Inter-annual variation in amphibian larval interspecies interactions.

The outcomes of species interactions can vary by life stage, year, and surrounding environmental conditions. Amphibian species are expected to compete most strongly during their tadpole stage when they exist in the highest densities. Changes in arrival timing, surrounding aquatic communities, and yearly conditions could all affect the outcome of larval competition. In Long Point, Ontario, the Fowler's toad (Anaxyrus fowleri) is at the northern edge of its range and overlaps with the more common American toad (Anaxyrus americanus). Both species breed in ponds that encounter high inter-annual variation. To determine whether these species compete strongly, and if this effect was replicated across multiple years, we raised both species as tadpoles together and, apart, in mesocosms in 2018 and 2021. We measured survivorship to, weight at, and time to metamorphosis for both species in both years. We determined that the presence of American toad tadpoles consistently had a detrimental effect on Fowler's toad tadpoles, even though this effect presented itself differently across years. Our study suggests that competitive exclusion by American toads could be occurring at the edge of the Fowler's toad's range. This study further demonstrates the importance of studying communities across multiple years to understand the full scope of species interactions.

The Role of Pandemic Fatigue in Seeking and Avoiding Information on COVID-19 Among Young Adults.

The health information environment surrounding COVID-19 is complex, with varying and competing information. This study uses the risk information seeking and processing model (RISP) to examine COVID-19 information seeking and avoiding among young adults. Pandemic fatigue is also operationalized and tested as a more nuanced measure of negative affective response within the RISP framework. Survey results (N = 527) reveal pandemic fatigue predicts information seeking and avoidance, but may have a weaker influence on these outcome variables than the RISP's original construct of negative affective response. Additionally, the original RISP model achieved slightly more explanatory power in predicting risk information seeking than our revised RISP model, using pandemic fatigue as an alternative measure of negative affective response. These findings indicate that contemporary concepts such as pandemic fatigue may be incorporated into applications of the RISP model, thus allowing researchers to evaluate other types of negative affective responses to risk and further expanding the utility of the model. Theoretical implications and practical recommendations for public health officials and health care workers are discussed.

Communication Overload in Hospitals: Exploring Organizational Safety Communication, Worker Job Attitudes, and Communication Efficacy.

Hospitals represent complex organizations where a range of hospital workers, from physicians to administrators, encounter a deluge of information they must quickly process and act upon. New technologies implemented to streamline patient care, like electronic health records and wearable technologies, have both enhanced and complicated communicative exchanges between hospital workers and their organizations. Hospital workers feeling over saturated with workplace communication, and thus unable to effectively manage or interpret workplace messages, experience what has been labeled communication overload, which can negatively impact worker productivity and concentration. This study examines hospital workers (N = 303) in a Midwestern U.S. healthcare network, and uses structural equation modeling to offer a preliminary theoretical model that demonstrates the effects and outcomes of communication overload in high-risk organizations. The model offers theoretical implications through depicting communication overload as indirectly related to burnout, job satisfaction, and organizational identification through participation in decision-making and organizational safety climate. Results suggest that even if communication overload is an expected state in high-risk organizations, managers can prevent its negative effects on workers' job attitudes by providing workers opportunities to get involved in organizational decision-making and constructing a robust organizational safety climate. Finally, we suggest pairings of organizational safety communication channels and sources through which high quantities of safety information can be communicated without communicatively overloading workers.

Association of transcutaneous CO2 with respiratory support: a prospective double blind observational study in children with bronchiolitis and reactive airway disease.

The use of clinical scoring to assess for severity of respiratory distress and respiratory failure is challenging due to subjectivity and interrater variability. Transcutaneous Capnography (TcpCO2) can be used as an objective tool to assess a patient's ventilatory status. This study was designed to assess for any correlation of continuous monitoring of TcpCO2 with the respiratory clinical scores and deterioration in children admitted for acute respiratory distress. A prospective observational study over one year on children aged 2 weeks to 5 years admitted with acute respiratory distress or failure secondary to Bronchiolitis and Reactive airway disease was performed. Continuous TcpCO2 monitoring for upto 48 h was recorded. Investigators, bedside physicians, respiratory therapists, and nurses were blinded from the transcutaneous trends at the time of data collection. Total of 813 TcpCO2 measurements at standard intervals of 30 min were obtained on 38 subjects. Subjects with abnormal TcpCO2 (> 45 mmHg) were younger (6.9 ± 5.2 vs. 23.05 ± 17.7 months,) and were more likely to be on higher oxygen flow rate (0.52 L/min/kg vs 0.46 lier/min/kg, p = 0.004) and higher FiO2 (38.4 vs 33.6, p < 0.001 using heated high flow nasal cannula. No difference was found in bronchiolitis score or PEW score in subjects with normal and abnormal TcpCO2. A small but statistically significant increase in TcpCO2 was observed at the escalation of care. Even though odds of escalation of care are higher with abnormal TcpCO2 (OR 1.92), this difference did not reach statistical significance. pCO2 can provide additive information for non-invasive clinical monitoring of children requiring varying respiratory support; however, it does not provide predictive value for escalation or de-escalation of care.

