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Objective: To comparatively evaluate performances of tablet-based versus paper-based Venous Insufficiency Epidemiologic and Economic Study-Quality of Life/Symptom (VEINES-QOL/Sym) questionnaire. Methods: We prospectively evaluated 78 consecutive patients who completed tablet-based and paper-based VEINES-QOL/Sym questionnaires and compared their scores, completion time, data entry time, and ease of use. We used Student's t-test and Wilcoxon test for quantitative variables, Bland–Altman test and kappa coefficient for agreement between questionnaires and patients, respectively. Spearman's correlation coefficient was used to assess correlations. Results: Most participants (83.3%) found it easier to use the tablet device. Less time was needed to complete the tablet-based (median, 4.75; IQR, 3–7 min) than the paper-based (median, 8.3; IQR, 6.3–11.3 min) questionnaire (p <.001). Better educated patients took less time to complete paper-based (p =.003) and tablet-based (p =.001) questionnaires and considered the latter easier to use (p =.010). Conclusions: The tablet-based VEINES-QOL/Sym proved to be an easy-to-use and time-saving tool. [ABSTRACT FROM AUTHOR]

Background: An estimated 11 million individuals are released from U.S. jails and prisons each year. Individuals with a history of incarceration have higher rates of cardiovascular disease (CVD) events and mortality compared to the general population, especially in the weeks following release from carceral facilities. Healthy sleep, associated with cardiovascular health, is an underexplored factor in the epidemiology of CVD in this population. Incarcerated people may have unique individual, environmental, and institutional policy-level reasons for being sleep deficient. The social and physical environment within carceral facilities and post-release housing may synergistically affect sleep, creating disparities in sleep and cardiovascular health. Since carceral facilities disproportionately house poor and minoritized groups, population-specific risk factors that impact sleep may also contribute to inequities in cardiovascular outcomes. Methods: This study is ancillary to an ongoing prospective cohort recruiting 500 individuals with known cardiovascular risk factors within three months of release from incarceration, the Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study. The Sleep Justice study will measure sleep health among participants at baseline and six months using three validated surveys: the Pittsburgh Sleep Quality Index (PSQI), the STOP-Bang, and the Brief Index of Sleep Control. In a subsample of 100 individuals, we will assess sleep over the course of one week using wrist actigraphy, a validated objective measure of sleep that collects data on rest-activity patterns, sleep, and ambient light levels. Using this data, we will estimate and compare sleep health and its association with CVD risk factor control in individuals recently released from carceral facilities. Discussion: The incarceration of millions of poor and minoritized groups presents an urgent need to understand how incarceration affects CVD epidemiology. This study will improve our understanding of sleep health among people released from carceral facilities and its potential relationship to CVD risk factor control. Using subjective and objective measures of sleep will allow us to identify unique targets to improve sleep health and mitigate cardiovascular risk in an otherwise understudied population. [ABSTRACT FROM AUTHOR]

Background and Purpose: Patient-Reported Measured Outcomes (PROMs) are essential to gain a full understanding of a patient's condition, and in spine surgery, these questionnaires are of help when tailoring a surgical strategy. Electronic registries allow for a systematic collection and storage of PROMs, making them readily available for clinical and research purposes. This study aimed to investigate the reliability between the electronic and paper form of ODI (Oswestry Disability Index), SF-36 (Short Form Health Survey 36) and COMI-back (Core Outcome Measures Index for the back) questionnaires. Methods: A prospective analysis was performed of ODI, SF-36 and COMI-back questionnaires collected in paper and electronic format in two patients' groups: Pre-Operatively (PO) or at follow-up (FU). All patients, in both groups, completed the three questionnaires in paper and electronic form. The correlation between both methods was assessed with the Intraclass Correlation Coefficients (ICC). Results: The data from 100 non-consecutive, volunteer patients with a mean age of 55.6 ± 15.0 years were analysed. For all of the three PROMs, the reliability between paper and electronic questionnaires results was excellent (ICC: ODI = 0.96; COMI = 0.98; SF36-MCS = 0.98; SF36-PCS = 0.98. For all p < 0.001). Conclusions: This study proved an excellent reliability between the electronic and paper versions of ODI, SF-36 and COMI-back questionnaires collected using a spine registry. This validation paves the way for stronger widespread use of electronic PROMs. They offer numerous advantages in terms of accessibility, storage, and data analysis compared to paper questionnaires. [ABSTRACT FROM AUTHOR]

Few biomarker-based validation studies have examined error in online self-report dietary assessment instruments, and food records (FRs) have been considered less than food frequency questionnaires (FFQs) and 24-hour recalls (24HRs). We investigated measurement error in online and paper-based FFQs, online 24HRs, and paper-based FRs in 3 samples drawn primarily from 3 cohorts, comprising 1,393 women and 1,455 men aged 45–86 years. Data collection occurred from January 2011 to October 2013. Attenuation factors and correlation coefficients between reported and true usual intake for energy, protein, sodium, potassium, and respective densities were estimated using recovery biomarkers. Across studies, average attenuation factors for energy were 0.07, 0.07, and 0.19 for a single FFQ, 24HR, and FR, respectively. Correlation coefficients for energy were 0.24, 0.23, and 0.40, respectively. Excluding energy, the average attenuation factors across nutrients and studies were 0.22 for a single FFQ, 0.22 for a single 24HR, and 0.51 for a single FR. Corresponding correlation coefficients were 0.31, 0.34, and 0.53, respectively. For densities (nutrient expressed relative to energy), the average attenuation factors across studies were 0.37, 0.17, and 0.50, respectively. The findings support prior research suggesting different instruments have unique strengths that should be leveraged in epidemiologic research. [ABSTRACT FROM AUTHOR]

Background: The partograph has been endorsed by World Health Organization (WHO) since 1994 which presents an algorithm for assessing maternal and foetal conditions and labor progression. Monitoring labour with a partograph can reduce adverse pregnancy outcomes such as prolonged labor, emergency C-sections, birth asphyxia and stillbirths. However, partograph use is still very low, particularly in low and middle income countries (LMICs). In Bangladesh the reported partograph user rate varies from 1.4% to 33.0%. Recently, an electronic version of the partograph, with the provision of online data entry and user aid for emergency clinical support, has been tested successfully in different settings. With this proven evidence, we conducted and operations research to test the feasibility and effectiveness of implementing an e-partograph, for the first time, in 2 public hospitals in Bangladesh Methods: We followed a prospective crossover design. Two secondary level referral hospitals, Jessore and Kushtia District Hospital (DH) were the study sites. All pregnant women who delivered in the study hospitals were the study participants. All nurse-midwives working in the labor ward of study hospitals were trained on appropriate use of both types of partograph along with standard labour management guidelines. Collected quantitative data was analyzed using SPSS 23 statistical software. Discrete variables were expressed as percentages and presented as frequency distribution and cross tabulations. Chi square tests were employed to test the association between exposure and outcome variables. Potential confounding factors were adjusted using multivariate binary logistic regression methods. Ethical approval was obtained from the institutional review board of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b). Findings: In total 2918 deliveries were conducted at Jessore DH and 2312 at Kushtia DH during one-year study period. Of them, 1012 (506 in each facility) deliveries were monitored using partograph (paper or electronic). The trends of facility based C-section rates was downwards in both the hospitals; 43% to 37% in Jessore and from 36% to 25% in Kushtia Hospital. There was a significant reduction of prolonged labour with e-partograph use. In Kushtia DH, the prolonged labour rate was 42% during phase 1 with the paper version which came down to 29% during phase-2 with the e-partograph use. The similar result was observed in Jessore DH where the prolonged labour rate reduced to 7% with paper partograph from the reported 30% prolonged labour with e-partograph. The e-partograph user rate was higher than the paper partograph during both phases (phase 1: 3.31, CI: 2.04–5.38, p < .001 and in phase 2: 15.20 CI: 6.36–36.33, p < .001) after adjusting for maternal age, parity, gestational age, religion, mother’s education, husband’s education, and fetal sex Conclusion: The partograph user rate has significantly improved with the e- partograph and was associated with an overall reduction in cesarean births. Use of the e-partograph was also associated with reduced rates of prolonged labour. This study has added to the growing body of evidence on the positive impact of e-partograph use. We recommend implementing e-partograph intervention at scale in both public and private hospitals in Bangladesh. Trial registration: ClinicalTrials.gov . [ABSTRACT FROM AUTHOR]

Background: Advances in medicine and public health mean that people are living longer; however, a significant proportion of that increased lifespan is spent in a prolonged state of declining health and wellbeing which places increasing pressure on medical, health and social services. There is a social and economic need to develop strategies to prevent or delay age-related disease and maintain lifelong health. Several studies have suggested links between the gut microbiome and age-related disease, which if confirmed would present a modifiable target for intervention development. The MOTION study aims to determine whether and how changes in the gut microbiome are associated with physical and mental capacity. A comprehensive longitudinal multiparameter study such as this has not been previously undertaken. Methods: MOTION is a longitudinal prospective cohort study with a focus on gut health and cognitive function. 360 healthy individuals aged 60 years and older, living in East Anglia, UK will be recruited to the study, stratified into one of three risk groups (cohorts) for developing dementia based on their cognitive function. Participants will attend study appointments every six months over four years, providing stool and blood samples and a health questionnaire. Participants will also undergo physical measurements and cognitive tests at alternating appointments, and undergo Optical Coherence Tomography scans at 3 timepoints. Two subgroups of participants in the study will provide colonic tissue biopsies (n = ≥30 from each cohort), and brain imaging (n = 30) at two timepoints. Discussion: This study will provide new insights into the gut-(microbiota)-brain axis and the relationship between age-associated changes in gut microbe populations and cognitive health. Such insights could help develop new microbe-based strategies to improve lifelong health and wellbeing. Trial registration: This study is registered in the ClinicalTrials.gov Database with ID: NCT04199195 Registered: May 14, 2019. [ABSTRACT FROM AUTHOR]

