Self-stabilised fractality of sea-coasts through damped erosion

Erosion of rocky coasts spontaneously creates irregular seashores. But the geometrical irregularity, in turn, damps the sea-waves, decreasing the average wave amplitude. There may then exist a mutual self-stabilisation of the waves amplitude together with the irregular morphology of the coast. A simple model of such stabilisation is studied. It leads, through a complex dynamics of the earth-sea interface, to the appearance of a stationary fractal seacoast with dimension close to 4/3. Fractal geometry plays here the role of a morphological attractor directly related to percolation geometry.Comment: 4 pages, 5 figure

Interrupting Microaggressions in Health Care Settings: A Guide for Teaching Medical Students

© 2020 Acholonu et al. Introduction: Microaggressions are connected to broader conceptualizations of the impact of implicit bias and systems of inequity. The body of evidence supporting the need for more-open discussions in medical education about race, racism, and their impact on health disparities continues to grow. Some have advocated for the importance of bringing anti-racist pedagogy into medical education curricula, which involves explicitly attempting to move beyond people\u27s comfort zones and acknowledging that discomfort can be a catalyst for growth. To discuss the intent and impact of microaggressions in health care settings and how we might go about responding to them, we developed a workshop for third-year undergraduate medical students within a longitudinal undergraduate medical education diversity and inclusion curriculum. Methods: This workshop occurred during a regularly scheduled clerkship intersession during the 2016-2017 academic year for third-year undergraduate medical students (N = 154). Prior to the workshop, the students were asked to anonymously submit critical incident reports on any microaggressions experienced or witnessed to develop case studies for problem-based learning. Teaching modalities included lecture, problem-based learning with case studies, pair and share, and facilitated small- and large-group debriefs. Results: The session was evaluated using a 4-point Likert scale to assess students\u27 comfort in learning about the information presented. Ninety-eight percent felt confident in identifying microaggressions, and 85% felt confident in interrupting microaggressions when they occur. Discussion: This personalized workshop exposes students to microaggressions personally experienced by colleagues with an attempt to interrupt them using empathy, awareness, and communication techniques

A trophic bottleneck?: The ecological role of trout‐perch P ercopsis omiscomaycus in S aginaw B ay, L ake H uron

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97230/1/jai12023.pd

Healthy & Empowered Youth: A Positive Youth Development Program for Native Youth

Introduction: During 2010–2012, Oregon Health & Science University’s Prevention Research Center, a Northwest Tribe, and the Northwest Portland Area Indian Health Board, collaborated to evaluate the Healthy & Empowered Youth Project, a school- and community-based positive youth development program for American Indian and Alaska Native high school students. Methods: The Native STAND (Students Together Against Negative Decisions) curriculum was enhanced with hands-on learning activities in media design to engage students in sexual and reproductive health topics covered by the curriculum. Guest speakers, field trips, and extracurricular activities were added to provide academic enrichment, engage students in cultural activities, and offer opportunities for career development. Students completed comprehensive pre- and postsurveys, and the authors conducted focus groups and key informant interviews with students and teachers. Data analysis was conducted during 2013–2014. Results: Survey findings demonstrated improvements in student leadership and achievement, physical and mental health, and protective sexual health behaviors. The percentage of female teens reporting use of a condom the last time they had sex increased from 17% to 30%, and those who reported ever having been tested for sexually transmitted illnesses doubled from 12% to 24%. Focus group and interview findings indicated similar improvements in student self-esteem, life skills, health behavior, and engagement in community. Conclusions: The Healthy & Empowered Youth Project educated and empowered Native high school students on a variety of sensitive health topics. The media enhancements were central to the program’s success, reinforcing and personalizing classroom lessons and generating health-related videos and posters that resonated with family and friends

The radiative and geometric properties of melting first-year landfast sea ice in the Arctic

In polar regions, sea ice is a crucial mediator of the interaction between Earth\u27s atmosphere and oceans. Its formation and breakup is intimately connected with large-scale climatic processes, local weather patterns, and the use of sea ice in coastal Arctic regions by Indigenous people. In order to investigate the physical phenomena at the heart of this process, a set of targeted, intensive observations were made over spring sea ice melt and breakup in Kotzebue Sound, Alaska. These observations were planned and executed through a collaborative effort in which an Indigenous Elder advisory council from Kotzebue and scientists participated in co-production of hypotheses and observational research, including a stronger understanding of the physical properties of sea ice during spring melt. Here we present the results of observations performed using high-endurance, fixed-wing uncrewed aerial vehicles (UAVs) containing custom-built scientific payloads. Repeated flights over the measurement period captured the early stages of the transition from a white, snow-covered state to a broken-up, bare blue-green state. We found that the reflectance of sea ice features depends strongly on their size. Snow patches get darker as they get smaller, an effect owed to the geometric relationship between the bright interior and the darker, melting feature edges. Conversely, bare patches get darker as they get larger. For the largest ice features observed, bare blue-green ice patches were found to be ≈ 20 % less reflective than average across all observational cases, while large snowy white ice patches were found to be ≈ 20 % more reflective than that same average

