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OBJECTIVES: 'Overweight and obesity' is the second biggest preventable cause of cancer after smoking. In 2018, Cancer Research UK launched an awareness raising campaign about the link between overweight and obesity and cancer risk. This study aimed to evaluate the reach and impact of the campaign. STUDY DESIGN: This study was a repeated cross-sectional online survey. METHODS: The campaign consisted of six elements including the main message that 'Obesity is a cause of cancer'. UK adults and Members of Parliament (MPs) were surveyed before the campaign (W1; n = 2124 and n = 151), 1 month (W2; n = 2050 and n = 151) and 3 months after the campaign (W3; n = 2059 and MPs not surveyed). Outcome measures were campaign reach, awareness of overweight and obesity as risk factors for cancer, attitudes towards individuals who are overweight or obese, support for policies to reduce obesity and reactions to the campaign. RESULTS: Overall, 76.2% of MPs and just under half of the public (47.5% in W2 and 36.8% in W3) reported having seen the campaign. Unprompted awareness of obesity as a risk factor increased among the public from 17.1% at W1 to 43.3% in W2 (odds ratio 3.71, 95% confidence interval 3.18-4.33) and 30.3% in W3 (odds ratio 2.11, 95% confidence interval 1.80-2.47). A similar pattern was seen for prompted awareness and among MPs. There were no consistent changes in attitudes towards overweight individuals or support for policies to reduce obesity. CONCLUSIONS: This evaluation suggests that the campaign achieved the primary objective of increasing awareness of the link between obesity and cancer without increasing negative attitudes towards individuals who are overweight or obese.

These NCCN Guidelines for Distress Management discuss the identification and treatment of psychosocial problems in patients with cancer. All patients experience some level of distress associated with a cancer diagnosis and the effects of the disease and its treatment regardless of the stage of disease. Clinically significant levels of distress occur in a subset of patients, and identification and treatment of distress are of utmost importance. The NCCN Distress Management Panel meets at least annually to review comments from reviewers within their institutions, examine relevant new data from publications and abstracts, and reevaluate and update their recommendations. These NCCN Guidelines Insights describe updates to the NCCN Distress Thermometer (DT) and Problem List, and to the treatment algorithms for patients with trauma- and stressor-related disorders.

Seasonal influenza vaccines protect against 3 (trivalent influenza vaccine [IIV3]) or 4 (quadrivalent influenza vaccine [IIV4]) viruses. IIV4 costs more than IIV3, and there is a trade-off between incremental cost and protection. This is especially the case in low- and middle-income countries (LMICs) with limited budgets; previous reviews have not identified studies of IIV4-IIV3 comparisons in LMICs. We summarized the literature that compared health and economic outcomes of IIV4 and IIV3, focused on LMICs.We systematically searched 5 databases for articles published before October 6, 2021, that modeled health or economic effects of IIV4 versus IIV3. We abstracted data and compared findings among countries and models.Thirty-eight studies fit our selection criteria; 10 included LMICs. Most studies (N = 31) reported that IIV4 was cost-saving or cost-effective compared with IIV3; we observed no difference in health or economic outcomes between LMICs and other countries. Based on cost differences of influenza vaccines, only one study compared coverage of IIV3 with IIV4 and reported that the maximum IIV4 price that would still yield greater public health impact than IIV3 was 13% to 22% higher than IIV3.When vaccination coverage with IIV4 and IIV3 is the same, IIV4 tends to be not only more effective but more cost-effective than IIV3, even with relatively high price differences between vaccine types. Alternatively, where funding is limited as in most LMICs, higher vaccine coverage can be achieved with IIV3 than IIV4, which could result in more favorable health and economic outcomes.

Policymakers, practitioners, and governing bodies increasingly recognize the critical role stakeholder engagement plays in successful environmental planning and decision-making. Although stakeholder engagement can improve project outcomes, identifying best practices for stakeholder engagement that apply to diverse topics and settings can be a challenge. Informed by our experience using Q methodology (QM) in five stakeholder meetings in agricultural watershed across the United States, this paper highlights our use of QM as an engagement tool and provides insights for future use. It demonstrates how QM addresses fundamental stakeholder engagement principles and provides guidance on using QM in stakeholder meetings. While we acknowledge inherent QM limitations regarding stakeholder participation and competent facilitators, we used QM to provide a flexible meeting structure that allowed participants to develop opinions and safely engage with peers and decision makers on complex and, at times, controversial topics.HIGHLIGHTSInsights on the use of Q methodology as a meeting facilitation toolOverview of how to use Q methodology for in stakeholder meetingsDetails how Q methodology can fulfill stakeholder engagement best practices Insights on the use of Q methodology as a meeting facilitation tool Overview of how to use Q methodology for in stakeholder meetings Details how Q methodology can fulfill stakeholder engagement best practices

