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Avorter ici ou ailleurs n'implique pas les mêmes droits pour les femmes, ni les mêmes conditions. Pratiqué depuis des siècles et dans toutes les sociétés, l'avortement dans le monde reste pour autant très inégalitaire en termes législatifs. Cet article retrace les contextes historiques, socioculturels et politiques dans lesquels ont émergé les décisions concernant la pénalisation et la dépénalisation de cet acte, notamment en Argentine. Les représentations du fœtus mais aussi du statut social des femmes, élaborées par chaque société, apportent une compréhension supplémentaire aux enjeux liés à cette pratique : universelle et transculturelle. Le corps féminin et sa fonction procréatrice répondent aux intérêts des politiques d'État. Le combat des femmes argentines pour la légalisation de l'avortement est ainsi un exemple de rébellion contre le poids des traditions patriarcales. The legal implications of abortion worldwide do not confer the same rights or conditions on women. Although abortion has been practiced for centuries in all societies, it remains highly unequal in legislative terms throughout the world. This article traces the historical, socio-cultural and political contexts in which decisions to criminalize and decriminalize abortion have been made, particularly in Argentina. Representations of the status of the fetus and of women's social condition that have been developed by each society, provide additional insight into the issues surrounding this universal and transcultural practice. The female body, and its procreative function, correspond to the interests of state policies. The fight by Argentinian women to legalize abortion is an example of rebellion against the weight of patriarchal traditions. [ABSTRACT FROM AUTHOR]

Twin gestations are associated with increased risk of pregnancy complications. However, high-quality evidence regarding the management of twin pregnancies is limited, often resulting in inconsistencies in the recommendations of various national and international professional societies. In addition, some recommendations related to the management of twin gestations are often missing from the clinical guidelines dedicated to twin pregnancies and are instead included in the practice guidelines on specific pregnancy complications (eg, preterm birth) of the same professional society. This can make it challenging for care providers to easily identify and compare recommendations for the management of twin pregnancies. This study aimed to identify, summarize, and compare the recommendations of selected professional societies from high-income countries on the management of twin pregnancies, highlighting areas of both consensus and controversy. We reviewed clinical practice guidelines of selected major professional societies that were either specific to twin pregnancies or were focused on pregnancy complications or aspects of antenatal care that may be relevant for twin pregnancies. We decided a priori to include clinical guidelines from 7 high-income countries (United States, Canada, United Kingdom, France, Germany, and Australia and New Zealand grouped together) and from 2 international societies (International Society of Ultrasound in Obstetrics and Gynecology and the International Federation of Gynecology and Obstetrics). We identified recommendations regarding the following care areas: first-trimester care, antenatal surveillance, preterm birth and other pregnancy complications (preeclampsia, fetal growth restriction, and gestational diabetes mellitus), and timing and mode of delivery. We identified 28 guidelines published by 11 professional societies from the 7 countries and 2 international societies. Thirteen of these guidelines focus on twin pregnancies, whereas the other 16 focus on specific pregnancy complications predominantly in singletons but also include some recommendations for twin pregnancies. Most of the guidelines are recent, with 15 of the 29 guidelines published over the past 3 years. We identified considerable disagreement among guidelines, primarily in 4 key areas: screening and prevention of preterm birth, using aspirin to prevent preeclampsia, defining fetal growth restriction, and the timing of delivery. In addition, there is limited guidance on several important areas, including the implications of the "vanishing twin" phenomenon, technical aspects and risks of invasive procedures, nutrition and weight gain, physical and sexual activity, the optimal growth chart to be used in twin pregnancies, the diagnosis and management of gestational diabetes mellitus, and intrapartum care.This consolidation of key recommendations across several clinical practice guidelines can assist healthcare providers in accessing and comparing recommendations on the management of twin pregnancies and identifies high-priority areas for future research based on either continued disagreement among societies or limited current evidence to guide care. [ABSTRACT FROM AUTHOR]

L'hyper-médicalisation de nos sociétés et notre confiance sans borne envers la médecine curative nous ont fait peu à peu perdre le sens profond des mots des maux. Nombreux sont aujourd'hui ceux qui interpellent les pouvoirs publics afin que soit promue une « politique du Care ». Le recours aux anglicismes est assurément « tendance » mais opposer le « cure » et le « care » ne fait pas sens. Nous invitons le lecteur à tenter de recouvrer la signification et la valeur du verbe soigner et du mot soin(s), pluriel et pourtant si singulier. Pour mener cette quête nous porterons notre attention sur quelques œuvres d'art qui peut-être nous permettrons, en trois temps, de (re)découvrir le sens profond de la relation de soins. The hyper-medicalization of our societies and our absolute confidence in curative medicine have made us gradually lose the deep meaning of the words of ailments. Many are now calling on the public authorities to promote a "policy of Care". The use of anglicisms is certainly "trendy" but opposing "cure" and "care" does not make sense. We invite our readers to try to recover the meaning and the value of the verb to treat and the word care(s), plural and yet so singular. To carry out this quest, we will focus our attention on a few works of art which will perhaps allow us, in three stages, to (re)discover the deep meaning of the care relationship. [ABSTRACT FROM AUTHOR]

This editorial introduces the virtual special issue on digital mediation in ESP genres, bringing together a number of studies presented at LSPPC6: the 6th International Conference of the Asia–Pacific LSP and Professional Communication Association, held in collaboration with the International Society for Gesture Studies - Hong Kong Hub and organized by the Department of English, City University of Hong Kong. The editorial examines: 1) theoretical issues raised by digital mediation , especially with respect to genre theory; 2) communicative practices in digital contexts , expanding the range of descriptions of ESP genres; and 3) implications for ESP pedagogy. [ABSTRACT FROM AUTHOR]

This study regards AI as a socioecological issue and highlights the social identity determinants of the social perceptions of AI, which is the main dependent variable. We analyze Greece in 2022 as a case study. Our findings suggest that specific social identity variables concerning fundamental and social values, such as religion, views on new technologies, economic and political standings, and education, impact social perceptions of AI in a positive or negative manner. To enhance the analysis, we independently analyze the social identity framework shaping the relationship between jobs and AI, and the need to scientifically verify the results of AI technologies with an expert. Overall, social views of AI are shaped by the influence of a composite portfolio of fundamental and social values (which reflect both social stability and adaptability to change), economic and political standings, and demographics. Therefore, the social understanding of AI, along with other major issues, relates to its complex cultural dimensions. The findings go beyond the superficial understanding of the qualities AI should have since they underline the importance of existing institutional and value systems in the design of appropriate policies to combat the negative consequences, or capitalize on the benefits of such technologies. • Social perceptions of AI are the socioeconomic drivers of AI development. • We pair economics, anthropology of technology, social identity, and futures studies. • Social identity variables of fundamental and social values impact perceptions of AI. • AI regulation require structures and networks aligned with understanding of identity. • Policy focus is needed on institutional framework and a smart state for safe use of AI. [ABSTRACT FROM AUTHOR]

In spite of the increase in formal and informal expectations for research by Canadian librarians, there have been few—if any—Canada-wide initiatives to help support librarians in meeting research expectations. Moreover, there have been few opportunities to address academic librarians' needs and Canadian librarian research culture in any systematic way, especially on a national scale. As a way of redressing these absences and filling this need, a four-day nation-wide institute was proposed and conducted in order to bring together Canadian librarians interested in developing their own research programs and working toward fostering a positive and productive research culture in Canadian academic libraries. This article describes the principles informing the institute's development and locates the institute's objectives within discussions of research culture, mentorship, and strengths-based approaches. [Copyright &y& Elsevier]

