were significantly associated with lower HSUVs compared to people without such disorders. This study, therefore, provides new insights into the burden of EDs. The derived HSUVs can also be used to populate future economic models.
To identify discrete approaches to specialist healthcare support for older care home residents in the UK and to estimate their prevalence.
Background:
Internationally, a range of new initiatives are emerging to meet the multiple and complex healthcare needs of care home residents. However, little is known about their relative effectiveness and, given their heterogeneity, a classification scheme is required to enable research staff to explore this.
Method:
A UK survey collected information on the funding, age, coverage, aims, staffing and activities of 64 specialist care home support services. Latent class analysis (LCA) was used to allocate the sample into subgroups with similar characteristics.
Findings:
Three classes were identified. Class 1 (55% of sample) contained services with a high probability of providing scheduled input (regular preplanned visits) and support for all residents and a moderate probability of undertaking medication management, but a low probability of training care home staff (‘predominantly direct care’). Class 2 (23% of sample) had a moderate/high probability of providing scheduled input, support for all residents, medication management and training (‘direct and indirect care’). Class 3 (22% of sample) had a low probability of providing scheduled input, support for all residents and medication management, but a high probability of providing training for care home staff (‘predominantly indirect care’). Consultants were more likely to be members of services in Class 1 than Class 2, and Class 2 than Class 3.
Conclusions:
LCA offers a promising approach to the creation of a taxonomy of specialist care home support services. The skills and knowledge required by healthcare staff vary between classes, raising important issues for service design. The proposed classification can be used to explore the extent to which different organisational forms are associated with better resident, process and service outcomes.
Remarkably few attempts have been made to estimate contemporary effective population size (Ne) for parasitic species, despite the valuable perspectives it can offer on the tempo and pace of parasite evolution as well as coevolutionary dynamics of host–parasite interactions. In this study, we utilized multi-locus microsatellite data to derive single-sample and temporal estimates of contemporary Ne for a cestode parasite (Schistocephalus solidus) as well as three-spined stickleback hosts (Gasterosteus aculeatus) in lakes across Alaska. Consistent with prior studies, both approaches recovered small and highly variable estimates of parasite and host Ne. We also found that estimates of host Ne and parasite Ne were sensitive to assumptions about population genetic structure and connectivity. And, while prior work on the stickleback–cestode system indicates that physiographic factors external to stickleback hosts largely govern genetic variation in S. solidus, our findings indicate that stickleback host attributes and factors internal to the host – namely body length, genetic diversity and infection – shape contemporary Ne of cestode parasites.
Little is known about terrestrial climate dynamics in the Levant during the penultimate interglacial-glacial period. To decipher the palaeoclimatic history of the Marine Oxygen Isotope Stage (MIS) 6 glacial period, a well-dated stalagmite (~194 to ~154 ka) from Kanaan Cave on the Mediterranean coast in Lebanon was analyzed for its petrography, growth history, and stable isotope geochemistry. A resolved climate record has been recovered from this precisely U–Th dated speleothem, spanning the late MIS 7 and early MIS 6 at low resolution and the mid–MIS 6 at higher resolution. The stalagmite grew discontinuously from ~194 to ~163 ka. More consistent growth and higher growth rates between ~163 and ~154 ka are most probably linked to increased water recharge and thus more humid conditions. More distinct layering in the upper part of the speleothem suggests strong seasonality from ~163 ka to ~154 ka. Short-term oxygen and carbon isotope excursions were found between ~155 and ~163 ka. The inferred Kanaan Cave humid intervals during the mid–MIS 6 follow variations of pollen records in the Mediterranean basins and correlate well with the synthetic Greenland record and East Asian summer monsoon interstadial periods, indicating short warm/wet periods similar to the Dansgaard-Oeschger events during MIS 4–3 in the eastern Mediterranean region.
Meeting the societal demand for food, bioproducts and water under climate change is likely to greatly challenge the maize-soybean agriculture of the Midwest USA, which is a globally significant resource. New agricultural systems are needed that can meet this challenge. Innovations in water management engineering and cropping system diversification may provide a way forward, enabling transformation to highly multifunctional agricultural watersheds that expand both agricultural production and water-related services to society, and which provide scalable units of climate adaptation in agriculture and water systems. Implementation and refinement of such watersheds require corresponding social innovation to create supportive social systems, in economic, political and cultural terms. A range of emerging social innovations can drive the emergence of highly multifunctional agricultural watersheds, by enabling robust cooperation, resource exchange and coordinated innovation across multiple societal sectors and scales. We highlight relevant innovations and opportunities for their exploratory implementation and refinement in the Midwest.