Promoting equity and inclusion with student-driven initiatives.

Representation is crucial in building more inclusive communities in science, technology, engineering, mathematics, and medicine (STEMM) fields. STEMM Diversity is a student-driven initiative that was founded to promote equity, diversity, and inclusion (EDI) at McGill University. Here, we discuss the lessons learned while developing STEMM Diversity that can help guide others to develop their own student-driven initiatives.

Mental Disorders, Substance Use Disorders, and Psychotropic Medication Use Among Sudden-Death Victims.

OBJECTIVE: The authors sought to estimate the prevalence of mental and substance use disorders and psychotropic medication prescriptions among working-age sudden-death victims. METHODS: Using a written protocol, the authors screened for sudden deaths attended by emergency medical services (EMS) in a large metropolitan county in North Carolina from March 1, 2013, to February 28, 2015. Sudden-death cases were adjudicated by three cardiologists. Mental health and chronic disease diagnoses and treatments were abstracted from EMS, medical examiner, toxicology, and autopsy reports and from clinical records for the past 5 years before death. RESULTS: Sudden death was identified for 399 adults ages 18-64 years, 270 of whom had available medical records. Most sudden-death victims were White (63%) and male (65%), had a comorbid condition such as hypertension or respiratory disease, and had a mean±SD age of death of 53.6±8.8 years. Most victims (59%) had at least one mental health or substance use disorder documented in a recent medical record; 76%-78% of victims with a mental disorder had a documented psychotropic medication prescription. However, fewer than one-half (41%) had a documented referral to a mental health professional. The most common diagnostic categories were depressive, anxiety, and alcohol-related disorders. Almost one-half (46%) of the victims had a recent psychotropic prescription, most commonly antidepressants (29%) and benzodiazepines (19%). CONCLUSIONS: Mental illness, substance use disorders, and psychotropic medication prescriptions were prevalent among sudden-death victims. The health care needs of these individuals may be better addressed by collaborative care for general medical and mental disorders.

Sending and Receiving Safety and Risk Messages in Hospitals: An Exploration into Organizational Communication Channels and Providers' Communication Overload.

This study explores hospital workers' experiences with workplace communication overload and its implications for effective safety and risk messaging in hospital organizations. We use a multi-step thematic analysis of interview (N = 12) and focus group (N = 8, 28 participants) data collected from hospital workers to analyze how they describe specific organizational communication channels influencing their communication overload. We specifically examine how workers' socially constructed channel affordances and constraints for sending/receiving safety information provide meaning to their communicatively overloaded states. Hospital workers explained that asynchronous channels such as e-mail and voicemail aggravated communication overload, while synchronous channels such as team huddles alleviated it. We discuss the implications of these results for the communication overload model by pointing to violations of communication channel preference and literature on the social affordances of communication channels. Study limitations and future directions are offered.

Hypocalcemia and a Positive Metabolic Screen for Severe Combined Immunodeficiency in an 11-Day-Old Male With DiGeorge Syndrome.

22q11 deletion syndrome (22q11DS), also known as DiGeorge syndrome or velocardiofacial syndrome, is the most common human genetic microdeletion. Hypocalcemia secondary to hypoparathyroidism is a common finding in this condition and may present with seizures. We describe a case of an 11-day-old male presenting with hypocalcemic seizures and a positive newborn screen for severe combined immunodeficiency as the primary manifestations of 22q11DS. Given the potential for wide phenotypic variability, clinicians should maintain a high index of suspicion for this syndrome, especially in the neonate presenting with hypocalcemia.

Exploring the Use of Psychological Skills Training Interventions in a Music Domain: A Systematic Review.

