bluuebunny/crossref_metadata_2025 huggingface dataset:
LO46: Lost to follow-up post-sexual and domestic assault: An evaluation of prevalence and correlates of cases presenting to the emergency department
Authors: Blaskovits F. , Muldoon K. , Drumm A. , Leach T. , Heimerl M. , Sampsel K.
Published: May 2019

Introduction: Domestic violence (DV) and sexual assault (SA), together called sexual and gender-based violence (SGBV), are traumatic and life-changing events. Post-assault follow-up care is essential for survivor recovery through medical care, mental health functioning, and injury reassessment. The objective of this analysis was to determine the frequency of loss to follow-up (LTFU) in a SGBV population, and the characteristics most commonly associated with LTFU. Methods: The Sexual Assault and Partner Abuse Care Program (SAPACP) is the only Ottawa program for emergency/forensic care. Demographic and assault characteristics were abstracted from the SAPACP clinical case registry (1 Jan 2015 to 20 Dec 2017). Descriptive analyses and bivariable/multivariable logistic regression modelling assessed factors most strongly associated with LTFU using odds ratios (OR), adjusted OR (AOR), and 95% confidence intervals (CI). Results: Among 894 initial SAPACP visits, 482 (53.9%) were LTFU. Of those LTFU, 445 (92.3%) were female, 185 (38.4%) arrived by ambulance, 284 presented acutely (58.9%), 70 (14.5%) had substance use issues, and 82 (17.0%) were re-victimized. There were 229 (47.5%) sexual assaults, 201 (41.7%) physical assaults, and 92 (19.1%) verbal assaults. LTFU patients were more likely to arrive by ambulance (AOR: 1.09, 95% CI: 1.34-2.69), experience re-victimization (AOR: 1.94, 95% CI: 1.25-3.03), and have a substance use disorder (AOR: 1.67, 95% CI:1.02-2.73). Those more likely to attend follow-up included sexual assault survivors (AOR: 0.37, 95% CI: 0.27-0.50) and acute presenters (AOR: 0.58, 95% CI: 0.44-0.78). Conclusion: Over half of patients arriving for initial SAPACP visits did not follow-up. LTFU was more likely among cases that arrived by ambulance, and those involving revicitimization or substance use disorders. Follow-up is critical for maintaining mental and physical health post-trauma. While some characteristics increased follow-up likelihood, this study has identified groups that need attention to reduce LTFU.
LO54: The CanadiEM Junior Editor program: a quantitative study and program evaluation
Authors: Wakeling S. , Chan T. , Thoma B.
Published: May 2019

Introduction: CanadiEM.org is a multi-author open access medical education website which aims to improve emergency care in Canada by building an online community of practice for healthcare practitioners and providing them with high quality, freely available educational resources. It is used by physicians, allied health professionals, and trainees globally. Junior (medical student and/or resident) Editors are key members of the community who are mentored to advance their academic skills and knowledge for their careers and the healthcare field. The program also aims to increase the sustainability of the CanadiEM project by supporting the creation and publishing of online content. We aimed to assess the impact and efficacy of this program while discovering ways to improve it. Methods: The experience of all current and previous Junior Editors were assessed through a survey developed by the authorship team for this purpose. The survey consisted of 48 questions, including 15 multiple choice questions rated using a Likert Scale, 10 open-ended questions, and 23 demographic or binary yes/no questions. The participants' perceptions of their experience, desire for future involvement, and opinions regarding implementation of the program at other medical education websites were assessed using open-ended qualitative questions. These responses were thematically analyzed. Results: A total of 28 Junior Editors responded (71.7% of those surveyed). They listed their responsibilities as uploading/copyediting posts, authorship of posts, infographic creation, social media promotion, authorship of podcast summaries, editing of podcasts, and logo design. Results revealed a positive experience across all domains, with participants citing a better experience when compared to previous similar roles. 85.7% (24/28) stated they achieved their expectations from the program, and 82.1% (23/28) would incorporate this program into another medical education website if given the opportunity. Conclusion: Junior Editors reported positive experiences across all responsibilities, with particular value placed on digital and authorship skills development, inspiration for future FOAMed, research engagement, and mentorship/networking. Through collaboration with current team members, we will implement improvement initiatives. Based upon these results, we believe that the Junior Editor model may also be viable within other medical education communities.
Design, implementation, and analysis considerations for cluster-randomized trials in infection control and hospital epidemiology: A systematic review
Authors: O’Hara Lyndsay M. , Blanco Natalia , Leekha Surbhi , Stafford Kristen A. , Slobogean Gerard P. , Ludeman Emilie , Harris Anthony D. ,   for the CDC Prevention Epicenters Program
Published: May 2019

Background:

In cluster-randomized trials (CRT), groups rather than individuals are randomized to interventions. The aim of this study was to present critical design, implementation, and analysis issues to consider when planning a CRT in the healthcare setting and to synthesize characteristics of published CRT in the field of healthcare epidemiology.

Methods:

A systematic review was conducted to identify CRT with infection control outcomes.

