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Background: WHO recommends two annual rounds of mass drug administration (MDA) with ivermectin, diethylcarbamazine, and albendazole (IDA) for lymphatic filariasis (LF) elimination in treatment naïve areas that are not co-endemic for onchocerciasis such as Papua New Guinea (PNG). Whether two rounds of MDA are necessary or sufficient and the optimal sampling strategies and endpoints for stopping MDA remain undefined. Methods and findings: Two cross-sectional studies were conducted at baseline (N = 49 clusters or villages) and 12 months after mass drug administration (MDA) with IDA (N = 47 villages) to assess lymphatic filariasis (LF) by circulating filarial antigenemia (CFA) and microfilariae (Mf). Before MDA, children aged 6–9 years (N~50) and those ≥ 10 years (N~50) in each village were randomly sampled. Before MDA, the population mean prevalence of LF in East New Britain Province (ENBP), Papua New Guinea, was estimated using population proportionate sampling (PPS, N = 30) to be 59/2,561 (2.3%) CFA positive and 14/2,561 (0.6%) Mf positive. No children were Mf positive. However, LF infection was highly heterogeneous; 8 villages (26.7%) had a CFA prevalence >2%, and 7 villages (23.3%) had an Mf prevalence >1%. To identify sentinel villages with LF in areas under-sampled by PPS, 19 additional villages suspected to have LF were sampled, with 15 (79%) having >2% CFA prevalence and 7 (38%) >1% Mf (range 1–22%). Twenty-four villages were evaluated before and after MDA in age-matched adults (≥ 18 years). Treatment reduced CFA prevalence by 34% and Mf prevalence by 90%. Post-MDA model-based geostatistics efficiently selected an additional 23 villages, of which 20 (87%) had a CFA prevalence > 2%. None of these villages had >1% Mf. Post-MDA, two of four districts had no villages with >1% Mf. Conclusions: Model-based geostatistics was more effective than PPS in sampling high-risk LF sites in a heterogeneous area. Low LF prevalence and partial reduction of CFA limit children's effectiveness as sentinels. A single round of high-coverage MDA with IDA achieved elimination targets in low-prevalence villages in PNG. Higher-prevalence areas will need additional MDA rounds, which could be targeted to smaller evaluation units to cut costs. Trial registration: Clinicaltrials.gov NCT04124250 Author summary: Why was this study done?: WHO has targeted lymphatic filariasis (LF) for global elimination as a public health problem using mass drug administration (MDA) as the primary intervention strategy. The WHO recently modified recommendations for MDA for LF with a combination of three co-administered drugs: ivermectin, diethylcarbamazine, and albendazole. This study examined the impact of one round of MDA on LF infection parameters in Papua New Guinea that had not previously received MDA for LF and examined new methodologies for monitoring and surveillance. What did the researcher do and find?: Before MDA, we randomly sampled sentinel villages using population proportional sampling of equal numbers of children 6–9 years and older children and adults using well-established LF infection parameters. Post-MDA, we selected sentinel villages using a geostatistical modeling design and focused on sampling adults. Population-proportional sampling estimated the overall LF mean prevalence. However, it led to the inappropriate conclusion that LF might be less important because PPS missed villages with high LF prevalence in less densely populated rural areas. Sampling children 6–9 years of age was inefficient because of low infection rates in this age group. One round of MDA with high coverage effectively reduced microfilaremia prevalence to very low levels in most sampled villages, but CFA prevalence decreased less dramatically. What do these findings mean?: Geostatistical modeling and sampling adults for microfilaria are preferred methods for monitoring the impact of MDA with IDA in areas heterogeneous for LF rather than PPS. Sampling children to monitor LF elimination may not be a reliable indicator for stopping MDA, because CFA declines slowly after IDA, and children have low LF infection prevalence. Results from this study suggest that one round of high-coverage MDA may be sufficient to eliminate LF in areas with low baseline prevalence. Additional rounds of MDA can then be targeted to high-risk LF locations selected by geostatistical modeling, thus reducing program costs. The accuracy of geostatistical modeling in identifying LF-infected villages improves with high-quality baseline surveillance. This approach may be especially useful in areas like Papua New Guinea, where MDA is logistically challenging and costly. [ABSTRACT FROM AUTHOR]

