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The Horizon 2020 project EU 1.5°C Lifestyles aims to mainstream lifestyles aligned with the aspirational target of the Paris Agreement. The project analyzes lifestyle perspectives at the household level and links them to studies of relevant political and socio-economic structures at various levels of government. Within this project, Citizen Thinking Labs were organized in five EU countries to explore the acceptance of and motivations and barriers to changes that could lead to lifestyles compatible with the 1.5°C target. Through a unique mixed-methods approach, including an exploratory board game (the Climate Puzzle), this research generated insights into citizen acceptance by exploring motivations and barriers associated with the acceptance of key lifestyle changes toward 1.5°C. The results confirm previous research in that citizens are more accepting of lower-impact lifestyle options requiring financial investment (e.g., changing lighting and using efficient devices) than higher-impact options that require more substantial behavior changes. Citizens were also motivated by perceived co-benefits for example, concerning health. The research developed insight into the conditions underlying the acceptance of the least preferred options that included plant-based eating and smaller housing. The results also indicated that citizens’ acceptance could be shaped by discussing options with other citizens. Thus, we note the important role citizens may play in devising solutions for overcoming barriers to the acceptance of less-preferred lifestyle options in various contexts. While this study focused on individuals, the findings also underscore the limitations of individual and household agency and the importance of modifying the socio-technical context that shapes behavioral patterns and environmental impacts.

Objective: Health misinformation is common and can lead to harmful behaviors such as medication non-adherence. We assessed the impact of a novel patient educational tool focused on overcoming misconceptions among patients with coronary artery disease (CAD). Methods: We developed the CAD Roadmap, an educational tool aimed at explaining the disease trajectory and overcoming common disease misconceptions (such as that statin medications are not beneficial). We designed a pilot survey to assess patients' 1) CAD-related knowledge, 2) medication-taking behavior, and 3) acceptability of the Roadmap. Survey participants were recruited online. CAD knowledge scores were compared with repeated measures t-tests. Results: Among 114 patients with CAD (mean age 67 years, 63% male), average CAD-related knowledge was 79.0% pre-test and 89.7% after review of the CAD Roadmap (p

Summary: Background: Blood-based biomarkers offer a promising, less invasive, and more cost-effective alternative for Alzheimer's disease screening compared to cerebrospinal fluid or imaging biomarkers. However, they have been extensively studied only in memory clinic-based cohorts. We aimed to validate them in a more heterogeneous, older patient population from primary care. Methods: We measured plasma Aβ42/Aβ40, P-tau181, NfL, and GFAP in 1007 individuals without dementia, aged 79–94 years, from the longitudinal, primary care-based German AgeCoDe study. We assessed the association with cognitive decline, disease progression, and the capacity to predict future dementia of the Alzheimer's type (DAT). We also evaluated biomarker dynamics in 305 individuals with a follow-up sample (∼8 years later). Findings: Higher levels of P-tau181 (HR = 1.32 [95% CI: 1.17–1.51]), NfL (HR = 1.19 [95% CI: 1.03–1.36]), and GFAP (HR = 1.36 [95% CI: 1.22–1.52]), and a lower Aβ42/Aβ40 ratio (HR = 0.80 [95% CI: 0.68–0.95]) were associated with an increased risk of progressing to clinically-diagnosed DAT. Additionally, higher levels of P-tau181 (β = −0.49 [95% CI: −0.71 to 0.26]), NfL (β = −0.29 [95% CI: −0.52 to 0.06]), and GFAP (β = −0.60 [95% CI: −0.83 to 0.38]) were linked to faster cognitive decline. A two-step DAT prediction strategy combining initial MMSE with biomarkers improved the identification of individuals in the prodromal stage for potential treatment eligibility. Biomarker levels changed over time, with increases in P-tau181 (β = 0.19 [95% CI: 0.14–0.25]), NfL (β = 2.88 [95% CI: 2.18–3.59]), and GFAP (β = 8.23 [95% CI: 6.71–9.75]). NfL (β = 2.47 [95% CI: 1.04–3.89]) and GFAP (β = 4.45 [95% CI: 1.38–7.51]) exhibited a faster increase in individuals progressing to DAT. Interpretation: Evaluating plasma biomarkers, alongside brief cognitive assessments, might enhance the precision of risk assessment for DAT progression in primary care. Funding: Alzheimer Forschung Initiative, Bundesministerium für Bildung und Forschung.

