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Abstract: With increasing use of golf carts and low speed vehicles (LSV) for recreational, work-related, and commuting purposes, the number of related injuries is also on the rise. The body of literature describing these injuries is informative but limited. From this scoping review, we found that, LSV related injuries preferentially affect children, older adults, and males. Common mechanisms of injury include ejection and collision. Associated alcohol consumption is common and typically related to increasing severity of injury. Various injuries may result from LSVs as described in the review, including soft tissue injuries, orthopedic injuries and TBI. Description of trends and classifications of injury will hopefully improve reporting and ability to make recommendations on safe use and regulation., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The purpose of this study was to determine student perceptions versus actual level of test anxiety, as measured by the Cognitive Test Anxiety Scale-2 (CTAS-2), and student and faculty perceptions of test anxiety with regard to prevalence, impact, ease of treatment, and importance in pharmacy education., Methods: Two independent Qualtrics questionnaires were distributed via email to all students and faculty in the professional pharmacy program (years 1-4) at the University of Mississippi. The first questionnaire evaluated pharmacy students' perceptions of test anxiety and self-awareness of personal test anxiety. The second questionnaire evaluated faculty members' perceptions of student test anxiety. The questionnaires had 50 and 21 questions, respectively, and were developed from validated, reliable questionnaires used in Cognitive Test Anxiety (CTA) research., Results: Questionnaires were completed by 123 students and 19 faculty. Overall, 46 % of students had a self-perception of "high test anxiety", with 28 % having a CTAS-2 score that correlated to severe test anxiety. A majority of faculty respondents (84 %) believed severe test anxiety affects 30 % or less of pharmacy students and may be associated with poor academic performance., Conclusion: Student pharmacists' self-perception of test anxiety and perception of difficulty mitigating test anxiety may be overestimated. Overall, faculty accurately estimated the degree of test anxiety, felt confident in being able to help students, and believed it should receive attention from both faculty and the university., Competing Interests: Declaration of Competing Interest The authors have no conflicts and no relevant financial information to disclose., (Copyright © 2024 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

The Women's Health Strategy 2022 aims to improve access to Women's Healthcare needs, with menopause care being a key component to optimise. This strategy encourages the 'expansion of women's health hubs around the country and other models of "one-stop clinics," bringing essential women's services together to support women'. 1 A service evaluation was completed at a local women's health hub in Oxfordshire to review referrals for specialist menopause care. The hub managed 75.1% (970/1291) of referrals in-house at the point of triage. Of these 970 menopause consultations, 10.7% (104/970) were referred onwards for secondary care management, with the remainder 89.3% (866/970) managed within the women's health hub. The service evaluation shows successful application of a local women's health hub in improving access to menopause care., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Katie Barber has received honoraria for teaching, research, and education from Besins, Exeltis, Astellas, Gedeon Richter, Theramex, and Viatris.

Female hypogonadism (FH) is a relatively common endocrine disorder in women of premenopausal age, but there are significant uncertainties and wide variation in its management. Most current guidelines are monospecialty and only address premature ovarian insufficiency (POI); some allude to management in very brief and general terms, and most rely upon the extrapolation of evidence from the studies relating to physiological estrogen deficiency in postmenopausal women. The Society for Endocrinology commissioned new guidance to provide all care providers with a multidisciplinary perspective on managing patients with all forms of FH. It has been compiled using expertise from Endocrinology, Primary Care, Gynaecology and Reproductive Health practices, with contributions from expert patients and a patient support group, to help clinicians best manage FH resulting from both POI and hypothalamo-pituitary disorders, whether organic or functional., (© 2024 The Author(s). Clinical Endocrinology published by John Wiley & Sons Ltd.)

