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In this article, we argue that number-making is a mode of imagining political futures – not only futures that are probable but, crucially, futures that are desired. In this way, rather than simply a mode of 'technicising' policy challenges, quantification fleshes out the utopian dream of a better world. Global governance is faced with the paradox of, on one hand, the utopian aspiration of the Sustainable Development Goals to create a perfect world (free of poverty, inequality, diseases and climate disaster) and, on the other hand, the dystopian effects of inaction – both tracked carefully through a complex network of indicators. This article focuses on the materiality of the Sustainable Development Goals as a productive device through which a monitoring agenda such as the Sustainable Development Goals has become ever more influential and has led to the emergence of a global public policy space. [ABSTRACT FROM AUTHOR]

Objectives: To provide guidance for the optimal administration of repetitive transcranial magnetic stimulation, based on scientific evidence and supplemented by expert clinical consensus. Methods: Articles and information were sourced from existing guidelines and published literature. The findings were then formulated into consensus-based recommendations and guidance by the authors. The guidelines were subjected to rigorous successive consultation within the RANZCP, involving the Section of ECT and Neurostimulation (SEN) Committee, its broader membership and expert committees. Results: The RANZCP professional practice guidelines (PPG) for the administration of rTMS provide up-to-date advice regarding the use of rTMS in clinical practice. The guidelines are intended for use by psychiatrists and non-psychiatrists engaged in the administration of rTMS to facilitate best practice to optimise outcomes for patients. The guidelines strive to find the appropriate balance between promoting best evidence-based practice and acknowledging that evidence for rTMS use is a continually evolving. Conclusion: The guidelines provide up-to-date advice for psychiatrists and non-psychiatrists to promote optimal standards of rTMS practice. [ABSTRACT FROM AUTHOR]

Purpose: We sought to compare the costs of ambulatory endovascular aneurysm repair (a-EVAR) and inpatient EVAR (i-EVAR) at up to 1-year of follow-up. Materials and Methods: A retrospective cohort study of consecutive patients undergoing elective EVAR between April 2016 and December 2018 at two academic centers. Patients planned for a-EVAR were compared with i-EVAR. Costs at 30 days and 1 year were extracted. These included operating room (OR) use, bed occupancy, laboratory and imaging, emergency department (ED) visits, readmissions, and reinterventions. Baseline characteristics were compared. Multiple regression model was used to identify predictors of increased EVAR costs. Repeated measures analysis of variance (ANOVA) was used to compare cost differences at 30 days and 1 year via an intention-to-treat analysis. Bonferroni post hoc test compared between-group differences. A p value<0.05 was considered statistically significant. Results: One hundred seventy patients were included. Most underwent percutaneous EVAR (>94%) under spinal anesthesia (>84%). Ambulatory endovascular aneurysm repair was successful in 84% (84/100). Ambulatory endovascular aneurysm repair patients (76±8 years) were younger than i-EVAR (78±9 years). They also had a smaller mean aneurysm diameter (56±6 mm) compared with i-EVAR (59±6 mm). Emergency department visits, readmissions, and reinterventions were similar up to 1 year (all p=NS). Ambulatory endovascular aneurysm repair costs showed a non-statistically significant reduction in total costs at 30 days and 1 year by 27% and 21%, respectively. Patients younger than 85 years and males had a 30-day cost reduction by 34% (p=0.027) and 33% (p=0.035), respectively with a-EVAR. Conclusions: Same-day discharge is feasible and successful in selected patients. Patients younger than 85 years and males have a short-term cost benefit with EVAR done in the ambulatory setting without increased complications or reinterventions. Clinical Impact: This study shows the overall safety of ambulatory EVAR with proper patient selection. These patient had similar post-intervention complications to inpatients. Same day discharge also resulted in short-term reduction in costs in male patients and patients younger than 85 years. [ABSTRACT FROM AUTHOR]

Background: Environmental exposures have been postulated to play an important role in the pathophysiology of chronic rhinosinusitis (CRS). Particulate matter (PM) is one of the most widely studied ambient air pollutants, but its peri-operative impact on CRS is unknown. Objective: To determine the effect of acute, peri-operative PM exposure on outcomes after endoscopic sinus surgery (ESS). Methods: Participants with CRS who self-selected ESS were prospectively enrolled. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility values scores were recorded. Using residence zip codes, a secondary analysis of patient exposure to PM <2.5 μm and <10 μm (PM2.5 and PM10, respectively) was performed for the month of surgery utilizing data from Environmental Protection Agency air quality monitors. Spearman's correlation coefficients (ρ), 95% confidence intervals (CIs), and effect estimates (β) were used to determine the magnitudes of association. Simple, multivariate regression analysis was also completed. Results: One hundred and seven patients from four geographically unique institutions across the US were enrolled with a follow-up of 6 months. Patients with higher peri-operative PM2.5 exposure had less improvement in their SNOT-22 scores after ESS compared to those with less exposure using both univariate analysis (ρ = 0.26, 95% CI: 0.08, 0.43; P =.01) and after covariate adjustment with multivariate analysis (B = 1.06, 95% CI: 0.001, 2.14, P =.05). Similar associations were not found with SF-6D outcomes or with PM10 as an exposure of interest. No significant correlations were found between peri-operative PM levels and Lund-Kennedy endoscopy scores post-operatively. Conclusion: Preliminary data from this pilot study reveal that PM exposure at the time of ESS may negatively associate with post-operative improvement in sinonasal quality-of-life. Larger, population-based studies with more standardized PM exposure windows are needed to confirm the clinical significance of the present findings. [ABSTRACT FROM AUTHOR]

