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Physical function (PF) limitations are common in aging. However, there is a dearth of interventions focused on addressing PF limitations in community-based settings, particularly in minoritized communities. To guide intervention development, we conducted focus groups to understand perceptions of PF limitations, gauge intervention interest, and identify potential intervention strategies as part of a large health partnership of African American churches in Chicago, IL. Participants were age 40+ years with self-reported PF limitations. Focus groups (N=6 focus groups; N=40 participants) were audio recorded, transcribed, and analyzed using thematic analysis methods.

Background: The COVID-19 pandemic has highlighted and exacerbated health inequities, as demonstrated by the disproportionate rates of infection, hospitalization, and death in marginalized racial and ethnic communities. Although non-English speaking (NES) patients have substantially higher rates of COVID-19 positivity than other groups, research has not yet examined primary language, as determined by the use of interpreter services, and hospital outcomes for patients with COVID-19. Methods: Data were collected from 1,770 patients with COVID-19 admitted to an urban academic health medical center in the Chicago, Illinois area from March 2020 to April 2021. Patients were categorized as non-Hispanic White, non-Hispanic Black, NES Hispanic, and English-speaking (ES) Hispanic using NES as a proxy for English language proficiency. Multivariable logistic regression was used to compare the predicted probability for each outcome (i.e., ICU admission, intubation, and in-hospital death) by race/ethnicity. Results: After adjusting for possible confounders, NES Hispanic patients had the highest predicted probability of ICU admission (p-value < 0.05). Regarding intubation and in-hospital death, NES Hispanic patients had the highest probability, although statistical significance was inconclusive, compared to White, Black, and ES Hispanic patients. Conclusions: Race and ethnicity, socioeconomic status, and language have demonstrated disparities in health outcomes. This study provides evidence for heterogeneity within the Hispanic population based on language proficiency that may potentially further contribute to disparities in COVID-19-related health outcomes within marginalized communities.

The author discusses the political implications of the persecution of the minority Muslim Uyghur population by the Chinese government. Topics explored include the investigation into the Uyghur genocide conducted by a group of human rights specialists and lawyers in London, England, the crimes against humanity allegedly committed by the Chinese government according to the investigation, and the possible reasons behind the lack of response from the United Nations (UN) on the issue.

Background: Older Black adults face a disproportionate burden of HIV prevalence, but less is known about racial disparities in age-related outcomes in HIV. We assessed the effect of HIV status and race on motor and pulmonary function, as well as how they contribute to mobility disability. Setting: Community-based study; Chicago, IL Methods: Participants were 363 community-dwelling adults age ≥ 50 years, 48% living with HIV, and 68% Black. Participants with HIV were recruited from a specialty HIV clinic, and participants without HIV (comparable on key demographic, lifestyle, and behavioral characteristics) were recruited from the community. Measures included motor function summarized by 10 motor performance measures, pulmonary function summarized by 3 measures assessed using handheld spirometry, and self-reported mobility disability. Results: In fully adjusted linear models, HIV was associated with better motor (β= 9.35, p< 0.001) and pulmonary function (β= 16.34, p< 0.001). For pulmonary function, the effect of HIV status was moderated by race (interaction between Black race and HIV status: β=  − 11.66, p= 0.02), indicating that better pulmonary function among participants with HIV was less evident among Black participants. In fully adjusted models, odds of mobility disability did not differ by race, HIV status, or pulmonary function; better motor function was associated with lower odds of mobility disability (OR = 0.91 per 1-point higher, 95% CI 0.88–0.93). Conclusion: Better motor and pulmonary function exhibited by participants with HIV could reflect access to medical care. Racial differences in lung function among participants with HIV indicate potential disparities in prevention or treatment of pulmonary disease or underlying risk factors.

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•Summarization of the most recent TPS applied studies with focus on rates of atypical diagnosis.•An overview of current clinical triage of urothelial carcinoma and role of urine cytology.•A review of performance of TPS in Upper Tract disease in most recent, post TPS studies.•Poignant summary of problematic areas of high grade urothelial carcinoma especially of the upper tract in this post TPS era.•Updates and succinct summaries of important ancillary tests that can be done on voided urine.•Photomicrographs illustrating difficulty with N:C ratios and rare variant morphology of HGUC.•An overview of AI and AIML in the arena of urine cytology.

