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• We compare Meaning Centered Psychotherapy (MCP) to Cognitive Behavioral Therapy (CBT) • This is a randomized controlled trial in a natural setting with cancer survivors. • MCP was more effective than CBT in increasing meaning in life. • MCP and CBT were similarly effective in improving depression. • MCP and CBT were similarly effective in developing posttraumatic growth. Meaning-centered psychotherapy (MCP) has been found to be effective in improving meaning in life and increasing fulfillment in participants with cancer. However, to date, no previous studies have compared MCP with evidence-based treatments such as cognitive behavioral therapy (CBT). The aim of this study was to analyze the differential efficacy of MCP, compared to CBT, in participants with cancer. The study is a randomized controlled trial with 76 participants, n = 41 (MCP) and n = 35 (CBT). At posttreatment, the MCP intervention for cancer survivors was more effective than CBT in increasing the presence of meaning in life, purpose and meaning in life, and life goals. Moreover, our results showed that, at posttreatment and the 6-month follow-up, MCP and CBT were similarly effective in improving depression and developing posttraumatic growth. This study suggests that MCP could be more effective than CBT in improving meaning in life, purpose, and life goals, and equally effective as CBT in improving depression and posttraumatic growth, in cancer survivors. [ABSTRACT FROM AUTHOR]

• Use multimodal functional imaging data. • Explore abnormalities in goal-directed and habitual-learning in patients with OCD. • Abnormal brain regions of goal-directed is associated with duration of illness. • Abnormal brain regions of goal-directed can distinguish the duration of illness. It is increasingly evident that structural and functional changes in brain regions associated with obsessive–compulsive disorder (OCD) are often related to the development of the disease. However, limited research has been conducted on how the progression of OCD may lead to an imbalance between goal-directed and habit-learning systems. This study employs resting-state functional imaging to examine the relationship between illness duration and abnormal brain function in goal-directed/habitual-learning systems. Demographic, clinical, and multimodal fMRI data were collected from participants. Our findings suggest that, compared to healthy controls, individuals with OCD exhibit abnormal brain functional indicators in both goal-directed and habit-learning brain regions, with a more pronounced reduction observed in the goal-directed regions. Additionally, abnormal brain activity is associated with illness duration, and the abnormalities observed in goal-directed regions are more effective in distinguishing different courses of OCD patients. Patients with different durations of OCD have functional abnormalities in the goal-directed and habitual-learning brain regions. There are differences in the degree of abnormality in different brain regions, and these abnormalities may disrupt the balance between goal-directed and habitual-learning systems, leading to increasing reliance on repetitive behaviors. [ABSTRACT FROM AUTHOR]

Bipolar disorder remains a disabling mental health condition despite the availability of effective treatments. Collaborative chronic care models (CCMs) represent an evidence-based way to structure care for conditions like bipolar disorder. Life Goals Collaborative Care (LGCC) was designed specifically for bipolar disorder, featuring psychoeducation alongside collaborative components (e.g. nurse care management or expert psychiatric consultation). Despite the use of Life Goals across health systems, a systematic review summarizing its effectiveness has never been conducted. We conducted a systematic review of randomized controlled trials (RCTs) of LGCC through December 2023 to help guide the field in treating bipolar disorder (PROSPERO: #404581). We evaluated study quality and outcomes in several symptom and quality of life domains. Ten articles describing eight studies met inclusion criteria. All studies featured group-based LGCC; most were compared to treatment as usual (TAU). Three of eight studies found LGCC to be associated with statistically significant effects for the prevention of manic episodes. Most studies finding positive effects featured additional collaborative care components beyond psychoeducation and were conducted in capitated healthcare systems. Limitations include: several types of potential bias in included studies; exclusion of observational studies of LGCC; lack of generalizability to pediatric populations; insufficient studies to conduct subgroup analyses; and low confidence in the quality of the evidence. In this systematic review, group-based LGCC demonstrated some positive effects for reducing mania recurrence; results for other outcome domains were equivocal. Future studies should investigate one-on-one LGCC, both in person and virtually, to enhance well-being for people with bipolar disorder. • Bipolar disorder frequently requires attention to psychoeducation and care coordination. • Life Goals Collaborative Care (LGCC) is a treatment approach featuring psychoeducation and collaborative care components. • Findings from this systematic review of LGCC suggest that it may reduce mania recurrence among people with bipolar disorder. • LGCC findings in other outcome domains, including depression and health-related quality of life, were less consistent. • Based on the included studies, confidence in the quality of the evidence was low, pointing to the need for further research. [ABSTRACT FROM AUTHOR]

To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. Thirty-three Hispanic/Latinx caregivers, predominantly of low income. Patterns in goal content and anticipated barriers and facilitators. Thematic analysis of goal sheets with a mixed inductive-deductive approach. Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators. [ABSTRACT FROM AUTHOR]

We consider goal-oriented adaptive space-time finite-element discretizations of the regularized parabolic p-Laplace problem on completely unstructured simplicial space-time meshes. The adaptivity is driven by the dual-weighted residual (DWR) method since we are interested in an accurate computation of some possibly nonlinear functionals at the solution. Such functionals represent goals in which engineers are often more interested than the solution itself. The DWR method requires the numerical solution of a linear adjoint problem that provides the sensitivities for the mesh refinement. This can be done by means of the same full space-time finite element discretization as used for the primal non-linear problems. The numerical experiments presented demonstrate that this goal-oriented, full space-time finite element solver efficiently provides accurate numerical results for different functionals. [ABSTRACT FROM AUTHOR]

This paper addresses the issue of trajectory planning for a free-floating dual-arm space robot, considering the constraints of collision avoidance while simultaneously minimizing the base position and attitude disturbance during on-orbit tasks. One arm is designated as the mission arm, tracking a prescribed path to complete specific goals, while the other serves as the balance arm, compensating for any base attitude disturbance. A collision-free path planning approach is presented for the mission arm, which utilizes a hybrid map, improved artificial potential field (IAPF) and adaptive coupling guidance method. The hybrid map in the mission arm joint space contains the coupling relationship between the deviation of the base position and the motion of the dual arms, along with obstacles transformed from Cartesian space. Then, to address the problem of the goals nonreachable with obstacles nearby (GNRON) of the artificial potential field (APF), a novel repulsive potential field is incorporated into the IAPF. To minimize the base position disturbance, a coupling guidance method is presented that enables the mission arm to move in areas with lower coupling factors on the hybrid map. Finally, simulations are conducted to demonstrate the effectiveness and superiority of the proposed hybrid map and coordinated trajectory planning approach. [ABSTRACT FROM AUTHOR]

Variants of perioperative cardiac output-guided haemodynamic therapy algorithms have been tested over the last few decades, without clear evidence of effectiveness. Newer approaches have focussed on individualisation of physiological targets and have been tested in early efficacy trials. Uncertainty about the benefits remains. Adoption of novel trial designs could overcome the limitations of smaller trials of this complex intervention and accelerate the exploration of future developments. [ABSTRACT FROM AUTHOR]

