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IntroductionClinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative clinical hypnosis (CH) would demonstrate greater heart-rate variability (HRV) during rest and relaxation at a 1-month post-surgery assessment compared to a treatment-as-usual group (TAU).MethodsAfter REB approval, trial registration and informed consent, 92 participants were randomized to receive CH (n = 45) or TAU (n = 47). CH participants received a CH session before surgery and during post-surgical in-hospital stay HRV was assessed during rest (5 min) and relaxation (10 min) before and 1-month after surgery. Pain intensity was obtained using a 0–10 numeric rating scale pre and post 1-week and 1-month post surgery.ResultsOne month after surgery, HRV was significantly higher in CH group (n = 29) during rest and relaxation (both p 0.48) but not the CH group. Pain intensity increased from pre-surgery to 1-week post-surgery (p

ABSTRACTBackground Post-viral pain syndrome, also known as post-viral syndrome, is a complex condition characterized by persistent pain, fatigue, musculoskeletal pain, neuropathic pain, neurocognitive difficulties, and sleep disturbances that can occur after an individual has recovered from a viral infection.Aims This narrative review provides a summary of the sequelae of post-viral syndromes, viral agents that cause it, and the pathophysiology, treatment, and future considerations for research and targeted therapies.Methods Medline, PubMed, and Embase databases were used to search for studies on viruses associated with post-viral syndrome.Conclusion Much remains unknown regarding the pathophysiology of post-viral syndromes, and few studies have provided a comprehensive summary of the condition, agents that cause it, and successful treatment modalities. With the COVID-19 pandemic continuing to affect millions of people worldwide, the need for an understanding of the etiology of post-viral illness and how to help individuals cope with the sequalae is paramount.

Background: Current literature does not provide conclusive evidence on whether routine pathologic examination of femoral heads from total hip arthroplasty is indicated or cost-effective. As a result, there is substantial variation in opinion among surgeons related to this issue. Our study aim was to determine factors that impact surgeon propensity to order pathologic examination of femoral heads. Methods: A 12-question survey was created to evaluate surgeon practices, indications, and patient care implications surrounding routine pathologic examination of femoral heads. The email survey was distributed to all members of the American Association of Hip and Knee Surgeons (n = 2598). Results: There were 572 survey respondents. Out of all respondents, 28.4% always send femoral heads to pathology, and 27.6% reported an institutional requirement to do so. Of the 572 surgeons, 73.6% report femoral head pathology has never resulted in a change in patient disease course. Factors that increase the likelihood of surgeons ordering femoral head pathologic examination include institutional requirements, medicolegal concern, and prior experience with femoral head pathologic examination changing patients' disease course (P < .001). Cost concern decreases the likelihood of surgeons ordering femoral head pathologic examination (P = .0012). Conclusions: A minority of surgeons routinely send femoral heads from total hip arthroplasty for pathologic examination, mostly because of institutional requirement. The majority of surgeons feel that femoral head pathologic examination never changes patient management, although others have infrequently detected malignancy and infection. Institutional policy, concern for litigation, and prior experience with discordant pathologic diagnoses increase femoral head pathologic examinations, while cost concern decreases them.

Abstract Ehlers-Danlos Syndrome (EDS) are a heterogeneous group of genetic connective tissue disorders, and typically manifests as weak joints that subluxate/dislocate, stretchy and/or fragile skin, organ/systems dysfunction, and significant widespread pain. Historically, this syndrome has been poorly understood and often overlooked. As a result, people living with EDS had difficulty obtaining an accurate diagnosis and appropriate treatment, leading to untold personal suffering as well as ineffective health care utilization. The GoodHope EDS clinic addresses systemic gaps in the diagnosis and treatment of EDS. This paper describes a leap forward—from lack of awareness, diagnosis, and treatment—to expert care that is tailored to meet the specific needs of patients with EDS. The GoodHope EDS clinic consists of experts from various medical specialties who work together to provide comprehensive care that addresses the multi-systemic nature of the syndrome. In addition, EDS-specific self-management programs have been developed that draw on exercise science, rehabilitation, and health psychology to improve physical and psychosocial wellbeing and overall quality of life. Embedded into the program are research initiatives to shed light on the clinical presentation, underlying mechanisms of pathophysiology, and syndrome management. We also lead regular educational activities for community health care providers to increase awareness and competence in the interprofessional management of EDS beyond our doors and throughout the province and country.