Decision models such as the drift-diffusion model (DDM) are widely used and broadly accepted for their ability to account remarkably well for binary choices between perceptual hypotheses about a stimulus or for preferential decisions between valued options (such as snacks or consumer products), and for their response time (RT) distributions, as a function of the stimulus or the option values. The DDM is built on an evidence accumulation to bound concept, where, in the value domain, a decision maker repeatedly samples the mental representations of the values of the options on offer until satisfied that there is enough evidence in favor of one option over the other. As the value signals that drive the DDM evidence are derived from value estimates that are not known to the decision maker with certainty, repeated sequential samples are necessary to average out noise. The classic DDM typically does not allow for different options to have different levels of variability in their value representations. However, recent value-based decision studies have shown that decision makers often report levels of certainty regarding value estimates that vary across choice options. There is therefore a need to extend the DDM to include an option-specific value certainty component. We present several such DDM extensions and validate them against empirical data from four previous studies. The data supports best a DDM version in which the drift of the accumulation is based on a sort of signal-to-noise ratio of value for each option (rather than a mere accumulation of samples from the corresponding value distributions). This DDM variant accounts for the positive impact of value certainty on choice consistency and for the negative impact of value certainty on RT.

A black hole candidate orbiting a luminous star in the Large Magellanic Cloud young cluster NGC 1850 ($\sim100$Myr) has recently been reported based on radial velocity and light curve modelling. Subsequently, an alternative explanation has been suggested for the system: a bloated post-mass transfer secondary star (M$_{\rm initial} \sim 4-5M_{\odot}$, M$_{\rm current} \sim 1-2M_{\odot}$) with a more massive, yet luminous companion (the primary). Upon reanalysis of the MUSE spectra, we found that the radial velocity variations originally reported were underestimated ($K_{\rm 2,revised} = 176\pm3$km/s vs $K_{\rm 2,original} = 140\pm3$km/s) because of the weighting scheme adopted in the full-spectrum fitting analysis. The increased radial velocity semi-amplitude translates into a system mass function larger than previously deduced ($f_{\rm revised}$=2.83$M_{\odot}$ vs $f_{\rm original}$=1.42$M_{\odot}$). By exploiting the spectral disentangling technique, we place an upper limit of 10\% of a luminous primary source to the observed optical light in NGC1850 BH1, assuming that the primary and secondary are the only components contributing to the system. Furthermore, by analysing archival near-infrared data, we find clues to the presence of an accretion disk in the system. These constraints support a low-mass post-mass transfer star but do not provide a definitive answer whether the unseen component in NGC1850 BH1 is indeed a black hole. These results predict a scenario where, if a primary luminous source of mass M $\ge 4.7M_{\odot}$, is present in the system (given the inclination and secondary mass constraints), it must be hidden in a optically thick disk to be undetected in the MUSE spectra., 10 pages, 8 Figures and 2 Tables. Accepted for publication by MNRAS

The Single Stage AMS radiocarbon facility at the Australian National University has operated for the past 14 years. This paper presents the pretreatment methods used for the major sample types dated and reflects on whether quality assurance protocols can adequately detect altered materials. The majority of fossil samples dated by the facility are from tropical and arid environments where diagenesis of both organic samples and carbonates is often severe. A large proportion of the samples submitted cannot be dated, and screening and quality assurance methods are crucial. Based on analysis of 250 measurements on bone collagen, quality assurance indicators for bone are revised. From May 2021, the laboratory has accepted dates on collagen where yield >0.5%, %C is in the range of 39.7–46.9, and the C:N ratio is between 3.00 and 3.30.

