Farming is physically and psychologically hazardous. Farmers face many barriers to help seeking from traditional physical and mental health services; however, improved internet access now provides ...promising avenues for offering support.
This study aims to co-design with farmers the content and functionality of a website that helps them adopt transferable coping strategies and test its acceptability in the broader farming population.
Research evidence and expert opinions were synthesized to inform key design principles. A total of 18 farmers detailed what they would like from this type of website. Intervention logic and relevant evidence-based strategies were mapped. Website content was drafted and reviewed by 2 independent mental health professionals. A total of 9 farmers provided detailed qualitative feedback on the face validity of the draft content. Subsequently, 9 farmers provided feedback on the website prototype. Following amendments and internal prototype testing and optimization, prototype usability (ie, completion rate) was examined with 157 registered website users who were (105/157, 66.9%) female, aged 21-73 years; 95.5% (149/156) residing in inner regional to very remote Australia, and 68.2% (107/157) "sheep, cattle and/or grain farmers." Acceptability was examined with a subset of 114 users who rated at least module 1. Interviews with 108 farmers who did not complete all 5 modules helped determine why, and detailed interviews were conducted with 18 purposively sampled users. Updates were then made according to adaptive trial design methodology.
This systematic co-design process resulted in a web-based resource based on acceptance and commitment therapy and designed to overcome barriers to engagement with traditional mental health and well-being strategies-ifarmwell. It was considered an accessible and confidential source of practical and relevant farmer-focused self-help strategies. These strategies were delivered via 5 interactive modules that include written, drawn, and audio- and video-based psychoeducation and exercises, as well as farming-related jokes, metaphors, examples, and imagery. Module 1 included distress screening and information on how to speak to general practitioners about mental health-related concerns (including a personalized conversation script). Modules were completed fortnightly. SMS text messages offered personalized support and reminders. Qualitative interviews and star ratings demonstrated high module acceptability (average 4.06/5 rating) and suggested that additional reminders, higher quality audio recordings, and shorter modules would be useful. Approximately 37.1% (52/140) of users who started module 1 completed all modules, with too busy or not got to it yet being the main reason for non-completion, and previous module acceptability not predicting subsequent module completion.
Sequential integration of research evidence, expert knowledge, and farmers' preferences in the co-design process allowed for the development of a self-help intervention that focused on important intervention targets and was acceptable to this difficult-to-engage group.
Australian New Zealand Clinical Trials Registry ACTRN12617000506392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372526.
The detection of nine quasars with redshifts between 3.0 and 3.8 is reported. The quasars were all found in a grism survey from their Lyman-alpha emission line. The r magnitudes of the quasars range ...from 18.5 to 21.7. The strengths of the Lyman-alpha lines are comparable to the values observed in other quasars (rest equivalent widths from 40 to 160 A). The spectrum of one of the objects possesses complex broad absorption features, similar to those seen in PHL 5200. A preliminary evaluation of these findings suggests that the comoving quasar density declines gradually beyond z = 3.
Purposes
Several reports have described a relationship between tumor volume and oncological outcomes for certain cancers. There is paucity of similar data for rectal cancer. We conducted this study ...to establish whether tumor volume, mesorectal volume, and the tumor volume to mesorectal volume ratio (TV/MRV), evaluated by magnetic resonance imaging (MRI), affect the oncological outcomes of patients with rectal cancer.
Methods
We performed volumetric analysis of rectal tumors from magnetic resonance imaging (MRI) images and assessed their correlation with oncological outcomes, using clinical and radiological databases.
Results
The subjects of this study were 25 of 35 patients who underwent rectal cancer surgery after staging with MRI, after the exclusion of 7 patients for whom MRI images could not be retrieved and 3 patients who had metastases identified at diagnosis. Tumor volume (TV) was a significant predictor of overall survival hazard ratio (95 % CI); 5.8 (1.2–29), (
P
= 0.03). Mesorectal volume (MRV) and TV/MRV did not correlate with oncological outcomes.
Conclusions
We found a direct relationship between tumor volume and overall survival, which may be used to stratify rectal tumors for neoadjuvant therapy. A larger prospective study is required to confirm this correlation.
Time trends in abundance, body size, species richness, and species composition indicate that crustacean zooplankton communities of southern Canadian Shield lakes changed between 1980 and 2003. Total ...abundance did not decline despite reductions in total phosphorus, but all other metrics changed. Species richness declined in Harp Lake (Ontario, Canada) following its Bythotrephes invasion, but richness increased in three other lakes. Average cladoceran body length increased from 0.6 to 1.0 mm in seven of the lakes, as larger-bodied taxa replaced smaller ones. Correlations with water quality and fish metrics suggest that cladoceran size increases were attributable to many factors: a decline in food availability following declining phosphorus levels increasing the competitive advantage of larger herbivores, a decline in acidity favouring the larger, acid-sensitive daphniids, and reduced risk of planktivory linked to a rise in dissolved organic carbon levels and changes in predation regimes. Zooplankton communities on the Canadian Shield are changing, and these changes are best viewed in a multiple-stressor context. Key anthropogenic stressors have also changed and may do so again if Ca concentrations continue to decline.