In our society, protecting users' privacy is of utmost importance, especially when users access websites. Increased awareness of privacy concerns has led web browsers to implement new mechanisms to improve privacy while browsing the Internet. In each new version of web browsers, it is claimed that they provide better improvements to protect our privacy. However, there is no analysis of these improvements. To cope with this issue, in this paper, we present an analysis of the privacy of different versions of the Chrome web browser. This analysis is based on the PrivacyScanner tool, which we have improved with the detection of additional tracking techniques. Our findings reveal that tracking protection has seen modest enhancements (namely, between Chrome version 83 and 90, we observed a 7.55% reduction in trackers and 4.76% decrease in Google Analytics elements). Therefore, despite these improvements, there is still ample room for further enhancement. [ABSTRACT FROM AUTHOR]

The Academy of Nutrition and Dietetics, representing credentialed nutrition and dietetics practitioners—registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered, and students and interns and professionals holding nutrition and dietetics undergraduate and advanced degrees-and Avalere Health, a Washington, DC-based strategic advisory services firm, have led the charge in closing malnutrition gaps with the Malnutrition Quality Improvement Initiative (MQii), a national nutrition-focused quality improvement initiative. The initiative’s journey from 2013-2019 utilized technical advisors and stakeholders to improve care and outcomes for hospitalized adults age 65 and older with a series of innovations. These innovations include the development of the first malnutrition electronic clinical quality measures (eCQMs) and a complementary interdisciplinary quality improvement toolkit and establishing the first nutrition-focused national Learning Collaborative. MQii's vision for future directions and applications in 2020 and beyond will explore partnerships to include the malnutrition eCQM in available clinical data registries. Qualified Clinical Data Registries will provide a pathway for collecting nutrition data relevant to RDNs because as of 2020, payments for Medicare Part B nutrition services and quality improvement are available for eligible RDNs participating in the Centers for Medicare and Medicaid Services Quality Payment Program. The MQii Toolkit’s technical specification manuals, data dictionaries, and implementation guides will help RDNs integrate the malnutrition quality measures into existing electronic health records and lead nutrition data collection and analysis. RDNs’ continued advancement with information technology leaders to incorporate terminology and clinical standards into electronic health record platforms will provide for malnutrition data transfer across care settings. Funding /Support Publication of this supplement was supported by Abbott. The Academy of Nutrition and Dietetics does not receive fundig for the MQii. Avalere Health’s work to support the MQii was funded by Abbott. [ABSTRACT FROM AUTHOR]

• A correlative color alteration with advancing age was observed in costal cartilage. • Mean gray value (MGV) was introduced to quantify the pigmentation of costal cartilage. • Age, but not gender, shows a significant relationship with MGV. • A linear regression model based on MGV was constructed for age estimation. Age estimation is considered a crucial and challenging issue in forensic casework. Costal cartilage appears a potential mortal remain in age-at-death estimation attributable to its correlative alteration in color based on pigment accumulation with the advancing age. In this study, samples from the second costal cartilage were collected in a Chinese Han population, and the cross sections were subsequently scanned and digitalized in a standard way. Color change was quantified using mean gray value (MGV), which was measured by Photoshop CS5. After the exclusion of samples with factors which could impair the quality of images and the accuracy of values, a high correlation was demonstrated between age and MGV in samples. A linear regression model (AGE = 173.425–0.755*aveMGV) was established for age prediction, with its performance evaluated using both samples from the training set and the blind test set, in which a mean absolute deviation of 4.42 years and 3.57 years was obtained, respectively. Altogether, MGV could be reckoned as a precise quantification of pigmentation in costal cartilage and an excellent indicator of age prediction in the age interval from 20 to 60 years. Moreover, our strategy appears more user-friendly and accurate, thus exceedingly practical for age estimation in forensic anthropology. [ABSTRACT FROM AUTHOR]

Child Maltreatment Fatalities (CMFs) have been alleged to exert great pressures on the delivery of Child Protective Services. Anecdotal accounts implicate CMFs as a cause of "vicious cycles" defined as sequences of scandal, outrage, and reform that destabilize and re-stabilize agency operations and personnel. In this paper we test the CMF cycle hypothesis using 22 years of data from the National Child Abuse and Neglect Data System (NCANDS). We employ Fourier time series and panel regression and find some evidence to support a cycle of CMF case accumulations that repeat at an 8 to 10 year interval. We show that previous levels of CMFs are much better predictors of subsequent CMFs than risk assessment factors used in much of the child welfare literature. We discuss the reasons why predictive analytics using traditional risk factors will continue to perform unsatisfactorily, and why dynamic models of CMFs will always perform better. Finally we consider how our research on the relative efficacy of traditional risk-as-hazard modelling vis a vis dynamic modelling can be used by academics and researchers to help practitioners operate more effective child welfare agencies. • Child Maltreatment Fatalities (CMFs) follow a periodic cycle. • Dynamic models outperform traditional models in predicting subsequent CMFs. • Complete elimination of CMFs is an unrealistic goal in child welfare. [ABSTRACT FROM AUTHOR]

In relational ontologies, care is considered as relationally constructed in practices. It is thus important to understand how caring relationships are produced. However, there are different ways of producing these caring relationships. This article contrasts the production of caring relationships in a logic of substitution and in a logic of care in a home-based strengthened educational childcare service. While most studies focus on the implications of different models of care for carers-carees dyadic interpersonal relationships, this study also considers how the design and use of tools, as well as relationships with third parties involved in care practices, differ within these two logics. This study also shows that they imply different temporal conceptions and orientations. • The article studies the production of caring relationships. • It contrasts a logic of substitution with a logic of care. • Carers-carees relationships differ in different care models. • Tools, their uses and relationships with third parties also differ in care models. • Different logics imply different temporal conceptions and orientations. [ABSTRACT FROM AUTHOR]

Given the increasing number and diversity of older adults and the transformation of health care services in the United States, it is the position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior that all older adults should have access to evidence-based food and nutrition programs that ensure the availability of safe and adequate food to promote optimal nutrition, health, functionality, and quality of life. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, in partnership with other practitioners and nutrition educators, should be actively involved in programs that provide coordinated services between the community and health care systems that include regular monitoring and evaluation of programming outcomes. The rapidly growing older population, increased demand for integrated continuous support systems, and rising cost of health care underscore the need for these programs. Programs must include food assistance and meal programs, nutritional screening and assessment, nutrition education, medical nutrition therapy, monitoring, evaluation, and documentation of evidence-based outcomes. Coordination with long-term care services and support systems is necessary to allow older adults to remain in their homes; improve or maintain their health and manage chronic disease; better navigate transitions of care; and reduce avoidable hospital, acute, or long-term care facility admissions. Funding of these programs requires evidence of their effectiveness, especially regarding health, functionality, and health care–related outcomes of interest to individuals, caregivers, payers, and policy makers. Targeting of food and nutrition programs involves addressing unmet needs for services, particularly among those at high risk for poor nutrition. Registered dietitian nutritionists and nutrition and dietetics technicians, registered must increase programmatic efforts to measure outcomes to evaluate community-based food and nutrition services. [ABSTRACT FROM AUTHOR]