Results:

We identified the following 7 epidemiological principles: (1) identify design type and justify the use of CRT; (2) account for clustering when estimating sample size and report intraclass correlation coefficient (ICC)/coefficient of variation (CV); (3) obtain consent; (4) define level of inference; (5) consider matching and/or stratification; (6) minimize bias and/or contamination; and (7) account for clustering in the analysis. Among 44 included studies, the most common design was CRT with crossover (n = 15, 34%), followed by parallel CRT (n = 11, 25%) and stratified CRT (n = 7, 16%). Moreover, 22 studies (50%) offered justification for their use of CRT, and 20 studies (45%) demonstrated that they accounted for clustering at the design phase. Only 15 studies (34%) reported the ICC, CV, or design effect. Also, 15 studies (34%) obtained waivers of consent, and 7 (16%) sought consent at the cluster level. Only 17 studies (39%) matched or stratified at randomization, and 10 studies (23%) did not report efforts to mitigate bias and/or contamination. Finally, 29 studies (88%) accounted for clustering in their analyses.

Conclusions:

We must continue to improve the design and reporting of CRT to better evaluate the effectiveness of infection control interventions in the healthcare setting.
A Zel’dovich–von Neumann–Döring-like detonation wave in a multi-temperature mixture
Authors: Madjarević Damir , Simić Srboljub , Soares Ana Jacinta
Published: May 2019

The detonation wave structure is analysed in a binary mixture undergoing a reversible chemical reaction represented by$A_{r}\rightleftharpoons A_{p}$. It is assumed that the flow satisfies the proper basic assumptions of the Zel’dovich–von Neumann–Döring (ZND) detonation model, namely the flow is one-dimensional and the shock is represented by a jump discontinuity, but the assumption of local thermodynamic equilibrium is disregarded. This allows us to deeply investigate the coupling between the detonation structure of overdriven detonations and its chemical kinetics. The thermodynamic non-equilibrium effects are taken into account in the mathematical description, using the model of a multi-temperature mixture developed within extended thermodynamics, which has been proved to be consistent with a kinetic theory approach. The reaction rate is then enriched with terms that take into account the temperatures of the constituents. The results show that the temperature difference between components within the detonation wave structure, which describes thermodynamic non-equilibrium, is driven by the chemical reaction. Numerical computations confirm the existence of non-monotonic profiles in the reaction zone of overdriven detonations which are sensitive to changes in the activation energy and reaction heat.
State Compliance with the Recommendations of the African Commission on Human and Peoples’ Rights, 1994-2004
Authors: Viljoen Frans , Louw Lirette
Published: May 2019

Current discourse on international human rights leaves little room for self-satisfaction about near-universal acceptance of wide-ranging normative frameworks with a global and regional scope. Recent times have witnessed growing academic concern with the “impact” or “effect” of international human rights treaties on thede jureandde factolegal position in state parties. These concerns are embedded in bigger and more enduring questions about the nature of state obligations under international law (including those derived from “nonbinding norms”) and compliance with them. However, general questions about obedience to international law have been replaced by attempts to answer the question whether human rights treaties in fact “make a difference.”
Military Commissions: A Concise History
Authors: Vagts Detlev F.
Published: May 2019

As military commissions have been revived in the wake of the attacks of September 11,2001, interest has grown in the history of the institution. The United States Supreme Court, in Hamdan v. Rumsfeld, sketched out some historical notes and set forth a tripartite division between law-of-war commissions, martial law commissions, and occupation tribunals. Various authors have advanced insights on this history, though most have focused on the prominent episodes, particularly the handful of Supreme Court cases. Even the most comprehensive article gives short shrift to the massive employment of commissions in the Reconstruction era and in postwar Germany. This essay attempts to advance the cause by sketching out the entire scope of the institution’s history and indicating what further research would have to be done to arrive at a truly comprehensive treatment. A basic difficulty is that the work product of military commissions is not encompassed in a series of trial reports like the Federal Supplement or the military’s own Court-Martial Reports. A handful of cases wound up in the Supreme Court and another half dozen stood out enough to attract historians’ interest. Otherwise, commission proceedings are memorialized, if at all, only in military general orders and records of trials that were maintained in the Office of the Judge Advocate General. I have explored the records pertaining to commissions in the Reconstruction period following the Civil War in anticipation of writing a comprehensive article. It is a difficult and time-consuming task. To complete the picture, similar pick-and-shovel work would have to be done on such extensive use of the commission as occurred in Germany after World War II. Both the Civil War-Reconstruction period and the German occupation produced thousands of trials.
The Military Commissions Act, the Geneva Conventions, and the Courts: A Critical Guide
Authors: Vázquez Carlos Manuel
Published: May 2019

The Military Commissions Act of 2006 (MCA) was precipitated by several of the United States Supreme Court’s holdings in Hamdan v. Rumsfeld. First, the administration perceived the need to respond to the Court’s invalidation of the military commissions established pursuant to the president’s Military Order of November 13,2001, as contrary to Congress’s stipulation that such tribunals conform to the laws of war. In addition, the Court’s holding that common Article 3 of the Geneva Conventions applies to the conflict with Al Qaeda carried important implications for other national security policies. Most important, the Court’s interpretation of the scope of common Article 3 imperiled the president’s program for the interrogation of Qaeda detainees because that article prohibits cruel and degrading treatment and violating it was a criminal offense under the War Crimes Act.
Commission of the European Communities v. Ireland. Case C-459/03. Judgment
Authors: Bodansky Daniel , Romano Cesare P. R.
Published: May 2019

Commission of the European Communities v. Ireland. Case C-459/03. Jud gment. At .