Aims: The experiment tested the effects of a web‐push survey research protocol, compared with the standard mailed paper‐and‐pencil protocol, among young adults aged 19–30 years in the 'Monitoring the Future' (MTF) longitudinal study. Design, Setting and Participants: The US‐based MTF study has measured substance use trends among young adults in panel samples followed biennially, using consistent mailed survey procedures from 1977 to 2017. In 2018, young adult participants in the MTF longitudinal component scheduled to be surveyed at ages 19–30 in 2018 (from high school senior cohorts of 2006–17, n = 14 709) were randomly assigned to receive the standard mail/paper survey procedures or new web‐push procedures. Measurements Primary outcomes were responding to the survey and prevalence estimates for past 30‐day use of alcohol, cigarettes, marijuana and illicit drugs. Findings The web‐push response rate was 39.07% [95% confidence interval (CI) = 37.889, 40.258]; this was significantly better than the standard MTF response rate of 35.12% (95% CI = 33.964, 36.285). After adjusting for covariates, the web‐push condition was associated with a 19% increase in the odds of responding compared with standard MTF (adjusted odds ratio = 1.188; 95% CI = 1.096, 1.287). Substance use prevalence estimates were very similar and differences became negligible when using attrition weights and controlling for socio‐demographic characteristics. Conclusions: The web‐push protocol produced a higher response rate than the mailed pencil and paper protocol in the Monitoring the Future panel study, without substantially affecting estimates of substance use once attrition weights and socio‐demographic variables were factored in. [ABSTRACT FROM AUTHOR]

Background: The gut microbiome is an important determinant of health and disease in preterm infants. Objectives: The objective of this article was to share our current protocol for other neonatal intensive care units to potentially expand their existing protocols, aiming to characterize the relationship between the intestinal microbiome and health outcomes in preterm infants. Methods : This prospective, longitudinal study planned to recruit 160 preterm infants born <32 weeks gestational age or weighing <1,500 g and admitted to one of two Level III/IV neonatal intensive care units. During the neonatal intensive care unit period, the primary measures included events of early life pain/stress, gut microbiome, host genetic variations, and neurobehavioral assessment. During follow-up visits, gut microbiome; pain sensitivity; and medical, growth, and developmental outcomes at 4, 8-12, and 18-24 months corrected age were measured. Discussion : As of February 14, 2020, 214 preterm infants have been recruited. We hypothesize that infants who experience greater levels of pain/stress will have altered gut microbiome, including potential adverse outcomes such as necrotizing enterocolitis and host genetic variations, feeding intolerance, and/or neurodevelopmental impairments. These will differ from the intestinal microbiome of preterm infants who do not develop these adverse outcomes. To test this hypothesis, we will determine how alterations in the intestinal microbiome affect the risk of developing necrotizing enterocolitis, feeding intolerance, and neurodevelopmental impairments in preterm infants. In addition, we will examine the interaction between the intestinal microbiome and host genetics in the regulation of intestinal health and neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

Background: The gut microbiome is an important determinant of health and disease in preterm infants. Objectives: The objective of this article was to share our current protocol for other neonatal intensive care units to potentially expand their existing protocols, aiming to characterize the relationship between the intestinal microbiome and health outcomes in preterm infants. Methods : This prospective, longitudinal study planned to recruit 160 preterm infants born <32 weeks gestational age or weighing <1,500 g and admitted to one of two Level III/IV neonatal intensive care units. During the neonatal intensive care unit period, the primary measures included events of early life pain/stress, gut microbiome, host genetic variations, and neurobehavioral assessment. During follow-up visits, gut microbiome; pain sensitivity; and medical, growth, and developmental outcomes at 4, 8-12, and 18-24 months corrected age were measured. Discussion : As of February 14, 2020, 214 preterm infants have been recruited. We hypothesize that infants who experience greater levels of pain/stress will have altered gut microbiome, including potential adverse outcomes such as necrotizing enterocolitis and host genetic variations, feeding intolerance, and/or neurodevelopmental impairments. These will differ from the intestinal microbiome of preterm infants who do not develop these adverse outcomes. To test this hypothesis, we will determine how alterations in the intestinal microbiome affect the risk of developing necrotizing enterocolitis, feeding intolerance, and neurodevelopmental impairments in preterm infants. In addition, we will examine the interaction between the intestinal microbiome and host genetics in the regulation of intestinal health and neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

This paper reports follow-up findings for an Mentalization based treatment (MBT) parenting intervention delivered to a community mental health sample. Parents completed the 12-week version of the Lighthouse Parenting Program (LPP) and were evaluated on parenting practices, parent-child relationships, parental mental health indicators, and child problem behaviour levels. We evaluated the extent to which improvements in mentalizing at follow-up mediated changes in parenting, parental adjustment, mental health, and child outcomes. Results included a reduction in parental coercive behaviours and child problems, improved parent-child relationship, and better parental psychological adjustment and mental health. Improvement in self-focused mentalizing were observed. Self-focused mentalizing mediated the changes in most outcomes from baseline to 3-month follow-up. These results provide strong preliminary evidence that the LPP improves parent and child outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Suitable assistive devices for children with cerebral palsy (CP) in low-income countries are often unavailable. Devices made from APT are in use in several countries but are unevaluated. Materials and methods: A 2-week training course focused on APT principles, measuring children and constructing postural support devices. Twenty-three Kenyans attended the course. The host organization identified four local children with CP who attended for assessment and measurement. Participants made the devices and children returned for fitting and necessary adjustment. Completion of post-course forms, action plans, visits after 14 months and contact 3 years later comprised the evaluation. Results: All participants found the course beneficial and valued the networking opportunity provided. They appreciated the practicality and utility of locally manufactured cost effective devices. The trainees planned further implementation to provide assistive devices for children with CP in their localities. Follow-up visits revealed several challenges to local ongoing production. Conclusions: Training people in low-income communities to make bespoke assistive devices for children with CP is straightforward, and the course was positively evaluated. However, maintaining device production is limited without local group support and stable leadership, ideally as part of an existing programme. Assistive devices are often unobtainable for children with cerebral palsy (CP) in low-income countries. APT is a cost effective way of fulfilling this need and it is relatively straightforward to train people who care for or work with those with CP to make devices using APT. Feedback from APT training suggests participants find the technique a practical way of producing assistive equipment for individuals with CP in their community. Maintaining device production requires support, leadership and increased public awareness of the use of APT at a local level. [ABSTRACT FROM AUTHOR]

Introduction: Sudden cardiac death from ventricular fibrillation (VF) remains a major health problem worldwide. Currently, there are limited treatment options available to patients who suffer from episodes of VF. Because Purkinje fibers have been implicated as a source of initiation of VF, we are presenting the first paper of a series highlighting the promising results of substrate modulation through "De‐Networking" of the Purkinje system preventing VF in patients without an alternative ablation strategy. Methods and Results: We studied 10 consecutive patients (two female) all but one implanted with an ICD with documented VF or fast polymorphic Ventricular tachycardia (VT) (five patients without history of structural heart disease, two with ischemic cardiomyopathy, one with hypertrophic obstructive cardiomyopathy, one with dilated cardiomyopathy, and one with aortic valve disease). After 3D electroanatomical mapping, the left bundle branch (LBB) and left ventricular Purkinje potentials were annotated creating a virtual triangle with the apex formed by the distal LBB and the base by the most distal Purkinje potentials. Linear radiofrequency catheter ablation at the base of the triangle was performed, followed by ablation within the virtual triangle sparing the LBB and both fascicles ("de‐networking"). All patients were treated without complications. During 1‐year follow‐up, only 2/10(20%) patients experienced recurrence in form of a single episode of polymorphic VT/VF. Conclusion: Catheter ablation of VF through "de‐networking" of the Purkinje system in patients without overt arrhythmia substrate or trigger appears safe and effective and will require further study in a larger patient cohort. [ABSTRACT FROM AUTHOR]