A CCD transit survey has been carried out with the 200 in. telescope of a strip of sky 5 arcmin wide and 9 hr long. Direct images and slitless spectra of over 43,000 objects were obtained on two ...successive nights. An automatic search for emission lines of given minimum equivalent width and signal-to-noise ratio yielded 52 candidate sources. Slit spectra revealed that 24 were emission-line galaxies with z less than 0.4 and eight were quasars with 2 between 1.00 and 2.76. The number of quasars detect agrees with that predicted from luminosity function models for z less than 2.9. The models also indicate that between 30 and 62 quasars with z less than 2.9 should have been found in this survey, but none were detected. This result reconfirms that there is a redshift cutoff near or below redshift three. The apparent conflict of this measurement with the known existence of dozens of quasars with redshifts larger than three is discussed.
Systems that are used by different organisations to grade the quality of evidence and the strength of recommendations vary. They have different strengths and weaknesses. The GRADE Working Group has ...developed an approach that addresses key shortcomings in these systems. The aim of this study was to pilot test and further develop the GRADE approach to grading evidence and recommendations.
A GRADE evidence profile consists of two tables: a quality assessment and a summary of findings. Twelve evidence profiles were used in this pilot study. Each evidence profile was made based on information available in a systematic review. Seventeen people were given instructions and independently graded the level of evidence and strength of recommendation for each of the 12 evidence profiles. For each example judgements were collected, summarised and discussed in the group with the aim of improving the proposed grading system. Kappas were calculated as a measure of chance-corrected agreement for the quality of evidence for each outcome for each of the twelve evidence profiles. The seventeen judges were also asked about the ease of understanding and the sensibility of the approach. All of the judgements were recorded and disagreements discussed.
There was a varied amount of agreement on the quality of evidence for the outcomes relating to each of the twelve questions (kappa coefficients for agreement beyond chance ranged from 0 to 0.82). However, there was fair agreement about the relative importance of each outcome. There was poor agreement about the balance of benefits and harms and recommendations. Most of the disagreements were easily resolved through discussion. In general we found the GRADE approach to be clear, understandable and sensible. Some modifications were made in the approach and it was agreed that more information was needed in the evidence profiles.
Judgements about evidence and recommendations are complex. Some subjectivity, especially regarding recommendations, is unavoidable. We believe our system for guiding these complex judgements appropriately balances the need for simplicity with the need for full and transparent consideration of all important issues.
Recent developments in high-contrast imaging techniques now make possible both imaging and spectroscopy of planets around nearby stars. We present the conceptual design of the Coronagraphic High ...Angular Resolution Imaging Spectrograph (CHARIS), a lenslet-based, cryogenic integral field spectrograph (IFS) for imaging exoplanets on the Subaru telescope. The IFS will provide spectral information for 140 x 140 spatial elements over a 1.75 arcsecs x 1.75 arcsecs field of view (FOV). CHARIS will operate in the near infrared (lambda = 0.9 - 2.5 micron) and provide a spectral resolution of R = 14, 33, and 65 in three separate observing modes. Taking advantage of the adaptive optics systems and advanced coronagraphs (AO188 and SCExAO) on the Subaru telescope, CHARIS will provide sufficient contrast to obtain spectra of young self-luminous Jupiter-mass exoplanets. CHARIS is in the early design phases and is projected to have first light by the end of 2015. We report here on the current conceptual design of CHARIS and the design challenges.
The spectroscopic Sloan Digital Sky Survey (SDSS) Data Release 7 (DR7) galaxy sample represents the final set of galaxies observed using the original SDSS target selection criteria. We analyse the ...clustering of galaxies within this sample, including both the Luminous Red Galaxy (LRG) and Main samples, and also include the 2-degree Field Galaxy Redshift Survey (2dFGRS) data. Baryon Acoustic Oscillations are observed in power spectra measured for different slices in redshift; this allows us to constrain the distance--redshift relation at multiple epochs. We achieve a distance measure at redshift z=0.275, of r_s(z_d)/D_V(0.275)=0.1390+/-0.0037 (2.7% accuracy), where r_s(z_d) is the comoving sound horizon at the baryon drag epoch, D_V(z)=(1+z)^2D_A^2cz/H(z)^(1/3), D_A(z) is the angular diameter distance and H(z) is the Hubble parameter. We find an almost independent constraint on the ratio of distances D_V(0.35)/D_V(0.2)=1.736+/-0.065, which is consistent at the 1.1sigma level with the best fit Lambda-CDM model obtained when combining our z=0.275 distance constraint with the WMAP 5-year data. The offset is similar to that found in previous analyses of the SDSS DR5 sample, but the discrepancy is now of lower significance, a change caused by a revised error analysis and a change in the methodology adopted, as well as the addition of more data. Using WMAP5 constraints on Omega_bh^2 and Omega_ch^2, and combining our BAO distance measurements with those from the Union Supernova sample, places a tight constraint on Omega_m=0.286+/-0.018 and H_0 = 68.2+/-2.2km/s/Mpc that is robust to allowing curvature and non-Lambda dark energy. This result is independent of the behaviour of dark energy at redshifts greater than those probed by the BAO and supernova measurements. (abridged)
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