Court of Justice of the European Communities (Grand Chamber), May 30, 2006.

On May 30,2006, the Court of Justice of the European Communities (ECJ) ruled on Case C-459/03, Commission v. Ireland, brought by the European Commission (Commission) and alleging Ireland's failure to fulfill obligations under the Treaty Establishing the European Community (EC Treaty). In 2001, Ireland had initiated proceedings against the United Kingdom before an ad hoc Arbitral Tribunal pursuant to the Annex VII dispute settlement procedures of the 1982 UN Convention on the Law of the Sea (LOS Convention). In the present case, the Commission alleged, first, that Ireland breached Article 292 of the EC Treaty and Article 193 of the EURATOM Treaty (EA Treaty) because, by submitting the dispute to Annex VII arbitration, Ireland failed to respect the ECJ's exclusive jurisdiction on the interpretation and application of EC law. Second, the Commission claimed that Ireland had violated Article 10 of the EC Treaty and Article 192 of the EA Treaty because, by not consulting with the Commission before initiating arbitral proceedings, Ireland had hindered the achievement of the EC's tasks and jeopardized the attainment of the objectives of the EC Treaty. The Court upheld all complaints.
The 2005 Judicial Activity of the International Court of Justice
Authors: Mathias Stephen
Published: May 2019

In 2005, the International Court of Justice issued three judgments.l In February, the Court upheld an objection to its jurisdiction in Certain Property (Liechtenstein v. Germany). In July, a chamber of the Court issued its judgment on the merits in Frontier Dispute (Benin/Niger). In December, the full Court issued its judgment on the merits in Armed Activities on the Territory of the Congo (Democratic Republic of the Congo v. Uganda).
NEO-MALTHUSIAN ENVIRONMENTALISM, WORLD FISHERIES CRISIS, AND THE GLOBAL COMMONS, 1950s–1970s
Authors: LOCHER FABIEN
Published: May 2019

The present article aims to analyse the role played by US neo-Malthusians in the construction of overfishing as a global environmental issue. Its main argument is that this group of thinkers and militants made decisive contributions, between the 1950s and 1970s, to the formulation and dissemination of the diagnosis of a global fisheries crisis threatening the planet's stocks. These warnings about a global fishing crisis paved the way for present-day concerns about a planetary decline of marine life. By assessing the role played by the neo-Malthusians, this article analyses the history of the post-Second World War debates on ocean productivity, ‘unconventional’ fisheries, and fisheries exhaustion, showing how they were marked by highly optimistic expectations regarding the exploitation of the ‘ocean frontier’. For the neo-Malthusians, it was crucial to discredit this cornucopian vision of the ocean as a horn of plenty, itself a result of contemporaneous euphoria in the world of industrial fishing. In conclusion, this article sheds new light on the history of debates about (over)population and world resources, and on the rise of an ‘environmentalism of the oceans’ in the second half of the twentieth century.
Collisional alpha transport in a weakly non-quasisymmetric stellarator magnetic field
Authors: Catto Peter J.
Published: May 2019

Alpha particle confinement is a serious concern in stellarators and provides strong motivation for optimizing magnetic field configurations. In addition to the collisionless confinement of trapped alphas in stellarators, excessive collisional transport of the trapped alpha particles must be avoided while they tangentially drift due to the magnetic gradient (the

$\unicode[STIX]{x1D735}B$

drift). The combination of pitch angle scatter off the background ions and the

$\unicode[STIX]{x1D735}B$

drift gives rise to two narrow boundary layers in the trapped region. The first is at the trapped–passing boundary and enables the finite trapped response to be matched to the vanishing passing response of the alphas. The second layer is a region that encompasses the somewhat more deeply trapped alphas with vanishing tangential

$\unicode[STIX]{x1D735}B$

drift. Away from (and between) these boundary layers, collisions are ineffective and the alpha

$\unicode[STIX]{x1D735}B$

drift simply balances the small radial drift of the trapped alphas. As this balance does not vanish as the trapped–passing boundary is approached, the first collisional boundary layer is necessary and gives rise to

$\surd \unicode[STIX]{x1D708}$

transport, with

$\unicode[STIX]{x1D708}$

the collision frequency. The vanishing of the tangential drift results in a separate, somewhat wider boundary layer, and significantly stronger superbanana plateau transport that is independent of collisionality. The constraint imposed by the need to avoid significant energy depletion loss in the slowing down tail distribution function sets the allowed departure of a stellarator from an optimal quasisymmetric configuration.
Vaccine Innovation and Adoption: Polio Vaccines in the UK, the Netherlands and West Germany, 1955–1965
Authors: Lindner Ulrike , Blume Stuart S
Published: May 2019