Abstract Basic numerical skills provide an important foundation for the learning of mathematics. Thus, it is critical that researchers and educators have access to valid and reliable ways of assessing young children's numerical skills. The purpose of this study was to evaluate the concurrent, predictive, and incremental validity of a two-minute paper-and-pencil measure of children's symbolic (Arabic numerals) and non-symbolic (dot arrays) comparison skills. A sample of kindergarten children (M age = 5.86, N = 439) were assessed on the measure along with a number line estimation task, a measure of arithmetic, and several control measures. Results indicated that performance on the symbolic comparison task explained unique variance in children's arithmetic performance in kindergarten. Longitudinal analyses demonstrated that both symbolic comparison and number line estimation in kindergarten were independent predictors of 1st grade mathematics achievement. However, only symbolic comparison remained a unique predictor once language skills and processing speed were taken into account. These results suggest that a two-minute paper-and-pencil measure of children's symbolic number comparison is a reliable predictor of children's early mathematics performance. Highlights • We tested the validity and reliability of a recently developed Numeracy Screener. • Performance on the symbolic comparison task predicted kindergarten children's arithmetic performance. • Performance on the symbolic comparison task in kindergarten predicted school mathematics achievement one year later. • The Numeracy Screener may be a useful tool for early mathematics researchers and educators alike. [ABSTRACT FROM AUTHOR]

Background: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. Aim: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. Methods: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single‐use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. Results: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). Conclusions: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less. Summary statement: What is already known about this topic? Traditional and dry bed baths are personal care procedures that are frequently carried out by nurses with patients in intensive care units.Bed baths may affect the hemodynamic parameters of patients in intensive care units, but few studies have evaluated their effects.Determination of the hemodynamic parameters of patients during bed baths, the duration of bathing and the cost of consumable bathing materials may help nurses to achieve patients' body hygiene in a more reliable way and to decide on and adopt measures to minimize risks. What this paper adds? This paper contributes to the performance of personal hygiene. It is necessary to closely monitor the hemodynamic parameters of intensive care patients when they are being given bed baths.This study has direct effects in awakening nurses to the potential risk of bed baths causing a change in hemodynamic parameters in intensive care patients and in taking measures to reduce these risks to a minimum. Also, giving dry bed baths, which are superior in taking less time and having lower costs, provides advantages to nurses in terms of work load, physical difficulties and finance. The implications of this paper: This study emphasizes the positive impacts of dry bed baths carried out by nurses for patients in intensive care units.The dry bed bath can be accepted as enhancing patient safety by being easy to perform and by shortening the time when the patient is exposed to environmental risks. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to evaluate the effect of the Roy adaptation model‐based strengthening program (RAMBSP) applied to nursing students on social media addiction, healthy lifestyle behaviours and self‐esteem. Methods: One hundred five nursing students studying at a nursing faculty of a university were included in this prospective, two‐armed (1:1), randomized controlled study. The study group (n:54) had 12 weeks of RAMBSP online group sessions. No intervention was made to the control group (n:51). The social media addiction level, which was the primary outcome of the study, was evaluated with the Bergen Social Media Addiction Scale (BSMAS) and healthy lifestyle behaviours and self‐esteem, which were secondary outcomes, were evaluated with the Healthy Lifestyle Behaviours Scale II (HLBS‐II) and the Rosenberg Self‐Esteem Inventory (REI). Students filled out BSMAS, HLBS‐II, and REI online via Google Forms before and after RAMBSP. Findings: At the end of the programme, there was no significant difference between the groups in terms of BSMAS scores of the students in the study group (p > 0.05); however, the difference was significant in terms of HLBS‐II and REI scores (p < 0.05). It was determined that the empowerment programme increased students' awareness of social media addiction. Conclusion: It is recommended to implement programmes that will increase students' awareness of social media addiction and its effects and to conduct new research that will cover large and different sample groups. Trial registration: It was registered at ClinicalTrials.gov in March 2021 (NCT04820517). Summary statement: What is already known about this topic? With the development of technology, social media addiction is widely seen in nursing students, who are a fragile group.Biopsychosocial approaches should be presented together in practices aimed at reducing or controlling the use of social media.It is not known whether an empowerment programme based on the nursing model (Roy adaptation model) to reduce social media addiction in nursing students is effective. What this paper adds? This programme constitutes an example of how to combine Roy adaptation model, one of the nursing models related to reducing social media addiction and providing controlled social media use, with the empowerment programme.The strengthening programme based on Roy adaptation model helped student nurses to acquire and maintain healthy lifestyle behaviours by increasing their awareness of social media addiction and improving their self‐esteem. The implications of this paper Roy adaptation model‐based psychoeducation should be conducted to enable nursing students to gain awareness of social media addiction and its consequences.Roy adaptation model‐based activities should be planned and implemented to intervene in students with social media addiction and to lead them to healthy social media use.Course contents should be added to the nursing curriculum to encourage the use of social media in a way that is effective, safe and contributes to personal development. [ABSTRACT FROM AUTHOR]

Higher education professional recognition programs, which lead to the awarding of such accolades as teaching and learning fellowships, offer participants opportunities to reflect carefully on their practice. However, few resources exist to help participants engage in reflection after the award-receiving stage. This reflection is important in helping participants not rest on their laurels and, instead, build on the practices for which they received recognition. Through a process of collaborative reflection, a group of fellowship-recipients, from different disciplines and higher education institutions, addressed this gap as stakeholder-participant-researchers by developing a transdisciplinary approach to undertaking post-award reflective practice. From this collaboration, a novel two-stage tool was developed using an iterative design methodology. The tool presented in this paper as the result of this research can be understood as a means of supporting self-paced, continued post-award reflective practice; the tool's first stage guides users through retrospective reflection, looking back on previous achievements, while the second stage leads users through anticipatory planning, looking towards the future, to achieve fresh goals. The tool thus deepens the reflective practice of recognition program awardees and supports their ongoing professional development. This paper reports on the development of this bespoke tool, which may be enacted in varied settings. [ABSTRACT FROM AUTHOR]

Strategic flood risk management of river catchments involves significant increases in the complexity both of the contents (e.g. the aims and measures) of a given strategy and also its social, spatial, and temporal scales. Conceptually, flood risk management research to date has underestimated the importance of time and temporality. This paper, which is based on ‘historical Institutionalism,’ introduces a temporal lens to focus on strategic flood risk management; it highlights issues of duration and timing as well as tempo and change in tempo with respect to the implementation of measures to reduce flood risk at catchment level. The application of a temporal lens is illustrated through empirical research into strategic flood risk management for the medium-sized Aist river catchment in Austria. The paper uses a longitudinal qualitative research design to analyze the changes in strategic flood risk management in the catchment. The analysis shows that strategy efforts in reaction to an extreme flood event in the catchment in August 2002 can be differentiated into three phases. Phase 1 is characterized by the design of ambitious catchment-wide management; Phase 2 by struggles to implement the strategy due to institutional conditions and protests by citizens; and Phase 3 by redesign of the initial strategic plan to make it less ambitious and by changes to the actor constellation supporting the plan. The present paper offers a process-oriented institutional explanation for this pattern of phases, and it highlights issues of timing and tempo. It concludes with general suggestions for enhancing the temporal dimension in flood risk management. [ABSTRACT FROM AUTHOR]

Background: Endovascular clot retrieval (ECR) is known to reduce global disability at 3 months post stroke however limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits between onset and 3 months. Aims: To assess language, swallowing, and cognitive performance following ECR and explore whether impairment severity is correlated with modified Thrombolysis in Cerebral Infarction score (mTICI), stroke severity or quality of life (QoL). Methods: Assessment was completed within 7 days (T1), 1 month (T2) and 3 months (T3) post‐stroke. Performance was measured with the Functional Oral Intake Scale (FOIS), Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT A and B) and Brixton Spatial Awareness Test. The Western Aphasia Battery (WAB) was used for left hemisphere stroke. QoL was measured with the Stroke and Aphasia Quality of Life Scale. Results: Twenty‐five participants (median 72 years; 64% male) were prospectively recruited following ECR. High reperfusion success (68% mTICI 3) and low stroke severity post ECR (median 24 h NIHSS = 3, IQR 7–18) were noted. At T1, 10 participants presented with aphasia, eight required a modified diet and 20 had impaired cognition. At T3 all had recovered to a normal oral diet, 39% had persistent cognitive impairment and 45% of patients with left hemisphere stroke remained aphasic. Performance on the WAB, FOIS, RBANS and TMT changed significantly over time (all p < 0.05). The severity score at T1 for all measures, excluding TMT B and Brixton, was significantly correlated with 24 h NIHSS. WAB scores at T3 were correlated with QoL (r = 0.618; p = 0.043). Conclusion: This exploratory study found the longitudinal performance of language, swallowing and cognition significantly improved over time and severity in the first‐week post‐ECR was correlated with 24 h NIHSS rather than the degree of reperfusion. WHAT THIS PAPER ADDS: What is already known on the subject: Randomised control trials have demonstrated the benefit of ECR in patients with ischemic stroke using global measures of disability and function. Limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits. There is also a reliance on screening assessments and a lack of consideration of the influence of co‐occurring impairments. What this paper adds to existing knowledge: This prospective study is amongst the first to explore the longitudinal trajectory of language, swallowing and cognitive impairment using a standardised assessment battery. Twenty‐four‐hour NIHSS was significantly correlated with language, swallowing, global cognition and some measures of executive function. Language performance post ECR was correlated with domain‐specific cognitive assessment of attention, immediate memory and delayed memory, which differed from swallowing performance post ECR that correlated with measures of executive function. What are the potential or actual clinical implications of this work?: It is important for speech‐language pathologists and the wider medical team to monitor language, swallowing and cognitive performance post ECR regardless of treatment success. Stroke severity at 24 h post‐ECR influences the severity of language, swallowing and cognitive impairments. [ABSTRACT FROM AUTHOR]

