Search

OBJECTIVES: Following the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and the subsequent global spread of the 2019 novel coronavirus disease (COVID-19), health systems and the populations who use them have faced unprecedented challenges. We aimed to measure the impact of COVID-19 on the uptake of hospital-based care at a national level. DESIGN: The study period (weeks ending 5 January to 28 June 2020) encompassed the pandemic announcement by the World Health Organization and the initiation of the UK lockdown. We undertook an interrupted time-series analysis to evaluate the impact of these events on hospital services at a national level and across demographics, clinical specialties and National Health Service Health Boards. SETTING: Scotland, UK. PARTICIPANTS: Patients receiving hospital care from National Health Service Scotland. MAIN OUTCOME MEASURES: Accident and emergency (A&E) attendances, and emergency and planned hospital admissions measured using the relative change of weekly counts in 2020 to the averaged counts for equivalent weeks in 2018 and 2019. RESULTS: Before the pandemic announcement, the uptake of hospital care was largely consistent with historical levels. This was followed by sharp drops in all outcomes until UK lockdown, where activity began to steadily increase. This time-period saw an average reduction of −40.7% (95% confidence interval [CI]: −47.7 to −33.7) in A&E attendances, −25.8% (95% CI: −31.1 to −20.4) in emergency hospital admissions and −60.9% (95% CI: −66.1 to −55.7) in planned hospital admissions, in comparison to the 2018–2019 averages. All subgroup trends were broadly consistent within outcomes, but with notable variations across age groups, specialties and geography. CONCLUSIONS: COVID-19 has had a profoundly disruptive impact on hospital-based care across National Health Service Scotland. This has likely led to an adverse effect on non-COVID-19-related illnesses, increasing the possibility of potentially avoidable morbidity and mortality. Further research is required to elucidate these impacts.

The discovery and characterization of retroviral oncogenes were important milestones in cancer research. The viruses turned out not to be key causes of cancer in humans, but the oncogenes they carried provided key clues to the role cellular genes, the proto-oncogene counterparts of these sequences, played in tumorigenesis. In this excerpt from his forthcoming book, Joe Lipsick looks back at early work on retroviruses, such as the experiments that distinguished their ability to infect and transform cells, the groundbreaking work on Src, and some of the controversy surrounding the Nobel Prize awarded for these discoveries.

研究機関が学術情報を発信する場合，研究者・科学ジャーナリスト・一般市民など，多様な受け手に合わせて，研究ストーリーの語り方と伝達手法を柔軟に選択・実践する必要がある。本稿では，その具体的なアプローチとして，プレプリントサーバーやソーシャルメディアによる情報発信，研究助成金の申請，論文のプレスリリース（国際的な科学ニュース配信サービスの活用，報道を促す文章とイラストの制作）について概説する。こうした多角的な情報発信手法を重層的に実践する，いわば「厚み」のある研究広報を実践することによって，学術情報を効果的に伝えることができるであろう。, Institutional communication of research results — to the academic community, news media, and society at large — is often handled in a rigid, formulaic manner, where in actuality greater flexibility and nuance (catering content and message to a variety of audiences and communication medium constraints) are needed to be effective. In this article we discuss the broad range of options available and introduce the concept of atsumi — depth, richness — in communication: a multi-pronged approach that can be adapted to maximize impact and ensure that key stakeholders are receiving the information they seek., 特集：科学研究分野・学術コミュニケーションにおける言語問題, Special feature: Language issues in scientific research and scholarly communication

Over the last decade, there has been an increasing awareness that colonialism continues through various overlapping iterations of coloniality, such as politics, economics, security and academia. Academics from global north countries and global south countries have highlighted and called for the dismantling of coloni-ality in its various iterations. Perhaps the most vocal decolonising calls have come from global north academics wanting to decolonise global north academia in the form of epistemic decolonisation. As such, in this article, I call on global north academics researching 'on and in' global south countries to employ decolonial me-thodologies to avoid inadvertently reinforcing coloniality. By utilising autoethnography and critical decolonial reflexivity, I offer ways for global north academics researching on or in global south countries to guard against reinforcing coloniality during their research. V zadnjem desetletju se povečuje zavedanje, da se kolonializem nadaljuje v številnih delno sovpadajočih različicah, med drugim na področju politike, gos-podarstva, varnosti in v akademski sferi. Mnogi akademiki iz držav globalnega severa in globalnega juga so osvetlili problem kolonialnosti in njegovih različnih ponovitev ter pozvali k njegovi odpravi. Verjetno naglasnejši pozivi k dekoloniza-ciji prihajajo iz vrst akademikov iz držav globalnega severa, ki želijo dekolonizirati lastno akademsko sfero z epistemsko dekolonizacijo. Kot eden izmed njih pozi-vam kolege, ki raziskujejo globalni jug ali izvajajo raziskave v državah, ki mu pri-padajo, naj uporabljajo delokonialne metode, da bi se izognili nenamerni krepitvi kolonialnosti. Z uporabo avtoetnografije in kritične dekolonialne refleksije, ki jo predlagam v pričujočem prispevku, lahko akademiki iz držav globalnega severa, ki izvajajo raziskave o državah globalnega juga in v njih samih, preprečijo, da bi s svojim delom nehote krepili kolonialnost.

Resumen Sudamérica hispanoparlante y el Oriente Próximo son, dada la magnitud de su producción científico-tecnológica, regiones periféricas en el sistema científico global. No obstante, sus sistemas universitarios se han fortalecido en las últimas décadas. Este artículo compara la evolución de los sistemas universitarios nacionales de la Sudamérica hispanoparlante y el Oriente Próximo en las áreas de investigación e innovación, abarcando las distintas disciplinas del conocimiento científico. Se consideran indicadores de investigación, impacto científico e innovación. Los resultados evidencian que Oriente Próximo, a pesar de sus limitaciones, incrementó la producción científica, la extensión de las redes de colaboración internacional y la transferencia de tecnologías desde la universidad a la industria. De manera opuesta, los países hispanoparlantes de Sudamérica han caído en un estancamiento de su actividad científica y de innovación. Abstract Hispanic South America and the Near East are considered peripheral regions in the global scientific system due to the size of their scientific and technological production. However, their higher education systems have shown significant growth over the last few decades. This article compares the evolution of the national higher education systems in research and innovation across all scientific disciplines in both regions. The exercise considers indicators associated with research production, scientific impact, and innovation. The results indicate that, despite their limitations, the Near East countries have increased their scientific output, extended their international collaboration networks, and improved technology transfer from universities to enterprises. In contrast, the scientific and innovation activities of countries in Hispanic South America have stagnated. Resumo A América do Sul Hispânica e Oriente Médio são considerados regiões periféricas no sistema científico global devido à magnitude de sua produção científico-tecnológica. No entanto, seus sistemas universitários foram fortalecidos nas últimas décadas. Este artigo compara a evolução dos sistemas universitários nacionais da América do Sul Hispânica e do Oriente Médio nas áreas de pesquisa e inovação, considerando indicadores de pesquisa, impacto científico e inovação em diferentes disciplinas do conhecimento científico. Os resultados indicam que, apesar de suas limitações, os países do Oriente Médio têm aumentado a produção científica, a ampliação das redes de colaboração internacional e a transferência de tecnologia da universidade para a indústria. Por outro lado, os países da América do Sul Hispânica apresentaram uma estagnação em sua atividade científica e inovação.

OBJECTIVE: To examine the frequency, natural history, and outcomes of 3 subtypes of abdominal pain (general abdominal pain, epigastric pain, localized abdominal pain) among patients visiting Canadian family practices. DESIGN: Retrospective cohort study with a 4-year longitudinal analysis. SETTING: Southwestern Ontario. PARTICIPANTS: A total of 1790 eligible patients with International Classification of Primary Care codes for abdominal pain from 18 family physicians in 8 group practices. MAIN OUTCOME MEASURES: The symptom pathways, the length of an episode, and the number of visits. RESULTS: Abdominal pain accounted for 2.4% of the 15,149 patient visits and involved 14.0% of the 1790 eligible patients. The frequencies of each of the 3 subtypes were as follows: localized abdominal pain, 89 patients, 1.0% of visits, and 5.0% of patients; general abdominal pain, 79 patients, 0.8% of visits, and 4.4% of patients; and epigastric pain, 65 patients, 0.7% of visits, and 3.6% of patients. Those with epigastric pain received more medications, and patients with localized abdominal pain underwent more investigations. Three longitudinal outcome pathways were identified. Pathway 1, in which the symptom remains at the end of the visit with no diagnosis, was the most common among patients with all subtypes of abdominal symptoms at 52.8%, 54.4%, and 50.8% for localized, general, and epigastric pain, respectively, and the symptom episodes were relatively short. Less than 15% of patients followed pathway 2, in which a diagnosis is made and the symptom persists, and yet the episodes were long with 8.75 to 16.80 months’ mean duration and 2.70 to 4.00 mean number of visits. Pathway 3, in which a diagnosis is made and there are no further visits for that symptom, occurred approximately one-third of the time, with about 1 visit over about 2 months. Prior chronic conditions were common across all 3 subtypes of abdominal pain ranging from 72.2% to 80.0%. Psychological symptoms consistently occurred at a rate of approximately one-third. CONCLUSION: The 3 subtypes of abdominal pain differed in clinically important ways. The most frequent pathway was that the symptom remained with no diagnosis, suggesting a need for clinical approaches and education programs for care of symptoms themselves, not merely in the service of coming to a diagnosis. The importance of prior chronic conditions and psychological conditions was highlighted by the results.

