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• A combined synchronous-asynchronous method is best for online screen-based simulation. • Synchronous-asynchronous screen-based simulation allows for experiential learning. • Trainees rapidly master asynchronous high-fidelity screen-based programs. Instructor-led synchronous screen-based simulation (SBS) allows distance teaching in anesthesia without the need for students to learn complex software but sacrifices experiential learning. A total of 14 nurse anesthesia students performed a limited online instructor-led synchronous SBS followed by self-directed asynchronous sessions (synchronous-asynchronous SBS). We compared the outcome measures, post-activity questionnaires and integrated-software performance scores, from this group with identical evaluations from a previous cohort who participated only in instructor-led synchronous SBS with the same digital scenario. Students preferred synchronous-asynchronous SBS sessions compared to instructor-led synchronous SBS sessions, perceived the educational value of experiential learning in the former sessions, and rated them as less stressful. Performances were similar with both methods of instruction. Students rapidly acquired self-assessed proficiency with a complex, high-fidelity software program. Synchronous-asynchronous SBS is preferable to instructor-led synchronous SBS because the former process permits experiential learning and is less stressful, and is associated with comparable performance scores. Proficiency was readily achieved with self-directed asynchronous SBS using a high-fidelity software program. [ABSTRACT FROM AUTHOR]

Prostate cancer is the most commonly occurring cancer in males overall, but ethnicity is a strong predictor of incidence. African and non-Hispanic Caucasian ethnicities possess the highest incidences, while those of Asian, East-Asian, and Indigenous peoples have the lowest. Comparisons between the genomic alterations of Asian, African, and non-Hispanic Caucasian (nHC) ethnicities have indicated that PTEN losses, and FXA1 alterations are common irrespective of ethnicity. While ERG deletions are less common in Asian populations, compared to African and nHC ethnicities. The ethnic contribution to prostate adenocarcinoma (PAC) was further evaluated using the cBioPortal Genomics data tool from Memorial Sloan Kettering (MSK). An evaluation of Asian (East Asian/Asian; N=131), African (N=165), and nHC (N=3,642) from 19 cohort studies, totaling 3,938 individuals, was undertaken. Overall survival outcomes were highest for nHC, individuals followed by African individuals. Comparative hazard ratios were highest for Asian individuals at 1.6. Expectedly, FOXA1, TP53 , and SPOP were among the most commonly altered genes in each ethnicity. Copy number alterations (CNAs) in 74 genes, including amplification of the antigen receptor gene (AR), were significantly enriched in Asian PAC (p=4.6 × 10-3). CNAs in 14 driver genes were enriched in Asians and tended to be co-altered. Mutations in 66 genes were enriched in Asians, including in mutations in ATRX, CDK12, FH, NF1 , and RAD51D that tended to co-mutate. Finally, 16 genes were found to be altered exclusively in a minority of the Asian population, including BLM , and CHD2. The described molecular differences may contribute to the ethnic disparities of PAC incidence. [ABSTRACT FROM AUTHOR]

• Research is needed on the effectiveness of telehealth group interventions • We evaluated a telehealth adaptation of group CBT for social anxiety disorder • The adapted intervention was acceptable to participants • Group members were highly engaged and satisfied with treatment • Group members reported decreases in social anxiety and associated symptoms In light of the growing interest in, and need for, the telehealth delivery of health care, additional research is needed on the acceptability and effectiveness of these types of interventions. This study examined the acceptability, feasibility, and preliminary effectiveness of an adapted telehealth-delivered group cognitive-behavioral therapy (CBT) intervention for adults with social anxiety disorder (SAD). This report describes the adaptation and subsequent implementation of an 8-week telehealth-delivered group treatment designed to reduce symptoms of SAD. Specific adaptations for delivering treatment during the COVID-19 pandemic and the subsequent enactment of social distancing measures are discussed. Posttreatment data indicated that the intervention was feasible to implement in an outpatient mental health clinic, acceptable to participants, and associated with reduction in symptoms of social anxiety, general anxiety, depression, and stress. [ABSTRACT FROM AUTHOR]

Caseload continuity of care models of midwifery are associated with benefits for both mothers and babies. For midwifery staff, caseload models offer flexibility, supportive work partnerships, and one-to-one care with women. However, most caseload models require midwives to be employed 0.7 full-time equivalent or more. To evaluate the satisfaction of women and staff with 0.5 full-time equivalent part-time caseload midwifery group practice care. A mixed-methods survey study was undertaken. Women, part-time and full-time caseload midwifery staff completed an online survey regarding their experiences. Descriptive statistics were calculated and thematic analysis of qualitative responses was undertaken. Women were highly satisfied with the part-time model of care. They indicated a number of advantages including excellent support, flexibility, and responsiveness in receiving care from two primary midwives. Similarly, caseload team midwives were satisfied with the part-time model and valued the flexibility that it offers. Improved coverage of hours and being part of a workplace that promoted work-life balance were perceived as key advantages of having part-time staff in the caseload team. The part-time model facilitated continuity of care and was received positively by women. For staff, part-time roles enhanced work satisfaction and reduced burnout. Most staff encouraged greater expansion of part-time roles. Organisations may reduce midwife burnout and associated costs by implementing part-time roles to support work-life balance and staff satisfaction. Part-time caseload midwifery models offered greater flexibility and work-life-balance for staff compared to full-time models and were well received by women. [ABSTRACT FROM AUTHOR]