The United States has embarked on a wide-ranging nuclear modernization program that will ultimately see every nuclear delivery system replaced with newer versions over the coming decades. In this issue of the Nuclear Notebook, we estimate that the United States maintains a stockpile of approximately 3,700 warheads—an unchanged estimate from the previous year. Of these, only about 1,770 warheads are deployed, while approximately 1,930 are held in reserve. Additionally, approximately 1,477 retired warheads are awaiting dismantlement, giving a total inventory of approximately 5,177 nuclear warheads. Of the approximately 1,770 warheads that are deployed, 400 are on land-based intercontinental ballistic missiles, roughly 970 are on submarine-launched ballistic missiles, 300 are at bomber bases in the United States, and approximately 100 tactical bombs are at European bases. The Nuclear Notebook is researched and written by the staff of the Federation of American Scientists' Nuclear Information Project: director Hans M. Kristensen, associate director Matt Korda, and senior research associates Eliana Johns and Mackenzie Knight. To see all previous Nuclear Notebook columns in the Bulletin of the Atomic Scientists dating back to 1987, go to . [ABSTRACT FROM AUTHOR]

Objective This study aimed to implement a point-of-care ultrasound (POCUS) program into a large neonatal intensive care unit (NICU) to enhance care by improving (1) umbilical venous catheter (UVC) tip identification and (2) central placement. Study Design A POCUS program was established with core providers who received training from external and internal experts. A prospective study (n = 94) compared the accuracy of UVC identification between neonatology-performed ultrasound (NeoUS) and X-ray relative to a referent of radiology-interpreted ultrasound. Finally, an ultrasound-guided UVC insertion protocol was introduced to rescue noncentral traditionally placed catheters (n = 37). Results Program implementation trained six providers for a total cost of approximately $10,500 USD. NeoUS was more accurate than X-ray at identifying UVC location (81.9 vs. 60.6%) with improved sensitivity and specificity (80.0 and 84.6 vs. 52.5 and 66.7%, respectively). POCUS guidance was able to rescue 89.2% of catheters that were originally noncentral. Conclusion POCUS implementation in a large NICU is feasible, affordable, and can improve quality of care. Key Points POCUS implementation is feasible and affordable. POCUS is more accurate than X-ray at monitoring UVCs. Central UVC placement can be increased with POCUS. [ABSTRACT FROM AUTHOR]

Introduction: Contingency management involves rewarding individuals based on objective evidence of behavioral changes. This study explores preferences for financial incentives in vaping cessation programs. Methods: A discrete choice experiment (DCE) was conducted among young adult current e-cigarette users aged 19-29. DCE attributes (and levels) included reward amount ($100, $300), reward schedule (consistent value, escalating value), reward procedure (gain-framed, loss-framed), vaping education modules (yes, no), text messaging support (yes, no), and cost ($30, $100). Participants were randomized into one of the four blocks, each containing four choice sets. Each choice set presented two hypothetical vaping cessation programs. Choice data (n × choice sets × alternative programs = 154 × 4 × 2 = 1,232 observations) were analyzed using generalized estimation equation models. Results: Participants showed a preference for vaping cessation programs offering a higher reward amount (odds ratio [OR] = 11.5; 95% CI,7.0-19.2), gain-framed rewards for sustained abstinence (OR = 1.4; 95% CI,1.0-1.8), text messaging support (OR = 1.9; 95% CI,1.4-2.5), and a lower program cost (OR = 2.6; 95% CI,1.8-3.8). Interaction tests showed significant effects of the rewards procedure among daily e-cigarette users (adjusted OR [AOR] = 2.1; 95% CI,1.3-3.5), but not some-day users; and among those with no quit attempts in the past six months (AOR = 2.7; 95% CI,1.5-4.7), but not those with previous quit attempts. Female participants preferred text messaging support (AOR = 3.6; 95% CI,2.3-5.4), whereas male participants did not show this preference. Conclusion: A multifaceted vaping cessation intervention augmented with financial incentives might improve participation and engagement among young adults. Future studies should investigate how these attributes can enhance program reach and vaping abstinence outcomes in real-world settings. [ABSTRACT FROM AUTHOR]