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

Introduction: Busulfan is a common component of allogeneic hematopoietic cell transplant (alloHCT) conditioning, however interpatient pharmacokinetic variability can result in enhanced toxicity or increased relapse risk. Therapeutic drug monitoring (TDM) can minimize variability, yet the optimal frequency of TDM is unknown. We compared outcomes for patients with one versus two sets of busulfan TDM during myeloablative conditioning (MAC) prior to alloHCT. Methods: We analyzed the impact of busulfan TDM frequency and dose adjustments, with the primary outcome being relapse-free survival (RFS). Other outcomes included the incidence of acute and chronic graft versus host disease (GVHD), oral mucositis, pulmonary toxicity, sinusoidal obstruction syndrome (SOS), the cumulative incidence of relapse (CIR), and overall survival (OS). Results: Twenty-two patients underwent one set of sampling while 53 patients underwent two sets. Similar baseline characteristics were observed between the groups. There were no significant differences observed in RFS by day +180 (77.3% vs. 79.2%, p = 1.0), CIR by day +180 (18.2% vs. 17.8%, p = 0.74), or OS (p = 0.73). The incidences of acute GVHD, chronic GVHD, SOS, and severe mucositis were also similar. In each group, 63% received busulfan dose adjustments after one set, with 52.8% receiving further dose adjustments following the second set. Conclusion: We observed no significant difference in alloHCT outcomes between patients who underwent one versus two sets of busulfan TDM sampling, suggesting that a single-time TDM and dose adjustment may be adequate to maximize outcomes after MAC alloHCT. [ABSTRACT FROM AUTHOR]

Introduction There is limited psychological support available to help people living with dementia to deal with the emotional consequences of their condition. Anxiety and depression are commonly experienced in this population, yet the use of counselling and psychotherapeutic interventions is not well documented. Aim This systematic review sought to understand the current knowledge on the role and impact of therapeutic counselling on the emotional experience of adults living with dementia. Methods Qualitative and quantitative research designs were accepted for review. A comprehensive search of the main biomedical, nursing and other specialist databases was performed to access articles published between 2015 and 2022. Trial registers and academic journals were also searched. 43 original studies were included: qualitative (n = 15); RCTs (n = 9); other designs (n = 19); plus eight systematic reviews. Results The majority of studies were conducted in Europe, the United Kingdom in particular, although a range of countries from across the globe were represented. The combined evidence from the different study designs suggest a range of ways that people living with different stages of dementia can participate in, and gain emotional benefit from, therapeutic counselling. Key themes identified: (1) The emotional and well-being benefits of therapeutic counselling; (2) No one size fits all - relational and tailored approaches driven by person-centred values; (3) Training, supervision and building community for counsellors; (4) Involvement of people with dementia in therapeutic interventions. Conclusions Our findings from this systematic review show that different therapeutic approaches have been tested with people at different stages of a dementia diagnosis. The results suggest the value of therapeutic counselling as a supportive medium to help with the processing and coping of difficult emotions and feelings across the trajectory of a dementia illness. [ABSTRACT FROM AUTHOR]

Background: Knee osteoarthritis is common in older people. Serum cartilage oligomeric matrix protein (sCOMP) is a biomarker of knee articular cartilage metabolism. The purpose of this study was 2-fold: to (1) determine acute effects of running and swimming on sCOMP concentration in older people; and (2) investigate relationships between sCOMP concentration change due to running and swimming and measures of knee health in older people. Hypotheses: Running would result in greater increase in sCOMP concentration than swimming, and increase in sCOMP concentration due to running and swimming would associate positively with measures of poor knee health. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: A total of 20 participants ran 5 km and 19 participants swam 1500 m. sCOMP concentration was measured immediately before, immediately after, and 15, 30, and 60 minutes after running or swimming. sCOMP concentration change due to running and swimming was compared. Correlations between sCOMP concentration change due to running and swimming, and other measures of knee health were evaluated, including the Tegner Activity Scale and Knee injury and Osteoarthritis Outcome Score. Results: sCOMP concentration increased 29% immediately after running, relative to baseline, but only 6% immediately after swimming (P < 0.01). No significant relationship was observed between acute sCOMP change due to running and swimming, and observed measures of knee health (P > 0.05). Participants with clinically relevant knee symptoms exhibited greater sCOMP concentration before and after running and swimming (P = 0.03) and had greater body mass (P = 0.04). Conclusion: Running results in greater acute articular cartilage metabolism than swimming; however, the chronic effects of this are unclear. Older people with clinically relevant knee symptoms possess greater sCOMP concentration and are heavier, independent of exercise mode and physical activity level. Clinical Relevance: These results describe the effects of exercise (running and swimming) for older physically active persons, with and without knee pain. [ABSTRACT FROM AUTHOR]

In this brief essay, we suggest that contemporary efforts at reworking Leon Trotsky's theory of uneven and combined development (UCD) are enriched by an historical ethnographic lens focused on "real people doing real things," which grounds and de-fetishizes the abstractions of capitalist development. We sketch three ways to develop UCD to better apprehend contemporary capitalism: tracing the effects of unevenness and combination within social formations; pointing to the ways those processes fracture historical consciousness; and underscoring the political implications for dividing populations and for creating novel combinations of people and socio-political experience. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of concomitant use of benzodiazepines on the efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant major depressive disorder (TR-MDD). Methods: This is a retrospective study comparing rTMS treatment outcomes between patients taking benzodiazepines (n = 59) and those who were not (n = 136). Participants completed the HAM-A, HAM-D17, MADRS and ZUNG at baseline and at the end of treatment. Results: Patients taking benzodiazepines during rTMS treatment did not show any difference in partial response, response or remission rates compared to patients not treated with benzodiazepines. There was a significant decrease (p <.0001) in depression and anxiety scores from baseline to post-treatment among both groups. Conclusions: Concomitant benzodiazepine treatment had no effect on the efficacy of rTMS treatment of TRD, contrary to previous research. [ABSTRACT FROM AUTHOR]

