Projecting Climate Dependent Coastal Flood Risk With a Hybrid Statistical Dynamical Model

Numerical models for tides, storm surge, and wave runup have demonstrated ability to accurately define spatially varying flood surfaces. However these models are typically too computationally expensive to dynamically simulate the full parameter space of future oceanographic, atmospheric, and hydrologic conditions that will constructively compound in the nearshore to cause both extreme event and nuisance flooding during the 21st century. A surrogate modeling framework of waves, winds, and tides is developed in this study to efficiently predict spatially varying nearshore and estuarine water levels contingent on any combination of offshore forcing conditions. The surrogate models are coupled with a time-dependent stochastic climate emulator that provides efficient downscaling for hypothetical iterations of offshore conditions. Together, the hybrid statistical-dynamical framework can assess present day and future coastal flood risk, including the chronological characteristics of individual flood and wave-induced dune overtopping events and their changes into the future. The framework is demonstrated at Naval Base Coronado in San Diego, CA, utilizing the regional Coastal Storm Modeling System (CoSMoS; composed of Delft3D and XBeach) as the dynamic simulator and Gaussian process regression as the surrogate modeling tool. Validation of the framework uses both in-situ tide gauge observations within San Diego Bay, and a nearshore cross-shore array deployment of pressure sensors in the open beach surf zone. The framework reveals the relative influence of large-scale climate variability on future coastal flood resilience metrics relevant to the management of an open coast artificial berm, as well as the stochastic nature of future total water levels.

Assessment of certified athletic trainers' levels of cultural competence in the delivery of health care

CONTEXT

The concept of culture and its relationship to athletic training beliefs and practices is virtually unexplored. The changing demographics of the United States and the injuries and illnesses of people from diverse backgrounds have challenged health care professionals to provide culturally competent care.

OBJECTIVE

To assess the cultural competence levels of certified athletic trainers (ATs) in their delivery of health care services and to examine the relationship between cultural competence and sex, race/ethnicity, years of athletic training experience, and National Athletic Trainers' Association (NATA) district.

DESIGN

Cross-sectional survey.

SETTING

Certified member database of the NATA.

PATIENTS OR OTHER PARTICIPANTS

Of the 13 568 ATs contacted, 3102 (age = 35.3 +/- 9.41 years, experience = 11.2 +/- 9.87 years) responded.

DATA COLLECTION AND ANALYSIS

Participants completed the Cultural Competence Assessment (CCA) and its 2 subscales, Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behavior (CCB), which have Cronbach alphas ranging from 0.89 to 0.92. A separate univariate analysis of variance was conducted on each of the independent variables (sex, race/ethnicity, years of experience, district) to determine cultural competence.

RESULTS

The ATs' self-reported scores were higher than their CCA scores. Results revealed that sex (F(1,2929) = 18.63, P = .001) and race/ethnicity (F(1,2925) = 6.76, P = .01) were indicators of cultural competence levels. However, we found no differences for years of experience (F(1,2932) = 2.34, P = .11) or NATA district (F(1,2895) = 1.09, P = .36) and cultural competence levels.

CONCLUSIONS

Our findings provide a baseline for level of cultural competence among ATs. Educators and employers can use these results to help develop diversity training education for ATs and athletic training students. The ATs can use their knowledge to provide culturally competent care to athletes and patients and promote a more holistic approach to sports medicine.

Reliability and validation of a Brazilian version of the Oral Health Impact Profile for assessing edentulous subjects

The aims of this study were to evaluate the reliability and to validate a Brazilian version of Oral Health Impact Profile for assessing edentulous subjects (OHIP-EDENT), an inventory for measuring oral health-related quality of life of edentulous subjects. The sample comprised 65 complete denture wearers (23 men, mean age of 69.1 +/- 10.3 years). The translated OHIP-EDENT was applied on two occasions with a washout period of 3 months. Reliability was assessed by an internal consistency analysis and a test-retest approach. A preliminary validation process was conducted by a qualitative approach/interview. Results of internal consistency showed a Cronbach's alpha of 0.86 or 0.90 for the first or second appointment respectively. Through the test-retest analysis, an intra-class correlation coefficient of 0.57 was found, and individual answers reflected a broad range of agreement. Interviewed volunteers (n = 6) comprehended most questions well. In conclusion, the Brazilian version of OHIP-EDENT is adequate for assessing the oral health-related quality of life for edentulous subjects.

