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The SDMPH 10-year anniversary conference created an opportunity for a researcher to present at a professional association conference to advance their research by seeking consensus of statements using Delphi methodology.
Methods
Conference attendees and SDMPH members who did not attend the conference were identified as Delphi experts. Experts rated their agreement of each statement on a 7- point linear numeric scale. Consensus amongst experts was defined as a standard deviation < = 1. Presenters submitted statements relevant to advancing their research to the authors to edit to fit Delphi statement formatting.
Statements attaining consensus were included in the final report after the first round. Those not attaining consensus moved to the second round in which experts were shown the mean response of the expert panel and their own response for opportunity to reconsider their rating for that round. If reconsideration attained consensus, these statements were included in the final report. This process repeated in a third and final round.
Results
37 Experts agreed to participate in the first round; 35 completed the second round, and 34 completed the third round; 35 statements attained consensus; 3 statements did not attain consensus.
Conclusions
A Delphi technique was used to establish expert consensus of statements submitted by the SDMPH conference presenters to guide their future education, research, and training.
Anxiety related school avoidance can affect up to 5% of a country’s students each year. VRET (Virtual Reality Exposure Therapy) is a novel therapy proven to be as effective as conventional approaches for treating many anxiety disorders. The aim of this research is to co-design and evaluate a VRET intervention for students experiencing school related anxiety.
Method:
Eighteen adolescents participated in design thinking workshops where they developed a script and storyboard for the VRET. Using an iterative approach, a VRET prototype was developed based on this work. Eighteen teenagers were subsequently recruited to engage with the VRET for one session each and provide feedback on their experience via a structured questionnaire (supervised by a study coordinator) particularly focusing on the ability of the VR experience to reduce school related anxiety.
Results:
Exposure therapy needs to produce an anxiety response to be effective. The VRET was effective in producing an anxiety response in 89% of participants. Results demonstrated that 93% of participants found the simulations immersive, 94% found the scenarios believable, and 83% could relate to ‘Dala’, the avatar in the videos. 100% of participants believed that VRET would help with school anxiety.
Conclusion:
This proof-of-concept study demonstrates favourable face validity indicating promise for this mode of intervention for delivering targeted support to anxious students. VRET could be used as a scalable, cost effective early intervention to reduce the severity of anxiety associated with school avoidance.
Noncrystalline aluminosilicates termed allophane and imogolite are common constituents of spodosols, soils derived from volcanic ash, and many inceptisols. The surface charge characteristics of their synthetic analogues may be used to better understand their ion retention properties. In this study, we determined the point of zero salt effect (PZSE) by potentiometric titration of allophanes with Al/Si ratios of 1.12, 1.52, and 2.04 and of imogolite with an Al/Si ratio of 2.02. We also used microelectrophoresis to determine the point of zero charge (PZC) at the particle shear plane for the same materials in CI solutions of Li, Na, Cs, and tetramethyl ammonium. The PZSE decreased with decreasing Al/Si ratio for the allophanes, but the imogolite PZSE was much lower than that of the allophane with 2.04 Al/Si. The PZC was always higher than the PZSE of the same material, especially for imogolite. The results are best explained if cations reside within the hollow tubes of imogolite. This conclusion is supported by a fluorescence study that showed that only quenchers smaller than the inner diameter of the imogolite tube could fully quench Ce-imogolite.
Caustic nuclear wastes have leaked from tanks at the US Department of Energy’s Hanford site in Washington State (USA) causing hundreds of thousands of gallons of waste fluids to migrate into the underlying sediments. In this study, four simulant tank waste (STW) solutions, which are high in NaOH (1.4 and 2.8 mol/kg), NaNO3 (3.7 mol/kg) and NaAlO2 (0.125 and 0.25 mol/kg), were prepared and reacted with reference kaolinite KGa-1 and KGa-2 at 50 and 80°C for up to 2 months. The structure and morphology of the resulting products were characterized using X-ray diffraction, scanning electron microscopy, and Fourier transform infrared spectroscopy. The products were also examined for cation exchange and Cs+ sorption as a function of ionic strength and types of cations in the background solutions. Cancrinite and sodalite were the only new minerals observed in all of the conditions tested in this experiment. Two major chemical processes were involved in the reactions: dissolution of kaolinite and precipitation of cancrinite and sodalite. Increasing NaOH concentration and temperature, and decreasing NaAlO2 concentration increased the transformation rate. Both cancrinite and sodalite appeared stable thermodynamically under the experimental conditions. The newly formed feldspathoids were vulnerable to acid attack and pronounced dissolution occurred at pH below 5.5. Cancrinite and sodalite can incorporate NaNO3 ion pairs in their cages or channels. Sodium in cancrinite and sodalite was readily exchangeable by K+, but less easily by Cs+ or Ca2+. The feldspathoid products sorb nearly an order of magnitude more Cs+ than the unaltered kaolinite. The Cs adsorption is reduced by competing cations in the background solutions. At low ionic strength (0.01 M NaNO3 or 0.005 M Ca(NO3)2), Ca2+ was more competitive than Na+. When the concentration of the background solution was increased 10 times, Na+ was more competitive than Ca2+.