Background Conferences are a widespread method of research dissemination; however, their impact on practice is not well understood empirically. We aimed to investigate how conference participation influences clinical and research practice in the stroke field and to explore which presentation formats are most impactful. Methods Clinicians, researchers and doctoral students who attended a multidisciplinary stroke conference were invited to participate. Surveys were administered at the conference and 3 months later. Both surveys contained questions about how respondents remember and apply information learnt at conferences in their clinical and/or research practice. Results Baseline survey responses from 120 conference participants were analysed (80.8% female, 69.0% clinicians, 60.8% aged 31–50 years), and 53 participants completed the follow-up survey. Of the 87 clinician respondents, 73 (83.9%) reported that their clinical practice had changed as a result of attending conferences. Workshops incorporating skill demonstrations were rated most useful for changing clinical practice, whereas oral presentations detailing methodology were more influential on research practice. Attending conferences was rated more impactful on clinical practice than reading journal articles or textbooks. Conclusion Conference presentations can be a useful method for disseminating research findings to influence clinical practice and should be considered by researchers to maximise the translation and impact of their work.

Short sleep duration and poor sleep quality are more prevalent among African Americans (AAs) and may be a modifiable risk factor for cardiometabolic disorders. However, research is limited about sleep-related attitudes, beliefs, and practices among AAs. Our objective was to evaluate these practices and beliefs surrounding sleep among urban-dwelling AAs.

To identify factors associated with receiving acute goal‐directed treatment, being assessed for ongoing rehabilitation, and receiving post‐acute rehabilitation after having a stroke. Retrospective analysis of National Stroke Audit data for patients with acute stroke treated at Australian hospitals during 1 September 2014 – 28 February 2015. 112 Australian hospitals that admit adults with acute stroke. Associations between patient‐related and organisational factors and the provision of rehabilitation interventions. Data for 3462 patients were eligible for analysis; their median age was 74 years, 1962 (57%) were men, and 2470 (71%) had received care in a stroke unit. 2505 patients (72%) received goal‐directed treatment during their acute admission; it was not provided to 364 patients (10.5%) who were responsive, had not fully recovered, and did not refuse treatment. Factors associated with higher odds of receiving goal‐directed treatment included goal‐setting with the patient and their family (odds ratio [OR], 6.75; 95% CI, 5.07–8.90) and receiving care in a stroke unit (OR, 2.08; 95% CI, 1.61–2.70). 1358 patients (39%) underwent further rehabilitation after discharge from acute care; factors associated with receiving post‐acute rehabilitation included care in a stroke unit (OR, 1.73; 95% CI, 1.34–2.22) and having an arm or speech deficit. Dementia was associated with lower odds of receiving acute goal‐directed treatment (OR, 0.49; 95%, 0.33–0.73) and post‐acute rehabilitation (OR, 0.43; 95%, 0.30–0.61). Access to stroke units and to early and ongoing rehabilitation for patients after stroke can be improved in Australia, both to optimise outcomes and to reduce the burden of care on underresourced community and primary care providers.

The article discusses about protests in China against the zero covid policy of the Chinese government. Topics discussed include China's violent suppression of Hong Kongers's freedoms, vaccinate its population with mRNA vaccines and cracks in the country's internet firewall and technological ingenuity of the protestors.

The article offers information on the services for teenagers in libraries and provides suggestions for librarians to interact with them. Topics discussed include the need to show respect and relatedness to teenagers, the need incorporate open communication atmosphere, and the need to evaluate the feedback provided by them.

BackgroundSubstantial disparities in life expectancy exist between Chicago’s 77 defined community areas, ranging from approximately 69 to 85 years. Prior work in New York City and Boston has shown that community-level racial and economic segregation as measured by the Index of Concentration at the Extremes (ICE) is strongly related to premature mortality. This novel metric allows for the joint assessment of area-based income and racial polarisation. This study aimed to assess the relationships between racial and economic segregation and economic hardship with premature mortality in Chicago.MethodsAnnual age-adjusted premature mortality rates (deaths <65 years) from 2011 to 2015 were calculated for Chicago’s 77 community areas. ICE measures for household income (

In southeastern Colorado, bedrock ground stone (BGS) features, also called bedrock metates or mortars, are a well-recognized part of the archaeological record. Although sometimes documented or recorded, they are rarely studied. However, elsewhere BGS are considered an important aspect of subsistence strategies, landscape adaptation, and symbolic ideology. A critical examination of any aspect of material culture begins with an unbiased description, and subsequent development of methods to scientifically examine the phenomena. This paper offers a methodology for recording BGS features to encourage reporting in the region. Results underscore the importance of developing accurate feature planviews, but also illustrate that minimal metric data (length, width, and depth) offer insight into how the landscape was inhabited by ancient peoples.

Bedrock ground stone features, found throughout the world, are particularly concentrated in the canyons of the Southern Plains of North America. Morphological analysis offers powerful tools for developing descriptions of bedrock ground stone (BGS) which can be used to discuss how prehistoric landscapes were inhabited. Metric representations of morphological variation can be used to test hypotheses about the nature of BGS features, which are often difficult to investigate and analyze. This paper presents a morphological approach to describe and analyze BGS surfaces in a side canyon of southeastern Colorado which can be applied by researchers to datasets in other regions. Results indicate that while variation exists, the BGS design (as determined by shape and size) are similar across the side canyon supporting the hypothesis that the canyon was occupied by a group of closely related people through time; although not all sites were used in the same manner.