This paper introduces a project to develop a digital academic writing tool at Leeds Beckett University (LBU). Essay X-ray is an interactive online tool designed to help students get to grips with the structure and style of academic writing and was developed using the Articulate Storyline 360 platform. The aim was to expand LBU's academic skills support for students tasked with essay assignments, especially at Level 4 (first year, undergraduate), enabling independent learning using a self-paced format available open access and 24/7. This would complement existing academic skills provision (one-to-ones, workshops, drop-ins, static online resources), with the interactive element facilitating active, hands-on learning (Lumpkin, Achen and Dodd, 2015). Following a successful development, review and rollout process, the utility of Essay X-ray as an independent learning tool but also as a classroom resource was reported by students and colleagues. Tentative talks about additional versions (Dissertation X-ray, Report X-ray) have taken place, indicating its potential for rollout to other subject areas and assessment types. Finally, in-house digital academic skills tools like Essay X-ray are posited as a potential response to the recent upsurge in Generative Artificial Intelligence (GenAI) tools. Essay X-ray requires users to think critically about essay structure, style and content to create their own original pieces of writing, thus responding to questions about the maintenance of academic integrity in a digital world. These features enable users to develop their essay writing skills, in contrast to passive engagement with a GenAI programme that merely writes an answer for them.

Postgraduate research students have poorer mental health than the general community. Improving their experiences of diversity, inclusion, and belonging at university may bolster their overall wellbeing and reduce poor mental health outcomes. The aim was to explore postgraduate research students' views on diversity, inclusion, and belonging, to understand how these experiences impact their mental health and wellbeing, and to identify ways to improve their experiences. Thirty-one postgraduate research students (aged 24-68 years, M = 35.78 years, SD = 10.38; 69% female), enrolled in health sciences degrees at a research-intensive Australian university, completed either an online qualitative survey or participated in a focus group. Content analysis was undertaken to identify core themes. The three main content areas included: diversity (promoting diversity, staff and student training), inclusion (support from supervisors and peers, support in the perinatal period) and belonging (social isolation, suggestions to improve a sense of belonging). Most participants had not received training in diversity, inclusion and belonging, and identified this as an important area of need. Strategies to reduce isolation may potentially improve students experience of inclusion and belonging.

The study explored the extent learners' age variances impacted their achievement in a national education assessment in Ghana and how these were moderated by the types of schools (i.e., private and public) they attended. A multistage sampling method was used, and the data were analyzed using a multilevel modeling technique. The sample comprised 19,210 primary grade 3 and 17,088 primary grade 6 learners from 525 and 499 schools, respectively. Relatively younger learners outperformed their older peers in both subjects except for primary 3 mathematics achievement. Schools marginally reduced the age effect on both subjects except primary 3 mathematics achievement, where there was an increase. Moreover, there was a statistically insignificant difference in private and public schools' impact on age-linked effects on subjects except for primary 3 mathematics. The study concludes that being relatively overage for a specific grade level is not beneficial, especially for English language achievement. Hence, enrolling learners at the prescribed age and school term is highly recommended.

