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Background: The safe release of a patient from hospital care after bariatric surgery depends upon the achievement of satisfactory health status. Here, we describe a new objective scale (the Readiness for Discharge, RFD Scale) to measure the patient's suitability for hospital discharge after bariatric surgery. Methods: We conducted a retrospective, observational analysis of data collected in a randomized clinical trial of an enhanced recovery after surgery protocol for laparoscopic sleeve gastrectomy from 3/15/2018 to 1/12/2019. Nursing staff assessed 122 patients every 4–8 h after surgery using a checklist to document 5 components: ambulation, vital signs, pain, nausea, and oral intake of clear fluid. Satisfaction of each component was scored as "1" (satisfactory) or "0" (not satisfactory). Scores were summed and analyzed for patterns. RFD = 5 marked the patient as ready for discharge. Results: Sufficient intake of clear liquid was the last RFD component satisfied in 87% of patients. Two overall response patterns emerged: "Steady Progressors" (n = 51) whose RFD score rose steadily from 0 to 5 without reversion to a lower score; and "Oscillators" (n = 71) who had at least one temporary decrease in RFD score on the way to attaining 5, or showed a simultaneous oscillation of components without change in RFD. Conclusions: The RFD checklist allows objective scoring of medical readiness for discharge after LSG and has the potential to improve clinical communication. [ABSTRACT FROM AUTHOR]

UPDATE ON SURGICAL MANAGEMENT OF OBSTRUCTIVE SLEEP APNOEA: A POSITION STATEMENT OF THE AUSTRA... Anders Sideris, Richard Lewis, Doug Mcevoy, Simon Joosten, Nicolette Holt and Stuart Mackay The Wollongong Hospital, NSW Surgery for adult obstructive sleep apnoea (OSA) plays a key role in contemporary management paradigms, most frequently as either a second-line treatment or in a facilitatory capacity. A LITERATURE REVIEW Thomas Meares Royal Brisbane and Womens Hospital, QLD Head and Neck cancers often require extended, complex, labour intensive surgery such as composite oral cavity resections, large pharyngectomy resections and skull based surgeries, which are usually in the setting of salvage surgery following failed chemotherapy / radiotherapy. Following SND, 15 patients (30%) had pathologic nodal upstaging, including 4 patients with initial clinical stage n0, and 11 patients with initial clinical stage n1. After controlling for the reduced number of presentations in 2020, the rates of pharyngitis, and laryngitis per 1000 patient presentations were significantly lower, whereas the rate of SSNHL per 1000 patient presentations increased by 41.0% (p = 0.01). [Extracted from the article]

NON-OPERATIVE MANAGEMENT OF ACUTE INFECTIOUS FLEXOR TENOSYNOVITIS: A REVIEW OF THE LITERATURE Sibon Fuzzard, Conor Morris, Vicky Tobin, Warren Rozen and David Hunter-Smith Peninsula Health, VIC B Background: b Infectious flexor tenosynovitis is a bacterial infection of the flexor tendon sheath which can spread aggressively and result in severe functional limitation. HS007 FUNCTIONAL RANGE OF MOTION AS OUTCOME MEASUREMENT OF NERVE TRANSFER SURGERY IN PATIENTS WITH... Pelicia Lim, Bridget Hill and Natasha Van Zyl Austin Health, VIC B Purpose of Study: b Poor hand function due to tetraplegia in patients with cervical spinal cord injury (SCI) can significantly be improved by nerve transfer surgery. Nine patients had no reconstruction of the donor hemi-hamate site defect, one patient underwent autologous bone grafting, one patient had Gel Foam reconstruction, and three patients had synthetic bone graft used. B Conclusion: b Surgeons should be aware that this data indicates that suture choice in hand trauma patients can greatly impact the risk of the patient developing hypersensitivity. [Extracted from the article]

