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Background: Increased patient utilization of cannabidiol (CBD) leads to potential drug interactions with various medications and questions posed to pharmacists. Objective: To quantify the knowledge gap of pharmacists on CBD and CBD-containing products and assess the degree a continuing pharmacy education (CPE) program alters pharmacist confidence and competency on CBD knowledge. Methods: A 1-h CPE activity was offered as a home study from May 9, 2022, through September 30, 2022. Subjects were practicing pharmacy preceptors in Alabama who completed the pre-survey and post-survey for inclusion in matched-pair analyses. The primary outcome measure was participant score improvement between the pre-post surveys. Secondary measures involved pre-post comparisons on self-rated Likert questions concerning participant confidence in counseling, answering drug information questions, and ensuring patient safety regarding CBD. Results: A total of 124 participants completed the course. After matched pairing, 64 and 56 individuals were included in the knowledge-based and confidence ranking analyses, respectively. Participant scoring improved on the knowledge-based questions between the pre-post surveys (50.0% vs 87.8%, P <.001). There was a significant confidence improvement of participants from baseline on counseling patients about prescription or over-the-counter CBD products, answering questions from other healthcare professionals about these products, and ensuring patient safety while using these products (Average 5-level Likert scale increases of 1.75, 1.73, 1.70, respectively; all P <.001). Conclusion: Implementation of a CPE program improved practicing pharmacists' knowledge on information about CBD, which lead to increased competency on counseling patients, answering drug information questions, and promoting patient safety. [ABSTRACT FROM AUTHOR]

About 60% of marine vessels' power is consumed to overcome friction resistance between the hull and water. Air lubrication can effectively reduce this resistance and lower fuel consumption, and consequently emissions. This study aims to analyze the use of a gas-injected liquid lubrication system (GILLS) to reduce friction resistance in a real-world scenario. A 3D computational fluid dynamics model is adopted to analyse how a full-scale ship (the Sea Transport Solutions Designed Catamaran ROPAX ferry) with a length of 44.9 m and a width of 16.5 m is affected by its speed and draught. The computational model is based on a volume of fluid model using the k-ꞷ shear stress transport turbulence model. Results show that at a 1.5 m draught and 20 knots cruising speed, injecting 0.05 kg/s of compressed air into each GILLS unit reduces friction resistance by 10.45%. A hybrid model of natural air suction and force-compressed air shows a friction resistance reduction of 10.41%, which is a promising solution with less required external power. The proposed technique offers improved fuel efficiency and can help to meet environmental regulations without engine modifications. [ABSTRACT FROM AUTHOR]

Background: Antibody‐mediated rejection (ABMR) poses a barrier to long‐term graft survival and is one of the most challenging events after kidney transplantation. Removing donor specific antibodies (DSA) through therapeutic plasma exchange (PLEX) is a cornerstone of antibody depletion but has inconsistent effects. Imlifidase is a treatment currently utilized for desensitization with near‐complete inactivation of DSA both in the intra‐ and extravascular space. Methods: This was a 6‐month, randomized, open‐label, multicenter, multinational trial conducted at 14 transplant centers. Thirty patients were randomized to either imlifidase or PLEX treatment. The primary endpoint was reduction in DSA level during the 5 days following the start of treatment. Results: Despite considerable heterogeneity in the trial population, DSA reduction as defined by the primary endpoint was 97% for imlifidase compared to 42% for PLEX. Additionally, imlifidase reduced DSA to noncomplement fixing levels, whereas PLEX failed to do so. After antibody rebound in the imlifidase arm (circa days 6–12), both arms had similar reductions in DSA. Five allograft losses occurred during the 6 months following the start of ABMR treatment—four within the imlifidase arm (18 patients treated) and one in the PLEX arm (10 patients treated). In terms of clinical efficacy, the Kaplan–Meier estimated graft survival was 78% for imlifidase and 89% for PLEX, with a slightly higher eGFR in the PLEX arm at the end of the trial. The observed adverse events in the trial were as expected, and there were no apparent differences between the arms. Conclusion: Imlifidase was safe and well‐tolerated in the ABMR population. Despite meeting the primary endpoint of maximum DSA reduction compared to PLEX, the trial was unsuccessful in demonstrating a clinical benefit of imlifidase in this heterogenous ABMR population. Trial Registration: EudraCT number: 2018‐000022‐66, 2020‐004777‐49; ClinicalTrials.gov identifier: NCT03897205, NCT04711850 [ABSTRACT FROM AUTHOR]