“An effective AIDS vaccine could be found as early as 2012, saving 6 million lives if the world is willing to put £10 bn a year into a new programme, the chancellor, Gordon Brown, said in a speech last night in Tanzania”. Faith in biomedical science; the conviction that new vaccines will be translated into lives saved; belief in the necessity of globally concerted action: the British minister's statement reflects views of vaccine innovation that are widely held today. New and improved vaccines seem our best hope of coping with the scourge of AIDS, of arming ourselves against the unknown threats of emergent diseases and potential bioterrorism, and of tackling the resurgence of old diseases arising once more in Europe. Global coordination, pooling our resources, seems self-evidently necessary, given the international nature of a modern epidemic. Much current discussion of vaccine development and use thus has a global character. That is to say, it is conducted under the banner of global slogans or it seeks to establish globally integrated approaches to vaccine research and development (R&D). Over the past two decades the development and rapid introduction of new vaccines have come to dominate the vaccine agenda worldwide. Social scientists and health policy analysts have been set to work, examining barriers to the implementation of international priorities at the national level. Why, for example, are national responses to the availability of new vaccines often so lethargic? A recent study of the adoption of Hemophilus influenza b (Hib) conjugate vaccine is a good example. It shows policy makers in four countries rationally weighing the burden to public health of the diseases against which the vaccine offers protection (bacterial meningitis and pneumonia), against the high cost of the vaccine. Health policy analysts tend to explain the decision to introduce a new vaccine, or to replace an existing vaccine by a new alternative, in terms of the epidemiology and seriousness of the disease, and of scientific consensus regarding the efficacy and potential risks of the vaccine and (perhaps) their costs. The studies of vaccine diffusion and adoption that they conduct have little or nothing to say about political disagreements, or the influence of commercial interests, national traditions, international relations, or global agendas. Where any attention is paid to vaccine history, it is generally in the attempt to illustrate factors (such as resistance to vaccination) that might cause deviations from the rational deployment of vaccines.
Ambiguous Signs, an Anonymous Character, Unanswerable Riddles: The Role of the Unknown in Johannine Epistemology
Authors: Attridge Harold W.
Published: May 2019

While the Gospel of John makes some forceful and explicit claims about the identity of Jesus and the character of his mission, it also invites readers into a deepened appreciation of its claims. Part of its strategy for doing so is to exploit ambiguity and to point to what the readers do not know. The article explores three examples of this pedagogical strategy: the deliberately hidden identity of the Beloved Disciple; the initial deeds of Jesus, labelled ‘signs’, which, however, do not in any direct and obvious way ‘signify’ anything, as the later works do; and the question debated by the crowds in Jerusalem, of where Jesus is from. In each case recognition of the unknown can be the first step towards discovering Truth.
A Note on the Death of Judas in Papias
Authors: Moss Candida R.
Published: May 2019

In early Christian literature the death of Judas is broadly understood as a fitting end to the life of the betrayer of Jesus. Papias’ description of Judas’ death can be illuminated by comparison with ancient biographical and medical literature, in which oedema and parasitic infections are a consequence of greed, and also apocalyptic texts, in which worms become an emblematic form of divine punishment after death. Viewed in this context the death of Judas serves a pedagogical function as a warning about the dangers of greed.
DSM-5 full syndrome, other specified, and unspecified eating disorders in Australian adolescents: prevalence and clinical significance
Authors: Mitchison Deborah , Mond Jonathan , Bussey Kay , Griffiths Scott , Trompeter Nora , Lonergan Alexandra , Pike Kathleen M. , Murray Stuart B. , Hay Phillipa
Published: May 2019

Background

Little information is available on the prevalence of Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 eating disorders in adolescence, and eating disorders remain unique in the DSM for not systematically including a criterion for clinical significance. This study aimed to provide the first prevalence report of the full suite of DSM-5 eating disorders in adolescence, and to examine the impact of applying a criterion for clinical significance.

Methods

In total, 5191 (participation rate: 70%) Australian adolescents completed a survey measuring 1-month prevalence of eating disorder symptoms for all criterial, ‘other specified’ and unspecified eating disorders, as well as health-related quality of life and psychological distress.

Results

The point prevalence of any eating disorder was 22.2% (12.8% in boys, 32.9% in girls), and ‘other specified’ disorders (11.2%) were more common than full criterial disorders (6.2%). Probable bulimia nervosa and binge eating disorder, but not anorexia nervosa (AN), were more likely to be experienced by older adolescents. Most disorders were associated with an increased odds for being at a higher weight. The prevalence of eating disorders was reduced by 40% (to 13.6%) when a criterion for clinical significance was applied.

Conclusions

Eating disorders, particularly ‘other specified’ syndromes, are common in adolescence, and are experienced across age, weight, socioeconomic and migrant status. The merit of adding a criterion for clinical significance to the eating disorders, similar to other DSM-5 disorders, warrants consideration. At the least, screening tools should measure distress and impairment associated with eating disorder symptoms in order to capture adolescents in greatest need for intervention.
Is close enough good enough?
Authors: Brown Campbell
Published: May 2019

Should we allow grave harm to befall one individual so as to prevent minor harms befalling sufficiently many other individuals? This is a question of aggregation. Can many small harms ‘add up’, so that, collectively, they morally outweigh a greater harm? The ‘Close Enough View’ supports a moderate position: aggregation is permissible when, and only when, the conflicting harms are sufficiently similar, or ‘close enough’, to each other. This paper surveys a range of formally precise interpretations of this view, and reveals some of the problems they face. It also proposes a novel interpretation which avoids these problems.
Théologies marranes
Authors: Wachtel Nathan
Published: May 2019