The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students.The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently.A cross-sectional study was conducted across 12 Australian universities.Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval.Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors.The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce.This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce.The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

BACKGROUND: Risk stratification has been proposed to improve the efficiency of population-level cancer screening. We aimed to describe and quantify the relative importance of different attributes of potential screening programs among the public, focusing on stratifying eligibility. METHODS: We conducted a discrete choice experiment in which respondents selected between 2 hypothetical screening programs in a series of 9 questions. We presented the risk factors used to determine eligibility (age, sex, or lifestyle or genetic risk scores) and anticipated outcomes based on eligibility criteria with different sensitivity and specificity levels. We performed conditional logit regression models and used the results to estimate preferences for different approaches. We also analyzed free-text comments on respondents' views on the programs. RESULTS: A total of 1,172 respondents completed the survey. Sensitivity was the most important attribute (7 and 11 times more important than specificity and risk factors, respectively). Eligibility criteria based on age and sex or genetics were preferred over age alone and lifestyle risk scores. Phenotypic and polygenic risk prediction models would be more acceptable than screening everyone aged 55 to 70 y if they had high discrimination (area under the receiver-operating characteristic curve ≥0.75 and 0.80, respectively). LIMITATIONS: Although our sample was representative with respect to age, sex, and ethnicity, it may not be representative of the UK population regarding other important characteristics. Also, some respondents may have not understood all the information provided to inform decision making. CONCLUSIONS: The public prioritized lives saved from cancer over reductions in numbers screened or experiencing unnecessary follow-up. Incorporating personal-level risk factors into screening eligibility criteria is acceptable to the public if it increases sensitivity; therefore, maximizing sensitivity in model development and communication could increase uptake. HIGHLIGHTS: The public prioritized lives saved when considering changing from age-based eligibility criteria to risk-stratified cancer screening over reductions in numbers of people being screened or experiencing unnecessary follow-up.The risk stratification strategy used to do this was the least important component, although age plus sex or genetics were relatively preferable to using age alone and lifestyle risk scores.Communication strategies that emphasize improvements in the numbers of cancers detected or not missed across the population are more likely to be salient than reductions in unnecessary investigations or follow-up among some groups.Future research should focus on developing implementation strategies that maximize gains in sensitivity within the context of resource constraints and how to present attributes relating to specificity to facilitate understanding and informed decision making., Financial support for this study was provided entirely by a grant from the Cancer Research UK Cambridge Centre (pump-priming award C9685/A25117). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

Introduction: Using risk stratification to determine eligibility for cancer screening is likely to improve the efficiency of screening programmes by targeting resources towards those most likely to benefit. We aimed to explore the implications of this approach from a societal perspective by understanding public views on the most acceptable stratification strategies. Methods: We conducted three online community juries with 9 or 10 participants in each. Participants were purposefully sampled by age (40–79 years), sex, ethnicity, social grade and English region. On the first day, participants were informed of the potential benefits and harms of cancer screening and the implications of different ways of introducing stratification using scenarios based on phenotypic and genetic risk scores. On the second day, participants deliberated to reach a verdict on the research question, ‘Which approach(es) to inviting people to screening are acceptable, and under what circumstances?’ Deliberations and feedback were recorded and analysed using thematic analysis. Results: Across the juries, the principle of risk stratification was generally considered to be an acceptable approach for determining eligibility for screening. Disregarding increasing capacity, the participants considered it to enable efficient resource allocation to high‐risk individuals and could see how it might help to save lives. However, there were concerns regarding fair implementation, particularly how the risk assessment would be performed at scale and how people at low risk would be managed. Some favoured using the most accurate risk prediction model whereas others thought that certain risk factors should be prioritized (particularly factors considered as non‐modifiable and relatively stable, such as genetics and family history). Transparently justifying the programme and public education about cancer risk emerged as important contributors to acceptability. Conclusion: Using risk stratification to determine eligibility for cancer screening was acceptable to informed members of the public, particularly if it included risk factors they considered fair and when communicated transparently. Patient or Public Contribution: Two patient and public involvement representatives were involved throughout this study. They were not involved in synthesizing the results but contributed to producing study materials, co‐facilitated the community juries and commented on the interpretation of the findings and final report.

Skeletal muscle extracellular matrix (ECM) is critical for muscle force production and the regulation of important physiological processes during growth, regeneration, and remodelling. ECM remodelling is a tightly orchestrated process, sensitive to multi-directional tensile and compressive stresses and damaging stimuli, and its assessment can convey important information on rehabilitation effectiveness, injury, and disease. Despite its profound importance, ECM biomarkers are underused in studies examining the effects of exercise, disuse, or aging on muscle function, growth, and structure. This review examines patterns of short- and long-term changes in the synthesis and concentrations of ECM markers in biofluids and tissues, which may be useful for describing the time course of ECM remodelling following physical activity and disuse. Forces imposed on the ECM during physical activity critically affect cell signalling while disuse causes non-optimal adaptations, including connective tissue proliferation. The goal of this review is to inform researchers, and rehabilitation, medical, and exercise practitioners better about the role of ECM biomarkers in research and clinical environments to accelerate the development of targeted physical activity treatments, improve ECM status assessment, and enhance function in aging, injury, and disease.