Healthful dietary changes after metabolic and bariatric surgery (MBS) may benefit not only patients, but the type and/or availability of foods/beverages in the family home food environment (HFE) overall, thereby reducing obesogenic environmental risks to child offspring in the home. Few studies have investigated the family HFE after MBS. To examine whether the HFE of mothers post-MBS differed from the HFE of mothers of normal weight, overweight, and with obesity using an open home food inventory. Cincinnati, Ohio and Newark, Delaware. Thirty-two mothers with a child (6–12 yr) participated (8 post-MBS, 8 normal weight, 8 overweight, 8 with obesity) in a pilot study. Research personnel recorded all foods and beverages in the home. Per person total energy and servings of fruits, vegetables, sugar-sweetened beverages, and energy-dense snack foods in the HFE were examined using 1-way analyses of variance and Cohen's d effect sizes. Mothers in the post-MBS group had significantly fewer servings of sugar-sweetened beverages available per person compared with mothers with obesity (P =.01). Effect sizes for group differences indicated total energy, sugar-sweetened beverages, and servings of fruits and vegetables were generally medium to large, most with lower mean values for the post-MBS group relative to comparator groups. These findings, while preliminary, highlight areas for future research and add to an emerging literature on obesogenic risks to offspring in the post-MBS home, a known subgroup at high risk for severe obesity. [ABSTRACT FROM AUTHOR]

To determine whether critical thinking improved after student-pharmacists participated in a semester-long critical thinking course in the first semester of pharmacy school. Students took the Health Sciences Reasoning Test-Numeracy (HSRT-N) on the first and last day of the course. The overall HSRT-N score, percentile ranking, and eight sub-categories within the HSRT-N (analysis, interpretation, inference, evaluation, explanation, induction, deduction, and numeracy) were evaluated. A multivariable quantile regression model evaluated the association between the post-test percentile and student age, at which campus the student was enrolled, and how many minutes the students required to take the test. There were no significant differences in overall scores, percentile, or the sub-category scores with the exception of a significant increase in the analysis score and a significant decrease in the induction score. There was a greater increase for students in the lower quartiles on the pre-test compared to students in the higher quartiles on the pre-test. The largest percentile change occurred in students in the 25th–50th percentiles. A statistically significant improvement in the analysis category of the HSRT-N and a greater increase for students in the lower quartiles on the pre-test to the post-test suggests students with the lowest quartiles on the HSRT-N would benefit the most from a critical thinking course. [ABSTRACT FROM AUTHOR]

Abstract The aim of this study is to examine and measure the characteristics of air cavities generated by breaking solitary waves by utilizing a novel tomographic X-ray system. Small scale experiments of solitary waves that propagate on a 5. 1 ∘ (1:10) beach are conducted. Waves with amplitude normalized with the water depth, a ∕ H = 0. 47 on a flat bottom are investigated by two perpendicular X-ray systems. Images are captured at locations from the surf zone to the swash zone and at maximum runup. A large air tube is observed right after the plunger impacts the dry beach. Void velocity and the shape of the large air tube, are measured and reported. The large air tube evolves from a symmetrical shape with two large air pockets located close to the walls of the wave tank, to an asymmetrical shape. Contrast enhanced X-ray images reveal that the swash tongue surface is unstable and that secondary mixing of air and water occurs. X-ray images from the maximum runup reveal that the air is still entrapped by the thin swash tongue at times close to maximum runup. [ABSTRACT FROM AUTHOR]