While little evidence supports the notion that financially responsible nonprofits must maintain low overhead ratios, the persistent preference for reduced overhead costs endures. Our study explores (a) the extent of underreporting behaviors, (b) the level of trust (or distrust) that nonprofit leaders have in overhead ratio reports, and (c) the motivations perceived by managers that drive nonprofits to adjust their overhead ratios and the resulting consequences. Experiment results from the "item sum double-list technique" (ISDLT) reveal that nonprofit managers may artificially lower their overhead ratios by approximately 10 percentage points, a range spanning from 7 to 16 percentage points. This adjustment aims to enhance their competitiveness in the funding market. Our vignette-based experiment uncovers significant trust issues related to reported low overhead ratios, potentially indicating accounting manipulation within the field. Complemented by open-ended survey responses from nonprofit managers, our research offers valuable insights into this domain. [ABSTRACT FROM AUTHOR]

Drosophila suzukii is an invasive pest that affects many fresh, soft-skinned fruits such as strawberries and blueberries. To combat this pest, growers use various methods including insecticide sprays, biological control, and sanitation practices. However, these methods are becoming increasingly ineffective against D. suzukii due to increased resistance against insecticides and increasing labor costs. Sterile Insect Technique (SIT) has been used successfully to control many agricultural pests, but the use of irradiation, sex sorting, and the requirement to scale these insects make it costly to implement. pgSIT (precision guided Sterile Insect Technique) is a novel and efficient way to generate sterile males through genetic engineering and overcomes the drawbacks of traditional SIT. pgSIT has been implemented in multiple Dipteran insects, including D. suzukii, and has been shown to suppress wild insect populations. To further characterize sterile pgSIT males, we evaluated their fertility capacity, lack of mature sperm, and ability to induce a mating refractory period in D. suzukii wildtype females. In this study, we found that pgSIT sterile males do not produce mature sperm and can induce a refractory mating period in wildtype females. Furthermore, sperm DNA is not detected in the reproductive tracts of pgSIT-mated female reproductive tracts. These findings further support the penetrance of the pgSIT technology in D. suzukii and provide further supporting data to governing regulatory bodies in their evaluation of this technology. [ABSTRACT FROM AUTHOR]

Background: Indigenous Peoples comprise the youngest and fastest growing demographic in Canada, with many living in urban-suburban areas. Given higher fertility rates, younger overall ages and higher adolescent pregnancy rates, perinatal research is needed—to inform policymaking and programming throughout pregnancy and childhood. Yet such data remain scarce in British Columbia (BC), Canada. This study therefore aimed to describe the experiences of young, urban, Indigenous mothers-to-be who enrolled in a larger BC early prevention trial designed to reach families experiencing socioeconomic disadvantage. Methods: This descriptive study utilized baseline data from a trial that enrolled first-time mothers-to-be who met indicators of socioeconomic disadvantage and who were residing in select urban-suburban areas. These indicators included being young (19 years or younger) or having limited income, low access to education, and being single (aged 20−24 years). We described and compared survey data on girls (n = 109; aged 14−19 years) and young women (n = 91; aged 20−24 years) using Chi-square or Student's t-tests. Results: Of the 739 trial participants, 200 or 27% identified as Indigenous and met trial eligibility criteria: limited income (92.9%), limited access to education (67.0%), and/or being single (90.9%). Beyond this, participants reported associated adversities including: unstable housing (63.3%), psychological distress (29.3%), severe anxiety or depression (48.5%), experiences of childhood maltreatment (59.4%) and intimate partner violence (39.5%). Compared to girls, young women reported higher income and educational attainment (p < 0.001), more unstable housing (p = 0.02) and more childhood maltreatment (p = 0.014). Many had recently received primary healthcare (75%), but few had received income assistance (34%). Most (80.5%) reported experiencing four or more adversities. Conclusions: We present data illustrating that a high proportion of pregnant Indigenous girls and young women engaged with public health and consented to long-term research participation—despite experiencing cumulative adversities. The trial socioeconomic screening criteria were successful in reaching this population. Girls and young women reported relatively similar experiences—beyond expected developmental differences in income and education—suggesting that adolescent maternal age may not necessarily infer risk. Our findings underscore the need for Indigenous community-led services that address avoidable adversities starting in early pregnancy. [ABSTRACT FROM AUTHOR]