A cornerstone of clinical medicine is intervening on a continuous exposure, such as titrating the dosage of a pharmaceutical or controlling a laboratory result. In clinical trials, continuous exposures are dichotomized into narrow ranges, excluding large portions of the realistic treatment scenarios. The existing computational methods for estimating the effect of continuous exposure rely on a set of strict assumptions. We introduce new methods that are more robust towards violations of these assumptions. Our methods are based on the key observation that changes of exposure in the clinical setting are often achieved gradually, so effect estimates must be "locally" robust in narrower exposure ranges. We compared our methods with several existing methods on three simulated studies with increasing complexity. We also applied the methods to data from 14 k sepsis patients at M Health Fairview to estimate the effect of antibiotic administration latency on prolonged hospital stay. The proposed methods achieve good performance in all simulation studies. When the assumptions were violated, the proposed methods had estimation errors of one half to one fifth of the state-of-the-art methods. Applying our methods to the sepsis cohort resulted in effect estimates consistent with clinical knowledge.

Self-efficacy, or the beliefs learners hold about what they can do, develops largely from how learners perceive and interpret four main sources of information: mastery experiences, vicarious experiences, social persuasions and physiological and affective states. Although the relationship between these sources and self-efficacy is well-established, less is known about the factors that may influence how early adolescent learners perceive and interpret information from these sources.The purpose of this study was to investigate how the predisposition of perfectionism might predict how learners perceive efficacy-relevant information in the domain of math.Using a correlational design, this study considered whether perfectionism was associated with how middle school students (N = 1683) perceive information from the four hypothesized sources of self-efficacy. Participants completed a paper-based survey at two time points. Perfectionism was measured at Time 1. Self-efficacy and its sources were measured at Time 2. Structural equation modelling techniques were used to examine the relationship between factors.Students who held themselves to high standards (i.e., greater self-oriented perfectionism) reported higher levels of mastery experiences, vicarious experiences, social messages and self-efficacy. Conversely, students who felt external pressure to be perfect (i.e., socially prescribed perfectionism) reported lower levels of mastery experiences, vicarious experiences and self-efficacy, as well as higher levels of negative physiological and affective states. The relationship between perfectionism and self-efficacy was partially mediated by students' perceptions of mastery. This study extends the current literature on the sources of math self-efficacy in early adolescence by showing how a predisposition like perfectionism is associated with how adolescent learners perceive and interpret efficacy-relevant information.

National planning and health organizations agree that to achieve healthy and sustainable food systems, planners must balance goals across a spectrum of sustainability issues that include economic vitality, public health, ecological sustainability, social equity, and cultural diversity. This research is an assessment of government-adopted food system plans in the U.S. that examines which topics, across the three dimensions of sustainability (social, environmental, and economic), are included in local food system plans and conducts an exploratory analysis that asks whether the community capitals (built, cultural, social, financial, human, and natural) available in a community are associated with the content of food system plans. The research team first developed a Sustainable Food System Policy Index made up of 26 policy areas across the three dimensions that, in aggregate, define and operationalize sustainable food systems. With this index we evaluated a sample of 28 food system plans for inclusion of these policy impact areas. We then performed an exploratory regression analysis to examine whether the availability of community capitals was associated with the content of food system plans. Findings indicated that jurisdictions integrated a broad range of issues into their food system plans; however, there are certain issues across every dimension of sustainability that are much less frequently included in plans, such as strategies related to participation in decision-making, financial infrastructure, and the stewardship of natural resources. Regression analysis identified statistically significant linear relationships between particular capitals and the proportion of policy areas included in plans. In particular, higher metrics associated with poverty were associated with the inclusion of fewer policy areas and with a potentially narrower policy agenda. This study adds to the plan evaluation literature as one of the first attempts to document the content of a sample of U.S. food system plans through a sustainability lens, contributing to the knowledge of what types of issues are advanced by local food system plans and the policy implications of current gaps in planning agendas.