Purpose: To compare and evaluate 2 methods of inventory management in automated dispensing cabinets (ADCs). Methods: Ten profiled ADCs had 2 inventory management models implemented over 2 months. Implementation of the models on each ADC involved adjustment of par levels (desired accessible quantities of medication) and removal of medications not used in the past 90 days or more. The par levels of 5 ADCs were adjusted using a formula developed based on the economic order quantity model. The par levels of the other 5 ADCs were adjusted using a formula based on historical average daily usage. The study endpoints include stock out rate, vend:fill ratio, quantity of expired medications, and inventory carrying cost. Results: The total of number of medications stocked in the 10 ADCs was reduced from 3035 in a 2-month pre-implementation period to 2932 in a 2-month post-implementation period yielding a reduction of inventory carrying cost by $11 011. The mean stock out rate in both study groups increased and vend:fill ratio decreased after implementation. The quantity of expired medications increased in the modified economic order quantity formula inventory management model and decreased in the average daily usage inventory management model. Conclusion : The implementation of 2 inventory management models on ADCs had a negative impact on stock out rate and vend:fill ratio, a mixed impact on quantity of expired medications, and a positive impact on inventory carrying cost reduction. [ABSTRACT FROM AUTHOR]

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

A call for papers for a special issue which aims to foster new lines of inquiry that consider how organizations use and abuse identity regulation is presented.

This study aimed to examine physical therapists' perspectives in conservative treatments of pediatric patients with adolescent idiopathic scoliosis (AIS). A cross-sectional survey design was used. A validated questionnaire was distributed to physical therapists, and the responses were analyzed. Preferred treatment frequency was 60 minutes (53.8%), twice weekly (41.5%), over 3 to 5 months (44.6%). Top 3 clinical interventions were core and trunk stability enhancement (90.8%), abdominal strengthening (83.1%), and postural correction (80.0%). Top 3 therapeutic goal-setting parameters were activity-based (78.5%), quality-of-life measure-based (56.9%), and participation-based (50.8%). The most common quality-of-life survey used was Oswestry low back pain disability questionnaire (15.6%) followed by Scoliosis Research Society-22 instrument (12.5%). According to our data, physical therapists believe that pediatric patients with AIS can benefit with addressing core and trunk stability, a 60-minute per session, twice weekly, over 3 to 5 months based on activity-based goal-setting and quality-of-life measures using Oswestry questionnaire. [ABSTRACT FROM AUTHOR]

The United Nations Subcommittee on the Prevention of Torture visits signatory nations to the Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT). Its role is to monitor and support signatory nations in implementing and complying with the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (CAT). In October 2022, the United Nations Subcommittee on the Prevention of Torture visited Australia but was barred from visiting mental health wards in Queensland and all detention facilities in New South Wales leading to the termination of its visit. This breach of Australia's obligations under the OPCAT presents a significant setback for the rights of people with mental illness and other involuntarily detained populations. This piece sets out to demonstrate the relevance of OPCAT to the mental health system in Australia. Individuals who are detained for compulsory treatment in locked facilities such as acute psychiatric inpatient wards and forensic mental health facilities are deprived of their liberty, often out of public view. Thus, it highlights the ethical and professional obligations of all mental health professionals, especially psychiatrists, to safeguard the human rights of individuals being detained in mental health facilities as enshrined in Australia's international legal obligations under the OPCAT. Adhering to these obligations diminishes the risk of future human rights violations of people with mental illness. [ABSTRACT FROM AUTHOR]

Background: Budesonide high-volume saline irrigations (HVSIs) are routinely used to treat chronic rhinosinusitis (CRS) due to improved sinonasal delivery and efficacy compared to intranasal corticosteroid sprays. The off-label use of budesonide is assumed to be safe, with several studies suggesting the systemically absorbed dose of budesonide HVSI is low. However, the actual budesonide dose retained in the sinonasal cavity following HVSI is unknown. The objective of this study was to quantify the retained dose of budesonide after HVSI. Methods: Adult patients diagnosed with CRS who had undergone endoscopic sinus surgery (ESS) and were prescribed budesonide HVSI were enrolled into a prospective, observational cohort study. Patients performed budesonide HVSI (0.5 mg dose) under supervision in an outpatient clinic, and irrigation effluent was collected. High-performance liquid chromatography was employed to determine the dose of budesonide retained after HVSI. Results: Twenty-four patients met inclusion criteria. The average corrected retained dose of budesonide across the cohort was 0.171 ± 0.087 mg (37.9% of administered budesonide). Increased time from ESS significantly impacted the measured retained dose, with those 3 months post-ESS retaining 27.4% of administered budesonide (P =.0004). Conclusion: The retained dose of budesonide in patients with CRS after HVSI was found to be significantly higher than previously estimated and decreased with time post-ESS. Given that budesonide HVSI is a cornerstone of care in CRS, defining the retained dose and the potential systemic implications is critical to understanding the safety of budesonide HVSI. [ABSTRACT FROM AUTHOR]