Background: Competent clinical reasoning forms the foundation for effective and efficient clinical swallowing examination (CSE) and consequent dysphagia management decisions. While the nature of initial CSEs has been evaluated, it remains unclear how new information gathered by speech–language therapists (SLTs) throughout a patient's acute‐care journey is integrated into their initial clinical reasoning and management processes and used to review and revise initial management recommendations. Aims: To understand how SLTs' clinical reasoning and decision‐making regarding dysphagia assessment and management evolve as patients transition through acute hospital care from referral to discharge. Methods & Procedures: A longitudinal, qualitative approach was employed to gather information from two SLTs who managed six patients at a metropolitan acute‐care hospital. A retrospective 'think‐aloud' protocol was utilized to prompt SLTs regarding their clinical reasoning and decision‐making processes during initial and subsequent CSEs and patient interactions. Three types of concept maps were created based on these interviews: a descriptive concept map, a reasoning map and a hypothesis map. All concept maps were evaluated regarding their overall structure, facts gathered, types of reasoning engaged in (inductive versus deductive), types of hypotheses generated, and the diagnosis and management recommendations made following initial CSE and during subsequent dysphagia management. Outcomes & Results: Initial CSEs involved a rich process of fact‐gathering, that was predominantly led by inductive reasoning (hypothesis generation) and some application of deductive reasoning (hypothesis testing), with the primary aims of determining the presence of dysphagia and identifying the safest diet and fluid recommendations. During follow‐up assessments, SLTs engaged in increasingly more deductive testing of initial hypotheses, including fact‐gathering aimed at determining the tolerance of current diet and fluid recommendations or the suitability for diet and/or fluid upgrade and less inductive reasoning. Consistent with this aim, SLTs' hypotheses were focused primarily on airway protection and medical status during the follow‐up phase. Overall, both initial and follow‐up swallowing assessments were targeted primarily at identifying suitable management recommendations, and less so on identifying and formulating diagnoses. None of the patients presented with adverse respiratory and/or swallowing outcomes during admission and following discharge from speech pathology. Conclusions & Implications: Swallowing assessment and management across the acute‐care journey was observed as a high‐quality, patient‐centred process characterized by iterative cycles of inductive and deductive reasoning. This approach appears to maximize efficiency without compromising the quality of care. The outcomes of this research encourage further investigation and translation to tertiary and post‐professional education contexts as a clear understanding of the processes involved in reaching diagnoses and management recommendations can inform career‐long refinement of clinical skills. WHAT THIS PAPER ADDS: What is already known on the subject: SLTs' clinical reasoning processes during initial CSE employ iterative cycles of inductive and deductive reasoning, reflecting a patient‐centred assessment process. To date it is unknown how SLTs engage in clinical reasoning during follow‐up assessments of swallowing function, how they assess the appropriateness of initial management recommendations and how this relates to patient outcomes. What this paper adds to the existing knowledge: Our longitudinal evaluation of clinical reasoning and decision‐making patterns related to swallowing management in acute care demonstrated that SLTs tailored their processes to each patient's presentation. There was an emphasis on monitoring the suitability of the initial management recommendations and the potential for upgrade of diet or compensatory swallowing strategies. The iterative cycles of inductive and deductive reasoning reflect efficient decision‐making processes that maintain high‐quality clinical care within the acute environment. What are the potential or actual clinical implications of this work?: Employing efficient and high‐quality clinical reasoning is a hallmark of good dysphagia practice in maximizing positive patient outcomes. Developing approaches to understanding and making explicit clinical reasoning processes of experienced clinicians may assist SLTs of all developmental stages to provide high standards of care. [ABSTRACT FROM AUTHOR]

The types of obstacles encountered in the road environment are complex and diverse, and accurate and reliable detection of obstacles is the key to improving traffic safety. Traditional obstacle detection methods are limited by the type of samples and therefore cannot detect others comprehensively. Therefore, this paper proposes an obstacle detection method based on longitudinal active vision. The obstacles are recognized according to the height difference characteristics between the obstacle imaging points and the ground points in the image, and the obstacle detection in the target area is realized without accurately distinguishing the obstacle categories, which reduces the spatial and temporal complexity of the road environment perception. The method of this paper is compared and analyzed with the obstacle detection methods based on VIDAR (vision-IMU based detection and range method), VIDAR + MSER, and YOLOv8s. The experimental results show that the method in this paper has high detection accuracy and verifies the feasibility of obstacle detection in road environments where unknown obstacles exist. [ABSTRACT FROM AUTHOR]

In 2004, California became the first state to require that employers provide paid family leave (PFL) to their employees. This paper examines the effect of California's PFL law on time spent caregiving to parents and to grandchildren by older adults aged 50–79. To identify the effect of the law, the paper uses the 1998–2016 waves of the Health and Retirement Study and a difference-in-differences approach comparing outcomes in California to other states before and after the implementation of the law. Results suggest that the law induced a switch in caregiving behavior with older adults spending less time caring for grandchildren and more time helping parents. Focusing on women, results further suggest that PFL affected older adults both through their own leave-taking and through reallocations of their caregiving time in response to leave-taking by new parents. The findings motivate thinking more broadly when calculating the costs and benefits of PFL policies; to the extent that California's PFL law enabled older adults to provide more care for their parents they otherwise would not have received, such an outcome represents an indirect benefit of the policy. [ABSTRACT FROM AUTHOR]

Meeting individuals' social care needs is a core element of UK social policy. However, the conceptualisation and operationalisation of 'unmet need' remain a challenge. This paper advances our understanding by incorporating a temporal dimension into the conceptual framework on unmet need to investigate the dynamics of met and unmet need for social care over time. Using data from Waves 8 and 9 of the English Longitudinal Study of Ageing, this paper examines five possible trajectories among individuals with a social care need for bathing or dressing at baseline: (a) no longer having such a need; (b) having continued needs met; (c) delayed needs met; (d) newly arisen unmet needs; and (e) repeated unmet needs. The results indicate that amongst those with need at baseline, unmet need has decreased over time – indicating that some needs for social care may be fulfilled with a delay. However, a significant proportion of older people experienced repeated unmet needs, particularly those who were younger, with no spouse or civil partner, and those whose activities of daily living index scores worsened over time. Understanding the dynamics of unmet need can support policy makers in better ensuring that those facing an elevated risk of repeated unmet need over time do not fall through the social care safety net. [ABSTRACT FROM AUTHOR]

Objectives: Internationally, hip or knee arthroplasty (TJA) with a 1-day hospital length of stay (LOS) is common and demonstrates improved patient and health service outcomes. This study aimed to develop and pilot an enhanced recovery program (ERP) for patients undergoing TJA to achieve a next-day discharge in an Australian public hospital setting. Methods: A project lead and six perioperative clinical craft group leads developed an ERP protocol based on enhanced recovery after surgery (ERAS) principles. Strict patient eligibility criteria were developed. Quality improvement methodology was used to implement the ERP. A patient navigator was put in place as a single contact point for patients. Results: A total of 825 patients were screened for the ERP and 47 patients completed the protocol. The mean ± standard deviation (s.d.) of the LOS was 34.7 (± 7.2) h with 41 patients (87%) achieving next-day discharge, the remaining six (13%) discharged on Day 2. Compliance with ERAS was high (96%) with mobilisation within 12 h occurring on 87% of occasions. There were no adverse events. Patient experience was positive. Conclusion: Next-day discharge was achieved with a selected cohort of patients with no adverse events and positive patient experience, using a multidisciplinary approach and an improvement framework. Broadening inclusion criteria will make ERP available to more patients. What is known about the topic? Next-day discharge following hip or knee arthroplasty in Australian public hospital settings is uncommon and little has been published reflecting enhanced recovery principles in this local context. What does this paper add? This paper describes the development and piloting of an enhanced recovery program using a novel approach to achieve next-day discharge following hip and knee replacement. What are the implications for practitioners? Other health services may leverage this approach to design and implement an enhanced recovery program to reduce hospital length of stay and improve patient and health service outcomes. [ABSTRACT FROM AUTHOR]

Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

This paper shows how system-level data can generate useful insights into the profile of first-year graduates who are teaching out-of-field (OOF). Understanding in-school demand and impacts on first-year graduates teaching OOF is important, especially when the first years of teaching are complex, busy, and involve a steep learning curve. A mixed methods sequential explanatory design was used to generate qualitative and quantitative data collected from teacher and principal surveys. This study establishes the prevalence of OOF teaching amongst first-year graduates in Western Australian public schools and develops a profile of their OOF experiences and support needs based on their perceptions and their principals' perceptions. This study details the supports that will make a difference to teachers' capability, in particular a reduction in load where the OOF teaching workload is high, and access to formal subject-specific mentoring, both noted in research as important support mechanisms. This paper provokes new research questions, highlights areas for further research, and establishes the need for more large-scale datasets and longitudinal studies to examine change over time and the enduring effects of OOF teaching, both in relation to transitions into teaching, as teachers learn on-the-job, and when teachers undertake formal professional development programmes or courses. [ABSTRACT FROM AUTHOR]