Background: Neck pain is a significant public health issue, especially among office workers, with a prevalence ranging from 42 to 68%. This study aimed to evaluate the cost-utility and cost-benefit of a multi-component intervention targeting neck pain in the general population of office workers in Switzerland. The 12-week multi-component intervention consisted of neck exercises, health promotion information workshops, and workplace ergonomics sessions. Methods: The study was designed as a stepped-wedge cluster randomized controlled trial and assessed using an employer's perspective. The main analysis focused on the immediate post-intervention period. Long-term effects were examined in a subsample at the 4, 8, and 12-month follow-ups. The intervention effects on costs and quality-adjusted life years (QALYs) were estimated using generalized linear mixed-effects models, controlling for confounding factors. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves were presented, along with calculations of the break-even point and the return on investment. Various sensitivity analyses were performed. Results: A total of 120 office workers participated in the trial, with 100 completing the intervention period and 94 completing the entire study. The main analysis included 392 observations. The intervention had a significant positive effect on QALYs and a nonsignificant effect on costs. The ICER was estimated at -25,325 per QALY gain, and the probability of the intervention being cost saving was estimated at 88%. The break-even point was reached one week after the end of the intervention. Conclusion: The multi-component intervention is likely to reduce company costs and simultaneously improve the quality of life of employees. However, the implementation of such interventions critically depends on evidence of their cost-effectiveness. As there is still a large research gap in this area, future studies are needed. Trial registration: ClinicalTrials.gov, NCT04169646. Registered 15 November 2019-Retrospectively registered. Trial protocol: Aegerter AM, Deforth M, Johnston V, Ernst MJ, Volken T, Luomajoki H, et al. On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial. BMC Musculoskelet Disord. 2020;21(1):391. https://doi.org/10.1186/s12891-020-03388-x. [ABSTRACT FROM AUTHOR]

Background: Undernutrition remains a global crisis and is a focus of Sustainable Development Goals. While there are multiple known, effective interventions, complex interactions between prevention and treatment and resource constraints can lead to difficulties in allocating funding. Simulation studies that use in silico simulation can help illuminate the interactions between interventions and provide insight into the cost-effectiveness of alternative packages of options. Methods: We developed an individual-based microsimulation model based on the Global Burden of Disease (GBD) 2021 study data to test a range of nutrition interventions, including antenatal interventions (iron and folic acid, multiple micronutrients, and balanced energy protein supplementation) and child interventions (treatment for severe acute malnutrition, treatment for moderate acute malnutrition, and wasting prevention with small-quantity lipid-based nutrient supplements). We also developed an analytic approach to process the results of the microsimulation and identify the optimal intervention funding allocation for a given budget size. We use Ethiopia as an example in this paper. Results: In our illustrative example of Ethiopia, the reallocation of the baseline budget to minimize disability-adjusted life years (DALYs) resulted in first funding the antenatal multiple micronutrients to their maximum coverage and then funding treatment for severe child acute malnutrition. Relative to the baseline allocation, the reallocation optimized to minimizing DALYs resulted in 592,000 fewer annual DALYs, constituting an 8.3% reduction in total DALYs in Ethiopia. For budgets larger than the baseline, our model recommended funding first targeted moderate acute malnutrition treatment, second universal moderate acute malnutrition treatment, third wasting prevention with small-quantity lipid-based nutrient supplements, and fourth balanced energy protein supplementation. Conclusions: Our simulation is a novel model for estimating optimal allocation of spending on antenatal and child health nutrition interventions which accounts for the interaction between preventive and therapeutic approaches. Our illustrative results show that an optimized reallocation of current spending can substantially improve pregnancy-related and child health without additional funding. We hope this model can add validity and confidence to prior results to aid stakeholders in funding decisions. [ABSTRACT FROM AUTHOR]