• Ecological suitability methodologies for estuarine habitats are presented. • Habitats for ecologically and socially important species are characterized. • Ecological and social weighting factors are developed and applied. • Results can be reported for defined spatial units and at the estuarine scale. • Ecological suitability measures can inform cumulative restoration assessments. Ecosystem management requires a systematic, holistic approach that considers ecological and social outcomes. Effective restoration practices promote a balance of ecological and social goals by addressing ecological integrity, efficiently maximizing benefits while minimizing investment, and encompassing collaborative stakeholder engagement. Socio-ecological assessments can inform adaptive management and be utilized to prioritize restoration activities and monitor restoration effectiveness. In estuarine systems, socio-ecological assessments should evaluate the ability of habitats to support both ecologically and locally important species. The composite measure presented utilizes a combination of ecological and social measures to characterize ecological suitability for individual and multiple Gulf of Mexico estuarine species. The ecological suitability value (ES) for a given spatial unit is based on a suite of biophysical measures of the quality and extent of suitable habitat for each species, the species' trophic importance in a food web context, and the importance of each species in relation to stakeholder values and benefits. ES values for individual spatial units can be aggregated to estimate the distribution of ecological suitability at the estuarine scale. The ES values are calculated using examples for each step in the process. The information provided by ecological suitability characterizations can support restoration prioritization decisions for Gulf of Mexico estuaries and can provide a baseline measure to gauge restoration effectiveness over time to inform cumulative restoration assessments. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate surface structures in two phase horizontal pipe flow. The flow regimes investigated vary from linear wavy flow to violent breaking wave regimes. Experiments are conducted in a 31 m long pipe with a diameter of 0.1 m. High temporally and spatially resolved X-ray measurements and conductance wave probe measurements are conducted simultaneously. The average phase speed measured by the conductance probes coincided with semi-theoretical linear wave theory for the cases where the surface was symmetrical about the centerline, and the superficial gas velocity U sg was kept below 2 m/s. The wave regimes, where asymmetrical surface structures were obtained, had an average phase speed that was lower than the semi theoretical prediction. This implies that asymmetry slows down the waves. In addition, the power spectral density (PSD) for the linear cases had distinct peaks, while for the other cases no peaks were obtained, and no preferred wavelengths were associate with the energy distribution for the nonlinear cases. The spectrum calculated from the X-ray images revealed that the second peak in the power density spectrum for the linear waves were not present at positions close to the pipe wall. The energy was instead distributed to other wave frequencies, which indicate that the waves were less regular close the pipe walls, and that the regions near the pipe wall are prone to extreme waves and breaking events. The irregularity close to the pipe walls and the broad energy distribution for the case with high gas velocity, are related to a one sided breaking event obtained on the left side of the pipe. [ABSTRACT FROM AUTHOR]

Background: Little data is available in the literature about the role of end tidal oxygen in critically ill patients. We sought to identify the association between the level of respiratory oxygen and clinical outcomes in critically-ill ventilated trauma and burn patients.Methods: A retrospective cohort of 55 trauma and burn patients from 2010 to 2016 was collected. Exposures of interest included a) expiratory end tidal oxygen (ETO2) and b) the difference between FiO2 and ETO2 (uptake). Associations of clinical characteristics with ETO2 and oxygen uptake were examined using a Spearman correlation. The relationships between discharge status, demographics, injury type, severity, and clinical characteristics were examined using chi-square (or Fisher's exact) tests and two-sample t-tests. Multivariable analyses using linear and logistic regression were performed to determine whether expiratory end tidal oxygen or oxygen uptake was an independent predictor of clinical outcomes.Results: Mean age for the patients was 46.3±18.2years with 41 (74.6%) male and 34 (61.8%) white. In the cohort, 27 (49.1%) of patients had burns and 28 (50.9%) blunt trauma. Oxygen uptake was negatively correlated with lactic acid, minute ventilation, total ICU days, and ventilator days (p<0.05). Patients who died demonstrated lower oxygen uptake than those alive, oxygen uptake remained significantly associated with discharge status after adjusting for potential confounders (p=0.028).Conclusion: A narrowed difference between ETO2 and inspiratory oxygen is associated with increased mortality in a cohort of ventilated trauma and burn patients. Future research is needed to further elucidate the role of respiratory oxygen level in larger, prospective studies. [ABSTRACT FROM AUTHOR]

Using data collected before and after the catastrophic flooding that took place in northern Bangladesh in 2014, this paper contributes to the growing evidence on the factors enhancing households’ resilience to shocks, or their “resilience capacities”. The analysis takes into account all three dimensions of resilience capacity—absorptive, adaptive, and transformative—as well as a broad range of specific capacities supporting them. In addition to disaster preparedness and mitigation, it finds suggestive evidence that the following capacities reduced the negative impact of the flooding on household food security: social capital, human capital, exposure to information, asset holdings, livelihood diversity, safety nets, access to markets and services, women’s empowerment, governance, and psycho-social capabilities such as aspirations and confidence to adapt. The paper highlights the importance of taking a comprehensive approach to understanding the determinants of resilience in future research, one that accounts for the full range of potential capacities. It also points to the value of taking a cross-sectoral, multi-intervention approach to on-the-ground resilience programing in Bangladesh and other developing-country areas that are increasingly vulnerable to climate shocks. [ABSTRACT FROM AUTHOR]