Posttraumatic stress disorder (PTSD) is a heritable (h2 = 24-71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale investigation of CNV in PTSD has been performed. We present an association study of CNV burden and PTSD symptoms in a sample of 114,383 participants (13,036 cases and 101,347 controls) of European ancestry. CNVs were called using two calling algorithms and intersected to a consensus set. Quality control was performed to remove strong outlier samples. CNVs were examined for association with PTSD within each cohort using linear or logistic regression analysis adjusted for population structure and CNV quality metrics, then inverse variance weighted meta-analyzed across cohorts. We examined the genome-wide total span of CNVs, enrichment of CNVs within specified gene-sets, and CNVs overlapping individual genes and implicated neurodevelopmental regions. The total distance covered by deletions crossing over known neurodevelopmental CNV regions was significant (beta = 0.029, SE = 0.005, P = 6.3 × 10-8). The genome-wide neurodevelopmental CNV burden identified explains 0.034% of the variation in PTSD symptoms. The 15q11.2 BP1-BP2 microdeletion region was significantly associated with PTSD (beta = 0.0206, SE = 0.0056, P = 0.0002). No individual significant genes interrupted by CNV were identified. 22 gene pathways related to the function of the nervous system and brain were significant in pathway analysis (FDR q

As the U.S. population shows increasing racial and ethnic diversity (Craig, Rucker, and Richeson 2018), it is imperative that engineering educators take steps to create a more inclusive engineering education environment. Several colleges in the U.S. have introduced diversity initiatives such as faculty/staff diversity training (O'Leary et al. 2020), diversity-focused workshops (Rheingans et al. 2018), and even mentoring programs to women and underrepresented racial and ethnic groups (Young 2018; Ikuma et al. 2019). At the University of Iowa, the College of Engineering recently established the Diversity, Equity and Inclusion (DEI) Council, and with their support, the authors aimed to learn about first-year engineering students' perceptions of diversity. To this end, the authors developed a hands-on workshop to facilitate conversation about diversity and learn how the students perceive diversity. While other institutions have also adopted diversity training for first-year engineering students, this pilot study is novel because it frames the conversation about diversity from the student's perspective rather than from the perspective of training, which has been shown to be ineffective (Naff and Kellough 2003; Chang et al. 2019; Dobbin and Kalev 2018). This education-based conversational approach is novel in that it leads to the inclusion, in addition to race and gender, of other dimensions of diversity that are rarely included in diversity training, including, but not limited to, sexual orientation, non-binary gender identity, age, political views, and religious beliefs.

Method books serve as a key curricular resource in beginning band classrooms. Previous examinations of beginning band method books focused primarily on performance technique and pedagogy; however, a curriculum with a singular emphasis on performance will not meet all elements of the 2014 National Core Arts Standards. Therefore, we analyzed 16 beginning band method books for exercises that included creative activities such as compose, arrange, and improvise. Results indicated that 2.53% (n = 66) of the total exercises (N = 2,612) contained creative activities. The most frequently identified creative activity instruction type was improvise (n = 31, 44.93%), followed by compose (n = 27, 39.13%), and arrange (n = 11, 15.94%). These data provide insight into the degree to which beginning band method books contain exercises that include creative activities, specific activity types, and instructional directives, and may support inservice music educators and fine arts administrators in selecting method books.

Research suggests that class-privileged students value learning for its own sake and study the liberal arts, while working-class students believe college is a means to an end. However, recent studies indicate that these associations are weakening. This paper investigates the link between class background, college values, and curricular choices, specifically course selection. In interviews with 68 working- and upper-middle-class liberal arts majors at two public universities in the northeastern U.S., nearly all students endorsed liberal education values (the belief that higher education is for personal edification) which they claimed to value above labor market outcomes. Working-class students chose courses in accordance with those values; however, upper-middle-class students chose courses for perceived career relevance or those rumored to be an 'easy A'. Although it appears that college logics have flipped, I argue that they remain rooted in social class. I then consider implications for social reproduction: while working-class students' adoption of traditional HE values and practices suggests some leveling of the playing field, it means little if privileged students have moved the goalposts to maintain advantage. I apply Sigal Alon's theory of "effectively expanded inequality," whereby the privileged classes adapt to increased access and competition by deploying new strategies to secure their class position.

We developed a sustained content literacy intervention that emphasized building domain and topic knowledge from Grade 1 to Grade 2 and evaluated transfer effects on students' reading comprehension outcomes. The Model of Reading Engagement (MORE) intervention emphasizes thematic lessons that provide an intellectual framework for helping students connect new learning to a general schema (i.e., how scientists study past events). A total of 30 elementary schools (N = 2,952 students; N = 144 teachers) were randomly assigned to a treatment or control group. Over 12 months, the treatment group students participated in (a) spring Grade 1 thematic content literacy lessons in science and social studies followed by wide reading of thematically related informational texts during summer, and (b) fall to spring Grade 2 thematic content literacy lessons in science. After implementation of Grade 1 thematic content literacy lessons and summer support for reading, treatment group students experienced smaller summer losses on a domain-general measure of reading than control group students. Following the sustained implementation of thematic content literacy lessons in science through Grade 2, treatment group students also outperformed their control group peers on a science content reading comprehension outcome (ES = 0.18). Furthermore, we found transfer effects on science content reading comprehension that varied by passage-item type (near-, mid-, and far-transfer passages determined by the inclusion and number of directly taught words in passages). A sustained content literacy intervention that aligns content and instruction across grades can help students transfer knowledge to novel reading comprehension tasks.

