Too hot to handle? An urgent need to understand climate change impacts on the biogeochemistry of tropical coastal waters.

Tropical regions contain ecologically and socio-economically important habitats, and are home to about 3.8 billion people, many of which directly depend on tropical coastal waters for their well-being. At the basis of these ecosystems are biogeochemical processes. Climate change is expected to have a greater impact in the tropics compared to temperate regions because of the relatively stable environmental conditions found there. However, it was surprising to find only 660 research articles published focusing on the impact of climate change on the biogeochemistry of coastal tropical waters compared to 4823 for temperate waters. In this perspective, we highlight important topics in need of further research. Specifically, we suggest that in tropical regions compared to temperate counterparts climate change stressors will be experienced differently, that organisms have a lower acclimation capacity, and that long-term baseline biogeochemical datasets useful for quantifying future changes are lacking. The low number of research papers on the impacts of climate change in coastal tropical regions is likely due to a mix of reasons including limited resources for research and limited number of long time series in many developing tropical countries. Finally, we propose some action points that we hope will stimulate more studies in tropical coastal waters.

Unclear host taxonomy hinders parasite studies: An up-to-date checklist of the protozoan and metazoan parasites of Phoxinus minnows (Teleostei: Leuciscidae).

Phoxinus minnows are small freshwater fish found throughout Eurasia. The taxonomy of this genus is still under investigation, and new species are regularly described. They are frequently introduced outside their native range due to their use as live bait for angling, and such fish introductions can have diverse impacts on the recipient areas. Before the rise in interest regarding the diversity of this genus in the past 15 years, studies carried out on their biology and ecology reported their findings for the Eurasian minnow Phoxinus phoxinus Linnaeus, 1758, which was then considered ubiquitous. A parasites checklist for Phoxinus minnows has yet to be published, and the recent progress on the taxonomy of this genus has enabled us to propose a reassignment of parasite records to their proper host. The most thoroughly studied potential species were the North European species Phoxinus sp. 7 sensu Palandacic et al. 2017, Phoxinus isetensis, and P. phoxinus. We were able to highlight a gap in knowledge for numerous species that have received little-to-no attention in terms of parasitology. Systematic molecular identification of Phoxinus minnows should be conducted when studying their parasites, as a reliable identification of the host is vital in parasitology research. Future research will certainly reveal a species-specific composition of the parasitofauna occurring in Phoxinus, especially among widespread parasites such as Gyrodactylus and Diplostomum. Such specificities could even become tools for assessing the introduction routes of Phoxinus species.

Media exposure, trustworthiness of sources and the health information literacy knowledge gap: a study in China.

Health information literacy (HIL), as an essential part of the wellbeing of citizens, is a crucial indicator used to measure a country's primary public health level. The present study collected 1051 samples in southern China to examine the factors predicting HIL. The results showed that males, those less educated, and older adults had lower HIL. Television exposure, unofficial Internet exposure, trust in government and trust in doctors and medical institutions were positively associated with HIL. In contrast, newspapers, radio exposure and trust in web celebrities were negatively associated with HIL. Official Internet media exposure helps to bridge the HIL knowledge gap generated by differences in education level, while trust in celebrities-especially web celebrities-could widen the HIL knowledge gap. This study extends the knowledge gap theory in health communication in the Chinese context and provides pathways for future health interventions.

The health equity characteristics of research exploring the unmet community mobility needs of older adults: a scoping review.

BACKGROUND: Unmet community mobility needs of older adults, published since the announcement of the UN sustainable development goals was synthesised to describe the health equity characteristics of research identifying unmet community mobility needs of older adults. METHODS: Searches were conducted in March and April 2020, 2275 articles were screened and 100 identified for data extraction. RESULTS: Findings showed underrepresentation of articles considering rural settings [9%] and originating in the global South [14%]. Gender, disability, education, and transport / driving were identified as key health equity characteristics and only 10 articles provided detail on all four of these. External factors inhibiting community mobility included built environments, service availability, and societal attitudes. Internal factors included finances, fear and apprehension, and functional limitations. CONCLUSIONS: The need for standardised reporting of participant characteristics in the community mobility of older adults was highlighted. These characteristics are required by research consumers to judge equity dimensions, and the extent to which findings represent minority or marginalised groups. 15 after the UN pledge to reduce inequalities, peer reviewed primary research does not reflect a global drive to end discrimination, exclusion and reduce the inequalities and vulnerabilities that leave people behind.