The importance and impact of youth violence is increasingly being recognised and is a cause of international concern. In the UK, youth violence, specifically knife crime, is on the increase and has resulted in the deaths of many young people. In order to explore the impact of knife crimes on mental health and wellbeing of individuals, a number of focus groups were conducted with 24 professionals from multiple agencies. Qualitative analysis showed various emerging themes, which included ineffective mental health systems, structural violence and inequalities, policing, safety and community engagement, vulnerability and resilience in minority communities. Equity in mental health services, further development and roll-out of public mental health approaches and training accompanied by sufficient resources is needed. [ABSTRACT FROM AUTHOR]

Background: Youth violence and knife crime is increasing dramatically, so much so it has been described as a global epidemic. The social, economic and political forces fuelling this rise mean that minority groups are particularly affected. Aim: This paper reviews the literature primarily from a UK perspective, and illustrates the disparate factors that are influencing the rise in youth violence and knife crime and illustrates the complexities of integrating the perspectives of different disciplines into coherent intervention strategies. Method: We conducted a systematic review of the literature that explores both the causes of increasing youth violence and knife crime as well as some of the interventions that have attempted to deal with the problem. Results: A complex interplay of social, economic, mental health and political factors underpin the increase in youth violence and knife crime. An uneasy tension exists between a traditional criminal justice system-based approach based upon deterrence and punishment, and a more liberal preventative model focusing on adolescent mental health. None of the interventions thus far have been particularly effective. Conclusion: Youth violence and knife crime is a global social issue that causes untold suffering to individuals, families and communities as well as fear that reverberates through society. Interventions have often been devised through the lens of particular disciplines or ideologies. Integrating these perspectives into a coherent approach that is actually effective demands greater co-operation, dialogue and mutual understanding between disciplines and agencies, as well as a robust framework for the evidence-based assessment of outcomes. [ABSTRACT FROM AUTHOR]

Indigenous psychedelic uses have long been imbricated with colonialism and its afterlives. Amidst tensions from accelerating investor interest in psychedelics and calls to decolonize research and practices, we argue that the study of psychedelics is troubled by dualisms used in both colonial and decolonial thought: subject and object, self and other, culture and nature, synthetic and natural, the colonizer and the indigenous, the literal and the metaphorical. Feminist and decolonial theory as well as a discussion of metaphor support our argument that the study of psychedelics often lacks critical engagement with these dualisms. A narrow understanding of coloniality hinders far-reaching critiques of contemporary capitalism, including progressive colonization of the life-world and commodification of psychedelic experiences. Fears that decolonization is becoming just a 'metaphor' implicitly reaffirm the conceptual power dynamics of colonization. In research on psychedelics, decolonization as a critical metaphor enables reassessing problematic distinctions that shape thinking, material realities, experiences. [ABSTRACT FROM AUTHOR]

In the first half of the twentieth century, many Australian artists, such as the Tasmanian ceramicist Violet Mace (1883–1968), sought to find a distinctly Australian visual expression. Although Modernist aesthetics challenged Mace and her contemporaries to explore abstraction, in order to convey Australia's specificity she turned to Australian history. Initially, her imagery touched on frontier conflict and the motifs of nineteenth-century Aboriginal artists such as Tommy McCrae. After tracing the sources of Mace's imagery, this article asks to what extent her representations de-historicised the frontier past and enabled contemporary viewers a comfortable distance from what many Australians now see as a story of violent conquest. Perhaps Mace's imagery can be read as an episode in a national history of slowly growing appreciation of Australian Aboriginal culture, increasing discomfort with the story of racial and cultural inferiority, and willingness to acknowledge that Australia is the product of invasion. [ABSTRACT FROM AUTHOR]