The purpose of this study was to systematically map and synthesise literature on interventions that promote the involvement of parents of school-aged children with disabilities in education. The study focused on peer-reviewed, primary intervention studies published in English between 2000 and 2021. Nine databases were searched, and 21 articles were identified and included in the review. The Mixed Methods Appraisal Tool was used to assess the quality of the included studies, and narrative analysis was used to synthesise the data. The duration of the interventions varied from 7 to 36 months. Most studies were conducted within the context of high-income countries and focused on parents of children with intellectual disabilities. Most studies reported positive effects on one or more groups: parents, children, schools, and communities. However, there was heterogeneity in the outcome measures used, which limits comparability across interventions. The quality assessment revealed high-/medium-bias risks in most articles. Future research should include higher quality studies driven by theoretical models. The results support the need for more research on parental involvement in the education of children with disabilities, especially intervention studies within the context of low- and medium-income countries.

The AACSB 2020 business standards update provides a "principle-based" approach to the continuous improvement process for a business school. This approach provides great flexibility for business schools to define faculty sufficiency and maintenance of faculty qualifications in a way that is congruent with their mission and expectations for faculty performance. In the following discussion, we dispel the folklore associated with faculty sufficiency and qualifications (Standard 3). Moreover, we provide a step-by-step process to guide business school administrators in maximizing guideline ratios related to the standard. Finally, examples are provided to illustrate specific strategies for navigating the standard.

O presente estudo buscou identificar compreensões acerca do Educar pela Pesquisa com direcionamento para o Ensino de Ciências, em um contexto de formação continuada com professoras que atuam na Educação Infantil. Para tanto realizamos um acompanhamento formativo pela via da Investigação-Formação-Ação com professoras que atuam na Educação Infantil. O objetivo consistiu em oportunizar um espaço de estudo e diálogo sobre os aspectos do Educar pela Pesquisa como modo de potencializar o ensino de Ciências na Educação Infantil. A pesquisa se caracteriza como de cunho qualitativo. O corpus da pesquisa foram as transcrições da gravação de três encontros de formação e a análise foi realizada por meio de Análise Textual Discursiva, da qual emergiram seis categorias iniciais: três categorias intermediárias e uma categoria final: O estudo do Educar pela Pesquisa como potencial para refletir sobre o Ensino de Ciências na Educação Infantil. O metatexto que foi elaborado indica a importância de oportunizar às professoras que atuam na Educação Infantil um espaço de formação continuada, que as auxilie na compreensão dos aspectos do Educar pela Pesquisa como modo para ensinar Ciências. Ressaltamos que ficou evidenciado a necessidade de um Ensino que tenha como referência o questionamento, a argumentação e a comunicação dos resultados por meio da mediação do professor. A vivência formativa apontou para a importância da reflexão dos aspectos teóricos para qualificar a prática pedagógica do coletivo em formação, indicando ainda a necessidade de oportunizar que os professores investiguem a sua prática por meio da reflexão, num movimento de reconstrução do conhecimento em espiral de forma contínua e sistemática.

BackgroundIn comparison to the general population, prison inmates are at a higher risk for drug abuse and psychiatric, as well as infectious, diseases. Although intramural health care has to be equivalent to extramural services, prison inmates have less access to primary and secondary care. Furthermore, not every prison is constantly staffed with a physician. Since transportation to the nearest extramural medical facility is often resource-intensive, video consultations may offer cost-effective health care for prison inmates. ObjectiveThis study aims to quantify the need for referrals to secondary care services and hospital admissions when video consultations with family physicians and psychiatrists are offered in prison. MethodsIn 5 German prisons, a mixed methods evaluation study was conducted to assess feasibility, acceptance, and reasons for conducting video consultations with family physicians and psychiatrists. This analysis uses quantitative data from these consultations (June 2018 to February 2019) in addition to data from a sixth prison added in January 2019 focusing on referral and admission rates, as well as reasons for encounters. ResultsAt the initiation of the project, 2499 prisoners were detained in the 6 prisons. A total of 435 video consultations were conducted by 12 physicians (3 female and 7 male family physicians, and 2 male psychiatrists during the study period). The majority were scheduled consultations (341/435, 78%). In 68% (n=294) of all encounters, the patient was asked to consult a physician again if symptoms persisted or got worse. In 26% (n=115), a follow-up appointment with either the video consultant or prison physician was scheduled. A referral to other specialties, most often psychiatry, was necessary in 4% (n=17) of the cases. Only in 2% (n=8) of the consultations, a hospital admission was needed. Usually, hospital admissions were the result of unscheduled consultations, and the videoconferencing system was the method of communication in 88% (n=7) of these cases, while 12% (n=1) were carried out over the phone. Reasons for admissions were severe abdominal pain, hypotension, unstable angina or suspected myocardial infarction, or a suspected schizophrenic episode. ConclusionsMost scheduled and unscheduled consultations did not require subsequent patient transport to external health care providers. Using telemedicine services allowed a prompt patient-physician encounter with the possibility to refer patients to other specialties or to admit them to a hospital if necessary.