Background After reaching an all time low in 2000, the rate of syphilis in the United States has been steadily increasing. Parallel benchmarking of the disease's mortality burden has not been undertaken. Methods Using ICD-10 classification, all syphilis-related deaths in the national Multiple Cause of Death dataset were examined for the period 2000-2014. Descriptive statistics and age-adjusted mortality rates were generated. Poisson regression was performed to analyze trends over time. A matched case-control analysis was conducted to assess the associations between syphilis-related deaths and comorbid conditions listed in the death records. Results A total of 1,829 deaths were attributed to syphilis; 32% (n = 593) identified syphilis as the underlying cause of death. Most decedents were men (60%) and either black (48%) or white (39%). Decedents aged ≥85 years had the highest average mortality rate (0.47 per 100,000 population; 95% confidence interval [CI], 0.42-0.52). For the sampled period, the average annual decline in mortality was −2.90% (95% CI, −3.93% to −1.87%). However, the average annual percent change varied across subgroups of interest. Conclusions Declines in U.S. syphilis mortality suggest early detection and improved treatment access likely helped attenuate disease progression; however, increases in the disease rate since 2000 may be offsetting the impact of these advancements. [ABSTRACT FROM AUTHOR]

Objective To describe common teaching activities included in post-graduate residencies, identify residents’ self-perceived ability to perform the activities, and report characteristics of residents who did not feel post-graduate residency training prepared them for an academic career. Methods Residency Directors of PGY-2 ASHP-accredited U.S. residency programs in the July 2013–June 2014 cycle were asked to forward a 16-item online survey to PGY-2 residents. The survey was designed to determine teaching activities from a list of 21 common activities and measure self-perception of skill development. Residents who felt unprepared for academia were analyzed. Results There were 446 residents in PGY-2 residencies in the 2013/2014 residency cycle and 237 (53%) completed the survey. Common teaching activities included delivering lectures and developing handouts, motivating students and providing feedback on rotation, and delivering continuing education programs. Comparisons between the activity occurrence and incidence of self-perceived proficiency were similar for all 21 activities. Forty residents originally intended to pursue academia but only 19 entered academia. Twenty-six residents reported not feeling adequately prepared as an influencing factor, significantly less exposure to several common teaching activities, and less self-perceived ability to perform the activities in 15 out of 21 common teaching activities. Conclusion PGY2 residents reported self-efficacy for all teaching activities experienced during residency training. Residents who felt unprepared to enter academia were exposed to significantly less teaching activities and reported less self-efficacy to perform the skills. Closer attention to the types of teaching activities included in residency programs is warranted. [ABSTRACT FROM AUTHOR]

Supervised machine learning approaches are increasingly used to analyze clinical data, including in geriatric oncology. This study presents a machine learning approach to understand falls in a cohort of older adults with advanced cancer starting chemotherapy, including fall prediction and identification of contributing factors. This secondary analysis of prospectively collected data from the GAP 70+ Trial (NCT02054741 ; PI: Mohile) enrolled patients aged ≥70 with advanced cancer and ≥ 1 geriatric assessment domain impairment who planned to start a new cancer treatment regimen. Of ≥2000 baseline variables ("features") collected, 73 were selected based on clinical judgment. Machine learning models to predict falls at three months were developed, optimized, and tested using data from 522 patients. A custom data preprocessing pipeline was implemented to prepare data for analysis. Both undersampling and oversampling techniques were applied to balance the outcome measure. Ensemble feature selection was applied to identify and select the most relevant features. Four models (logistic regression [LR], k-nearest neighbor [kNN], random forest [RF], and MultiLayer Perceptron [MLP]) were trained and subsequently tested on a holdout set. Receiver operating characteristic (ROC) curves were generated and area under the curve (AUC) was calculated for each model. SHapley Additive exPlanations (SHAP) values were utilized to further understand individual feature contributions to observed predictions. Based on the ensemble feature selection algorithm, the top eight features were selected for inclusion in the final models. Selected features aligned with clinical intuition and prior literature. The LR, kNN, and RF models performed equivalently well in predicting falls in the test set, with AUC values 0.66–0.67, and the MLP model showed AUC 0.75. Ensemble feature selection resulted in improved AUC values compared to using LASSO alone. SHAP values, a model-agnostic technique, revealed logical associations between selected features and model predictions. Machine learning techniques can augment hypothesis-driven research, including in older adults for whom randomized trial data are limited. Interpretable machine learning is particularly important, as understanding which features impact predictions is a critical aspect of decision-making and intervention. Clinicians should understand the philosophy, strengths, and limitations of a machine learning approach applied to patient data. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer survivors (BCSs) experience symptoms affecting overall quality of life (QOL), often for a prolonged period post-treatment. Meditative Movement (MM), including Qigong and Tai Chi Easy (QG/TCE), has demonstrated benefit for improving QOL issues such as fatigue and sleep, but there is limited evidence of its impact on cognitive function, overall physical activity, and body weight for BCSs.Design: This double-blind, randomized controlled pilot study with 87 female BCSs explored effects of QG/TCE on mental and physical QOL (Medical Outcomes Survey, Short Form), cognitive function (Functional Assessment of Cancer Therapy-Cognitive Function and two cognitive performance tests from the WAIS III), overall levels of physical activity (PA)(Brief Physical Activity Questionnaire) and body mass index (BMI).Interventions: Twelve weekly sessions of QG/TCE were compared to sham Qigong (SQG), a gentle movement control intervention similar to QG/TCE but without the focus on breathing and meditative state.Results: Both groups demonstrated pre-to-post-intervention improvements in physical and mental health, level of PA, self-reported cognitive function, and cognitive performance tests, though without significant differences between QG/TCE and SQG. For a subset of women enrolled later in the study, a significant reduction in BMI [-0.66 (p=0.048)] was found for QG/TCE compared to SQG.Conclusions: Practices that include gentle movement (such as QG/TCE or our sham protocol) among women with a history of breast cancer may improve many facets of the cancer experience, including QOL, cognitive function, and PA patterns. Practicing QG/TCE may show some advantage for BMI reduction compared to non-meditative gentle exercise. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to understand how Thomas Cook can turn Entrepreneurs into Intrapreneurs by: looking at the intrinsic and extrinsic motivators as well as the factors in a corporate environment that are conducive to, and act as barriers against entrepreneurial behaviour. A case study approach was adopted. Interviews were carried out with, amongst others, entrepreneurs and intrapreneurs in Thomas Cook. It was found that Entrepreneurs and Intrapreneurs have complementary skills, particularly in navigating a corporate political environment. With top level sponsorship and support, they achieve their goals by sometimes breaking rules. Connecting the Entrepreneurs and Intrapreneurs to engage with each other, and utilising their skills for bigger and wider challenges, provides development opportunities for both groups. Due to an embargo, the paper refers to research carried out in the late 2000's. [ABSTRACT FROM AUTHOR]