Patient Education for Kidney Failure Treatment: A Mixed-Methods Study.

RATIONALE & OBJECTIVE: Education programs are needed for people with advanced chronic kidney disease to understand kidney failure treatment options and participate in shared decision-making (SDM). Little is known about the content and accessibility of current education programs or whether they support SDM. STUDY DESIGN: Stakeholder-engaged, mixed-methods design incorporating qualitative observations and interviews, and a quantitative content analysis of slide presentations. SETTING & PARTICIPANTS: Four sites located in Boston, Chicago, Portland (Maine), and San Diego. ANALYTICAL APPROACH: Thematic analysis based on the Ottawa Framework (observations and interviews) and descriptive statistical analysis (slide presentations). RESULTS: Data were collected from observations of 9 education sessions, 5 semistructured interviews with educators, and 133 educational slide presentations. Sites offered group classes or one-on-one sessions. Development, quality, and accuracy of educational materials varied widely. Educators emphasized dialysis (often in-center hemodialysis), with little mention of conservative management. Educators reported patients were often referred too late to education sessions and that some patients become overwhelmed if they learn of the implications of kidney failure in a group setting. Commonly, sessions were general and did not provide opportunities for tailored information most supportive of SDM. Few nephrologists were involved in education sessions or aware of the educational content. Content gaps included prognosis, decision support, mental health and cognition, advance care planning, cost, and diet. Slide presentations used did not consistently reflect best practices related to health literacy. LIMITATIONS: Findings may not be broadly generalizable. CONCLUSIONS: Education sessions focused on kidney failure treatment options do not consistently follow best practices related to health literacy or for supporting SDM. To facilitate SDM, the establishment of expectations for kidney failure treatment options should be clearly defined and integrated into the clinical workflow. Addressing content gaps, health literacy, and communication with nephrologists is necessary to improve patient education in the setting of advanced chronic kidney disease.

Knowledge and Perceptions of Carbohydrates among Nutrition-Major and Nutrition-Elective Undergraduate Students in Canada.

Objective: The purpose of the study was to assess knowledge and perceptions related to carbohydrates, including sugars, among Canadian nutrition-major undergraduates compared to those enrolled in elective nutrition courses (i.e., "nutrition-elective students").Methods: Cross-sectional surveys were distributed during class time at eight Canadian universities, which included 32 questions on demographics, knowledge and perceptions of carbohydrates and sugars. Descriptive analyses were performed. Differences between groups were tested by Chi-squared statistics.Results: A total of 1207 students (60% nutrition-majors) participated in the survey (January 2016-February 2017). Internet-based sources accounted for one-third of the sources where students obtained nutrition information. About 61% of internet-bases sources were "online" or "website" with no qualifiers, and about a quarter was from social media. A higher percentage of nutrition-majors correctly answered knowledge questions of carbohydrates compared with nutrition-elective students (p < 0.01); no difference was observed for sugars-related knowledge questions. The perceptions of sugars were generally negative and did not differ between groups.Conclusions: Several knowledge gaps and common perceptions on topics related to carbohydrates and sugars were identified; nutrition-major students performed better than nutrition-elective students on carbohydrate knowledge questions, but not sugars. These results highlight the importance of identifying methods to help students bridge knowledge gaps and develop skills to critically evaluate nutrition information from various resources and challenge personal biases.

The interpretation of CHA2DS2-VASc score components in clinical practice: a joint survey by the European Heart Rhythm Association (EHRA) Scientific Initiatives Committee, the EHRA Young Electrophysiologists, the Association of Cardiovascular Nursing and Allied Professionals, and the European Society of Cardiology Council on Stroke.