Background: New “hyperspecialty” ambulatory surgical centers (HASCs) have been introduced to deliver safe and cost-efficient care, allowing patients to spend additional nights in an extended care suite before discharge. This study compared the 90-day complications and readmissions of total joint arthroplasty (TJA) at an HASC and inpatient TJA at a tertiary hospital. Methods: We retrospectively reviewed 1365 primary, unilateral, TJAs (658 total hip arthroplasty, 707 total knee arthroplasty) performed at 4 HASCs in 2017-2021. Following their outpatient procedure, patients were discharged to an extended care suite staffed full-time by nurses and physical therapists. These patients were matched 1:1 with 1365 inpatient TJAs (628 total hip arthroplasty, 737 total knee arthroplasty) based on demographics, joint, and American Society of Anesthesiologists (ASA) score. Ninety-day complications and readmissions were compared. Results: The mean age was 60.0 ± 9.8 years and 59.4 ± 8.1 years in the inpatient and outpatient groups, respectively (P = .106). There was no difference in ASA≥3 patients (16.4% vs 17.7%; P = .387) and operative time (86.9 ± 31.8 vs 88.7 ± 27.9 minutes; P = .118). Five patients (0.4%) in the outpatient group were transferred to an acute hospital. When comparing 90-day outcomes between the inpatient and outpatient groups, there was no difference in pulmonary embolism (0.1% vs 0.0%; P = .317), mechanical complications (0.3% vs 0.7%; P = .165), periprosthetic joint infections (0.5% vs 1.1%; P = .092), or readmissions (1.2% vs 1.5%; P = .513). A subgroup analysis of ASA≥3 patients yielded similar findings. Conclusions: Patients undergoing outpatient TJA at a novel HASC had similar complication and readmission rates as those undergoing TJA at a tertiary hospital. Based on these data, such facilities seem appropriate for the care of outpatient TJA patients with ASA

Against the background of expanding parental choices and declining global birth rates, schools are experiencing rising competition regarding student enrolment. Schools have responded by strategically presenting information about their students' academic achievement and whole-person development orientation in the hope of attracting parents' interest. However, few studies have investigated the impact of these factors on student enrollment, particularly in the context of diverse school types and educational orientations. Accordingly, this study utilized data from 327 secondary schools in Hong Kong to examine the effects of academic achievement orientation and whole-person development orientation on student intake. Using hierarchical regression analysis, we found a positive association between high whole-person development orientation and student intake in aided schools with a strong academic development orientation. The result implies parents are increasingly concerned about their children's academic achievement and whole-person development at school. The study contributes to a broader understanding of the factors influencing parental choice in high-performing education systems, providing valuable insights for policymakers and educators seeking to improve educational offerings, enhance school transparency, and be better aligned with parental expectations.

Recent research into imposter phenomenon, or internal feelings of questioning competence, has shifted away from conceptualizing the feeling as an individual characteristic that requires an individual solution toward instead examining the role of context. We used a 2 (Generational Status: First Generation vs. Continuing Generation) × 3 (Environment: Classroom vs. Peer vs. Administration) × 2 (Social Comparison: Present vs. Absent) experimental vignette design. Overall, we found that, for both first- and continuing-generation students, social comparison messages differentially impacted imposter feelings depending on context, with the most elevated levels in social comparison messages from administrators and peers. Findings contribute to a better understanding of structural conditions that exacerbate or lessen imposter feelings at highly selective post-secondary institutions.

QuPath, originally created at the Centre for Cancer Research & Cell Biology at Queen’s University Belfast as part of a research programme in digital pathology (DP) funded by Invest Northern Ireland and Cancer Research UK, is arguably the most wildly used image analysis software program in the world. On the back of the explosion of DP and a need to comprehensively visualise and analyse whole slides images (WSI), QuPath was developed to address the many needs associated with tissue based image analysis; these were several fold and, predominantly, translational in nature: from the requirement to visualise images containing billions of pixels from files several GBs in size, to the demand for high-throughput reproducible analysis, which the paradigm of routine visual pathological assessment continues to struggle to deliver. Resultantly, large-scale biomarker quantification must increasingly be augmented with DP. Here we highlight the impact of the open source Quantitative Pathology & Bioimage Analysis DP system since its inception, by discussing the scope of scientific research in which QuPath has been cited, as the system of choice for researchers.