Objective To determine if self-perceived teaching proficiency obtained from a teaching certificate at the end of post-graduate training is appropriate to measure program effectiveness and if the teaching certificate program influenced the decision to choose academia as a career. Methods Pharmacy practice faculty from U.S. Schools and Colleges of Pharmacy were surveyed to determine teaching activities included in teaching certificate programs from a list of 21 teaching activities, if they felt their teaching certificate prepared them to conduct the teaching activities by the end of the program, and to indicate if, after one year in academia, they continued to believe the teaching certificate program prepared them to perform the teaching activities. Results There were 1620 faculty surveyed and a 32% response rate. The self-perceived ability at the end of residency compared at two time points (directly at the end of residency and retroactively after one year in academia) was similar for 15 of the 21 skills. Self-perceived ability at the 1-year time point was significantly higher for four skills ( p < 0.05): writing a course syllabus, developing a grading rubric, writing an experiential rotation syllabus, and serving as a student advisor. Self-perceived abilities were significantly lower at the latter time point for two skills—incorporating active learning and delivering a lecture. Overall, 70% of respondents reported that the teaching certificate program influenced their decision to choose a career in academia. Conclusion Self-perceived ability to perform teaching skills measured at the end of teaching certificate programs is similar to self-perceived ability measured at the end of one year in academia indicating self-perception of ability is an appropriate measure of teaching certificate program efficacy. Greater emphasis on skills involving delivering a didactic lecture and incorporating active learning seems warranted. [ABSTRACT FROM AUTHOR]

Psychosocial factors have significant potential to affect long-term outcomes of bariatric surgery, including emotional adjustment, adherence to the recommended postoperative lifestyle regimen, weight loss outcomes, and co-morbidity improvement and or resolution. Thus, it is recommended that bariatric behavioral health clinicians with specialized knowledge and experience be involved in the evaluation and care of patients both before and after surgery. The evaluating clinician plays a number of important roles in the multidisciplinary treatment of the bariatric patient. Central among these is the role of identifying factors that may pose challenges to optimal surgical outcome and providing recommendations to the patient and bariatric team on how to address these issues. This document outlines recommendations for the psychosocial evaluation of bariatric surgery patients, appropriate qualifications of those conducting these evaluations, communication of evaluation results and suggested treatment plan, and the extension of behavioral healthcare of the bariatric patient to the entire span of the surgical and postsurgical process. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to evaluate the cardiorespiratory response and energy expenditure during the practice of Tai Chi Easy (TCE). TCE has been proposed as a low-intensity alternative to traditional physical activity.Design: Oxygen cost data were collected from 10 healthy adult women (mean age of 47.9 ± 12.8 years) at rest and during a 30-min session of TCE using an automated metabolic cart and heart rate (HR) telemetry. The Borg rating of perceived exertion (RPE) scale was utilized to measure subjective intensity of the TCE movements.Results: The mean oxygen consumption (VO(2)) for the movements ranged from 4.3 ml kg(-1)min(-1) to 5.5 ml kg(-1)min(-1) with an overall mean of 5.0 ml kg(-1)min(-1). The mean HR for all activity was 67.0 beats per minute and the mean energy expenditure (EE) was 1.6 Kcal min(-1).Conclusions: Cardiorespiratory and EE responses to TCE indicate that this a low intensity exercise appropriate for individuals requiring activity prescriptions of approximately 2 metabolic equivalents (METs). [ABSTRACT FROM AUTHOR]