Healthcare practitioners will encounter children who use orthoses to improve or maintain body structures and functions, activities and participation. Orthotic interventions involve complex science and the benefits need to outweigh the burden. Interdisciplinary collaborative family centred goal setting, from birth to adulthood is essential. An understanding of why and when orthoses are helpful allows a deeper discussion with families and can improve adherence. This article presents a systematic 'Inside-Out Approach' incorporating the International Classification of Functioning, Disability and Health and the International Organization for Standardization objectives for orthotic interventions. Pictorial and Table Tools identify potential goals for bones and joints, muscles, motor control of standing and walking, activities and participation, and prevention of pain which is an indicator of quality of life. Achieving short and long term goals requires early intervention. The design, alignments and dosage, the duration and frequency the child needs to wear the orthosis, required to achieve goals will be determined by an understanding of natural history and prognosis, the agreed goals and the child's schedule of activities. A Dosage Tool is presented. Recent improved understanding of the contribution of the footwear, individualized and optimized joint and segment alignments and segment proportion is discussed. [ABSTRACT FROM AUTHOR]

Women's mortality at a reproductive age has been a global concern, and its decrease has been incorporated as a target of the UN Sustainable Development Goals. The aim of this study was to describe the spatial–temporal evolution of mortality rates among women of reproductive age in Brazilian municipalities by groups of causes and socioeconomic indicators from 2000 to 2018. Ecological analysis. This work was an ecological, descriptive study that analyzed estimates of mortality rates among women of reproductive age (15–49 years) by main groups of causes of death from the Global Burden of Disease (GBD) study in three consecutive trienniums, T1 (2000–2002), T2 (2009–2011), and T3 (2016–2018). To quantify the temporal evolution in mortality rates, the present study calculated the percentage change for each triennium. The spatial analysis of mortality rates was carried out using Moran's index. The Pearson coefficient was used to analyze the correlation between the data. A significant decline in mortality rates was found for all groups of causes in all regions of the country. Despite the downward trend, the percentage change from 2009 to 2011 to 2016 to 2018 showed a decrease in the group of Noncommunicable Diseases (NCDs) and external causes. The decline in mortality rates of women due to external causes showed only a minimal change in the North and Northeast regions from T2 to T3, whereas a cluster of neighboring municipalities with high mortality rates persisted in the municipalities of the South region and in the state of Roraima. The ranking of the main causes of death in Brazilian municipalities showed an increase in neoplasms in detriment to cardiovascular diseases (CVDs). The main causes of death in women of reproductive age at a more local level could be used to recognize inequalities and to develop interventions aimed at tackling premature and preventable deaths. [ABSTRACT FROM AUTHOR]

Occupational therapy practice for children and young people with cerebral palsy targets many areas to support direct and indirect needs to achieve health, activity performance, and participation outcomes. This aligns with and is complemented by the World Health Organization (2001) International Classification of Functioning, Disability and Health (ICF) framework. This article seeks to support understanding of how occupational therapy practice fits into the ICF framework and to demonstrate the need to address all ICF domains. A broad overview of areas supported by occupational therapists working with children and young people with cerebral palsy GMFCS level III to V is therefore presented. Consideration here is given to environmental factors, hand function and management of secondary effects of neural mechanisms, and supporting activity performance and participation. Additionally, in consideration of these practice examples, this article aims to show that support needs for children and young people with cerebral palsy are ongoing throughout childhood and adolescence and into adulthood. Complexity of presentation means that surveillance mechanisms in services are required. Concurrently, children and young people and their parents/carers require support to enhance abilities to facilitate performance and participation goals independently. [ABSTRACT FROM AUTHOR]

This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. Both countries have made progress on child stunting (Brazil: PC = −38%; Ecuador: PC = −43%) and child wasting prevalences (Brazil: PC = −42%; Ecuador: PC = −41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = −75%; Ecuador: PC = −60%) and neonatal mortality rates (Brazil: PC = −69%; Ecuador: PC = −51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = −40%; Ecuador: PC = −58%), tuberculosis (Brazil: PC = −27%; Ecuador: PC = −55%) and malaria incidences (Brazil: PC = −97%; Ecuador: PC = −100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = −89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = −37%; Ecuador: PC = −40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = −67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters. [ABSTRACT FROM AUTHOR]

Differential attainment (DA) in post graduate medical training is a recognised challenge and refers to unexplained variation across groups when split by several protected characteristics. The Royal College of Radiology is committed to fostering diversity, inclusivity, and equality with the goal of narrowing existing gaps and improving training outcomes. This was a mixed methods study aiming to understand the causes of DA with view to helping the RCR develop strategies to address this. A cross-sectional survey was completed by 140 clinical oncology trainees in September 2022. Trainees and trainers (17 and 6 respectively) from across England, Scotland, Wales and Northern Ireland, took part in focus group and interviews from August to December 2022. Quantitative and qualitative data merged and interpreted. Results showed international medical graduates and trainees from ethnic minority backgrounds were more likely to encounter challenges. The qualitative findings were used to identify three themes through which these problems could be framed. The trainee as a "space invader," the hidden curriculum of clinical oncology training and the process of navigating and tacking the training journey. Differential attainment is the product of a complex interplay between the trainee, trainer, and the training environment. Therefore, interventions must be tailored to different people and contexts. At a national level, the RCR can adopt general policies to promote this such as mentorship programmes, protected time for supervision and cultural competency training. Efficacy of proposed interventions for trial and their impact on DA should be evaluated to drive evidence-based changes. • The GMC and Royal Colleges are committed to bridging existing gaps and addressing differential attainment. • A mixed-method research approach to provide a holistic understanding of differential attainment in Clinical Oncology. • Analysis of exclusionary mechanisms identified three main themes: space invaders, hidden curriculum and navigating. [ABSTRACT FROM AUTHOR]

Characterize experiences with cancer and perceptions of the preventable cancer burden attributable to diet among firefighters. A cross-sectional survey was distributed to assess cancer history and perceptions of cancer. US. US-based firefighters. History of cancer, perceptions of cancer, and perceptions of diet as a means to prevent cancer. Descriptive statistics and use of the Behaviour Change Technique Taxonomy v1 (BCTTv1) to evaluate qualitative responses. A total of 471 firefighters participated. Nearly half (48.4%) voiced they strongly agreed that they were at risk for cancer, whereas 44.6% agreed that changing diet could decrease cancer risk. The most common BCTTv1 codes focused on types of education, including "Instruction on how to perform the behavior" (45.1%, n = 189), followed by those centered on behavior execution (eg, "Action planning" [24.8%, n = 104]). Qualitatively, many were concerned about misinformation. Firefighters acknowledge the role of diet in cancer risk and have a desire for knowledge and behavioral support (eg, goal setting) that includes an emphasis on evidence and tackling misinformation. This information should serve as the basis of future interventions that target diet. [ABSTRACT FROM AUTHOR]