Aim: To assess the risks, benefits, and resource implications of home‐blended food for children with gastrostomy tubes compared with a formula diet. Method: This prospective cohort study of children (aged 0–18 years) collected baseline data on gastrointestinal symptoms, nutritional intake, anthropometric outcomes, parent and child quality of life, and resource use. A propensity score‐weighted generalized linear mixed model was used to compare children receiving a home‐blended versus formula diet. Results: Baseline data were obtained for 180 children (2019–2021; 107 males, 73 females; mean age 9 years 7 months [SD 4 years 5 months]). Children receiving a home‐blended diet (n = 104) had similar diagnoses and age but more lived in areas of lower deprivation and parental education was higher compared to the parents of children receiving a formula diet (n = 76). Children receiving home‐blended diets had significantly better gastrointestinal scores than those receiving formula diets (B = 13.8, p < 0.001). The number of gut infections and tube blockages were similar between the two groups but with fewer stoma site infections in the group receiving home‐blended food. Children receiving a home‐blended diet had more fibre in their diet compared to children receiving a formula diet. Interpretation: Home‐blended diets should be seen as a safe option for children who are gastrostomy‐fed unless clinically contraindicated. Equality of access to home‐blended diets for children with gastrostomy should be assessed by local clinical teams. What this paper adds: Children with gastrostomy receiving a home‐blended diet had fewer gastrointestinal symptoms compared to children receiving a formula diet.Children with gastrostomy receiving a home‐blended diet had no more complications than children receiving a formula diet. What this paper adds: Children with gastrostomy receiving a home‐blended diet had fewer gastrointestinal symptoms compared to children receiving a formula diet.Children with gastrostomy receiving a home‐blended diet had no more complications than children receiving a formula diet. [ABSTRACT FROM AUTHOR]

Purpose: The quality of patient-reported outcome (PRO) data can be compromised by non-response (NR) to scheduled questionnaires, particularly if reasons for NR are related to health problems, which may lead to unintended bias. The aim was to investigate whether electronic reminders and real-time monitoring improve PRO completion rate.Methods: The population-based study "Quality of life in Danish multiple myeloma patients" is a longitudinal, multicentre study with consecutive inclusion of treatment-demanding newly diagnosed or relapsed patients with multiple myeloma. Education of study nurses in the avoidance of NR, electronic reminders, 7-day response windows and real-time monitoring of NR were integrated in the study. Patients complete PRO assessments at study entry and at 12 follow-up time points using electronic or paper questionnaires. The effect of the electronic reminders and real-time monitoring were investigated by comparison of proportions of completed questionnaires before and after each intervention.Results: The first 271 included patients were analysed; of those, 249 (85%) chose electronic questionnaires. Eighty-four percent of the 1441 scheduled PRO assessments were completed within the 7-day response window and 11% after real-time monitoring, achieving a final PRO completion rate of 95%. A significant higher proportion of uncompleted questionnaires were completed after the patients had received the electronic reminder and after real-time monitoring.Conclusions: Electronic reminders and real-time monitoring contributed to a very high completion rate in the study. To increase the quality of PRO data, we propose integrating these strategies in PRO studies, however highlighting that an increase in staff resources is required for implementation. [ABSTRACT FROM AUTHOR]

Introduction: Developments in information and communication technologies have enabled electronic health and seen a huge expansion over the last decade. This has increased the possibility of self-management of health issues. Purpose: To assess the effectiveness of the Baby Buddy app on maternal self-efficacy and mental well-being three months post-birth in a sample of mothers recruited antenatally. In addition, to explore when, why and how mothers use the app and consider any benefits the app may offer them in relation to their parenting, health, relationships or communication with their child, friends, family members or health professionals. Methods: We will use a mixed-methods approach, a cohort study, a qualitative element and analysis of in-app data. Participants will be first-time pregnant women, aged 16 years and over, between 12 and 16 weeks of gestation and recruited from five English study sites. Evaluation plan: We will compare maternal self-efficacy and mental health at three months post-delivery in mothers who have downloaded the Baby Buddy app compared with those that have not downloaded the app, controlling for confounding factors. Women will be recruited antenatally between 12 and 16 weeks of gestation. Further follow-ups will take place at 35 weeks of gestation and three months post-birth. Data from the cohort study will be supplemented by in-app data that will include, for example, patterns of usage. Qualitative data will assess the impact of the app on the lives of pregnant women and health professionals using both focus groups and interviews. Ethics: Approval from the West Midlands-South Birmingham Research Ethics Committee (NRES) (16/WM/0029) and the University of the West of England, Bristol, Research Ethics Committee (HAS.16.08.001). Dissemination: Findings of the study will be published in peer reviewed and professional journals, presented locally, nationally and at international conferences. Participants will receive a summary of the findings and the results will be published on Best Beginnings' website. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa (HS) is a complex, chronic inflammatory skin disorder whose pathophysiology is poorly understood. Genetic studies have shown that HS is predisposed by mutations in the γ-secretase gene, but only a proportion of familial and partial sporadic cases have been shown to possess such mutations. HS has high genetic heterogeneity and is thought to be triggered by a combination of genetics and environmental factors. Aims: The study aimed to investigate the genetic causes of HS in a large cohort of patients and to update the mutation spectrum of γ-secretase complex genes. Methods: We conducted mutational screening of 95 sporadic HS cases and one large family with both HS and acne conglobata (AC) to identify mutations in the coding and splice junction region of γ-secretase complex genes (nicastrin (NCSTN), presenilin 1 (PSEN1), presenilin enhancer 2 (PSENEN), and aph-1 homolog B, gamma-secretase subunit (APH1B)). Results: Our study identified a nucleotide substitution of 1876C>T in the NCSTN gene, which caused a stop codon (p. Arg626X) in the affected members of a large family with HS and AC. No pathogenic variants were detected in 95 sporadic cases of HS, indicating there is possible genetic heterogeneity. Conclusion: We report a new family with a nonsense mutation in the NCSTN gene that supports the role of the γ-secretase complex genes in HS with AC. The updated γ-secretase mutation spectrum for HS now includes 78 mutations. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. Background: The ability to accurately document patients’ symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122–1131). Design: The project was a mixed‐method, two‐phase study that collected data from two sites. Methods: In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Results: Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. Conclusions: We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Relevance to clinical practice: Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases. [ABSTRACT FROM AUTHOR]

A rich literature has argued that so-called aspiration-raising policies tend to individualize structural conditions and thereby reproduce forms of inequality through young people's aspirations. This paper explores how aspiration-raising policy discourses are lived in ways that both accentuate but that might also contest their terms. Drawing on Lauren Berlant, we theorize aspiration as ongoing performances that can be altered and remade in affective scenes of interruption. We put our theorization to work in a longitudinal study that followed a young woman, Marie, throughout her upper secondary education. Whilst Marie's performances of aspiration predominantly chimed with such individualistic policy discourses, she would also describe moments where these performances were seemingly interrupted. These were moments where Marie vividly experienced concerns related to planetary crises. The analysis carefully unpacks these moments, and we argue that they bring Marie into contact with the political stakes in her life and lead her to search for alternative, more sustainable, and collective modalities of aspiration. Hence, supplementing previous studies that have shown how inequality is reproduced through aspirations, the paper contributes with new understandings of how alternative modalities of aspiration may emerge that potentially exceed structural limits. [ABSTRACT FROM AUTHOR]