This research investigated the innovative services provided to child victims of abuse by the Dubai Foundation for Women and Children (DFWAC) using a qualitative methodology: in-depth interviewing of 20 participants and analysis of DFWAC documents. A logic model is used as a framework for understanding the program and shows the relationships among resources used, the processes and activities implemented, outputs, and outcomes. The similarities to and differences from the Child Advocacy Center model are discussed. The findings suggest that DFWAC has appropriate policies and procedures for assisting child victims of abuse, and ecological theory is used to explain the results. Although more work is needed to accurately document DFWAC's effectiveness, the DFWAC is an innovative example of civil society's capacity to address child abuse. [ABSTRACT FROM AUTHOR]

Utilize the unique capabilities of a longitudinal design to 1) examine whether burnout is increasing over time among 2 cohorts of pediatricians, and 2) identify factors associated with decreased burnout. Data from a national longitudinal study, the American Academy of Pediatrics Pediatrician Life and Career Experience Study, were used to examine self-reported burnout over a 5-year period (2012 to 2016) among 2002 to 2004 and 2009 to 2011 residency graduates (N = 1804). Study participation rates ranged from 94% in 2012 to 85% in 2016. Mixed-effects logistic regression for longitudinal analysis was used to examine burnout over time. In any given year, between 20% and 35% of study pediatricians reported that they were currently experiencing burnout. Significant increases in burnout over time were found for all participants combined and for each subgroup examined. Several factors were associated with reduced burnout. The largest associations with reduced burnout were found for increased flexibility in work schedule (adjusted odds ratio [aOR], 0.28; 95% confidence interval [CI], 0.22–0.35), decreased work busyness (aOR, 0.28; 95% CI, 0.22–0.36), or a job change (aOR, 0.48; 95% CI, 0.36–0.65). Following 5 years of participation in a longitudinal study, more than 1 in 3 early- to mid-career pediatricians reported experiencing burnout. This represents a 75% relative increase in burnout from the start of the study. Specific characteristics of pediatricians' jobs, such as flexible work schedules and busyness of work settings, were most strongly associated with reduced burnout. [ABSTRACT FROM AUTHOR]

Highlights • El Nino impacts on six socio-ecological systems are described. • Diverse experiences of 2015–16 El Nino event across these systems. • System resilience shaped by interaction of short and long term processes. • El Nino experiences provide window for analysing long term resilience. Abstract In a context of both long-term climatic changes and short-term climatic shocks, temporal dynamics profoundly influence ecosystems and societies. In low income contexts in the Tropics, where both exposure and vulnerability to climatic fluctuations is high, the frequency, duration, and trends in these fluctuations are important determinants of socio-ecological resilience. In this paper, the dynamics of six diverse socio-ecological systems (SES) across the Tropics – ranging from agricultural and horticultural systems in Africa and Oceania to managed forests in South East Asia and coastal systems in South America – are examined in relation to the 2015–16 El Niño, and the longer context of climatic variability in which this short-term 'event' occurred. In each case, details of the socio-ecological characteristics of the systems and the climate phenomena experienced during the El Niño event are described and reflections on the observed impacts of, and responses to it are presented. Drawing on these cases, we argue that SES resilience (or lack of) is, in part, a product of both long-term historical trends, as well as short-term shocks within this history. Political and economic lock-ins and dependencies, and the memory and social learning that originates from past experience, all contribute to contemporary system resilience. We propose that the experiences of climate shocks can provide a window of insight into future ecosystem responses and, when combined with historical perspectives and learning from multiple contexts and cases, can be an important foundation for efforts to build appropriate long-term resilience strategies to mediate impacts of changing and uncertain climates. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Summarizes major milestones in evolution of modern loess science from 1824 to 1964. • Provides historical account of how modern loess science originated from Rhine valley. • Gathers and interprets correspondences among the pioneers and their field travels. • Reveals how early studies on Chinese loess advanced understanding of loess formation. • Explains reasons for delay in dissemination of loess knowledge among Chinese scholars. Abstract Loess is the most important aeolian deposit of the Quaternary and plays an important role in explorations of the evolution of paleoclimate and paleoenvironment. In recent years, historians of science have been working on how loess research originated, developed, and was promoted in Europe in the early 19th century. The Chinese community has a clear history of the loess research from the late 20th century. However, it remains unclear when and how modern loess studies were communicated between western and eastern academic societies and who contributed to the development and dissemination of modern loess knowledge, especially from the western to the eastern societies. Based on books, essays, memoirs, travel notes, published letters, and other types of records from geologists, such as K. Leonhard (1779–1862), C. Lyell (1797–1875), and R. Pumpelly (1837–1923), the present study clarifies the way and process by which loess research originated from the Rhine valley and spread to Britain onto the United States and, in particular, China. It was discovered that loess was formally defined in 1824 in the Rhine valley. In the 1830s, L. Horner (1785–1864) and Lyell introduced loess research from the Rhine valley to Britain. At the same time, Lyell put forward the theory of the fluvial origin of loess and verified his theory by expanding study areas to the United States. In 1866, Pumpelly, the first foreign geologist investigating Chinese loess, put forward lacustrine formation of loess. Pumpelly's hypothesis was soon argued against in 1870 by F. von Richthofen (1833–1905), who thought loess was formed via an aeolian mode based on a wide investigation in the Loess Plateau of China. Although the above main hypotheses originated based on investigations of Chinese loess, they were not disseminated to China and received by Chinese scholars in a timely manner, and the local loess research in China launched almost 130 years later by the stimulation from work by scholars of the Soviet Union. [ABSTRACT FROM AUTHOR]

Abstract Since the late 1990s social enterprises have been increasingly utilised as a means of delivering of health and social care services. However, there is little evidence on if, and how, provision by social enterprise might achieve positive health outcomes, particularly in comparison to other modes of delivery. In this paper, we draw upon the multiple perspectives offered by stakeholders involved in a rural social enterprise initiative based in Scotland, UK, and in a nearby comparator public sector organisation. Both types of organisation aim to increase the physical activity levels of people with chronic health conditions. In order to gain perspectives on the range of mechanisms and outcomes involved in different types of organisation providing similar interventions, realist evaluation of data gathered from in-depth semi-structured interviews (n = 68) was undertaken. Interviews were carried out with beneficiaries, service providers and external stakeholders and Context-Mechanism-Outcome (CMO) configurations developed to support our explanations for how, and in what ways, social enterprise might impact differently on health. Our findings highlight that the social enterprise is differentiated from the publicly-run service in two distinct ways: firstly, the social enterprise was better able to flexibly deliver a bespoke programme designed around the needs of service users; and secondly, their role as a community 'boundary spanner' helped facilitate strong ties and feelings of connectedness between beneficiaries, organisational staff and community stakeholders. However, these advantages were significantly compromised when funding was constrained. Our findings serve as an important basis for future research to better understand the means by which social enterprises might deliver health outcomes, particularly in comparison with public sector providers. Highlights • Presents perspectives on if and how delivery by a social enterprise may influence health outcomes. • Programme Theory is presented, developed from Context-Mechanism-Outcomes configurations. • The flexibility, and boundary-spanning, approaches of social enterprises influence health outcomes. • More research is needed to test and develop theory. [ABSTRACT FROM AUTHOR]