Background: Complete resection followed by adjuvant chemotherapy is the gold standard for patients with localized cholangiocarcinoma (CC) or gallbladder cancer (GBC). However, this is not always feasible, and recurrence rates remain high. Objectives: To understand the real-world proportions and reason for treatment failure in resected biliary tract cancers. Design and methods: We performed a retrospective population-based review of patients with GBC or CC [intrahepatic (IHCC) or extrahepatic (EHCC)] resected between 2005 and 2019 using the BC Cancer provincial database. A chart review was conducted to characterize demographics, treatments received and outcomes. Results: In total, 594 patients were identified of whom 416 (70%) had disease recurrence. Most GBCs (96%) were diagnosed incidentally, and repeat oncologic resection was performed in 45%. Adjuvant chemotherapy was received in 51% of patients diagnosed after 2017 (mostly capecitabine). Patient co-morbidities, disease progression and patient preference were the commonest reasons for not proceeding with adjuvant chemotherapy. One-third of patients did not complete all planned cycles. Median overall survival was significantly higher in those with complete (R0) versus incomplete (R1) resection [31.6 versus 18 months, hazard ratio (HR): 0.43, 95% confidence interval (CI): 0.35–0.53] and in those with versus without re-resection for GBC [29.4 versus 19 months, HR: 0.55, 95% CI: 0.41–0.73]. There was a trend towards improved survival with versus without adjuvant therapy (HR: 0.79, 95% CI: 0.61–1.02). Only 25% in the more contemporary cohort (2017–2019) had an R0 resection and completed adjuvant chemotherapy. Conclusion: Complete resection, including reresection for incidentally diagnosed GBCs, and adjuvant chemotherapy were associated with improved outcomes in this retrospective cohort, yet many patients were not able to complete these treatments. Neoadjuvant strategies may improve treatment delivery and ultimately, outcomes. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aim to develop and propose an evaluation method for analyzing the design of operating rooms (ORs) from the perspective of surgical teams' reported experiences and stress levels. Background: Stress and burnout of surgical team members can lead to diminished performance and medical errors, which endangers the safety of both the patients and team members. The design and layout of the OR play a critical role in managing such stress. Methods: To understand surgical teams' spatial needs related to their experiences and stress, we administered a survey and in-depth focus group discussions to three surgical teams from the same organization. The identified spatial needs were translated into functional scenarios and spatial metrics, essentially viewing the OR through the perspective of users. Results: Our analysis revealed four integral sections—patient flow, room organization, access to facilities/medical equipment/support staff/team members, and staff well-being—identified as critical design factors associated with the experiences and stress levels of the surgical teams in the ORs. Conclusions: We expect this method to serve as a tool for evaluating the effect of the design of OR layouts on stress, thereby supporting the well-being and resiliency of surgical teams. [ABSTRACT FROM AUTHOR]

The embedding of immigration checks into public institutions constitutes an integral part of contemporary bordering regimes. In this article, we situate recent changes to the UK's internal borderscape in two parts of the public sector: higher education and health care. We argue that, analyzed from institutional perspectives, these changes reflect not only a dispersal and deterritorialization of the UK's border regime, but also the emergence of specific relations between the government department responsible for this regime – the Home Office – and other parts of the public sector and its institutions. We maintain that these relations have developed into two main forms : the routinization of borderwork within public sector employees' roles, drawing workers from across public institutions into relations with the Home Office and subordinating the needs of those institutions to the demands of the UK's internalized border regime; and the establishment of information systems for datafication, to enable reporting and sharing data between public sector institutions and the Home Office, which are exploited for surveillance purposes. Such relations not only vulnerabilize public sector institutions by draining their resources and destabilizing institutional cultures, but also drive ongoing changes in the bureaucratic field of the state. [ABSTRACT FROM AUTHOR]

Introduction: Over the last decade, hypertension (HPT) is among the leading causes of death and morbidity in Ghana. In recent past, most health policy research in Ghana and Africa focussed on communicable diseases. In recent times, Ghana and other developing nations have shifted their attention to non-communicable diseases because most of these countries are going through an epidemiologic transition where there is a surge in the prevalence of HPT. This paper was therefore set out to estimate the cost of treating HPT in Ghana from the patients' and health system's perspectives. Method: We used a cost of illness framework to simulate the cost of HPT management in Ghana taking into account 4 of the common target organ complications with the most mortality implication. A decision analytic model (DAM) was developed in Microsoft® Excel to simulate the progression of HPT patients and the Markov model was employed in simulating the lifetime cost of illness. Results: The results show that by 10 years from diagnosis, the probability of death from any of the 4 complications (ie, stroke, myocardial infarction, heart failure, and chronic kidney disease) is roughly 41.03%. By 20 years (or 243 months) from diagnosis, the probability of death is estimated to be 69.61%. However, by the 30th anniversary, the probability of death among the cohort is 82.3%. Also, the lifetime discounted cost of treating HPT is about GHS 869 106 which could range between GHS 570 239 and GHS 1.202 million if wide uncertainty is taken into account. This is equivalent to USD 119 056 (range: USD 78 115-164 723). Conclusion: By highlighting the lifetime cost of treating HPT in Ghana, policies can be formulated regarding the cost of treating HPT by the non-communicable disease unit and National Health Insurance Authority (NHIA) of the Ministry of Health. [ABSTRACT FROM AUTHOR]

Background: Carpal Tunnel Syndrome (CTS) is associated with a significant personal and societal burden. Evaluating access to care can identify barriers, limitations, and disparities in the delivery of healthcare services in this population. The purpose of this study was to evaluate access to overall healthcare and healthcare utilization among patients with CTS. Methods: This is a retrospective cohort study conducted with the All of Us database. Patients diagnosed with CTS that completed the access to care survey were included and matched to a control group. The primary outcomes were access to care across 4 domains: (1) delayed care, (2) could not afford care, (3) skipped medications, and (4) over 1 year since seeing provider. Secondary analysis was then performed to identify patient-specific factors associated with reduced access to care. Results: In total, 7649 patients with CTS were included and control matched to 7649 patients without CTS. In the CTS group, 33.7% (n = 2577) had delayed care, 30.4% (n = 2323) could not afford care, 15.4% (n = 1180) skipped medications, and 1.6% (n = 123) had not seen a provider in more than 1 year. Within the CTS cohort, low-income, worse physical health, and worse mental health were associated with poor access to care. Conclusion: Patients experience notable challenges with delayed care, affordability of care, and medication adherence regardless of having a diagnosis of CTS. Targeted interventions on modifiable risk factors such as low income, poor mental health, and poor physical health are important opportunities to improve access to care in this population. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of a 2-day, in-person interprofessional palliative care course for staff working in long-term care (LTC) homes. Methods: A qualitative descriptive study design was employed. LTC staff who had participated in Pallium Canada's Learning Essential Approaches to Palliative Care LTC Course in Ontario, Canada between 2017 and 2019 were approached. Semi-structured interviews were conducted, using an online videoconferencing platform in mid-2021 in Ontario, Canada. These were done online, recorded, and transcribed. Data were coded inductively. Results: Ten persons were interviewed: four registered practical nurses, three registered nurses, one nurse practitioner, and two physicians. Some held leadership roles. Participants described ongoing impact on themselves and their ability to provide end-of-life (EOL) care (micro-level), their services and institutions (meso-level), and their healthcare systems (macro-level). At a micro-level, participants described increased knowledge and confidence to support residents and families, and increased work fulfillment. At the meso-level, their teams gained increased collective knowledge and greater interprofessional collaboration to provide palliative care. At the macro level, some participants connected with other LTC homes and external stakeholders to improve palliative care across the sector. Training provided much-needed preparedness to respond to the impact of the COVID-19 pandemic, including undertaking advance care planning and EOL conversations. The pandemic caused staff burnout and shortages, creating challenges to applying course learnings. Significance of results: The impact of palliative care training had ripple effects several years after completing the training, and equipped staff with key skills to provide care during the COVID-19 pandemic. Palliative care education of staff remains a critical element of an overall strategy to improve the integration of palliative care in LTC. [ABSTRACT FROM AUTHOR]

