Sea ice concentration decline in an important Adélie penguin molt area.

Unlike in many polar regions, the spatial extent and duration of the sea ice season have increased in the Ross Sea sector of the Southern Ocean during the satellite era. Simultaneously, populations of Adélie penguins, a sea ice obligate, have been stable or increasing in the region. Relationships between Adélie penguin population growth and sea ice concentration (SIC) are complex, with sea ice driving different, sometimes contrasting, demographic patterns. Adélie penguins undergo a complete molt annually, replacing all their feathers while fasting shortly after the breeding season. Unlike most penguin species, a majority of Adélies are thought to molt on sea ice, away from the breeding colonies, which makes this period particularly difficult to study. Here, we evaluate the hypothesis that persistent areas of high SIC provide an important molting habitat for Adélie penguins. We analyzed data from geolocating dive recorders deployed year-round on 195 adult penguins at two colonies in the Ross Sea from 2017 to 2019. We identified molt by detecting extended gaps in postbreeding diving activity and used associated locations to define two key molting areas. Remotely sensed data indicated that SIC during molt was anomalously low during the study and has declined in the primary molt area since 1980. Further, annual return rates of penguins to breeding colonies were positively correlated with SIC in the molt areas over 20 y. Together these results suggest that sea ice conditions during Adélie penguin molt may represent a previously underappreciated annual bottleneck for adult survival.

Value-Based Payment to Support Health Care Transition for Young Adults with Intellectual and Developmental Disabilities: A Feasibility Study.

INTRODUCTION: Only 20% of youth with intellectual and developmental disability (ID/DD) receive health care transition (HCT) preparation from their health care providers (HCPs). To address HCT system gaps, the first-of-its-kind HCT value-based payment (VBP) pilot was conducted for young adults (YA) with ID/DD. METHODS: This feasibility study examined the acceptability, implementation, and potential for expansion of the pilot, which was conducted within a specialty Medicaid managed care organization (HSCSN) in Washington, DC. With local pediatric and adult HCPs, the HCT intervention included a final pediatric visit, medical summary, joint HCT visit, and initial adult visit. The VBP was a mix of fee-for-service and pay-for-performance incentives. Feasibility was assessed via YA feedback surveys and interviews with HSCSN, participating HCPs, and selected state Medicaid officials. RESULTS: Regarding acceptability, HSCSN and HCPs found the HCT intervention represented a more organized approach and addressed an unmet need. YA with ID/DD and caregivers reported high satisfaction. Regarding implementation, nine YA with ID/DD participated. Benefits were reported in patient engagement, exchange of health information, and care management and financial support. Challenges included care management support needs, previous patient gaps in care, and scheduling difficulties. Regarding expansion, HSCSN and HCPs agreed that having streamlined care management support, medical summary preparation, and payment for HCT services are critical. DISCUSSION: This study examined the benefits and challenges of a HCT VBP approach and considerations for future expansion, including payer/HCP collaboration, HCT care management support, and updated system technology and interoperability.

High-resolution recording of foraging behaviour over multiple annual cycles shows decline in old Adélie penguins' performance.

Age-related variation in foraging performance can result from both within-individual change and selection processes. These mechanisms can only be disentangled by using logistically challenging long-term, longitudinal studies. Coupling a long-term demographic data set with high-temporal-resolution tracking of 18 Adélie penguins (Pygoscelis adeliae, age 4-15 yrs old) over three consecutive annual cycles, we examined how foraging behaviour changed within individuals of different age classes. Evidence indicated within-individual improvement in young and middle-age classes, but a significant decrease in foraging dive frequency within old individuals, associated with a decrease in the dive descent rate. Decreases in foraging performance occurred at a later age (from 12-15 yrs old to 15-18 yrs old) than the onset of senescence predicted for this species (9-11 yrs old). Foraging dive frequency was most affected by the interaction between breeding status and annual life-cycle periods, with frequency being highest during returning migration and breeding season and was highest overall for successful breeders during the chick-rearing period. Females performed more foraging dives per hour than males. This longitudinal, full annual cycle study allowed us to shed light on the changes in foraging performance occurring among individuals of different age classes and highlighted the complex interactions among drivers of individual foraging behaviour.