Abstract Objective Disasters are place-based traumatic events, yet contemporary understandings of disaster recovery often do not consider the role of community organizations. We examine organization type and proximity as they relate to post-disaster mental health in a longitudinal study following the 2013 Boston Marathon bombings. Method Residents of metropolitan Boston (N = 846) were recruited via a probability-based sampling strategy within weeks of the bombings and were surveyed several times over a two-year period. Residents of metropolitan New York (N = 941) were recruited and surveyed at the same time and used for comparison due to similarities in community demographics, geography, and disaster histories. We identified six different organization types nearby resident: safety-based organizations, religious organizations, educational organizations, child- and family-promoting organizations, health-based organizations, and voluntary community organizations. With possible environmental detriments (crowds and noise) or benefits of organizations amplified in areas closest to the resident, the concentration of these local organization types was examined at different distance-based boundaries. Contextual data for both communities came from the U.S. Census, Google Places API, and Guidestar. Results For Boston metropolitan area residents, having more safety-based organizations within a half-mile to one-mile area in the aftermath of the bombings was associated with poorer functioning six to seven months later and greater psychological distress two years later. However, the presence of more safety-based organizations in the one to three mile area was associated with decreased psychological distress two years later. More health-based and voluntary community organizations in the half-mile to one-mile area were also associated with fewer fears and worries about future adversity two years post-bombing. Exposure to the bombings and other community traumas moderated this relationship among Boston area participants. Conclusion Results suggest that local community organizations are not merely buildings or structures but ecological sources of support to those in need after a disaster. Highlights • Local community organization proximity and concentration is studied post-disaster. • Boston and New York residents were sampled after the 2013 Boston Marathon bombings. • Six organization types were examined in relation to post-disaster mental health. • Boston area locals benefited from select organizations (e.g., health-based) nearby. • Disaster exposure moderated the community organization-mental health relationship. [ABSTRACT FROM AUTHOR]

Mental state reasoning has been theorized as a core feature of how we navigate our social worlds, and as especially vital to moral reasoning. Judgments of moral wrong-doing and punish-worthiness often hinge upon evaluations of the perpetrator's mental states. In two studies, we examine how differences in cultural conceptions about how one should think about others' minds influence the relative importance of intent vs. outcome in moral judgments. We recruit participation from three societies, differing in emphasis on mental state reasoning: Indigenous iTaukei Fijians from Yasawa Island (Yasawans) who normatively avoid mental state inference in favor of focus on relationships and consequences of actions; Indo-Fijians who normatively emphasize relationships but do not avoid mental state inference; and North Americans who emphasize individual autonomy and interpreting others' behaviors as the direct result of mental states. In study 1, Yasawan participants placed more emphasis on outcome than Indo-Fijians or North Americans by judging accidents more harshly than failed attempts. Study 2 tested whether underlying differences in the salience of mental states drives study 1 effects by inducing Yasawan and North American participants to think about thoughts vs. actions before making moral judgments. When induced to think about thoughts, Yasawan participants shifted to judge failed attempts more harshly than accidents. Results suggest that culturally-transmitted concepts about how to interpret the social world shape patterns of moral judgments, possibly via mental state inference. [ABSTRACT FROM AUTHOR]

Abstract Aims Select patients with brain metastases receive stereotactic radiosurgery (SRS) with the objective of improving survival and intracranial disease control. Brain metastases number and volume are prognostic factors used to inform patient selection. The aim of this study was to assess the rate of change of brain metastases size and number (growth kinetics) between the diagnostic and day of SRS magnetic resonance imaging (MRI) scans. Materials and Methods All patients treated with Gamma Knife SRS between October 2015 and April 2017 were included in this single-centre retrospective analysis. Brain metastases number and diameter were recorded at diagnosis and treatment. For patients with multiple brain metastases, the largest lesion was the index lesion. Distant intracranial control and overall survival were reported from the date of SRS. Results In total, 146 patients received 156 episodes of SRS. The median interval between diagnostic and SRS MRI was 20 days (range 1–68). Interval growth in the index lesion of at least 3 mm or the development of a new brain metastasis was noted in 60.2% of patients. This was associated with age less than 60 years (P = 0.001), Eastern Cooperative Oncology Group (ECOG) performance status 2 or above (P = 0.04), non-small cell lung carcinoma (NSCLC) (P = 0.03) or melanoma histologies (P = 0.05) and uncontrolled extracranial disease (P = 0.05). These patients were also more likely to develop distant intracranial recurrence (P = 0.046). Clinically significant growth was not associated with scan interval or differences in overall survival. The Kaplan–Meier estimate of probability of survival at 12 months was 59.3% (95% confidence interval 46.7–75.2%) for all patients. Conclusion Intracranial progression between diagnosis and day of SRS is common. Risk factors are uncontrolled extracranial disease, poorer performance status, NSCLC or melanoma histologies and age less than 60 years. These patients would benefit from an MRI closer to treatment to inform patient selection and target delineation for SRS planning. Highlights • Significant intracranial progression between diagnosis and radiosurgery treatment is common. • Interval growth of at least 3mm or the development of a new brain metastasis occurred in 60% of patients. • Faster intracranial growth was associated with young age, poor performance status and uncontrolled extracranial disease. • Patients with significant intracranial progression were more likely to develop distant intracranial recurrence. [ABSTRACT FROM AUTHOR]

Abstract The aim of the study was to describe nursing students' reflections on caring for end-of-life patients in a youth volunteer service. A purposive sample of 11 nursing students in one province in China were interviewed and diaries were collected. The data were analysed using qualitative content analysis. The students described the service as "an empowering care that makes a difference – but not without challenges on different levels". The service was said to provide devoted caring adjusted to the person's need, condition and wishes. According to the students, the service had an impact on them; the internal and/or external support was stimulating and rewarding, whereas deficient support was frustrating and made them feel helpless. They emphasized the need for improvements at different levels. In conclusions, the youth volunteer service empowers both patients and students and can be seen as person-centred care. The students' professional knowledge, skills and ability improved, while these aspects were still perceived as deficient. Appropriate curriculum and training for nursing students are necessary and should be tailored to improving students' caring ability and confidence. Expanding the service was emphasized and suggestions for improvements were identified. Highlights • Students found participation in the service to be rewarding and meaningful. • Students improved knowledge, skills, ability – changed attitudes and views on life. • Students found the service emotional and not without challenges. • More mentoring, knowledge and support are needed. • Appropriate curriculum and training for nursing students should be designed. [ABSTRACT FROM AUTHOR]

Abstract According to data from recent studies from Europe, a large percentage of patients have restricted access to innovative medicines for metastatic melanoma. Melanoma World Society and European Association of Dermato-oncology conducted a Web-based survey on access to first-line recommended treatments for metastatic melanoma by current guidelines (National Comprehensive Center Network, European Society for Medical Oncology [ESMO] and European Organization for Research and Treatment of Cancer/European Association of Dermato-oncology/European dermatology Forum) among melanoma experts from 27 European countries, USA, China, Australia, Argentina, Brazil, Chile and Mexico from September 1st, 2017 to July 1st, 2018. Data on licencing and reimbursement of medicines and the number of patient treated were correlated with the data on health expenditure per capita (HEPC), Mackenbach score of health policy performance, health technology assessment (HTA), ASCO and ESMO Magnitude of clinical benefit scale (ESMO MCBS) scores of clinical benefit and market price of medicines. Regression analysis for evaluation of correlation between the parameters was carried out using SPSS software. The estimated number of patients without access in surveyed countries was 13768. The recommended BRAFi + MEKi combination and anti-PD1 immunotherapy were fully reimbursed/covered in 19 of 34 (55.8%) and 17 of 34 (50%) countries, and combination anti-CTLA4+anti-PD1 in was fully covered in 6 of 34 (17.6%) countries. Median delay in reimbursement was 991 days, and it was in significant correlation with ESMO MCBS (p = 0.02), median market price (p = 0.001), HEPC and Mackenbach scores (p < 0.01). Price negotiations or managed entry agreements (MEAs) with national authorities were necessary for reimbursement. In conclusion, great discrepancy exists in metastatic melanoma treatment globally. Access to innovative medicines is in correlation with economic parameters as well as with healthcare system performance parameters. Patient-oriented drug development, market access and reimbursement pathways must be urgently found. Highlights • New therapies have dramatically improved the prognosis of metastatic melanoma, but disparities in access to these medicines exist worldwide. • BRAFi+MEKi combinations are fully reimbursed in 17 of 34 (50%) countries. • Anti-PD1 immunotherapies are fully reimbursed in 17 of 34 (50%) countries. • Combination immunotherapy (anti-CTLA4+anti-PD1) is reimbursed in 9 of 34 (26.4%) countries, in 3 countries with restrictions. • Patient-oriented research, development, market access and reimbursement mechanisms must be urgently developed. [ABSTRACT FROM AUTHOR]

