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Parkinson's disease (PD) is a prevalent neurodegenerative condition, ranking as the most common among movement disorders. People living with Parkinson's disease benefit from the specialised skills and expertise of a dedicated Parkinson's disease and movement disorders nurse specialist (PDMDNS) (Bramble, Carroll, & Rossiter, 2018). Access to a PD nurse embedded into the local health setting impacts the potential to avoid hospital admissions due to worsening of symptoms, improving quality of life through improved access to specialist services and reducing carer burden (Bramble et al. 2018) The World Health Organisation advocates for the tracking healthcare workforce demographics and distribution trends to ensure equity of health care services and robust economic planning to meet future needs (WHO 2016). This marks the fourth publication in an ongoing annual series examining the longitudinal trends of the PDMDNS workforce in Australia (Williams et al., 2021, 2023). [ABSTRACT FROM AUTHOR]

Parkinson's disease is a progressive neurological disorder typically beginning in middle or late life, with risk increasing with age. Accessing health services for people living with Parkinson's disease can be challenging and stressful, often resulting in the worsening of current symptoms, the development of new symptoms, including infection, fatigue, and confusion, or medication changes. This can lead to an increased length of stay in hospital and/or readmission, further worsening symptoms. The aim of this scoping review is to explore how quality improvement and healthcare redesign initiatives have contributed to understanding issues around length of stay and readmission to hospital for people living with Parkinson's disease. The review was guided by Arksey and O'Malley's framework and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist. The Excerpta Medica dataBASE (EMBASE), Medline, and Cumulated Index in Nursing and Allied Health Literature (CINAHL) databases were searched for relevant articles published between 2019 and 2023. The included articles were categorised using thematic analysis. Ten articles were included in this review, resulting in the following three major categories: issues contributing to length of stay and readmission, interventions, and recommendations. Quality improvement and healthcare redesign can improve the length of stay and readmission rates for people living with Parkinson's disease through robust design, delivery, and evaluation. [ABSTRACT FROM AUTHOR]

With businesses increasingly prioritizing data-driven decision making, the demand for business analysts is high and expected to grow. In response, many universities and institutions have developed courses and programs related to business analytics to prepare more graduates for careers in this field. Business analytics programs and educators consistently strive to achieve a high level of student learning success, ensuring competence in working in the business analytics field after graduation. In this study, we aim to examine key factors influencing student learning in business analytics, focusing on performance expectancy and satisfaction. We examined specific factors, including personal interest, career relevance expectancy, learning effort, and perceived course structure effectiveness, from perspectives related to both students and instructors. A research model was developed and empirically tested. The results showed that all factors significantly influenced both perceived academic performance and learning satisfaction. Additionally, personal interest and career relevance expectancy could significantly impact learning effort. [ABSTRACT FROM AUTHOR]

One promising idea to use excess glycerol generated during biodiesel fabrication is to produce hydrogen (H2) via the steam reforming of glycerol (GSR). This study combined GSR and water-gas shift (WGS) reactors to minimize energy usage and carbon monoxide (CO) emissions while augmenting H2 production. Choice of a Ni/γ-Al2O3 catalyst for the GSR reaction at 0.101 MPa and 923 K resulted in a product stream having 66.12% and 9.68% H2 and CO, respectively. For the WGS reactor, a Pt/HAP catalyst achieved 100% conversion of CO at 0.101 MPa and 723 K. Combining the two catalysts at an optimized temperature of 923 K for over 15 h resulted in H2 and CO levels at 69.85% and 1.77%, respectively: thus, increasing the production rate of H2 by 5% while reducing CO by 81%. Coking did occur during the GSR reaction. Overall, the combined reactor has potential to reduce complexity and energy usage. [ABSTRACT FROM AUTHOR]