Over the past few decades, the role of neonatal dietitians has undergone substantial transformation. Anticipated ongoing evolution is in line with the evolving goals of neonatal care, expanding beyond mere neonatal survival to encompass the enhancement of the quality of life and long-term outcomes for both ill and premature infants and their families. This review will describe the vital role that neonatal dietitians can fulfil, from the unit level to the broader network level, in collaboration with families and the comprehensive multidisciplinary team. It highlights the importance of optimal neonatal dietetic staffing, both within neonatal units and in broader healthcare contexts, to achieve these objectives effectively. [ABSTRACT FROM AUTHOR]

Some young physicians decide their ultimate life goals early in life. The purpose of this article is to convey the message with feeling that because everyone lives only once, I want them to try many various things. The author introduces several unpredictable episodes that became watershed moments for him, and describes how he each behaved. Although all of the episodes were unexpected, they all shared a common thread that ultimately led the author in a positive direction. I made the decision to not build walls for myself before I even began, and to think about how I wanted to be a more evolved version of myself in the future than I am today. I would like to convey this message to young physicians to encourage them. To act, you must be determined, and to resolve, you must have a dream. As long as you have a dream and work hard, you can achieve your dreams. [ABSTRACT FROM AUTHOR]

Social comparison is an inevitable aspect of human life, often leading to personal relative deprivation, wherein individuals experience a sense of unfair treatment when they perceive themselves as being at a disadvantage in comparison to others. Earlier research has observed a phenomenon called "lying flat" associated with personal relative deprivation, characterized by a lack of motivation for self-improvement. The purpose of this study is to investigate whether this pattern is suitable for the domains of health-promoting lifestyles given that health-promoting is driven by self-improvement motivation. In three studies conducted in China, an understudied non-Western society, we investigated the association between personal relative deprivation and health-promoting lifestyles by utilizing diverse measures and samples. Findings from Study 1 (N = 12,465) indicated a negative relationship between personal relative deprivation and health-promoting behavior. This effect was particularly prominent among older individuals (Study 2, N = 11,378). Study 3 (N = 234) indirectly explored the possibility that a decreased priority given to health goals explains the reduced adoption of health-promoting behaviors when experiencing personal relative deprivation. First, all health-promoting lifestyles are self-reported. Second, the mechanism between PRD and health-promoting lifestyles was not directly examined. Overall, this research confirms the physical "lying flat" phenomenon, highlighting that personal relative deprivation contributes to unhealthy diets and physical inactivity. Moreover, our findings also suggest that the lower significance placed on health goals relative to other life goals may serve as an underlying reason for this phenomenon. • Personal relative deprivation negatively affects health-promoting lifestyles. • Both physical activity and daily diet were affected by personal relative deprivation. • Personal relative deprivation also affects older individuals' lifestyles. • Reduced relative value placed on health may serve as a potential mechanism. [ABSTRACT FROM AUTHOR]

Recent advances in small, connected and intelligent satellite systems have created a wide range of opportunities for the adoption of intelligent Distributed Satellite Systems (iDSS) in communication, navigation and Earth Observation (EO) missions. iDSS are goal-oriented systems comprising of multiple satellites or modules that interact, communicate and/or cooperate with each other to accomplish the desired mission goals. The ability to mass-produce low-cost small satellites and contemporary developments in avionics/astrionics technology have spurred interest in iDSS, especially for Low Earth Orbit (LEO) satellite constellations and regional clusters. The SmartSat Cooperative Research Centre (CRC) and Australian space roadmap, as well as the landmark National Space Programme strategy and priorities, encompass EO. To date, insufficient progress and no conclusive outcome was made in terms of how contemporary Multidisciplinary Design Optimization (MDO) models and tools can be best tailored to the new capabilities and specificities of iDSS. The MDO of iDSS is challenging because it introduces new variables and highly non-linear interactions. In this context, we propose an MDO methodology to optimize an iDSS for persistent coverage over the entire Australian landmass. Several aspects of the iDSS are considered in this work, including the constellation model, subsystem models and the coupling interactions between different satellite subsystems and constellation design parameters. The constellation configuration, as well as the subsystems, are modelled using OpenMDAO, which is used to analyze and visualize the planned iDSS EO mission. The iDSS is then optimized using the Multidisciplinary Feasible (MDF) architecture approach and the iDSS interdependencies are numerically treated using the Nonlinear Block Gauss-Seidel (NLBGS) iterative solver. The resulting N 2 diagrams are presented and the proposed solution is both spatially and temporally optimized, demonstrating that the proposed iDSS will enable near real-time persistent coverage over the entire Australian continent. The following are the main contributions of the work presented in the manuscript: • Review of iDSS specificities and definition of a Multidisciplinary Design Optimization (MDO) framework suitable to flexibly address these factors and their evolutions; • Design optimization of an iDSS constellation for an Earth Observation (EO) mission to provide persistent regional coverage; • Consideration of prospective requirements for developing trusted autonomy in iDSS. [ABSTRACT FROM AUTHOR]

The United States Department of Agriculture expanded the Supplemental Nutrition Assistance Program (SNAP)-Ed program to all 50 states in 2004. In 2010, the Healthy, Hunger-Free Kids Act required that agencies implementing SNAP-Ed support policy, systems, and environmental (PSE) strategies, in addition to providing direct education (DE). Research has evaluated the impact of PSEs on health, but few studies have investigated the process of PSE implementation. The objective of this study was to identify facilitators and barriers to PSE implementation at SNAP-Ed partner sites from the perspectives of site contacts and SNAP-Ed implementers. This study employed a qualitative longitudinal design. The PSE planning and implementation process was observed over 1 year at SNAP-Ed partner sites. Semistructured interviews were conducted with site contacts and SNAP-Ed implementers throughout the year. Participants were SNAP-Ed implementers (n = 8) and site contacts (n = 18) from 18 partner sites where both PSE and direct education were occurring. SNAP-Ed implementers were debriefed once, and site contacts were interviewed three times over the course of the study. This study was conducted in a Southern US state with SNAP-Ed partner sites that intended to implement PSEs. The duration of data collection was October 2017 through September 2018. A thematic analysis of barriers and facilitators to PSE implementation across sites was conducted. The PSE implementation barriers were lack of site or implementer readiness or capacity; breakdowns in communication; and DE prioritized over PSE. Facilitators were effective communication; site capacity or readiness; and alignment between site and SNAP-Ed goals. Communication, capacity, and coordination between SNAP-Ed and partner sites were key components over the timeline of PSE planning and potential implementation. [ABSTRACT FROM AUTHOR]