"The Continuing Storm: Learning from Katrina, 2022" by Kai Erikson and Lori Peek is the final installment of the Katrina Bookshelf Series by the University of Texas Press. The book explores the events and aftermath of Hurricane Katrina, shedding light on overlooked aspects of the disaster. The authors analyze the social factors, location decisions, and infrastructure that played a role in the devastation of New Orleans. They also critique the media's portrayal of the events and its impact on public perception. The book encourages readers to reflect on the societal implications of the Katrina story and the need for a more critical examination of our current society. It challenges traditional approaches to disasters and offers new perspectives on the long-term effects of traumatic events. The authors argue that for some survivors, a disaster may not be over, highlighting ongoing psychological and social impacts. They also discuss the displacement of poor black citizens and the failure of remedial actions in the New Orleans recovery. The book emphasizes the importance of rethinking emergency management and gaining a better understanding of the social history and conditions that contribute to vulnerability. It concludes by suggesting that lessons from events like Katrina and Covid-19 can enhance future preparedness and response efforts. [Extracted from the article]

Disappointment is common in many organizations. Yet little is known about how individuals' talk about their workplace disappointment shapes their identification with organizations. We conducted an analysis of 104 academics in a prestigious British university to make two contributions to our understanding of the discursive constitution of organizational identification (OID). First, we show how individuals used different types of disappointment-talk to narrate and respond to identification dilemmas in distinct ways. Our findings extend existing research by showing that discourses of emotion do not simply delimit agency but also enable individuals to resist and reject organizational discourses that attempt to anchor them to specific identity positions. Second, we identify a novel way in which individuals can configure the multiple discourses that can be in tension and generate disappointment – unravelling. Here, individuals draw upon one among the multiple discourses in conflict (in our case, prestige) to 'unravel' the knotting between the various discourses that constituted their OID dilemmas. We also consider the implications of our study for academic labour in universities. [ABSTRACT FROM AUTHOR]

Virtual reality is providing new opportunities for health and well-being, organizational learning, and tourism management. The study reported in this paper aims to examine whether engaging in a virtual reality tourism experience could function as a restorative intervention strategy to enhance mental well-being of employees in the workplace. The study employed a lab-based pre–post experimental design to test the effectiveness of a virtual reality tourism experience, involving a nature-based marine setting, to enhance mental restoration and reduce mental fatigue. The results show that 3 minutes of a virtual tourism experience can lead to enhanced concentration while boosting the mental well-being of employees, while, at the same time, providing destinations with an opportunity to promote "real" experiences. [ABSTRACT FROM AUTHOR]

Background: Two classes of primary reverse total shoulder arthroplasty (rTSA), inlay (in-rTSA), and onlay (on-rTSA) were compared to determine differences in rates of revision. Methods: Between 1 January 2012 and 31 December 2020, all primary in-rTSA or on-rTSA procedures were compared from a large national arthroplasty registry by cumulative percentage revision (CPR). Kaplan–Meier estimates of survivorship and hazard ratios from Cox proportional hazard models adjusted for age, gender, glenosphere size, and humeral fixation determined any associations to the risk of revision. Results: Of the 14,807 in-rTSA and 6590 on-rTSA procedures, the CPR at seven years was 4.9%. There was an increased risk of revision for in-rTSA vs on-rTSA (p = 0.039) when adjusted for age, gender, glenosphere size, and humeral fixation. Glenosphere size <38 mm adjusted for age and gender (p = 0.016) increased the revision risk. Revision for instability/dislocation occurred more often for in-rTSA vs on-rTSA (p < 0.001) in the first three months. Males had a higher rate of revision than females for in-rTSA (3months+, p = 0.001) and for on-rTSA (p < 0.001). Discussion: Care should be taken when considering in-rTSA particularly in males, and if preoperative planning suggests a small (<38 mm) glenosphere. Level of evidence: Level III, therapeutic study. Original article. [ABSTRACT FROM AUTHOR]