The objective of this study was to assess the effect of providing mats in the farrowing pen on behaviour and lesions in sows (n = 38) and piglets. Nineteen of the sows and their litters housed in farrowing crates with metal slatted floors were provided with mats, the remaining 19 acting as controls. Sow skin was inspected pre-farrowing and at weaning: the skin and feet of piglets were examined when they were 6 days old. Skin lesions were scored (on a scale of 0 to 6) according to severity. Total lesion scores per sow and median total lesion scores per litter were calculated. Sow behaviour was recorded by direct observation at feeding. Usage of a heat pad for lying in the presence or absence of mats was assessed over a 2hr observation period. Median skin lesion scores of sows did not differ between treatments. Litters from the control treatment had lower skin lesion scores (median [range] 8 [2-12] vs 10 [5-21]; P < 0.05). Median lesion scores of the front legs tended to be higher for piglets on mats (median [range] 8 [1.5-13] vs 4 [1.5-8]; ns). Sows on metal flooring went from kneeling to lowering their hindquarters faster (median [range] 15 [2—45] s) than sows on mats (23 [11—54] s) (P < 0.05). Furthermore, they slipped more on their front (median [range] 2.7 [0-8.7] vs 0 [0-1.3] slips min1; P < 0.001) and hind (median [range] 5.3 [0.3-31.7] vs 1.9 [0-33.3] slips min1; P < 0.05) feet while standing, than sows on mats. More piglets lay on the heat pad when it was covered by a mat (mean ± SEM 45.97 ± 4.49 %) than when no mat was provided (29.29 ± 4.47 %)(P < 0.05). Mats improve sow comfort and reduce slipping. They encourage piglets to lie on the heat pad but cause damage to the skin of the front legs. Providing pigs with mats in the farrowing house could greatly improve welfare on slatted floors, but further research is needed to identify materials that are less abrasive.
Praziquantel (PZQ) is the drug of choice for schistosomiasis. The potential drug resistance necessitates the search for adjunct or alternative therapies to PZQ. Previous functional genomics has shown that RNAi inhibition of Ca2+/calmodulin-dependent protein kinase II (CaMKII) gene in Schistosoma adult worms significantly improved the effectiveness of PZQ. Here we tested the in vitro efficacy of 15 selective and non-selective CaMK inhibitors against Schistosoma mansoni and showed that PZQ efficacy was improved against refractory juvenile parasites when combined with these CaMK inhibitors. By measuring CaMK activity and the mobility of adult S. mansoni, we identified two non-selective CaMK inhibitors, Staurosporine (STSP) and 1Naphthyl PP1 (1NAPP1), as promising candidates for further study. The impact of STSP and 1NAPP1 was investigated in mice infected with S. mansoni in the presence or absence of a sub-lethal dose of PZQ against 2- and 7-day-old schistosomula and adults. Treatment with STSP/PZQ induced a significant (47–68%) liver egg burden reduction compared with mice treated with PZQ alone. The findings indicate that the combination of STSP and PZQ dosages significantly improved anti-schistosomal activity compared to PZQ alone, demonstrating the potential of selective and non-selective CaMK/kinase inhibitors as a combination therapy with PZQ in treating schistosomiasis.
Vitamin D insufficiency and deficiency have been associated with an increased risk of adverse pregnancy outcomes. Controversy remains as findings have been inconsistent between disparate populations. The aim of this study was to investigate the relationship between vitamin D status and pregnancy outcomes in a large, prospective pregnancy cohort. 25-Hydroxyvitamin D concentration was analysed in serum samples collected at 15 weeks of gestation from 1710 New Zealand women participating in a large, observational study. Associations between vitamin D status and pre-eclampsia, preterm birth, small for gestational age (SGA) and gestational diabetes were investigated. The mean 25-hydroxyvitamin D concentration was 72·9 nmol/l. In all, 23 % had 25-hydroxyvitamin D concentrations <50 nmol/l, and 5 % of participants had concentrations <25 nmol/l. Women with 25-hydroxyvitamin D concentrations <75 nmol/l at 15 weeks of gestation were more likely to develop gestational diabetes mellitus than those with concentrations >75 nmol/l (OR 2·3; 95 % CI 1·1, 5·1). However, this effect was not significant when adjustments were made for BMI and ethnicity (OR 1·8; 95 % CI 0·8, 4·2). 25-Hydroxyvitamin D concentration at 15 weeks was not associated with development of pre-eclampsia, spontaneous preterm birth or SGA infants. Pregnancy complications were low in this largely vitamin D-replete population.
Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.