Background:. In the past decades, reconstructive choices after female genital mutilation extended beyond de-infibulation and scar release. The current trend to expand techniques addressing sexual and aesthetic aspects by reconstructing the clitoris and prepuce, and dissecting the clitoral nerves raises concern, as there is a paucity of evidence on the functional outcomes and suspected iatrogenic lacerations. Methods:. A total of 128 female genital mutilation patients were included in the study. To evaluate clitoral sensitivity after elevation, the Semmes-Weinstein-monofilament test was performed before and after genital reconstruction. Results:. Preoperatively, patients with a visually intact clitoris showed significantly better sensitivity compared with patients with a mutilated clitoris or infibulation (P < 0.0001). Surgery was performed in 84 patients. After clitoral reconstruction (CR), 70 of 73 patients were able to perceive 2.83 monofilaments (95.9%), whereas three perceived 3.61. Patients with a visually intact clitoris served as control, and 95.0% perceived 2.83 monofilaments. We showed a significant improvement of clitoral sensitivity (P = 0.0020) in the subgroup consisting of patients with a mutilated clitoris in whom the test was performed before and after reconstruction. Conclusions:. Clitoral sensitivity improves significantly after CR. Seventy of 73 patients attained the same sensitivity as unharmed women. No patient showed a decreased sensitivity compared with their preoperative findings. Therefore, our study supports the argument that CR offers sufficient improvement of objective clitoral sensitivity without additionally addressing clitoral nerves.

O presente estudo tem por objetivo avaliar a relação entre os índices de balneabilidade e as taxas de internações hospitalares por enteropatias infecciosas para os municípios litorâneos do Rio Grande do Sul. Considerando que é esperada uma relação direta na incidência de enteropatias conforme a piora das condições das águas de contato primário, busca-se testar empiricamente esta relação a partir do método de Regressão com Descontinuidade, usando dados da FEPAM e do Sistema de Informações Hospitalares do DATASUS, para os meses de alta temporada, de novembro de 2004 a dezembro de 2015. Como regra de seleção para definição dos municípios considerados como de piores condições em relação aos demais, foi utilizada a norma nacional dada pelo CONAMA, como limite para os níveis de coliformes termotolerantes, e posteriormente, foi testado também os limites indicados pela OMS. Os resultados se mostraram inconclusivos para o caso utilizando a norma aplicada pelo CONAMA e positivo para as taxas de internações por enteropatias quando usada a indicação da OMS.

Many office and residential buildings in Europe need to be renovated in the near future to meet current energy efficiency requirements. This often comes down to updating the insulation performance of the building envelope including the windows. Most “old” windows consist of a frame and a double insulated glass unit (IGU) or even monolithic glass panes – typically without any low-e coating. These non-coated double glazings have an Ug-value of 2.7 W/m²K (single glazing even 5.2 W/m²K). Modern coated triple glazed IGUs provide Ug-values of up to 0.5 W/m²K. This paper deals with the question of how old insulating glass units can be re-manufactured to match the state of the art in terms of the energy efficiency. For this purpose, dismounted IGUs from the 1980s are used. After analyzing the remaining functionality, the double IGUs are disassembled. The single glass pane is cleaned, and the old edge sealing is removed. The old glass pane is combined it with a new coated low-e glass and a spacer system to form a new upgraded IGU with warm edge technology. This study demonstrates that remanufactured IGUs can achieve the performance of IGUs made from new glass.