INTRODUCTION: Risk-stratified cancer screening has the potential to improve resource allocation and the balance of harms and benefits by targeting those most likely to benefit. Public acceptability has implications for engagement, uptake and the success of such a programme. Therefore, this review seeks to understand whether risk stratification of population-based cancer screening programmes is acceptable to the general public and in what context. METHODS: Four electronic databases were searched from January 2010 to November 2021. Qualitative, quantitative and mixed-methods papers were eligible for inclusion. The Joanna Briggs Institute convergent integrated approach was used to synthesize the findings and the quality of included literature was assessed using the Mixed Methods Appraisal Tool. The Theoretical Framework of Acceptability was used as a coding frame for thematic analysis. PROSPERO record 2021 CRD42021286667. RESULTS: The search returned 12,039 citations, 22 of which were eligible for inclusion. The majority of studies related to breast cancer screening; other cancer types included ovarian, kidney, colorectal and prostate cancer. Risk stratification was generally acceptable to the public, who considered it to be logical and of wider benefit than existing screening practices. We identified 10 priorities for implementation across four key areas: addressing public information needs; understanding communication preferences for risk estimates; mitigating barriers to accessibility to avoid exacerbating inequalities; and the role of healthcare professionals in relation to supporting reduced screening for low-risk individuals. CONCLUSION: The public generally find risk stratification of population-based cancer screening programmes to be acceptable; however, we have identified areas that would improve implementation and require further consideration. PATIENT OR PUBLIC CONTRIBUTION: This paper is a systematic review and did not formally involve patients or the public; however, three patient and public involvement members were consulted on the topic and scope before the review commenced., JUS (Advanced Fellowship NIHR300861) is funded by the NIHR for this research project. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funder: Mark Foundation For Cancer Research; Id: http://dx.doi.org/10.13039/100014599, Funder: Rosetrees Trust; Id: http://dx.doi.org/10.13039/501100000833, Funder: Urology Foundation; Id: http://dx.doi.org/10.13039/501100007568, Funder: Yorkshire Cancer Research; Id: http://dx.doi.org/10.13039/100011703, OBJECTIVE: To explore patient experience of follow-up care after kidney cancer surgery and to develop recommendations for best practice. METHODS: We conducted two focus groups, including 14 participants with experience of kidney cancer follow-up after surgery, to elicit patient views on current follow-up care. Thematic analysis was used to identify unifying themes to describe the patient experience of follow-up, and the results were then used to develop a set of recommendations for best practice. RESULTS: We identified six themes (feelings of abandonment; uncertainty about the plan; anxiety about appointments; variation in care; a need for information; and a need for emotional support) that described current patient experience and areas in which current care could be improved. In particular, while most of the participants felt that their physical needs had been met, many had struggled with unmet emotional needs and a lack of information and resources. This was especially noted in the period immediately following surgery, when feelings of abandonment were common, and around follow-up scans and routine appointments, which were a source of anxiety. Our participants also described concerns about the lack of consistency between different hospitals and centres around the United Kingdom, with differences in the content and quality of follow-up care. Based on the results, we developed a list of recommendations to address some of the challenges described through relatively minor changes to the care pathway. CONCLUSIONS: We identified gaps and variability in current follow-up care after kidney cancer surgery, and have developed a set of recommendations that, if implemented, would improve the follow-up care experience for these patients.

Funder: Manchester Cancer Research Centre, Funder: East of England Clinical Academic Reserve, In the UK, the National Institute for Health and Care Excellence (NICE) recommends that women at moderate or high risk of breast cancer be offered risk-reducing medication and enhanced breast screening/surveillance. In June 2022, NICE withdrew a statement recommending assessment of risk in primary care only when women present with concerns. This shift to the proactive assessment of risk substantially changes the role of primary care, in effect paving the way for a primary care-based screening programme to identify those at moderate or high risk of breast cancer. In this article, we review the literature surrounding proactive breast cancer risk assessment within primary care against the consolidated framework for screening. We find that risk assessment for women under 50 years currently satisfies many of the standard principles for screening. Most notably, there are large numbers of women at moderate or high risk currently unidentified, risk models exist that can identify those women with reasonable accuracy, and management options offer the opportunity to reduce breast cancer incidence and mortality in that group. However, there remain a number of uncertainties and research gaps, particularly around the programme/system requirements, that need to be addressed before these benefits can be realised.