The revised Suicide Crisis Inventory (SCI)-2 is a self-report measure to assess the suicide crisis syndrome (SCS). We aimed to assess the factor structure, reliability, and validity of SCI-2 among adults with major depression. Using a cross-sectional design, between November 2021 and August 2022, the Hindi SCI-2, along with other self-report measures, was administered to Indian adult respondents clinically diagnosed with major depression across 24 centers in India. Confirmatory factor analysis was carried out to test the factor structure of SCI-2. Additionally, convergent, discriminant, and criterion validity were tested using bivariate or biserial correlations, as appropriate. We obtained responses from 654 participants (Mean age = 36.9 ± 11.9 years, 50.2 % female). The SCI-2 fit both a one-factor (χ2[1769] = 14,150.74, p <.001, CFI = 0.98, RMSEA = 0.10), and five-factor solution (χ2[1759] = 13,130.83, p <.001,CFI = 0.98, RMSEA = 0.10) with the five-factor solution providing a significantly better fit. Internal consistencies of the SCI-2 total and subscale scores ranged from good to excellent. Most subscales significantly converged with each other and with other relevant measures although these associations were weak for thwarted belongingness and goal reengagement subscales. Small to moderate associations were noted in support of discriminant and criterion validity. We could not assess the predictive validity of SCI-2 for suicidal behaviors. Consistent with prior data, the Hindi SCI-2 fit a five-factor solution and showed good psychometric properties. These findings support the use of SCI-2 to assess SCS among Indian adults with major depression. • In the general population, the SCI-2 has demonstrated a five-factor solution. • We performed confirmatory factor analysis of Hindi SCI-2 in major depression. • The five-factor model of SCI-2 showed a superior fit versus the one-factor model. • Excellent internal consistency and good convergent validity were noted. • These findings support the use of SCI-2 in major depression in Asian settings. [ABSTRACT FROM AUTHOR]

In this paper, a novel thin-wall milling strategy named "L-stock method" is proposed. The demand of thin walls has continued its increase due to the strict goal setting of reducing carbon emission. However, its practical machining method has not changed for a long time even though many measures were proposed in the literature. In the proposed method, the directional relationships between the cutting process and the compliant direction are focused, and plunge milling is applied aggressively, which leaves an "L"-shaped stock material, to increase the workpiece stiffness. The synergetic advantages of the proposed method are verified mainly by experiments. [ABSTRACT FROM AUTHOR]

Although goal-directed fluid therapy (GDFT) has been proven to be effective in reducing the incidence of postoperative complications, the underlying mechanisms remain unknown. The aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative complications. We further tested the role of this mediation effect using mean arterial pressure, a hemodynamic indicator. This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine arthrodesis. We used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative complications. We conducted mediation analysis using the mediation package in R (version 3.1.2), based on 5,000 bootstrapped samples, adjusting for covariates. Among the 300 patients in the study, 40% (120/300) developed postoperative complications within 30 days. GDFT was associated with fewer 30-day postoperative complications after adjustment for confounders (odds ratio: 0.460, 95% CI: 0.278, 0.761; P = 0.003). The total effect of GDFT on postoperative complications was –0.18 (95% CI : –0.28, –0.07; P < 0.01). The average causal mediation effect was –0.08 (95% CI : –0.15, –0.04; P < 0.01). The average direct effect was –0.09 (95% CI : –0.20, 0.03; P = 0.17). The proportion mediated was 49.9% (95% CI : 18.3%, 140.0%). The intraoperative blood pressure lability mediates the relationship between GDFT and the incidence of postoperative complications. Future research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications. [ABSTRACT FROM AUTHOR]

This study aimed to examine changes in the proportion of smokers who were advised to quit smoking by health professionals as part of routine consultations or interactions with their patients between 2008 and 2019. Serial cross-sectional study. Data from two nationally representative cross-sectional surveys were used to examine changes over time in the proportions of smokers who were seen by a doctor or other healthcare provider for any health concern and were advised to quit smoking ('Advice_HP'). An additional dichotomous variable ('AdviceAccess_HP') was created and included smokers who were not seen by a doctor or other healthcare provider in the past 12 months in the 'no advice' received category. Crude and adjusted absolute differences in prevalence rates of smokers who were advised to quit smoking by health professionals as part of routine consultations or interactions with their patients between 2008 and 2019 were evaluated using a generalised linear model. The proportion of smokers who were seen by a health professional for any health concern increased from 58.8% in 2008 to 88.7% in 2019. The proportion of 'AdviceAccess_HP' increased from 33.6% in 2008 to 45.2% in 2019; however, the proportion of 'Advice_HP' decreased from 57.1% in 2008 to 51.0% in 2019. After adjustment for sociodemographic and smoking behaviour characteristics, differences remained virtually unchanged. In 2019, health professionals missed the opportunity to provide around 10 million smokers with brief advice to stop smoking. Monitoring the actions needed to encourage smoking cessation is critical for achieving the United Nations sustainable development goals. Primary healthcare workers should serve as role models for patients and provide brief advice that increases the likelihood of successfully quitting tobacco use, particularly in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Discussions between health professionals and nursing home (NH) residents or their families about the current or future goals of health care may be associated with better outcomes at the end of life (EOL), such as avoidance of unwanted interventions or death in hospital. The timing of these discussions varies, and it is possible that their influence on EOL outcomes depends on their timing. This study synthesized current evidence concerning the timing of goals of care (GOC) discussions in NHs and its impact on EOL outcomes. Systematic review. Adult populations in NH settings. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. We searched PubMed, Embase, and Cumulative Index of Nursing and Allied Health from January 2000 to September 2022. We included studies that examined timing of GOC discussions in NHs, were peer-reviewed, and published in English. Quality of the studies was assessed using the Newcastle-Ottawa Scale. Screening of 1930 abstracts yielded 149 papers that were evaluated for eligibility. Of the 18 articles, representing 16 distinct studies that met review criteria, 12 evaluated the timing of advance directives. There was variation in the timing of GOC discussions and compared with discussions that occurred within a month of death, earlier discussions (eg, at the time of facility admission) were associated with lower rates of hospitalization at the EOL and lower health care costs. The timing of GOC discussions in NHs varies and evidence suggests that late discussions are associated with poorer EOL outcomes. The benefits of goal-concordant care may be enhanced by earlier and more frequent discussions. Future studies should examine the optimal timing for GOC discussions in the NH population. [ABSTRACT FROM AUTHOR]

Diversity is a critical component in the advancement of human endeavor in science. Students who complete their education and training at diverse schools can serve patients from a wide range of ethnic backgrounds and promote cross-cultural competence. However, developing a diverse environment of professionals is a long-term effort which often takes generations to complete. Increasing awareness of underrepresented genders and/or minorities helps to establish goals for building a future of improved diversity. Specific to radiation oncology, professions such as medical physicists and radiation oncology physicians have reported underrepresented females and minorities. The problem is that there is a paucity of literature regarding diversity of medical dosimetry professionals. The professional organization does not track diversity data for those members currently working in the profession. Therefore, the purpose of this research was to present aggregate data demonstrating the diversity of medical dosimetry applicants and graduates. The methodology involved quantitative data collection from medical dosimetry program directors which answered the research question, what is the diversity of medical dosimetry applicants and graduates? In comparison to the U.S. population, there were less applicant and accepted students of Hispanic/Latino and African American ethnicities whereas the Asian population was higher. While the U.S. population data reveals 3% more females, there were 35% more female than male applicant and accepted students in this study. However, the results differ significantly from medical physics and radiation oncology physicians with only 30% female clinicians. [ABSTRACT FROM AUTHOR]