Background Context: Smartphone-based applications enable new prospects to monitor symptoms and assess functional outcome in patients with lumbar degenerative spinal disorders. However, little is known regarding patient acceptance and preference towards new modes of digital objective outcome assessment.Purpose: To assess patient preference of an objective smartphone-based outcome measure compared to conventional paper-based subjective methods of outcome assessment.Study Design: Prospective observational cohort study.Patient Sample: Fourty-nine consecutive patients undergoing surgery for lumbar degenerative spinal disorder.Outcome Measures: Patients completed a preference survey to assess different methods of outcome assessment. A 5-level Likert scale ranged from strong disagreement (2 points) over neutral (6 points) to strong agreement (10 points) was used.Methods: Patients self-determined their objective functional impairment using the 6-minute Walking Test application (6WT-app) and completed a set of paper-based patient-reported outcome measures (PROMs) before and 6 weeks after surgery. Patients were then asked to rate the methods of outcome assessment in terms of suitability, convenience, and responsiveness to their symptoms.Results: The majority of patients considered the 6WT-app a suitable instrument (median 8.0, interquartile range [IQR] 4.0). Patients found the 6WT more convenient (median 10.0, IQR 2.0) than the Zurich Claudication Questionnaire (ZCQ; median 8.0, IQR 4.0, p=.019) and Core Outcome Measure Index (COMI; median 8.0, IQR 4.0, p=.007). There was good agreement that the 6WT-app detects change in physical performance (8.0, IQR 4.0). 78 % of patients considered the 6WT superior in detecting differences in symptoms (vs. 22% for PROMs). Seventy-six percent of patients would select the 6WT over the other, 18% the ZCQ and 6% the COMI. Eighty-two percent of patients indicated their preference to use a smartphone app for the assessment and monitoring of their spine-related symptoms in the future.Conclusions: Patients included in this study favored the smartphone-based evaluation of objective functional impairment over paper-based PROMs. Involving patients more actively by means of digital technology may increase patient compliance and satisfaction as well as diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Chronic low back pain is a leading cause of disability worldwide. A clinical model for its cause is lacking. Defining a cause based clinical model and a framework of understanding back pain in terms of peripheral structural and central functional pain is essential for optimal management. We describe the results of the largest published audit of 41 chronic low back pain patients, receiving outpatient sublingual ketamine therapy for defined central functional pain along with conventional peripheral structural pain management. Our clinical model assigns Movement Dysfunction as the primary cause for low back pain symptoms and restores it with Movement Therapy focused rehabilitation which is also defined. Patients were derived from a tertiary single neurosurgical specialist practice in Brisbane Australia over a three year period. Severe pain and disability measurements more than halved and only 13% of patients ceased ketamine prematurely due to predominantly non-sinister side effects common to all pharmaceutical therapies. All other surveyed metrics of utility were highly favourable in this challenging cohort of chronic back pain patients biased to poor outcomes. Outpatient ketamine maintains high efficacy and safety used in conjunction with a unique clinical model that describes chronic low back pain. This paper builds on our previous publications that describe the disease of movement dysfunction as an integral factor to the development of a cause based clinical model for the condition of chronic low back pain symptoms. Our clinical application of this model, applying the necessary dual approach of controlling symptoms arising from peripheral structural pain and central functional pain in conjunction with elimination of root causation has shown favourable outcomes in patients with high levels of pain and disability based on their tertiary referral origin and high Oswestry Disability Scores. Removing chronic low back pain from its position as one of the world's leading causes of pain and disability is more likely if the rehabilitation industry can replicate and test treatment algorithms based around established clinical models of disease which is the important subject of this paper. [ABSTRACT FROM AUTHOR]

Background: This study takes on the challenge of quantifying a complex causal loop diagram describing how poverty and health affect each other, and does so using longitudinal data from The Netherlands. Furthermore, this paper elaborates on its methodological approach in order to facilitate replication and methodological advancement. Methods: After adapting a causal loop diagram that was built by stakeholders, a longitudinal structural equation modelling approach was used. A cross-lagged panel model with nine endogenous variables, of which two latent variables, and three time-invariant exogenous variables was constructed. With this model, directional effects are estimated in a Granger-causal manner, using data from 2015 to 2019. Both the direct effects (with a one-year lag) and total effects over multiple (up to eight) years were calculated. Five sensitivity analyses were conducted. Two of these focus on lower-income and lower-wealth individuals. The other three each added one exogenous variable: work status, level of education, and home ownership. Results: The effects of income and financial wealth on health are present, but are relatively weak for the overall population. Sensitivity analyses show that these effects are stronger for those with lower incomes or wealth. Physical capability does seem to have strong positive effects on both income and financial wealth. There are a number of other results as well, as the estimated models are extensive. Many of the estimated effects only become substantial after several years. Conclusions: Income and financial wealth appear to have limited effects on the health of the overall population of The Netherlands. However, there are indications that these effects may be stronger for individuals who are closer to the poverty threshold. Since the estimated effects of physical capability on income and financial wealth are more substantial, a broad recommendation would be that including physical capability in efforts that are aimed at improving income and financial wealth could be useful and effective. The methodological approach described in this paper could also be applied to other research settings or topics. [ABSTRACT FROM AUTHOR]

Introduction: Speech Language Therapy First Point of Contact Clinic (SLT‐FPOCC) models can assist assessment of low‐risk patient populations referred to ear, nose and throat (ENT) services. To further improve ENT waitlist management and compliance with best‐practice care, consideration of other low‐risk populations that could be safely managed through this service model is needed. The aims of this paper are to evaluate the clinical and service outcomes of completing vocal cord check (VCC) assessments for patients' pre and post thyroid/parathyroid surgery within an SLT‐FPOCC model and examine consumer perceptions. Methods & Procedures: The service followed existing SLT‐FPOCC procedures, with ENT triaging referrals, then SLT completing pre‐ and postoperative VCC assessment (interview, perceptual assessment, flexible nasendoscopy), with assessment data later reviewed by ENT to diagnose laryngeal pathology. Clinical and service outcomes were collected prospectively. Patients completed an anonymous post‐service satisfaction survey. Results: Of the first 100 patients referred for preoperative VCCs, SLT assessment identified 42 with dysphonia and 30 reporting dysphagia, while ENT confirmed 9 with significant preoperative anatomical findings. Eighty‐three underwent surgery, with 63 (95 nerves at surgical risk) returning for a postoperative VCC. Postoperative VCC identified three temporary neuropraxias (3.2%) and three unilateral vocal fold paresis (3.2%). Patients were highly satisfied with the service. All 163 pre‐/postoperative VCCs were completed with no adverse events. Conclusion & Implications: The current data support SLT‐FPOCC service expansion to include pre and post thyroid/parathyroid surgery VCC checks, with positive consumer perception. The model supports delivery of best practice management (i.e., pre‐ and postoperative VCC) for patients receiving surgery for thyroid/parathyroid dysfunction, and associated efficiencies for ENT services. WHAT THIS PAPER ADDS: What is already known: Assessment of laryngeal function via flexible nasoendoscopy is recommended best practice for patients pre and postthyroid/parathyroid surgery, as recurrent laryngeal nerve injury is a low incidence (<10%), yet well‐recognised risk of these surgeries. Traditionally, general surgeons refer presurgical patients to ear, nose and throat (ENT) for vocal cord check (VCC) assessment. However, with access to specialist outpatient services under increasing pressure, there is growing support for utilisation of other health professionals, such as speech‐language therapists working in first point of contact (FPOCC) models, to assist with the administration of pre‐ and postsurgical assessments of such low‐risk populations. What this study adds: This work expands on the emerging body of evidence for speech language therapy (SLT) led FPOCC models within ENT outpatient services, providing clinical and service outcomes to support the safety of a new model designed to administer VCCs for patients pre and post thyroid/parathyroid surgery. Adopting a similar model to a prior published SLT‐led FPOCC model, the trained SLT completes the pre‐ and postsurgical VCC including flexible nasoendoscopy and videostroboscopy, with images and clinical information then presented to ENT for diagnosis and management planning. This study also provides the first data on consumer perceptions of this type of service model. Clinical implications of this study: Data on 100 consecutive presurgical patients revealed positive service findings, supporting the safety of this model. Nature and incidence of clinical findings pre and post surgery were consistent with previously published studies using traditional models of care (i.e., ENT completing the flexible nasendoscopy). Consumer perception was positive. This model enables delivery of pre‐and postsurgical assessments for patients receiving thyroid/parathyroid surgery, consistent with best practice care, and reduces burden on ENT services. In total 163 ENT appointments were avoided with this model, with positive implications for ENT waitlist management. [ABSTRACT FROM AUTHOR]

Background: People who have communication difficulties may benefit from using augmentative and alternative communication (AAC). Understanding and measuring outcomes from the use of AAC is an important part of evaluating the impact of devices and services. Outcome measurement needs to reflect the changing nature of the impact of using AAC on an individual's ability to participate in activities of daily life. There is a limited understanding of the concepts that should inform the evaluation of outcomes from AAC device provision, nor how people's expectations from AAC may change over time. Aims: To inform the development of a patient‐reported outcome measure for AAC by understanding more about people's expectations from AAC and how these change over time. Methods & Procedures: A longitudinal qualitative research study was designed and carried out with seven participants over a period of 2 years. Participants were recruited from a regional specialist assessment service for AAC in the south‐west of the UK. Four semi‐structured interviews were carried out: (1) before assessment for AAC, (2) after assessment, (3) directly after provision of an AAC device and (4) between 6 and 12 months after provision. An original analytic method was used in this study that built on the principles of longitudinal interpretative phenomenology analysis, applied with a dialogic theoretical lens. This approach enabled the inclusion of a range of multimodal and embodied data collected to this study and allowed the research team to draw out salient themes across the cohort group while attending to the influence of time and context on experience. Outcomes & Results: The results confirm and extend the three core concepts that were used to guide analysis: changes; contexts; future possibilities. The contextual and temporal influences on outcomes attainable from AAC for this cohort were also identified and illustrated through cross‐case comparison. Deeper, analytic, and conceptual engagement with theory, which was then applied to analysis of the data, provided methodological rigour in the study. The results enhance our understanding of people's hopes and expectations from AAC and how these change over time. Conclusions & Implications: This qualitative longitudinal research study provides new insights into the journeys of people who experience communication disability, and the shifting nature of their sense of identity as they engage with, and learn from using, AAC. The study is significant as it attends to the dynamic nature of experience and how contextual and experiential factors influence people's hopes and expectations from AAC. The paper presents an original application of longitudinal qualitative research methodology with people who use AAC which can be further applied and tested in the field of communication disability research. WHAT THIS PAPER ADDS: What is already known on this subject: We did not know the impact that time has on the concepts that have been identified to represent important outcomes from AAC. The existing concepts used to define outcomes from AAC were not adequately conceptualized to develop a patient‐reported outcome measure. This study sought to extend our knowledge about outcomes from AAC. What this paper adds to the existing knowledge: This study adds to the methodological toolkit available for qualitative inquiry in the field of communication disability research by presenting a longitudinal qualitative research methodology. It adds depth to our understanding of the concepts that underpin outcomes from AAC and highlights the dynamic nature of contexts and how this influences desired outcomes. What are the potential or actual clinical implications of this work?: This longitudinal qualitative research study provides a broader perspective on the experience of getting AAC. It will enable clinicians to better navigate the contextual and transitionary factors that influence people's experience of acquiring AAC devices. The enhanced concepts described will also support clinical conversations that consider the wider facets of communication and what AAC can add to existing communicative tool kits beyond getting a message across. [ABSTRACT FROM AUTHOR]