Diesel engine failures are one reason for delays and breakdowns on the UK rail network, resulting in significant fines and related financial penalties for a train operating company. Preventing such failures is the ultimate goal, but forecasting or predicting future failures before they occur would be highly desirable. In this study, we take real world Diesel Multiple Unit sensor data, recorded in the form of event data, and repurpose it for the remote condition monitoring of critical diesel engine operations. A methodology based on windowing of data is proposed that demonstrates the effective processing of event data for predictive modelling. This study specifically looks at predicting engine failures, and through this methodology, models trained on the processed data resulted in accuracies of 88%. Explainable AI methods are then utilised to provide feature importance explanations for the model's performance. This information helps the end user understand specifically which sensor data from the larger dataset is most relevant for predicting engine failures. The work presented is useful to the railway industry, but more specifically to train operator companies who ideally want to foresee failures before they occur to avoid significant financial costs. The methodology proposed is applicable for the predictive maintenance of many systems, not just railway diesel engines. [ABSTRACT FROM AUTHOR]

The essential proposal of this text is that psychedelic-induced metaphysical experiences should be integrated and evaluated with recourse to metaphysics. It will be argued that there is a potential extra benefit to patients in psychedelic-assisted therapy if they are provided with an optional, additional, and intelligible schema and discussion of metaphysical options at the integrative phase of the therapy. This schema (the "Metaphysics Matrix") and a new Metaphysics Matrix Questionnaire ("MMQ") stemming there from will be presented, the latter of which can also be used as an alternative or additional tool for quantitative measurement of psychedelic experience in trials. Metaphysics is not mysticism, despite some overlap; and certainly not all psychedelic experience ismetaphysical ormystical--all three terms will be defined and contrasted. Thereafter psychedelic therapy will be presented and analysed in order to reveal the missing place for metaphysics. Metaphysics, with epistemology (theory of knowledge) and axiology (ethics and aesthetics), is a defining branch of Philosophy. Metaphysics, in contrast to mysticism, is considered to be based on argument rather than pure revelation. Thus, in psychedelic-assisted psychotherapy one sees here the potential bridge between reason-based philosophy and practical therapy--or, more broadly, with psychedelic-assisted psychotherapy there is the potential and mutually beneficial fusion of philosophy with practical science. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 30% to 50% of hospital discharge antimicrobials are inappropriate. Limited data exist on approaches to improve antimicrobial prescribing practices at the time of discharge from a community hospital. Objective : To assess the impact of a comprehensive pharmacist-led antimicrobial stewardship intervention at discharge. Methods: We conducted a quasi-experimental, pre-post study. A biphasic intervention took place on 2 medicine units from November 2019 to May 2020 at a community hospital. Baseline data were collected, followed by prescriber education on antimicrobial stewardship to both units (education phase). Next, a pharmacist-led intervention took place on one unit (intervention phase). The primary outcome was composite appropriateness of an oral antimicrobial prescribed to an adult at the time of discharge, defined by narrow spectrum of activity, dosing, and duration of therapy. The primary outcome was assessed using Fisher exact test. Results: Baseline composite appropriateness was 30% (n = 12) on the control unit and 30.8% (n = 20) on the intervention unit. From baseline to posteducation, no significant change in composite appropriateness was found on the control (30% to 26.7%, P = 0.256) or intervention (30.8% to 19.4%, P = 0.09) unit. There was no significant difference between the education to intervention phase (26.7% vs 35%, P = 0.254) on the control unit. On the intervention unit, a significant difference in composite appropriateness was found from the education to intervention phase (19.4% vs 47.8%, P = 0.017). Conclusion and Relevance: A pharmacist-led intervention improved appropriateness of oral antimicrobials prescribed at discharge. One-time education was insufficient for improving antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

In this article, we examine the role and effectiveness of the Centers for Disease Control and Prevention in the USA and Europe and consider possible lessons for future pandemic planning in Australia. We also 'map' the interjurisdictional communication pathways that have been secured since the election of the new Commonwealth government. We suggest a number of steps that could be taken to upgrade the collection, distribution, accessibility and timelines of key information required to improve pandemic management and national health outcomes. While it may be hard to contemplate a move to a fully integrated National capacity when we are only just emerging from the pandemic, we do have a unique opportunity to at least start the process of review. We should use the lessons we have learned to transform our systems, rather than 'tinker' with them and ensure we are better prepared for next time. What is known about the topic? Much has been reported on the challenges of coronavirus disease 2019 presented to everyone at a global and country level. The pandemic highlighted the often dysfunctional decision making at all levels that impacted on the responses of govenments. What does this paper add? This paper reviews in particular the responses of the Centers for Disease Control and Prevention (CDCs) and 'maps' the interjurisdictional pathways that exist or have been proposed in Australia and outlines the opportunity that the new Government has to ensure a proper process of review of these responses. It also provides some suggestions and priorities for consideration in the planning of an Australian CDC as recently canvassed in the discussion paper released by the Department of Health and Ageing. What are the implications for practitioners? An understanding of the complexities of our health 'governance' systems and the opportunity to commence a discussion on how we might transform our systems rather than work around the 'edges' to ensure we are better prepared for the next pandemic. [ABSTRACT FROM AUTHOR]