Abstract Patients with hereditary gastrointestinal (GI) cancers represent a substantial fraction of the overall affected population. Although awareness for hereditary GI cancer syndromes is on the rise, identification of patients and measures of surveillance are often unclear in everyday clinical routine. Therefore, the European Society of Digestive Oncology expert discussion 2018 at the World Congress on Gastrointestinal Cancer focussed on screening and surveillance of hereditary colorectal, gastric and pancreatic cancers. An international panel of experts and opinion leaders developed the here presented recommendations based on published evidence and on profound clinical expertise to facilitate clinical routine in identification and caretaking of patients with familial GI cancers. Highlights • Hereditary causes account for a substantial fraction of gastrointestinal cancers. • Family history remains the key for identifying patients and individuals at risk. • Caretaking for patients and individuals at risk is a multidisciplinary approach. • Genetic counselling should be offered before germline mutational analysis. • Appropriate surveillance measures can prevent potentially fatal cancers. [ABSTRACT FROM AUTHOR]

Abstract Context Social media (SoMe) has transformed communication among health care professionals by enabling rapid and global information exchange. Yet, the novelty of SoMe and concerns about potential risks continue to be barriers to adoption. Objective To encourage appropriate professional use of SoMe by physicians in concordance with best practices and to update practical guidelines for effective and professional use of these communication technologies. Evidence aquisition The European Association of Urology (EAU; @Uroweb) brought together a committee of SoMe stakeholders in the urology field. PubMed and the grey literature were searched to identify SoMe position papers by other medical societies and organizations. Evidence synthesis Updated practical guidelines for effective and professional use of SoMe communication technologies. A core of 10 practical recommendations for the responsible, ethical, and constructive use of SoMe communication technologies was articulated. The guidelines are limited by their inherent subjective nature and lack of robust evidence supporting their utility. Conclusions SoMe is reshaping the way the urological care providers communicate; however, appropriate engagement requires courtesy, professionalism, and honesty. Adherence to guidelines will help users harness the benefits of SoMe in a safe and effective manner. Patient summary Social media has transformed communication among health care professionals. This narrative review article provides an update of practical guidelines for effective and professional use of these communication technologies. Take Home Message Social media (SoMe) has transformed communication among health care stakeholders; however, appropriate engagement requires courtesy, professionalism, and thoughtfulness. Adherence to 10 practical recommendations will assist users in harnessing the deliverables of SoMe in a safe and effective manner. [ABSTRACT FROM AUTHOR]

Abstract This study examines the forms of abuse and neglect experienced by children living in orphanages in East Java Province, efforts by children in orphanages to deal with the acts of abuse experienced, and the role of the orphanage or the Child Social Welfare Institution (LKSA) in providing protection and fulfillment of the rights of abandoned children. The research was conducted in five cities namely Surabaya, Malang, Nganjuk, Madiun, and Probolinggo. The number of respondents in each district/city as many as 100 children, in addition to in-depth interviews were conducted on 2–3 informants caretaker and caregiver in each orphanage to get data about the institution. The results show that almost all facilities for children in orphanages are satisfactory but they still experience abuse, especially physical and psychological abuse. The perpetrators of the violence are caregivers, friends, and seniors. To realize the condition of the child-friendly home, there needs to be an effort to foster commitment and understanding in relation to child care activities both among carers and nursing parlors based on child protection efforts and fight for the fulfillment of children's rights and not just services. The efforts of parenting should not only focus on the needs of the child (need based), but the fulfillment of children's rights. [ABSTRACT FROM AUTHOR]

Objectives To assess the organizational health literacy (OHL) of a group of hospitals and investigate the relationships among OHL, patient satisfaction, and patients' health literacy. Study design This cross-sectional study is conducted in one state hospital, one university hospital, and one private hospital in Istanbul. OHL of the hospitals, patient satisfaction, and health literacy of a sample group of patients were investigated. Methods OHL data were collected from six managers of each hospital by filling out the ‘Health Literate Health care Organizations-10’ (HLHO-10) questionnaire during face-to-face interviews. Patient satisfaction and patient health literacy data were collected from representative samples of inpatients in each hospital (n = 491 for the university hospital, 482 for the state hospital, and 486 for the private hospital). The ‘Rapid Estimate of Adult Literacy in Medicine’ test was used for measuring health literacy. Collected data were analyzed by the SPSS program. Results The Turkish version of HLHO-10 questionnaire had high internal consistency (Cronbach's alpha = 0.916). Health literacy and patient satisfaction levels of the university hospital inpatients were significantly higher (P < 0.001) than those of the other hospitals. A high level of OHL was associated with high patient satisfaction. Conclusions OHL seems to be a significant determinant of patient satisfaction. [ABSTRACT FROM AUTHOR]

Peter Hochachka was an early pioneer in the field of comparative biochemistry. He passed away in 2002 after 4 decades of research in the discipline. To celebrate his contributions and to coincide with what would have been his 80th birthday, a group of his former students organized a symposium that ran as a satellite to the 2017 Canadian Society of Zoologists annual meeting in Winnipeg, Manitoba (Canada). This Special Issue of CBP brings together manuscripts from symposium attendees and other authors who recognize the role Peter played in the evolution of the discipline. In this article, the symposium organizers and guest editors look back on his career, celebrating his many contributions to research, acknowledging his role in training of generations of graduate students and post-doctoral fellows in comparative biochemistry and physiology. [ABSTRACT FROM AUTHOR]

Objective: To assess in vitro fertilization (IVF) and pregnancy outcomes in patients having their first frozen embryo transfer (FET) after a freeze-all cycle versus similar patients having their first fresh embryo transfer (ET).Design: Retrospective cohort study.Setting: None.Patient(s): Registry data on 82,935 patient cycles from the Society for Assisted Reproductive Technology (SART).Intervention(s): All first fresh autologous IVF cycles were analyzed and compared to first FET cycles after a freeze-all first IVF stimulation. The cycles were subdivided into cohorts based upon the number of oocytes retrieved (OR): 1-5 (low), 6-14 (intermediate), and 15+ (high responders). Univariate analyses were performed on cycle characteristics, and multivariable regression analyses were performed on outcome data.Main Outcome Measure(s): Clinical pregnancy rate (CPR) and live-birth rate (LBR).Results: Of the 82,935 cycles analyzed, 69,102 patients had their first fresh transfer, and 13,833 had a first FET. High responders were found to have a higher CPR and LBR in the FET cycles compared with the fresh ET cycles (61.5 vs. 57.4%; 52.0 vs. 48.9%). In intermediate responders, both CPR and LBR were higher after fresh ET compared with FET (49.6% vs. 44.2%; 41.2 vs. 35.3%). Similarly, in low responders, CPR and LBR were higher after fresh compared with FET (33.2% vs. 15.9%; 25.9% vs. 11.5%).Conclusion(s): A freeze-all strategy is beneficial in high responders but not in intermediate or low responders, thus refuting the idea that freeze-all cycles are preferable for all patients. [ABSTRACT FROM AUTHOR]