« Théologie marrane » : la notion qu’emploie Richard H. Popkin pour qualifier la pensée religieuse d’Isaac La Peyrère (1596-1676) est-elle généralisante à d’autres auteurs ou personnages (qu’ils soient d’origine nouvelle-chrétienne ou non) ? L’on se propose de tenter une expérimentation : examiner deux cas éloignés dans l’espace et dans le temps, ceux du Père Francisco de la Cruz (vers 1530-1579) au Pérou, et de Pedro de Rates Henequim (1680-1744) au Brésil. Outre leurs destins tragiques, ces deux auteurs ont pour autre point commun que leurs pensées religieuses respectives s’orientent essentiellement vers (et depuis) le continent américain, où doivent advenir le Cinquième Empire et la Rédemption de l’humanité. Dans la confusion des innombrables spéculations que comportent tant de croyances messianiques et millénaristes, peut-on mettre au jour des configurations régies par quelque logique ? Au terme de l’analyse, il apparaît que, dans un champ limité, un certain nombre de thèmes s’articulent les uns aux autres selon des transformations de type structural, s’inscrivant comme autant de variantes à l’intérieur d’un même thème.
Epidemiologic patterns of humanSalmonellaserotype diversity in the USA, 1996–2016
Authors: Judd M. C. , Hoekstra R. M. , Mahon B. E. , Fields P. I. , Wong K. K.
Published: May 2019

Although researchers have described numerous risk factors for salmonellosis and for infection with specific common serotypes, the drivers ofSalmonellaserotype diversity among human populations remain poorly understood. In this retrospective observational study, we partition records of serotyped non-typhoidalSalmonellaisolates from human clinical specimens reported to CDC national surveillance by demographic, geographic and seasonal characteristics and adapt sample-based rarefaction methods from the field of community ecology to study howSalmonellaserotype diversity varied within and among these populations in the USA during 1996–2016. We observed substantially higher serotype richness in children <2 years old than in older children and adults and steadily increasing richness with age among older adults. Whereas seasonal and regional variation in serotype diversity was highest among infants and young children, variation by specimen source was highest in adults. Our findings suggest that the risk for infection from uncommon serotypes is associated with host and environmental factors, particularly among infants, young children and older adults. These populations may have a higher proportion of illness acquired through environmental transmission pathways than published source attribution models estimate.
Ongoing change in post-independence São Tomé: The use of rhotics as a marker of national identity among young speakers of Santomean Portuguese
Authors: Bouchard Marie-Eve
Published: May 2019

This paper examines variation in the use of rhotics in Santomean Portuguese. In Portuguese, the distribution of rhotics is determined by syllable structure (Bonet & Mascaró, 1997). However, the emerging variety of Portuguese spoken in São Tomé and Príncipe diverges from the standard norm and shows great variability in its use of rhotics; specifically, Santomeans often use a strong-R in positions that require a weak-r in European and Brazilian Portuguese. Sociolinguistic interviews with 56 speakers from the capital of São Tomé and Príncipe and its surroundings provide 5287 data points for analysis. Based on the apparent-time construct (Bailey, 2004; Bailey et al., 1991), variation patterns show a language change in progress in the use of the strong-R, with younger speakers using it more frequently. Results also reveal the emergence of rhotic fricatives in the speech of Santomeans born after the independence of the country.
Rare cause of cardiac failure in an infant
Authors: Henriques Cláudio , Andrade Helena , Pires António
Published: May 2019

Congenital stenosis of the pulmonary veins is a rare condition whose outcome is guarded despite the available treatment options. We report a case of a 6-month-old infant with significant stenosis of all four pulmonary veins.
Proposal for a new funding system for mental health departments. Results from an evaluative multicentre Italian study (I-psycost)
Authors: Grigoletti Laura , Amaddeo Francesco , Grassi Aldrigo , Boldrini Massimo , Chiappelli Marco , Percudani Mauro , Catapano Francesco , Fiorillo Andrea , Bartoli Luca , Bacigalupi Maurizio , Albanese Paolo , Simonetti Simona , Perali Federico , De Agostini Paola , Tansella Michele ,   Gruppo I-Psycost
Published: May 2019

Aims– To obtain a new, well-balanced mental health funding system, through the creation of i) a list of psychiatric interventions provided by Italian Community-based Psychiatric Services (CPS), and associated costs; ii) a new prospective funding system for patients with a high use of resources, based on packages of care.Methods– Five Italian Community-based Psychiatric Services collected data from 1250 patients during October 2002. Socio-demographical and clinical characteristics and GAF scores were collected at baseline. All psychiatric contacts during the following six months were registered and categorised into 24 service contact types. Using elasticity equation and contact characteristics, we estimate the costs of care. Cluster analysis techniques identified packages of care. Logistic regression defined predictive variables of high use patients. Multinomial Logistic Model assigned each patient to a package of care.Results– The sample's socio-demographic characteristics are similar, but variations exist between the different CPS. Patients were then divided into two groups, and the group with the highest use of resources was divided into three smaller groups, based on number and type of services provided.Conclusions– Our findings show how is possible to develop a cost predictive model to assign patients with a high use of resources to a group that can provide the right level of care. For these patients it might be possible to apply a prospectiveper-capitafunding system based on packages of care.

