Well-informed Guidance Research Articles

A nationwide survey of bereavement care for siblings provided by paediatric palliative care teams.

Bereavement support is considered a core standard of care for paediatric palliative care (PPC) teams. Support for grieving siblings can present unique challenges. Developmentally appropriate care can help children navigate their grief experience. To describe the provider perspectives (mission and development) of bereavement care for siblings, and to describe the bereavement follow-up interventions offered for siblings by hospital-based PPC teams nationwide. Qualitative study conducted by semidirected telephone interviews. At least one member from each PPC team was interviewed. Interviews transcribed verbatim were analysed using grounded theory. Twenty-one teams participated (response rate 91%). Most teams (80%) provided individual psychotherapy to families, and a few (28%) offered group interventions. PPC teams endeavour to expand their bereavement services and create a stronger collaboration network with community services. However, limited human resources, lack of facilities and financing, and geographical distances were frequent obstacles to bereavement care program development. PPC teams support bereaved siblings as an integral part of palliative care. Although PPC teams cannot meet all the needs of bereaved families, they can serve as important reference points to consolidate knowledge of available local resources and offer well-informed guidance to families and community users. Greater public awareness of childhood bereavement and engaging with community structures could help overcome some of the common obstacles to service development. Further studies are warranted in evaluating bereavement services in France and in other healthcare systems.

New Masks, New Meanings: Covid Perspectives on African Art History: Part 2: Coups, Pandemics, and Careers in African Art History

New Masks, New Meanings: Covid Perspectives on African Art History: Part 2: Coups, Pandemics, and Careers in African Art History

An Understanding of the Drivers of Infectious Diseases in the Modern World Can Aid Early Control of Future Pandemics.

Infectious diseases have been a significant challenge to health and wellbeing from ancient times, with substantial economic implications globally. Despite the advent of technology, infectious diseases continue to affect people of various social statuses and across geographical locations. Understanding some of the drivers of infectious diseases, antimicrobial resistance, vaccination, and vaccine hesitancy is a step towards thriving in the modern world, achieving fewer morbidities and mortalities, and adequately controlling future pandemics. Pharmacists are strategically placed as healthcare team members to promote early disease control through health education, advocacy, cross-professional and specialty collaboration, communal trust-building, research, and global unity. Not forgetting that infectious diseases in the modern world are about people and science, credible crisis communication during the early phases of disease outbreaks paves the way for well-informed guidance globally.

Predictive approaches to heterogeneous treatment effects: a scoping review

BackgroundRecent evidence suggests that there is often substantial variation in the benefits and harms across a trial population. We aimed to identify regression modeling approaches that assess heterogeneity of treatment effect within a randomized clinical trial.MethodsWe performed a literature review using a broad search strategy, complemented by suggestions of a technical expert panel.ResultsThe approaches are classified into 3 categories: 1) Risk-based methods (11 papers) use only prognostic factors to define patient subgroups, relying on the mathematical dependency of the absolute risk difference on baseline risk; 2) Treatment effect modeling methods (9 papers) use both prognostic factors and treatment effect modifiers to explore characteristics that interact with the effects of therapy on a relative scale. These methods couple data-driven subgroup identification with approaches to prevent overfitting, such as penalization or use of separate data sets for subgroup identification and effect estimation. 3) Optimal treatment regime methods (12 papers) focus primarily on treatment effect modifiers to classify the trial population into those who benefit from treatment and those who do not. Finally, we also identified papers which describe model evaluation methods (4 papers).ConclusionsThree classes of approaches were identified to assess heterogeneity of treatment effect. Methodological research, including both simulations and empirical evaluations, is required to compare the available methods in different settings and to derive well-informed guidance for their application in RCT analysis.