This European Heart Rhythm Association (EHRA) Scientific Initiatives Committee, EHRA Young Electrophysiologists, Association of Cardiovascular Nursing and Allied Professionals, and European Society of Cardiology (ESC) Council on Stroke joint survey aimed to assess the interpretation of the CHA2DS2-VASc score components and preferred resources for calculating the score. Of 439 respondents, most were general cardiologists (46.7%) or electrophysiologists (EPs) (42.1%). The overall adherence to the ESC-defined scoring criteria was good. Most variation was observed in the interpretation of the significance of left ventricular ejection fraction and brain natriuretic peptide in the scoring for the 'C' component, as well as the 'one-off high reading of blood pressure' to score on the 'H' component. Greater confidence was expressed in scoring the 'H' component (72.3%) compared with the 'C' (46.2%) and 'V' (45.9%) components. Respondents mainly relied on their recall for the scoring of CHA2DS2-VASc score (64.2%). The three most favoured referencing resources varied among different professionals, with pharmacists and physicians relying mainly on memory or web/mobile app, whereas nurses favoured using a web/mobile app followed by memory or guidelines/protocol. In conclusion, this survey revealed overall good adherence to the correct definition of each component in scoring of the 'C', 'H', and 'V' elements of the CHA2DS2-VASc score, although the variation in their interpretations warrants further clarifications. The preferred referencing resources to calculate the score varied among different healthcare professionals. Guideline education to healthcare professionals and updated and unified online/mobile scoring tools are suggested to improve the accuracy in scoring the CHA2DS2-VASc score.

Factors influencing COVID-19 knowledge-gap: a cross-sectional study in China.

BACKGROUND: In the face of a sudden outbreak of COVID-19, it is essential to promote health communication, especially to reduce communication inequality. The paper targeted China to investigate whether social structural factors (education level and urban-rural differences) lead to the knowledge gap of COVID-19. Also, this paper examined whether media use, interpersonal communication, public communication, and perceived salience of information can influence the knowledge gap of COVID-19. Furthermore, this paper explored the strategies to promote communication equality. METHODS: An online survey on COVID-19 knowledge and its influencing factors was conducted in February 2020, with a valid sample of 981 participants. The dependent variable was the total score of knowledge related to COVID-19. In addition to demographic variables such as education level and residence, the main explanatory variables include four independent variables: the use of different media (print media, radio, television, Internet), interpersonal communication, public communication, and perceived salience of information. This paper utilized descriptive statistics, correlation analysis, and hierarchical multiple regression analysis for data processing. RESULTS: Descriptive statistics indicated that the Internet was the most frequent source of information for participants to obtain COVID-19 knowledge (M = 6.28, SD = 1.022). Bi-variate analysis and regression analysis presented that education level, Internet media use, and perceived salience of information predicted the difference in knowledge level. Hierarchical multiple regression showed that Internet media use significantly predicted differences in the level of knowledge related to COVID-19 among groups with different education levels. CONCLUSIONS: This study found a COVID-19 knowledge gap among the Chinese public, especially the digital knowledge gap. Education level, perceived salience of information, and internet media use can significantly predict the difference in COVID-19 knowledge level. In contrast, the use of traditional media such as newspaper, radio, and television, public communication, and interpersonal communication did not improve knowledge level. Internet media use and education level have an interactive effect on the formation of a COVID-19 knowledge gap. That is, online media use will expand the COVID-19 knowledge gap between groups with different education levels.

Social vulnerability and disaster: understanding the perspectives of practitioners.

This paper seeks to understand how local emergency managers perceive and define social vulnerability. There has been a significant increase recently in the amount of research on social vulnerability, yet little is known about the extent to which that knowledge is being translated into practice. To address this void, the authors conducted semi-structured interviews with a sample of local emergency managers (N=24), asking them to describe what social vulnerability means to them. The analysis identified four primary perspectives on social vulnerability prevalent in the sample, pertaining to: (i) culture and poverty; (ii) a moral imperative; (iii) a lack of security; and (iv) a lack of knowledge and awareness. Although these practitioner viewpoints may not align perfectly with the definitions of social vulnerability predominant in the hazards and disasters literature, the results of this study do suggest a possible narrowing of the gap between research and practice as it relates to social vulnerability.