One of the main challenges in aquaculture is the constant search for sustainable alternative feed ingredients that can successfully replace fishmeal (FM) without any negative effects on fish growth and health. The goal of the present study was to develop a toolbox for rapidly anticipating the dynamics of fish growth following the introduction of a new feed; nonlethal, biochemical, and molecular markers that provide insights into physiological changes in the fish. A nutritional challenge by feeding a conventional feed rich in FM protein (FM diet) versus an experimental feed rich in plant protein (PP) and low FM inclusion (PP diet), in 20 different families of gilthead sea bream (Sparus aurata) was performed. Fifteen and 30 days after the initiation of the nutritional challenge, the transcriptional response of gilthead seabream erythrocytes along with classical hematological biochemical markers were compared. Zootechnical, biochemical, and transcriptome data from each family under different dietary treatments were combined into a classification model to identify variables that can predict the growth rate at the end of the 14‐month farming period (July 2018–September 2019). A highly accurate model was produced (A > 80%) based on the combination of seven markers (five molecular and two biochemical markers) and with high potential in separating faster and slower growing fish as early as 30 days after the initiation of feeding. [ABSTRACT FROM AUTHOR]

We conduct a field experiment to evaluate labor market speeddates where unemployed workers meet temporary employment agencies. Participation in such events increases immediate job finding by six to seven percentage points. Afterwards employment effects diminish, suggesting that temporary employment has no long-lasting effect on employment prospects. While the intervention is cost-effective for the unemployment insurance (UI) administration, higher labor earnings of treated job seekers do not compensate for the decline in benefit payments. Survey evidence shows that speeddate participation increases job search motivation and reduces reservation wages. These findings concur with predictions of a model where job seekers update their labor market beliefs. [ABSTRACT FROM AUTHOR]

U.S. fertility declined as expected during the Great Recession, but then continued to fall throughout the recovery period. This drop was more acute among young women and unmarried women, whose births are more likely to be unintended. We use a combined-survey estimation strategy to estimate birth intention consistently over time. We find that between 2007 and 2019 intended births fell by 8.5 percent, while unintended births fell by 22 percent. The decline in unintended births is primarily explained by changes in demographic characteristics of women of childbearing age, reductions in sexual activity, and shifts to more effective methods of contraception. [ABSTRACT FROM AUTHOR]

The State of Nevada launched the Nevada SafeVoice anonymous tip line to prevent harmful events in schools and to promote student safety, health, and wellbeing. We assessed the extent to which SafeVoice contributed to reductions in school discipline incidents, youth suicides, and increases in the positive school climate. Using interrupted time-series analyses, we found statistically significant reductions in the rates of violence against staff (an estimated 32% reduction across the two school years) and possession of weapons (also 32%). Comparing annual data over time, we also found significant improvements in school climate during the study period from 2018 to 2019. We found no effects of SafeVoice on incident rates of bullying, cyberbullying, violence against students, or suicides among youth. We estimated that savings associated with the prevented incidents of violence against staff and weapons possession totaled $34 million. Every dollar spent on the State's operation of SafeVoice saved $13.80 in identifiable prevented events, including $3.45 in direct out-of-pocket costs. [ABSTRACT FROM AUTHOR]