Relationship between Candida and nocturnal denture wear: quantitative study

The purpose of this study was to evaluate the relationship between Candida and denture wear during the night. Twenty-four edentulous volunteers were randomly divided into two groups. Group I (GI, n = 11) was composed of volunteers who wore their complete dentures day and night and Group II (GII, n = 13) was composed of volunteers who wore their complete dentures only during the day. Three examination periods were performed for both groups. In GI, the first examination (A) was carried out after overnight denture wearing. Subsequent examinations were conducted after one (B) and seven nights (C) without denture use during sleep. In GII, the first (A) was done without previous use during sleep, and the following were carried out after one (B) and seven nights (C) of overnight denture wearing. Total unstimulated saliva was collected in a sterile container and cultured in duplicate inside Petri dishes. The values of colony forming units (CFU mL(-1) +/- s.d.) were obtained: GI A - 10.1 x 10(3) +/- 1.2 x 10(4), B - 2.0 x 10(3) +/- 2.6 x 10(3), and C - 2.6 x 10(3) +/- 5.9 x 10(3) and GII: A - 0.4 x 10(3) +/- 0.6 x 10(3), B - 9.4 x 10(3) +/- 17.7 x 10(3) and C - 6.3 x 10(3) +/- 15.3 x 10(3). The mean counts for Candida sp. were expressed as log (CFU + 1) mL(-1) and statistical significance of differences among groups was tested by anova (alpha = 0.05). Multiple comparisons were performed according to Bonferroni test and indicated significant differences between A-B and A-C, but not between B and C for both groups. It was concluded that there is a significant relationship between continuous denture wear and Candida sp.

Estimating primary production at depth from remote sensing

By use of a common primary-production model and identical photosynthetic parameters, four different methods were used to calculate quanta (Q) and primary production (P) at depth for a study of high-latitude North Atlantic waters. The differences among the four methods relate to the use of pigment information in the upper water column. Methods 1 and 2 use pigment biomass (B) as an input and a subtropical, empirical relation between K(d) (diffuse attenuation coefficient) and B to estimate Q at depth. Method 1 uses measured B, but Method 2 uses B derived from the Coastal Zone Color Scanner (subtropical algorithm) as inputs. Methods 3 and 4 use the phytoplankton absorption coefficient (a(ph)) instead of B as input, and Method B uses empirically derived a(ph)(440) and K(d) values, and Method 4 uses analytically derived a(ph)(440) and a (total absorption coefficient) values based on the same remote measurements as Method 2. When the calculated and the measured values of Q(z) and P(z) were compared, Method 4 provided the closest results [for P(z), r(2) = 0.95 (n = 24), and for Q(z), r(2) = 0.92 (n = 11)]. Method 1 yielded the worst results [for P(z), r(2) = 0.56 and for Q(z), r(2) = 0.81]. These results indicate that one of the greatest uncertainties in the remote estimation of P can come from a potential mismatch of the pigment-specific absorption coefficient (a(ph)*), which is needed implicitly in current models or algorithms based on B. We point out that this potential mismatch can be avoided if we arrange the models or algorithms so that they are based on the pigment absorption coefficient (a(ph)). Thus, except for the accuracy of the photosynthetic parameters and the above-surface light intensity, the accuracy of the remote estimation of P depends on how accurately a(ph) can be estimated, but not how accurately B can be estimated. Also, methods to derive a(ph) empirically and analytically from remotely sensed data are introduced. Curiously, combined application of subtropical algorithms for both B and K(d) to subarctic waters apparently compensates to some extent for effects that are due to their similar and implicit pigment-specific absorption coefficients for the calculation of Q(z).

