Time-Integrated Neutrino Source Searches with 10 Years of IceCube Data

This Letter presents the results from pointlike neutrino source searches using ten years of IceCube data collected between April 6, 2008 and July 10, 2018. We evaluate the significance of an astrophysical signal from a pointlike source looking for an excess of clustered neutrino events with energies typically above ∼1  TeV among the background of atmospheric muons and neutrinos. We perform a full-sky scan, a search within a selected source catalog, a catalog population study, and three stacked Galactic catalog searches. The most significant point in the northern hemisphere from scanning the sky is coincident with the Seyfert II galaxy NGC 1068, which was included in the source catalog search. The excess at the coordinates of NGC 1068 is inconsistent with background expectations at the level of 2.9σ after accounting for statistical trials from the entire catalog. The combination of this result along with excesses observed at the coordinates of three other sources, including TXS 0506+056, suggests that, collectively, correlations with sources in the northern catalog are inconsistent with background at 3.3σ significance. The southern catalog is consistent with background. These results, all based on searches for a cumulative neutrino signal integrated over the 10 years of available data, motivate further study of these and similar sources, including time-dependent analyses, multimessenger correlations, and the possibility of stronger evidence with coming upgrades to the detector.

Reconceptualization of emotion regulation: strategy use, flexibility, and emotionality

BACKGROUND AND OBJECTIVES

Previous research has identified associations between emotion regulation strategy use patterns and emotional and behavioral functioning outcomes. The current study examined the construct of ER by integrating ER strategy use with flexibility to use strategies and overall level of experienced emotion to determine patterns of ER functioning.

DESIGN

Self-report data regarding strategy use, flexibility, and affect intensity was collected from undergraduate psychology students (N = 380).

METHODS

A latent profile analysis (LPA) was used to identify a profile structure of ER. Multivariate Analysis of Variance (MANOVA) was used to examine the effect of ER profile on the following outcomes: ER difficulties, internalizing problems, and externalizing behaviors.

RESULTS

The LPA supported a 3-profile and a 6-profile model. MANOVA results indicated that the 3-profile model and the 6-profile model predicted outcomes of ER difficulties and internalizing and externalizing behaviors.

CONCLUSIONS

The 3-profile model demonstrated greater separation of profiles than the 6-profile model, whereas the 6-profile model demonstrated more nuanced profiles than the 3-profile model. Overall, our results suggest that integrating strategy use, flexibility, and emotionality yields profiles of ER that can be used for better prediction of functioning than using strategy use alone.

Peer, social media, and alcohol marketing influences on college student drinking

OBJECTIVE

To investigate how alcohol marketing and peers may promote college students' alcohol use through social media.

PARTICIPANTS

College students (N = 682) aged 18 to 22 years from a large Southern university completed paper surveys in April 2014.

METHODS

Structural equation modeling was used to investigate relationships among variables as well as moderation by gender and race.

RESULTS

Drinking behavior was directly related to perceived norms and attitudes toward alcohol that develop, in part, from direct and indirect interactions with their online and offline peers, as well as engagement with alcohol-related content on social media. Gender and ethnicity moderated some effects.

CONCLUSIONS

College student drinking is influenced by friends' alcohol-related content posted on social networking sites and by greater engagement with traditional and online alcohol marketing. College campus alcohol misuse interventions should include components to counter peer influences and alcohol marketing on social media.

Confidence in skills applied to patient care among PharmD students in telehealth medication management programs versus other settings

INTRODUCTION

Exposure to medication therapy management (MTM) courses has demonstrated to increase student pharmacist's confidence in the application of patient care skills. The purpose of this study was to evaluate the effects of student pharmacists' work experience in a telehealth MTM program, versus hospital or community settings, on their confidence in skills applied in patient care.

METHODS

This was a cross-sectional multicenter survey. Confidence in patient care among student pharmacists was assessed between those who worked in a telehealth MTM program versus other settings. The data was evaluated using Chi-Square, Fisher exact, unpaired-t, Kruskal-Wallis, and Mann-Whitney U tests.