Circumpolar assessment of mercury contamination: the Adélie penguin as a bioindicator of Antarctic marine ecosystems.

Due to its persistence and potential ecological and health impacts, mercury (Hg) is a global pollutant of major concern that may reach high concentrations even in remote polar oceans. In contrast to the Arctic Ocean, studies documenting Hg contamination in the Southern Ocean are spatially restricted and large-scale monitoring is needed. Here, we present the first circumpolar assessment of Hg contamination in Antarctic marine ecosystems. Specifically, the Adélie penguin (Pygoscelis adeliae) was used as a bioindicator species, to examine regional variation across 24 colonies distributed across the entire Antarctic continent. Mercury was measured on body feathers collected from both adults (n = 485) and chicks (n = 48) between 2005 and 2021. Because penguins' diet represents the dominant source of Hg, feather δ13C and δ15N values were measured as proxies of feeding habitat and trophic position. As expected, chicks had lower Hg concentrations (mean ± SD: 0.22 ± 0.08 µg·g‒1) than adults (0.49 ± 0.23 µg·g‒1), likely because of their shorter bioaccumulation period. In adults, spatial variation in feather Hg concentrations was driven by both trophic ecology and colony location. The highest Hg concentrations were observed in the Ross Sea, possibly because of a higher consumption of fish in the diet compared to other sites (krill-dominated diet). Such large-scale assessments are critical to assess the effectiveness of the Minamata Convention on Mercury. Owing to their circumpolar distribution and their ecological role in Antarctic marine ecosystems, Adélie penguins could be valuable bioindicators for tracking spatial and temporal trends of Hg across Antarctic waters in the future.

Factors predicting help seeking for mental illness among college students.

BACKGROUND: Evidence supports the contribution of various stigma-related constructs to help-seeking. These constructs have yet to be tested in a single model among college students, a group highly affected by mental illness. AIMS: Using data from 153 college students, this study examines factors contributing to help seeking for mental illness. METHOD: Using path analysis, the current study evaluated a model of the relationship between level of familiarity, personal stigma, desired social distance, label avoidance, attitudes towards treatment seeking and intentions to seek treatment. RESULTS: Findings support a model of help-seeking describing the relationship between familiarity with mental illness, personal stigma, social distance, label avoidance, attitudes and intentions to seek treatment. CONCLUSIONS: Findings suggest label avoidance, attitudes towards treatment seeking and intentions to seek treatment might be augmented through interventions aimed at increasing college students' levels of familiarity, or intimate contact, with individuals with mental illness. Additional implications for practice and further research are addressed.

Outcomes of Pediatric to Adult Health Care Transition Interventions: An Updated Systematic Review.

PROBLEM: A previous systematic review found that health care transition (HCT) interventions result in positive outcomes related to population health, patient experience of care, and utilization. Since its publication, new national statistics, updated professional guidance, and a growing body of published literature on HCT have prompted the need for an updated systematic review that aims to examine outcomes of the latest pediatric-to-adult HCT interventions. ELIGIBILITY CRITERIA: Eligible studies were published in English between May 2016 and December 2018, described HCT interventions for youth moving from pediatric to adult outpatient health care, quantitative in design, and peer-reviewed. SAMPLE: Nineteen articles from a literature search of CINAHL, OVID Medline, PubMed, Scopus, Web of Science were included in this review. RESULTS: All included studies examined youth with special health care needs. Most of the positive outcomes identified were related to population health, followed by improvements in utilization. All studies mentioned transfer assistance, most described transition planning supports, and almost half reported on integration into adult care. CONCLUSIONS: This review strengthens the evidence that a structured HCT process for youth with special health care needs can show improvements in adherence to care, disease-specific measures, quality of life, self-care skills, satisfaction with care, health care utilization, and HCT process of care. IMPLICATIONS: Future research studies should utilize interventions that incorporate all HCT components (planning, transfer, and integration) and assess provider experience of care as well as cost of care.

Website Designs for Communicating About Chemicals in Cigarette Smoke.