• The ecological suitability approach builds upon previous restoration frameworks. • The conceptual approach is applicable to multiple ecosystem types. • A balance of ecological and social outcomes for targeted restoration is promoted. • Ecological suitability is a novel way to communicate potential restoration outcomes to ecosystem managers and stakeholders. A combination of ecological and socio-economic outcome indicators is essential for understanding and assessing the effectiveness of the remediation and restoration of degraded ecosystems and revitalizing communities that could benefit from these ecosystem management activities. In this paper, we propose and develop a conceptual approach to characterize ecological suitability that incorporates ecological attributes that support ecosystem structural diversity and functionality, stakeholder values and perceptions, and the benefits derived from ecosystem goods and services. A structured literature review was used to identify existing restoration frameworks and indicators to inform the conceptual foundation for characterizing ecological suitability. The structure of the conceptual approach primarily builds from ecological and social attributes in the International Principles and Standards for the Practice of Ecological Restoration (Gann et al., 2019). We provide a conceptual example of the ecological suitability approach in estuaries. This example is based on habitat suitability and food web characterizations in combination with the provisioning of ecosystem services and desired social benefits to prioritize and evaluate restoration effectiveness. This foundational work sets the stage for developing a composite measure of ecological suitability. The holistic conceptual approach presented complements existing information regarding restoration effectiveness evaluations. Characterizing ecological suitability is a novel way to incorporate ecological and social information and communicate potential restoration outcomes to ecosystem managers and stakeholders. [ABSTRACT FROM AUTHOR]

This integrative review of literature explores the best practice for establishing and maintaining a hospital-based nurse preceptor program. The intent is to provide nurse leadership and educators with guidance for optimizing preceptor programs in order to improve patient, staff, and organizational outcomes. The project team conducted an integrative review of literature to inform best practice using the Johns Hopkins Evidence-Based Practice Model and Guidelines. Data sources included the PubMed, CINAHL, and Cochrane databases. Each applicable article underwent a rigorous review and appraisal by the project team. The team used the Johns Hopkins Evidence-Based Practice Model to guide the appraisal process and to synthesize results to generate a comprehensive list of recommendations. The search yielded 115 unique articles that answered the evidence-based practice question. What are best practices for establishing and maintaining a hospital-based nursing preceptor program? Due to the abundance of data, the practice question was divided into three separate sub questions that explored preceptor development, continuous preceptor support, and essential competencies of preceptors. Relevant evidence included one level I article, seven level II articles, and one level IV article. Most of the evidence was found in articles ranking as level III (n = 54) and level V (n = 52). Many preceptorship themes and recommendations resonate throughout multiple levels of evidence. Recommendations include implementing an evidence-based, standardized curriculum that features diverse teaching modalities, critical thinking, and clinical reasoning. Common themes in the literature echo that preceptors need ongoing education, training, and support to improve nursing satisfaction, retention, and the quality of nursing care. [ABSTRACT FROM AUTHOR]

Cardiac magnetic resonance elastography (MRE) can be used to assess myocardial stiffness in vivo. Rodents play an important role in modern cardiovascular research, and small animal cardiac MRE may reveal important aspects of myocardial stiffness. The aim of this study was to explore the feasibility of small animal cardiac MRE through investigation of stiffness measurements of small cardiac phantoms that have known underlying stiffness. Agarose gel phantoms of three different geometrical designs were used: homogeneous gels, solid hearts, and biventricular phantoms. The size of the heart phantoms was comparable with that of an end-diastolic rat heart. All phantoms were made with different underlying stiffnesses agarose concentration, (7.5, 10.0,15.0)g/l, and MRE acquisition was performed with three different frequencies (360, 380, 400)Hz. Two different post-processing methods were applied to the MRE wave images: local frequency estimate (LFE) and direct inversion (DI). The stiffness associated with the different agarose concentrations (7.5, 10.0, 15.0)g/l in the homogenous gels at 400 Hz were (1.80 ± 0.18, 3.13 ± 0.20, 4.13 ± 0.37)kPa for LFE and (2.25 ± 0.24, 4.35 ± 0.45, 6.54 ± 0.44)kPa for DI, respectively. Significant differences in MRE-derived stiffness were observed among phantoms with different agarose concentrations for all geometries. However, biases in the stiffness measurements among the different geometries were observed and could not be explained by the measurement variability. The relative stiffness uncertainty was smallest for the LFE inversion algorithm. The stiffness measurements validate the use of the MRE technique to differentiate between various underlying stiffnesses in small cardiac phantoms. The stiffness measurements seemed to be dominated by geometrical effects when the cardiac MRE wavelength was longer than half the size of the heart. LFE was the inversion algorithm that was most sensitive to the changes in underlying stiffness. [ABSTRACT FROM AUTHOR]