OBJECTIVE Lipid emulsion contributes to parenteral nutrition associated cholestasis (PNAC). For decades, soybean oil–based intravenous lipid emulsion (SO-ILE) was the predominant product. Recently, a multicomponent lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil and fish oil (SMOF-ILE) has been used off-label in neonatal care. This study evaluates the incidence of PNAC in neonates who received SMOF-ILE or SO-ILE. METHODS This was a retrospective review of neonates who received SMOF-ILE or SO-ILE for at least 14 days. Patients receiving SMOF-ILE were matched based on gestational age (GA) and birth weight to a historical cohort receiving SO-ILE. The primary outcomes were the incidences of PNAC among all patients and patients without intestinal failure. The secondary outcomes were clinical outcomes and incidence of PNAC stratified by GA. Clinical outcomes included liver function tests, growth parameters, and development of retinopathy of prematurity and intraventricular hemorrhage. RESULTS Forty-three neonates who received SMOF-ILE were matched to 43 neonates who received SOILE. There were no significant differences in baseline characteristics. The incidence of PNAC in the total population was 12% in the SMOF-ILE cohort and 23% in the SO-ILE cohort (p = 0.26). The lipid dosage of SMOF-ILE was significantly higher at time of peak direct serum bilirubin concentration compared with SO-ILE cohort (p = 0.05). Clinically significant differences were noted in laboratory endpoints in several subgroups. CONCLUSIONS There was no significant difference in the incidence of PNAC among neonates in a SMOFILE cohort compared with a historical SO-ILE cohort.

Community pharmacists in Japan participate in many important clinical cases involving drug therapies. This involvement should be researched and widely publicized to promote evidence-based medicine (EBM). However, the awareness level about the establishment of clinical evidence among community pharmacists remains unknown. Therefore, this large-scale questionnaire survey was conducted among members of the Okayama Pharmaceutical Association to clarify the awareness about the establishment of clinical evidence among community pharmacists to determine the major factors affecting their awareness. Questionnaires requiring open-ended responses were developed in Google Forms. Finally, 366 valid answers were obtained and statistically analyzed based on three aspects: academic conference presentation, research article publication, and research conduct. More than 50% of the participants agreed that they must engage in the establishment of clinical evidence. However, they were unwilling to engage in it by themselves. Additionally, the awareness about the establishment of clinical evidence among participants aged 70% of the participants did not have enough time to engage in the establishment of clinical evidence, suggesting that reducing workload and ensuring adequate time are necessary for such engagements. Our novel findings may increase the establishment of clinical evidence by community pharmacists, improve community pharmacists’ social standing, and promote EBM in Japan.

OBJECTIVE: To explore primary care physician (PCP) perspectives on the clinical utility of virtual visits. DESIGN: Qualitative design involving semistructured interviews. SETTING: Primary care practices within 5 regions in southern Ontario. PARTICIPANTS: Primary care physicians representing different practice sizes and remuneration models. METHODS: Interviews were conducted with PCPs who were involved in a large-scale pilot implementation of virtual visits (patient-provider asynchronous messaging, or synchronous audio or video communication). The first phase involved a convenience sample of users in the first 2 regions where the pilot was initiated; after implementation in all 5 regions, purposive sampling was used to ensure diversity within the sample (eg, physicians representing different use frequencies of virtual visits, regions, and remuneration models). Interviews were audiorecorded and transcribed. An inductive thematic analysis was used to identify prominent themes and subthemes. MAIN FINDINGS: Twenty-six physicians were interviewed. Fifteen were recruited using convenience sampling and 11 through purposive sampling. Four themes regarding the clinical utility of virtual visits were identified: virtual visits can effectively resolve many patient concerns, with some variation in PCP comfort using virtual visits for specific conditions; virtual visits are beneficial for a range of patients but some patients might overuse or inappropriately use them; PCPs prefer to use asynchronous messaging (eg, text or online messaging) because of its convenience and flexibility; and virtual visits can provide value at the patient, provider, and health system levels. CONCLUSION: While participants believed that virtual visits can be appropriately used to resolve a variety of clinical concerns, they found in practice that virtual visits are fundamentally different from face-to-face encounters. Professional guidelines on appropriate use cases should be established to develop a standard framework for virtual care.

OBJECTIVE In the management of diabetic ketoacidosis (DKA), the standard of care is to administer insulin glargine after ketoacidosis has resolved and the patient is transitioning from intravenous (IV) insulin to subcutaneous insulin; however, there is evidence to suggest that earlier administration of insulin glargine may accelerate resolution of ketoacidosis. The objective of this research is to determine the efficacy of early subcutaneous insulin glargine on time to resolution of ketoacidosis in children with moderate to severe DKA. METHODS This retrospective chart review evaluated children age 2 to 21 years old admitted for moderate to severe DKA who received insulin glargine within 6 hours of hospital admission (early insulin glargine) compared with those who received insulin glargine greater than 6 hours from admission (late insulin glargine). The primary outcome was duration of time the patient received IV insulin. RESULTS A total of 190 patients were included. The median time on IV insulin was lower in patients who received early insulin glargine compared with those who received late insulin glargine (17.0 [IQR, 14–22.8] vs 22.9 hours [IQR, 4.3–29.3]; p = 0.0006). Resolution of DKA was faster in patients who received early insulin glargine compared with those who received late insulin glargine (median, 13.0 [IQR, 9.8–16.8] vs 18.2 hours [IQR, 12.5–27.6]; p = 0.005). Length of pediatric intensive care unit (PICU) and hospital stay and incidences of hypoglycemia and hypokalemia were similar between the 2 groups. CONCLUSIONS Children with moderate to severe DKA who received early insulin glargine had a significantly lower time on IV insulin, as well as significantly faster time to resolution of DKA when compared with those who received late insulin glargine. There were no significant differences observed in hospital stay and rates of hypoglycemia and hypokalemia.

OBJECTIVE: To identify how graduating and incoming family medicine residents (FMR) experienced changes to their education during the early waves of the COVID-19 pandemic. DESIGN: The Family Medicine Longitudinal Survey was modified with questions related to the impact of COVID-19 on FMR and their training. Short-answer responses underwent thematic analysis. Responses to Likert scale and multiple-choice questions were reported as summary statistics. SETTING: Department of Family and Community Medicine at the University of Toronto in Ontario. PARTICIPANTS: Graduating FMR in spring 2020 and incoming FMR in fall 2020. MAIN OUTCOME MEASURES: Residents’ perceptions of the impact of COVID-19 on clinical skills acquisition and preparedness for practice. RESULTS: Surveys response rates were 124 of 167 (74%) and 142 of 162 (88%) for graduating and incoming residents, respectively. Important themes for both cohorts included reduced access to clinical environments, reduced patient volumes, and lack of exposure to procedural skills. While the graduating cohort indicated they felt confident to begin practising family medicine, they described being impacted by the loss of a tailored learning environment, including canceled or altered electives. In contrast, incoming residents reported the loss of core skills, such as physical examination competency, as well as the loss of face-to-face communication, rapport, and relationship-building opportunities. However, both cohorts endorsed gaining new skills during the pandemic, including conducting telemedicine appointments, pandemic planning, and interfacing with public health. CONCLUSION: Based on these results, residency programs can specifically tailor solutions and modifications to address common themes across cohorts to facilitate optimal learning environments in pandemic times.