Rationale: New pulmonary rehabilitation models can improve access to this effective but underused treatment for people with chronic respiratory disease; however, cost-effectiveness has not been determined. Objectives: To compare the cost-effectiveness of telerehabilitation, including videoconferencing and synchronous supervision, with standard center-based pulmonary rehabilitation. Methods: Prospective economic analyses were undertaken from a societal perspective alongside a randomized controlled equivalence trial in which adults with stable chronic respiratory disease undertook an 8-week outpatient center-based program or telerehabilitation. Clinical assessment for effectiveness (Chronic Respiratory Disease Questionnaire dyspnea domain score) was undertaken at baseline, after pulmonary rehabilitation, and at 12-month follow-up. Individual-level administrative and self-report healthcare cost data were collected over 12 months after the program (Australian dollars, 2020). Results: There were no between-group differences for effectiveness (Chronic Respiratory Disease Questionnaire dyspnea domain mean difference, −0.2 [standard error, 1.0]; P = 0.61) or total costs ($565 [5,452]; P = 0.92) over 12 months. On the cost-effectiveness plane, 97.4% of estimates fell between the equivalence margins for effectiveness. Application of a range of values for cost margin demonstrated a 95% probability that telerehabilitation was equivalent to center-based pulmonary rehabilitation when the threshold was $11,000. The results were robust to approach and sensitivity and subgroup analyses. The internal rate of return was 134% over 5 years. Program completion (regardless of model) was associated with a significant reduction in total costs in the following 12 months (β, −$17,960; 95% confidence interval, −29,967 to −5,952). Conclusions: This study supports delivery of telerehabilitation as a cost-effective alternative model of pulmonary rehabilitation for people with chronic respiratory disease. Clinical trial registered with the Australian and New Zealand Clinical Trials Register (ACTRN12616000360415). [ABSTRACT FROM AUTHOR]

Objective: The Federated States of Micronesia (FSM) experience periodic outbreaks of vaccine-preventable diseases. Our objective was to assess the cost-effectiveness of routine outreach and catch-up campaign strategies for increasing vaccination coverage for the measles, mumps, and rubella (MMR) vaccine among children aged 12 months through 6 years in Chuuk, FSM. Methods: We used a cost-effectiveness model to assess 4 MMR vaccination strategies from a public health perspective: routine outreach conducted 4 times per year (quarterly routine outreach), routine outreach conducted 2 times per year (biannual routine outreach), catch-up campaigns conducted once per year (annual catch-up campaign), and catch-up campaigns conducted every 2 years with quarterly routine outreach in non–catch-up campaign years (status quo). We calculated costs and outcomes during a 5-year model horizon and summarized results as incremental cost-effectiveness ratios. We analyzed the following public health outcomes: additional protected person-month (PPM), doses administered and protected people (ie, a child who completed a 2-dose MMR series). We conducted 1-way sensitivity analyses to evaluate the stability of incremental cost-effectiveness ratios and to identify influential model inputs. Results: Among the 4 MMR vaccination strategies, quarterly routine outreach was the most effective and most expensive strategy, and biannual routine outreach was the least expensive and least effective strategy. Quarterly routine outreach (vs status quo) yielded approximately an additional 7001 PPMs and 132 vaccine doses administered, with incremental costs of about $4 per PPM, $193 per dose administered, and $123 per protected person. Conclusion: Routine outreach and catch-up campaign vaccination strategies can be important interventions to improve health in Chuuk, FSM. More frequent routine outreach events could improve MMR coverage and reduce the likelihood of outbreaks of vaccine-preventable diseases such as measles and mumps. [ABSTRACT FROM AUTHOR]