Mind the gap: Developments in autonomous driving research and the sustainability challenge.

Scientific knowledge on autonomous-driving technology is expanding at a faster-than-ever pace. As a result, the likelihood of incurring information overload is particularly notable for researchers, who can struggle to overcome the gap between information processing requirements and information processing capacity. We address this issue by adopting a multi-granulation approach to latent knowledge discovery and synthesis in large-scale research domains. The proposed methodology combines citation-based community detection methods and topic modelling techniques to give a concise but comprehensive overview of how the autonomous vehicle (AV) research field is conceptually structured. Thirteen core thematic areas are extracted and presented by mining the large data-rich environments resulting from 50 years of AV research. The analysis demonstrates that this research field is strongly oriented towards examining the technological developments needed to enable the widespread rollout of AVs, whereas it largely overlooks the wide-ranging sustainability implications of this sociotechnical transition. On account of these findings, we call for a broader engagement of AV researchers with the sustainability concept and we invite them to increase their commitment to conducting systematic investigations into the sustainability of AV deployment. Sustainability research is urgently required to produce an evidence-based understanding of what new sociotechnical arrangements are needed to ensure that the systemic technological change introduced by AV-based transport systems can fulfill societal functions while meeting the urgent need for more sustainable transport solutions.

Climate change opens new frontiers for marine species in the Arctic: Current trends and future invasion risks.

Climate change and increased anthropogenic activities are expected to elevate the potential of introducing nonindigenous species (NIS) into the Arctic. Yet, the knowledge base needed to identify gaps and priorities for NIS research and management is limited. Here, we reviewed primary introduction events to each ecoregion of the marine Arctic realm to identify temporal and spatial patterns, likely source regions of NIS, and the putative introduction pathways. We included 54 introduction events representing 34 unique NIS. The rate of NIS discovery ranged from zero to four species per year between 1960 and 2015. The Iceland Shelf had the greatest number of introduction events (n = 14), followed by the Barents Sea (n = 11), and the Norwegian Sea (n = 11). Sixteen of the 54 introduction records had no known origins. The majority of those with known source regions were attributed to the Northeast Atlantic and the Northwest Pacific, 19 and 14 records, respectively. Some introduction events were attributed to multiple possible pathways. For these introductions, vessels transferred the greatest number of aquatic NIS (39%) to the Arctic, followed by natural spread (30%) and aquaculture activities (25%). Similar trends were found for introductions attributed to a single pathway. The phyla Arthropoda and Ochrophyta had the highest number of recorded introduction events, with 19 and 12 records, respectively. Recommendations including vector management, horizon scanning, early detection, rapid response, and a pan-Arctic biodiversity inventory are considered in this paper. Our study provides a comprehensive record of primary introductions of NIS for marine environments in the circumpolar Arctic and identifies knowledge gaps and opportunities for NIS research and management. Ecosystems worldwide will face dramatic changes in the coming decades due to global change. Our findings contribute to the knowledge base needed to address two aspects of global change-invasive species and climate change.

Current state and future prospects of research on fear of cancer recurrence.

Despite a rapidly growing research interest in fear of cancer recurrence, lack of consensus on definition and measurement including clinical fear of cancer recurrence, sparse model development and testing, and limited available clinical interventions have impeded knowledge transfer into patient services. To move forward, a 2-day colloquium was held in Ottawa, Canada in August 2015 to progress knowledge and identify future research directions. A comprehensive research program was proposed, including development of a clinical definition, an updated review of screening measures, and a review of existing interventions. A new special interest group was created with the International Psychosocial Oncology Society to facilitate the implementation of this research program and future international collaborations. Copyright © 2016 John Wiley & Sons, Ltd.

Science foresight using life-cycle analysis, text mining and clustering: A case study on natural ventilation.