AIM: The aim of this paper was to systematically review existing empirical literature addressing the use of psychological skills training (PST) interventions commonly employed in sport applied to a music domain. Included PST studies must have an experimental or quasi-experimental design and no clinical or pharmacological interventions and/or assessments. METHODS: The databases MEDLINE (EBSCO), PsychInfo, Psych Articles, CINAHL Plus with full text, Google Scholar, SportDiscus, and Music Index were searched using a combination of the terms. music*, performance psychology, performance enhancement, music performance, intervention, psychological skills training, and music performance psychology. Due to the novelty of the existing literature, there were no limitation restrictions to publication year, the standard of musician (e.g., expert, novice, professional, amateur), participant age, or type of intervention setting. RESULTS: The initial search revealed 323 published articles. After applying the inclusion and exclusion criteria, 10 articles were deemed sufficient for review. Four additional articles were found via pen-and-paper method by evaluating the reference sections of the included articles. All reviewed studies demonstrated that aspects of PST interventions commonly employed in sport (except Alexander technique) are effective at subjectively enhancing performance in a music domain. The PST interventions varied vastly in duration, as well as the types of (and a theoretical and empirical rationale for) psychological skills employed. CONCLUSIONS: Music performers may benefit from PST interventions typically used in sport; however, unique considerations of the music performance environment must be addressed in the design of such PST interventions.

Acute lymphoblastic leukemia presenting as cholestatic jaundice in a 7-year-old boy.

This is a case of a 7-year-old boy with acute lymphoblastic leukemia presenting with cholestasis and elevated transaminase levels. Acute lymphoblastic leukemia is the most common malignancy in children and can have variable presenting clinical manifestations. However, cholestasis is less commonly encountered in the pediatric population and can be a diagnostic challenge. We present a case of a 7-year-old boy discovered to have elevated transaminase levels while undergoing an evaluation for motor tics, which subsequently progressed to cholestasis and acute liver failure secondary to acute lymphoblastic leukemia. He demonstrated marked improvement after induction therapy and is in clinical remission. Clinicians should be ever mindful of the potentially unique presentations of childhood leukemia.

Evaluation of an Internet-based intervention for ICD patients with elevated symptoms of posttraumatic stress disorder.

BACKGROUND: To date, treatment to reduce posttraumatic stress disorder (PTSD) symptoms in implantable cardioverter defibrillator (ICD) patients has been limited by lack of symptom recognition, lack of provider referrals, barriers to treatment access, and inadequate evidence base of treatment effectiveness in this population. METHODS: Participants were 46 patients with ICDs (17 paired) with elevated PTSD symptoms who were recruited in electrophysiology clinics at community and university hospitals as well as ICD support forums. Participants were provided the Web-based, brief psychosocial intervention, which was tailored to ICD patients and contained elements of evidence-based cognitive-behavioral protocols for PTSD. Pretest and posttest measurement assessed participants' trauma experiences, mental health, and device-specific distress (device acceptance and shock anxiety). RESULTS: Postintervention scores on the PTSD Checklist (PCL; M = 35.5, SD = 10.09) were significantly lower than preintervention scores (M = 46.31, SD = 9.88), t (16) = 3.51, P = 0.003, d = 1.08. CONCLUSIONS: Preliminary results indicate that future research with a more robust design is warranted. Given limitations in accessibility of mental health providers to manage cardiac-related psychological sequelae, brief, Web-based intervention may be an effective, supplemental, clinical modality to offer treatment to this population.

Detecting suspicious activities at sea based on anomalies in Automatic Identification Systems transmissions.

Automatic Identification Systems (AIS) are a standard feature of ocean-going vessels, designed to allow vessels to notify each other of their position and route, to reduce collisions. Increasingly, the system is being used to monitor vessels remotely, particularly with the advent of satellite receivers. One fundamental problem with AIS transmission is the issue of gaps in transmissions. Gaps occur for three basic reasons: 1) saturation of the system in locations with high vessel density; 2) poor quality transmissions due to equipment on the vessel or receiver; and 3) intentional disabling of AIS transmitters. Resolving which of these mechanisms is responsible for generating gaps in transmissions from a given vessel is a critical task in using AIS to remotely monitor vessels. Moreover, separating saturation and equipment issues from intentional disabling is a key issue, as intentional disabling is a useful risk factor in predicting illicit behaviors such as illegal fishing. We describe a spatial statistical model developed to identify gaps in AIS transmission, which allows calculation of the probability that a given gap is due to intentional disabling. The model we developed successfully identifies high risk gaps in the test case example in the Arafura Sea. Simulations support that the model is sensitive to frequent gaps as short as one hour. Results in this case study area indicate expected high risk vessels were ranked highly for risk of intentional disabling of AIS transmitters. We discuss our findings in the context of improving enforcement opportunities to reduce illicit activities at sea.

Loitering with intent-Catching the outlier vessels at sea.