Key Points Question Are results of universal and selective screening for suicide risk implemented in a pediatric emergency department associated with future suicidal behaviors? Findings In this cohort study of 15 003 youths aged 8 to 18 years, positive screens were significantly associated with subsequent suicide-related hospital visits compared with standard emergency department procedures. Screening also more than doubled the detection of suicide risk compared with treatment as usual. Meaning These findings suggest that screening for suicide risk in pediatric emergency departments is an effective approach to identify risk for subsequent suicide-related emergency department visits., This cohort study examines the association between results of universal and selective screening for suicide risk in a pediatric emergency department using the Ask Suicide-Screening Questions (ASQ) instrument and subsequent suicide-related outcomes., Importance According to National Patient Safety Goal 15.01.01, all individuals being treated or evaluated for behavioral health conditions as their primary reason for care in hospitals and behavioral health care organizations accredited by The Joint Commission should be screened for suicide risk using a validated tool. Existing suicide risk screens have minimal or no high-quality evidence of association with future suicide-related outcomes. Objective To test the association between results of the Ask Suicide-Screening Questions (ASQ) instrument in a pediatric emergency department (ED), implemented through selective and universal screening approaches, and subsequent suicide-related outcomes. Design, Setting, and Participants In this retrospective cohort study at an urban pediatric ED in the United States, the ASQ was administered to youths aged 8 to 18 years with behavioral and psychiatric presenting problems from March 18, 2013, to December 31, 2016 (selective condition), and then to youths aged 10 to 18 years with medical presenting problems (in addition to those aged 8-18 years with behavioral and psychiatric presenting problems) from January 1, 2017, to December 31, 2018 (universal condition). Exposure Positive ASQ screen at baseline ED visit. Main Outcomes and Measures The main outcomes were subsequent ED visits with suicide-related presenting problems (ie, ideation or attempts) based on electronic health records and death by suicide identified through state medical examiner records. Association with suicide-related outcomes was calculated over the entire study period using survival analyses and at 3-month follow-up for both conditions using relative risk. Results The complete sample was 15 003 youths (7044 [47.0%] male; 10 209 [68.0%] black; mean [SD] age, 14.5 [3.1] years at baseline). The follow-up for the selective condition was a mean (SD) of 1133.7 (433.3) days; for the universal condition, it was 366.2 (209.2) days. In the selective condition, there were 275 suicide-related ED visits and 3 deaths by suicide. In the universal condition, there were 118 suicide-related ED visits and no deaths during the follow-up period. Adjusting for demographic characteristics and baseline presenting problem, positive ASQ screens were associated with greater risk of suicide-related outcomes among both the universal sample (hazard ratio, 6.8 [95% CI, 4.2-11.1]) and the selective sample (hazard ratio, 4.8 [95% CI, 3.5-6.5]). Conclusions and Relevance Positive results of both selective and universal screening for suicide risk in pediatric EDs appear to be associated with subsequent suicidal behavior. Screening may be a particularly effective way to detect suicide risk among those who did not present with ideation or attempt. Future studies should examine the impact of screening in combination with other policies and procedures aimed at reducing suicide risk.

OBJECTIVE Critically ill pediatric patients commonly experience opioid-induced dysmotility. Methylnaltrexone, a subcutaneously administered, peripherally acting mu-opioid receptor antagonist, is a compelling adjunct to enteral laxatives in patients with opioid-induced dysmotility. Data for methylnaltrexone use in critically ill pediatric patients are limited. The purpose of this study was to determine the effectiveness and safety of methylnaltrexone for opioid-induced dysmotility in critically ill infants and children. METHODS Patients younger than 18 years who received subcutaneous methylnaltrexone from January 1, 2013, through September 15, 2020, in the pediatric intensive care units at an academic institution were included in this retrospective analysis. Outcomes included incidence of bowel movement, enteral nutrition feeding volume, and adverse drug events. RESULTS Twenty-four patients, median age 3.5 years (IQR, 0.58–11.1), received 72 methylnaltrexone doses. The median dose was 0.15 mg/kg (IQR, 0.15–0.15). Patients were receiving a mean ± SD of 7.5 ± 4.5 mg/kg/day of oral morphine milligram equivalents (MMEs) at methylnaltrexone administration and received opioids for median 13 days (IQR, 8.8–21) prior to methylnaltrexone administration. A bowel movement occurred within 4 hours following 43 (60%) administrations and within 24 hours following 58 (81%) administrations. Enteral nutrition volume increased by 81% (p = 0.002) following administration. Three patients had emesis and 2 received anti-nausea medication. No significant changes in sedation or pain scores were observed. Withdrawal scores and daily oral MMEs decreased following administration (p = 0.008 and p = 0.002, respectively). CONCLUSIONS Methylnaltrexone may be an effective treatment for opioid-induced dysmotility in critically ill pediatric patients with low risk of adverse effects.

OBJECTIVE To determine the optimal empiric dosing regimen to achieve therapeutic serum concentrations of vancomycin and aminoglycosides in pediatric patients who are receiving continuous renal replacement therapy (CRRT). METHODS This retrospective study investigated pediatric patients ( RESULTS Forty-three patients were included in this study. The median dose required to reach therapeutic serum concentrations for vancomycin was 17.6 mg/kg (12.8–20.4 mg/kg) every 12 hours (6–30 hours) in continuous venovenous hemodialysis (CVVHD) patients and 16.3 mg/kg (13.9–21.4 mg/kg) every 12 hours (6–24 hours) in continuous venovenous hemodiafiltration (CVVHDF) patients. The median dose for aminoglycosides was unable to be determined. In CVVHD patients, the median vancomycin ke was 0.04 hr−1, t½ was 18 hours, and Vd was 1.6 L/kg. In CVVHDF patients, the median vancomycin ke was 0.05 hr−1, t½ was 14 hours, and Vd was 0.6 L/kg. No correlation was found between age and weight with regard to effective dosing regimen. CONCLUSIONS To achieve therapeutic trough concentrations in pediatric patients on CRRT, vancomycin should be dosed at approximately 17.5 mg/kg administered every 12 hours.

OBJECTIVE To evaluate the effect of a pharmacist-led discharge counseling service at a pediatric hospital. METHODS This was a prospective observational cohort study. Patients in the pre-implementation phase were identified by the pharmacist at the time of admission medication reconciliation, whereas patients in the pos-timplementation phase were identified at the time of pharmacist discharge medication counselling. Caregivers were contacted within 2 weeks of the patients' discharge date to complete a 7-question telephone survey. The primary objective was to measure the effect of the pharmacist-led service on caregiver satisfaction, using a pre- and post- implementation telephone survey. The secondary objectives were to evaluate the effect of the service on 90-day medication-related readmissions and determine the change in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey response (Question 25) regarding discharge medications following implementation of the new service. RESULTS A total of 32 caregivers were included in both the pre- and post-implementation groups. The most common reason for inclusion was high-risk medications (84%) in the pre-implementation group and device teaching (62.5%) in the post-implementation group. The primary outcome, the average composite score on the telephone survey, was 30.94 ± 3.50 (average ± SD) in the pre-implementation group and 32.5 ± 2.26 in the post-implementation group (p = 0.038). There were no medication-related readmissions within 90 days in either group. The score on HCAHPS Question 25 was not different between groups (p = 0.761). CONCLUSIONS Implementation of a pharmacist-led discharge counseling service in pediatric patients improved caregiver satisfaction and understanding as shown by a postdischarge telephone survey.

This paper addresses the linkages between research and development (R&D) and innovation on the one hand and the socioeconomic impact of research, development and innovation (RDI) on the other hand. More specifically, the paper suggests a two-stage methodology directed to analyse the performance of RDI in business enterprises and assess their development impact. A conceptual four-dimensional model and an integrated analytical framework were developed. This approach is complemented by the development of a statistical survey mainly designed to generate appropriate indicators for analysing the vital role of RDI in business enterprises. The survey results revealed several analytical points as well as specific imbalances of RDI system in business enterprises that need to be addressed by policymakers. Furthermore, the analytical results stress the need for Egyptian business enterprises to enhance and diversify their cooperation with other RDI-producing institutions to benefit from comparative advantages and improve the quality of RDI outputs.

Resumen La investigación tuvo como objetivo establecer si existe diferencia en la actitud relacionada a la ciencia en los estudiantes universitarios de diversos ciclos académicos. Para ello se realizó una investigación no experimental de diseño transversal de tipo descriptivo. La población estuvo constituida por estudiantes de las escuelas de Ciencias Administrativas y Ciencias Contables y Financieras de universidades públicas y privadas de Tacna, durante el año 2022. Para el levantamiento de los datos se usó el Protocolo de actitudes relacionadas con la ciencia. Respecto a los estudiantes de la Escuela de Ciencias Contables y Financieras el análisis de varianzas de Kruskal-Wallis ha podido hallar un p-valor inferior a ,005 (p=,000) lo que indica que al menos dos de los ciclos investigados no son homogéneos con los demás. La misma diferencia entre ciclos se observa en las categorías de enseñanza de la ciencia (p=,000), imagen de la ciencia (p=,000), incidencia social (p=,003) y características de la ciencia (p=,000). Con respecto a la carrera de Ciencias Administrativas la prueba de ANOVA mostró un p-valor superior a ,05 (p=,058), lo cual, permite afirmar que la actitud hacia la ciencia es homogénea en los diferentes ciclos académicos estudiados. Abstract The objective of the research was to establish if there is a difference in the attitude related to science in university students of different academic cycles. For this purpose, non-experimental research of descriptive cross-sectional design was carried out. The population consisted of students of the schools of Administrative Sciences and Accounting and Financial Sciences of public and private universities of Tacna, during the year 2022. For data collection, the Protocol of Attitudes Related to Science was used. With respect to the students of the School of Accounting and Financial Sciences, the Kruskal-Wallis analysis of variance found a p-value of less than .005 (p=.000), which indicates that at least two of the cycles investigated are not homogeneous with the others. The same difference between cycles is observed in the categories of science teaching (p=.000), image of science (p=.000), social incidence (p=.003) and characteristics of science (p=.000). The ANOVA test showed a p-value higher than .05 (p=.058), which allows us to affirm that the attitude towards science is homogeneous in the different academic cycles studied.