Pregnancy initiates a temporary transition in the maternal physiological state, with a shift in the oral microbiome and a potential increase in frequency of oral diseases. The risk of oral disease is higher among populations of Hispanic and Black women and those with lower socioeconomic status (low SES), demonstrating a need for intervention within these high-risk populations. To further our understanding of the oral microbiome of high-risk pregnant women, we characterized the oral microbiome in 28 nonpregnant and 179 pregnant low-SES women during their third trimester living in Rochester, New York. Unstimulated saliva and supragingival plaque samples were collected cross-sectionally, followed by assessment of the bacterial (16S ribosomal RNA) and fungal (18S ITS) microbiota communities. Trained and calibrated dentists performed oral examinations to determine the number of decayed teeth and plaque index. Initially, plaque from 28 nonpregnant women and 48 pregnant women were compared; these data showed significant differences in bacterial abundances based on pregnancy status. To further our understanding of the oral microbiome within the pregnant population, we next examined the oral microbiome within this population based on several variables. Streptococcus mutans, Streptococcus oralis, and Lactobacillus were associated with a greater number of decayed teeth. The composition of fungal communities differed between plaque and saliva, demonstrating 2 distinct "mycotypes" that were represented by a greater abundance of Candida in plaque and Malassezia in saliva. Veillonella rogosae, a common oral bacterium, was negatively associated with both plaque index and salivary Candida albicans colonization by culture data. This was further emphasized by in vitro inhibition of C. albicans by V. rogosae. Identification of interactions between the bacterial or fungal oral communities revealed that V. rogosae was positively associated with the oral commensal Streptococcus australis and negatively with the cariogenic Lactobacillus genus, suggesting V. rogosae as a potential biomarker of a noncariogenic oral microbiome. [ABSTRACT FROM AUTHOR]

Attention has recently been given to the role of race in many aspects of the research process; however, minimal has been written to critique the role of race in qualitative fieldnotes. This gap creates potential conflicts about representation that can exclude marginalized communities and call into question findings when race is ignored in the research process. To successfully address potential investigator biases with a lens towards social justice and equity in healthcare, a critique of foundational methods is required. Here we posit that a qualitative health researchers' primary tool is their fieldnotes because they contextualize findings and serve as a method to learn through systematic interpretation of local meanings revealed by participants. Here, we provide researchers guidance for teaching and writing fieldnotes that speak to current nuances of observations and interactions with participants. Definitions related to race and ethnicity, the importance of applying appropriate sensitizing frameworks, followed by a discussion of how to use fieldnotes in findings are covered. We include (1) a call for more preparation of novice researchers and a challenge for established researchers to update expertise for collecting and using fieldnotes in the research process, (2) guidance on negotiating difficult situations, and (3) the significance of language in creating credibility in findings when addressing race in qualitative research. [ABSTRACT FROM AUTHOR]

Background: Concurrent administration of vancomycin and piperacillin/tazobactam (VAN+PTZ) may increase the risk of acute kidney injury (AKI) in hospitalized patients. Comprehensive characterization of VAN+PTZ associated AKI and recovery patterns remains lacking in previous reports. Objective: To compare the incidence of AKI associated with VAN+PTZ compared to either cefepime (CEF) or meropenem (MER) with VAN in adult general ward patients. Methods: A multicenter, retrospective, propensity score cohort study was conducted in non-critically ill adult patients. Included patients were concurrently administered VAN+PTZ or VAN+CEF/MER. Patients developing AKI ≤48 hours following combination therapy were excluded. The primary endpoint was to compare the incidence of AKI between study groups. Multivariable Cox regression modeling in predicting AKI was also conducted. Results: A total of 3199 patients met inclusion criteria and were evaluated. The incidence of AKI in VAN+PTZ and VAN+CEF/MER groups were 16.4% and 8.7%, respectively (P <.001). The onset to AKI was 1.8 days earlier with VAN+PTZ compared to VAN+CEF/MER (P <.001). Multivariable prediction model showed concomitant VAN+PTZ was identified as an independent risk factor of developing AKI (HR 2.34, 1.82-3.01, P <.001). The VAN+PTZ group experienced significantly higher rates of severe AKI (stage II or III) compared to the VAN+CEF/MER group (P =.002). No differences in the AKI recovery patterns were found between study groups. Conclusions: Concomitant VAN+PTZ in adult general ward patients was independently associated with an increased risk of AKI overall. More severe AKI was also associated with VAN+PTZ. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the social demographics and clinical profile of patients referred to the psychiatry service within the local Queensland metropolitan Aboriginal Medical Service (AMS). Method: This was a retrospective cohort study of patients referred to the psychiatry service provided at three clinics of a metropolitan AMS, over an 18-month period. Medical records were accessed to determine demographic and diagnostic information. Results: Diagnostically, 53% of patients had mood/anxiety disorders, 10% psychosis, 23% substance use and 14% with other diagnoses. There was approximately 50% non-attendance rate with no statistical difference between gender and age groups. The highest proportion of non-attenders within age groups was males 45–54 years old. The patients needed to travel an average of 20 km to attend the AMS. Conclusion: The high non-attendance rates, and proportionately more males within the age group 45–54 years who were more likely to not attend their mental health appointments, suggested a target area for outreach services which have been implemented in the AMS. Some of the recommended solutions included confirming attendance the day prior and supporting with transport. This study highlighted the large distance that Aboriginal and Torres Strait Islander people must travel to access culturally appropriate service. [ABSTRACT FROM AUTHOR]

Objective: A lack of access to psychiatric services for adult ADHD is a recognised issue in South Australia and nationally. This study aims to explore the practices of local psychiatrists and their attitudes towards adult ADHD, with a view to determining any barriers influencing accessibility to treatment. Methods: We developed an online survey to examine the aims of the study. Free text boxes were included to obtain qualitative data. Quantitative data were tallied and presented as percentages. Qualitative data (free text responses) were analysed thematically. Results: 73 out of 322 psychiatrists responded (22.7%). The greatest barrier to seeing adult ADHD was the fear of being inundated with cases (68.5%), followed by lack of experience managing ADHD (32.9%), and potential drug-seeking behaviour of patients (31.5%). Two overarching qualitative themes were identified: practical barriers and attitudinal barriers. Conclusion: ADHD service provision is complex and relates to many systemic factors such as public versus private, funding, and service organisation. More psychiatrists need to become involved in treating ADHD so that the work is more widely spread. Increased training in ADHD is also needed to increase confidence in managing the condition. [ABSTRACT FROM AUTHOR]