PurposeThe present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups.MethodsData were derived from a prospective multicenter cohort study conducted in primary care – the AgeCoDe/AgeQualiDe study. In total, 2,436 patients 75 years and older were followed from baseline to ninth follow-up. To assess depressive symptoms, the short version of the Geriatric Depression Scale (GDS-15, cutoff score 6) was used. Age-specific competing risk regressions were performed to analyze risk factors for incident depressive symptoms in different age groups (75 to 79, 80 to 84, 85+ years), taking into account the accumulated mortality.ResultsThe age-specific incidence rate of depression was 33 (95% CI 29-38), 46 (95% CI 40-52) and 63 (95% CI 45-87) per 1,000 person years for the initial age groups 75 to 79, 80 to 84 and 85+ years, respectively. In competing risk regression models, female sex, mobility as well as vision impairment, and subjective cognitive decline (SCD) were found to be risk factors for incident depression for age group 75 to 79, female sex, single/separated marital status, mobility as well as hearing impairment, and SCD for age group 80 to 84, and mobility impairment for age group 85+.ConclusionDepressive symptoms in latest life are common and the incidence increases with increasing age. Modifiable and differing risk factors across the highest age groups open up the possibility of specifically tailored prevention concepts.

Purpose: A high rate of lost to follow-up (LTFU) in patients with phenylketonuria (PKU) represents a main challenge. In this study, we investigated potential risk factors for becoming LTFU related to adolescence as a critical period of life. Methods: We retrospectively analyzed longitudinal data collected from 1993 to 2019 of patients diagnosed with classic PKU that were followed at our center during adolescence (14–18 y) and at least once in adulthood (>18 y). Patients who interrupted their contact with our center after the 18th birthday for at least 2 years were classified as LTFU. We performed a multivariate regression analysis to investigate following potential risk factors for becoming LTFU in adult life: sex, dietary compliance during adolescence assessed through the mean of the annual medians of phenylalanine plasma values, average number of contacts with the center during adolescence and age at first visit after the 18th birthday. Results: 93 patients (52 males, 41 females) were included in the study. 58% became LTFU during adulthood. The mean age at the last visit before becoming LTFU was 26.2 ± 5.1 years. In the multivariate Cox regression analysis we found that poor dietary compliance during adolescence was significantly associated with a higher risk of becoming LTFU during adulthood (p-value = 0.028). Discussion: Adult patients who displayed poor treatment adherence during adolescence should be identified and carefully monitored to prevent loss of contact.

Education is key in preparing healthcare professionals for the current and future needs of the clinical environment. Hence, ESTRO facilitated a workshop, with a track focusing on radiation therapists’ (RTT) education and whether it is fit for the current demands of RTTs. An international group of participants with academic and clinical backgrounds discussed the current situation in their respective working environments, evaluated the challenges in RTT education, and highlighted opportunities and possible solutions to meet current and future needs. Key outcomes highlighted the importance of strengthening collaboration between clinical and academic staff.

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IntroductionIn order to successfully move from place to place, our brain often combines sensory inputs from various sources by dynamically weighting spatial cues according to their reliability and relevance for a given task. Two of the most important cues in navigation are the spatial arrangement of landmarks in the environment, and the continuous path integration of travelled distances and changes in direction. Several studies have shown that Bayesian integration of cues provides a good explanation for navigation in environments dominated by small numbers of easily identifiable landmarks. However, it remains largely unclear how cues are combined in more complex environments.MethodsTo investigate how humans process and combine landmarks and path integration in complex environments, we conducted a series of triangle completion experiments in virtual reality, in which we varied the number of landmarks from an open steppe to a dense forest, thus going beyond the spatially simple environments that have been studied in the past. We analysed spatial behaviour at both the population and individual level with linear regression models and developed a computational model, based on maximum likelihood estimation (MLE), to infer the underlying combination of cues.ResultsOverall homing performance was optimal in an environment containing three landmarks arranged around the goal location. With more than three landmarks, individual differences between participants in the use of cues are striking. For some, the addition of landmarks does not worsen their performance, whereas for others it seems to impair their use of landmark information.DiscussionIt appears that navigation success in complex environments depends on the ability to identify the correct clearing around the goal location, suggesting that some participants may not be able to see the forest for the trees.

Introduction More than 170 countries have implemented disability-targeted social protection programmes, although few have been rigorously evaluated. Consequently, a non-randomised controlled trial is being conducted of a pilot ‘cash-plus’ programme implemented by UNICEF Laos and the Laos government for children with disabilities in the Xiengkhouang Province in Laos. The intervention combines a regular cash transfer with provision of assistive devices and access for caregivers to a family support programme.Methods and analysis The non-randomised controlled trial will involve 350 children with disabilities across 3 districts identified by programme implementers as eligible for the programme (intervention arm). Implementers have also identified approximately 180 children with disabilities in neighbouring districts, who would otherwise meet eligibility criteria but do not live in the project areas (control arm). The trial will assess the impact of the programme on child well-being (primary outcome), as well as household poverty, caregiver quality of life and time use (secondary outcomes). Baseline data are being collected May–October 2023, with endline 24 months later. Analysis will be intention to treat. A complementary process evaluation will explore the implementation, acceptability of the programme, challenges and enablers to its delivery and mechanisms of impact.Ethics and dissemination The study has received ethical approval from the London School of Hygiene and Tropical Medicine and the National Ethics Committee for Health Research in Laos. Informed consent and assent will be taken by trained data collectors. Data will be collected and stored on a secure, encrypted server and its use will follow a detailed data management plan. Findings will be disseminated in academic journals and in short briefs for policy and programmatic actors, and in online and in-person events.Trial registration number ISRCTN80603476.

