Antibiotic use and misuse are common in pregnant women and young children. Few studies have assessed real-world discussions of antibiotics in these populations. Using social media posts of pregnant ...women and parents, our goal was to identify key themes about facilitators and barriers to appropriate antibiotic usage.
A purposive sample of public posts and comments relevant to antibiotic use was collected from the BabyCenter United States social media site. Using a directed content analysis, themes related to facilitators and barriers to appropriate antibiotic use were identified.
Seven hundred and twenty-six posts and 5227 comments were analysed. Themes centred around individual factors, interpersonal factors, and structural factors. Individual factors included knowledge and beliefs. Though misinformation was present, most parents were aware of appropriate antibiotic usage and perceived antibiotics as safe and effective. Some hesitance around using antibiotics led to recommendations for home remedies or over-the-counter treatments. Interpersonal factors focused on a lack of available offline peer support, the expertise of providers, as well as a potential lack of attention from those providers. Structural factors, including access to care, also impacted parents' antibiotic use and misuse.
Though most parents demonstrated appropriate knowledge about antibiotics and a willingness to follow guidelines, negative experiences with their providers, a lack of support from peers, and structural factors presented as potential barriers to appropriate antibiotic use. Implementing avenues for peer support for parents, allowing more time for providers to address parents' concerns, and improving access to providers could improve appropriate antibiotic use in parents.
Shedding light on the validity of sentence completion test (SCT) verbal defensiveness as an index of defensive behavior, the current two-part study examined the relationship between psychological ...threat and verbal defensiveness among military security and mission-critical team candidates using SCTs. Our study showed that as the threatening nature of SCT stems increased, defensive responses also increased, substantiating the link between psychological threat and defensive behavior. In addition, expert ratings of stem content revealed moderately strong relationships with defensive responses across two different SCTs, irrespective of their structural characteristics. In contrast to previous studies using total verbal defensiveness scores, we examined specific defensive response types and their associations with stem threat ratings, finding that omissions, denial, and comments about the test were linked to stem threat levels. Lastly, our study extends the application of the SCT verbal defensiveness index beyond specialized personnel selection, finding no significant differences in verbal defensiveness based on gender or military status. Overall, these findings contribute to a comprehensive understanding of defensive behavior and its contextual variations.
Repeated outbreaks of emerging pathogens underscore the need for preparedness plans to prevent, detect, and respond. As countries develop and improve National Action Plans for Health Security, ...addressing subnational variation in preparedness is increasingly important. One facet of preparedness and mitigating disease transmission is health facility accessibility, linking infected persons with health systems and vice versa. Where potential patients can access care, local facilities must ensure they can appropriately diagnose, treat, and contain disease spread to prevent secondary transmission; where patients cannot readily access facilities, alternate plans must be developed. Here, we use travel time to link facilities and populations at risk of viral hemorrhagic fevers (VHFs) and identify spatial variation in these respective preparedness demands.
We used geospatial resources of travel friction, pathogen environmental suitability, and health facilities to determine facility accessibility of any at-risk location within a country. We considered in-country and cross-border movements of exposed populations and highlighted vulnerable populations where current facilities are inaccessible and new infrastructure would reduce travel times. We developed profiles for 43 African countries. Resulting maps demonstrate gaps in health facility accessibility and highlight facilities closest to areas at risk for VHF spillover. For instance, in the Central African Republic, we identified travel times of over 24 h to access a health facility. Some countries had more uniformly short travel times, such as Nigeria, although regional disparities exist. For some populations, including many in Botswana, access to areas at risk for VHF nationally was low but proximity to suitable spillover areas in bordering countries was high. Additional analyses provide insights for considering future resource allocation. We provide a contemporary use case for these analyses for the ongoing Ebola outbreak.
These maps demonstrate the use of geospatial analytics for subnational preparedness, identifying facilities close to at-risk populations for prioritizing readiness to detect, treat, and respond to cases and highlighting where gaps in health facility accessibility exist. We identified cross-border threats for VHF exposure and demonstrate an opportunity to improve preparedness activities through the use of precision public health methods and data-driven insights for resource allocation as part of a country's preparedness plans.