Palmer amaranth is a highly invasive weed species causing huge economiclosses in agricultural cropping systems under a broad range of environmentalconditions. Sensitivity of this species to ozone (O3) airpollution and to soil water deficit, relative to native species or competingcrops, may affect its competitiveness and invasive potential. In recentyears, both high tropospheric O3 and soil water deficiency havebecome common in the San Joaquin Valley of California. Responses to theseenvironmental parameters may help predict the invasiveness of this speciesand have implications for landscape hydrology. We assessed the impact of O3 and soil water deficit on Palmer amaranth. Five- toseven-leaf–stage potted plants were placed in continuous stirred tankreactor chambers and maintained for 30 to 35 d under 12-h mean daylight O3 exposures (0700–1900 hours) of 4, 59, or 114 ppb O3. Within the chambers the plants were either well-watered(WW) or exposed to regulated deficit irrigation (RDI) and grown for about 7wk. Dry weights of the leaves, stems, roots, and leaf area were determined.Day- and nighttime stomatal conductances (gs) were measured at 1.5-h intervals. Nocturnal gs was about 16 to 29% of daytime gs; this suggests that the species could have substantialnighttime water loss, uncoupled from carbon gain in the weed, and couldaffect water availability for crops and reduce irrigation efficiency.Nocturnal gs was lower in the RDI than in the WW, but daytime gs was not affected by O3 or irrigation regime. Neither O3 nor irrigation regime affected root or shoot parameters. As O3 and drought are two key stressors in the San JoaquinValley, to which potential competing species have been found to besensitive, Palmer amaranth may proliferate and become more invasive in thefuture, potentially altering landscape hydrology and reducing irrigationefficiency.
A well-dated δ18O record in a stalagmite from a cave in the Klamath Mountains, Oregon, with a sampling interval of 50 yr, indicates that the climate of this region cooled essentially synchronously with Younger Dryas climate change elsewhere in the Northern Hemisphere. The δ18O record also indicates significant century-scale temperature variability during the early Holocene. The δ13C record suggests increasing biomass over the cave through the last deglaciation, with century-scale variability but with little detectable response of vegetation to Younger Dryas cooling.
Horseweed has become increasingly difficult to control in the San Joaquin Valley (SJV) of California. Resistance to glyphosate may not fully explain the quasi-invasive behavior of this native species. We contrast glyphosate-resistant (GR) and glyphosate-susceptible (GS) horseweed biotypes for vigor during the vegetative stage and for resistance to ozone (O3). The SJV is impacted by O3 air pollution, which could be a factor in competitiveness of GR vs. GS. Both biotypes were exposed during the seedling and vegetative stages of rosette development to a range of O3 concentrations in greenhouse exposure chambers. Leaf injury was evaluated visually and biomass production and allocation destructively. In O3-free air, the GR biotype exhibited fewer foliar lesions, more vigorous growth, and 40% greater biomass than the GS biotype. The slope of the response to O3 was greater in the GR than in the GS biotype, implying greater relative sensitivity to O3. This was due to greater vigor at low O3, as the biotypes performed similarly at high O3. The competitive advantage of the GR biotype may be reduced in polluted environments. There appeared to be no linkage between the evolution of resistances to O3 and to glyphosate.
We present the first description of an antimicrobial stewardship program (ASP) used to successfully manage a multi-antimicrobial drug shortage. Without resorting to formulary restriction, meropenem utilization decreased by 69% and piperacillin-tazobactam by 73%. During the shortage period, hospital mortality decreased (P=.03), while hospital length of stay remained unchanged.
To Grasp Fully The Nature And Significance Of The Economic policies at the heart of dominant political projects, those policies have to be studied in the round. They have to be grasped as complex totalities which touch all aspects of the political agenda; and they have to be seen as constructed and contested wholes, whose contradictions, internal inconsistencies and conceptual limits are as vital to their trajectory as are their axioms, theories and content. Academically and professionally, the study of policy in this rounded way is often a more difficult task to complete than might be expected, in part because of the powerful divisions within and between the intellectual disciplines which comprise the social sciences.
Advances in overall management have led to an increasing number of adolescents with congenital heart disease reaching adulthood. This study aimed to evaluate the health-related quality of life in adolescents with heart disease, and examine its relationship with the adolescents’ knowledge and understanding of their congenital heart disease, its severity, and its relationship to the degree of anxiety and depression, feeling of optimism and sense of coherence experienced by the adolescents together with their social support.
Methods and results
Adolescents with heart disease were recruited from an ambulatory setting at a tertiary centre. Patients completed self-report questionnaires including the Paediatric Quality of Life Inventory 3.0-Cardiac Module, a questionnaire assessing the adolescents’ knowledge of their cardiac condition, the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Life Orientation Test-Revised, and Sense of Coherence-13, supplemented by clinical information provided by the attending cardiologists. A total of 114 patients aged 12–20 years were recruited over 15 months. In all, 98% of patients were in New York Heart Association class I. Their health-related quality of life was found to positively correlate with a low level of anxiety and depression (Pearson correlation, r = −0.57, p < 0.001), a good knowledge of their cardiac condition (r = 0.31, p < 0.01), feelings of optimism (r = 0.39, p < 0.001), adequate social support (r = 0.27, p < 0.01), and a strong sense of coherence (r = 0.24, p < 0.01).
Conclusions
Adolescents’ knowledge and understanding of their cardiac abnormality together with an improved sense of well-being had a positive influence on their health-related quality of life.
The IntCal09 and Marine09 radiocarbon calibration curves have been revised utilizing newly available and updated data sets from 14C measurements on tree rings, plant macrofossils, speleothems, corals, and foraminifera. The calibration curves were derived from the data using the random walk model (RWM) used to generate IntCal09 and Marine09, which has been revised to account for additional uncertainties and error structures. The new curves were ratified at the 21st International Radiocarbon conference in July 2012 and are available as Supplemental Material at www.radiocarbon.org. The database can be accessed at http://intcal.qub.ac.uk/intcal13/.