In this opinion piece, I reflect on my experiences of being a 'nomad academic', who has in the past five years conducted research in Denmark, Sweden and Japan. I tie those experiences into the most recent report by Elsevier, a Netherlands-based academic publishing company, who have published research focusing on gender and academic trajectories (2021). Their findings posit that researcher mobility is important for career advancement, but it is not women who tend to benefit from this logic. To address the constrictions of female academic mobility, I thus share some 'best case scenario' experiences, in terms of platforms available at the different institutions I have so far worked, that have made it possible for me as a female researcher to make the most of my mobility. I also invite you, kind reader, to think together with me, how Aoyama Gakuin University can become an even more inclusive hub of international research., この意見文書において、過去5年間にデンマーク、スウェーデン、そして日本で研究を行ってきた「ノマド研究者」としての私の経験を振り返る。その経験を、オランダに本拠地を置く学術出版社エルゼビア（Elsevier）がジェンダー及びアカデミックの道筋に焦点を当てた研究を発表した最新の報告書と結びつける（2021）。エルゼビアの調査結果によると、研究者のモビリティはキャリアアップのために重要だが、このロジックの恩恵を受ける傾向があるのは女性ではないという。そこで、女性のアカデミックなモビリティの制約に対処するために、私がこれまでに勤務したさまざまな機関で利用できたプラットフォームという観点から、女性研究者である私がモビリティを最大限に活用することを可能にした「ベストケースシナリオ」の経験をいくつか紹介する。また、青山学院大学がよりインクルーシブな国際研究の拠点となるにはどうすればよいのか、読者の方々も私と一緒に考えていただきたい。

Several major global challenges, including climate change and water scarcity, warrant a scientific approach to generating solutions. Developing high quality and robust capacity in (bio)statistics is key to ensuring sound scientific solutions to these challenges, so collaboration between academic and research institutes should be high on university agendas.To strengthen capacity in the developing world, South-North partnerships should be a priority. The ideas and examples of statistical capacity-building presented in this article are the result of several monthly online discussions between a mixed group of authors having international experience and formal links with Hasselt University in Belgium. The discussion focuses on statistical capacity-building through education (teaching), research, and societal impact. We have adopted an example-based approach, and in view of the background of the authors, the examples refer mainly to biostatistical capacity-building. Although many universities worldwide have already initiated university collaborations for development, we hope and believe that our ideas and concrete examples can serve as inspiration to further strengthen South-North partnerships on statistical capacity-building. We are grateful to the reviewer for the in-depth reading of earlier drafts of this article and for many valuable suggestions. We also acknowledge the support of Kristien Verbrugghen (VLIRUOS director) and Tim Zeuwts (VLIR-UOS staff ) and of Lieve Quanten and Stefanie Kerkhofs (both UHasselt)

OBJECTIVE: To systematically examine the content of opioid-related advertisements. DESIGN: Content analysis and quantitative assessment. SETTING: North America. PARTICIPANTS: Researchers examined advertisements in 2 issues per year from 1996 to 2016 of American Family Physician, Canadian Family Physician, the Canadian Medical Association Journal, JAMA, and the New England Journal of Medicine. MAIN OUTCOME MEASURES: Number of advertisements, nature of the claims made, and quality of cited evidence in the advertisements. RESULTS: Opioid advertisements composed 89 of the 3173 pharmaceutical advertisements in 210 journal issues searched. Seventy-three advertisements were able to be obtained for analysis. Thirty-four (46.6%) did not mention the addictive potential of opioids, and 54 of 73 (74.0%) did not mention the possibility of death. All referenced studies in advertisements were funded by pharmaceutical organizations or had pharmaceutical company employees as authors. No advertisements cited high-quality evidence. CONCLUSION: Many claims of the effectiveness and safety of opioids were published in medical journals through advertisements. Advertisements did not usually mention key negative information about opioids. Although the extent to which these advertisements directly influenced the development of the opioid crisis in North America is unknown, the marked omission of important detrimental effects of opioids may have played a role. Further efforts to restrict opioid marketing may be warranted.

Will Degrowth Save the World: Degrowth & Education

OBJECTIVE: To characterize transitions to acute and residential care and identify variables associated with specific transitions among community-based persons living with dementia (PLWD). DESIGN: Retrospective cohort study using primary care electronic medical record data linked with health administrative data. SETTING: Alberta. PARTICIPANTS: Adults aged 65 years or older living in the community who had been diagnosed with dementia and who saw a Canadian Primary Care Sentinel Surveillance Network contributor between January 1, 2013, and February 28, 2015. MAIN OUTCOME MEASURES: All emergency department visits, hospitalizations, residential care (supportive living and long-term care) admissions, and deaths within a 2-year follow-up period. RESULTS: In total, 576 PLWD were identified who had a mean (SD) age of 80.4 (7.7) years; 55% were female. In 2 years, 423 (73.4%) had at least 1 transition and, of these, 111 (26.2%) had 6 or more. Emergency department visits, including multiple visits, were common (71.4% had ≥1, 12.1% had ≥4). Of those hospitalized (43.8%), nearly all were admitted from the emergency department; the average (SD) length of stay was 23.6 (35.8) days, and 32.9% had at least 1 alternate level of care day. In total, 19.3% entered residential care, most admitted from hospital. Those admitted to hospital and those admitted to residential care were older and had greater historical health system use, including home care. One-quarter of the sample did not have any transitions (or die) during follow-up; they were typically younger and had limited historical health system use. CONCLUSION: Older PLWD experienced frequent, and frequently compound, transitions that have implications for them, their family members, and the health system. There was also a large proportion without transitions suggesting that appropriate supports enable PLWD to do well in their own communities. The identification of PLWD who are at risk of or who make frequent transitions may allow for more proactive implementation of community-based supports and smoother transitions to residential care.

Biobank research may lead to an improved understanding of disease etiology and advance personalized medicine. Denmark (population ~5.9 million) provides a unique setting for population-based health research. The country is a rich source of biobanks and the universal, tax-funded healthcare system delivers routinely collected data to numerous registries and databases. By virtue of the civil registration number (assigned uniquely to all Danish citizens), biological specimens stored in biobanks can be combined with clinical and demographic data from these population-based health registries and databases. In this review, we aim to provide an understanding of advantages and possibilities of biobank research in Denmark. As knowledge about the Danish setting is needed to grasp the full potential, we first introduce the Danish healthcare system, the Civil Registration System, the population-based registries, and the interface with biobanks. We then describe the biobank infrastructures, comprising the Danish National Biobank Initiative, the Bio- and Genome Bank Denmark, and the Danish National Genome Center. Further, we briefly provide an overview of fourteen selected biobanks, including: The Danish Newborn Screening Biobank; The Danish National Birth Cohort; The Danish Twin Registry Biobank; Diet, Cancer and Health; Diet, Cancer and Health - Next generations; Danish Centre for Strategic Research in Type 2 Diabetes; Vejle Diabetes Biobank; The Copenhagen Hospital Biobank; The Copenhagen City Heart Study; The Copenhagen General Population Study; The Danish Cancer Biobank; The Danish Rheumatological Biobank; The Danish Blood Donor Study; and The Danish Pathology Databank. Last, we inform on practical aspects, such as data access, and discuss future implications. Biobank research may lead to an improved understanding of disease etiology and advance personalized medicine. Denmark (population ~5.9 million) provides a unique setting for population-based health research. The country is a rich source of biobanks and the universal, tax-funded healthcare system delivers routinely collected data to numerous registries and databases. By virtue of the civil registration number (assigned uniquely to all Danish citizens), biological specimens stored in biobanks can be combined with clinical and demographic data from these population-based health registries and databases. In this review, we aim to provide an understanding of advantages and possibilities of biobank research in Denmark. As knowledge about the Danish setting is needed to grasp the full potential, we first introduce the Danish healthcare system, the Civil Registration System, the population-based registries, and the interface with biobanks. We then describe the biobank infrastructures, comprising the Danish National Biobank Initiative, the Bio-and Genome Bank Denmark, and the Danish National Genome Center. Further, we briefly provide an overview of fourteen selected biobanks, including: The Danish Newborn Screening Biobank; The Danish National Birth Cohort; The Danish Twin Registry Biobank; Diet, Cancer and Health; Diet, Cancer and Health – Next generations; Danish Centre for Strategic Research in Type 2 Diabetes; Vejle Diabetes Biobank; The Copenhagen Hospital Biobank; The Copenhagen City Heart Study; The Copenhagen General Population Study; The Danish Cancer Biobank; The Danish Rheumatological Biobank; The Danish Blood Donor Study; and The Danish Pathology Databank. Last, we inform on practical aspects, such as data access, and discuss future implications.

Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.

Au tournant des années 2000, des publications scientifiques ont commencé à s’interroger sur les gaz à effet de serre émis par les activités de recherche. Depuis la fin des années 2010, les travaux quantifiant l’« empreinte carbone » de la recherche se sont intensifiés et diversifiés. Plusieurs strates de temporalités distinctes doivent toutefois être identifiées afin de déplier le singulier du terme empreinte carbone. La première est celle qui renvoie à la filiation terminologique entre l’« empreinte environnementale » et l’empreinte carbone. La deuxième situe un processus de quantification carbone entre la fin des années 1990 et le début des années 2000, qui s’inscrit lui-même dans l’histoire longue de la quantification. La troisième strate est l’utilisation de cette catégorie dans de nombreuses publications scientifiques, l’empreinte carbone de la recherche étant une partie d’un ensemble plus vaste. Se dessine alors un espace de commensurabilité scientifique : une fois sous la forme de cet équivalent dioxyde de carbone, des activités, ou des segments d’activités, sont rendus comparables par cette métrique commune. L’enquête de terrain menée dans le cadre d’une thèse de science politique permet de faire entendre la parole de personnels de recherche en France effectuant un travail d’estimation d’empreinte carbone de la recherche. Si ce processus de quantification aux motivations diverses conduit à interroger des pratiques ou des perceptions, ce qui est mis en nombre n’est pas seulement un « coût » de la recherche mais aussi différentes formes de temps de l’activité scientifique. At the turn of the millennium, scientific publications began to wonder about the greenhouse gases emitted by research activities, through the category of “carbon footprint”. Since the end of the 2010s, this quantification has intensified and diversified. However, several distinct layers of temporalities must be identified in order to unfold the singularity of the term carbon footprint. The first refers to the terminological filiation between the “ecological footprint” and the carbon footprint. The second situates the process of carbon quantification between the late 1990s and the early 2000s, which is itself part of the long history of quantification. The third layer is the use of this category in many scientific publications: the carbon footprint of research is part of a larger body of work. A space of scientific commensurability then emerges in the form of the carbon dioxide equivalent: activities, or segments of activities, are made comparable by this common metric. The fieldwork conducted as part of a political science dissertation allows us to hear the diverse motivations of research staff in France who are undertaking this carbon footprint estimation. If this process of quantification questions scientific practices or perceptions, what is quantified is not only a "cost" of research but also the different forms of time on scientific activity.

One of the requirements of the qualification paper is to process data and information, as well as to conduct research in the analytical part, it is mandatory to use various research methods. The aim of the research is to analyse the compliance of the application of research methods with the tasks of the qualification work and the usefulness of the research results to achieve the set goal, as well as to provide recommendations on the application of descriptive and inferential statistics in the development of qualification work.

Este artigo trata da produção intelectual realizada entre a dissertação de mestrado defendida em 1985 no Programa de Pós-Graduação em Comunicação da Escola de Comunicação e Artes da Universidade de São Paulo e a pesquisa mais recente, em desenvolvimento. O objetivo é identificar as marcas deixadas pela formação obtida em nível de pós-graduação, considerando que o doutorado foi realizado no mesmo programa, relacionando-as às pesquisas realizadas durante a trajetória acadêmica. This paper examines the intellectual production developed between the master’s thesis defended in 1985 under the graduate program in Communication in the Art and Communication School at University of São Paulo, and the most recent ongoing research. It seeks to identify the marks left by a graduate academic education, considering that the PhD was developed under the same Program, and relating it to other research performed during the academic path.

OBJECTIVE Sepsis causes morbidity and mortality in pediatric patients, but timely antibiotic administration can improve sepsis outcomes. The pharmacy department can affect the time from order to delivery of antibiotics. By evaluating the pharmacy process, this study aimed to decrease the time from antibiotic order to delivery to within 45 minutes. METHODS All antibiotic orders placed following a positive sepsis screen for acute care patients at a freestanding children's hospital from April 1, 2019, to December 31, 2019, were reviewed. Lean Six Sigma methodology including process mapping was used to identify and implement improvements, including educational interventions for providers. Outcome measures included time from antibiotic order placement to delivery and to administration. Additional assessment of process measures included evaluation of order priority, PowerPlan (an internally created order set) use, and delivery method. RESULTS Ninety-eight antibiotic orders for 85 patients were evaluated. In an individual chart of antibiotic delivery time, a trend towards faster delivery time was observed after interventions. Stat orders (40.5 minutes [IQR, 19.5–48]) were delivered more quickly than routine orders (51 minutes [IQR, 45–65]; p < 0.001). Orders using the PowerPlan (20.5 minutes [IQR, 18.5–38]) were delivered more quickly than those that did not (47 minutes [IQR, 34–64]; p < 0.01). Shorter time to administration was observed with pneumatic tube delivery (41 minutes [IQR, 20–50]) than with direct delivery to a health care provider (51 minutes [IQR, 31–83]; p < 0.05) or to the automated dispensing cabinet's refrigerator (47 minutes [IQR, 41–62]; p < 0.0001). CONCLUSIONS Multifactorial coordinated interventions within the pharmacy department improve medication delivery time for pediatric sepsis antibiotic orders.

OBJECTIVE To evaluate the clinical effect and estimate cost avoidance attributed to a pharmacist-led admission medication reconciliation service at a children's hospital. METHODS This was a prospective observational cohort study that measured pharmacist interventions for pediatric patients over a 90-day period. Pharmacists logged all interventions identified during medication reconciliation in real time. Patient demographic data were collected retrospectively. Cost avoidance from prevented adverse drug events (ADEs) was estimated based on previously published literature. RESULTS Pharmacists completed 283 admission medication reconciliations during the study period. Of those, 69% of medication reconciliations required intervention. Interventions affected care during the hospital admission in 21.9% of patients and 8 medication reconciliations resulted in prevention of a major ADE. This pharmacist-led service resulted in an estimated cost avoidance of $46,746.65 in the 3-month period. CONCLUSIONS Implementation of a pharmacist-led admission medication reconciliation service for pediatric patients improved medication safety and resulted in significant cost avoidance, which justifies investment in these pharmacist resources.

OBJECTIVE Neonatal gentamicin dosing algorithms are not designed to achieve serum trough concentrations ≤1 mcg/mL. The purpose of our study was to evaluate a new gentamicin algorithm based on serum creatinine (SCr) and gestational age (GA) designed to achieve serum gentamicin trough concentrations ≤1 mcg/mL. METHODS A retrospective cohort study was conducted in a level IIIB neonatal intensive care unit. The incidence of elevated serum gentamicin troughs for this study was compared with the center's previously published results to evaluate the proposed dosing algorithm. Patients were included if gentamicin was administered within the first 7 days of life and a serum gentamicin trough concentration and a baseline SCr concentration were obtained. Patients were further subdivided into groups based on GA for data analysis: ≤30 weeks (group 1), 30–34 weeks (group 2), and ≥35 weeks (group 3). The SCr was considered mildly elevated (0.81–0.99 mg/dL) or elevated (≥1 mg/dL). The respective outcomes between the post-algorithm and control groups were examined using intention-to-treat analysis and Bayesian modeling to calculate rate differences. RESULTS Of the 2377 patients evaluated, 366 met the inclusion criteria. Significantly lower percentages of elevated serum gentamicin troughs were noted in groups 2 and 3 subsequent to the implementation of the dosing algorithm with 16% and 15% lower rate differences, respectively. Regardless of GA, there were significantly fewer elevated serum troughs in the post-implementation groups than in the control with mildly elevated and elevated SCr p < 0.001. CONCLUSIONS Using a dosing algorithm based on SCr significantly reduced the number of elevated serum trough rates in neonates with a GA greater than 30 weeks.