To reveal the energy consumption characteristics of a steel bar and all-lightweight shale ceramsite concrete (ALWSCC), focusing on hot rolled crescent ribbed bars (CRB) and hot rolled plain steel bars (PSB), a series of pull-out tests were carried out. The bonding failure modes, the contribution of the ribs to bond-slip failure and the energy consumption characteristics were analyzed based on the curves of pull-out load F-slip displacement S and energy consumption W–slip displacement S. Results show that the splitting failure is the main failure of the CRB specimen, and the pulling out failure is the main failure of the PSB one. The ratio of the total energy dissipation of splitting failure to that of the pulling out failure is less than 30%. The mechanical bite force between CRB and concrete contributes more than 95% to the bond strength. The pull-out force is divided into four stages, such as the chemical adhesive force stage (elastic and micro-elastic strain stage), the common-effect stage of mechanical bearing force and static frictional force (plastic development stage), and the frictional force stage (crushed stage). The new design is proposed to guarantee the ductility of the reinforced concrete structure, which is based on the bond-slip energy consumption rather than the traditional strength design. The conclusions provide a reference to the reinforced concrete practice. [ABSTRACT FROM AUTHOR]

A Shift2Rail funded research project called RUN2Rail has investigated a range of new technologies for railway rolling stock. The project included a task on the use of active suspensions, and one of the subtasks was to propose a strategy supporting the authorisation by safety authorities for highly innovative mechatronic vehicles to be placed on the market. The incorporation of electronics and control into suspension systems is still at an early stage, so this paper provides a framework for a practical and efficient authorisation strategy, primarily based upon existing European regulations and standards but in general applicable worldwide. [ABSTRACT FROM AUTHOR]

Purpose: Access and affordability of hearing health care varies depending on residency and individual financial means. Those living in rural areas have limited health care resources and experience higher levels of poverty compared to those living in urban regions. The purpose of this study was to determine the feasibility of interprofessional collaboration among physicians and audiologists and pharmacists and audiologists to improve access and affordability of hearing health care in rural communities. Method: Sixteen family physicians and medicine residents and 15 community pharmacists participated in the study. Physicians and residents completed an online survey to assess education regarding hearing health care and their understanding of hearing loss intervention. They also participated in small virtual focus group discussions. Pharmacists participated in virtual discussions based on guided questions. Results: The discussions with both physicians and pharmacists highlighted the need for more education, resources, and awareness of the negative impact of hearing loss on overall quality of life. Comments from these discussions were placed within the socio-ecological model of health behavior to increase understanding of hearing health behavior. Conclusions: Increased collaboration among medical professionals has the potential to improve access to hearing health care for those living in audiologically underserved regions of the country. Further research will identify how to increase effective and sustainable hearing health care resources in rural communities. [ABSTRACT FROM AUTHOR]

Introduction: Previous surveys on teaching and learning curriculum (TLC) programs focus on specific populations (ie, schools and colleges of pharmacy). However, the prevalence and characteristics of TLC programs available through pharmacy residency programs across the spectrum of postgraduate year one (PGY1) programs is not known. Objectives: To determine the national prevalence, requirements, cost, and reasons for offering TLC programs in United States (US). Methods: After pilot testing, an electronic survey was sent to all pharmacy PGY1 residency program directors in the US. The survey asked respondents if a TLC program was available through their program and, if so, queried additional details about requirements for resident participants and cost considerations. Additionally, participants were asked to rank reasons for not making TLC programs available, if applicable. Data were summarized using descriptive statistics. Results: There were 419 surveys at least partially completed, which represented a 28.2% response rate and similar geographic distribution of respondents to that of the overall population of residency programs. Nearly 95% of responding residency programs offer a TLC program to their residents. Consistent with recommendations, a variety of teaching activities are completed by residents, with classroom instruction (75.2%) being most common. However, dyssynchrony exists between classroom instruction and didactic assessment (59.3%). Simulation and laboratory teaching opportunities was the least prevalent teaching activity (49%). Most TLC programs are not associated with a fee, but about 25% reported charging at least $25 per resident. Conclusion: TLC programs are commonly offered through PGY1 pharmacy residency programs in the US. Most programs are facilitated by schools or colleges of pharmacy and offer residents a wide variety of teaching opportunities. However, there remains a gap in assessment and in simulation or lab teaching opportunities. The results of this study can be used by residency and TLC programs for self‐examination and quality improvement efforts. [ABSTRACT FROM AUTHOR]