To succeed, an accreditation process for clinical ethics fellowship programs (CEFPs) would need support from CEFP directors. To assess CEFP directors' opinions, we surveyed all 36 CEFP directors in the United States and Canada, achieving a 100% response rate. We found that support for accreditation is strong, with 30.6% strongly supportive, 44.4% supportive, 22.2% neutral, 2.8% opposed, and 0% strongly opposed. Most directors (77.8%) would be likely to apply for accreditation within the next five years regardless of the availability of government funding; even more (86.1%) would apply if government funding became available for accredited programs. Most directors thought that lack of a national accreditation process (75.0%), lack of agreed-upon standards (90.0%), and lack of funding for CEFPs (91.7%) were at least moderate problems for the field. When directors were asked what they thought was the greatest challenge or barrier to developing an accreditation process, many mentioned the diversity of programs and the challenge of achieving consensus on accreditation standards. Directors offered a variety of suggestions for how to overcome or manage challenges or barriers, including collecting data on existing programs, mirroring standards established for other health professions, and setting clear expectations on the need for compromise. When directors were asked how they expected that accreditation and government funding would affect their own programs, the field of clinical ethics, and patient care, directors mostly had very positive expectations; no director expected negative effects in any of these areas. Overall, this study provides evidence that developing an accreditation process for CEFPs would be both possible and desirable. Our findings have immediate practical implications for the field and will inform efforts that are already underway to establish an accreditation process for CEFPs. [ABSTRACT FROM AUTHOR]

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to evaluate the implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia using Reach, Effectiveness, Adoption, Implementation, and Maintenance Qualitative Evaluation for Systematic Translation framework. Methods: Using a convergent mixed-methods design, semi-structured one-on-one interviews with physiotherapist adopters and nonadopters of GLA:D® via telehealth were analyzed thematically alongside the examination of registry data (1 March 2020–10 February 2022) from patients with hip or knee osteoarthritis completing GLA:D® via telehealth (telehealth-only) or combined with in-person care (hybrid). Effectiveness was determined as changes from baseline to 3-month follow-up (mean differences, 95% confidence intervals, effect size) for Knee injury and Osteoarthritis Outcome Score (KOOS-12)/Hip disability and Osteoarthritis Outcome Score-12 (HOOS-12), and chair stand test. Group- and individual-level changes were compared to published minimally clinically important change scores. Results: Twenty-three interviews (12 adopters, 11 nonadopters) found key barriers/facilitators to reach and adoption, high perceived effectiveness, and strategies to support sustainability. Of 2612 registered patients, 85 (3%) and 115 (4%) completed GLA:D® via telehealth-only or hybrid model, respectively. Most effectiveness outcomes were associated with moderate-large improvements. Group-level changes exceeded minimally clinically important change values for KOOS/HOOS-quality of life and chair stand test. Nearly two out of three patients reached a minimally clinically important change for KOOS/HOOS-quality of life. With telehealth-only and hybrid delivery, 99% (n = 82) and 85% (n = 97) were satisfied/very satisfied. Physiotherapist adoption was limited (n = 128, 6%). Discussion: GLA:D® delivered via telehealth is effective, had high patient satisfaction, and was perceived positively by physiotherapist adopters. Addressing low reach and adoption requires further implementation strategies to facilitate greater telehealth opportunities for patients and physiotherapists. [ABSTRACT FROM AUTHOR]

