Integrating multiple sign types to improve occupancy estimation for inconspicuous species.

Standard occupancy models enable unbiased estimation of occupancy by accounting for observation errors such as missed detections (false negatives) and, less commonly, incorrect detections (false positives). Occupancy models are fitted to data from repeated site visits in which surveyors record evidence of species presence. Use of indirect sign (e.g., scat, tracks) as evidence of presence can vastly improve survey efficiency for inconspicuous species but can also introduce additional sources of error. We developed a "multi-sign" occupancy approach to model the detection process separately for unique sign types and used this method to improve estimates of occupancy dynamics for an inconspicuous species, the American pika (Ochotona princeps). We investigated how estimates of pika occupancy and environmental drivers differed under four increasingly realistic representations of the observation process: (1) perfect detection (commonly assumed for modeling pika occupancy), (2) standard occupancy model (single observation process without possibility of false detection), (3) multi-sign with no false detections (non-false positive model), and (4) multi-sign with false detections (full model). For the multi-sign occupancy models, we modeled the detection of each sign type (fresh scat, fresh haypiles, pika calls, and pika sightings) separately as a function of climatic and environmental covariates. Estimates of occupancy processes and inferences about environmental drivers were sensitive to different detection models. Simplified representations of the detection processes generally resulted in higher occupancy estimates and higher turnover rates than the full multi-sign model. Environmental drivers also varied in their influence on occupancy models, where (e.g.) forb cover was estimated to more strongly influence occupancy in the full multi-sign model than the simpler models. As has been reported previously in other contexts, unmodeled heterogeneity in the observation process can lead to biases in occupancy processes and uncertainty in the relationships between occupancy and environmental covariates. Overall, our multi-sign approach to dynamic occupancy modeling, which accounts for spatio-temporal variation in reliability among sign types, has strong potential to generate more realistic estimates of occupancy dynamics for inconspicuous species.

The myth of vaccination and autism spectrum.

BACKGROUND: Among all of the studied potential causes of autism, vaccines have received some of the most scrutiny and have been the topic of many evidence-based studies. These efforts have led the great majority of scientists, physicians, and public health researchers to refute causation between vaccines and autism. RATIONALE: This presumed association and concern has been a major contributor to parents' refusal to immunize their children and has become a major threat to public health in secluded populations over the last two decades, even prior to the COVID-19 pandemic. With the emergence of COVID-19 immunizations, sentiments towards this topic were addressed as a public health concern that may influence the ability to overcome the Corona virus worldwide. SCIENTIFIC REVIEW OF DATA: Despite the overwhelming data demonstrating that there is no link between vaccines and autism, many parents are hesitant to immunize their children because of the alleged association. Other contributing factors to the myths and conspiracy theories surrounding the association between vaccines and autism include the fact that the diagnosis of autism is typically made after the age of receiving the main childhood immunizations, as well as the occasional occurrence of regression after the age of first year vaccinations. In spite of vast evidence that the main contribution to the increase in incidence is from improvement of the diagnostic process, this rapid and publicized rise in autism diagnoses feeds parental concerns regarding any medical intervention that may be associated with the health of their children. RECOMMENDATIONS: It is plausible that with more evidence-based studies linking autism to specific etiologies the myth will diminish and disappear eventually. In an era where conspiracy theories are prevalent on social media, it is critical that evidence-based studies relating autism to specific etiologies be made public, and that information concerning autism diagnosis and causes be made more readily available through social media and parental organizations.

Learning About and Destigmatizing Substance Use Disorders: a Video-Based Educational Module Using Simulated Patients.

OBJECTIVE: The authors developed and tested video clips depicting three paradigmatic substance use disorder (SUD) clinical scenarios, each portrayed by a different simulated patient interacting with the same clinician. METHODS: The authors embedded 21 short video clips (with a cumulative duration of 27 min) into a 2-h session on SUDs. The didactic was delivered online through synchronous videoconferencing with Zoom. The primary outcome compared learners' scores on the Attitudes and Confidence in the Treatment of Patients with Substance Use Disorders (ACT-SUDS) before and after participating in the didactic. RESULTS: Fifty-eight second-year medical students participated and completed the survey prior to the didactic; 42 (72%) of them completed the survey immediately after. Compared to baseline, ACT-SUDS increased after the didactic: from 3.7 ± 0.5 to 4.0 ± 0.4 (mean difference = 0.4 [95% confidence interval = 0.2-0.5], paired-t = 5.75, p < 0.001), as did each of its four subscales: confidence, enjoyment, SUD as a medical disorder, and attitudes toward Alcoholics Anonymous (AA; t ≥ 3.0, p ≤ 0.005). CONCLUSIONS: The video-based educational module proved easy to implement in the virtual classroom and led to measurable changes in perceptions and attitudes toward SUDs. The module is available to view or freely download and is amenable for adaptation by end-use instructors.