Traumatic imagination includes creative processes in which traumatic memories are transformed into narratives of suffering. This article emphasizes the importance of storytelling in victims' mental health and offers a literary perspective on how some women's experiences of suffering can be expressed in the telling of traditional stories, which confer some protection from stigma to individual women in Turkish and Afghan societies. [ABSTRACT FROM AUTHOR]

The article presents the 2022 national standards for diabetes self-management education and support (DSMES). Also cited are the growing number of American children and adults affected by both Type 1 and 2 diabetes, the importance of DSMES in educating people with diabetes (PWD) on how to self-manage their condition, and the quality standards of the U.S. Centers for Medicare & Medicaid Services.

CT colonography has emerged as the investigation of choice for suspected colorectal cancer in patients when a colonoscopy in incomplete, is deemed high risk or is declined because of patient preference. Unlike a traditional colonoscopy, it frequently reveals extracolonic as well as colonic findings. Our study aimed to determine the prevalence, characteristics and potential significance of extracolonic findings on CT colonography within our own institution. A retrospective review was performed of 502 patients who underwent CT colonography in our institution between January 1, 2010 and January 4, 2015. Of 502 patients, 60.63% had at least one extracolonic finding. This was close to other similar-sized studies (Kumar et al. Radiology 236(2):519–526, 2005). However, our rate of E4 findings was significantly higher than that reported in larger studies at 5.3%(Pooler et al. AJR 206:313–318, 2016). The difference may be explained by our combination of symptomatic/screening patients or by the age and gender distribution of our population. Our study lends support to the hypothesis that CT colonography may be particularly useful in identifying clinically significant extracolonic findings in symptomatic patients. CT colonography may allow early identification of extracolonic malignancies and life-threatening conditions such as an abdominal aortic aneurysm at a preclinical stage when they are amenable to medical or surgical intervention. However, extracolonic findings may also result in unnecessary investigations for subsequently benign findings. [ABSTRACT FROM AUTHOR]

Introduction: Sodium fluoride (NaF) tubes are the recommended tubes for glucose measurements, but these are expensive, have limited number of uses, and are not always available in low resource settings. Alternative sample handling techniques are thus needed. We compared glucose stability in samples collected in various tubes exposed to different pre-analytical conditions in Uganda. Methods: Random (non-fasted) blood samples were drawn from nine healthy participants into NaF, Ethylenediaminetetraacetic acid (EDTA), and plain serum tubes. The samples were kept un-centrifuged or centrifuged with plasma or serum pipetted into aliquots, placed in cool box with ice or at room temperature and were stored in a permanent freezer after 0, 2, 6, 12 and 24 hours post blood draw before glucose analysis. Results: Rapid decline in glucose concentrations was observed when compared to baseline in serum (declined to 64%) and EDTA-plasma (declined to 77%) after 6 hours when samples were un-centrifuged at room temperature whilst NaF-plasma was stable after 24 hours in the same condition. Un-centrifuged EDTA-plasma kept on ice was stable for up to 6 hours but serum was not stable (degraded to 92%) in the same conditions. Early centrifugation prevented glucose decline even at room temperature regardless of the primary tube used with serum, EDTA-plasma and NaF-plasma after 24 hours. Conclusion: In low resource settings we recommend use of EDTA tubes placed in cool box with ice and analysed within 6 hours as an alternative to NaF tubes. Alternatively, immediate separation of blood with manual hand centrifuges will allow any tube to be used even in remote settings with no electricity. [ABSTRACT FROM AUTHOR]

The article presents the discussion on highlighting the importance of increasing access to DSMES services supporting the ongoing self-management and decision making. Topics include diabetes self-management education and support (DSMES) being a critical element of care for all people with diabetes (PWD); and addressing the emotional burden of living with and managing diabetes such as diabetes distress and considering the multitude of daily demands.