Background Some states allow simulation substitution of supervised clinical instruction. However, a review of the literature found that a standard substitution ratio for simulation hours to supervised clinical hours does not exist among prelicensure nursing programs. Method A descriptive survey was sent to more than 1,400 prelicensure schools of nursing. Results Schools of nursing reported various substitution ratios demonstrating ambiguity between institutions. Conclusion This study provided an initial view of current practices related to simulation as a substitution for supervised clinical experiences. [ABSTRACT FROM AUTHOR]

Human activity has growing impacts on the natural capital humans depend on for existence. While many of these impacts are regional, national, or international in scope, it is increasingly evident that decisions made at the local community level are also important. Yet, understanding the impacts of local decisions, as well as how to correct or mitigate these impacts, can be problematic, as communities differ in resources, priorities, dependencies on natural capital, and even opinions about whether these impacts actually affect quality of life. Every community has unique characteristics, however effective decision support at the community level requires common reference points in measures of human well-being upon which to base decision support. We have developed a community classification system that is intended to find such common ground in community characteristics and tie these common elements to measures of human well-being. This community classification system was developed in the USA with publically available data on resource dependence, socio-economic composition, and existence of natural capital. The resulting classification was applied to coastal communities at the county level and then used to predict human well-being based on an existing human well-being index. Coastal communities were separated into eight characteristics groups based on Bayesian cluster analysis. Classification groups were found to be associated with significant differences in human well-being. More importantly, significant differences in specific elements of well-being were associated with key community characteristics, such as population density and economic dependence on local natural resources. In particular, social cohesion and the leisure time were strong elements of well-being in low density communities with high natural resource dependence but this association weakened as population densities and economically diversity increased. These sorts of commonalities in community type that can be tied to differences in human well-being are important because they provide clear ties to environmental service flows, as well as a meaningful reference point from which to measure the local impacts of decisions as changes in community-specific human well-being. [ABSTRACT FROM AUTHOR]

Summary As the post-MDG era approaches in 2016, reducing child undernutrition is gaining high priority on the international development agenda, both as a maker and marker of development. Revisiting Smith and Haddad (2000), we use data from 1970 to 2012 for 116 countries, finding that safe water access, sanitation, women’s education, gender equality, and the quantity and quality of food available in countries have been key drivers of past reductions in stunting. Income growth and governance played essential facilitating roles. Complementary to nutrition-specific and nutrition-sensitive programs and policies, accelerating reductions in undernutrition in the future will require increased investment in these priority areas. [ABSTRACT FROM AUTHOR]

The prevalence of undernourishment in India – the percent of people consuming insufficient calories to meet their energy requirements – has been rising steadily since the mid 1980s. Paradoxically, this period has been one of robust poverty reduction and rapid economic growth. The reasons for the apparent reductions in calorie consumption underlying increased undernourishment have been the subject of intense debate both within India and internationally. This paper critically reviews this debate, finding that is has taken place outside of the context of India’s recent nutrition and epidemiological transitions, which appear to have brought with them increased, not decreased, food consumption. The debate has also taken place under the unchallenged assumption that the data on which the conflicting trends are based, collected as part of the country’s Household Consumption and Expenditure Surveys (HCESs), are reliable. The paper provides supporting literature and empirical evidence that a probable key source of the calorie decline is incomplete collection of data on food consumed away from peoples’ homes, which is widespread and rapidly increasing. Complete measurement of this food source in the HCESs of all developing countries is vital for accurate measurement of both undernourishment and poverty – and for resolving the Indian calorie debate. [ABSTRACT FROM AUTHOR]