The primary objective of this research was to assess the impact of a novel, peer-directed intervention (iNSPiRED) on diabetes distress (DD) among veterans with type 2 diabetes and DD. Secondary objectives were to assess iNSPiRED's impact on anxiety, depression, and diabetes self-management behaviors. A single-blinded, randomized, parallel-group trial was conducted. Participants (n = 218) were recruited through a Veterans Affairs medical center and community agencies in a major metropolitan area from September 2019 through January 2022. Certified mental health peer specialists delivered iNSPiRED, a three-month goal-setting and resource navigation intervention. Outcomes were assessed at baseline, postintervention, and month six. Multilevel random-intercept linear regression models with treatment x time interaction terms were used to assess treatment effects. Frequency of following a healthy eating plan was higher for iNSPiRED vs usual care at month three relative to baseline (B = 0.58; p = 0.03) after adjusting for race and socioeconomic status. No other treatment effects differed significantly from zero (ps ≥ 0.05). Peer-directed interventions have the potential to deliver low-cost, highly scalable care. However, based on the largely negative findings of the current study, it is likely that more intense, multimodal interventions are needed to address DD. • Diabetes distress (DD) is linked to poor diabetes outcomes and quality of life. • A peer-led intervention (iNSPiRED) targeting DD and related outcomes was tested. • iNSPiRED participants improved more in frequency of healthy eating vs usual care. • No other treatment effects differed significantly from zero (ps ≥ 0.05). • More intense, multimodal interventions may be needed to address DD. [ABSTRACT FROM AUTHOR]

We discuss goal-oriented adaptivity in the frame of conforming finite element methods and plain convergence of the related a posteriori error estimator for different general marking strategies. We present an abstract analysis for two different settings. First, we consider problems where a local discrete efficiency estimate holds. Second, we show plain convergence in a setting that relies only on structural properties of the error estimators, namely stability on non-refined elements as well as reduction on refined elements. In particular, the second setting does not require reliability and efficiency estimates. Numerical experiments underline our theoretical findings. [ABSTRACT FROM AUTHOR]

Palliative radiotherapy is commonly used to achieve haemostasis for malignancy-induced haemorrhages. Our study aimed to examine the efficacy of palliative radiotherapy in the control of haemorrhages caused by various types of malignancy. A systematic review of the literature was conducted to determine the level of evidence for the use of palliative radiotherapy in achieving haemostasis. Searches of the Medline, Embase and Cochrane databases were completed for studies published between January 1947 and May 2017. Studies that reported either a qualitative or a quantitative effect of radiotherapy were selected for inclusion during the review process. In total, 836 abstracts were screened; 13 prospective and 45 retrospective studies met the criteria for inclusion in the review. Selected studies were sorted based on the underlying tumour type to provide readers the opportunity to compare dose and fractionation schedules. Significant variations in reporting of outcomes and low total patient numbers did not allow for a quantitative analysis to be carried out. A higher median dose and a hypofractionated schedule seem to provide numerically higher rates of control based on the available data. Palliative radiotherapy is useful in the management of bleeding related to advanced and incurable malignancies. Brachytherapy seems to be effective in haemostasis of certain malignancies, especially that of gynaecological origin. Treatment should be tailored to individual patient situations given the palliative goals of any such therapy. Further prospective studies could help to delineate optimal dose and fractionation schedules. • Radiation therapy is commonly used to achieve haemostasis in malignancy-induced haemorrhages. • Significant variations exist in radiation treatments with variable clinical outcomes. • Higher doses with a low number of fractions seem to achieve higher rates of haemostasis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To explore how outpatient dietitians select and use applications (apps) to support nutrition education. Qualitative analysis of 20 dietitians who participated in semistructured interviews investigating their app use and recommendation processes. Transcripts were analyzed using thematic analysis. Four themes described how dietitians perceive apps for nutrition education: (1) nutrition education goals focus on long-term lifestyle behavior change while protecting patients' relationship with food, (2) attitudes toward tracking apps influence app selection, (3) dietitians differentiate among patients who will benefit from tracking vs information apps, and (4) barriers to optimal app use result in adaptations by dietitians. Barriers exist to optimal app use for nutrition education. However, accessible app design, app selection guides, and research expounding the effects of apps and their use by dietitians may improve how practitioners incorporate apps into nutrition education. [ABSTRACT FROM AUTHOR]

High-contact structured diabetes prevention programs are effective in lowering weight and HbA1cs, yet their intensity level can create barriers to participation. Peer support programs improve clinical outcomes among adults with Type 2 diabetes, but their effectiveness in diabetes prevention is unknown. This study examined whether a low-intensity peer support program improved outcomes more than enhanced usual care in a diverse population with prediabetes. The intervention was tested in a pragmatic 2-arm RCT. Participants were adults with prediabetes at three healthcare centers. Participants randomized to the enhanced usual care arm received educational materials. Participants in the Using Peer Support to Aid in Prevention and Treatment in Prediabetes arm were matched with a peer supporter: another patient who had made healthy lifestyle changes and was trained in autonomy-supportive action planning. Peer supporters were instructed to provide weekly telephone support to their peers on specific action steps toward behavioral goals for 6 months, then monthly support for 6 months. Changes in primary outcomes of weight and HbA1c and secondary outcomes of enrollment in formal diabetes prevention programs, self-reported diet, physical activity, health-specific social support, self-efficacy, motivation, and activation at 6 and 12 months were examined. Data collection occurred from October 2018 to March 2022, with analyses completed in September 2022. Among 355 randomized patients, in intention-to-treat analyses, there were no between-group differences in HbA1c or weight changes at 6 and 12 months. Using Peer Support to Aid in Prevention and Treatment in Prediabetes participants were more likely to enroll in structured programs at 6 (AOR=2.45, p =0.009) and 12 (AOR=2.21, p =0.016) months and to report eating whole grains at 6 (4.49, p =0.026) and 12 (4.22, p =0.034) months. They reported greater improvements in perceived social support for diabetes prevention behaviors at 6 (6.39, p <0.001) and 12 (5.48, p <0.001) months, with no differences in other measures. A stand-alone, low-intensity peer support program improved social support and participation in formal diabetes prevention programs but not weight or HbA1c. It will be important to examine whether peer support could effectively complement higher-intensity, structured diabetes prevention programs. This trial is registered at ClinicalTrials.gov, NCT03689530. Full protocol available at https://clinicaltrials.gov/ct2/show/NCT03689530. [ABSTRACT FROM AUTHOR]