Introduction: fishing communities continue to face a heavy burden of HIV-infection. Access to HIV prevention methods remains problematic. Provision of affordable interventions such as condoms can help, but there is limited information on consistent condom use and associated factors among members of fishing communities around Lake Victoria. Methods: we promoted and provided free condoms to HIV negative fisherfolks enrolled in a longitudinal observational cohort between 2012 and 2017 in Uganda. We defined consistent condom use as a participant selfreporting 100% condom use while having sex with a new sexual partner. Results: in total 615 persons were analysed. Of these 63 (10.2%) reported consistent condom use. Being male, Muslim and mobile were independently associated with high consistent condom use while having sex under influence of alcohol and having genital discharge or sores were associated with low use. Conclusion: findings suggest low consistent condom use, calling for attention to barriers to consistent condom use. [ABSTRACT FROM AUTHOR]

Harbour seals (Phoca vitulina) and grey seals (Halichoerus grypus) both occur within the UK, but display regional contrasting population trends. While grey seals are typically increasing in number, harbour seals have shown varying trends in recent decades following repeated pandemics. There is a need for monitoring of regional and local populations to understand overall trends. This study utilized a 20‐year dataset of seal counts from two neighboring harbours in the Solent region of south England. Generalized additive models showed a significant increase in the numbers of harbour (mean 5.3–30.5) and grey (mean 0–12.0) seals utilizing Chichester Harbour. Conversely, in Langstone Harbour there has been a slight decrease in the number of harbour seals (mean 5.3–4.0). Accompanying photographic data from 2016 to 18 supports the increase in seal numbers within Chichester Harbour, with a total of 68 harbour and 8 grey seals identified. These data also show evidence of site fidelity of harbour seals in this area, with almost a quarter of animals resighted within the past three years. Overall, this long‐term study indicates an increasing number of both harbour and grey seals within the Solent. However, more research is required to identify the drivers of this trend. [ABSTRACT FROM AUTHOR]

Summary: The optimum approach towards immunosuppression withdrawal following kidney transplant failure is unclear. Prolonged weaning may be associated with reduced sensitization, less graft nephrectomy and greater likelihood of retransplantation, but conversely increased risk of infection, malignancy and death. We conducted a single‐centre retrospective analysis of patients experiencing graft failure between 2007 and 2017, comparing rates of sensitization, retransplantation, nephrectomy, infection, malignancy and death between patients who had immunosuppression weaned over <90 vs. 90–180 vs. >180 days. Patient survival after immunosuppression withdrawal over <90 vs. 90–180 vs. >180 days was 73.3%, 72.1% and 80.4%, respectively (P = 0.35), with no differences in cPRA (80.06 vs. 81.21 vs. 85.42, P = 0.66) or retransplantation rate [24/31 (77.4%) vs. 21/35 (60.0%) vs. 22/36 (61.1%), P = 0.13]. There was significantly less nephrectomy after late immunosuppression cessation [10/42 (23.8%) vs. 7/42 (16.7%) vs. 3/43 (7.0%), P = 0.01] but no differences in infections or malignancy. On competing risk regression (death as competing risk) controlling for cofactors including age, nephrectomy and rejection, prolonged immunosuppression did not predict likelihood of retransplantation (SHR 1.000, P = 0.88). Prolonged immunosuppression withdrawal does not reduce sensitization or improve retransplantation rates but is associated with less nephrectomy. Immunosuppression withdrawal should be tailored to individual circumstances after graft failure. [ABSTRACT FROM AUTHOR]

The article agrees with the need to implement interventions to address the mental health needs of the military population in Ukraine and calls for the Ukrainian Health Services to be primed for potential psychological casualties in the future.