Detection of small molecule metabolites (SMM), particularly those involved in energy metabolism using MALDI-mass spectrometry imaging (MSI), is challenging due to factors including ion suppression ...from other analytes present (e.g., proteins and lipids). One potential solution to enhance SMM detection is to remove analytes that cause ion suppression from tissue sections before matrix deposition through solvent washes. Here, we systematically investigated solvent treatment conditions to improve SMM signal and preserve metabolite localization. Washing with acidic methanol significantly enhances the detection of phosphate-containing metabolites involved in energy metabolism. The improved detection is due to removing lipids and highly polar metabolites that cause ion suppression and denaturing proteins that release bound phosphate-containing metabolites. Stable isotope infusions of 13C6nicotinamide coupled to MALDI-MSI (“Iso-imaging”) in the kidney reveal patterns that indicate blood vessels, medulla, outer stripe, and cortex. We also observed different ATP:ADP raw signals across mouse kidney regions, consistent with regional differences in glucose metabolism favoring either gluconeogenesis or glycolysis. In mouse muscle, Iso-imaging using 13C6glucose shows high glycolytic flux from infused circulating glucose in type 1 and 2a fibers (soleus) and relatively lower glycolytic flux in type 2b fiber type (gastrocnemius). Thus, improved detection of phosphate-containing metabolites due to acidic methanol treatment combined with isotope tracing provides an improved way to probe energy metabolism with spatial resolution in vivo.
•Candidates higher in SCT verbal defensiveness were less likely to be selected in high-risk operational and military security programs.•SCT verbal defensiveness was negatively correlated with ...NEO-PI-R Extraversion, Agreeableness, and Conscientiousness, and positively correlated with select PAI scales shown to have a strong, negative correlation with Agreeableness.•Individuals high in SCT verbal defensiveness are more likely to display greater behavioral unreliability compared to those low in verbal defensiveness on the SCT.•SCT verbal defensiveness does not appear to simply reflect verbal or intellectual ability.•SCT verbal defensiveness likely reflects situational demands and “darker” personality characteristics.
The current two-part study examined SCT verbal defensiveness as a predictor of assessment and selection outcome among high-risk operational and military security program candidates. In addition, we examined the relationship between SCT verbal defensiveness and personality, as well as general cognitive ability. Candidates higher in SCT verbal defensiveness were less likely to be selected in both programs. SCT verbal defensiveness was negatively correlated with Extraversion, Agreeableness, and Conscientiousness, as well as other indices of behavioral dysregulation on the PAI, suggesting greater behavioral unreliability in those high in SCT verbal defensiveness. Data in both samples revealed no significant correlation between SCT verbal defensiveness and general cognitive ability. Overall, results suggest that SCT verbal defensiveness reflects situational demands and “darker” personality characteristics.
The present study was performed to test whether acute stress exposure would significantly increase human compliance and suggestibility. One hundred active duty military participants enrolled in ...military survival school training were randomized to receive the Gudjonsson Compliance and Suggestibility Scales (GCS and GSS) prior to, during or after exposure to interrogation stress. All participants were also assessed prior to, and after stress exposure for symptoms of dissociation. Stress exposure significantly increased compliance in individuals who exhibited a pre-stress propensity to dissociation; stress exposure significantly increased suggestibility. These data support the view that some individuals are more likely than others to experiencing an increase in compliance and in suggestibility if exposed to interrogation stress. These data also suggest that individuals who are vulnerable to stress induced increases in suggestibility and compliance can be identified using psychological measures of dissociation.