Focused Clinical Question: With the 2018 AAP/EFP disease classification with the staging and grading systems, does risk assessment for different ethnic group result in a different focus for clinical needs? This comparative analysis aimed to assess two previously reported cohort studies in African‐American (Af‐A) and Asian‐American (As‐A) as to the risk for these two populations for clinical attachment loss (CAL) and gingival phenotype. Summary: In comparison of As‐A and Af‐A cohorts, As‐A had higher frequency of thin tissue phenotype, less width of keratinized gingiva (KGW), and more gingival recession (GR). On other hands, Af‐A showed higher prevalence of thick phenotype, longer total tooth length and root length (RL). These gingival and dental anatomical patterns suggest there are differential risk for GR, patterns for CAL, and periodontal prognosis between two cohorts. Conclusion(s): Because of nature of dental and gingival anatomy between these two cohorts, As‐A are more susceptible in GR and the short RL affords this population less ability to withstand the clinical presentation of periodontal disease. From a therapeutic perspective, clinicians should evaluate patients with different risk assessment based on their dental and gingival characterization. Af‐A may have clinical characteristics that makes this population less at risk for mucogingival defects. Conversely, phenotype modification therapy should be considered when treating As‐A because of the high prevalence of thin tissue phenotype, inadequate KGW, and GR. Clinicians should also diligently monitor periodontal CAL around the teeth with shorter RL in periodontal or orthodontic therapy for better teeth prognosis. [ABSTRACT FROM AUTHOR]

EN BLOC SCIATIC and FEMORAL NERVE RESECTION DURING EXTENDED RADICAL PELVIC SURGERY: ONCOLOGIC... Kilian Brown, Michael Solomon, Yee Chen Lau, Daniel Steffens, Kirk Austin and Peter Lee Royal Prince Alfred Hospital, NSW B Purpose: b Extended radical resection (ERR) represents the only potentially curative option for patients with advanced pelvic malignancy. Of the remaining cohort 16 patients (59%) had R0 margin status, while 7 patients (26%) had R1 and 4 patients (15%) had R2 margin status. Group 1 had 87 patients with PCI's between 0 to 5, Group 2 had 72 patients with PCI's between 6 to 10, Group 3 had 58 patients with PCI's between 11 and 15 and Group 4 had 37 patients with PCI > 15. Analysing data from 38 patients who underwent second look surgery demonstrated disease recurrence in 39% of patients with negative pre-operative imaging. SO408P EFFECT OF SODIUM THIOSULPHATE THERAPY ON CISPLATIN-INDUCED NEPHROPATHY IN HIPEC PATIENTS Tahiya Amin, Mohamed Al Shahrani, Andrew Tse, Nayef Alzahrani, Andrew Tse and David Morris St George Hospital, NSW B Background: b Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been utilized for the management of patients with peritoneal carcinomatosis (PC). [Extracted from the article]

B Results: b 105 patients with comparable demographics completed the QoR15 questionnaire after elective IH. 77 patients (73%) underwent IH as day-procedure with 59 (76%) patients had laparoscopic surgery. In total 40 cases, male patients occupied 22 patients and the female patients were 18.Among the total 40 cases, 36 patients underwent surgical interventions. The majority of patients conducted the telehealth consultation from home, while three patients dialled in from work, and another patient from interstate while on holidays. In patients for whom swabs and pus were sent, three patients had no difference in organisms grown, three patients had a sterile swab though had organisms cultured from pus, and one patient had polymicrobial culture results that had one organism grown from swab and from pus that was not found in the other specimen. Most of the patients were in the age group of 20 - 39 years (n = 47, 42.1%) followed by 40 -59 years (n = 40, 36.4%) and 16.4% (n = 18) of the patients were more than or equal to 60 years and only 5 patients (4.5%) were below 20 years of age. [Extracted from the article]

Purpose: To investigate associations between older drivers' perceived vision‐related night‐driving difficulties and night‐time driving performance measured on a closed‐road circuit. Methods: Participants included 26 older drivers (71.8 ± 6.3 years) who reported vision‐related night‐driving difficulties assessed with the vision and night driving questionnaire (VND‐Q). High‐contrast, photopic visual acuity (VA) and ratings of discomfort glare (de Boer scale) were also assessed. Night‐time driving performance was measured on a closed‐road circuit that involved recognition, hazard avoidance and lane‐keeping tasks in the absence and presence of intermittent glare. Generalized linear mixed models investigated the relationship between VND‐Q scores and overall driving performance scores, as well as with discomfort glare ratings and VA. Results: Greater levels of vision‐related night‐driving difficulties (VND‐Q scores) were significantly associated with poorer night‐driving performance (p = 0.003); the association was even stronger for driving performance in the presence of intermittent glare (p = 0.001). Reduced VA was associated with poorer night‐driving performance (p = 0.022) but the association was weaker than for the VND‐Q scores. In contrast, ratings of discomfort glare were not significantly associated with driving performance (p = 0.14). Conclusion: The VND‐Q was significantly associated with night‐time driving performance and provides a useful instrument for assessing vision‐related night‐driving difficulties which can be incorporated into clinical vision assessments. [ABSTRACT FROM AUTHOR]