Background: In this 30‐year national review, we describe trends in DD transplantation for paediatric recipients, assess the impact of paediatric allocation bonuses and identify outstanding areas of need for this population. Methods: A retrospective review of all DD kidney only transplants to paediatric recipients (<18 years old) in Australia between 1989 and 2018 was conducted using deidentified extracts from the ANZDATA. Results: Of the 1011 kidney only transplants performed in paediatric recipients during the study period, 426 (42%) were from deceased donors. Paediatric candidates on the DD waiting list had consistently higher rates of transplantation and shorter time from dialysis initiation to transplantation compared with adult candidates (median 372 vs 832 days in 2018, for example). Donor characteristics remained more favourable for paediatric recipients, despite a decline in the overall quality of the donor pool. The mean number of HLA antigen mismatches for paediatric recipients of DD transplants increased each decade (2.86 [1989–1998], 3.85 [1999–2008], 4.01 [2009–2018]). Both patient and graft survival have improved for paediatric DD transplant recipients in the most recent era (5‐year graft and patient survival 85% vs 65% and 99% vs 94%, respectively, for 2009–2018 vs 1999–2008). Conclusions: The current DD kidney allocation system in Australia provides rapid access to high‐quality organs for paediatric recipients, and early graft loss has decreased significantly in recent years; however, additional targeted interventions to address HLA matching may improve long‐term outcomes in this population. [ABSTRACT FROM AUTHOR]

As we review health governance during the COVID-19 pandemic, we have an opportunity to reflect on these processes and ensure that future challenges might be managed in a more collaborative and whole of system response. This 'Perspective' reviews COVID-19 responses in Australia, reflects on a number of potential solutions that have been developed by organisations over the past two decades and proffers a governance framework for a Communicable Disease and Pandemic Management Authority that might assist health responses to future challenges. What is known about the topic? Responses to the COVID-19 pandemic were at best disorganised with multiple failures at almost every level. Reflecting on these responses is essential if we are to perform better in future health and societal crises, which will inevitably occur. What does this paper add? This paper summarises a number of organisational 'structures' and discussion documents that have been developed over the past decades which might be useful starting points for development of a structure(s) that would leave Australia in a better position when the next 'wave' hits. What are the implications for practitioners? Good governance is fundamental to how we do business and the complexities of the health and welfare system(s) only compound these challenges. [ABSTRACT FROM AUTHOR]

In 2016 Allan D. Grody and Peter J. Hughes proposed a method and system termed 'Risk Accounting', an integrated financial and risk accounting framework. Risk Accounting incorporates a novel operational risk exposure quantification technique based on the Risk Unit (RU), a new common additive metric designed to express all forms of operational risk in banks. In this paper, we report on initial tests of the inherent predictiveness of the RU. The test focused on the period leading up to the global financial crisis of 2007-8 and involved the restatement into RUs of publicly available accounting data in the United States relative to a subset of large US banks. We contend that the RU's inherent predictiveness could be concluded if it is demonstrated that an accelerated increase in trended operational risk RUs and subsequent material unexpected losses are positively correlated. We further describe how a monetary value can be stochastically derived and assigned to the RU over time. The inclusion of valued RUs in accounting systems will potentially enable the systematic adjustment of financial performance and condition relative to accepted nonfinancial risks to complement the accounting treatment already applied to financial (credit and market) risks. The resulting harmonisation of the accounting treatment applied to both financial and nonfinancial risks based on stochastic modelling will enable risk-adjusted economic profit to be adopted as the primary business performance metric and economic capital as the primary method of determining both operating and regulatory capital requirements. The real-time or near-real-time production of portfolio views of operational risk exposures based on the RU adds analytical rigour to their management and causes risk mitigation to become both a risk reduction and a profit optimisation initiative. The more effective management, oversight and governance of exposures to operational risks is the anticipated outcome. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) infection is a significant cause of morbidity and mortality after solid organ transplantation. There has been a significant shift in disease epidemiology with the introduction of antiviral prophylaxis, with CMV disease occurring later and clinical presentations more atypical. We describe two cases of very late‐onset CMV disease where first disease occurred 15 and 18 years post–renal transplantation, with both cases complicated by antiviral drug resistance. We subsequently review the published cases and literature of very late‐onset CMV disease (onset > 10 years post–solid organ transplantation) as an increasingly recognized phenomenon which is emerging as an important aspect in improving long‐term patient outcomes in the current era of renal transplantation. [ABSTRACT FROM AUTHOR]