Abstract This paper provides a report of the discussions held at the first workshop on Measurement and Computation of Fire Phenomena (MaCFP) on June 10–11 2017. The first MaCFP workshop was both a technical meeting for the gas phase subgroup and a planning meeting for the condensed phase subgroup. The gas phase subgroup reported on a first suite of experimental-computational comparisons corresponding to an initial list of target experiments. The initial list of target experiments identifies a series of benchmark configurations with databases deemed suitable for validation of fire models based on a Computational Fluid Dynamics approach. The simulations presented at the first MaCFP workshop feature fine grid resolution at the millimeter- or centimeter-scale: these simulations allow an evaluation of the performance of fire models under high-resolution conditions in which the impact of numerical errors is reduced and many of the discrepancies between experimental data and computational results may be attributed to modeling errors. The experimental-computational comparisons are archived on the MaCFP repository [1]. Furthermore, the condensed phase subgroup presented a review of the main issues associated with measurements and modeling of pyrolysis phenomena. Overall, the first workshop provided an illustration of the potential of MaCFP in providing a response to the general need for greater levels of integration and coordination in fire research, and specifically to the particular needs of model validation. Highlights • A report on the 1st workshop organized by the IAFSS Working Group on Measurement and Computation of Fire Phenomena (MaCFP). • A focus on validation of fire models based on Computational Fluid Dynamics (CFD). • A first suite of experimental-computational comparisons corresponding to an initial list of target experiments. • A discussion of the importance of grid resolution and a novel description of computational grid design. • A review of current issues associated with measurements and modeling of pyrolysis phenomena. [ABSTRACT FROM AUTHOR]

The number of deaths from car accidents and from the unlawful use of guns can be described by logistic growth curves. The annual rates of both have traced completed logistic trajectories following which they have been self-regulated for many decades at what seems to be a homeostatic equilibrium level through legislative actions. Exception constitutes the number of deaths from mass shootings, which has been so far tracing an exponential trajectory. Despite the fact that mass-shooting deaths represent only 0.1 % of all gun deaths today, they are poised to continue growing exponentially until they become the major cause of gun deaths, short of unprecedented action by society. • The number of deaths from car accidents and from the unlawful use of guns can be described by logistic growth curves. • Annual rates of deaths from guns and car accidents (but not from mass shootings) have been self-regulated for many decades. • Mass-shooting deaths represent only 0.1 % of all gun deaths in the US today but they are growing exponentially. • Mass-shootings will continue growing exponentially short of unprecedented action by society. [ABSTRACT FROM AUTHOR]

Digital platforms are changing economies and societies, challenging the fundamental institutions of democracy and requiring an understanding of the driving factors behind the development of such platforms. Therefore, we have investigated the impact of dominant platforms on standardization in innovation ecosystems on the level of technologies, firms, and societies. We have conducted a systematic review of the literature on standardization and ecosystems. We define ecosystem-based standardization as the development of a standard embodied in a dominant platform. Important innovation-related findings include that processes are embedded in the platform, allowing for complementary innovation using modular capabilities and, thus, requiring the traditional view of the relationship between product and process innovation to be revisited. Ecosystem-based standardization foments both technological and organizational modularity, which increases innovation speed as well as synergies within the ecosystem. However, the power asymmetry generated by ecosystem-based standardization favors value appropriation by platform sponsors, which has vast implications for the development of regulations and institutions. • We define ecosystem-based standardization as the development of a standard embodied in a dominant platform. • Processes are embedded in the platform, allowing for complementary innovation using modular capabilities • Hence, the traditional view of the relationship between product and process innovation needs to be revisited. • Ecosystem-based standardization foments technological and organizational modularity, driving innovation speed and synergy. • Power asymmetry generated by ecosystem-based standardization favors value appropriation by platform sponsors. [ABSTRACT FROM AUTHOR]

Background Recent studies have highlighted the presence of disclosed and undisclosed financial conflicts of interest among authors of clinical practice guidelines. Objective We sought to determine to what extent urology guideline authors receive and report industry payments in accordance with the Physician Payment Sunshine Act. Design, setting, and participants We selected the 13 urology guidelines that were published by the American Urological Association (AUA) after disclosure was mandated by the Physician Payment Sunshine Act. Payments received by guideline authors were searched independently by two investigators using the Open Payments database. Outcome measures and statistical analysis Our primary outcome measure was the number of authors receiving payments from industry, stratified by amount thresholds. Our secondary outcome measure was the number of authors with accurate conflict of interest disclosure statements. Results and limitations We identified a total of 54 author disclosures. Thirty-two authors (59.3%) received at least one payment from industry. Twenty (37.0%) received >$10 000 and six (11.1%) received >$50 000. Median total payments were $578 (interquartile range $0–19 228). Twenty (37.0%) disclosure statements were inaccurate. Via Dollars for Docs, we identified $74 195.13 paid for drugs and devices directly related to guideline recommendations. We were limited in our ability to determine when authors began working on guideline panels, as this information was not provided, and by the lack of specificity in Dollars for Docs. Conclusions Many of the AUA guideline authors received payments from industry, some in excess of $50 000. A significant portion of disclosure statements were inaccurate, indicating a need for more stringent enforcement of the AUA disclosure policy. Patient summary Pharmaceutical company payments to doctors have been shown to influence how doctors treat patients. If these doctors are charged with making clinical recommendations to other doctors, in the form of clinical practice guidelines, the issue of industry payments becomes more severe. We found that many urologists on guideline panels receive money from industry and that a significant portion did not disclose all payments received. [ABSTRACT FROM AUTHOR]

Discretion is an essential and unavoidable element of most decision-making and is thus often closely related to the judgment exercised by politicians and practitioners alike. It is evident that discretionary power can be executed in different ways, leading to different results. Therefore, it also has a significant influence on the effectiveness of the environmental assessment (EA) as examined in recent environment impact assessment (EIA) and strategic environment assessment (SEA) literature. However, limited attention has been given to the practitioners' role and how they exercise their discretion, while the effectiveness and implementation of decisions has been a recurrent theme in EA literature. This article explores the connections between discretion and some of the fundamental ideas behind how EIA and SEA function in our societies. Firstly, the article develops and presents a theoretical model of discretion, allowing us to explore the phenomena of discretion from four dimensions: source, form, value and dynamics of discretion. Secondly, a review of EA literature is performed with the purpose of mapping how discretion is studied and what kind of discretion is found in the context of EA – focusing on one of the dimensions – ‘source of discretion’. The results imply that it is prevalent for practitioners to exercise rule, value and task discretion in every choice they make at each stage of the EA implementation process, which influences EA effectiveness, either positively or negatively, depending on how discretionary power is exercised and reflected in EA practitioners' practice. It draws both the management's attention to how to regulate EA policies and the practitioners' attention to how to make a difference. [ABSTRACT FROM AUTHOR]