In-service courses for teachers are often provided by so called facilitators who function as teacher trainers and whose tasks in the education system are multifaceted. The professional development (PD) of facilitators is of great importance, and the complex process of scaling up might lead to unexpected constraints, and influence the effectiveness of a program. In general, more research is needed concerning facilitators’ PD with respect to their different roles and functions. In this paper, a project will be presented that focused on qualifying facilitators for the topic “inclusive mathematics” and accompanied the process of scaling up. In the end, unexpectedly, five out of 15 facilitators did not finish the program. Therefore, the challenges and concrete reasons for dropout were investigated in detail. The paper will present a case analysis, where Facilitators’ multifaceted roles, functions, and tasks emerged as the central category. Moreover, conclusions for professionalization programs and research will be derived and discussed.

Uma versão analítica do método de ordenadas discretas (ADO) é usada para determinar uma solução precisa e consistente para o problema do Reverso de Temperatura em misturas binárias de gases rarefeitos. As equações cinéticas usadas são baseadas no modelo cinético McCormack. Apresenta-se o desenvolvimento completo de uma solução analítica na variável espacial, além de resultados numéricos para os valores críticos do calor latente para a inversão de sentido do gradiente de temperatura e do fluxo de calor de cada gás nas misturas Neônio-Argônio e Hélio-Xenônio. O algoritmo é considerado simples de ser elaborado e o código desenvolvido (em FORTRAN) requer em torno de um segundo para ser executado em um computador com processador Intel Core i3 - 2.30 GHz.

A adolescência, segundo a Organização Mundial da Saúde, abrange dos 10 aos 19 anos. Por sua vez, uma gestação que por ventura ocorra nesta faixa etária, caracteriza-se como precoce. A gravidez na adolescência traz mudanças físicas, psicológicas, sociais e econômicas, afetando o desenvolvimento das jovens. Objetivo: Discorrer sobre a depressão pós-parto em adolescentes, demonstrando o impacto da patologia na díade mãe-bebê, juntamente com o reconhecimento, acolhimento e manejo adequado pela enfermagem. Materiais e Métodos: O trabalho adotou uma metodologia de pesquisa descritiva, com base em revisão narrativa da literatura. A revisão de literatura abrangeu trabalhos publicados desde 2013, com consulta a fontes como Scielo, Portal Domínio Público, BDTD e Google Acadêmico, os critérios de inclusão foram baseados na relevância do conteúdo, enquanto os artigos inacessíveis, experimentais e não relacionados ao tema foram excluídos. Emergiu cinco categorias: Maternidade precoce; Puerpério; Depressão Pós-Parto; Interação mãe e recém-nascido; Atuação da Enfermagem diante a Depressão Pós-Parto. Conclusão: A depressão pós-parto em adolescentes é uma condição complexa que tem um impacto significativo na díade mãe-bebê. Essa patologia pode comprometer a formação de um vínculo saudável entre a mãe adolescente e o bebê, prejudicando os cuidados com a criança e aumentando o risco de problemas de saúde mental para ambos. No entanto, o reconhecimento, acolhimento e manejo adequado desempenham um papel crucial na mitigação desses efeitos prejudiciais.

Nesta pesquisa, objetivou-se analisar, por meio de revisão da literatura, publicações nacionais sobre economia compartilhada e consumo colaborativo nas coleções brasileiras da Scielo e nos principais periódicos de administração, identificando o alcance da temática no Brasil e apontando insights para pesquisas futuras. Por meio dos resultados, percebeu-se que, por se tratar de um assunto relativamente recente no contexto nacional ainda existe espaço para a ampliação do número de estudos em relação ao fenômeno do compartilhamento, seja por meio da diversificação dos aspectos metodológicos ou mesmo a ampliação e aprofundamento de temáticas de pesquisa. Acredita-se que por meio dos insights de pesquisas identificados neste estudo seja possível refletir sobre possíveis direcionamentos e agenda de pesquisa para próximos estudos sobre os temas, contribuindo de forma significativa para os pesquisadores que possuem interesse em desbravar estas temáticas em suas pesquisas no contexto brasileiro.