Declaration of Interest: None
Heterogeneity of the Departments of Mental Health in the Veneto Region ten years after the National Plan 1994-96 for Mental Health. Which implication for clinical practice? Findings from the PICOS Project
Authors: Lasalvia Antonio , Gentile Bruno , Ruggeri Mirella , Marcolin Alessandro , Nosè Flavio , Cappellari Lodovico , Lamonaca Dario , Toniolo Emanuele , Busana Claudio , Campedelli Antonio , Cuccato Giancarlo , Danieli Andrea , De Nardi Fabio , De Nardo Vincenzo , Destro Ernesto , Favaretto Gerardo , Frazzingaro Silvio , Giacopuzzi Mario , Pristinger Paolo , Pullia Giuseppe , Rodighiero Sandro , Tito Paolo , Aprile Francesco , Nicolaou Stylianos , Coppola Giuseppe , Garzotto Nicola , Gottardi Umberto , Lazzarin Ermanna , Migliorini Giuseppe , Pavan Luigi , Ramaciotti Fabrizio , Roveroni Paolo , Russo Salvatore , Urbani Pierpaolo , Tansella Michele
Published: May 2019

Aims - This study aims to present data on structural and human resources of public mental health services located in the Veneto Region, Italy, and to discuss them in the light of implementation of the first National Target Plan for Mental Health (“Progetto Obiettivo 1994-1996”) ten years after its launch. Methods - The study was conducted in the context of the PICOS (Psychosis Incident Cohort Outcome Study) Project, a large first-presentation multisite study on patients with psychotic disorders attending community mental heath services in the Veneto Region. Human and structural resources were surveyed in 26 study sites using a structured interview administered by the PICOS local referents. Results - CMHCs and Day Centres were homogeneously distributed across the Region and their overall rates per resident population met the national standards; a wide variability in the distribution of Day Hospitals was found, with the overall rate per resident population very far from meeting the national standard; the overall rate for Residential Facilities beds was higher than the recommended national standard, showing however an high variability across sites. The overall rate of mental health professionals per resident population was only slightly below the national standard: this was mainly achieved thanks to non-profit organizations which supplement the public system with unspecialised professionals; however, a wide variability in the local rates per resident population was found, with the 50% of the sites showing rates far lower the national standard. Specific lack of trained professionals involved in the provision of psychosocial interventions was found in most sites. Conclusions - A marked variability in human and structural resources across community mental health services in the Veneto Region was found. Possible reasons for this heterogeneity were analysed and implications for mental health care provision were further discussed.

Declaration of Interest: The study has been supported by the Regione del Veneto, Giunta Regionale, Ricerca Sanitaria Finalizzata 2004, Venezia, Italia (grant to Professor M. Ruggeri).
An Examination of Temperature Trends at High Elevations Across the Tibetan Plateau: The Use of MODIS LST to Understand Patterns of Elevation‐Dependent Warming
Authors: Pepin Nick , Deng Haijun , Zhang Hongbo , Zhang Fan , Kang Shichang , Yao Tandong
Published: May 2019

Research has revealed systematic changes in warming rates with elevation (EDW) in mountain regions. However, weather stations on the Tibetan plateau are mostly located at lower elevations (3,000‐4,000 m) and are nonexistent above 5,000 m, leaving critical temperature changes unknown. Satellite LST (Land Surface Temperature) can fill this gap but needs calibrating against in situ air temperatures (Tair). We develop a novel statistical model to convert LST to Tair, developed at 87 high‐elevation Chinese Meteorological Administration stations. Tair (daily maximum/minimum temperatures) is compared with Moderate Resolution Imaging Spectroradiometer (MODIS) Aqua LST (1330 and 0130 local time) for 8‐day composites during 2002‐2017. Typically, 80‐95% of the difference between LST and Tair (ΔT) is explained using predictors including LST diurnal range, morning heating/nighttime cooling rates, the number of cloud free days/nights, and season (solar angle). LST is corrected to more closely represent Tair by subtracting modeled ΔT. We validate the model using an AWS on Zhadang Glacier (5800 m). Trend analysis at the 87 stations (2002‐2017) shows corrected LST trends to be similar to original Tair trends. To examine regional contrasts in EDW patterns, elevation profiles of corrected LST trends are derived for three ranges (Qilian Mountains, NyenchenTanglha, and Himalaya). There is limited EDW in the Qilian mountains. Maximum warming is observed around 4,500‐5,500 m in NyenchenTanglha, consistent with snowline retreat. In common with other studies, there is stabilization of warming at very high elevations in the Himalaya, including absolute cooling above 6,000 m, but data there are compromised by frequent cloud.
Drivers and Surface Signal of Interannual Variability of Boreal Stratospheric Final Warmings
Authors: Thiéblemont R. , Ayarzagüena B. , Matthes K. , Bekki S. , Abalichin J. , Langematz U.
Published: May 2019