The COVID-19 pandemic presents challenges to the provision of community programs and access to mental health services for young people. We examined the feasibility, reach, and acceptability of multi-technology delivery of an integrated system that assesses and provides feedback on youth mental health and wellbeing and connects them to care within the context of a youth sports development program. The system was delivered via computer, telephone, and teleconference with 66 adolescent boys participating in a rugby league development program in three communities in Australia. Young people completed online wellbeing and mental health measures (Assess step), parents were provided with telephone feedback on results, support, and referral options (Reflect step), and youth received teleconferenced workshops and online resources (Connect step). The multi-technology delivery was feasible to implement, and reach was high, with barriers experienced at the Assess step but minimally experienced at the Reflect and Connect steps. Delivering the system via multiple forms of technology was rated as highly beneficial and enjoyable by young people. Players improved in self-reported prosocial behaviour, gratitude, and anxiety symptoms from pre- to post-program. Strong collaboration between researchers, organisational personnel, and community members is important for achieving these outcomes.

In the first year of the COVID-19 pandemic, millions of people experienced travel disruptions and tourism destinations felt the economic sting of low visitor numbers. Using online interviews, this study followed 29 surfers over the course of 6 months to explore their experiences of the pandemic as travelers and hosts within tourism destinations in the US, Europe, Africa, the Middle East, Australia, the Caribbean, and Latin America. It examines the effect of the pandemic on their travel plans, travel experiences, and tourism destinations where they lived. Many participants experienced travel disruptions and had to go through different decision-making and behavioral processes when they did travel. They also had conflicting feelings about decreased numbers of tourists at the beginning of the pandemic and when tourists began to return. The results have implications for travel companies to maintain flexible policies and the need to diversify coastal economies and possibly implement more separation between tourists and residents.

As part of contemporary racial reckoning, institutions are acknowledging their historical legacies of racism and discrimination. Media institutions, given their role in the social construction of reality, have been called to account by racial justice activists for perpetuating the white-dominant status quo. We develop a framework for recognizing and interpreting efforts at historical repair work in journalism, second draft of history journalism (SDOH), whereby contemporary consciousness about racial injustice, structural inequality, and exclusionary practices inside and outside journalism prompt news organizations to revisit the historical record. Through case study exemplars at U.S. newspapers, we define the three main modes—active, reflective, and active/reflective, and four key characteristics of SDOH journalism—discursive consciousness, institutional consciousness, moral consciousness, and past orientation. We address the contested boundaries of journalism’s cultural authority as journalists negotiate between SDOH journalism’s moral advocacy in pursuit of social justice and journalists’ professional journalistic norms of objectivity and neutrality.

Purpose: Violence against women is one of the most widespread problems facing Kenyan women today. The central problem of this study is the way women react to domestic violence and in particular why they do not seek redress through the available channels. Whilst women are particularly affected by domestic violence, they are also the primary victims of rape or sexual attacks by strangers. The purpose of this study is to investigate the status of domestic violence against women in urban informal settlements of Nairobi and why the women do not seek any redress. Methodology: The paper used a desk study review methodology where relevant empirical literature was reviewed to identify main themes and to extract knowledge gaps. Findings: Though GBV is a well-known vice that pervades all social strata all over the world, most women suffer in silence. This is mainly due to cultural beliefs, poverty, lack of resources or weak and unsupportive community structures, discriminatory laws governing marriage and divorce, social stigma, their economic dependency on men as well as their ignorance of their rights. Due to their low levels of education, most women believe that their husbands have a right to beat them. They do not know that they have available options, which can save them from abusive relationships. Unique Contribution to Theory and Practice: When developing and putting up interventions to help survivors of gender-based violence, these interventions should be designed in partnership with the women they are intended to benefit

The aim of this study was to investigate coping styles, posttraumatic stress, and mental health symptoms among a sample of community members affected by 2019-20 Australian bushfires. Using a convenience sampling approach, an online survey was used to assess a range of coping strategies, posttraumatic stress and symptoms of depression, anxiety, and stress among the affected community members of Black Summer bushfires. The results revealed that study participants reported moderate symptoms of depression and stress, and severe levels of anxiety. Additionally, participants reported use of both approach and avoidance coping strategies following the bushfire event as well as experiencing symptoms of posttraumatic stress, such as having intrusive thoughts and symptoms of avoidance and hyperarousal. Despite the durability of many individuals, others remain affected by the event and there is evidence there may be longer term mental health consequences of the bushfires for some people. Given these findings, it is imperative that mental health services be readily available for people in the bushfire-affected areas. Mental health nurses have an important role to play in supporting individuals affected by disasters. Awareness of the short- and long-term impacts of disasters on the mental health of people is paramount for mental health nurses.