Background As Canada continues to address challenges related to the opioid crisis, individuals suffering from opioid use disorder (OUD) can be especially vulnerable to physical and psychological destabilization after surgery. Adopting a harm reduction approach postoperatively can be a success factor for safe recovery and satisfactory analgesia. Purpose We present the case of a 40-year-old patient (referred to as DC) with OUD using illicit fentanyl, heroin, and oxycodone preoperatively and admitted for an elective liver resection for steroid-induced hepatoma. Despite a preoperative anesthesia assessment and the initiation of a standard balanced multimodal analgesic regimen, suboptimal analgesia was evident in the first 24 h postoperatively. This lack of analgesic efficacy precipitated DC’s use of illicit self-injected intravenous (IV) opioid and significant emotional distress. To address this, a nurse practitioner and anesthesiologist within the Toronto General Hospital acute and transitional pain program and the surgical team quickly met and adopted a harm reduction approach to manage DC’s postoperative pain and emotional distress. The ultimate goal was to eliminate self-administration of illicit IV opioids and prevent DC from attempting to leave hospital against medical advice. Following an interprofessional team discussion that included DC, IV fentanyl was offered via a patient-controlled analgesia pump to DC’s satisfaction (exceeding standard settings), providing acceptable pain relief. To our knowledge, DC did not self-administer additional illicit drugs during the remainder of hospitalization. Outcome This harm reduction approach resulted in DC’s safe recovery, achievement of postoperative functional milestones, and continued engagement with outpatient pain treatment.

Cosmopolitanism and nationalism are often presented in binary terms, as standing in opposition to each other, especially with regards to education. In this paper, we establish a framework for studying education policy today through the lens of a concept we have developed: 'cosmopolitan nationalism'. Many education systems around the world are grappling with and simultaneously integrating both cosmopolitan and nationalist elements in policy objectives, curricular content and pedagogic approaches. Through an in-depth analysis of three country examples -- China, the US and Israel -- we outline four different manifestations of education policy that can be explained by employing the analytical lens of cosmopolitan nationalism: (i) the increasing prominence and visibility of the International Baccalaureate within these three public education systems; (ii) reforms of specific curricula elements and pedagogies legitimised with reference to approaches assessed as globally leading through international assessments; (iii) efforts to promote national education systems as international beacons of best practice; (iv) creation of alternative education provisions that are promoted globally for very specific purposes and populations. We argue that, given our heterogeneous sample of case study countries, and careful analysis of these, a cosmopolitan nationalism lens offers important insights into education policy-making today which has the potential to be applied in other contexts.

Some research has shown that using videos in online courses can promote learner's connection to the instructor (Banerjee et al., 2020). This quasi-experimental self-study aimed to explore the impact of brief three-minute instructor-generated videos in twin segments of an online graduate teacher education seminar focused on Globalization, Communities, and Schools. Specifically, we sought to understand the extent to which the insertion of these videos influenced teacher candidates' perceptions of the dynamics of a Community of Inquiry (CoI) and their overall satisfaction as learners. The quantitative analysis of survey data using T-tests showed no statistically significant difference in overall learner satisfaction, social presence, teaching presence, or instructor social presence between the course with and without videos. However, there were significant differences in several individual items within each survey instrument. Student interviews and course evaluation comments were examined for themes revealing the strong presence of the instructor in various ways such as personalized feedback and caring tone. These findings suggest that while the videos may not have a significant impact on overall satisfaction, they do contribute to a more personalized and caring learning environment. Follow-up discussions with the instructor also revealed the reluctance to include short videos was grounded in his fear of inadvertently compromising the accessibility standards he wanted to honor--suggesting a continued need for growth in online instructors' digital competencies and additional research into the perceived obstacles of expanding modalities of online graduate teacher education.