The Family Smoking Prevention and Tobacco Control Act requires the US government to inform the public about the quantities of toxic chemicals in cigarette smoke. A website can accomplish this task efficiently, but the site's user interface must be usable to benefit the general public. We conducted online experiments with national convenience samples of 1,451 US adult smokers and nonsmokers to examine the impact of four interface display elements: the chemicals, their associated health effects, quantity information, and a visual risk indicator. Outcomes were perceptions of user experience (perceived clarity and usability), motivation (willingness to use), and potential impact (elaboration about the harms of smoking). We found displaying health effects as text with icons, providing quantity information for chemicals (e.g., ranges), and showing a visual risk indicator all improved the user experience of a webpage about chemicals in cigarette smoke (all p < .05). Displaying a combination of familiar and unfamiliar chemicals, providing quantity information for chemicals, and showing a visual risk indicator all improved motivation to use the webpage (all p < .05). Displaying health effects or quantity information increased the potential impact of the webpage (all p < .05). Overall, interface designs displaying health effects of chemicals in cigarette smoke as text with icons and with a visual risk indicator had the greatest impact on the user experience, motivation, and potential impact of the website. Our findings provide guidance for accessible website designs that can inform consumers about the toxic chemicals in cigarette smoke.

Icons for health effects of cigarette smoke: a test of semiotic type.

We sought to identify icons to effectively communicate health harms of chemicals in cigarette smoke. Participants were a convenience sample of 701 U.S. adults. A within-subjects online experiment explored the effects of icon semiotic type: symbolic (arbitrary, most abstract), indexical, and iconic (representative, most concrete). Outcomes were perceived representation, affect toward smoking, elaboration, perceived severity, and perceived effectiveness. For not-easy-to-visualize harms of cancer and addiction, symbolic icons received the highest ratings (all p < .001). For easy-to-visualize symptoms of heart attack/stroke, indexical icons received the highest ratings (all p < .001). For easy-to-visualize harm of reproductive organ damage, the iconic image did best (all p < .001). Icon type often had a larger impact among participants with higher health literacy. Symbolic icons may be most effective for health effects not easily visualized. Iconic or indexical icons may be more effective for health effects attributable to specific body parts or symptoms.

Changing public stigma with continuum beliefs.

BACKGROUND: Given the egregious effect of public stigma on the lives of people with mental illness, researchers have sought to unpack and identify effective components of anti-stigma programs. AIM: We expect to show that continuum messages have more positive effect on stigma and affirming attitudes (beliefs that people with mental illness recover and should be personally empowered) than categorical perspectives. The effect of continuum beliefs will interact with contact strategies. METHOD: A total of 598 research participants were randomly assigned to online presentations representing one of the six conditions: three messages (continuum, categorical, or neutral control) by two processes (education or contact). Participants completed measures of continuum beliefs (as a manipulation check), stigma and affirming attitudes after viewing the condition. RESULTS: Continuum messages had significantly better effect on views that people with mental illness are "different," a finding that interacted with contact. Continuum messages also had better effects on recovery beliefs, once again an effect that interacted significantly with contact. CONCLUSIONS: Implications of these findings for improving anti-stigma programs are discussed.

Who Comes Out With Their Mental Illness and How Does It Help?

Coming out with mental illness may be an effective strategy for reducing self-stigma. This study examined predictors and consequences of coming out. Participants (N = 106) with severe mental illness who reported being out (n = 79) or not out (n = 27) endorsed benefits of being out (BBOs) and reasons for staying in. Predictors from baseline measures were self-stigma, insight, and psychiatric diagnosis. Three outcome measures-basic psychological needs, care engagement, and depression-were also completed at baseline and 1-month follow-up. Among participants already out, BBOs and reasons for staying in were significantly and independently associated with self-stigma, insight, and lifetime affective diagnoses. In terms of consequences, BBOs were associated with cross-sectional and 1-month measures of engagement for those already out, but not for closeted participants. Among closeted participants, BBOs were associated with baseline and 1-month measures of basic psychological needs. Implications for strategies meant to promote disclosure in order to decrease self-stigma are considered.

What is the impact of self-stigma? Loss of self-respect and the "why try" effect.