A history of stressors in athletes represents psychosocial factors that may lead to sport injury. However, empirical studies have provided varying results for the relationship between stress history and sport injury. We examined prior literature on the stress history - sport injury relationship within a systematic review and, by meta-analysis, we offered a pooled estimate of the strength of this relationship. We searched seven major academic databases (Sportdiscus, Psyinfo, Academic Search Premier, Ovid, Scopus, Web of Science, and PubMed) from January 2000 to September 2023 and identified 19 empirical studies that examined injuries in sports contexts for meta-analysis. In 19 empirical studies of moderate to high publication quality, we found moderate heterogeneity (Q(17) = 98.61; p <.001), low sensitivity (I2 77.82–83.77), and low publication bias (Z-value = 7.74; p <.001). Further, using a random effect estimate-r, we found a low but significant correlation between stress history and sport injury, yielding a small overall effect size (ES) of r =.12. Furthermore, moderation analyses found adolescents (r =.14), contact-sport athletes (r =.09), non-elite athletes (r =.13), and non-European athletes (America r =.16; Asia r =.14; Oceania r =.14) to have a relatively higher ES than their counterparts in this stress history/sport injury relationship. We concluded that inevitable life stressors may lead to many negative consequences for athletes, such that sports professionals should provide stress management educational programs to enhance athletes' health and well-being. [ABSTRACT FROM AUTHOR]

Coercive control has been shown to be far more damaging for victims psychologically than physical violence. Linked to this, domestic violence perpetrators are increasingly turning to the online world to enact control and abuse. Women are most likely to be killed once they have separated from their abusers, and perpetrators harness the online realm to continue the abuse long after a relationship has ended, with devastating consequences. This article draws on a subsection of data from a qualitative study as it relates to survivor accounts of online and technological abuse (via social media, mobile phones, Global Positioning Systems [GPS] tracking, etc.) as it is enacted by cisgender men against cisgender women. We reveal crucial evidence of the ways in which intimate partner abuse via the technological realm serves to exacerbate harm and prevent victims from fully recovering from their trauma. [ABSTRACT FROM AUTHOR]

The production of data and numbers has become the key mechanism of both knowing and governing global public policy. And yet, processes of quantification are inherently paradoxical: from expectations of technocratic rationality and political usability of producing 'global' numbers that count for 'local' politics and needs to practical limitation of measurement and the necessity to work with 'good enough' data. This begs a question – how do these competing epistemic, political and value orders manifest themselves through the work that experts do? In this article, we explore the problem by focussing on reflexivity as a way for experts (primarily those working in key International Organisations) to make sense of and tame the tensions inherent in their work. Through rich qualitative exploration of over 80 semi-structured interviews with experts working in the areas of poverty, education and statistical capacity development, we contribute to debates in the social studies of quantification by arguing that reflexivity is not just a mental process that experts engage in but rather an important resource allowing them to make sense of the contradictions inherent in their work and to mobilise political and ethical considerations in the technocratic process of producing numbers. We identify three types of reflexivity: (1) epistemic reflexivity – regarding the quality of data and its epistemic status as reflecting the reality; (2) care-ful reflexivity – regarding values embedded in data and the duty of care to the populations affected by the measurement and (3) instrumental reflexivity – regarding political rationality and necessary trade-off required to realise political goals. Overall, the article argues that reflexivity becomes an increasingly central expert practice, allowing the transformation of the process of quantification into one of qualification enabling them to attach political attributes and values to data and measurement. [ABSTRACT FROM AUTHOR]

H13 tool steel was additively manufactured by selective laser melting (SLM). The sample printed at a higher laser scan speed exhibited higher strength and ductility than those of the sample printed at a lower speed. The samples were repeatedly exposed to a massive heat input during the SLM. The in-situ tempering effect was applied to the sample; the phase fraction is changed by varying the heat input by controlling the laser scan speed. The microstructure analysis showed that the sample printed at a higher scan speed had a higher fraction of retained austenite than at a lower speed. The former was affected by deformation-induced martensitic transformation with enhanced strain-hardening ability. This study entailed the control of process parameters to improve the mechanical properties and the productivity of SLM-printed H13 tool steel. It investigated the relationship between the laser scan speed and the phase fraction, whose effect on the mechanical properties was confirmed. [ABSTRACT FROM AUTHOR]

Athletes display differing sleep habits to non-athletic populations; similarly, differences occur in sleep habits between athletes from different sports. There is currently limited research investigating the differences in sleep habits and behaviors between different levels of competition within the same sport. A total of 224 rugby union athletes (109 academy, 38 semi-professional, 84 professional) completed the Athlete Sleep Behavior Questionnaire and the Pittsburgh Sleep Quality Index. Professional athletes displayed a significantly longer self-reported sleep duration compared to semi-professional and academy athletes (7 h 52 min ± 51 min vs. 7 h 16 min ± 1 h 15 min vs. 7 h 19 min ± 1 h 12 min, p < 0.01). Pittsburgh Sleep Quality Index global scores revealed a significantly lower (p = 0.04, d = 0.3) score for professional athletes (5.2 ± 2.5 AU) than academy athletes (6.0 ± 2.7 AU). Individual components of the Pittsburgh Sleep Quality Index revealed significant differences (p < 0.05) between groups for sleep duration and daytime dysfunction. No significant differences (p > 0.05) were observed between levels of competition for the Athlete Sleep Behavior Questionnaire global score; however, significant differences (p < 0.05) were observed for 6 of the 18 items. This study was the first to investigate sleep behaviors across multiple levels of competition in rugby union athletes. Professional athletes displayed longer sleep duration compared to semi-professional and academy level athletes. Additionally, results highlighted that differences exist between levels of competition for specific sleep behaviors. This study identified that sleep behaviors could be improved for all levels of rugby union athletes. [ABSTRACT FROM AUTHOR]