Direct measurement of the interaction between phosphatidylglycerol bilayers in aqueous electrolyte solutions

Results are presented of force measurements between deposited bilayers of dimyristoylphosphatidyl glycerol (DMPG) at T greater than Tm, and distearoylphosphatidyl glycerol (DSPG) at T less than Tm. Below a bilayer separation of 100 nm, a repulsive double-layer force is measured, which can be explained through the combined screening and binding effect of the counterions in electrolyte solutions of NaCl, HCl, CaCl2, or mixtures of these. The binding of cations to bilayers in the fluid phase (DMPG) appears to be greater than to bilayers in the gel phase (DSPG). At shorter range, below approximately 3 nm, an attractive interaction is measured in solutions containing CaCl2, which was found to be slightly stronger than the theoretically expected van der Waals interaction. No hydration force was observed to exist in solutions containing CaCl2. In NaCl solutions, the measured interbilayer force can completely be accounted for by the electrostatic repulsion, down to a bilayer separation of at least 2 nm, below which no accurate measurements were possible anymore. Parallel measurements on PG monolayers show that the contraction of a DMPG monolayer following addition of CaCl2 is significantly greater than what is predicted from the change in the double-layer free energy alone. This indicates that changes in the lateral interactions between the lipid headgroups probably involve Ca2+-bridge binding and/or a possible dehydration of the lipid headgroups through Ca2+ binding. The results shed new light on both the interbilayer and intrabilayer interactions of PG and identify the possible factors responsible for the morphological behavior of PG aggregates.

Direct measurements of forces between phosphatidylcholine and phosphatidylethanolamine bilayers in aqueous electrolyte solutions

We report direct measurements of the full interbilayer force laws (force vs. distance) between bilayers of various phosphatidylcholines and phosphatidylethanolamine in aqueous solutions. Bilayers were first deposited on molecularly smooth (mica) surfaces and the interbilayer forces then measured at a resolution of 1 A. Three types of forces were identified: attractive van der Waals forces, repulsive electrostatic (double-layer) forces, and (at short range) repulsive steric hydration forces. Double-layer forces, which arise from ion binding, were insignificant in monovalent salt solutions, e.g., NaCl up to 1 M, but were already present in solutions containing millimolar levels of CaCl2 and MgCl2, giving rise to forces in excellent agreement with theory. Ca2+ binds more strongly than Mg2+, and both bind less to lecithin bilayers in the fluid state (T greater than Tc). The plane of charge coincides with the location of the negative phosphate groups, while the effective plane of origin of the van der Waals force is 4-5 A farther out. In water, the adhesion energies are in the range 0.10-0.15 erg/cm2 for lecithins and approximately 0.8 erg/cm2 for phosphatidylethanolamine. The adhesion energies vary on addition of salt due to changes in the repulsive double-layer and hydration forces rather than to a change in the attractive van der Waals force. The short-range repulsive forces which balance the van der Waals force at separations of 10-30 A are due to a combination of hydration and steric repulsions, the latter arising from thermal motions of head groups and thickness fluctuations of fluid bilayers (above Tc). It is also concluded that bilayer fusion is not simply related to the interbilayer force law.

Three-Dimensional Flow in the Upper Ocean

Measurements made from the Research Platform FLIP provide some of the first direct observations of three-dimensional flow within the surface mixed layer of the ocean. Relatively narrow regions of downwelling flow were found within the mixed layer, in coincidence with bands of convergent surface flow. At mid-depth in the mixed layer, the downwelling flow had magnitudes of up to 0.2 meter per second and was accompanied by a downwind, horizontal jet of comparable magnitude. There is some evidence that these motions transport heat and phytoplankton within the mixed layer.