It is of critical importance that findings from the wealth of clinical physical therapist research are transferred into clinical practice without unnecessary delays. There is a lack of knowledge about strategies that can be used to effectively implement physical therapist research findings and evidence-based practice (EBP) into everyday clinical practice in different national settings and contexts. The purpose of this article is to contribute to knowledge about effective strategies for implementing EBP that have been studied in different national physical therapy settings. The specific aims of this article are to share experiences and provide a current multinational perspective on different approaches and strategies for implementing EBP and to highlight important considerations and implications for both research and practice. Six research studies from various settings in 3 countries are described and synthesized. Key characteristics of the studies and intervention components are tabulated and mapped to the Cochrane Effective Practice and Organisation of Care taxonomy. Commonalities and differences are presented. The implementation strategies described were: a theory-based guideline implementation tailored to identified barriers and facilitators; a multifaceted EBP training package; journal clubs; a multifaceted strategy comprising contextualized procedures, protocols, and standardized resources; barrier identification, education, audit, feedback, and reminders; and contextualized guidelines. Commonalities were the use of a multifaceted approach, educational measures, and clinical guidelines. Key outcomes across the studies were improved attitudes and increased awareness, knowledge, skills, and confidence in EBP; better access to clinical practice guidelines and other EBP resources; identification of barriers that could be targeted in future implementation activities; earlier referrals; and use of recommended outcome measures. The article can serve as a template for other physical therapist researchers in designing implementation studies, as well as to inform policies and practice for health care managers and decision makers who are looking for ways to implement research findings in their organizations.

Changes in reproductive hormones during menopause are associated with accumulation of intra-abdominal adipose tissue (IAAT), a subclinical indicator of cardiometabolic disease risk. Independent of reproductive hormones, unhealthy lifestyle contributes to IAAT gain. The Women in the Southside Health and Fitness (WISHFIT) Study aims to develop a lifestyle approach to slowing IAAT accumulation as women begin the menopausal transition.

The article reports that according to according to the U.S. Department of Health and Human Services, adverse outcomes for adolescent parents and their children can be felt across multiple generations in health, socioeconomic status, and social-emotional development. It mentions that significant research showing that both teen parents and their children are especially vulnerable to adverse childhood experiences (ACEs).

The purpose of this research is to investigate long term effects of cognitive skill degradation through the use of automation. Even though advanced studies have looked into information automation (IA) in aviation, the amount of empirical data on the effects of these systems on the retention of cognitive skills is less deeply examined. Measurement and analysis of the effects of IA on cognitive performance is an important first step in understanding cognitive skill degradation, which should be considered during the design of these systems. The use of an automation aid is expected to result in a high level of performance degradation over time. Participants were randomly placed into three experimental groups (manual, alternating, or automation) and asked to perform flight planning calculations as an experiment task. Participants performed the task five times, once every two weeks. The manual group used the manual method throughout the experiment, the alternating group switched between the manual and automated method every trial. The automation group used the manual method for the first trial, the automated method for the three consecutive trials and then went back to using the manual method during the last trial. The automation group showed the most performance degradation and highest workload, while the alternating group presented reduced performance degradation and workload, and the manual group showed the least performance degradation and workload. This work provides the foundation for the design of guidelines and recommendations for IA systems in order to prevent cognitive skill degradation.

Factors at multiple ecological levels, including the child, family, home, medical care, and community, impact adolescent asthma outcomes.

The article discusses about an experience of Ann Buchsbaum of surviving holocaust. It further discusses that Chinese government has forcibly detained millions of Uyghurs and other Turkic Muslims, without due process, in concentration camps in Xinjiang province while destroying thousands of mosques, evoking a present-day Kristallnacht.

The research in the management of severe sepsis and septic shock has resulted in a number of therapeutic strategies with significant survival benefits. These results also emphasize the primary importance of early hemodynamic resuscitation, or early goal‐directed therapy (EGDT), and place the emergency physician in the center of the multidisciplinary team caring for patients with this disease. However, in a busy emergency department, the translation of research into clinical practice is far from ideal. While the benefits are significant, the successful implementation of EGDT is filled with challenges and obstacles. In this article, we will discuss the steps taken at our institution to create, implement, measure, and improve on a six‐hour severe sepsis and septic shock treatment bundle incorporating EGDT in the emergency department setting, resulting in significant mortality benefit.

Manmade disasters have risen over the past decaFde. Specifically, chemical weapons used in acts of aggression pose an increasing threat to our society. These potential disaster situations raise concerns regarding preparedness for both adults and children. This article's purpose is to review general principles of chemical exposure and treatment of specific chemical agents, and to identify specific pediatric considerations involved.