Background: Early intervention is recommended for pre‐school children with low language. However, few robustly evaluated language interventions for young children exist. Furthermore, in many interventions the theoretical underpinnings are underspecified and the 'active ingredients' of the interventions not tested. This paper presents a quasi‐experimental study to test the efficacy and examine the active ingredients of Building Early Sentences Therapy (BEST): an intervention based on usage‐based theory designed to support young children to understand and produce two‐, three‐ and four‐clause element sentences. BEST manipulates the input children hear to support them to harness the cognitive mechanisms hypothesized in usage‐based theories to promote the development of abstract linguistic representations. One such input manipulation is the use of signing alongside verbal input signalling both content and morphology of target sentences. Aims: To examine whether (1) BEST is more efficacious than treatment as usual (TAU); and (2) signing of content and morphology is an active ingredient of the intervention. Methods & Procedures: A quasi‐experimental study recruited children aged 3;5–4;5 years from 13 schools. Schools were assigned to receive either BEST with sign, BEST without sign or TAU. The TAU group received their usual classroom provision. Across arms schools were matched with respect to classroom oral language environment and indices of deprivation. Participants were 48 children (28 boys) with expressive and/or receptive language abilities ≤ 16th centile measured using the New Reynell Developmental Language Scales (NRDLS). Outcomes gathered by researchers blind to treatment arm were NRDLS production and comprehension standard scores and measures of production of targeted sentence structures. Outcomes & Results: Primary outcomes indicate that BEST with sign was significantly more efficacious than TAU with respect to NRDLS production standard score, but not comprehension. The advantage for production was maintained at follow‐up. BEST without sign was significantly more efficacious than TAU on measures of targeted vocabulary, sentence structure and morphology. The results from this quasi‐experimental study provide evidence for the efficacy of a usage‐based intervention on expressive language outcomes for preschool children with low language abilities. There is also evidence to support the inclusion of sign as an active ingredient, and so efforts to train interventionists in its use are worthwhile. Conclusions & Implications: Patterns of findings across outcomes suggest signing of content and morphology may support the development of abstract linguistic representations and accelerate language learning. Given these positive results and the scale of this study, a fully powered randomized controlled trial is warranted. WHAT THIS PAPER ADDS: What is already known on the subject: Robust language skills are crucial for positive social, emotional, academic and economic outcomes across the lifespan. There is a paucity of robustly evaluated interventions for preschool children with language difficulties. The development of such interventions is crucial for ameliorating language difficulties and promoting positive educational and psychosocial outcomes. What this study adds to the existing knowledge: This paper evaluates BEST, a novel usage‐based language intervention targeting children with language difficulties in the early years. Findings indicate that a usage‐based intervention is efficacious for treating language difficulties. In particular, BEST benefited expressive language development, bringing benefits to both treated and untreated language structures and improving standard scores. The role of sign as an active ingredient is also supported. Further evaluation is warranted. What are the practical and clinical implications of this work?: Findings suggest that BEST may be effective for targeting children who have been identified as having language difficulties. In particular, expressive language may be improved when the intervention is delivered as it was originally manualized, including a signing system to represent content and grammatical morphology. More broadly, these findings also provide preliminary evidence that the use of a signing system does not hinder oral language development in children with language difficulties and may conversely support their expressive language. Future research exploring the role and underpinning mechanisms of sign in language intervention is warranted. [ABSTRACT FROM AUTHOR]

This paper examines factors influencing agricultural land-use efficiency among 35 ethnic minority groups in Vietnam during the 2010–2018 period. A hybrid approach comprising the Difference-in-Difference model with Propensity Score Matching (DID_PSM) is adopted to examine the effect of different land sizes, land elevations, and land tenure on land-use efficiency. The results show that: (1) land size and agricultural production form an 'U-shaped' relationship; (2) farming on high land decreases efficiency by around 7.7%–8.0%; (3) farmers purchasing or hiring land in long-term are 7.3%–8.2% more efficient. The paper also discusses typical land characteristics of mountainous areas including steep and fragmentation related to the three comparing factors. From these results, implications are made for Vietnamese authorities about 'land accumulation' policies and other 'farming on elevation' techniques. [ABSTRACT FROM AUTHOR]

Industry 4.0 represents the most advanced stage of organization of industrial companies, allowing them to respond to an uncertain and changing environment, particularly as accentuated by the recent crisis resulting from COVID-19. Management innovation (MI) contributes to this process of permanent adaptation. The MI implementation phase is a critical step in MI generation that can generate many potential obstacles. This study focuses on these obstacles while considering the different activities (or subprocesses) embedded in this phase and the different actors involved in this complex process. We conducted a longitudinal case study in real time to investigate the implementation of MI internally generated by a multinational industrial company. Our results show that the obstacles encountered during the MI implementation phase may differ depending on the different activities and actors of this phase, thus leading us to question current implementation frameworks. This paper contributes by refining the theoretical model of MI generation and providing a better understanding of the obstacles that occur during the MI implementation phase. From a managerial perspective, this paper highlights key management principles to overcome the obstacles identified. [ABSTRACT FROM AUTHOR]

Objectives: Unwarranted clinical variations in radical prostatectomy (RP) procedures are frequently reported, yet less attention is given to the variations in associated costs. This issue can further widen disparities in access to care and provoke questions about the overall value of the procedure. The present paper aimed to delve into the disparities in hospital, medical provider and out-of-pocket costs for RP procedures in Australia, discussing plausible causes and potential policy opportunities. Methods: A retrospective cohort study using Medibank Private claims data for RP procedures conducted in Australian hospitals between 1 January 2015 and 31 December 2020 was undertaken. Results: Considerable variations in both medical provider and out-of-pocket costs were observed across the country, with variations evident between different states or territories. Particularly striking were the discrepancies in the costs charged by medical providers, with a notable contrast between the 10th and 90th percentiles revealing a substantial difference of A$9925. Hospitals in Australia exhibited relatively comparable charges for RP procedures. Conclusions: Initiatives such as enhancing transparency regarding individual medical provider costs and implementing fee regulations with healthcare providers may be useful in curbing the variations in RP procedure costs. What is known about the topic? Unwarranted clinical variations in radical prostatectomy procedures are well documented in the literature; however, variations in cost are less widely reported. What does this paper add? This paper aims to highlight the cost variations in radical prostatectomy procedures in Australia, discussing their plausible causes, implications and proposing potential policy opportunities. What are the implications for practitioners? Excessive fees imposed by medical providers may contribute to inequalities in healthcare access. Enhancing transparency of individual medical provider costs and implementing fee regulations may be useful in controlling unwarranted variations in procedure costs. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

This paper explores how the transition to parenthood reshapes foodwork in families by drawing on ethnographic, longitudinal research conducted with parents of young children in the south-east of England. It utilizes the conceptual framework offered by practice theory and unpacks how parents' interpretations, techniques, and emotions surrounding eating transform as feeding and eating become routinized. The findings demonstrate the profound influence of feeding young children on the perception and practice of commensality at home. Mealtimes are increasingly recognized as crucial moments for transmitting manners and tastes across generations. Moreover, the analysis reveals that caregiving and other practices have a ripple effect on adults' eating practices, leading to changes in their food priorities, meal schedules, practical arrangements, and even the division of labor along gender lines. The findings underline the complexity of implementing institutional advice, for instance on "good" child feeding, as it requires changes in parents' own food practices and emotional relationships with food. By emphasizing the lived experiences of practitioners, this paper supports the growing call to incorporate identities, such as gender, into practice theoretical analysis, ultimately enhancing our understanding of how practices evolve and endure. [ABSTRACT FROM AUTHOR]

Building on my ongoing ethnographic research with people living with HIV in different European countries, the paper focuses on RD, a Catalan man I have interviewed three times since 2014. In RD's life narrative, 'crisis' is a recurring theme including both the most blatant forms, like the severe housing crisis in Spain that followed the global financial crisis, and the most ordinary ones like domestic violence. Analysing the impact of crises in RD's perception and experience of the present, interwoven with the past(s) and the future(s), the paper discusses two main benefits of longitudinal ethnographic research. First, it allows to capture how crisis is not just a moment or a phase in RD's life, but acts as context generating a recurring experience of an 'uncanny present' shaped by logics of return and repetition of the past, and anticipation of the future. Second, it supports RD's self‐awareness around his ability to navigate the unknown when experiencing the 'uncanny present'; this highlights the ethical care dimension entailed by such methodology. The paper presents two main benefits of longitudinal ethnographic research. First, it allows to capture how crisis, for some people, is not just a moment or phase but acts as context generating a recurring experience of an 'uncanny present'. Second, it supports participants' self‐awareness around their ability to navigate the unknown, this demonstrating the ethical care dimension of the research. [ABSTRACT FROM AUTHOR]