Illegal, Unreported and Unregulated (IUU) fishing activities pose one of the most significant threats to sustainable fisheries worldwide. Identifying illegal behaviour, specifically fishing and at-sea transhipment, continues to be a fundamental hurdle in combating IUU fishing. Here, we explore the use of spatial statistical methods to identify vessels behaving anomalously, in particular with regard to loitering, using the Indonesian Exclusive Economic Zone (EEZ) and surrounding waters as a case-study. Using Automatic Identification System (AIS) for vessel tracking, we applied Generalized Additive Models to capture both the temporal and spatial nature of loitering behaviour. We identified three statistically anomalous loitering behaviours (based on time, speed and distance) and applied the models to 2700 vessels in the region. We were able to rank vessels for individual and joint probability of atypical behaviour, providing a hierarchical list of vessels engaging in anomalous behaviour. While identification of irregular behaviour does not mean vessels are definitely engaging in illegal activities, this statistical modelling approach can be used to prioritise the allocation of enforcement resources and assist authorities under the United Nations Food and Agricultural Organization Port State Measures Agreement for management and enforcement of IUU fishing associated activities.

An Evaluation of Army Wellness Center Clients' Health-Related Outcomes.

PURPOSE: To examine whether Army community members participating in a best-practice based workplace health promotion program (WHPP) experience goal-moderated improvements in health-related outcomes. DESIGN: Pretest/posttest outcome evaluation examining an autonomously participating client cohort over 1 year. SETTING: Army Wellness Center facilities on 19 Army installations. PARTICIPANTS: Army community members sample (N = 5703), mostly Active Duty Soldiers (64%). INTERVENTION: Assessment of health risks with feedback, health assessments, health education classes, and health coaching sessions conducted by health educators at a recommended frequency of once a month for 3 to 12 months. MEASURES: Initial and follow-up outcome assessments of body mass index (BMI), body fat, cardiorespiratory fitness, blood pressure, and perceived stress. ANALYSIS: Mixed model linear regression testing for goal-moderated improvements in outcomes. RESULTS: Clients experienced significant improvements in body fat (-2% change), perceived stress (-6% to -12% change), cardiorespiratory fitness (+6% change), and blood pressure (-1% change) regardless of health-related goal. Only clients with a weight loss goal experienced BMI improvement (-1% change). Follow-up outcome assessment rates ranged from 44% (N = 2509) for BMI to 6% (N = 342) for perceived stress. CONCLUSION: Army Wellness Center clients with at least 1 follow-up outcome assessment experienced improvements in military readiness correlates and chronic disease risk factors. Evaluation design and follow-up-related limitations notwithstanding results suggest that best practices in WHPPs can effectively serve a globally distributed military force.

Sport-related anxiety: current insights.

To date, much research has been devoted to understanding how anxiety can affect sport performance, both in practice and in competitive settings. It is well known that sport has the potential for high levels of stress and anxiety, and that practicing and employing a range of psychological strategies can be beneficial in anxiety management. Equally, growing evidence also suggests that anxiety can play a role in sport injury prevention, occurrence, rehabilitation, and the return to sport process. The purpose of this paper is to provide current insights into sport-related anxiety. More specifically, it will provide the reader with definitions and theoretical conceptualizations of sport-related anxiety. This will be followed by making a case for considering the term "performance" to be broader than activities associated with sport-related performance in practice and competition, by including performance activities associated with sport injury prevention, rehabilitation, and the return to sport process. The paper will then highlight the importance of recognizing early signs and symptoms of anxiety, and the potential need for referral. Finally, the conclusions will emphasize the need for appropriate, client-specific, and practitioner competent care for athletes experiencing sport-related anxiety.

The use of a static measure to predict foot posture at midstance during walking.

Previous studies have successfully used the longitudinal arch angle (LAA) to assess foot posture, but the measurement consistency and ability of the LAA to predict dynamic foot posture during activity in a variety of foot types have not been evaluated. The purpose of this study was to determine the reliability of the LAA as well as if the clinical method of assessing the LAA could be used to predict the LAA at midstance during walking for supinated, normal, and pronated foot types. The Arch Height Ratio was used to select 35 participants with 12 supinated, 46 normal, and 12 pronated feet. A standard goniometer was used to measure the LAA (CLINIC_LAA) on both feet while standing. Both feet were then filmed using a high speed camera while walking on a treadmill. The LAA was determined by the angle formed by two lines drawn between the markers placed on the first metatatarsal and medial malleolus with the apex the navicular tuberosity. The LAA in midstance (WALK_LAA) was determined using the mean of five walking trials. The reliability of the CLINIC_LAA assessed on both feet by two raters over two days were excellent. There was no difference between the left and right foot for the CLINIC_LAA. The Pearson correlation between CLINIC_LAA and WALK_LAA for all 70 feet was r=0.96 (r2=0.92). The results indicate the LAA is highly predictive of foot posture at midstance in walking explaining over 90% of the variance for a wide range of foot types.