Creativity involves associative thinking: linking concepts from memory. Computational models of semantic memory allow researchers to quantify associative thinking as movement through a semantic space of concepts. Associative thinking reflects a search process operating on a semantic memory network structure. Highly creative people travel further in semantic space, switch between more semantic subcategories, and make larger leaps between associations. Creativity involves both free associations, in which concepts are spontaneously connected, and goal-directed associations, in which concepts are strategically combined. Free association is relevant for artistic creativity, implicating domain-general cognitive abilities in domain-specific creative expertise. Neuroscience evidence indicates associative thinking engages brain regions involved in both semantic and episodic memory. Creativity has long been thought to involve associative processes in memory: connecting concepts to form ideas, inventions, and artworks. However, associative thinking has been difficult to study due to limitations in modeling memory structure and retrieval processes. Recent advances in computational models of semantic memory allow researchers to examine how people navigate a semantic space of concepts when forming associations, revealing key search strategies associated with creativity. Here, we synthesize cognitive, computational, and neuroscience research on creativity and associative thinking. This Review highlights distinctions between free- and goal-directed association, illustrates the role of associative thinking in the arts, and links associative thinking to brain systems supporting both semantic and episodic memory – offering a new perspective on a longstanding creativity theory. [ABSTRACT FROM AUTHOR]

The article emphasizes the importance of a patient-centered approach in neurological rehabilitation and physiotherapy for individuals with traumatic brain injury. It highlights the need to consider neuroplasticity, motor learning, and motor control principles, as well as setting specific measurable goals and involving the patient in goal-setting. It also discusses the different stages of rehabilitation and the various physiotherapeutic interventions that can be used to promote recovery.

OBJECTIVE: We sought to assess whether the change from in-person to virtual interviews was associated with differences in applicant and match location geography. METHODS: We conducted a retrospective study of all U.S. applicants to a large pediatric residency. Distances from applicants to our residency program (applicant-to-program) and residency location (applicant-to-match) were compared across demographic subgroups and eras, defined as pre-COVID (2018-2020) and COVID (2021-2022). RESULTS: Applicant-to-program distance (pre-COVID median 737 miles, IQR 265, 1254; COVID median 739 miles; IQR 268, 1284, P = .31) did not change across eras. While overall applicant-to-match distance (pre-COVID median 425 miles, IQR 88, 1142; COVID median 354 miles; IQR 80, 1084, P = .11) did not change, subgroup analysis revealed that applicant-to-match distance for those not participating in a couples match was farther during the pre-COVID era (430 vs 340 miles, P = .04). CONCLUSIONS: A transition to virtual interviews was associated with shorter distance between applicants and residency location for those matching alone at a large, urban pediatric residency. While decisions about where to apply appeared unchanged, rank list decisions may have been impacted by virtual interviews for these applicants. Further study to describe geographic considerations in the virtual era are needed to inform advancement of larger workforce goals. [ABSTRACT FROM AUTHOR]

Evaluate the delivery of a "family night" event to demonstrate Accreditation Council for Education in Nutrition and Dietetics (ACEND) Didactic Program in Dietetics (DPD) curriculum standards. Experiences beyond the classroom can apply multiple aspects of nutrition education to enhance students' behavioral capability and self-efficacy for future practice. Undergraduate students in a junior-level Nutrition Education and Counseling course within an ACEND accredited DPD. Student delivered a family night event at a campus-based child development center. Through intentional design, event delivery encompassed audience assessment, goal setting, theory application, message identification, handout development, developmentally appropriate activities, food tasting, and interpersonal communication with diverse audiences. Outcome evaluation aligned select ACEND Knowledge Requirements for Dietitians and Nutritionists (KRDN) to these event components: apply assessment of target audience educational and resource needs to program materials (KRDN 1.3); develop a handout including instructor assigned components (KRDN 2.1); engage with parents and children during event (KRDN 2.1); develop a culturally appropriate handout and activity (KRDN 2.6); develop education strategies in the form of a handout, activity, and food tasting (KRDN 3.2); convey messages and developmentally appropriate feeding suggestions (KRDN 3.3). Primary themes within evaluation included: 1) student enthusiasm to deliver the event; 2) challenges conveying feeding information; 3) the need to foster students' cultural awareness prior to resource development; 4) the need for example handouts demonstrating appropriate and inappropriate formatting; and 5) identification of additional areas of student learning for similar assignments (ie communication "soft skills", advertising programs, negotiation). Delivering a "family night" event allows undergraduate students to develop behavioral capability and self-efficacy for nutrition education. Training students on "soft skills" for communication with facility staff and participants; intentional assessment to establish cultural awareness; and prior role play can help assure a successful event which promotes positive feeding practices among participants. None [ABSTRACT FROM AUTHOR]

The 2018 AHA/ACC clinical practice guidelines set standards for treatment selection and low-density lipoprotein cholesterol (LDL-C) lowering among patients with atherosclerotic cardiovascular disease (ASCVD) and/or type 2 diabetes mellitus (T2DM). However, real-world evidence on rates of lipid testing and LDL-C target attainment following guideline directed treatment (GDT) post-release of practice guidelines is limited. To assess the rates of lipid testing among patients with ASCVD and/or T2DM pre and post initiating statins or proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) and the extent of LDL-C target attainment in 12 months post-initiation after GDT versus non-GDT post-release of practice guidelines. Adults initiating statins or PCSK9i between 01/01/2019 and 12/31/2020 with prior evidence of ASCVD and/or T2DM, and health plan enrollment for 12-month pre- and post-index pharmacy claim date (either statin or PCSK9i) were identified from the Healthcare Integrated Research Database. Lipid testing patterns and LDL-C target attainment rates (<70mg/dL) based on procedure codes or available lab results were examined. GDT was defined as high-intensity statin initiation in patients with ASCVD, moderate- or high-intensity statin initiation in patients with T2DM without ASCVD, PCSK9i in patients with ASCVD added to high-intensity statin and sustained high-intensity statin while persistent on PCSK9i during the 12 months follow-up period. Descriptive statistics were reported, and no statistical testing was performed. In total, 71,581 statin initiators with ASCVD/T2DM, and 3,038 PCSK9i initiators with ASCVD were included (mean age: 61-65 years; males: 55-60%). Among statin initiators and PCSK9i initiators with prior ASCVD, 72% and 79% had lipid testing during 12-month baseline, and 69% and 75% during 12-month follow-up, respectively. LDL-C target attainment rates during 12-month post-initiation among a subset of patients with at least one valid LDL-C measurement is as follows: 53% in GDT statin initiators with prior ASCVD versus 35% for non-GDT, 35% in GDT statin initiators with prior T2DM without ASCVD versus 16% for non-GDT, 65% among GDT PCSK9i initiators with prior ASCVD versus 53% for non-GDT, and 80% among patients with prior ASCVD with sustained high-intensity statin while persistent on PCSK9i versus 64% for non-persistent PCSK9i/statin. Lipid testing rates were moderate. LDL-C target attainment in high-risk patients with lipid testing treated per 2018 AHA/ACC guidelines (i.e., GDT) were modestly improved versus non-GDT. Interventions to improve lipid testing rate may increase opportunities for treatment modification based on guidelines and better LDL-C target attainment to help reduce the risk of cardiovascular events. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coalition formation with task dependencies has been the focus of few of the literature on multi-agent coalition formation. In contrast, very little attention has been given to the case where each agent has several alternative sets of tasks leading it to its goal satisfaction. The task dependencies impact the feasibility of the coalitions depending on the considered tasks alternative at a given time. Hence, the performance of a single task, whether by coalition formation (group of agents) or by a single performance, could affect the feasibility of other coalitions in the system. However, these task dependencies play a crucial role in many real-world multi-agent applications. Against this background, we consider in this paper multiple self-interested agents each of which has a goal it needs to achieve by performing a set of tasks. Each agent has several alternative sets of tasks leading it to its goal satisfaction. The tasks in an alternative exhibit dependencies and require sequential execution. So, to jointly achieve goals, the agents may form interdependent coalitions. We introduce a new algorithm that we call the Selective Exploration Algorithm (SEA) for coalition formation that accounts for the task dependencies to consider only feasible coalitions and reduce the size of the search space to explore and identify the optimal coalition structure. [ABSTRACT FROM AUTHOR]