BACKGROUND: The "Why Try" phenomenon, a consequence of self-stigma, is a sense of futility that occurs when people believe they are unworthy or incapable of achieving personal goals because they apply the stereotypes of mental illness to themselves. AIMS: This study examines a four-stage model of self-stigma (aware, agree, apply, and self-stigma harm) and examines the "why try" effect as a result. We do that by testing a measure of "why try." METHOD: Two hypothetical path models were tested. In the first, applying stereotypes to oneself leads to diminished self-respect and a sense of "why try". In the second, the effect of applying stereotypes on "why try" is mediated by diminished self-respect. Participants completed the "why try" measure along with measures of self-stigma, public stigma, recovery, and empowerment. RESULTS: Results show application of stereotypes to oneself predicts diminished self-respect and "why try". "Why try" was significantly associated with agreement with public stigma, depression, and diminished sense of personal recovery. CONCLUSIONS: Findings from this study reveal the complex impact of self-stigma demonstrating its emotional and behavioral consequences. Implications for impacting self-stigma are discussed.

Going with the floe: Sea-ice movement affects distance and destination during Adélie penguin winter movements.

Seasonal migration, driven by shifts in annual climate cycles and resources, is a key part of the life history and ecology of species across taxonomic groups. By influencing the amount of energy needed to move, external forces such as wind and ocean currents are often key drivers of migratory pathways exposing individuals to varying resources, environmental conditions, and competition pressures impacting individual fitness and population dynamics. Although wildlife movements in connection with wind and ocean currents are relatively well understood, movements within sea-ice fields have been much less studied, despite sea ice being an integral part of polar ecology. Adélie penguins (Pygoscelis adeliae) in the southern Ross Sea, Antarctica, currently exist at the southernmost edge of their range and undergo the longest (~12,000 km) winter migration known for the species. Within and north of the Ross Sea, the Ross Gyre drives ocean circulation and the large-scale movement of sea ice. We used remotely sensed sea-ice movement data together with geolocation-based penguin movement data to test the hypothesis that penguins use gyre-driven sea-ice movement to aid their migration. We found that penguins traveled greater distances when their movement vectors were aligned with those of sea ice (i.e., ice support) and the amount of ice support received depended on which route a penguin took. We also found that birds that took an eastern route traveled significantly further north in two of the 3 years we examined, coinciding with higher velocities of sea ice in those years. We compare our findings to patterns observed in migrating species that utilize air or water currents for their travel and with other studies showing the importance of ocean/sea-ice circulation patterns to wildlife movement and life history patterns within the Ross Sea. Changes in sea ice may have consequences not only for energy expenditure but, by altering migration and movement pathways, to the ecological interactions that exist in this region.

Sex-specific recruitment rates contribute to male-biased sex ratio in Adélie penguins.

Sex-related differences in vital rates that drive population change reflect the basic life history of a species. However, for visually monomorphic bird species, determining the effect of sex on demographics can be a challenge. In this study, we investigated the effect of sex on apparent survival, recruitment, and breeding propensity in the Adélie penguin (Pygoscelis adeliae), a monochromatic, slightly size dimorphic species with known age, known sex, and known breeding history data collected during 1996-2019 (n = 2127 birds) from three breeding colonies on Ross Island, Antarctica. Using a multistate capture-mark-recapture maximum-likelihood model, we estimated apparent survival (S^), recapture (resighting) probability (p^), and the probability of transitioning among breeding states and moving between colonies (ψ^; colony-specific non-juvenile pre-breeders, breeders, and non-breeders). Survival rate varied by breeding status and colony, but not sex, and pre-breeders had higher survival rates than breeders and non-breeders. Females had a higher probability of recruiting into the breeding population each year and may enter the breeding pool at younger ages. In contrast, both sexes had the same probability of breeding from year to year once they had recruited. Although we detected no direct sex effects on survival, the variation in recruitment probability and age-at-first reproduction, along with lower survival rates of breeders compared to pre-breeders, likely leads to shorter lifespans for females. This is supported by our findings of a male-biased mean adult sex ratio (ASR) of 1.4 males for every female (x^ proportion of males = 0.57, SD = 0.07) across all colonies and years in this metapopulation. Our study illustrates how important it can be to disentangle sex-related variation in population vital rates, particularly for species with complex life histories and demographic dynamics.