Springtime stratospheric final warming (SFW) variability has been suggested to be linked to the tropospheric circulation, particularly over the North Atlantic sector. These findings, however, are based on reanalysis data that cover a rather short period of time (1979 to present). The present work aims to improve the understanding of drivers, trends and surface impact of dynamical variability of boreal SFWs using chemistry‐climate models. We use multidecadal integrations of the fully coupled chemistry‐climate models Community Earth System Model version 1 (Whole Atmosphere Community Climate Model) and ECHAM/Modular Earth Submodel System Atmospheric Chemistry‐O. Four sensitivity experiments are analyzed to assess the impact of external factors; namely, the quasi‐biennial oscillation, sea surface temperature (SST) variability, and anthropogenic emissions. SFWs are classified into two types with respect to their vertical development; that is, events which occur first in the midstratosphere (10‐hPa first SFWs) or first in the upper stratosphere (1‐hPa first SFWs). Our results confirm previous reanalysis results regarding the differences in the time evolution of stratospheric conditions and near‐surface circulation between 10 and 1‐hPa first SFWs. Additionally, a tripolar SST pattern is, for the first time, identified over the North Atlantic in spring months related to the SFW variability. Our analysis of the influence of remote modulators on SFWs revealed that the occurrence of major warmings in the previous winter favors the occurrence of 10‐hPa first SFWs later on. We further found that quasi‐biennial oscillation and SST variability significantly affect the ratio between 1‐hPa first and 10‐hPa first SFWs. Finally, our results suggest that ozone recovery may impact the timing of the occurrence of 1‐hPa first SFWs.
Response of the Northern Stratosphere to the Madden‐Julian Oscillation During Boreal Winter
Authors: Yang Chengyun , Li Tao , Xue Xianghui , Gu Sheng‐yang , Yu Chao , Dou Xiankang
Published: May 2019

In this study, the effects of the Madden‐Julian oscillation (MJO) on the northern stratosphere during boreal winter are investigated, especially in cases with the absence of a stratospheric sudden warming (SSW) event. During the wintertime, the polar cap temperature is expected to increase following MJO phase 2 (P2), P3, P4, and P7. However, the responses after P2 and P3 are much weaker if the dates from 50 days before to 50 days after the SSW central days are excluded from the composite. This result implies that the stratospheric polar warming following MJO P2 and P3 is sensitive to the occurrence of SSWs. After excluding the SSW events from the composite, the subsequent temperature anomalies strengthen and become more significant approximately 30 days after MJO P4 and 10 days after MJO P7. Planetary wave (PW) anomalies are enhanced in the midlatitudes of the upper troposphere, lagging MJO P4 by 15–25 days and lagging MJO P7 by 5–15 days. Thus, the upward propagation and dissipation of PWs in the stratosphere are significantly enhanced, further strengthening the Brewer‐Dobson circulation in the Northern Hemisphere stratosphere. The WN1, which is induced by the MJO in the stratosphere, is the dominant component of PW perturbation. The enhanced PW dissipation in the high latitudes of the stratosphere is weaker in terms of lagging MJO P4, so the zonal wind and temperature anomalies after MJO P4 are less significant in the polar region, especially in the lower stratosphere.
Ensemble Spatial Precipitation Analysis From Rain Gauge Data: Methodology and Application in the European Alps
Authors: Frei Christoph , Isotta Francesco A.
Published: May 2019

The deterministic nature of conventional precipitation data sets complicates their utility in applications. The underlying estimation principle (minimizing errors) involves biases in extremes, and conventional uncertainty quantification (cross‐validation) is impractical. We present a method to derive spatial analyses of daily precipitation, probabilistically, as an ensemble, conditional on the available rain gauge data. The method builds on and extends previous techniques using conditional simulation with Gaussian Random Fields. The extension involves trans‐Gaussian and piecewise covariance modeling to let the ensemble respond to regional precipitation conditions, Bayesian inference to account for parameter uncertainty, and simulation on a primary grid to ensure the ensemble has a well‐defined areal support. While addressing prevalent issues of existing techniques, our method involves a compromise in global consistency that limits the utility of the ensemble over large domains. We apply the method to derive ensembles of area‐mean precipitation for hydrological area units in the Alps. The ensembles are demonstrated to plausibly capture variations in uncertainty with rainfall condition, rain gauge density, and averaging area. Evaluations suggest that the probabilistic estimates are internally consistent and of good statistical reliability. There is a tendency to underestimate uncertainty for light precipitation. Results point to remarkable uncertainties, even with the dense gauge networks in the Alps: For means over 500‐km2 areas we find the ensemble spread to be typically a factor of 2–4 (factor of 1.5) for intense convective (stratiform) events. This also implies nonnegligible uncertainty in climate indices. Probabilistic representation of interpolation uncertainty in spatial data sets allows users to track them into applications.
Regional Snow Parameters Estimation for Large‐Domain Hydrological Applications in the Western United States
Authors: Sun Ning , Yan Hongxiang , Wigmosta Mark S. , Leung L. Ruby , Skaggs Richard , Hou Zhangshuan
Published: May 2019