This article first describes and then proposes a practical solution to the professional dilemma between the duty of impartiality and the duty of human rights advocacy that many teachers experience when teaching and talking about politically sensitive issues with students. The article begins by presenting an analysis of the source and signification of the tension between impartiality and human rights advocacy based on evidence from research on teachers' perspectives, the conceptual literature on teaching and learning about controversial issues, and the legal and ethical framework of education. Then, drawing on scholarship on respect for students' right to freedom of religion, the article advances and defends set of basic pedagogical guidelines for teaching and talking about politically sensitive issues that permit teachers to maintain a professional stance of impartiality without abrogating their responsibility to act as human rights advocates. Key to squaring the circle between impartiality and human rights advocacy, the article argues, is for teachers to strive to remain descriptive in their treatment of politically sensitive issues and insist on high standards of reasoning and evidence while at the same time respecting students' right to an opinion, no matter how mistaken that opinion may seem.

Inclusive education in the United Arab Emirates (UAE) is evolving with ambitious policies and strategic plans. The extent to which these policies and plans are being embedded into practice in mainstream schools across the country has not been fully captured. This research used an online survey to investigate teachers' perceived competence in implementing inclusive education practices with students with disabilities in mainstream schools and explore its relationship with demographic variables. Participants included 999 teachers from public and private schools across the seven Emirates of the UAE. Greater competence was reported in implementing practices that create an environment conducive to effective learning and less competence in implementing practices that use knowledge of the student. Differences were found between demographic variables and teachers' perceived competence in implementing inclusive education practices with recent professional development in inclusive and/or special education emerging as the most significant predictor. Implications for practice and further research are considered.

Inclusive education has been widely accepted as a useful policy to offer equal access to education to all children. However, practices have stalled in many countries, including the United Arab Emirates (UAE), necessitating support for system strengthening to enhance the existing practices in schools. While leadership is at the heart of effective practices, there is little discussion on the leadership required to leverage inclusive practices. In the UAE, little information is available regarding inclusive education leadership at early school levels, which is dominated by female teachers. This study examined the structural validity of the heuristic leadership framework, which focuses on leadership tenets (transaction, transformation and instruction) controlled by school leaders, to explain female leadership practices in the implementation of inclusive education in early education schools in the UAE. A scale based on the study framework (heuristics leadership framework) was used to collect data from 151 school leaders, including principals, vice principals, faculty heads and lead teachers, working at early school levels across the UAE. The results of this study provide theoretical support for the heuristic leadership framework and some demographics, providing valuable insights into leadership practices among female education leaders in the UAE.

This study explores the mechanisms that underlie the effect of school marketing strategies on parents' perceived school attractiveness, particularly emphasizing the mediating role of parents' perceptions of being welcomed in urban schools. Additionally, we investigated how schools' marketing strategies work differently among parents with different value orientations toward schooling. Structural Equation Modeling and Cluster Analysis Data were applied to analyze 510 questionnaires collected from parents. Two experiential marketing strategies, namely, one-way disseminating materials and interactive social networking, impacted parents' perceived attractiveness of schools differently with the feeling of being welcomed mediating the relationship between parents and schools. Additionally, parents' value orientations toward schooling could be classified into three profiles. The results suggest that schools should consider parents' needs and preferences concerning their children's schooling and employ appropriate marketing strategies to engage different types of parents. To facilitate this outcome, individualized interaction is necessary to accommodate the diverse needs of parents. The overall structural equation model validates the mechanism of experiential marketing in influencing parental perceptions, and the cluster analysis underscores the need to explore the complex relationship between parents' educational priorities and their interpretation of marketing strategies.

In this series, we report the findings from four patients who presented with pain and mechanical symptoms after revision total knee arthroplasty with the DePuy Sigma TC3 RP prosthesis. Plain radiographs for each patient demonstrated failure of the femoral component at the modular junction of the femoral prosthesis. Retrieved implants at the time of surgery revealed fractures occurring exclusively at the femoral adapter bolt and the corresponding adapter. Retrieval analysis was performed on two of the four cases by visual light microscopy. Our findings suggest that the implants had suffered from fatigue fractures likely due to cyclic loading. This is the first case series to describe the failure mechanism and clinical scenarios contributing to failure of the femoral locking bolt and adapter sleeve in this prosthesis. Keywords: Total knee arthroplasty, Implant failure revision, Modular