Understanding young people's lives through a focus on their micro‐geographies has been central for exercising young people's voices through research. However, such a focus has also neglected the multiple and complex realities of growing up that ripple throughout their lives, resulting in calls for more research to go beyond capturing daily snapshots of experience. This paper acknowledges that decades of research with and for young people living on city streets has underpinned activism and challenged western child rights discourse, helping to ensure that abuses and violations of street young people's rights are confronted. Yet, much of this research draws attention to lives lived in present moments – the difficulties encountered and capabilities displayed. It does not account for the temporal fluidity of how young people's realities are future impacted by slow crises and challenging daily life experiences as they grow towards adulthood. This paper explores the crisis temporalities of young people's street lives through a youth‐led ethnographic longitudinal approach. The paper focuses on 18 youth researchers and over 200 of their peers' experiences of research over three years while living on the streets of three African cities. The paper discusses the challenges of undertaking longitudinal research alongside the temporal affordances of surviving urban informality and the compounding effects of slow crises on present and future‐oriented survival. These affordances emerge as street youth respond to daily trials, experience setbacks, crises, triumphs, and failures, yet show resilience and employ capabilities. The paper concludes by demonstrating the crucial importance of ethnographic longitudinal research for policy and practice to ensure that youth who age on the streets, and their families, are supported in accordance with social justice concerns. [ABSTRACT FROM AUTHOR]

This paper draws on a four‐year qualitative study that examines changes to legal processes related to the response to domestic violence in Seattle that began before and continued through the COVID‐19 pandemic, to examine a series of crisis temporalities that were exacerbated by the pandemic and associated lockdowns. In reflecting on the crisis temporalities that mark this research project, I underscore how such crises can also create conditions that lead to long overdue social change. In this case, the modernisation of a court system that for too‐long served as an obstacle to survivors' legal protection and facilitated abusers' ability to engage in slow violence during Domestic Violence Protection Order (DVPO) hearings. This paper thus highlights the 'temporal affordances' of longitudinal research that enable analysis to better understand the factors that motivate transition over time, particularly those in traditional institutions like the legal system. This paper draws on a four‐year qualitative study that examines changes to legal processes related to the response to domestic violence in Seattle that began before and continued through the COVID‐19 pandemic, to examine a series of crisis temporalities that were exacerbated by the pandemic and associated lockdowns. In reflecting on the crisis temporalities that mark this research project, I underscore how such crises can also create conditions that lead to long overdue social change. This paper thus highlights the 'temporal affordances' of longitudinal research that enable analysis to better understand the factors that motivate transition over time, particularly those in traditional institutions like the legal system. [ABSTRACT FROM AUTHOR]

This paper is based on the ReFashion study which used mixed‐method longitudinal research to track and amplify the experiences and coping mechanisms of 200 women garment workers in Cambodia as they navigated the financial repercussions of the COVID‐19 pandemic. It develops the idea and practice of 'feminist longitudinal research' (FLR) through re‐centring the too often marginalised knowledges and ways of knowing of Cambodian researchers and research participants. Hearing and learning from their experiences reveal the labours and care‐work involved in the 'doing' of longitudinal research during a time of extraordinary crisis, and the potential for feminist consciousness raising and solidarity that can arise both within and beyond the confines of an academic study. The paper advocates for geographers and other social scientists to go beyond technically‐framed issues of participant 'attrition' and 'retention' in longitudinal studies to think more creatively and critically about the process of longitudinal research and what it means for those taking part in it. FLR not only evidences the temporally contingent gendered impacts of a phenomenon, but can be distinguished by its intentionality and/or potential to challenge the patriarchal status quo, both in the lives of researchers and participants. [ABSTRACT FROM AUTHOR]

Managing and analysing large qualitative datasets pose a particular challenge for researchers seeking a consistent and rigorous approach to qualitative data analysis. This paper describes and demonstrates the development and adoption of a matrix tool to guide the qualitative data analysis of a large sample (N = 122) of interview data. The paper articulates the theoretical and conceptual underpinnings of the matrix analysis tool and how it was developed and applied in a longitudinal mixed methods out-of-home-care research study. Specific illustrations and examples of data integration and data analysis are provided to demonstrate the benefits and potentials of constructing matrix tools to guide research teams when working with large qualitative data sets alone or in combination with quantitative data sets. [ABSTRACT FROM AUTHOR]

Objectives: A cost-efficient approach for assessing working postures could be to build statistical models for predicting results of direct measurements from cheaper data, and apply these models to samples in which only the latter data are available. The present study aimed to build and assess the performance of statistical models predicting inclinometer-assessed trunk and arm posture among paper mill workers. Separate models were built using administrative data, workers' ratings of their exposure, and observations of the work from video recordings as predictors. Methods: Trunk and upper arm postures were measured using inclinometry on 28 paper mill workers during three work shifts each. Simultaneously, the workers were video filmed, and their postures were assessed by observation of the videos afterwards. Workers' ratings of exposure, and administrative data on staff and production during the shifts were also collected. Linear mixed models were fitted for predicting inclinometer-assessed exposure variables (median trunk and upper arm angle, proportion of time with neutral trunk and upper arm posture, and frequency of periods in neutral trunk and upper arm inclination) from administrative data, workers' ratings, and observations, respectively. Performance was evaluated in terms of Akaike information criterion, proportion of variance explained (R²), and standard error (SE) of the model estimate. For models performing well, validity was assessed by bootstrap resampling. Results: Models based on administrative data performed poorly (R² ≤ 15%) and would not be useful for assessing posture in this population. Models using workers' ratings of exposure performed slightly better (8% < R² ≤ 27% for trunk posture; 14% < R² ≤ 36% for arm posture). The best model was obtained when using observational data for predicting frequency of periods with neutral arm inclination. It explained 56% of the variance in the postural exposure, and its SE was 5.6. Bootstrap validation of this model showed similar expected performance in other samples (5th-95th percentile: R² = 45-63%; SE = 5.1-6.2). Conclusions: Observational data had a better ability to predict inclinometer-assessed upper arm exposures than workers' ratings or administrative data. However, observational measurements are typically more expensive to obtain. The results encourage analyses of the cost-efficiency of modeling based on administrative data, workers' ratings, and observation, compared to the performance and cost of measuring exposure directly. [ABSTRACT FROM AUTHOR]

BACKGROUND:Neurorehabilitation covers a large range of disorders, assessment approaches and treatment methods. There have been previous citation analyses of rehabilitation and of its subfields. However, there has never been a comprehensive citation analysis in neurorehabilitation. OBJECTIVE: The present study reports findings from a citation analysis of the top 100 most cited neurorehabilitation papers to describe the research trends in the field. METHODS: A de-novo keyword search of papers indexed in the Web of Science Core Collection database yielded 52,581 papers. A candidate pool of the 200 most-cited papers published between 2005 and 2016 was reviewed by the clinician authors. The papers in the top 100 deemed to be irrelevant were discarded and replaced by the most highly-cited articles in the second tier deemed to be clinically relevant. RESULTS: The most frequently cited neurorehablitation papers appeared in Stroke, Movement Disorders, and Neurology. Papers tended to focus on treatments, especially for stroke. Authorship trends suggest that top cited papers result from group endeavors, with 90% of the papers involving a collaboration among 3 or more authors. CONCLUSION: Treatment studies, often focused on stroke, appear to have the highest impact in the field of neurorehabilitation. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the 30-day emergency department (ED) return rate between patients given a Take Home Medication pack (THM) versus a standard paper prescription (SPP) prior to discharge. Methods: This was an observational, prospective cohort study in an urban, university-affiliated, level I trauma center. Patients were identified through daily pharmacy reports. Consecutive adult patients discharged from the ED with either a THM or equivalent SPP were included. For each patient, baseline characteristics including age, gender, primary care provider (PCP), primary language, ethnicity, marital status, and insurance status were recorded from the electronic medical record (EMR). Review of the EMR was used to determine whether patients returned to the ED within 30 days and whether the return visit was for all-causes or for the same complaint targeted by the THM or SPP from the index visit. Similarly, visits to other providers in the health system within 30 days were recorded. Results: A total of 711 patients were included in the study, with 268 receiving a THM and 443 receiving a SPP. In comparison with the SPP group, the THM group was more likely to have an all-cause return (Relative Risk [RR] = 1.7, P < .01). Variables associated with increased odds of returning to the ED within 30 days included study group (adjusted Odds Ratio [aOR]: 1.7), male gender (aOR: 1.6), African American ethnicity (aOR: 3.0), public insurance (aOR: 3.3), and institutional financial assistance (aOR: 5.0). The difference between study groups for index visit complaint-specific returns was not significant. Conclusions: Patients receiving a THM demonstrated a higher all-cause return rate than patients receiving a SPP. A randomized study is needed evaluating the effect of THM on return ED visits. [ABSTRACT FROM AUTHOR]