In snow‐dominated regions, a key source of uncertainty in hydrologic prediction and forecasting is the magnitude and distribution of snow water equivalent (SWE). With ensemble simulations, this work demonstrates that SWE variability across the mountain ranges of the western United States (represented by 246 Snow Telemetry stations) can largely be captured at the daily time scale by a simple mass and energy‐balance snow model with four physically reasonable parameters—three snow albedo parameters and one snow temperature threshold for precipitation partitioning. The model skill is lower in the maritime Pacific Northwest where SWE variability is more sensitive to errors associated with simulated energy balance (e.g., downward radiation fluxes) and the temperature‐only precipitation partitioning approach. Poor model skill in high‐altitude, windy locations in the Northern Rockies can be attributed to precipitation undercatch and underrepresented wind processes. For the purpose of large‐domain hydrologic applications, regional snow parameters were developed for eight ecoregions characterized by a distinct hydroclimatic regime across the western United States. Results suggest that regionally coherent snow parameterizations are able to capture daily variations in SWE at most Snow Telemetry stations, suggesting that areas with a similar hydroclimate share a similar snow regime. While the three albedo parameters show limited spatial variability across all regions, the regional snow temperature threshold (Ts) shows marked spatial variation correlated with relative humidity; the Ts values increase from 0.2 °C in the higher‐humidity Pacific Northwest to 4.0 °C in the colder, lower‐humidity Rocky Mountains.
Retrieval of Snow Water Equivalent, Liquid Water Content, and Snow Height of Dry and Wet Snow by Combining GPS Signal Attenuation and Time Delay
Authors: Koch Franziska , Henkel Patrick , Appel Florian , Schmid Lino , Bach Heike , Lamm Markus , Prasch Monika , Schweizer Jürg , Mauser Wolfram
Published: May 2019

For numerous hydrological applications, information on snow water equivalent (SWE) and snow liquid water content (LWC) are fundamental. In situ data are much needed for the validation of model and remote sensing products; however, they are often scarce, invasive, expensive, or labor‐intense. We developed a novel nondestructive approach based on Global Positioning System (GPS) signals to derive SWE, snow height (HS), and LWC simultaneously using one sensor setup only. We installed two low‐cost GPS sensors at the high‐alpine site Weissfluhjoch (Switzerland) and processed data for three entire winter seasons between October 2015 and July 2018. One antenna was mounted on a pole, being permanently snow‐free; the other one was placed on the ground and hence seasonally covered by snow. While SWE can be derived by exploiting GPS carrier phases for dry‐snow conditions, the GPS signals are increasingly delayed and attenuated under wet snow. Therefore, we combined carrier phase and signal strength information, dielectric models, and simple snow densification approaches to jointly derive SWE, HS, and LWC. The agreement with the validation measurements was very good, even for large values of SWE (>1,000 mm) and HS (> 3 m). Regarding SWE, the agreement (root‐mean‐square error (RMSE); coefficient of determination (R2)) for dry snow (41 mm; 0.99) was very high and slightly better than for wet snow (73 mm; 0.93). Regarding HS, the agreement was even better and almost equally good for dry (0.13 m; 0.98) and wet snow (0.14 m; 0.95). The approach presented is suited to establish sensor networks that may improve the spatial and temporal resolution of snow data in remote areas.
Large Earthquake Reshapes the Groundwater Flow System: Insight From the Water‐Level Response to Earth Tides and Atmospheric Pressure in a Deep Well
Authors: Zhang H. , Shi Z. , Wang G. , Sun X. , Yan R. , Liu C.
Published: May 2019

Quantitative evaluation of earthquake‐induced permeability changes is important for understanding key geological processes, such as advective transport of heat and solute and the generation of elevated fluid pressure. Many studies have independently documented permeability changes in either an aquifer or an aquitard, but the effects of an earthquake on both the aquifer and aquitard of the same aquifer system are still poorly understood. In this study, we use the well water‐level response to earth tides and atmospheric pressure to study the changes in hydraulic properties in an aquifer and an overlying confining layer in Beijing, China, following the 11 March 2011 Tohoku earthquake in Japan. Our results show that both the tidal response amplitude and the phase shift increased and that the phase shift changed from negative to positive after the earthquake. We identified increased permeability in both the aquifer and aquitard by the barometric response function method. The horizontal transmissivity of the aquifer increased by a factor of 6, and the vertical diffusivity of the aquitard doubled.
RENU2 UV PMT Observations of the Cusp
Authors: Fritz Bruce A. , Lessard Marc R. , Dymond Kenneth F. , Kenward David R. , Lynch Kristina A. , Hecht James H. , Clemmons James H. , Cook Timothy , Chakrabarti Supriya , Solomon Stanley C.
Published: May 2019

The Rocket Experiment for Neutral Upwelling 2 (RENU2) sounding rocket launched from the Andøya Space Center on 13 December 2015 into the dayside polar cusp. An ultraviolet photomultiplier tube (UV PMT) on the RENU2 payload was oriented to look up along the spin axis for emissions of neutral atomic oxygen above the payload. Data from the UV PMT have been compared to predicted auroral emissions calculated by the Global Airglow (GLOW) model. The comparison between GLOW calculations driven by RENU2 electron precipitation measurements and UV PMT data suggest enhanced neutral density in the cusp at altitudes above the RENU2 trajectory.