A dialogue state tracker is a component in a task-oriented dialogue system that monitors the current state of a conversation and gives information about its context and history to other system components. The dynamic and open-ended character of human interactions is one of the primary obstacles in dialogue state monitoring, necessitating robust and adaptable models to keep up with the quick context changes. Recently, numerous deep learning-based algorithms have been developed for this purpose. Still, these models are typically heavily-engineered and conceptually sophisticated, making them challenging to deploy, debug, and maintain in a production environment. To overcome these challenges, we offer the BERT-SIAM-DST model, a unique way to dialogue state monitoring employing a Siamese network with BERT as the base network. This model uses the robust representation capabilities of BERT and the ability of Siamese networks to record correlations between inputs to make accurate predictions regarding the current state of the discussion. In addition, the number of parameters does not increase proportionally with the size of the ontology, and the model is adaptable to alterations in the domain ontology. We test the performance of the BERT-SIAM-DST model on the standard WoZ 2.0 dataset of annotated dialogues and compare it to other approaches. Compared to numerous baseline models, the BERT-SIAM-DST model is effective at tracking the state of discussions, demonstrating the promise of BERT-based Siamese networks for this purpose. [ABSTRACT FROM AUTHOR]

• A randomised pilot trial amongst adults with Cystic Fibrosis • Intervention consisted of wearable technology, goal setting and text message feedback • Active comparator group wore wearable technology only • Physical activity increased for both groups • Text messages based on collaborative goal setting showed significantly greater improvements Regular participation in physical activity (PA) is encouraged for people with Cystic Fibrosis (CF). This study aimed to assess the effectiveness of an intervention using wearable technology, goal setting and text message feedback on PA and health outcomes in people with CF. This was a pilot randomised trial conducted at University Hospital Limerick. Participants were randomly assigned to the intervention (INT) or active comparator (AC). The 12-week intervention consisted of wearable technology (Fitbit Charge 2) which was remotely monitored, and participants set step count goals. Participants were sent a one-way text message once a week over 12 weeks to positively reinforce and encourage PA participation. The AC group received the wearable technology alone. Follow up was assessed at 24 weeks. Outcomes assessed were PA, aerobic capacity, lung function, sleep, quality of life and wellbeing. Step count increased significantly for the INT group over 12 weeks when compared to the AC group (p=0.019). The INT group had a 28% week-to-week percentage change (Weeks 1-12), while the AC group reduced by 1%, p=0.023. Within group changes demonstrated that VO2 peak (ml/kg/min) significantly increased for the INT group at 12 weeks (24.4 ±7.65 to 26.13 ±7.79, p=0.003) but not at 24 weeks (24.45 ±7.05, p=0.776). There were no significant differences observed for VO2 peak (ml/kg/min) for the AC group. There was no significant effect on lung function, sleep, well-being, or quality of life for either group. A personalised PA intervention using wearable technology, goal setting and text message feedback increased PA and aerobic capacity in people with CF. Integration of this intervention into usual care may encourage regular PA participation for people with CF. [ABSTRACT FROM AUTHOR]

Exposure to stress during the prenatal period is often associated with adverse maternal and neonatal health outcomes and is increasing in prevalence in the United States. Health care providers play a crucial role in addressing and mitigating this stress, but there is a lack of consensus regarding effective interventions. This review evaluates the effectiveness of prenatal provider-based interventions that reduce stress for pregnant people, especially those who are disproportionately affected by stress. A search of relevant English-language literature was conducted using PubMed, CINAHL, Web of Science, Embase, and PyscInfo. Inclusion criteria were 1) the target population was pregnant people, 2) the intervention was delivered within the U.S. health care system, and 3) the study intervention had the goal of reducing stress (stress-reducing intervention). A total of 3,562 records were identified in the search and 23 were included in analysis. The four identified categories for provider-led stress-reducing prenatal interventions included in the review are 1) skills-building, 2) mindfulness, 3) behavioral therapy, and 4) group support. Findings suggest an increased overall likelihood of mood and maternal stress improvement among pregnant people who complete provider-based stress-reducing interventions, especially group-based therapies that integrate resource allocation, skills-building, mindfulness, and/or behavioral therapy into an intersectional program. However, the efficacy of each type of intervention varies by category and type of maternal stress targeted. Although few studies demonstrated a significant reduction in stress for pregnant people, this review highlights the critical need for increased research and attention to stress-reducing interventions in the prenatal period, especially as it pertains to minoritized populations. [ABSTRACT FROM AUTHOR]

• We examined LDL-C treatment in Israeli patients with premature ACS. • 34.5% of Arab Israeli patients achieved LDL-C<55mg/dl at 1 year. • 45.3% of Jewish Israeli patients achieved LDL-C<55mg/dl at 1 year. • The use of ezetimibe and PCSK9 inhibitors was trivial in both groups. • MACCE occurred more often among Arab patients. There are significant health gaps between Arabs and Jews in Israel. However, there are limited data on the management and treatment of dyslipidemia among Israeli adults who experience premature acute coronary syndrome (ACS). This study aimed to assess the differences between Arabs and Jews with regard to lipid-lowering therapy administration and low-density lipoprotein cholesterol (LDL-C) levels goal attainment at 1 year post-ACS. This study included patients aged ≤55 years who had been hospitalized for ACS at Meir Medical Center between 2018 and 2019. Outcomes included the rate of use of lipid-lowering medications, LDL-C levels 1 year post-admission, and major adverse cardiovascular and cerebrovascular events (MACCE) during 30 months of follow-up. The study population comprised 687 young adults with a median age of 48.5 years. 81.9% of the Arab patients and 79.8% of the Jewish patients were discharged on high intensity statins. At 1 year of follow-up, the proportions of Arab patients who had LDL-C levels <70 mg/dL and <55 mg/dL were lower than those of Jewish patients (43.8% vs. 58%, p < 0.001 and 34.5% vs. 45.3%, p < 0.001, respectively). At 1 year of follow-up, only 25% and 4% of both groups were treated with ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitor. The incidence of MACCE was significantly higher among Arab patients. Our study highlighted the need for a more aggressive lipid-lowering strategy in both Arab and Jewish populations. Culturally adapted interventions are required to reduce gaps between Arab and Jewish patients. [ABSTRACT FROM AUTHOR]