Background: Telling personal stories of violence has been central to recent advocacy efforts to prevent violence against women around the world. In this paper, we explore the use of personal storytelling as a form of activism to prevent femicide in Turkey. This study is part of a broader storytelling initiative called SHAER (Storytelling for Health: Acknowledgement, Expression and Recovery) to alleviate the psychological and emotional suffering of women who have experienced gender-based violence in high-prevalence settings. Objectives: We conceptually explore personal stories of violence as a form of both distributed agency and activism. This conceptual framework is used to answer the following research question in the Turkish context: How do women use their personal stories of interpersonal violence for their own benefit (support) and that of others (activism)? Methods: Our study is based on 20 in-depth semi-structured interviews with women who have experienced violence and were purposefully recruited by the 'We Will End Femicide' Platform in Istanbul. Interviews were conducted between March and August 2019. We used inductive and deductive thematic analysis to identify instances of personal storytelling at three levels: intrapersonal, relational and collective. Results: Our results show how the use of personal storytelling can provide a means of healing from experiences of violence. However, this process is not linear and is often influenced by the surrounding context including: the listener of the story, their reaction, and what social networks the woman has to support her. In supportive social contexts, personal storytelling can be an effective support for activism against violence: personal stories can provide opportunities for individuals to shape broader discourses about violence against women and the right of women to share their stories. Conclusions: Telling one's personal story of violence can both support women's agency and contribute to the collective struggle against violence against women more broadly. [ABSTRACT FROM AUTHOR]

A 44-year- old male person with tetraplegia (C-5 AIS—A (American Spinal Cord Injury Association Standard Neurological Classification of Spinal Cord Injury Impairment Scale)) developed urinary tract infection and received appropriate antibiotic. Subsequently, he started sweating and shivering when he was sitting up; these symptoms resolved while lying on his back. Autonomic dysreflexia triggered by truncal movements continued to occur for 3 months. CT of the spine showed L5–S1 discitis. MRI of the spine showed diffuse marrow oedema in L5 and S1 vertebrae and a large abscess at L5/S1 level. Blood culture yielded Serratia marcescens sensitive to meropenem. Meropenem followed by ertapenem was given for 12 weeks. After 11 months, MRI showed resolution of discitis and epidural collection. The patient was able to sit up for 9 hours without developing autonomic dysreflexia. If a person with cervical spinal cord injury develops posture-related autonomic dysreflexia (eg, in sitting position, lying on sides or while hoisted), disco-vertebral pathology should be suspected. [ABSTRACT FROM AUTHOR]

What is known on the subject: Healthcare assistants are untrained and unregistered frontline staff but are expected to be proactive in preventing and responding to 'untoward' incidents quickly and efficiently when working within adult acute inpatient psychiatric settings.Healthcare assistants should be trained to provide enhanced care to service users residing in acute psychiatric settings. To date, a training programme in Psychological First Aid has not been expended in such a setting with nonregistered staff. What the paper adds to existing knowledge: The study demonstrates that training healthcare assistants in Psychological First Aid is useful in improving their confidence in caring for service users, therapeutic engagement with service users and ward culture in general. What are the implications for practice: A training programme in Psychological First Aid for healthcare assistants to enhance ward culture can be implemented in different practice environments.Psychological First Aid is harmonious with nursing values and provides healthcare assistants with a relevant, useful and easily understood toolkit to apply in acute psychiatric settings. Introduction: Healthcare assistants working within adult acute inpatient psychiatric settings are untrained and unregistered, however, they can contribute to quality service if they receive some training. Psychological First Aid training has never been expended in these settings, so this study intends to fill this gap in the existing evidence with this category of healthcare personnel. Aim: The aim of this study was to introduce and evaluate first aid training for healthcare assistants. Method: A pre/post design was adopted to gather data using questionnaires and interviews. The groups of participants included 16 healthcare assistants trained in Psychological First Aid, a sample of service users and four ward managers. Results: Post‐training, (a) healthcare assistants and service users ranked the therapeutic milieu of the ward more favourably, (b) the self‐efficacy of the healthcare assistants increased, and the number of 'untoward' incidents decreased, and (c) health care assistants' confidence in their skills was high. The ward manager interviews post‐training revealed four themes: (a) staff utilization of new skills and renewed enthusiasm, (b) calmer atmosphere on the ward and staff togetherness, (c) confidence and reflection on practice and (d) therapeutic engagement. Discussion: Training healthcare assistants is useful in improving staff confidence, therapeutic engagement with service users and ward culture in general. Implications for practice: Techniques and skills learnt are relevant and useful to healthcare assistants and provide an easily understood toolkit that is harmonious with nursing values. If executed correctly, the training can enhance practice and care outcomes and the overall service user experience. [ABSTRACT FROM AUTHOR]