Science foresight comprises a range of methods to analyze past, present and expected research trends, and uses this information to predict the future status of different fields of science and technology. With the ability to identify high-potential development directions, science foresight can be a useful tool to support the management and planning of future research activities. Science foresight analysts can choose from a rather large variety of approaches. There is, however, relatively little information about how the various approaches can be applied in an effective way. This paper describes a three-step methodological framework for science foresight on the basis of published research papers, consisting of (i) life-cycle analysis, (ii) text mining and (iii) knowledge gap identification by means of automated clustering. The three steps are connected using the research methodology of the research papers, as identified by text mining. The potential of combining these three steps in one framework is illustrated by analyzing scientific literature on wind catchers; a natural ventilation concept which has received considerable attention from academia, but with quite low application in practice. The knowledge gaps that are identified show that the automated foresight analysis is indeed able to find uncharted research areas. Results from a sensitivity analysis further show the importance of using full-texts for text mining instead of only title, keywords and abstract. The paper concludes with a reflection on the methodological framework, and gives directions for its intended use in future studies.

Understanding the Financial Knowledge Gap: A New Dimension of Inequality in Later Life.

To understand individuals' financial behaviors, it is important to understand the financial knowledge gap - the distance between one's objective and subjective financial knowledge. Overestimating one's financial knowledge can lead to risky financial behaviors. To date, limited empirical work has examined how financial knowledge gap varies across age groups. We analyze the size and nature of the financial knowledge gap and its variation across age groups. Using nationally representative data, we find robust evidence that older adults overestimate their financial knowledge. Social workers can assess the financial knowledge gap and educate their clients to protect from financial fraud, exploitation, and abuse.

Anti-NMDA receptor encephalitis: clinical characteristics, predictors of outcome and the knowledge gap in southwest China.

BACKGROUND AND PURPOSE: The aim was to analyse the clinical profiles and outcomes of patients with anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis in China. METHODS: A retrospective study of anti-NMDAR encephalitis in China was performed between June 2011 and June 2014. The clinical characteristics and predictors of poor outcome were determined. RESULTS: A total of 51 patients with a definitive diagnosis of anti-NMDAR encephalitis were included in this study. Four of them were surgically confirmed to have a neoplasm. Thirty-two patients, amongst whom 24 were female, presented with psychiatric disorder as the initial symptom, whereas 14 patients, of whom nine were male, presented with seizure as the initial symptom (P = 0.011). Twenty-nine patients (56.86%) were initially misdiagnosed with psychosis, viral encephalitis or other diseases, and 58.8% of the patients experienced at least one type of complication. It typically took 3 weeks before these patients were admitted to our hospital and another 2 weeks before the correct diagnosis was made. Forty-one patients (80%) reached a good outcome; 10 patients (20%) had a poor outcome. Older age, extended hospital stay, memory deficits, decreased consciousness, central hypoventilation, complications and abnormal cerebrospinal fluid results were associated with poor outcome (P < 0.05). CONCLUSIONS: Female patients more frequently initially present with psychiatric disorder but male patients more frequently initially present with seizure. Patients with anti-NMDAR encephalitis in China have a lower incidence of neoplasm. Nevertheless, this study reveals several challenges in treating anti-NMDAR encephalitis in China that may contribute to poor outcome.

Complex systematic review - Perioperative antibiotics in conjunction with dental implant placement.

OBJECTIVES: The aim of this study was to revisit the available scientific literature regarding perioperative antibiotics in conjunction with implant placement by combining the recommended methods for systematic reviews and complex systematic reviews. MATERIAL AND METHODS: A search of Medline (OVID), The Cochrane Library (Wiley), EMBASE, PubMed and Health technology assessment (HTA) organizations was performed, in addition to a complementary hand-search. Selected systematic reviews and primary studies were assessed using GRADE and AMSTAR, respectively. A meta-analysis was performed. RESULTS: The literature search identified 846 papers of which 10 primary studies and seven systematic reviews were included. Quality assessment of the systematic reviews revealed two studies of moderate risk of bias and five with high risk of bias. The two systematic reviews of moderate risk of bias stated divergent numbers needed to treat (NNT) to prevent one patient from implant failure. Four of the primary studies comparing antibiotic prophylaxis with placebo were estimated to be of low, or moderate, risk of bias and subjected to meta-analysis. The NNT was 50 (pooled RR 0.39, 95% CI 0.18, 0.84; P = 0.02). None of these four studies individually show a statistical significant benefit of antibiotic prophylaxis. Furthermore, narrative analysis of the studies eligible for meta-analysis reveals clinical heterogeneity regarding intervention and smoking. CONCLUSION: Antibiotic prophylaxis in conjunction with implant placement reduced the risk for implant loss by 2%. However, the sub-analysis of the primary studies suggests that there is no benefit of antibiotic prophylaxis in uncomplicated implant surgery in healthy patient.