Purpose: Foster youth are at increased risk for negative sexual health outcomes and rarely receive the information or social/ familial support needed to reduce risks. Foster and kinship care-givers report lacking the information and skills needed to effectively talk to youth in their care about sexual health. In a sample of caregivers from 2 large urban jurisdictions, our goals were to: 1) describe caregiver sexual health variables including communication and monitoring characteristics; and 2) assess associations between self-reported emotion regulation and caregiver-youth conflict and these variables. Methods: We administered surveys to foster and kinship caregivers in New York, New York and Los Angeles, California. Surveys assessed caregiver emotion regulation, caregiver-youth conflict, sexual/reproductive health knowledge, communication expectations and behaviors, and caregiver monitoring/youth disclosure. We generated descriptive statistics for all variables (aim 1) then performed multivariate regression analyses for aim 2. Results: Our sample included 127 foster and kinship care-givers who were primarily female (92%) and African American (55%). Most reported having >4 years of caregiving experience with foster youth (66%). On average, caregivers answered sexual health knowledge questions correctly 68% of the time. Caregiver-youth conflict was the only variable significantly associated with assessed sexual health variables; it was inversely associated with percent correct on the knowledge scale, outcomes expectations, number of topics discussed, and monitoring/disclosure. Conclusion: Our study suggests that caregiver-youth conflict behaviors are related to sexual health knowledge, communication, and monitoring variables. Further prospective and longitudinal investigation is warranted to better characterize the complex relationship between these variables. [ABSTRACT FROM AUTHOR]

Objective: US-based academic institutions involved in global health (GH) partnerships can have a positive impact on health care systems in low/middle-income countries but lack a consistent approach. Existing priority setting and resource allocation (PSRA) frameworks do not adequately capture the interpersonal and sociopolitical complexity of decision-making in GH work. The authors explored how US-based GH practitioners prioritize and allocate resources for different types of support in academic GH partnerships. Method: In 2020 to 2021, the authors invited 36 US-based GH practitioners from the 2015 Pediatric GH Leadership Conference to participate in individual 1-hour semi-structured interviews. Using an iterative and inductive grounded theory approach, the study team analyzed interview transcripts through the lens of Heyse's framework on decision-making in humanitarian aid. Results: The authors interviewed 20 GH practitioners and reached thematic sufficiency. A descriptive conceptual framework, capturing 18 distinct themes in 4 major categories, emerged from the data. In this framework, categories included: 1) stakeholders: those who influence and are influenced by the partnership; 2) goals: vision, mission, aims, and scope of the partnership; 3) implementation strategy: approach to accomplishing goals, categorized as relationship-oriented, task-oriented, context-oriented, or nonprescriptive; and 4) approach to conflict: response when goals and strategies do not align among stakeholders. Conclusion: Themes revealed a dynamic process for PSRA. Using our study findings, and building on existing literature, our framework highlights the complex interpersonal relationships, resource limitations, and sociopolitical and economic constraints that affect PSRA in GH partnerships. Finally, themes point to the field's evolution toward a more decolonized approach to GH. [ABSTRACT FROM AUTHOR]

The discovery of place cells and other spatially modulated neurons in the hippocampal complex of rodents has been crucial to elucidating the neural basis of spatial cognition. More recently, the replay of neural sequences encoding previously experienced trajectories has been observed during consummatory behavior—potentially with implications for rapid learning, quick memory consolidation, and behavioral planning. Several promising models for robotic navigation and reinforcement learning have been proposed based on these and previous findings. Most of these models, however, use carefully engineered neural networks, and sometimes require long learning periods. In this paper, we present a self-organizing model incorporating place cells and replay, and demonstrate its utility for rapid one-shot learning in non-trivial environments with obstacles. [ABSTRACT FROM AUTHOR]

Previous research has explored the effectiveness of wearable activity trackers (wearables) for increasing child physical activity (PA) levels, but there have been mixed results. The use of theoretical frameworks and co-design techniques are recognised ways of increasing an intervention's acceptability and effectiveness. This study aims to use co-design workshops and an evidence-based theoretical framework (the Behaviour Change Wheel) to develop a family-based PA intervention using wearables. Three stages of intervention development outlined by the Behaviour Change Wheel were used. Co-design workshops with seven families (11 parents and 12 children) and seven PA experts were conducted where stakeholders discussed how to overcome previously identified barriers to families being active and using wearables. This resulted in the intervention's components being developed, with each component's mechanisms of action (e.g. intervention functions and behaviour change techniques) being retrospectively identified. The 'Move & Connect' intervention was developed, which targets family PA and wearable use. The intervention takes a flexible approach and includes eight components, including wearable devices (Fitbit Alta HR), support resources, an introductory workshop, collective challenges, goal setting and reviewing, engagement prompts, social support and health-related resources (e.g. educational videos). The intervention incorporates six intervention functions targeting PA and wearable use: education, training, modelling, persuasion, incentivisation and environmental restructuring and 24 behaviour change techniques, including goal setting, social comparison, feedback on behaviour and graded task. This is the first known study to use an evidence-based framework and co-design to develop a family-based wearable intervention. The identification of the intervention's mechanisms of action will prove useful when implementing and evaluating the 'Move & Connect' intervention and allow researchers to replicate its components. [ABSTRACT FROM AUTHOR]

'Goal-directed haemodynamic therapy' describes various haemodynamic treatment strategies that have in common that interventions are titrated to achieve predefined haemodynamic targets. However, the treatment strategies differ substantially regarding the underlying haemodynamic target variables and target values, and thus presumably have different effects on outcome. It is an over-simplifying approach to lump complex and substantially differing haemodynamic treatment strategies together under the term 'goal-directed haemodynamic therapy', an imprecise umbrella term that we should thus stop using. [ABSTRACT FROM AUTHOR]

In the seminal paper of Bank and Weiser (1985) [17] a new a posteriori estimator was introduced. This estimator requires the solution of a local Neumann problem on every cell of the finite element mesh. Despite the promise of Bank–Weiser type estimators, namely locality, computational efficiency, and asymptotic sharpness, they have seen little use in practical computational problems. The focus of this contribution is to describe a novel algorithmic approach to constructing hierarchical estimators of the Bank–Weiser type that is designed for implementation in a modern high-level finite element software with automatic code generation capabilities. We show how to use the estimator to drive (goal-oriented) adaptive mesh refinement for diverse Poisson problems and for mixed approximations of the nearly-incompressible elasticity problems. We provide comparisons with various other used estimators. Two open source implementations in the DOLFIN and DOLFINx solvers of the FEniCS Project are provided as supplementary material. [ABSTRACT FROM AUTHOR]