Provincial academies represent an important bridge between amateur and professional level rugby union in New Zealand. Athletes are provided with professional-level coaching; however, limited direct nutrition support is available. Congested training schedules and the requirement to work or study due to a lack of financial support may present a challenge towards athletes meeting nutrition requirements. The aim of the study was to facilitate improvement in nutrient intake, body composition and subjective well-being in provincial academy athletes via the implementation of a nutrition-support protocol based around behaviour change techniques. Significant increases in total energy (pre: 2492 ± 762 kcal; post: 2614 ± 625 kcal), relative energy (pre: 24.4 ± 7.5 kcal·kg; 25.5 ± 6.0 kcal·kg), total protein (pre: 131.1 ± 41.8 g; 153.8 ± 37.1 g) and relative protein (pre: 1.3 ± 0.4 g·kg; post: 1.5 ± 0.3 g·kg) were observed. Furthermore, changes in subjective sleep quality, stress, mood and upper body soreness were observed following the intervention. No changes were observed in body composition, carbohydrate or fat intake. Significant variability in nutrition and body composition changes highlights the importance of applying an individualised approach to nutrition support provision in developmental athletes. Practitioners working within these environments should be aware of the challenges and influences contributing to athletes' nutrition choices and habits. [ABSTRACT FROM AUTHOR]

College students are at risk for adverse mental and physical health. Physical activity (PA) can reduce risks and promote positive mental health; however, less than half of college students meet PA recommendations. Further, few students seek ancillary help such as counseling services. Therefore, in this study we implemented a 5-week evidence-based PA program (#ubwell) in collaboration with counseling services designed to promote students' PA participation and motivation, as well as positive mood states and mental health. Results showed participants increased in positive feelings and arousal levels during all PA sessions. Additionally, intrinsic motivation significantly increased from pre to post, but PA participation and mood states did not change significantly. The increased motivation and positive affect are promising, and additional research with larger samples and additional campus recreation activities (e.g., fitness classes, intramurals) may provide greater insight into the benefits of PA programs for mental health and wellness. [ABSTRACT FROM AUTHOR]

Internationally, lead agencies and consumer movements emphasise the need for high-level research participation in mental health. However, evidence suggests that people with lived experience tend to be recruited as subjects rather than as active agents in research, or are consulted in tokenistic ways. Although participatory research has the potential to rectify epistemic disparities, few studies have grappled with how to move from exclusion and tokenism to high-level research participation. This paper describes a qualitative co-evaluation of a co-produced model of research partnership, Raising the Bar, which involved deliberate establishment and facilitation of six participatory research teams, comprising 28 lived experience and 'conventional' mental health researchers. Findings indicate that the theoretical elements of the model set the bar high from the outset, supporting research teams to address inconsistencies in knowledge about participation. It also provided researchers with the competencies and resources to undertake participatory research in egalitarian team structures, and to negotiate new forms of non-traditional research outputs - thereby challenging whom research might be for and how it might be made accessible. Finally, the model shifted collective meanings about research, lending credibility to participatory practices, which came to be seen as essential for meeting the needs of affected communities. Nonetheless, systemic barriers to participatory research remain, and need to be recognised and acted upon to promote a culture that supports high-level research participation. [ABSTRACT FROM AUTHOR]

Purpose: Significant increases in the volume of preprint articles due to the COVID-19 pandemic, we examined the reliability of preprint articles compared to their peer-reviewed publications. Materials and Methods: Preprint articles evaluating experimental studies of select treatment options (anticoagulation, dexamethasone, hydroxychloroquine, remdesivir, and tocilizumab) for COVID-19 in the critically ill, available in a peer-reviewed publication were screened for inclusion within Altmetric (n = 2040). A total of 40 articles met inclusion criteria, with 21 being randomly selected for evaluation. The primary outcome of this evaluation was a change in a study's reported primary outcome or statistical significance between preprint and peer-reviewed articles. Secondary outcomes included changes in primary/secondary outcome effect size and change in study conclusion. Results: One article (4.8%, 95% CI 0.12%-23.8%) had a change in the primary outcome. Seven articles (33.3%, 95% CI 14.6%-57.0%) had a change in the primary outcome's effect measure. Five studies (23.8%, 95% CI 8.2%-47.2%) had changes in statistical significance of at least one secondary outcome. Four studies (19.0%, 95% CI 5.4%-41.9%) had a change in study conclusion. Conclusions: In preprint articles of COVID-19 treatments, the provided primary outcome is generally reliable, while interpretation of secondary outcomes should be made with caution, while awaiting completion of the peer-review process. [ABSTRACT FROM AUTHOR]

Return to learn (RTL) is the individualized process of coordinating cognitive care and reintegration for students into the academic setting after any sport and recreational-related concussion (SRRC). The guidelines for RTL are based on empirical evidence, however, implementation differs by institution. The purpose of the policy analysis is to evaluate RTL guidelines after SRRC of student-athletes in New England secondary school public school systems. A review of the six New England states' policies surrounding RTL was conducted. The Comprehensive Analysis of Physical Activity Framework was referenced to identify the analytic components of existing legislation and because of the relatively new implementation of RTL-specific policy, a novel policy analysis tool was utilized. States with RTL-specific language scored on average 7.9 to 11.1 points higher when compared to states without RTL-specific language. This difference was associated with disparities in access to RTL resources for residents according to their geographic location. Lobbying efforts should be targeted toward states without RTL-specific language to provide equal care and opportunities for student-athletes to receive RTL services. RTL policy provides a responsibility to assist students who have suffered from an SRRC and can serve to improve health outcomes and academic achievement. [ABSTRACT FROM AUTHOR]