BackgroundSocial media (SM) has been recognized as a professional communication tool in the field of orthopedic and trauma surgery that can enhance communication with patients and peers, and increase the visibility of research and offered services. The specific purposes of professional SM use and the benefits and concerns among orthopedic and trauma surgeons, however, remain unexplored. ObjectiveThis study aims to demonstrate the specific uses of different SM platforms among orthopedic and trauma surgeons in Germany as well as the advantages and concerns. MethodsA web-based questionnaire was developed on the use of SM in a professional context by considering the current literature and the authors’ topics of interest. The final questionnaire consisted of 33 questions and was distributed among German orthopedic and trauma surgeons via the mail distributor of the Berufsverband für Orthopädie und Unfallchirurgie (Professional Association of Orthopaedic Surgeons in Germany). The study was conducted between June and July 2022. A subgroup analysis was performed for sex (male vs female), age (

Com o avanço da globalização e das ferramentas digitais é possível assumir trabalhos via home office para empresas locais ou, até mesmo, para o outro lado do mundo. Este estudo visa investigar mobilidades relativas ao trabalho em home office de brasileiros que atuam no mercado internacional. Foram coletadas narrativas de 14 trabalhadores de carreiras diversas. Os resultados apontam que (i) as formas de ingresso no home office transnacional ocorreram devido a mobilidades geográficas anteriores, como trabalho, estudo e turismo no exterior, bem como ao uso de ferramentas para mobilidade tecnológica como plataformas digitais, Google, LinkedIn, e Whatsapp; (ii) apenas um entrevistado é contratado como funcionário por empresa estrangeira, os demais são autônomos, trabalham por contrato e prestam serviços para empresas e/ou via plataformas digitais. A remuneração em moeda estrangeira acima do valor do mercado brasileiro é vista como vantagem; (iii) o investimento em si e em equipamentos tecnológicos e de infraestrutura do home office são necessários para acessar oportunidades de vagas globais via mobilidade tecnológica. A acentuada flexibilização do trabalho aliada à mobilidade tecnológica e à imobilidade geográfica, evidencia uma nova modalidade de trabalho propiciada pela mobilidade global virtual que denominou-se home office transnacional.

Non-clustered protocadherins (ncPcdhs) are adhesive molecules with spatio-temporally regulated overlapping expression in the developing nervous system. Although their unique role in neurogenesis has been widely studied, their combinatorial role in brain physiology and pathology is poorly understood. Using probabilistic cell typing by in situ sequencing, we demonstrate combinatorial inter- and intra-familial expression of ncPcdhs in the developing mouse cortex and hippocampus, at single-cell resolution. We discovered the combinatorial expression of Protocadherin-19 (Pcdh19), a protein involved in PCDH19-clustering epilepsy, with Pcdh1, Pcdh9 or Cadherin 13 (Cdh13) in excitatory neurons. Using aggregation assays, we demonstrate a code-specific adhesion function of PCDH19; mosaic PCDH19 absence in PCDH19+9 and PCDH19 + CDH13, but not in PCDH19+1 codes, alters cell–cell interaction. Interestingly, we found that PCDH19 as a dominant protein in two heterophilic adhesion codes could promote trans-interaction between them. In addition, we discovered increased CDH13-mediated cell adhesion in the presence of PCDH19, suggesting a potential role of PCDH19 as an adhesion mediator of CDH13. Finally, we demonstrated novel cis-interactions between PCDH19 and PCDH1, PCDH9 and CDH13. These observations suggest that there is a unique combinatorial code with a cell- and region-specific characteristic where a single molecule defines the heterophilic cell–cell adhesion properties of each code.

Objective Building on Existing Tools To improvE chronic disease pRevention and screening in primary care Wellness of cancer survIvorS and patiEnts (BETTER WISE) was designed to assess the effectiveness of a cancer and chronic disease prevention and screening (CCDPS) programme. Here, we compare outcomes in participants living with and without financial difficulty.Design Secondary analysis of a cluster-randomised controlled trial.Setting Patients of 59 physicians from 13 clinics enrolled between September 2018 and August 2019.Participants 596 of 1005 trial participants who responded to a financial difficulty screening question at enrolment.Intervention 1-hour CCDPS visit versus usual care.Outcome measures Eligibility for a possible 24 CCDPS actions was assessed at baseline and the primary outcome was the percentage of eligible items that were completed at 12-month follow-up. We also compared the change in response to the financial difficulty screening question between baseline and follow-up.Results 55 of 265 participants (20.7%) in the control group and 69 of 331 participants (20.8%) in the intervention group reported living with financial difficulty. The primary outcome was 29% (95% CI 26% to 33%) for intervention and 23% (95% CI 21% to 26%) for control participants without financial difficulty (p=0.01). Intervention and control participants with financial difficulty scored 28% (95% CI 24% to 32%) and 32% (95% CI 27% to 38%), respectively (p=0.14). In participants who responded to the financial difficulty question at both time points (n=302), there was a net decrease in the percentage of participants who reported financial difficulty between baseline (21%) and follow-up (12%, p