Unscheduled bleeding on hormone replacement therapy (HRT) can affect up to 40% of users. In parallel with the increase in HRT prescribing in the UK, there has been an associated increase in referrals to the urgent suspicion of cancer pathway for unscheduled bleeding. On behalf of the British Menopause Society (BMS) an expert review panel was established, including primary and secondary care clinicians with expertise in the management of menopause, with representatives from key related organisations, including the Royal College of Obstetricians & Gynaecologists, the British Gynaecological Cancer Society, British Society for Gynaecological Endoscopy, Royal College of General Practitioners and Faculty of Sexual and Reproductive Health, and service development partners from NHS England and GIRFT (Getting it Right First Time). For each topic, a focused literature review was completed to develop evidence led recommendations, where available, which were ratified by consensus review within the panel and by guideline groups., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The brain's remarkable properties arise from the collective activity of millions of neurons. Widespread application of dimensionality reduction to multi-neuron recordings implies that neural dynamics can be approximated by low-dimensional "latent" signals reflecting neural computations. However, can such low-dimensional representations truly explain the vast range of brain activity, and if not, what is the appropriate resolution and scale of recording to capture them? Imaging neural activity at cellular resolution and near-simultaneously across the mouse cortex, we demonstrate an unbounded scaling of dimensionality with neuron number in populations up to 1 million neurons. Although half of the neural variance is contained within sixteen dimensions correlated with behavior, our discovered scaling of dimensionality corresponds to an ever-increasing number of neuronal ensembles without immediate behavioral or sensory correlates. The activity patterns underlying these higher dimensions are fine grained and cortex wide, highlighting that large-scale, cellular-resolution recording is required to uncover the full substrates of neuronal computations., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To map ophthalmologist locations and surgical practices as they vary sub-nationally within Honduras to maximize the impact of efforts to develop cataract surgical capacity., Methods: An anonymous survey was sent to all Honduran ophthalmologists with questions on surgical volume, department-level location, type of facility in which they work, surgical methods, and age. Surgical volume, population, and poverty data sourced through the Oxford Poverty Human Development Initiative were mapped at the department level, and cataract surgical rates (CSR; surgeries per million population per year) were calculated and mapped., Results: Sixty-one of the 102 Honduran ophthalmologists contacted responded. Of those, 85% perform cataract surgery, and 49% work at least part time in a non-profit or governmental facility. Honduras has fewer surgical ophthalmologists per million than the global average, and though national CSR appears to be increasing, it varies significantly between departments. The correlation between CSR and poverty is complex, and outliers provide valuable insights., Conclusion: Mapping ophthalmological surgical practices as they relate to population and poverty at a sub-national level provides important insights into geographic trends in the need for and access to eye care. Such insights can be used to guide efficient and effective development of cataract surgical capacity., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Background: This study aims to examine the relationship of emotional intelligence to physician burnout and well-being and compare these changes between medical and surgical residents during training., Methods: The longitudinal study used survey data, collecting measures on burnout and emotional intelligence in residents. Postgraduate year 1 residents at a community-based Michigan hospital completed the following surveys: Maslach Burnout Inventory, Physician Wellness Inventory, and Trait Emotional Intelligence Questionnaire-Short Form survey. These measures were given quarterly in postgraduate year 1 and once during subsequent years., Results: Seventy-seven residents completed measurements during their first 3 years. Forty-two (54.5%) were in the medical resident group; the remaining 35 (45.5%) were in the surgical resident group. Significant increases in measured burnout during the first year improved in subsequent years but did not return to baseline (P < .01). Emotional exhaustion (Maslach Burnout Inventory-Emotional Exhaustion) increased a relative 44% the first year (P = .000) and decreased 23% by the third year (P < .01). The Physician Wellness Inventory subscales also had significant decreases (P = .01) but less than the Maslach Burnout Inventory subscales (improvement ≤25%). Both medical and surgical groups had similar decreases in the Physician Wellness Inventory subscales (-25%) in their first year. The emotional intelligence score significantly correlated with exhaustion (Maslach Burnout Inventory-Emotional Exhaustion: r = -0.243; P = .002) and distress (Physician Wellness Inventory-Distress: r = -0.197; P = .014)., Conclusion: The risk for burnout increased sharply at the beginning of training for this hospital resident participant group and remained high throughout residency. Emotional intelligence is an important factor associated with less emotional exhaustion during residency., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The majority of non-metastatic breast cancer patients in sub-Saharan Africa are recommended to have mastectomy. The impact of mastectomy on a predominantly young African patient population requires evaluation. The BREAST-Q is a validated patient-reported outcome measure of quality-of-life following breast surgery that has been translated into 30 languages-none in Africa. This study aimed to translate and assess the psychometric properties of the mastectomy module of the BREAST-Q for use in Nigeria., Methods: The BREAST-Q mastectomy module was translated from English to Yoruba and its psychometric properties assessed using best practice guidelines. Translation was performed in 4 steps: forward translation (x2), back translation, back translation review, and cognitive interviews with post-mastectomy patients. The translated BREAST-Q instrument was administered to post-mastectomy patients (n = 21) alongside the EORTC-QLQ BR23 to evaluate construct validity. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC); surveys were re-administered 4 weeks apart., Results: The translation process identified English phrases not amenable to direct translation, including "emotionally healthy" and descriptions of pain ("nagging," "throbbing," "sharp"). Translations were amended to reflect local context and question intent. During cognitive interviews, patients provided suggestions to simplify complex phrases, e.g. "discomfort in your breast area.". Internal consistency within scales was over 0.70 for psychosocial wellbeing (α = 0.84-0.87), sexual wellbeing (α = 0.98-0.99), physical wellbeing in chest (α = 0.84-0.86), and satisfaction with care (α = 0.89-0.93). ICC for test-retest reliability was moderate (0.46-0.63)., Conclusions: The Yoruba version of the BREAST-Q mastectomy module presents a unique opportunity to adequately capture the experiences of Nigerian women post mastectomy. This instrument is being used in a pilot study of Nigerian patients to identify targets for intervention to improve the patient experience and compliance with breast cancer surgery., (© 2024. The Author(s).)