The deep sea has become an area of increasing interest due to the potential for mining the seafloor for valuable minerals. However, a critical knowledge gap in terms of understanding the economic value that the deep sea provides to societies makes it extremely difficult to estimate the long term economic impacts of mining activities. This article conducts a systematic review and meta-analysis of previous literature on the economic value of the deep sea, with the objective of integrating the findings of previous literature and identifying areas for future research. 25 studies were included in the systematic review, of which 15 were included in the meta-analysis. Although the systematic review reveals a lack of sufficient data to accurately estimate the economic value of the deep sea, the meta-analysis indicates that the functioning of the deep sea as an ecosystem significantly influences the economic value that it provides to society. The limited number of studies identified, along with the broad variety in their methods, scope, valuation perspective and purpose, emphasizes the need for future research into economic value-aspects of the deep sea. More importantly, this study reveals an urgent need for further scientific research into the deep sea's ecosystem in order to ensure the resource is managed sustainably in the long-term. [ABSTRACT FROM AUTHOR]

India's rural poor are caught in a downward energy poverty cycle with either a lack of access to modern energy sources or reliable grid electricity supply. Overcoming these barriers will require strategies that account for extremely low levels of income, lack of access to finance, poor awareness of alternative energy technologies and deficient post-installation service on solar home systems (SHSs). Our study is novel in examining reasons accounting for the slow adoption of SHSs in rural areas from the perspective of a rural (Grameen) bank. We reveal current government energy policies especially SHS subsidy scheme, largely exclude those below the poverty line. This self-induced socioeconomic barrier, in turn, limits the involvement of the banking sector who report additional barriers including higher lending costs and financial risks coupled with internally restrictive lending practices. We propose a revised framework the Rural Energy Transformation through Pro-Poor Subsidy to support an SHS capital subsidy scheme which specifically includes below poverty line households, and incorporates an electronic subsidy disbursement mechanism designed to improve efficiency and effective delivery between five key actors. These include the National Bank for Agriculture and Rural Development, the Regional Rural Banks and suppliers deploying and maintaining subsidised SHS and the rural households. The framework would establish a contractual partnership between banks and suppliers, and at a policy level would require the government to mandate banks to lend at low margins and offer dedicated subsidy benefits to low-income populations to enable a rural energy transformation. [ABSTRACT FROM AUTHOR]

The article looks at cooperation between women's non-governmental organizations (NGOs) and grassroots feminist groups in Georgia. It challenges the NGOization framework that depicts civil society in post-Soviet Eastern Europe as dominated by Western-sponsored, bureaucratized, and professionalized organizations that fail to mobilize the population. It reports that women's NGOs have served towards gender equality in Georgia.

The small, decentralised communities, known as outstations which satellite larger Indigenous Australian remote communities have often been conceptualised as places that are beneficial to health and well-being. This paper provides an exploration of the meaning of an outstation for one family and the benefits that this connection brings to them, which are expressed in a deep connection to the land, continuing relationships with ancestors and a safe refuge from the stresses of the larger community. We argue that the outstation provides a place for people to be in control of their lives and form hopes and plans for the future. These benefits are positioned in a context where the future liveability and sustainability of the outstation is both fragile and vulnerable. [ABSTRACT FROM AUTHOR]

In this study, we provide new national- and state-level estimates of workload and workforce instability among child welfare agencies using previously unavailable data that includes unique identifiers for US child welfare caseworkers in 46 states and supervisors in 43 states. We identify and describe 139,921 unique caseworkers and 31,124 unique supervisors who were in the child welfare workforce between 2003 and 2015. The median caseworker handles 55 cases annually and is on the job for about 1.8 years. The median state has an annual front-line caseworker turnover rate of between 14 and 22% annually, and a supervisor turnover rate of about 20% annually. [ABSTRACT FROM AUTHOR]

Public Child Welfare Agencies (PCWAs) may use volunteers in a number of capacities to support improved youth outcomes while addressing resource shortages and promoting positive community relationships. However, no prior research has examined volunteer use in various capacities by PCWAs and the potential outcomes of this use. This qualitative study explores how PCWAs in one state utilize volunteers and the perceived effects of this volunteer use. Qualitative telephone interviews were conducted with representatives from PCWAs in twelve metropolitan counties. Using grounded theory analysis, interview data were thematically coded and organized into a conceptual model depicting the potential effects of volunteer use on agency and child outcomes. Most ( n  = 9) agencies used volunteers, but only four used volunteers in roles where they had direct contact with youth (e.g., as mentors). Respondents described volunteer programs as promoting outcomes in three major areas: community engagement, agency access to supports and resources, and positive youth development. Moreover, respondents described potential connections among these outcome areas, with community engagement leading to more supports and resources, which in turn, promoted positive youth development. Findings suggest that the use of volunteers may help PCWAs to achieve their goals of advancing child permanency, safety, and well-being. [ABSTRACT FROM AUTHOR]

The optimism surrounding multistakeholder research initiatives does not match the clear view of policies that are needed to exploit the potential of these collaborations. Here we propose some action items that stem from the integration between research advancements with the perspectives of patient-advocacy organizations, academia, and industry. [ABSTRACT FROM AUTHOR]

In this paper, we present recent data on Early Holocene human occupations from Taltal, in the coast of the Atacama Desert. We focus on evidences of mobility and subsistence economy, discussing the data in terms of a concept of territoriality adapted from cultural geographers working with hunting-gathering societies. We attempt to show that the Huentelauquén Cultural Complex, usually considered the earliest evidence of human occupation in the coast of northern Chile, exhibits an already consolidated territorialisation process. We question whether it represents the earliest phases of the peopling process or if such evidence are still lacking at a regional level. We try to go beyond the characterization of Huentelauquén Cultural Complex as an early maritime adaptation, understanding it as the earliest socio-territorial identity known to date for the Arid Coast of northern Chile. [ABSTRACT FROM AUTHOR]

The main objectives of the present study are to (a) map interventions that can be used to develop good safety culture in transport companies within road, sea, air and rail transport, (b) assess expected effects of interventions on safety culture and safety outcomes and (c) identify factors influencing safety culture change. By systematically reviewing the scientific literature, we identify 20 studies that describe and evaluate interventions to improve safety culture in road, rail, sea and air transport organizations. The review is reported according to PRISMA guidelines. The interventions studied vary widely in their comprehensiveness, but a lack of both standardized outcome measures and controlled evaluations means that it is difficult to compare different interventions, either within or across sectors. Most studies, however, report improvements in safety culture where this is measured. We find that attempts to understand the mechanisms of cultural change leading to behavioural change and improved safety performance are lacking. Although safety culture is an organizational measure, we only found one peer-reviewed study of an attempt to improve safety culture in a single air transport organization and no studies of this in the maritime sector. We conclude that on the whole the reviewed safety culture interventions seem to be effective, but comprehensive and resource demanding. We suggest that future research should develop simpler interventions by focusing on the basic requirements of safety culture change. We contribute to this by identifying four key activities ( content ) which seem to be common in all the reviewed interventions, and eight key factors ( process ) influencing the success of efforts to influence safety culture. The basic requirements of safety culture change seem to be to institutionalize joint discussions of work place hazards facilitated by manager commitment and employee involvement. [ABSTRACT FROM AUTHOR]

The high rate of adult criminal justice involvement in the United States has resulted in many unintended consequences for families of offenders. Families involved with the criminal justice system are disproportionately involved with the child welfare system, and adolescents involved in both systems (i.e., dual system involvement) exhibit higher levels of delinquency. Yet, a lack of research exists on dual system involvement and the effects on youth. The current study leveraged nationally representative and longitudinal data of families involved in the child welfare system to examine whether maternal criminal justice involvement predicted increases in youth delinquency. An ecological model tested the effects of maternal justice involvement beyond cumulative risks as well as the potential buffer of parental monitoring and non-violent discipline on system involvement. Results suggested child welfare-involved youth exhibited similar levels of delinquency over time, regardless of maternal justice involvement. Although youth with maternal justice involvement reported more parental monitoring, the level of monitoring mattered more for youth without maternal justice involvement who exhibited decreased delinquency in the presence of high parental monitoring compared to low monitoring. The differential pattern of association between parental monitoring and youth delinquency for dual-system involved families suggests they are distinct and may carry implications for treatment response aimed at delinquency reduction through parent training. These findings underscore the importance of interagency coordination around policy and interventions to identify these high risk families at risk of slipping through the cracks of multiple service involvement. [ABSTRACT FROM AUTHOR]