A search for Type Ia supernovae at cosmological distances is being undertaken in an attempt to exploit their standard candle property to constrain the mass density of the universe. We describe the rationale for such a program, the observational approach and strategy taken, and the progress made to date. The science that is being generated by the project in additional to supernova detection is also discussed briefly.
The environmental impact resulting from the use of fossil fuel as an energy source affects the entire globe. Eventually, fossil fuels will no longer be a reasonable source of energy and alternative energy sources will be needed. Thermoelectric materials (TE) that directly convert heat into electricity are a viable option to replace the conventional fossil fuel because they are reliable, cost effective, and use no moving parts. Recently researchers discovered the existence of giant Seebeck coefficient in manganese oxide (MnO2) powders, which ignited an increased interest in MnO2-based materials. In this work we present a systematic structural and electrical characterization of amorphous and crystalline MnxOy thin films. These films were deposited at room temperature on heated silicon and sapphire substrates by DC Magnetron Sputtering. Our preliminary results show that MnxOy/silicon thin films undergo a crystalline change from Mn2O3 to Mn3O4 as annealing temperature is increased from 300°C to 500°C.
Autoantibodies have been implicated in the etiologic pathway of depressive disorders. Here, we determine the association between the presence of a panel of autoantibodies at baseline and change in depression symptom score over 5-year follow-up in a cohort of healthy elderly Australians.
Methods
Serum samples from 2049 randomly selected subjects enrolled in the Hunter Community Study (HCS) aged 55–85 years were assayed for a range of autoimmune markers (anti-nuclear autoantibodies, extractable nuclear antigen autoantibodies, anti-neutrophil cytoplasmic autoantibodies, thyroid peroxidase autoantibodies, tissue transglutaminase autoantibodies, anti-cardiolipin autoantibodies, rheumatoid factor and cyclic citrullinated peptide autoantibodies) at baseline. Depression symptom score was assessed using the Centre for Epidemiological Study (CES-D) scale at baseline and 5 years later.
Results
Autoantibody prevalence varied amongst our sample with ANA being the most prevalent; positive in 16% and borderline in 36% of study population. No evidence for a relationship was found between change in CES-D score over time and any autoimmune marker. Statins and high cholesterol were significantly associated with change in CES-D score over time in univariate analysis; however, these were probably confounded since they failed to remain significant following multivariable analysis.
Conclusions
Autoantibodies were not associated with change in CES-D score over time. These findings point to an absence of autoimmune mechanisms in the general population or in moderate cases of depression.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
On June 13, 2012, a group of key stakeholders, leaders, and national experts on tuberculosis (TB), occupational health, and laboratory science met in Atlanta, Georgia, to focus national discussion on the higher than expected positive results occurring among low-risk, unexposed healthcare workers undergoing serial testing with interferon-γ release assays (IGRAs). The objectives of the meeting were to present the latest clinical and operational research findings on the topic, to discuss evaluation and treatment algorithms that are emerging in the absence of national guidance, and to develop a consensus on the action steps needed to assist programs and physicians in the interpretation of serial testing IGRA results. This report summarizes its proceedings.
In this book, published in 1686, the scientist Robert Boyle (1627–91) attacked prevailing notions of the natural world which depicted 'Nature' as a wise, benevolent and purposeful being. Boyle, one of the leading mechanical philosophers of his day, believed that the world was best understood as a vast, impersonal machine, fashioned by an infinite, personal God. In this cogent treatise, he drew on his scientific findings, his knowledge of contemporary medicine and his deep reflection on theological and philosophical issues, arguing that it was inappropriate both theologically and scientifically to speak of Nature as if it had a mind of its own: instead, the only true efficient causes of things were the properties and powers given to matter by God. As such, A Free Enquiry into the Vulgarly Received Notion of Nature represents one of the subtlest statements concerning the philosophical issues raised by the mechanical philosophy to emerge from the period of the scientific revolution.
Edited by
Alex S. Evers, Washington University School of Medicine, St Louis,Mervyn Maze, University of California, San Francisco,Evan D. Kharasch, Washington University School of Medicine, St Louis
To assess whether a print-based intervention led to increased contact with consumer health organisations (CHOs) by general practice patients with chronic disease.
Background
CHOs can enhance people's capacity to manage chronic illness by providing information, education and psychosocial support. However, these organisations appear to be grossly under-utilised by patients and clinicians.
Methods
A total of 276 patients completed a computer-assisted telephone interview before randomisation to an intervention (n = 141) or control (n = 135) group. The intervention consisted of mailed printed materials designed to encourage contact with a CHO relevant to the patient's main diagnosed chronic condition. Follow-up interviews were conducted 4 and 12 months later.
Findings
Patients with conditions other than diabetes who received the intervention were twice as likely as those in the control group to contact a consumer health organisation during the 12-month study period: 41% versus 21% (P < 0.001). No such effect was found for diabetes patients, probably because of pre-existing high levels of contact with diabetes organisations. The intervention package received strong patient endorsement. Low-intensity interventions may be effective in improving access to CHOs for patients with chronic disease.