Objectives. To create causal loop diagrams that characterize intersectional stigma experiences among Black, gay, bisexual, same gender–loving, and other men who have sex with men and to identify intervention targets to reduce stigma and increase testing and prevention access. Methods. Between January and July 2020, we conducted focus groups and in-depth interviews with 80 expert informants in New York City, which were transcribed, coded, and analyzed. These qualitative insights were developed iteratively, visualized, and validated in a causal loop diagram (CLD) using Vensim software. Results. The CLD revealed 3 key feedback loops—medical mistrust and HIV transmission, serosorting and marginalization of Black and gay individuals, and family support and internalized homophobia—that contribute to intersectional HIV and related stigmas, homophobia, and systemic racism. On the basis of these results, we designed 2 novel intervention components to integrate into an existing community-level anti-HIV stigma and homophobia intervention. Conclusions. HIV stigma, systemic racism, and homophobia work via feedback loops to reduce access to and uptake of HIV testing, prevention, and treatment. Public Health Implications. The CLD method yielded unique insights into reciprocal feedback structures that, if broken, could interrupt stigmatization and discrimination cycles that impede testing and prevention uptake. (Am J Public Health. 2022;112(S4):S444–S451. https://doi.org/10.2105/AJPH.2022.306725 )

Funder: Kidney Cancer UK, Funder: Mark Foundation For Cancer Research; Id: http://dx.doi.org/10.13039/100014599, Funder: The Rosetrees Trust, Funder: The Urology Foundation, Funder: Yorkshire Cancer Research; Id: http://dx.doi.org/10.13039/100011703, OBJECTIVE: To review the current state of genetic risk models for predicting the development of kidney cancer, by identifying and comparing the performance of published models. METHODS: Risk models were identified from a recent systematic review and the Cancer-PRS web directory. A narrative synthesis of the models, previous validation studies and related genome-wide association studies (GWAS) was carried out. The discrimination and calibration of the identified models was then assessed and compared in the UK Biobank (UKB) cohort (cases, 452; controls, 487 925). RESULTS: A total of 39 genetic models predicting the development of kidney cancer were identified and 31 were validated in the UKB. Several of the genetic-only models (seven of 25) and most of the mixed genetic-phenotypic models (five of six) had some discriminatory ability (area under the receiver operating characteristic curve >0.5) in this cohort. In general, models containing a larger number of genetic variants identified in GWAS performed better than models containing a small number of variants associated with known causal pathways. However, the performance of the included models was consistently poorer than genetic risk models for other cancers. CONCLUSIONS: Although there is potential for genetic models to identify those at highest risk of developing kidney cancer, their performance is poorer than the best genetic risk models for other cancers. This may be due to the comparatively small number of genetic variants associated with kidney cancer identified in GWAS to date. The development of improved genetic risk models for kidney cancer is dependent on the identification of more variants associated with this disease. Whether these will have utility within future kidney cancer screening pathways is yet to determined.

In this project we will observe the persuasiveness of visualization when pertaining to audio data. Specifically, we look at instrumental music composition and observe how visualization can facilitate the communication of a music-maker's state of mind. We first examine, through a research process, how visualization can facilitate the processing of information. Then, steps are taken using data bending and digital data visualization techniques – with minimal creative input – to generate animated visuals from the audio data. Finally, the digital visualizations are introduced to participants via a survey to measure how effective these visualizations were at translating intentionality.

IntroductionFactors that negatively impact women's disaster experiences include poor disaster preparedness, lack of access to a safe place, displacement worries, distance from shelters, risk of abuse in shelters, poverty, and low cultural position of women in rural Bangladesh. This study aimed to give voice to women who experienced gender-based vulnerabilities during natural disasters.MethodsThe research was conducted with women in the two disaster-prone areas utilizing a qualitative approach. Women, aged 18 years or above, who were permanent residents of the selected disaster-prone areas and have experienced one or more disasters, were invited to participate in the study. Twenty-four women volunteered to participate. Data were collected through semi-structured in-depth interview recordings containing questions on sociodemographic characteristics and open-ended questions to assess gender-based vulnerabilities during disasters; data were analyzed using thematic analysis techniques.ResultsOne main theme and six sub-themes emerged from the analysis. Women were often in the middle of making life choices between the risk of being abused and death in disasters. Shelters lacked privacy, heightened the risk of abuse, and women faced social stigma if displaced from their homes during a disaster. The women also experienced health risks because of inadequate hygiene and poor living arrangements such as a lack of adequate shelters, toilet facilities, and secure gender-segregated living arrangements if relocation was essential during a disaster.DiscussionFindings from this study provide guidance to policymakers and disaster aid organizations on disaster preparedness and post-disaster facilities to address the socio-cultural needs of rural women in disaster-prone areas of Bangladesh.