In studies of mammalian mastication, a possible relationship has been proposed between bilateral recruitment of jaw adductor muscle force during unilateral chewing and the degree of fusion of the mandibular symphysis. Specifically, species that have unfused, mobile mandibular symphyses tend to utilize lower levels of jaw adductor force on the balancing (nonchewing) than the working (chewing) side of the head, when compared to related species with fused symphyses. Here, we compare jaw adductor recruitment levels in two species of musteloid carnivoran: the carnivorous ferret (unfused symphysis), and the frugivorous kinkajou (fused symphysis). During forceful chewing, we observe that ferrets recruit far more working‐side muscle force than kinkajous, regardless of food toughness and that high working‐to‐balancing side ratios are the result of increased working‐side force, often coupled with reduced balancing‐side force. We propose that in carnivorans, high working‐to‐balancing side force ratios coupled with an unfused mandibular symphysis are necessary to rotate the hemimandible for precise unilateral occlusion of the carnassial teeth and to sustain laterally oriented force on the jaw to engage the carnassial teeth during shearing of tough foods. In contrast, the kinkajou's flattened cheekteeth permit less precise occlusion and require medially‐oriented forces for grinding, thus, a fused symphysis is mechanically beneficial. Research Highlights: Ferrets' (unfused mandibular symphyses) use of asymmetrical jaw muscle activity may optimi forces for carnassial shearing. Kinkajous' more nearly equal force may be facilitated by their fused symphysis and flat cheek teeth. [ABSTRACT FROM AUTHOR]

People with disabilities (PWD) are the largest minority group in the world, making up 16% of the world's population, an estimated 1.3 billion people. People with disabilities die earlier, have poorer health outcomes, and are more affected by emergencies and natural disasters. Factors contributing to health inequities can be characterized as socioeconomic, political, involve social determinants of health, include higher risk factors, and display a wide spectrum of health system barriers. Too often, health care training programs exclude specific standards for disability training. By mapping the new American Association of Colleges of Nursing (AACN) The Essentials: Core Competencies for Professional Education with The Core Competencies for Disability Health Care Education, we can provide a synergistic relationship that will prepare future advanced practice nurses to provide effective care to people with disabilities across the lifespan and in every delivery care system. [ABSTRACT FROM AUTHOR]

Objectives: Physical activity (PA) can reduce depressive symptoms but has not been tested amongst depressed older caregivers and their care‐recipients. The aim of this single‐blind randomized controlled trial was to investigate the effect of a 6‐month tailored PA program on depressive symptoms in older caregivers. Method: Caregivers were included if they had scores of ≥5 on the 15‐item geriatric depression scale (GDS‐15). Care‐recipients could have any type of physical, mental or cognitive condition requiring support. The PA intervention group completed an individualized program based on the Otago‐Plus Exercise Program. The primary outcome was improvement in depressive symptoms in caregivers measured at six and 12 months. Results: Two hundred and twelve participants (91 dyads and 30 caregivers only) were randomized using a 3:3:1 ratio to PA intervention, social‐control, and usual‐care control groups. There were no significant differences in depressive symptoms of the caregivers between the three groups at 6 months or 12 months. However, more than 50% of caregivers in all three groups no longer had a GDS‐15 score ≥5 at 6 months. Further analysis revealed that caregivers in the PA group caring for someone with a standardised mini‐mental state examination (SMMSE) score ≥24 had significantly less depressive symptoms than those caring for someone with a SMMSE score <24 compared with social‐control (p < 0.02) and usual‐care groups (p < 0.02). Conclusions: A PA intervention may be beneficial for some caregivers in reducing symptoms of depression but may not be as beneficial to caregivers of people living with cognitive impairment. Key points: Physical activity (PA) may help to reduce depression, stress and burden in caregivers.This study investigated the effects of an individually tailored, home‐based PA intervention for both caregivers and care‐recipients, of 6 months' duration, on improving depressive symptoms in older caregivers.A PA intervention may be beneficial for caregivers in reducing symptoms of depression but may not be as beneficial to caregivers of people living with cognitive impairment. [ABSTRACT FROM AUTHOR]