Participant expectations and experiences of a tailored physiotherapy intervention for people with Parkinson’s and a history of falls

This is the author accepted manuscript. The final version is available from Taylor & Francis via the DOI In this recordPurpose People with Parkinson’s are twice as likely to fall as older people within the general population. This longitudinal qualitative study was part of a larger programme of research including a randomised controlled trial to test the effectiveness of a tailored physiotherapy intervention. Specific qualitative aims focused on a subsample of trial participants in the intervention arm of the trial, and comprised the following: - To explore the expectations of participants about the intervention - To investigate participants’ experiences of the intervention, and its perceived impacts - To understand the facilitators and barriers to engagement Methods Two semi-structured interviews were completed with a theoretical sample of people with Parkinson’s from the intervention arm, initially after randomisation but before the intervention commenced, and then again six months later. Results Forty two participants out of a large clinical trial were interviewed initially, with 37 agreeing to a second interview at six months. Prior experience of rehabilitation plus information accessed through the trial consent procedure informed participants’ realistic expectations. Most found the level of the intervention acceptable, and perceived a range of benefits. However, views about equipment provided were more equivocal. The biggest barriers to participation were time and motivation, whilst social support facilitated engagement with the intervention. Conclusion This study is the first to capture expectations about participation in a programme of exercises and strategies. It highlights that previous challenges to engagement in physical exercises and activities are not a barrier to future participation and provides new insights into the role of equipment and technology in programmes of physical activity for people with Parkinson’s. The challenge of ensuring that programmes of exercise and strategies become an embedded feature of everyday life is highlighted, particularly alongside busy social engagements and leisure pursuits.National Institute for Health Research (NIHR

Re-examining the effect of door-to-balloon delay on STEMI outcomes in the context of unmeasured confounders: a retrospective cohort study

Literature studying the door-to-balloon time-outcome relation in coronary intervention is limited by the potential of residual biases from unobserved confounders. This study re-examines the time-outcome relation with further consideration of the unobserved factors and reports the population average effect. Adults with ST-elevation myocardial infarction admitted to one of the six registry participating hospitals in Australia were included in this study. The exposure variable was patient-level door-to-balloon time. Primary outcomes assessed included in-hospital and 30 days mortality. 4343 patients fulfilled the study criteria. 38.0% (1651) experienced a door-to-balloon delay of >90 minutes. The absolute risk differences for in-hospital and 30-day deaths between the two exposure subgroups with balanced covariates were 2.81 (95% CI 1.04, 4.58) and 3.37 (95% CI 1.49, 5.26) per 100 population. When unmeasured factors were taken into consideration, the risk difference were 20.7 (95% CI −2.6, 44.0) and 22.6 (95% CI −1.7, 47.0) per 100 population. Despite further adjustment of the observed and unobserved factors, this study suggests a directionally consistent linkage between longer door-to-balloon delay and higher risk of adverse outcomes at the population level. Greater uncertainties were observed when unmeasured factors were taken into consideration

The radiative and geometric properties of melting first-year landfast sea ice in the Arctic

In polar regions, sea ice is a crucial mediator of the interaction between Earth’s atmosphere and oceans. Its formation and breakup is intimately connected with large-scale climatic processes, local weather patterns, and the use of sea ice in coastal Arctic regions by Indigenous people. In order to investigate the physical phenomena at the heart of this process, a set of targeted, intensive observations were made over spring sea ice melt and breakup in Kotzebue Sound, Alaska. These observations were planned and executed through a collaborative effort in which an Indigenous Elder advisory council from Kotzebue and scientists participated in coproduction of hypotheses and observational research, including a stronger understanding of the physical properties of sea ice during spring melt. Here we present the results of observations performed using high-endurance, fixed-wing uncrewed aerial vehicles (UAVs) containing custom-built scientific payloads. Repeated flights over the measurement period captured the early stages of the transition from a white, snow-covered state to a broken-up, bare blue-green state. We found that the reflectance of sea ice features depends strongly on their size. Snow patches get darker as they get smaller, an effect owed to the geometric relationship between the bright interior and the darker, melting feature edges. Conversely, bare patches get darker as they get larger. For the largest ice features observed, bare blue-green ice patches were found to be about 20% less reflective than average across all observational cases, while large snowy white ice patches were found to be about 20% more reflective than that same average