Opinion on potential health effects of exposure to electromagnetic fields.

In January 2015, the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) published its final opinion on "Potential health effects of exposure to electromagnetic fields." The purpose of this document was to update previous SCENIHR opinions in the light of recently available information since then, and to give special consideration to areas that had not been dealt with in the previous opinions or in which important knowledge gaps had been identified.

Ignorance or bias? Evaluating the ideological and informational drivers of communication gaps about climate change.

Does the relationship between media use and learning about climate change depend more on audiences' scientific literacy on their ideological biases? To answer this question, we evaluate both the knowledge gap and belief gap hypotheses as they relate to climate change. Results indicate belief gaps for news and entertainment content and a knowledge gap for edutainment content. Climate change knowledge among conservatives decreased with greater attention to political news, but increased with greater attention to science news. TV entertainment was associated with a significant decrease in knowledge about climate change among liberals to similar levels as conservatives. Edutainment was associated with a widening gap in knowledge based on respondents' scientific literacy. Implications for informal learning about controversial science through the media are discussed.

Extending the Knowledge Gap Hypothesis to Narrative Persuasion: Parents' Information-Seeking Intention and Learning About Adolescent Children's Covid-19 Vaccination.

The gap in knowledge and information-seeking between high and low socioeconomic status (SES) has been well documented. This study extends this knowledge gap hypothesis to narrative persuasion in the context of parents' knowledge and information-seeking intention concerning adolescents' COVID-19 vaccination. It specifically tests if the gap is moderated by a message type (narrative vs. non-narrative). An online quasi-experiment, with a 2 (participants' education level: high vs. low) × 3 (message type: narrative vs. non-narrative vs. no-message) between-subject design, showed a main effect of education level (i.e., parents with a higher [vs. lower] education level rated a higher intention to seek information and provided more correct answers on questions about adolescents' COVID-19 vaccination) and an interaction between the two factors. The interaction showed that the gap between high- and low-education groups in information-seeking intention disappeared among those who read the narrative or non-narrative, and the gap in knowledge disappeared among those who read the narrative. Study findings suggest the utility of narratives in narrowing the gap in knowledge and information-seeking to improve parents' decisions on child vaccination.

Tolerance, physical dependence, and addiction: Knowledge gaps and misconceptions of first-year pharmacy students.

INTRODUCTION: Misconceptions related to terminology used in the diagnosis and treatment of substance use disorders are common among healthcare providers and may contribute to inappropriate management and education of patients. The objective of this study was to evaluate baseline knowledge of addiction, tolerance, and physical dependence in first-year pharmacy students completing a unit on the neurobiological basis of addiction. METHODS: Students were asked to define the terms addiction, tolerance, and dependence at the beginning of a didactic unit on nervous system pathophysiology and pharmacology. Handwritten responses were transcribed to a spreadsheet and deidentified by sequential assignment to a single numeric identifier. Data were analyzed by three reviewers through open coding and thematic analysis. Descriptive statistics were used to describe the results. RESULTS: One hundred eighty-seven individual student submitted responses were included in the analysis. Many students were unable to provide a substantive definition for the terms physical dependence (32%) and addiction (27%). The definition of tolerance was partially correct in >80% of student responses, though no students provided a complete description. Approximately 5% of students defined physical dependence as addiction, and > 18% incorrectly attributed withdrawal symptoms to addiction. CONCLUSIONS: Significant knowledge gaps or misconceptions regarding terminology related to substance use disorder exists among first-year pharmacy students despite continuing efforts within professional organizations to develop consensus definitions. Developing effective teaching methods to identify and correct misinformation and preconceptions related to care for patients with substance use disorders should continue to be a priority for pharmacy educators.