Ritlecitinib is a small molecule in clinical development that covalently and irreversibly inhibits Janus kinase 3 (JAK3) and the TEC family of kinases (BTK, BMX, ITK, TXK, and TEC). This phase 1, open‐label, parallel‐group study assessed target occupancy and functional effects of ritlecitinib on JAK3 and TEC family kinases in healthy participants aged 18‐60 years who received 50 or 200 mg single doses of ritlecitinib on day 1. Blood samples to assess ritlecitinib pharmacokinetics, target occupancy, and pharmacodynamics were collected over 48 hours. Target occupancy was assessed using mass spectroscopy. Functional inhibition of JAK3‐dependent signaling was measured by the inhibition of the phosphorylation of its downstream target signal transducer and activator of transcription 5 (pSTAT5), following activation by interleukin 15 (IL‐15). The functional inhibition of Bruton's tyrosine kinase (BTK)‐dependent signaling was measured by the reduction in the upregulation of cluster of differentiation 69 (CD69), an early marker of B‐cell activation, following treatment with anti‐immunoglobulin D. Eight participants received one 50 mg ritlecitinib dose and 8 participants received one 200 mg dose. Ritlecitinib plasma exposure increased in an approximately dose‐proportional manner from 50 to 200 mg. The maximal median JAK3 target occupancy was 72% for 50 mg and 64% for 200 mg. Ritlecitinib 50 mg had >94% maximal target occupancy of all TEC kinases, except BMX (87%), and 200 mg had >97% for all TEC kinases. For BTK and TEC, ritlecitinib maintained high target occupancy throughout a period of 48 hours. Ritlecitinib reduced pSTAT5 levels following IL‐15‐ and BTK‐dependent signaling in a dose‐dependent manner. These target occupancy and functional assays demonstrate the dual inhibition of the JAK3‐ and BTK‐dependent pathways by ritlecitinib. Further studies are needed to understand the contribution to clinical effects of inhibiting these pathways. [ABSTRACT FROM AUTHOR]

Importance: Primary open-angle glaucoma (POAG) polygenic risk scores (PRSs) continue to be evaluated in primarily European-ancestry populations despite higher prevalence and worse outcomes in African-ancestry populations., Objective: To evaluate how established POAG PRSs perform in African-ancestry samples from the Genetics in Glaucoma Patients of African Descent (GIGA), Genetics of Glaucoma in Individuals of African Descent (GGLAD), and Million Veteran Program (MVP) datasets and compare these with European-ancestry samples., Design, Setting, and Participants: This was a multicenter, cross-sectional study of POAG cases and controls from Tanzania, South Africa, Nigeria, Ghana, and the US. Included were individuals of African descent from South Africa and Tanzania from the GIGA dataset; individuals of African descent from Ghana, Nigeria, and the US from the GGLAD dataset; and individuals of African or European descent from the US in the MVP dataset. Data were analyzed from January 2022 to July 2023., Exposures: Three PRSs derived from large meta-analyses of European and Asian populations, namely Gharahkhani et al (Gharahkhani PRS), Han et al (Han PRS), and Craig et al (Craig PRS)., Main Outcomes and Measures: Odds ratios (ORs) for POAG risk stratification comparing the highest and lowest quintiles; area under the receiver operating characteristic curve (AUROC), and liability coefficient of determination (R2) for the addition of PRS to a baseline of age, sex, and first 5 principal components., Results: A total of 11 673 cases and 66 432 controls were included in this study across 7 ancestral groups. Mean (SD) age of the total participants was 76.9 (8.7) years, with 74 304 males (95.1%). The following were included in each dataset: GIGA (663 cases, 476 controls), GGLAD (1471 cases, 1482 controls), and MVP (9559 cases, 64 474 controls). Increases in ORs were found for the highest POAG risk quintile ranging from an OR of 1.68 (95% CI, 1.17-2.43) in Ghanaians to 7.05 (95% CI, 2.73-19.6) in the South African multiple ancestry group (which derives from at least 5 distinct ancestral groups: Khoisan, Bantus, Europeans, Indians, and Southeast Asians) with the Gharahkhani PRS. The Han PRS showed OR increases for the highest POAG risk quintile ranging from 2.27 (95% CI, 1.49-3.47) in African American individuals in the GGLAD dataset to 7.24 (95% CI, 6.47-8.12) in Europeans. The Craig PRS predicted OR increases in the highest quintile for all groups ranging from 1.51 (95% CI, 1.05-2.18) in Ghanaians to 6.31 (95% CI, 5.67-7.04) in Europeans. However, AUROC and R2 increases above baseline were lower for all African-ancestry compared with European-ancestry groups in the 3 tested PRSs., Conclusions and Relevance: In this cross-sectional study, despite some improvements in OR-based risk stratification using the Gharahkhani PRSs, Han PRSs, and Craig PRSs, consistently lower improvements in AUROC and R2 for African-ancestry compared with European-ancestry groups highlight the need for risk prediction models tailored to diverse populations.