Abstract Purpose Co‐creation, characterised by artists and patients creating a joint work of art, may support patients with the integration of life events, such as living with cancer, into their life story. In the process of co‐creation, resonance relationships between patients, artists and material may evolve that support such integration. Using the framework of resonance theory, we aim to investigate if and how patients move through the three phases of resonance during a process of co‐creation and explore the role of uncontrollability in this process. Methods Ten patients who received cancer treatment with palliative intent completed co‐creation processes, which were audio recorded. These recordings were imported in Atlas‐Ti and analysed by applying content analysis. We searched for the three phases of resonance, Being affected, touched and moved; Self‐efficacy and responding; Adaptive transformation. We additionally searched for signs of uncontrollability. Results Patients used 4–8 sessions (median 5 sessions) with a duration 90–240 min per session (median duration 120 min). We found that patients move through the three phases of resonance during co‐creation processes. Uncontrollability both presents a challenge and an invitation to integrate experiences of contingency into one's life narrative. Patients express self‐recognition and the experience of contingency in their work of art. Conclusions Integration of experiences of contingency into a life narrative can be supported by the process of co‐creation of art, which invites patients to relate to their illness, their environment and themselves. The phases of resonance in combination with uncontrollability as a continuously present factor, provide a means to both study and support the integration of experiences of contingency into the life narrative.

Objective: Patients with peripheral arterial disease (PAD) have a significant risk of myocardial infarction and death secondary to concomitant coronary artery disease (CAD). This is particularly true in patients with critical limb-threatening ischemia (CLTI) who exceed a 20% mortality rate at 6 months despite standard treatment with risk factor modification. Although systematic preoperative coronary testing is not recommended for patients with PAD without cardiac symptoms, the clinical manifestations of CAD are often muted in patients with CLTI due to poor mobility and activity intolerance. Thus, the true incidence and impact of “silent” CAD in a CLTI cohort is unknown. This study aims to determine the prevalence of ischemia-producing coronary artery stenosis in a CLTI cohort using coronary computed tomography angiography (cCTA) and computed tomography (CT)-derived fractional flow reserve (FFRCT), a noninvasive imaging modality that has shown significant correlation to cardiac catheterization in the detection of clinically relevant coronary ischemia. Methods: Patients presenting with newly diagnosed CLTI at our institution from May 2020 to April 2021 were screened for underlying CAD. Included subjects had no known history of CAD, no cardiac symptoms, and no anginal equivalent complaints at presentation. Patients underwent cCTA and FFRCT evaluation and were classified by the anatomic location and severity of CAD. Significant coronary ischemia was defined as FFRCT ≤0.80 distal to a >30% coronary stenosis, and severe coronary ischemia was documented at FFRCT ≤0.75, consistent with established guidelines. Results: A total of 170 patients with CLTI were screened; 65 patients (38.2%) had no coronary symptoms and met all inclusion/exclusion criteria. Twenty-four patients (31.2%) completed cCTA and FFRCT evaluation. Forty-one patients have yet to complete testing secondary to socioeconomic factors (insurance denial, transportation inaccessibility, testing availability, etc). The mean age of included subjects was 65.4 ± 7.0 years, and 15 (62.5%) were male. Patients presented with ischemic rest pain (n = 7; 29.1%), minor tissue loss (n = 14; 58.3%) or major tissue loss (n = 3; 12.5%). Significant (≥50%) coronary artery stenosis was noted on cCTA in 19 of 24 patients (79%). Significant left main coronary artery stenosis was identified in two patients (10%). When analyzed with FFRCT, 17 patients (71%) had hemodynamically significant coronary ischemia (FFRCT ≤0.8), and 54% (n = 13) had lesion-specific severe coronary ischemia (FFRCT ≤0.75). The mean FFRCT in patients with coronary ischemia was 0.70 ± 0.07. Multi-vessel disease pattern was present in 53% (n = 9) of patients with significant coronary stenosis. Conclusions: The use of cCTA-derived fractional flow reserve demonstrates a significant percentage of patients with CLTI have silent (asymptomatic) coronary ischemia. More than one-half of these patients have lesion-specific severe ischemia, which may be associated with increased mortality when treated solely with risk factor modification. cCTA and FFRCT diagnosis of significant coronary ischemia has the potential to improve cardiac care, perioperative morbidity, and long-term survival curves of patients with CLTI. Systemic improvements in access to care will be needed to allow for broad application of these imaging assessments should they prove universally valuable. Additional study is required to determine the benefit of selective coronary revascularization in patients with CLTI.