RESULTS

282 surveys were completed. First-year student pharmacists who worked in the telehealth MTM programs, versus other settings, were more confident in the provision of a comprehensive medication review (CMR) (p < .001), interviewing patients (p < .001), identifying medication errors (p < .001), and making therapeutic recommendations to patients (p = .04) and prescribers (p = .04). Second and third-year student pharmacists who worked in telehealth MTM programs, versus other settings, were more confident in the provision of a CMR (p ≤ .005). Fourth-year student pharmacists who worked in the telehealth MTM programs, versus other settings, were more confident in the provision of a CMR (p = .003), interviewing patients (p = .02), and identifying medication errors (p = .04).

CONCLUSION

Student pharmacists' participation in a telehealth MTM program may markedly increase their confidence in skills applied in patient care. MTM work experience should be offered to student pharmacists during their PharmD programs to enhance their confidence in the provision of patient care.

Managerial skills of new practitioner pharmacists within community practice

OBJECTIVES

To identify managerial skills required in community pharmacy practice, explore new practitioners' previous exposure to these skills, and assess new practitioners' perceived preparedness to take on managerial responsibilities.

METHODS

A survey was developed with the use of Qualtrics and distributed by state pharmacy associations using a convenience sample of pharmacists from Iowa, Kentucky, Michigan, Ohio, and Pennsylvania. Pharmacists not practicing in a community pharmacy setting at the time of the study were excluded. New practitioners were defined as pharmacists practicing for no more than 10 years.

RESULTS

A total of 168 pharmacists completed the survey. More than one-half (56%) of respondents self-reported being in a managerial position, and 90% of respondents thought that managerial skills were always or very often necessary. At graduation, 15% of respondents rated their managerial skill proficiency to be high to very high, with this increasing to 57% at current point in their career. When comparing managers versus non-managers, 78% of skills assessed showed higher utilization in managers. Interestingly, only 44% of skills showed a higher proficiency in managers. Finally, 88% of respondents thought that their managerial skills could be improved.

CONCLUSION

New practitioners in community practice reported a high utilization of managerial skills, as well as improved proficiency throughout their careers. These skills are important in both community pharmacy training and practice. Managers reported higher utilization of managerial skills, but that utilization did not always correlate with proficiency. This highlights the need to further identify and improve managerial skills during pharmacy education and as part of ongoing continuing professional development.

Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed?

Background

The wide-ranging program of reforms brought about by the Health and Social Care Act (2012) in England fundamentally changed the operation of the public health system, moving responsibility for the commissioning and delivery of services from the National Health Service to locally elected councils and a new national public health agency. This paper explores the ways in which the reforms have altered public health commissioning.

Methods

We conducted multi-methods research over 33 months, incorporating national surveys of Directors of Public Health and local council elected members at two time-points, and in-depth case studies in five purposively selected geographical areas.

Results

Public health commissioning responsibilities have changed and become more fragmented, being split amongst a range of different organisations, most of which were newly created in 2013. There is much change in the way public health commissioning is done, in who is doing it, and in what is commissioned, since the reforms. There is wider consultation on decisions in the local council setting than in the NHS, and elected members now have a strong influence on public health prioritisation. There is more (and different) scrutiny being applied to public health contracts, and most councils have embarked on wide-ranging changes to the health improvement services they commission. Public health money is being used in different ways as councils are adapting to increasing financial constraint.

Conclusions

Our findings suggest that, while some of the intended opportunities to improve population health and create a more joined-up system with clearer leadership have been achieved, fragmentation, dispersed decision-making and uncertainties regarding funding remain significant challenges. There have been profound changes in commissioning processes, with consequences for what health improvement services are ultimately commissioned. Time (and further research) will tell if any of these changes lead to improved population health outcomes and reduced health inequalities, but many of the opportunities brought about by the reforms are threatened by the continued flux in the system.

White matter predicts functional connectivity in premanifest Huntington's disease

Objectives

The distribution of pathology in neurodegenerative disease can be predicted by the organizational characteristics of white matter in healthy brains. However, we have very little evidence for the impact these pathological changes have on brain function. Understanding any such link between structure and function is critical for understanding how underlying brain pathology influences the progressive behavioral changes associated with neurodegeneration. Here, we demonstrate such a link between structure and function in individuals with premanifest Huntington's.