OBJECTIVE To evaluate the effects of dietary eicosapentaenoic acid (EPA) in children with atopic dermatitis. METHODS Forty-eight children with atopic dermatitis were randomly allocated to receive either 250 mg twice daily EPA (n = 24) or placebo (n = 24) for 4 weeks. The absolute improvement in the SCORing Atopic Dermatitis (SCORAD) index and the necessity to use topical corticosteroids was evaluated. RESULTS Based on an intention-to-treat analysis, after 2 weeks the scores decreased to 30.50 ± 8.91 and 38.34 ± 10.52 in the EPA and placebo groups, respectively (p = 0.015). Per-protocol analysis showed a decrease in scores to 18.01 ± 10.63 in the EPA group and to 30.11 ± 9.58 in the placebo group (p = 0.001). After 2 weeks, corticosteroid was needed in 11 (50.0%) patients in the EPA group and 14 (58.3%) patients in the placebo group (p = 0.571), and after 4 weeks, it was needed in 7 (33.3%) patients in the EPA group and 14 (63.6%) patients in the placebo group, respectively (p = 0.047). CONCLUSIONS Our results show significant favorable effects of EPA on the SCORAD scale and with regard to the necessity for corticosteroid readministration. Few adverse effects were reported in the 2 groups. We conclude that EPA supplementation is a well-tolerated and effective add-on strategy for reducing the severity of atopic dermatitis in children.

OBJECTIVE The primary objective was to evaluate the effect of parenteral potassium chloride (KCl) supplementation on potassium (K+) concentrations in a non-cardiac pediatric population. Secondary outcomes were to identify variables that may influence response to KCl supplementation (i.e., change in K+ concentration after KCl administration) and assess the incidence of hyperkalemia. METHODS This single-center, retrospective study evaluated infants and children who received parenteral KCl supplementation of 0.5 or 1 mEq/kg between January 2017 and December 2019. RESULTS The study included 102 patients with a median age of 1 year (IQR, 0.4–3.9) and weight of 9.1 kg (IQR, 4.9–14.2) who received 288 parenteral KCl administrations. One hundred seventy-three administrations were in the 1 mEq/kg group, and 115 administrations were in the 0.5 mEq/kg group. The median changes in K+ were 0.8 and 0.5 mEq/L in the 1 mEq/kg and 0.5 mEq/kg groups, respectively. Patients who had a repeat K+ concentration within 4 hours of the end of a 1 to 2–hour infusion had a higher median change in K+ compared with those who had a concentration drawn after this time frame (0.8 vs 0.6 mEq/L; p < 0.01). CONCLUSIONS There is a paucity of data on the correlation between parenteral KCl supplementation and change in K+ concentrations in pediatric patients. Our study demonstrated an association between KCl supplementation doses of 1 and 0.5 mEq/kg and changes in K+ of 0.8 and 0.5 mEq/L, respectively, in non-cardiac pediatric patients, with low observed incidence of hyperkalemia.

OBJECTIVE Acetaminophen is a commonly administered analgesic and antipyretic medication that is generally well-tolerated. Recent studies in critically ill adults and subsets of pediatric patients with underlying cardiac disease identify an association between adverse hemodynamic effects with intravenous (IV) acetaminophen. However, the data may not be generalizable to a broader population of critically ill children. The objective of this study was to determine the incidence of hemodynamic changes associated with IV acetaminophen administration in critically ill pediatric medical-surgical patients. METHODS This was a retrospective observational study of all patients 18 years of age and younger who received at least 1 dose of IV acetaminophen in a pediatric intensive care unit at a quaternary care medical center, between July and December 2018. The primary outcome was the incidence of hypotension, defined as a decrease in mean arterial pressure (MAP) by at least 15% from baseline. Potential risk factors for IV acetaminophen-associated hypotension were assessed. RESULTS A total of 212 patients received 492 doses of IV acetaminophen. The primary endpoint of hypotension occurred following 24% of doses. An intervention for hypotension, primarily fluid resuscitation, was required for 11.9% of the dose-associated hypotension events. Patients receiving vasoactive infusions had more frequent dose-associated hypotension events than those not receiving infusions; however, no other potential risk factors were identified. CONCLUSIONS The incidence of hypotension observed in critically ill pediatric patients after IV acetaminophen administration is clinically relevant. Large placebo-controlled trial and further study of the risk factors and mechanism of this hemodynamic change are warranted.

Prior research in management and economics has predominantly focused on how managers or policymakers can shape workers’ allocation of effort using output-based or effort-based incentives. In many settings, however, managers may seek to influence workers’ effort choices through resource allocation—that is, changing the cost of securing resources for different projects or activities. In this paper, we develop a formal model to investigate how a worker changes the allocation of a fixed amount of effort across different projects in response to changes in the cost of securing resources for each project. Our model shows how cutting resources available to one project, under certain circumstances, can inadvertently reduce the share of effort allocated to other projects and vice versa. We use the insights from the model to explore the effectiveness of funding strategies designed to influence the research direction of academic scientists. We specifically examine how U.S. scientists working in stem cell research responded to a 2001 policy change that restricted access to federal funding for research in the human embryonic stem cell (hESC) area. In line with our model’s predictions, we find that cutting resources for hESC research inadvertently reduced U.S. scientists’ output in non-hESC areas of stem cell research—an effect that is strongest among the highest-ability scientists. Our findings highlight the complexities of incentivizing effort allocation using resource-based incentives. In particular, we show how altering resource-based incentives in one area can have unforeseen spillover effects on effort allocation in other areas. Funding: Financial support from the London Business School is gratefully acknowledged. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2021.1565 .

Background: Coronavirus disease (COVID-19) infection during pregnancy could damage the placenta, but data on neonates born to COVID-19-positive mothers is scarce. In this case series, we aim to describe clinical characteristics, transmission rate and outcomes at 3 months of age among neonates born to mothers with COVID-19 diagnosed near the time of delivery. Methods: Prospective, multicenter case series from Suriname. We collected clinical data of neonates born to mothers with COVID-19 infection between June and August 2021. COVID-19 swabs were taken within 5 days and 2 weeks after birth. Follow-up took place at 3 months. Results: We enrolled 18 neonates. However, 18/18 (100%) mothers were infected in the third trimester and 10/18 (55.6%) had severe COVID-19 infection requiring ICU admission and 2/10 (20%) died. In total 16/18 (77.8%) neonates were born after cesarean section and 13/18 (72.2%) were born preterm (median 35 weeks, Interquartile range 32 + 4-38 + 0). Neonatal intensive care unit admission was needed in 7/18 (38.9%) neonates. Respiratory symptoms occurred in 12/18 (66.7%), 5/18 (27.8%) were suspected of early-onset sepsis and 1/18(5.6%) of late-onset sepsis. One preterm neonate developed necrotizing enterocolitis. A nasopharyngeal swab was positive in 1/18 (5.5%) neonates within 5 days of life and in 0/11 (0%) neonates after 2 weeks. Follow-up showed mild neurodevelopmental delay in 2/14 (14.3%) patients. Conclusion: We describe a high proportion of severely ill mothers due to COVID-19 infection with subsequent cesarean delivery and prematurity. Accounting for gestational age at birth, the neonatal clinical course and findings at follow-up appeared similar to neonates born to COVID-19-negative mothers. Maternal vaccination is recommended to prevent neonatal risks associated with prematurity and cesarean delivery.

BACKGROUND: Multiple sclerosis (MS), which is frequently seen in young adults, affects mental health because of disease symptoms and cognitive disorders. This study was conducted to evaluate the presence of alexithymia and problem- or emotion-focused coping strategies with stress in MS patients, determine the relationship between these variables, and compare the results of MS patients with those of healthy individuals. METHODS: This descriptive, cross-sectional, and comparative study was carried out with the participation of 120 MS patients presenting to a neurology clinic and outpatient clinic of a university hospital and 120 healthy individuals. Data were collected using a personal information form, the Toronto Alexithymia Scale, and the Ways of Coping Scale. RESULTS: The 40.8% rate of alexithymia in the MS patients was higher than that in the healthy individuals (21.7%). Compared with healthy individuals, MS patients use emotion-focused coping methods, such as a lack of self-confidence approach and a submissive approach, more frequently (P < .05). A significant negative correlation was found between the alexithymia and problem-focused coping strategies of MS patients (P < .01). CONCLUSION: Alexithymia is more common in MS patients than in healthy individuals. Alexithymia negatively affects the methods patients use to cope with stress. In the treatment and care of MS patients, nurses should plan interventions for the ability of these patients to recognize and express their emotions and develop positive coping methods.