The approach to beauty of London‐based experimental architectural studio NaJa & deOstos is to explore traditional cultures and technological digital environments. Co‐founders Ricardo de Ostos and Nannette Jackowski, who also lead Intermediate Unit 3 at the Architectural Association School of Architecture, here discuss how architectural language and its representation both reference and challenge cultural contexts. [ABSTRACT FROM AUTHOR]

Left ventricular outflow tract obstruction is a serious complication of mitral valve surgery (repair and replacement) and transcatheter mitral valve replacement. An appreciation of the various mechanisms which cause outflow obstruction in these settings is critical to avoiding this complication and to initiating appropriate treatment. This article discusses the mechanisms, pathophysiology, and imaging of left ventricular outflow tract obstruction which can arise following insertion of a variety of mitral valve prosthetics. [ABSTRACT FROM AUTHOR]

Information gaps from uninvestigated habitats can hinder population assessments and the efficacy of conservation actions for marine mammals, particularly for populations of widely distributed species. The full extent of occurrence of the world's largest (putative) population of Indo‐Pacific humpback dolphins (Sousa chinensis) in the Pearl River estuary (PRE) is not known due to a poor understanding of the western boundary of the population's range. This information gap is the basis of the most critical obstacle for assessing the population's status.To determine the distribution and abundance of the PRE humpback dolphins in the far western portion of its range, systematic line‐transect vessel surveys were conducted in the Moyang River estuary (MRE) during 2013–2015. Photo identification of dolphins and cross‐matching of individual dolphins between different regions were also undertaken to examine individual movement patterns.The abundance of humpback dolphins in the MRE was estimated to be 528 individuals (coefficient of variation: 28.7–50.2%).Cross‐matching of individually identified dolphins from the MRE (present survey area) with those from other survey areas of the PRE showed that dolphins moved frequently across different regions of the PRE, indicating dolphins from both PRE and MRE comprise a single population (which is renamed to be the PRE–MRE population). The western boundary of this population appears to be in the waters on the eastern side of Hailing Island, as dolphins were never observed further west.Supporting around one‐fifth of the PRE–MRE population and providing a quarter of the habitat of the entire PRE–MRE population, the MRE clearly also deserves consideration for greater conservation measures. Strengthening the management with stringent controls over fishing activities in the MRE and establishing a marine protected area in the core habitat are recommended to facilitate better conservation for the entire PRE–MRE humpback dolphin population. [ABSTRACT FROM AUTHOR]

Background/Objectives: Juvenile melanoma (before 20 years of age) is a rare condition with poorly defined risk factors. We describe features of juvenile melanoma in Western Australia over the last two decades. Method: A retrospective review of juvenile melanomas was conducted from prospectively maintained databases, reviewed for patients’ characteristics, clinical information, histology, treatment, recurrence and survival data. Results: Altogether 95 cases of juvenile melanoma were reported to the Western Australian Cancer Registry between 2000 and 2013. Of these, 27 patients were referred to the Western Australian Melanoma Advisory Service. Over 72% were aged between 13 and 19 years. The most common site for primary melanoma was the head and neck (31.8%). Eight patients (36.4%) had a pre-existing naevus, 13.6% reported 1–5 blistering sunburns in the past and 59.1% had a Fitzpatrick skin grade of 3 or less. Most (88%) were diagnosed with a primary invasive lesion at presentation. Superficial spreading melanomas predominated (27.3%). All but one patient had localised disease at presentation, with six patients undergoing further treatment, including chemotherapy and neck dissection for metastases. At the time of review, two patients had died, due to stroke and metastatic disease. Conclusions: Juvenile melanoma remains a rarity in Western Australia despite a very high incidence of adult melanoma. Unlike in adults, no definitive risk factors have been established. A significant proportion of this cohort had a pre-existing naevus and while most melanomas occurred in sun-exposed areas in light-skinned individuals the association between sunburn and melanoma was not strong. [ABSTRACT FROM AUTHOR]