Methods

Using diffusion tractography and resting state functional magnetic resonance imaging to characterize white matter organization and functional connectivity, we investigate whether characteristic patterns of white matter organization in the healthy human brain shape the changes in functional coupling between brain regions in premanifest Huntington's disease.

Results

We find changes in functional connectivity in premanifest Huntington's disease that link directly to underlying patterns of white matter organization in healthy brains. Specifically, brain areas with strong structural connectivity show decreases in functional connectivity in premanifest Huntington's disease relative to controls, while regions with weak structural connectivity show increases in functional connectivity. Furthermore, we identify a pattern of dissociation in the strongest functional connections between anterior and posterior brain regions such that anterior functional connectivity increases in strength in premanifest Huntington's disease, while posterior functional connectivity decreases.

Interpretation

Our findings demonstrate that organizational principles of white matter underlie changes in functional connectivity in premanifest Huntington's disease. Furthermore, we demonstrate functional antero–posterior dissociation that is in keeping with the caudo–rostral gradient of striatal pathology in HD.

Testing Hadronic Interactions at Ultrahigh Energies with Air Showers Measured by the Pierre Auger Observatory

Ultrahigh energy cosmic ray air showers probe particle physics at energies beyond the reach of accelerators. Here we introduce a new method to test hadronic interaction models without relying on the absolute energy calibration, and apply it to events with primary energy 6-16 EeV (E_{CM}=110-170  TeV), whose longitudinal development and lateral distribution were simultaneously measured by the Pierre Auger Observatory. The average hadronic shower is 1.33±0.16 (1.61±0.21) times larger than predicted using the leading LHC-tuned models EPOS-LHC (QGSJetII-04), with a corresponding excess of muons.

Integration, influence and change in public health: findings from a survey of Directors of Public Health in England

BACKGROUND

Following the Health and Social Care Act in England, public health teams were formally transferred from the NHS to local authorities in April 2013.

METHODS

Online survey of Directors of Public Health (DsPH) in local authorities in England (n = 152) to investigate their experience within local government 1 year on. Tests of association were used to explore relationships between the perceived integration and influence of public health, and changes in how the public health budget was being spent.

RESULTS

The organization of and managerial arrangements for public health within councils varied. Most DsPH felt that good relationships had been established within the council, and the move had made them more able to influence priorities for health improvement, even though most felt their influence was limited. Changes in commissioning using the public health budget were already widespread and included the de-commissioning of services.

CONCLUSIONS

There was a widespread feeling amongst DsPH that they had greater influence since the reforms, and that this went across the local authority and beyond. Public health's influence was most apparent when the transfer of staff to local government had gone well, when collaborative working relationships had developed, and when local partnership groups were seen as being effective.

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8±0.7(stat)±6.7(syst)  MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principles calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.

Impact of Community Interventions on the Social Representation of Depression in Rural Gujarat

There is a pressing need to develop community interventions that will address stigma against mental illness in rural India. This cross-sectional study will compare social representations of depression in villages where educational programs have targeted mental illness and stigma versus control villages. Participants from the villages exposed to the educational interventions (n = 146) will be compared with a sample from six control villages (n = 187) in the same geographic region, using a structured questionnaire. The impact of the intervention as a predictor for questionnaire score will be assessed along with socio-demographic variables. The intervention villages showed higher levels of literacy regarding depression and lower levels of stigma, after adjusting for all other socio-demographic variables. While some demographic factors associated with the knowledge and attitudes towards depression are not modifiable, our research provides evidence in favor of the positive influence a community grassroots intervention can have on mental health literacy in rural settings.

Search for patterns by combining cosmic-ray energy and arrival directions at the Pierre Auger Observatory

Energy-dependent patterns in the arrival directions of cosmic rays are searched for using data of the Pierre Auger Observatory. We investigate local regions around the highest-energy cosmic rays with [Formula: see text] eV by analyzing cosmic rays with energies above [Formula: see text] eV arriving within an angular separation of approximately 15[Formula: see text]. We characterize the energy distributions inside these regions by two independent methods, one searching for angular dependence of energy-energy correlations and one searching for collimation of energy along the local system of principal axes of the energy distribution. No significant patterns are found with this analysis. The comparison of these measurements with astrophysical scenarios can therefore be used to obtain constraints on related model parameters such as strength of cosmic-ray deflection and density of point sources.