Objective: To assess the role of recombinant human LH (r-hLH) supplementation in ovarian stimulation for ART in specific subgroups of patients.Design: Systematic review.Setting: Centers for reproductive care.Patient(s): Six populations were investigated: 1) women with a hyporesponse to recombinant human FSH (r-hFSH) monotherapy; 2) women at an advanced reproductive age; 3) women cotreated with the use of a GnRH antagonist; 4) women with profoundly suppressed LH levels after the administration of GnRH agonists; 5) normoresponder women to prevent ovarian hyperstimulation syndrome; and 6) women with a "poor response" to ovarian stimulation, including those who met the European Society for Human Reproduction and Embryology Bologna criteria.Intervention(s): Systematic review.Main Outcome Measure(s): Implantation rate, number of oocytes retrieved, live birth rate, ongoing pregnancy rate, fertilization rate, and number of metaphase II oocytes.Result(s): Recombinant hLH supplementation appears to be beneficial in two subgroups of patients: 1) women with adequate prestimulation ovarian reserve parameters and an unexpected hyporesponse to r-hFSH monotherapy; and 2) women 36-39 years of age. Indeed, there is no evidence that r-hLH is beneficial in young (<35 y) normoresponders cotreated with the use of a GnRH antagonist. The use of r-hLH supplementation in women with suppressed endogenous LH levels caused by GnRH analogues and in poor responders remains controversial, whereas the use of r-hLH supplementation to prevent the development of ovarian hyperstimulation syndrome warrants further investigation.Conclusion(s): Recombinant hLH can be proposed for hyporesponders and women 36-39 years of age. [ABSTRACT FROM AUTHOR]

Context The European Association of Urology guidelines on urinary incontinence (UI) have been updated in cyclical fashion with successive major chapters being revised each year. The sections on assessment, diagnosis, and nonsurgical treatment have been updated as of mid-2016. Objective We present a condensed version of the full guideline on assessment and nonsurgical management of UI, with the aim of improving accessibility and increasing their dissemination. Evidence acquisition Our literature search was updated from the previous cut-off of July 2010 up to April 2016. Evidence synthesis was carried out by a pragmatic review of current systematic reviews and any newer subsequent high-quality studies, based on Population, Interevention, Comparator, and Outcome questions. Appraisal was conducted by an international panel of experts, working on a strictly nonprofit and voluntary basis, to develop concise evidence statements and action-based recommendations using modified Oxford and GRADE criteria. Evidence synthesis The guidelines include algorithms that summarise the suggested pathway for standard, uncomplicated patients with UI and are more useable in daily practice. The full version of the guideline is available at http://uroweb.org/guideline/urinary-incontinence/ . Conclusions These updated guidelines provide an evidence-based summary of the assessment and nonsurgical management of UI, together with a clear clinical algorithm and action-based recommendations. Although these guidelines are applicable to a standard patient, it must be remembered that therapy should always be tailored to individual patients’ needs and circumstances. Patient summary Urinary incontinence is a very common condition which negatively impacts patient's quality of life. Several types of incontinence exist and since the treatments will vary, it is important that the diagnostic evaluation establishes which type is present. The diagnosis should also identify patients who need rapid referral to an appropriate specialist. These guidelines aim to provide sensible and practical evidence-based guidance on the clinical problem of urinary incontinence. [ABSTRACT FROM AUTHOR]

The European Society for Medical Oncology (ESMO) consensus conference on mature B cell lymphomas and chronic lymphocytic leukaemia (CLL) was held on 20 June 2015 in Lugano, Switzerland, and included a multidisciplinary panel of 25 leading experts. The aimof the conference was to develop recommendations on critical subjects difficult to consider in detail in the ESMO Clinical Practice Guidelines. The following areas were identified: (1) the elderly patient, (2) prognostic factors suitable for clinical use, and (3) the 'ultra-high-risk' group. Before the conference, the expert panel was divided into three working groups; each group focused on one of these areas in order to address clinically-relevant questions relating to that topic. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, each working group developed recommendations to address each of the four questions assigned to their group. These recommendations were presented to the entire panel and a consensus was reached. This consensus, which was further developed in continuous post-meeting discussions, formed the basis of three manuscripts, each covering one of the three key areas identified. This manuscript presents the consensus recommendations regarding the clinical management of elderly patients diagnosed with malignant lymphoma. Four clinically-relevant topics identified by the panel were: 1) how to define patient fitness, 2) assessing quality of life, 3) diagnostic work-up and 4) clinical management of elderly patients with lymphoma. Each of these key topics is addressed in the context of five different lymphoma entities, namely: CLL, follicular lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma and diffuse large B-cell lymphoma. Results, including a summary of evidence supporting each recommendation, are detailed in thismanuscript. [ABSTRACT FROM AUTHOR]

Background In recent years there has been much emphasis on ‘research waste’ caused by poor question selection, insufficient attention to previous research results, and avoidable weakness in research design, conduct and analysis. Little attention has been paid to the effect of inadequate development of interventions before proceeding to a full clinical trial. Objective We therefore propose to enrich the development phase of the MRC Framework by adding crucial elements to improve the likelihood of success and enhance the fit with clinical practice Methods Based on existing intervention development guidance and synthesis, a comprehensive iterative intervention development approach is proposed. Examples from published reports are presented to illustrate the methodology that can be applied within each element to enhance the intervention design. Results A comprehensive iterative approach is presented by combining the elements of the MRC Framework development phase with essential elements from existing guidance including: problem identification, the systematic identification of evidence, identification or development of theory, determination of needs, the examination of current practice and context, modelling the process and expected outcomes leading to final element: the intervention design. All elements are drawn from existing models to provide intervention developers with a greater chance of producing an intervention that is well adopted, effective and fitted to the context. Conclusion This comprehensive approach of developing interventions will strengthen the internal and external validity, minimize research waste and add value to health care research. In complex interventions in health care research, flaws in the development process immediately impact the chances of success. Knowledge regarding the causal mechanisms and interactions within the intended clinical context is needed to develop interventions that fit daily practice and are beneficial for the end-user. [ABSTRACT FROM AUTHOR]

Citizen Review Panels (CRPS) are groups of volunteers mandated by United States federal law to examine policies, procedures, and practices of public (e.g., state) child welfare agencies, and make recommendations for systemic improvements. To date, several researchers have made clarion calls for training frameworks and approaches for CRP members. Despite the federal mandate, millions of dollars in resources allocated to these panels, and the potential to positively impact the child welfare system, no published training frameworks exist. This brief documents the evaluation of an online training for CRP members (N = 21) in one southeastern state. The training was developed based on needs identified in existing CRP literature, and delivered via an online learning platform. A pre-experimental (pre/post) approach was used to evaluate the training. Results indicate a significant improvement in knowledge associated with serving on the CRP, and overall, participants viewed the training as being positively impactful to their work as a CRP member. The brief will provide an overview of the training, evaluation approach, and briefly discuss salient implications derived from the results. [ABSTRACT FROM AUTHOR]