The 7th Sibelius Academy Research Days event was organized for the seventh time at the Black Box of the Helsinki Music Building on March 8–9, 2022. The program included paper presentations and lecture concerts by Sibelius Academy doctoral students, keynote lectures and presentations, and a guest lecture on grant writing and research funding., The 7th Sibelius Academy Research Days event was organized at the Black Box of the Helsinki Music Building on March 8–9, 2022. The program included paper presentations and lecture concerts by Sibelius Academy doctoral students, keynote lectures and presentations, and a guest lecture on grant writing and research funding.

本論では、大学における卒業研究について、文系の学問領域に焦点を当てて、いかなる研究指導が求められるかを論じることが目的とする。 そこで、第1章では、心理学という学問において研究とその指導について論じる。そこでは、心理学研究の活性化、研究のサイクルの循環、個人と心理学という学問の接点を論じ、研究指導の課題を論じる。第2章では、言語学という学問を背景に、工学部において卒業研究という研究指導の課題を論じる。特に、研究をまとめていく中での最終成果となる論文化する中での、読むことと書くことに着目して、指導の留意点について論じる。そして、人文系の学問における研究指導をする中で、学校教育での最終地点である、卒業研究を学びの最終地点に相応しいものに近づけていき、よりよきものとするための課題を論じていく。, This paper discusses how a research seminar for liberal arts should be. In section 2, Kazuhito Ozawa discusses revitalization of psychological research and the interface between the individual and research. Students should be trained in the methodology of psychology. Teachers aim to provide guidance that will help students grow through their studies. In section 3, Yuka Shigemitsu reports an instructing method for the Seminar. The seminar emphasizes reading and writing style for academic purposes. She states that the students should acquire the pattern of academic paper and should be accustomed to writing the academic paper on their own.

Phenylketonuria (PKU) is the most prevalent inborn error of amino acid metabolism, necessitating patients to strictly restrict dietary phenylalanine. As this can be a confusing and concerning diagnosis, patients and loved ones will likely be drawn to learn more. A critical factor for citizens to harness the health-related digital information is to ensure that it is easy to read. This study assessed the readability of 100 digital articles related to PKU and explored the effect of the source of online information on the readability of these articles. For each article, 5 readability tests were conducted using on-line readability software. From the 100 assessed websites, 34% were commercially sourced. Of the remaining 66 sites, 40% had.org and 17% had.gov extensions. All 5 tests confirm that a large majority of the sample was written at an unacceptable reading level. In fact, over two-thirds of the sample received a readability score within the difficult range for three of the tests, while the remaining two deemed 49% and 45% of the sample as difficult to read, respectively. Commercially sourced websites were deemed to be more difficult to read than the other sites with respect to the two of the five measures. Despite the large amount of PKU information online, most of it may be incomprehensible to the average person and thus miss the mark in helping patients and caregivers manage their condition. Opportunities exist for authors of digital health promotional information to effectively achieve their goal by using comprehensible, easy-to-read language.

IntroductionPrimary cam morphology is highly prevalent in many athlete populations, causing debilitating hip osteoarthritis in some. Existing research is mired in confusion partly because stakeholders have not agreed on key primary cam morphology elements or a prioritised research agenda. We aimed to inform a more rigorous, inclusive and evidence-based approach to research on primary cam morphology and its natural history by working towards agreement on a set of research priorities for conditions affecting the young person’s hip.MethodsAn international expert panel—the Young Athlete’s Hip Research (YAHiR) Collaborative—rated research priority statements through an online two-round Delphi exercise and met online to explore areas of tension and dissent. Panellists ranked the prioritised research statements according to the Essential National Health Research (ENHR) ranking strategy. Reporting of results followed REPRISE (REporting guideline for PRIority SEtting of health).ResultsA diverse Delphi panel (n=65, Delphi rounds 1 and 2; three ENHR strategy surveys: n=49; n=44; n=42) from 18 countries representing six stakeholder groups, prioritised and ranked 18 of 38 research priority statements. The prioritised statements outlined seven research domains: (1) best practice physiotherapy, (2) rehabilitation progression and return to sport, (3) exercise intervention and load management, (4) primary cam morphology prognosis and aetiology, (5) femoroacetabular impingement syndrome prognosis and aetiology, (6) diagnostic criteria, and (7) screening. The panel recommended areas of tension and dissent for the research community to focus on immediately.ConclusionWhile informing more rigorous, inclusive and evidence-based research, this consensus is a roadmap for researchers, policy-makers and funders to implement research dedicated to reducing the cost and burden of hip disease related to primary cam morphology.

RESUMO A pandemia da Covid-19 é um exemplo poderoso do modo como os nossos direitos são reconfigurados e, em especial, os direitos das crianças. Mobilizadas pela exigência de assegurar que, no contexto de crise pandémica, as vozes das crianças não ficassem invisíveis, foram desenvolvidas algumas estratégias de investigação que assumiram um caráter inovador, dadas as contingências decorrentes da situação de confinamento. Este texto visou à reflexão sobre os desafios éticos e metodológicos na pesquisa com crianças, atendendo ao quadro de pandemia e confinamento, repensando estratégias e o processo de construção de conhecimento com estas e acerca das suas vidas. ABSTRACT The Covid-19 pandemic is a powerful example of how our rights and, in particular, children’s rights are reconfigured. In order to ensure that, in a pandemic context, children’s voices were not kept invisible, we developed some research strategies, which assumed an innovative character, given the contingencies resulting from the lockdown situation. This text aimed to reflect on the ethical and methodological challenges in research with children, taking into account the pandemic and confinement, rethinking strategies and the process of building knowledge with them and about their lives.

Au cœur de la Stratégie nationale de recherche (SNR) lancée en 2014, les discours sur l’exploration apparaissent comme une ressource symbolique importante pour la légitimation des politiques publiques de la recherche. L’objectif de cette contribution est d’analyser les stratégies de communication des institutions au regard des enjeux idéologiques entourant la notion d’exploration. En analysant dans un premier temps quatre communications produites au moment de la mise en place de la SNR et du quatrième Programme d’investissements d’avenir, nous cherchons à dégager ce qui, dans la communication publique, se rapporte à un référentiel de l’exploration. Puis, il s’agira de dresser une cartographie des acteurs institutionnels en fonction de leur positionnement communicationnel vis-à-vis de l’exploration, en mettant en évidence que ceux-ci s’appuient sur une réactualisation de l’idéologie du progrès. At the heart of the National research strategy (SNR) launched in 2014 in France, speeches on exploration seem to be important symbolic resources for the science public policies legitimation. The aim of this article is to analyze the communication strategies of institutions in view of the ideological concerns surrounding the notion of exploration. First, by analyzing four communications produced at the launch of the SNR and the fourth “Programme d’investissements d’avenir”, this contribution intends to highlight what, in the public communication, can be related to a cognitive framework of exploration. Then, it will be about mapping the institutional actors according to their communicative positioning towards exploration, highlighting that they rely on an updated ideology of progress.

Pour conserver leur statut sur les réseaux sociaux numériques, les influenceuses « beauté » orientent principalement leur activité vers le maintien et l’accroissement de leur prestige en ligne. S’inscrivant dans le cadre de la sociologie configurationnelle de Norbert Elias, l’étude précise la manière dont elles construisent ce prestige au sein d’une configuration particulière : le réseau social Instagram. Il s’agit de comprendre comment les enquêtées gèrent leur exposition corporelle et esthétique. Loin d’une diffusion unilatérale des normes de beauté qu’elles tentent et espèrent incarner, les influenceuses sont soumises à des contraintes normatives fortes liées à leur position au cœur de multiples interdépendances avec les marques, leurs abonnés, leur agence, la plateforme ciblée par l’enquête ici, mais aussi avec leurs homologues sur les réseaux sociaux. In order to maintain their status on digital social networks, beauty influencers mainly orient their activity towards maintaining and increasing their online prestige. In line with Norbert Elias' configurational sociology, our study describes how they build this prestige within a particular configuration: the social network Instagram. The aim is to understand how the respondents manage their exposure in terms of aesthetics and appearance. Far from a unilateral diffusion of the beauty norms they embody, the female influencers are shackled by strong normative constraints linked to their position at the heart of multiple interdependencies with brands, their followers, their agency, the platform targeted by the survey here, and their peers.