La présente étude a été réalisée pour tester si l’exposition au stress aigu augmenterait significativement l’observance humaine et la suggestibilité. Cent participants militaires en service actif inscrits à une formation dans une école de survie militaire ont été randomisés pour recevoir les échelles de conformité et de suggestibilité Gudjonsson (GCS et GSS) avant, pendant ou après l’exposition au stress de l’interrogatoire. Tous les participants ont également été évalués avant et après l’exposition au stress pour les symptômes de dissociation. L’exposition au stress augmentait significativement l’observance chez les individus qui présentaient une propension à la dissociation avant le stress. L’exposition au stress augmentait considérablement la suggestibilité. Ces données soutiennent l’idée que certaines personnes sont plus susceptibles que d’autres de connaître une augmentation de la conformité et de la suggestibilité si elles sont exposées au stress de l’interrogatoire. Ces données suggèrent également que les personnes vulnérables à l’augmentation de la suggestibilité et de l’observance induites par le stress peuvent être identifiées à l’aide de mesures psychologiques de dissociation.
•Database of Rift Valley Fever occurrences from 46 countries over 22 years.•Predictions of Rift Valley Fever suitability for every month over 1995–2016.•Identifies areas at-risk by synthesizing ...time-series of environmental predictions.•We use human and livestock data to identify possible hotspots of disease spillover.•We identify places where long-term and routine preparation efforts should be focused.
Rift Valley Fever (RVF) poses a threat to human and animal health throughout much of Africa and the Middle East and has been recognized as a global health security priority and a key preparedness target.
We combined RVF occurrence data from a systematic literature review with animal notification data from an online database. Using boosted regression trees, we made monthly environmental suitability predictions from January 1995 to December 2016 at a 5 × 5-km resolution throughout regions of Africa, Europe, and the Middle East. We calculated the average number of months per year suitable for transmission, the mean suitability for each calendar month, and the “spillover potential,” a measure incorporating suitability with human and livestock populations.
Several countries where cases have not yet been reported are suitable for RVF. Areas across the region of interest are suitable for transmission at different times of the year, and some areas are suitable for multiple seasons each year. Spillover potential results show areas within countries where high populations of humans and livestock are at risk for much of the year.
The widespread environmental suitability of RVF highlights the need for increased preparedness, even in countries that have not previously experienced cases. These maps can aid in prioritizing long-term RVF preparedness activities and determining optimal times for recurring preparedness activities. Given an outbreak, our results can highlight areas often at risk for subsequent transmission that month, enabling decision-makers to target responses effectively.
ABSTRACT
This paper describes the rapidly evolving and unusual supernova LSQ13ddu, discovered by the La Silla-QUEST survey. LSQ13ddu displayed a rapid rise of just 4.8 ± 0.9 d to reach a peak ...brightness of −19.70 ± 0.02 mag in the LSQgr band. Early spectra of LSQ13ddu showed the presence of weak and narrow $\mathrm{ He}\, {\small I}$ features arising from interaction with circumstellar material (CSM). These interaction signatures weakened quickly, with broad features consistent with those seen in stripped-envelope SNe becoming dominant around two weeks after maximum. The narrow $\mathrm{ He}\, {\small I}$ velocities are consistent with the wind velocities of luminous blue variables but its spectra lack the typically seen hydrogen features. The fast and bright early light curve is inconsistent with radioactive 56Ni powering but can be explained through a combination of CSM interaction and an underlying 56Ni decay component that dominates the later time behaviour of LSQ13ddu. Based on the strength of the underlying broad features, LSQ13ddu appears deficient in He compared to standard SNe Ib.
Slow slip events (SSEs) accommodate a significant proportion of tectonic plate motion at subduction zones, yet little is known about the faults that actually host them. The shallow depth (<2 km) of ...well-documented SSEs at the Hikurangi subduction zone offshore New Zealand offers a unique opportunity to link geophysical imaging of the subduction zone with direct access to incoming material that represents the megathrust fault rocks hosting slow slip. Two recent International Ocean Discovery Program Expeditions sampled this incoming material before it is entrained immediately down-dip along the shallow plate interface. Drilling results, tied to regional seismic reflection images, reveal heterogeneous lithologies with highly variable physical properties entering the SSE source region. These observations suggest that SSEs and associated slow earthquake phenomena are promoted by lithological, mechanical, and frictional heterogeneity within the fault zone, enhanced by geometric complexity associated with subduction of rough crust.
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