Quality Measurement Gaps in Pediatric-To-Adult Health Care Transition in the United States: A Framework to Guide Development of New Measures.

PURPOSE: Pediatric-to-adult health care transition (HCT) is a critical component of care for youth and young adults (Y/YA), especially those with chronic conditions. Positive outcomes in population health, patient experience, and utilization of care for Y/YA with chronic conditions have been associated with a structured HCT approach. Despite these outcomes and professional recommendations, few Y/YA receive HCT guidance from providers. Compounding this problem is the lack of attention to HCT quality measurement to stimulate and evaluate practice improvements and ensure accountability in pediatric and adult care. METHODS: A multistep process was undertaken to develop a new HCT quality measurement framework and identify existing HCT measures from national databases. Based on an environmental scan, the framework was created, measure gaps identified, and measure concepts proposed to fill these gaps. A multistakeholder advisory committee provided guidance throughout this initiative. RESULTS: The HCT measurement framework has 11 domains: one structure domain (health organization characteristics), three process domains (clinician HCT activities, Y/YA/F activities, continuity of care), four outcome domains (population health, utilization/cost/value of care, patient experience, and clinician experience), and three mediator domains (Y/YA/F-centered care, care coordination, and Y/YA/F characteristics). The search yielded 49 potentially relevant measures but only four qualified as directly relevant to HCT. Fifty four HCT measure concepts were proposed to address these shortcomings. DISCUSSION: Pediatric-to-adult HCT quality measurement is largely absent in nationally recognized databases. This article provides a comprehensive HCT quality measurement framework, which was used to identify gaps and propose measure concepts as a roadmap for future HCT quality measurement improvements.

Genomes of Single-Stranded DNA Viruses in a Fecal Sample from South Polar Skua (Stercorarius maccormicki) on Ross Island, Antarctica.

South polar skuas migrate from subtropical regions to breed along coastal Antarctica. In a fecal sample collected on Ross Island, Antarctica, we identified 20 diverse microviruses (Microviridae) that share low levels of similarity to currently known microviruses; 6 appear to use a Mycoplasma/Spiroplasma codon translation table.

Case for mandatory COVID-19 vaccinations for workers in health and aged care settings: a guide for leaders.

BACKGROUND: This brief paper provides an overview of the analysis in support of mandating COVID-19 vaccinations for all workers in health and aged care settings in Australia. Leaders of health and aged care organisations have a duty of care under work health and safety legislation to eliminate and/or control the risk of transmission of vaccine-preventable disease in their facilities, including COVID-19. METHODS: Key issues that should be considered by healthcare leaders when mandating that all health and aged care workers be vaccinated against COVID-19 were analysed by executives from a large Australian national health and aged care provider and discussed in this paper. RESULTS: This paper summarises the medical/scientific, ethical, legal, work health and safety, workers' compensation and industrial relations considerations when mandating COVID-19 vaccination for healthcare workers. CONCLUSION: Leaders of health and aged care organisations must provide a safe environment and workplace for all those who work for them, as well as for those who receive care or treatment at one of their facilities. It is hoped that this paper will assist leaders of healthcare organisations in making their own decisions during this time.

Foraging dive frequency predicts body mass gain in the Adélie penguin.

Quantifying food intake in wild animals is crucial to many ecological and evolutionary questions, yet it can be very challenging, especially in the marine environment. Because foraging behavior can be inferred from dive recordings in many marine creatures, we hypothesized that specific behavioral dive variables can indicate food intake. To test this hypothesis, we attached time-depth recorders to breeding Adélie penguins also implanted with RFID tags that crossed a weighbridge as they traveled to and from the ocean to feed their chicks. The weighbridge reported how much mass the penguin had gained during a foraging trip. The variables that explained a significant amount of the change in body mass while at sea were the number of foraging dives per hour (46%) and the number of undulations per hour (12%). Most importantly, every increment of 1 in the rate of foraging dives per hour equated to a penguin gaining an average 170 g of mass, over the course of a 6-60 h foraging trip. These results add to a growing understanding that different metrics of foraging success are likely appropriate for different species, and that assessing the types and frequencies of dives using time-depth recorders can yield valuable insights.