To examine the culturally embedded nature of religious practices, we conducted a mixed‐methods study in which Muslim American adolescents described how and why their religious practices had changed in recent years (see Etengoff & Daiute, 2013, J. Adolesc. Res., 28, 690). Participants included 201 Muslim adolescents (ages 13–19) from predominantly immigrant families; all were contestants in a Muslim Inter‐Scholastic Tournament regional competition. Participants completed surveys including an item regarding whether their religious practices had changed, and for those who answered affirmatively, open‐ended questions about the change. Additional measures assessed ethnic identity and perceived discrimination. As hypothesized, the 60% of participants who reported a change in religious practices described this shift as a response to new contexts, people, and religious knowledge. Those who reported a change also reported higher levels of ethnic identity exploration and perceived discrimination. Overall, Muslim American adolescents’ descriptions portrayed religious practices as developing through reciprocal interactions with culture. More generally, participants’ descriptions point to the viability of a model in which religious practices change and in turn are changed by cultural contexts. Statement of contributionWhat is already known on this subject?Religious development is viewed as taking place in relational systems with reciprocity between individuals and surrounding contexts.Variations in contexts predict variations in religious development, but mechanisms of development are not well understood.Muslim Americans, including adolescents, show high levels of religious involvement and experience unique cultural and religious contexts.Muslim American emerging adults describe their religious practices as responsive to sociocultural contexts.What does the study add?This study focuses on Muslim American adolescents, a group that has received little research attention, especially in regard to religious development.Participants reported a wide array of changes in religious practices, and they described these changes as responses to social and cultural influences.Participants’ descriptions of changing practices can be understood through a Vygotskian framework in which religious practices are cultural tools that both respond to and shape surrounding cultural contexts. [ABSTRACT FROM AUTHOR]

The article offers information on the January/February 2017 issue of the Architectural Design magazine. Topics include the guest-editor Lucy Bullivant and editorial board which include Mark Burry, Denise Bratton and Patrik Schumacher; the table of contents and the information on membership and subscription.

An introduction is presented in which the editor discusses various reports within the issue on topics including the use of hyperlocal as an emerging form of four-dimensional design, the collaborative citymaking and the tragic context of Aleppo in Syria.

Left ventricular outflow tract obstruction resulting from strut impingement upon the interventricular septum is a rare complication of bioprosthetic mitral valve insertion. Obstruction is more likely to develop when a small, high profile prosthetic valve is inserted into a patient with a small outflow tract. The likelihood of this complication may be reduced by appropriate modification of surgical technique. [ABSTRACT FROM AUTHOR]

ABSTRACT In previous work, our laboratory developed a Drosophila model for studying the adverse effects of fungal volatile organic compounds (VOCs) emitted by growing cultures of molds. In this report, we have extended these studies and compared the toxic effects of fungal VOCs emitted from living cultures of four molds isolated after Hurricane Katrina from a flooded home in New Orleans. Strains of Aspergillus, Mucor, Penicillium, and Trichoderma were grown with wild-type larvae and the toxic effects of volatile products on the developmental stages of Drosophila larvae were evaluated. Furthermore, heterozygous mutants of Drosophila carrying the apoptotic genes, reaper and dronc, were used to assess the role of apoptosis in fungal VOCs mediated toxicity. Third-instar larvae of Drosophila carrying these apoptotic genes were exposed to fungal VOCs emitted from growing mold cultures for 10 days. The larval strains carrying apoptopic genes survived longer than the control wild type larvae; moreover, of those that survived, heterozygous reaper and dronc strains progressed to pupae and adult phases more rapidly, suggesting that fungal VOCs may induce apoptotic changes in flies. These data lend support to the use of Drosophila as an inexpensive and genetically versatile toxicological model to investigate the mechanistic basis for some of the human illnesses/symptoms associated with exposure to mold-contaminated indoor air, especially after hurricanes. © 2013 Wiley Periodicals, Inc. Environ Toxicol 30: 614-620, 2015. [ABSTRACT FROM AUTHOR]

Children aged 6-7 years judged a loyal and a partially disloyal member of a school in terms of how typical they are within the school group and their likely acceptance by peers from the same school and a different school. Second-order mental-state understanding ( SOMSU) predicted whether children thought atypical members would be included differently in the two groups. Counterfactual reasoning ability, multiple classification ability, and working memory ability did not predict children's judgements of group members. Moreover, as predicted by the developmental subjective group dynamics model, only children with higher levels of SOMSU and who discerned differences in the typicality of normative and deviant ingroup members inferred that peers would differently include atypical individuals from the same and different groups. [ABSTRACT FROM AUTHOR]