• Resilience projects can optimize impacts on households' ability to recover from shocks by layering interventions cross-sectorally. • Projects with systems-level interventions should pro-actively plan for direct participation of households so they can take full advantage of their benefits. • Unique sampling design and data collection challenges need to be taken into account in planning complete and valid resilience impact evaluations. Developing-country households are facing an increasingly challenging set of shocks—including climate, economic, political, and health shocks—that in combination present a novel threat to their livelihoods and well-being, and thus to international development progress. There is a growing need to strengthen the evidence base for interventions and programming approaches that bolster households' resilience to such shocks. In response, this paper documents an impact evaluation of the USAID-funded "Pastoralist Areas Resilience Improvement and Market Expansion" (PRIME) project implemented from 2012 to 2017 in one of the most shock-prone areas of the world, the drylands of Ethiopia. The project's overall goal was to reduce poverty and hunger by enhancing households' ability to recover from recurring climate shocks and their downstream economic impacts. As it were, soon after its inception, the drylands were hit by an exceptionally harsh and prolonged shock, a series of multiple, back-to-back, severe droughts. The droughts led to a sharp drop in households' well-being, measured here by their food security. Using Difference-in-Difference Propensity Score Matching (DID-PSM) in one of the first causal resilience evaluations, this paper demonstrates that, nevertheless, the project's resilience-strengthening interventions had a positive impact on their ability to recover, slowing the decline in food security considerably. Delving deeper into how this impact was achieved, the paper finds that two programming approaches optimized resilience impacts. First, "Comprehensive Resilience Programming", whereby interventions spanning multiple sectors were implemented simultaneously in the same geographical areas, made a major difference. Second, while interventions were mainly implemented at a systems-level (e.g., establishing veterinary pharmacies), many households made the decision to actively participate in them. The paper finds that the impact on their resilience was far greater when they did so. The lessons for future resilience projects are that (1) greater impacts can be achieved by taking advantage of the synergies induced when interventions are layered cross-sectorally, and (2) projects with systems-level interventions should pro-actively plan for the direct participation of households so they can take full advantage of their benefits and thereby achieve greater resilience to shocks. The paper also offers some lessons for future resilience impact evaluations. [ABSTRACT FROM AUTHOR]

Successful interventions are needed to help improve obesity rates in the United States. Roughly two-thirds of adults in the United States are overweight, and almost one-third are obese. In 1991, the National Institutes of Health released a consensus statement endorsing bariatric surgery as the only means for sustainable weight loss for severely obese patients. However, approximately one-third of bariatric patientswill experience significant post surgical weight gain. Purpose of study: This study is designed to determine if meditative movement (MM) would be a feasible physical activity (PA) modality to initiate weight loss in bariatric surgery patients who have re-gained weight. Methods used: A feasibility study was recently completed in 39 bariatric patients at Scottsdale Bariatric Center (SBC) during regularly scheduled bariatric support groups at SBC. A short demonstration of MM was presented after which a short focus group was conducted to gauge interest level, acceptability and the potential demand for MM programs in this population. Attitudes and intentions surrounding MM were also collected. Findings: Approximately 75% of participants indicated they would consider practicing MM as part of their post surgical PA routine. Conclusions:MMmay be a feasible PA modality in bariatric patients to improve bariatric surgery weight outcomes. [ABSTRACT FROM AUTHOR]

Highlights: [•] Metabolic insult increases cation channel permeability of inner retinal neurons. [•] Vinpocetine reduces cation channel permeability in some neurons during ischemia. [•] Vinpocetine prevents loss of Ca2+ binding protein labeling during metabolic insult. [•] Vinpocetine alters cation channel permeability in NMDA but not kainate activation. [•] Vinpocetine’s actions may involve NMDA glutamate receptors and intracellular Ca2+. [ABSTRACT FROM AUTHOR]

Abstract: Humans are dependent upon the services provided by nature, and unless we effectively account for the range of values from ecosystems in our efforts to protect the environment, we cannot sustain human well-being. In light of this dependence, a national measure of well-being is needed which is responsive to changes in the provisioning of ecosystem services as well as service flows from economic and social sectors. To conceptualize the eco-human linkages we must identify the measurable components of well-being that can be related to ecosystem service provisioning. The indicators and metrics used in existing well-being indices provide a basis for developing a core set of domains to develop such a composite measure of well-being; however these indices lack the ability to link well-being endpoints specifically to service flows from different types of capital. This paper suggests a core set of well-being domains that can be linked to ecosystem services via their relationship to economic, environmental and societal well-being. The well-being domains identified will serve as the foundation for developing an index of well-being for the U.S. which will be used to evaluate the provisioning of ecosystem, economic and social services in a predictive modeling framework. We present an overview of selected well-being measures and discuss the potential relationships between ecosystem services and the domains selected to develop the index structure. [Copyright &y& Elsevier]

Summary: Experimental impact evaluation methods have recently emerged as a dominant force within the development effectiveness movement. Although these methods have improved understanding of what works, their “gold standard” status threatens to exclude a large body of alternative evidence. This paper evaluates the impact of CARE’s SHOUHARDO project in Bangladesh, which employed a rights-based, livelihoods approach. Using a mixed-methods protocol, we find plausible evidence that the project led to an extraordinarily large reduction in child malnutrition. While offering valuable policy lessons, we illustrate how rigorous evaluation can be undertaken even without the randomization and control groups required by the experimental methods. [ABSTRACT FROM AUTHOR]