The aim of this study was to seek opinions regarding the perceived advantages and disadvantages of the two main models of clinical education used in Australia. A questionnaire was designed specifically for this study and distributed to physiotherapists involved in clinical education at health units throughout Australia. There were 343 respondents (giving an approximate response rate of 74.5%). In most health units (78.4%) the model of clinical education currently used involves a number of physiotherapists sharing responsibility for the clinical education of students (SR model). Only a minority reported employing a designated clinical educator (DCE) to provide clinical education. Overall, respondents preferred the DCE model to the SR model. The perceived advantages of the DOE model included an increased time to devote to clinical education, improved consistency of supervision and decreased stress levels for staff.

Purpose. We examined the cardiovascular health profiles of benefit-eligible hospital employees who participated in an incentive screen program for 4 years. We also determined if cardiovascular health changes differed between participants (CHAP) who enrolled in structured follow-up risk reduction programs (CHAPplus) compared with those who chose less formal options (CHAPonly).Methods. CHAP consisted of cardiovascular screens, results counseling, and encouragement to participate in education and behavioral support programs. After adjusting for gender, medication use, and baseline levels of adiposity and physical activity, cardiovascular health changes were tested with repeated-measures analysis of covariance (ANCOVA) among CHAP participants and by CHAP type.Results. CHAP 4-year members (n = 278) were generally healthy and mostly women (87%) with an average age of 40.6 ± .5 years at baseline. Despite increases in overall (p = .034) and central adiposity (p = .001), cardiovascular health improvements were found for the total cholesterol/high-density lipoprotein ratio (TCHOL/HDL; p = .007), low-density lipoprotein (p = .009), and blood glucose (p = .018) among 4-year CHAP members. CHAPonlyemployees showed greater improvements in most cardiovascular health indicators than CHAPplusparticipants, although these differences did not achieve statistical significance.Discussion. Cardiovascular health improvements were associated with long-term participation in a hospital worksite incentive screen program. The cardiovascular health benefits tended to be greatest for CHAP employees who chose informal follow-up risk reduction options (CHAPonly) than those who enrolled in structured programs (CHAPplus).

Although the dissociative sedative ketamine is used commonly for pediatric procedural sedation in other settings, the safety of this agent in pediatric gastroenterology is not well-studied. A 5-year experience with ketamine sedation for pediatric gastroenterology procedures was reviewed to document the safety profile of this agent and to identify predictors of laryngospasm during esophagogastroduodenoscopy (EGD).

Although the dissociative sedative ketamine is used commonly for pediatric procedural sedation in other settings, the safety of this agent in pediatric gastroenterology is not well-studied. A 5-year experience with ketamine sedation for pediatric gastroenterology procedures was reviewed to document the safety profile of this agent and to identify predictors of laryngospasm during esophagogastroduodenoscopy (EGD). The study was a retrospective consecutive case series of children receiving ketamine administered by pediatric gastroenterologists skilled in basic airway management to facilitate pediatric gastrointestinal procedures during a 5-year period. Patient's records were reviewed to determine indication, dosage, adverse effects, drugs, inadequate sedation, and recovery time for each sedation. A multiple logistic regression analysis was performed to identify predictors of laryngospasm during EGD. Outcome measures were descriptive features of sedation, including adverse effects and predictors of laryngospasm during EGD. During the study period pediatric gastroenterologists administered ketamine 636 times, primarily for EGD (86%) and primarily by the intravenous route (98%). The median loading dose and total dose were 1.00 mg/kg and 1.34 mg/kg, respectively. Inadequate sedation was noted in seven (1.1%) procedures. Adverse effects included transient laryngospasm (8.2%), emesis (4.1%), recovery agitation (2.4%), partial airway obstruction (1.3%), apnea and respiratory depression (0.5%), and excessive salivation (0.3%). There were no adverse outcomes attributable to ketamine. Nearly half (46%) the subjects had severe underlying illness (American Society of Anesthesiologists [ASA] class =3). All instances of laryngospasm occurred during EGD (9.5% incidence), and the only independent predictor of laryngospasm in this sample was decreasing age. The incidence of laryngospasm was 13.9% in preschool-aged (=6 years) children and was 3.6% in school-aged (>6 years) children (difference 10.3%, 95% confidence intervals 5.5–14.9%). No dose relationship was noted with laryngospasm, and the risk did not increase with underlying illness. Pediatric gastroenterologists skilled in ketamine administration and basic airway management can effectively administer this drug to facilitate gastrointestinal procedures. Transient laryngospasm occurred in 9.5% of children receiving ketamine for EGD, and its incidence was greater in preschool than in school-aged children.