Wind turbine performance analysis for energy cost minimization

The use of wind energy worldwide has overgrown in recent years to reduce greenhouse gas emissions. Wind power is free, but the installation and maintenance of wind turbines remain very costly. The size of the installation of the wind turbine is not only determined by wind statistics at a given location, but also by turbine infrastructure and maintenance costs. The payback time of the turbine is dependent on turbine energy costs. This study estimates the wind power generation capacity of Northern and Southern Oman and discusses the selection of the most economical, efficient and reliable wind turbines in Oman. HOMER Pro Software was used in this paper to evaluate the wind energy data in the north and south of Oman and to provide well-informed guidance on the most suitable turbines for the power needs of each area. Six different standard wind turbines were measured and compared in terms of the cost of energy and performance. The simulation analysis reveals that the DW54 turbine is the best possible turbine to generate electricity in northern Oman at $0.119/kW. Due to the difference in the wind regime between the north and the south of Oman, the simulation showed that the Hummer H25.0–200 kW turbine is the best option for south Oman with power generation at $0.070/kW. The northern wind turbine plant can efficiently contribute to decarbonization of the energy sector in Oman, with a potential reduction of CO2 emission approximately 19,000 tons/year in comparison to natural gas and 28,000 tons/year in comparison to diesel. In the Southern Power Plant, carbon emissions are reduced by 18,000 and 12,000 tons/year compared to diesel and natural gas.

Projections of Future Sea Level Contributions from the Greenland and Antarctic Ice Sheets: Challenges Beyond Dynamical Ice Sheet Modeling

As Earth's climate warms, rising sea levels are becoming a great concern. Providing substantiated and well-informed guidance on the amount and rate of future sea level rise is important, but remains challenging. Observations of the Greenland and Antarctic Ice Sheets-Earth's largest freshwater reservoirs-reveal their ongoing, rapid, and complex changes in response to an evolving climate. The improved understanding of ice sheet behavior resulting from observations is driving the development of ice sheet models, and is allowing better simulation of past, present, and future ice sheet evolution. However, insight into future changes requires a better understanding of how ice sheets interact with other components of the Earth system and associated feedbacks. As climate models start to include dynamical ice sheet components, our understanding of such interactions and the feedback mechanisms will advance. These new developments in ice sheet modeling and their implementation in climate models are timely, as observations indicate an accelerating contribution of ice sheets to sea level rise.

Analysis of power-aware buffering schemes in wireless sensor networks

We study the power-aware buffering problem in battery-powered sensor networks, focusing on the fixed-size and fixed-interval buffering schemes. The main motivation is to address the yet poorly understood size variation-induced effect on power-aware buffering schemes. Our theoretical analysis elucidates the fundamental differences between the fixed-size and fixed-interval buffering schemes in the presence of data-size variation. It shows that data-size variation has detrimental effects on the power expenditure of the fixed-size buffering in general, and reveals that the size variation induced effects can be either mitigated by a positive skewness or promoted by a negative skewness in size distribution. By contrast, the fixed-interval buffering scheme has an obvious advantage of being eminently immune to the data-size variation. Hence the fixed-interval buffering scheme is a risk-averse strategy for its robustness in a variety of operational environments. In addition, based on the fixed-interval buffering scheme, we establish the power consumption relationship between child nodes and parent node in a static data-collection tree, and give an in-depth analysis of the impact of child bandwidth distribution on the parent's power consumption. This study is of practical significance: it sheds new light on the relationship among power consumption of buffering schemes, power parameters of radio module and memory bank, data arrival rate, and data-size variation, thereby providing well-informed guidance in determining an optimal buffer size (interval) to maximize the operational lifespan of sensor networks.

Current Department of Defense Guidance for Total Force Fitness

ABSTRACTFitness and health care have traditionally had a major focus in the military and will continue to be an important focus for the medical community throughout the 21st century. The challenges of meeting comprehensive mental and physical care for service members are many, especially in this era of persistent conflict. We must clearly define what those fitness components will be, how they will be assessed as an individual measure, as well as how it will be applied to the community at large. How will it be “trained” and who determines and what is the “end state” are only some of the tasks ahead. The Department of Defense (DoD) will be an active participant in these discussions as we forge ahead. Effective, well-informed guidance from our senior leaders is paramount to the success of this initiative and ensures that it becomes integrated into the entire life cycle of our service members.