The prevailing hypotheses for the persistent symptoms of Long COVID have been narrowed down to immune dysregulation and autoantibodies, widespread organ damage, viral persistence, and fibrinaloid microclots (entrapping numerous inflammatory molecules) together with platelet hyperactivation. Here we demonstrate significantly increased concentrations of von Willebrand factor (VWF), platelet factor 4 (PF4), serum amyloid A (SAA), α-2 antiplasmin (α-2AP), endothelial-leukocyte adhesion molecule 1 (E-selectin), and platelet endothelial cell adhesion molecule (PECAM-1) in the soluble part of the blood. It was noteworthy that the mean level of α-2 antiplasmin exceeded the upper limit of the laboratory reference range in Long COVID patients, and the other 5 were significantly elevated in Long COVID patients as compared to the controls. This is alarming if we take into consideration that a significant amount of the total burden of these inflammatory molecules has previously been shown to be entrapped inside fibrinolysis-resistant microclots (thus decreasing the apparent level of the soluble molecules). We conclude that presence of microclotting, together with relatively high levels of six biomarkers known to be key drivers of endothelial and clotting pathology, points to thrombotic endothelialitis as a key pathological process in Long COVID.

Introduction An ERAS (Enhanced Recovery After Surgery) programme was created to reduce length of stay (LoS) and improve outcomes following renal transplant surgery. This aimed to reduce post-operative hospital-acquired infection, especially COVID-19. Methods The ERAS protocol was finalised following a literature review and MDT discussion. ERAS information, with post-operative exercise advice, was distributed to patients on the renal transplant waitlist. LOS was evaluated, comparing ERAS with pre-ERAS recipients and, to remove pandemic bias, pre-pandemic (December 2019) recipients. Secondary outcomes were opiate use, mobilisation, bowel function and patient-reported outcomes. ERAS protocol compliance was monitored. Data analysis was with student t-test and Chi-2 test in GraphPad Prism. Results Some 35 consecutive recipients completed ERAS protocol (March 2021). Baseline characteristics were comparable between live-donor recipients 9/35 vs 13/35 pre-ERAS and 12/35 pre-COVID. BMI>30 was higher in ERAS group (19vs. 11vs. 8). Median LoS was significantly reduced: ERAS - 5 days, pre-ERAS - 7 days, pre-COVID - 8 days (p=0.01). 51% of ERAS discharges were within 5 days vs. 17% pre-ERAS vs. none pre-COVID (X2 12.59, p5 days), potential preventable reasons were identified. 79.2% of ERAS recipients mobilised on day 1 post-op. ERAS indicated no significant reduced opiate use. Two ERAS recipients were readmitted within 30 days (vs.9/70 pre-ERAS) and one returned to theatre (vs.5/70 pre-ERAS). Conclusion This ERAS programme successfully reduced the LoS by 2 days in comparative population with minimal adverse events. Patient and staff feedback was positive. It's hypothesised that assigning a specialist ERAS nurse will improve compliance.

Despite the increased risk of disasters in the Bangladesh, there is a dearth of research about women’s physical and mental health vulnerability following disasters. This study aimed to explore the physical and mental health status and associated risk factors of women in recurrent disaster-affected areas of Bangladesh. Participants (N = 408) were recruited using systematic random sampling from two purposively selected disaster-prone areas (Upazilas of Sagata and Sarankhola), using a structured questionnaire conducted in person. Physical and mental health status was assessed using the health Short Form 12 (SF-12) measure that is comprised of both physical health (PCS-12) and mental health (MCS-12) subscales. Of the 408 participants, the mean scores on PCS-12 and MCS-12 subscales were 43.85 ± 28.04 and 37.70 ± 27.29, respectively, which were strongly correlated, r = .71, p

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