OBJECTIVE: To determine factors associated with having a focused practice among a sample of family medicine graduates in Canada and to assess the characteristics of FPs with focused practices and the range of services provided by these FPs in relation to the full scope of office-based care. DESIGN: Secondary analyses of cross-sectional data from the 2013-2014 Western Family Medicine Resident Follow-Up Survey. SETTING: Western University in London, Ont. PARTICIPANTS: Western University family medicine residency graduates who completed the program between 1985 and 2012. MAIN OUTCOME MEASURES: Physician and practice characteristics and the clinical services that survey participants provide. RESULTS: Completion of postgraduate third-year (PGY3) training was associated with having a focused practice. Focused practice FPs were more likely to be remunerated by fee-for-service, alternative payment plans, or alternative funding plans compared with non–focused practice FPs, who were more likely to participate in group payment models. Focused practice FPs appeared to be a heterogeneous group who were distinguished by being either an office-based focused practice FP (OBFFP) or a non–office-based focused practice FP (NOBFFP). Office-based focused practice FPs were less likely than NOBFFPs to have completed PGY3 training and more likely to work under a fee-for-service or group payment model. Further, the OBFFP group offered a greater variety of primary care services than the NOBFFP group, but offered less variety than non–focused practice FPs. CONCLUSION: Completion of PGY3 training and payment through certain remuneration models were both associated with focused practice. Important differences exist between OBFFPs and NOBFFPs. The overall service provision of focused practice FPs was centred on specialized areas, especially among those practising in non–office-based settings. Novel findings from this study provide insights for family medicine education, work force planning, and policy making in the Canadian health system.

Depuis quelques années, la fréquentation juvénile des espaces communicationnels en ligne s’accompagne de vérifications de présence toujours plus diversifiées et intrusives, telles que l’heure de la dernière connexion, l’ouverture ou non d’un contenu ou le fait d’être en train de rédiger une réponse. La SnapMap, issue de l’application Snapchat, s’impose aujourd’hui comme une illustration significative de cette logique de surveillance, en permettant aux jeunes d’afficher en temps réel leur position géographique. Cette contribution empirique, qui s’appuie sur une méthodologie qualitative (27 entretiens semi-directifs), rend compte des appropriations, détournements et enjeux de ce dispositif sociotechnique particulièrement bavard sur la présence et l’activité, en ligne comme hors ligne, des pairs adolescents. Il ressort que si elle peut être utilisée par simple curiosité ou servir des stratégies de regroupement ou d’évitement, la SnapMap reste surtout un révélateur de vérité dans le cas de fortes amitiés ou de relations sentimentales. Elle apparaît aussi comme un espace résolument codifié : la déconnexion volontaire à l’outil entraîne la nécessité d’une justification et le manque de maîtrise dans le partage de sa localisation y est socialement sanctionné. For the past few years, young people's use of online communication spaces has been accompanied by increasingly diversified and intrusive presence checks, such as the time of the last connection, whether or not a piece of content has been opened, or whether or not a reply is being written. The SnapMap, a product of the Snapchat application, is today the most obvious illustration of this surveillance logic, allowing young people to display their geographical position in real time. This empirical contribution, which is based on a qualitative methodology (27 semi-directive interviews), takes into account the appropriations, detour and stakes of this particularly chatty socio-technical device on the presence and activity, both online and offline, of adolescent peers. It emerges that if it can be used out of simple curiosity or to serve grouping or avoidance strategies, the SnapMap remains above all a revelation of truth in the case of strong friendships or sentimental relationships. It also appears to be a deeply codified space: voluntary disconnection from the tool leads to the need for a justification and the lack of control in sharing one's location is socially sanctioned.

OBJECTIVE: To investigate abdominal aortic aneurysm (AAA) screening rates in the 6 months before and after the introduction of updated Canadian Task Force on Preventive Health Care (CTFPHC) guidelines to determine effects on practice patterns, as well as to determine whether certain patient characteristics impact AAA screening rates. DESIGN: Retrospective chart review. SETTING: Academic family health centre in London, Ont. PARTICIPANTS: Male patients between the ages of 65 and 80. MAIN OUTCOME MEASURES: Screening rates for AAA before and after the guideline update were compared using the normal approximation of the binomial distribution. Analysis of demographic characteristic effects on screening rates was completed with the Fisher exact test. Number of visits to the clinic with a primary care provider within the study period and imaging type were collected. RESULTS: Of the 266 patients included in the study, 160 patients were eligible for screening at the start of the study period, 6 months before publication of the CTFPHC AAA guideline. Individuals eligible for screening visited the clinic an average (SD) of 2.44 (1.82) times in the 6 months before and 2.66 (1.99) times in the 6 months after. Overall, 69 individuals had AAA screening completed and 9 had a discussion of AAA screening without any imaging, for a total uptake rate of 88.5% for those who had screening recommended. The overall imaging rate was 48.9%. There was no statistically significant difference in screening rates between the time periods (P=.337) among those eligible for screening. For demographic characteristics for risk stratification, 7 individuals had a documented family history, of whom 5 had imaging of their abdominal aorta performed, plus 1 additional individual who had screening recommended but not completed. This was not statistically significant relative to the total population (P=.0598). Positive smoking status (active or ex-smoker) was more common, with 135 individuals having a relevant smoking history. Approximately half of these current and former smokers (68 individuals [50.4%]) had any sort of abdominal aortic imaging performed or recommended, which was not statistically significantly different compared with non-smokers (62 of 126 imaging performed or recommended, 49.2%; P=.9016). CONCLUSION: Screening practices did not change appreciably with the introduction of the CTFPHC AAA screening guidelines. Further research is needed to improve AAA screening rates. It is worth exploring electronic medical record–based reminders, nursing staff involvement in screening, screening programs via public health, and point-of-care ultrasound screening in a primary care setting.

Hearing loss has been identified as a potential major modifiable risk factor for developing dementia. This study examined associations between formal behavioural pure-tone and speech audiometry assessed by an audiologist with development of dementia in the Mayo Clinic Study of Aging (MCSA).The MCSA is a prospective population-based study examining the incidence, prevalence, and risk factors of mild cognitive impairment and dementia in Olmsted County, Minnesota, USA. Participants undergo clinical examinations with neuropsychological testing at enrolment and every 15 months. Participants were 50 years or older at enrolment between Nov 29, 2004, and Dec 23, 2019, who underwent formal behavioural audiometric evaluation by an audiologist due to concerns about hearing loss or as a part of annual comprehensive health assessments. Associations of pure-tone average (PTA) and word recognition scores (WRS) with the development of dementia were evaluated using Cox proportional hazards regression with age as the timescale, and associations with changes in cognitive testing scores over time were evaluated using linear mixed-effects models.Among 1200 eligible participants, the mean age at enrolment was 79 years (SD 9), 593 (49%) were men, and 207 developed dementia during a mean of 7·0 years (SD 3·7) of follow-up. After adjusting for sex, years of education, smoking status, diabetes, hypertension, apolipoprotein E ε4 carriership, and hearing rehabilitation (defined as hearing aid or cochlear implant use), neither PTA (hazard ratio [HR] per 10-decibels hearing level increase of 0·99 (95% CI 0·89-1·12; p=0·91) nor WRS (HR per 10% decrease of 0·98, 95% CI 0·89-1 ·07; p=0·65) was significantly associated with the development of dementia. However, both PTA and WRS were significantly associated with poorer performance in cognitive testing over time: participants with a PTA higher than 25 decibels hearing level or a WRS lower than 100% had significantly worse declines in cognitive testing scores. Informant-based hearing difficulties assessed by the participant's study partner were significantly associated with the development of dementia (HR 1·95, 95% CI 1·45-2·62; p0·0001).In this prospective population-based study, subjective informant-based hearing difficulties were associated with development of dementia, whereas objective measures on formal behavioural audiometry were predictive of poorer performance on cognitive testing over time but not the development of dementia. Other factors related to central processing might potentiate the effects of peripheral hearing loss detected on behavioural audiometric testing.National Institute of Health, the Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic, the GHR Foundation, the Mayo Foundation for Medical Education and Research, the Liston Award, the Schuler Foundation, the Rochester Epidemiology Project medical records linkage system, and the National Institute on Aging.

The escalating threat of antibiotic-resistant pathogens resulting from the rapid emergence of antimicrobial resistance (AMR) is a significant health and economic concern worldwide, exacerbated by the misuse of antibiotics in both humans and livestock. This has led to critical challenges when treating infections by multi-drug resistant (MDR) pathogens, which often display high mortality and morbidity rates. An international action plan and multisectoral cooperative approach are therefore needed to combat and halt AMR dissemination. Critical to these efforts are enhanced research programs aimed at identifying new antimicrobial agents, as well as the use of advanced biotechnology tools to develop alternative antimicrobial approaches. Bacteriophages (phages)-viruses that infect and kill bacteria-represent a promising tool for combatting the global threat of antibiotic-resistant pathogens. Phages and their potential applications have been extensively studied in Europe and the United States (US) for decades. However, although health authorities in the Gulf Health Council (GHC), including Saudi Arabia, have developed an action plan to combat AMR, phage research in the Middle East has lagged behind global scientific efforts. Thus, there is still a paucity of phage-related studies in this region, including those focused on therapeutic applications, clinical trials, biotechnology, and biocontrol. This article highlights the importance of bacteriophage research and development and discusses the potential implementation of phage-based therapies in Saudi Arabia.