Fungi are implicated in poor indoor air quality and may pose a potential risk factor for building/mold related illnesses. Fungi emit numerous volatile organic compounds (VOCs) as alcohols, esters, ethers, ketones, aldehydes, terpenoids, thiols, and their derivatives. The toxicity profile of these VOCs has never been explored in a model organism, which could enable the performance of high throughput toxicological assays and lead to a better understanding of the mechanism of toxicity. We have established a reductionist Drosophila melanogaster model to evaluate the toxicity of fungal VOCs. In this report, we assessed the toxicity of fungal VOCs emitted from living cultures of species in the genera, Trichoderma, Aspergillus, and Penicillium and observed a detrimental effect on larval survival. We then used chemical standards of selected fungal VOCs to assess their toxicity on larval and adult Drosophila. We compared the survival of adult flies exposed to these fungal VOCs with known industrial toxic chemicals (formaldehyde [37%], xylene, benzene, and toluene). Among the tested fungal VOC standards, the compounds with eight carbons (C8) caused greater truncation of fly lifespan than tested non-C8 fungal VOCs and industrial toxins. Our data validate the use of Drosophila melanogaster as a model with the potential to elucidate the mechanistic attributes of different toxic VOCs emitted by fungi and also to explore the potential link between reported human illnesses/symptoms and exposure to water damaged and mold contaminated buildings. © 2012 Wiley Periodicals, Inc. Environ Toxicol 29: 829-836, 2014. [ABSTRACT FROM AUTHOR]

Background It is important to integrate adolescent health domains into pre-service nursing education in order to enhance undergraduate nursing students' competencies in promoting adolescent health. Aim To determine the effectiveness of a structured adolescent health summer programme for Chinese undergraduate nursing students. Methods A quasi-experimental design was used to evaluate differences in the Chinese undergraduate nursing students' perceived competency in promoting adolescent health. A stand-alone adolescent health course was implemented as an intervention with pre- and post-tests of a 2-week intensive summer programme in 2010. The questionnaire included demographics, adolescent health competency checklist and programme evaluation. Descriptive statistics with the Wilcoxon signed-ranks test and the Mann- Whitney U-test were used for data analysis. Results Of the 113 nursing students, seniors perceived higher adolescent health competence mean scores than the juniors in the post-test phase. Majority of nursing students revealed the increasing awareness of the importance in promoting healthy lifestyle behaviours and psychosocial well-being after attending the summer programme. They agreed that nurses do have a role to play. Limitations This 2-week summer programme may only have short-term impacts on students' perception. Conclusions A stand-alone adolescent health summer programme can prepare nursing students to respond to the health issues of adolescents by enhancing their competence in health need assessment and service delivery. Implications for nursing and health policy Nurses serve in a leadership role for health policies and programmes. In nursing education, it is important for students to understand how to put in place policies to resolve adolescent health issues. [ABSTRACT FROM AUTHOR]

Does children's bias toward their own groups reflect egocentrism or social understanding? After being categorized as belonging to 1 of 2 fictitious groups, 157 six- to ten-year-olds evaluated group members and expressed preferences among neutral items. Children who expected the in-group to share their item preferences (egocentric social projection) showed intergroup bias. However, most bias was expressed by children who expected their in-group to share, but the out-group to oppose, their own evaluations of members. These oppositional expectations were associated with better social perspective taking, and better understanding that groups expect loyalty from their members. Consistent with the developmental model of subjective group dynamics (D. Abrams, A. Rutland, J. Pelletier, & J. M. Ferrell, 2009), social understanding, rather than egocentrism, provides a more parsimonious explanation of children's intergroup bias. [ABSTRACT FROM AUTHOR]

This research examines adults', and for the first time, children's and adolescents' reaction to being ostracized and included, using an on-line game, 'Cyberball' with same and opposite sex players. Ostracism strongly threatened four primary needs (esteem, belonging, meaning, and control) and lowered mood among 8- to 9-year-olds, 13- to 14-year-olds, and adults. However, it did so in different ways. Ostracism threatened self-esteem needs more among 8- to 9-year-olds than older participants. Among 13- to 14-year-olds, ostracism threatened belonging more than other needs. Belonging was threatened most when ostracism was participants' first experience in the game. Moreover, when participants had been included beforehand, ostracism threatened meaning needs most strongly. Gender of other players had no effect. Practical and developmental implications for social inclusion and on-line experiences among children and young people are discussed. [ABSTRACT FROM AUTHOR]

The article offers information on the contributors of the Architectural Design magazine which include the Dutch architect Saski Beer, architect Moritz Behrens and the practicing architect Mark Burry.