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Mountain regions harbor unique and rich biodiversity, forming an important part of our global life support system. This rich biodiversity underpins the ecological intactness and functioning of mountain ecosystems, which are imperative for the provision of key ecosystem services. A considerable amount of data are required to assess ecological intactness and ecosystem functioning and, given the profound anthropogenic pressures many mountain regions are being subjected to, are urgently needed. However, data on mountain biodiversity remain lacking. The essential biodiversity variables (EBVs) framework can help focus efforts related to detecting, investigating, predicting, and managing global biodiversity change, but has not yet been considered in the context of mountains. Here, we review key biological processes and physical phenomena that strongly influence mountain biodiversity and ecosystems and elucidate their associations with potential mountain EBVs. We identify seven EBVs of highest relevance for tracking and understanding the most critical drivers and responses of mountain biodiversity change. If they are implemented, the selected EBVs will contribute useful information to inform management and policy interventions seeking to halt mountain biodiversity loss and maintain functional mountain ecosystems. [ABSTRACT FROM AUTHOR]

Introduction: Opioid stewardship efforts can promote safe and effective use of opioids to optimize pain control and minimize unintended consequences. The purpose of this study is to assess the difference in post-operative opioid discharge prescribing in patients undergoing coronary artery bypass graft (CABG) surgery following implementation of a tripartite opioid stewardship intervention. Methods: This was a single-center, quality improvement study at a large, quaternary academic medical center. Adult patients undergoing CABG from July 2019 to June 2020 (pre-intervention) and November 2020 to February 2021 (post-intervention) were included. The intervention included adopting hospital-wide post-surgical opioid discharge prescribing guidelines, discharge prescriber education, and electronic medical record changes. The primary outcome was the proportion of patients receiving an opioid prescription at discharge. Secondary outcomes included total morphine milligram equivalents (MME) prescribed and non-opioid analgesics prescribed at discharge. Results: A total of 200 patients were included in the study; 100 pre- and 100 post-intervention. There was no difference in opioid discharge prescribing at discharge (74% pre-intervention vs. 72% post-intervention; P =.87). There was no difference in MMEs prescribed at discharge (145.6 ± 57 pre- vs. 162.2 ± 95 post-; P =.202). No difference was seen in non-opioid analgesic prescriptions prescribed at discharge (35% pre- vs. 40% post-; P =.56). Conclusion: A multipronged opioid stewardship intervention did not lead to a reduction in opioid prescribing at discharge. Post-intervention, there was a non-statistically significant increase in the proportion of patients who received non-opioid analgesics discharge. Future studies should assess the effect of different stewardship interventions on prescribing and patient outcomes. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) could revolutionise health care, potentially improving clinician decision making and patient safety, and reducing the impact of workforce shortages. However, policymakers and regulators have concerns over whether AI and clinical decision support systems (CDSSs) are trusted by stakeholders, and indeed whether they are worthy of trust. Yet, what is meant by trust and trustworthiness is often implicit, and it may not be clear who or what is being trusted. We address these lacunae, focusing largely on the perspective(s) of clinicians on trust and trustworthiness in AI and CDSSs. Empirical studies suggest that clinicians' concerns about their use include the accuracy of advice given and potential legal liability if harm to a patient occurs. Onora O'Neill's conceptualisation of trust and trustworthiness provides the framework for our analysis, generating a productive understanding of clinicians' reported trust issues. Through unpacking these concepts, we gain greater clarity over the meaning ascribed to them by stakeholders; delimit the extent to which stakeholders are talking at cross purposes; and promote the continued utility of trust and trustworthiness as useful concepts in current debates around the use of AI and CDSSs. [ABSTRACT FROM AUTHOR]

The developmental exchange is a central feature of social development, interpersonal dynamics, situated learning, and personal transformation. It is the enabling process in Guided Autobiography (GAB) settings that promotes the achievement of personal goals and group accomplishments. Nevertheless, these exchanges are embedded in the GAB structures of time, events, participants, themes, perspectives, medium, and quest for relevance. Ongoing research studies are gradually clarifying the actual, ideal, and social image of self as well as the processes, outcomes, and specific learning topics achieved during the GAB experience as they unfold through the listening, participating, and diversifying structures of the developmental exchange. (Contains 4 tables.)

This article discusses the proposition that learning is an unexplored feature of the guided autobiography method and its developmental exchange. Learning, conceptualized and explored as the embedded and embodied processes, is essential in narrative activities of the guided autobiography method leading to psychosocial development and growth in dynamic, temporary social groups. The article is organized in four sections and summary. The first section provides a brief overview of the guided autobiography method describing the interplay of learning and experiencing in temporary social groups. The second section offers a limited review on learning and experiencing as processes that are essential for development, growth, and change. The third section reviews the small group activities and the emergence of the "developmental exchange" in the guided autobiography method. Two theoretical constructs provide a conceptual foundation for the developmental exchange: a counterpart theory of aging as development and collaborative-situated group learning theory. The summary recaps the main ideas and issues that shape the guided autobiography method as learning and social experience using the theme, "Where to go from here." (Contains 1 figure.)