Purpose: For many years, universities have been confronted with the rise of a managerial logic, in line with the new public management movement. They have been encouraged to implement new accounting tools such as cost calculations. Literature shows mixed results regarding the institutionalization of such tools, and the logic they try to support. In most studies, the agency of actors is examined to explain the institutionalization of accounting tools and only few studies consider the specific characteristics of these accounting tools to understand this process. To enrich the literature on institutionalization, this article examines how the affordances of costing tools affect the institutionalization of these tools and the institutionalization of new logics in pluralistic organizations such as universities. Design/methodology/approach: The data were collected at a French university which is considered as an example of successful institutionalization of the tool and is cited as a model to follow. The data include a four-month participant observation and 18 interviews. Access to internal and external documents was also available. The analysis of the data is based on a framework proposed by Jarzabkowski and Kaplan (2015), which draws on the concept of affordance of tools, to investigate how the possibilities and constraints of costing tools shape the selection, application and outcomes of cost calculations. Findings: The results show that the affordances of cost calculations facilitate the institutionalization of a new logic and its coexistence with previous logics. Technical affordances are mobilized by actors aiming to bring in a new logic without directly confronting the old ones. Role affordances also play a major role in the institutionalization by facilitating the adhesion of the actors through multiple applications of the tool. Finally, value-based affordances reinforce the institutionalization of a managerial logic by emphasizing the values shared with the other logics and thus facilitating the coexistence of the three logics at stake in the university. Originality/value: This research provides three main contributions. First, it contributes to the literature on the institutionalization of accounting tools. It shows the relevance of the concept of affordance (Leonardi and Vaast, 2017) to unpack the characteristics of accounting tools (including the constraints and the possibilities they offer) and to achieve a better understanding of the institutionalization of accounting tools. Second, this paper contributes to the literature dealing with the role of accounting tools in the institutionalization of logics. The results suggest that the institutionalization of tools and the institutionalization of logics are two different phenomena that move at different speeds. However, these phenomena interact: the institutionalization of accounting tools can facilitate the coexistence of different logics in pluralistic organizations. Third, this paper contributes to the literature on affordances. The data reveal several types of affordances for accounting tools: technical affordances that refer to the technical possibilities to shape and tweak the tool; role affordances that refer to the various roles and purposes that the tool can fulfill and value-based affordances that refer to the plasticity of the values and beliefs that the tool can convey. The study shows that each type of affordance is prevalent at a different time of the process of institutionalization and that the combination of these affordances contributes to the institutionalization of the tool and of new logics. [ABSTRACT FROM AUTHOR]

This article delves into the perceived influence of funders on the approaches of artists and arts managers in managing community-based arts programs. A case study of two community music programs in Northeast England reveals how managers adapt their language, evaluation methods, and program delivery to align with funders’ perceived requirements and ensure program sustainability, a practice referred to as “chameleonic practice.” The findings of this study are particularly pertinent as many artists and arts managers express concerns about cultural funders being out of touch with their work, leading to significant pressure on arts managers. In addition to providing recommendations for addressing this disconnect, the article suggests the need for future research to explore frameworks that support collaborative practices among all stakeholders involved in delivering community arts programs. [ABSTRACT FROM AUTHOR]

Introduction: Mutations associated with HIV drug resistance (DR) affect clinical outcomes. Understanding the prevalence of HIV DR and its association with viral suppression and survival in the paediatric population is key to inform patient care and health policies., Methods: We used Brazilian monitoring systems to identify genotyping tests performed in children living with HIV aged ≤18 months between 2009 and 2020. We categorized HIV DR using three criteria: any HIV DR (R 1 ), DR to nevirapine or efavirenz (R 2 ), and DR to at least one antiretroviral recommended for children with HIV in Brazilian guidelines (R 3 ). We investigated factors associated with HIV DR, viral suppression, and survival up to 3 years old using multivariable models. Lastly, we describe the annual prevalence of each type of HIV DR in Brazilian children with HIV between 2009 and 2020., Results: We included 1152 children with HIV with a median age of 5 months at genotype testing; 57% were females. R 1 was observed in 30%, R 2 in 17%, and R 3 in 21%. Children with HIV whose birth parents were exposed to nevirapine or efavirenz before delivery had higher odds of R 2 (odds ratio 3.4; 95% confidence interval [CI] 1.1-10.8). Children with HIV with R 1 or R 3 had higher rates of death than those with HIV with no HIV DR in the adjusted models (adjusted hazard ratios 4.7 [95% CI 1.6-13.9] and 4.1 [95% CI 1.4-12.4], respectively). The prevalence of resistance to nevirapine and efavirenz peaked in 2015. Over time, the prevalence of genotyping tests with no detected resistance varied between 57% and 87%., Conclusion: HIV DR is highly prevalent in children with HIV and is associated with lower survival., (© 2024 British HIV Association.)

The article reflects on the evolution of social work research over the past 40 years, responding to Ronald A. Feldman's analysis of its progress and challenges. Topics discussed include the enduring gaps between research and practice, the contrasting focus of Doctor of Philosophy (PhD) and Doctor of Social Work (DSW) programs, and the quality concerns surrounding doctoral education in social work.