The influence of subcolony-scale nesting habitat on the reproductive success of Adélie penguins.

Group-size variation is common in colonially breeding species, including seabirds, whose breeding colonies can vary in size by several orders of magnitude. Seabirds are some of the most threatened marine taxa and understanding the drivers of colony size variation is more important than ever. Reproductive success is an important demographic parameter that can impact colony size, and it varies in association with a number of factors, including nesting habitat quality. Within colonies, seabirds often aggregate into distinct groups or subcolonies that may vary in quality. We used data from two colonies of Adélie penguins 73 km apart on Ross Island, Antarctica, one large and one small to investigate (1) How subcolony habitat characteristics influence reproductive success and (2) How these relationships differ at a small (Cape Royds) and large (Cape Crozier) colony with different terrain characteristics. Subcolonies were characterized using terrain attributes (elevation, slope aspect, slope steepness, wind shelter, flow accumulation), as well group characteristics (area/size, perimeter-to-area ratio, and proximity to nest predators). Reproductive success was higher and less variable at the larger colony while subcolony characteristics explained more of the variance in reproductive success at the small colony. The most important variable influencing subcolony quality at both colonies was perimeter-to-area ratio, likely reflecting the importance of nest predation by south polar skuas along subcolony edges. The small colony contained a higher proportion of edge nests thus higher potential impact from skua nest predation. Stochastic environmental events may facilitate smaller colonies becoming "trapped" by nest predation: a rapid decline in the number of breeding individuals may increase the proportion of edge nests, leading to higher relative nest predation and hindering population recovery. Several terrain covariates were retained in the final models but which variables, the shapes of the relationships, and importance varied between colonies.

Multidrone aerial surveys of penguin colonies in Antarctica.

Speed is essential in wildlife surveys due to the dynamic movement of animals throughout their environment and potentially extreme changes in weather. In this work, we present a multirobot path-planning method for conducting aerial surveys over large areas designed to make the best use of limited flight time. Unlike current survey path-planning solutions based on geometric patterns or integer programs, we solve a series of satisfiability modulo theory instances of increasing complexity. Each instance yields a set of feasible paths at each iteration and recovers the set of shortest paths after sufficient time. We implemented our planning algorithm with a team of drones to conduct multiple photographic aerial wildlife surveys of Cape Crozier, one of the largest Adélie penguin colonies in the world containing more than 300,000 nesting pairs. Over 2 square kilometers was surveyed in about 3 hours. In contrast, previous human-piloted single-drone surveys of the same colony required over 2 days to complete. Our method reduces survey time by limiting redundant travel while also allowing for safe recall of the drones at any time during the survey. Our approach can be applied to other domains, such as wildfire surveys in high-risk weather conditions or disaster response.

Call for Improvements to Federal Child and Adolescent Psychiatry Workforce Projection Methods.

For several decades, national surveys and reports have well documented the serious, growing, and unmet need for mental and behavioral health services among children, adolescents, and young adults (C/A/YA) in the United States.1-3 Moreover, shortages and maldistribution of child and adolescent psychiatrists have been repeatedly reported.4,5 This scarcity is especially concerning given that in 2017, an estimated 44% of child and adolescent psychiatrists were age 55 and older.6 The American Academy of Child and Adolescent Psychiatry (AACAP) and other mental and behavioral health organizations have consistently advocated for substantially expanding the child and adolescent psychiatry workforce through loan relief and other mental and behavioral health workforce programs serving C/A/YA.7-11 Despite this, national projections of the future child and adolescent psychiatry workforce, produced by the federal Health Resources and Services Administration (HRSA) for the first time in 2018, estimated an oversupply of child and adolescent psychiatrists in the United States by 2030.12 Moreover, these projections also found a surplus of school counselors, social workers, and psychiatric nurse practitioners, all of whom play a role in serving C/A/YA with mental and behavioral health conditions.13.