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ObjectivesCompliant surfaces beneath a casualty diminish the quality of cardiopulmonary resuscitation (CPR) in clinical environments. To examine this issue in a sporting environment, we assessed chest compression quality and rescuer exertion upon compliant sports safety matting.MethodsTwenty-seven advanced life support providers volunteered (13 male/14 female; mass = 79.0 ± 12.5 kg; stature = 1.77 ± 0.09 m). Participants performed 5 × 2 min, randomized bouts of continuous chest compressions on a mannequin, upon five surfaces: solid floor; low-compliance matting; low-compliance matting with a backboard; high-compliance matting; high-compliance matting with a backboard. Measures included chest compression depth and rate, percentage of adequate compressions, and rescuer heart rate and perceived exertion.ResultsChest compression depth and rate were significantly lower upon high-compliance matting relative to other surfaces (p

There has been resistance to COVID-19 public health restrictions partly due to changes and reductions in work, resulting in financial stress. Psychological reactance theory posits that such restrictions to personal freedoms result in anger, defiance, and motivation to restore freedom. In an online study (N = 301), we manipulated the target of COVID-19 restrictions as impacting self or community. We hypothesized that (a) greater pandemic-related financial stress would predict greater reactance, (b) the self-focused restriction condition would elicit greater reactance than the community-focused restriction condition, (c) reactance would be greatest for financially-stressed individuals in the self-focused condition, and (d) greater reactance would predict lower adherence to social distancing guidelines. Independent of political orientation and sense of community, greater financial stress predicted greater reactance only in the self-focused condition; the community-focused condition attenuated this association. Additionally, greater reactance was associated with lower social distancing behavior. These findings suggest that economic hardship exacerbates negative responses to continued personal freedom loss. Community-focused COVID-19 health messaging may be better received during continued pandemic conditions.

A good deal of recent research has examined children’s norm learning across a wide range of novel contexts. The typical interpretation of these findings is that children’s norm learning is driven by group-based biases. In this paper, we present an alternative interpretation and corresponding meta-analyses that cast the current body of evidence in a rather different light. First, we argue the extant literature uses an ill-suited standard for assessing bias. Rather than comparing children’s judgments to what is expected under random chance (a ‘random standard’), bias is better assessed by comparing children’s judgments to what is most probable, given their total evidence (an ‘evidential standard’). Next, we report a meta-analysis of the known findings to date (k = 40 effect sizes; N = 1,369 in total; ages 4- to 13-years-old) to compare children’s norm learning against an appropriate evidential standard. Meta-analytic estimates reveal that children’s norm learning is not restrictively biased toward narrow-scope inferences on account of group-based factors. Rather, the findings to date are consistent with children’s norm learning being rational (i.e., statistically appropriate, given their evidence) or even inclusively biased toward making the wide-scope inference that a novel norm applies to everyone in a population. We conclude with brief discussion of implications for current understanding and future research on norm acquisition.

IntroductionVestibular hypofunction is associated with dizziness, imbalance, and blurred vision with head movement. Vestibular rehabilitation is the gold standard recommendation to decrease symptoms and improve postural stability. The Clinical Practice Guidelines for vestibular hypofunction suggest home exercises 3–5 times daily, but patient adherence is a problem, with compliance rates often below 50%.MethodsAn app was developed to increase engagement with home exercises by providing exercises as games. This study compared the accuracy of exercise performance in a one-time session using the app versus no-app and gathered participant feedback on using the app for vestibulo-ocular reflex (VOR) and balance exercises. The app was tested with 40 adults (20 women), mean age of 67 ± 5.7 years, with symptomatic unilateral or bilateral vestibular hypofunction. Participants completed VOR exercises in pitch and yaw planes, weight-shift, and single-leg balance exercises using an inertial motion unit to move the character on the tablet screen. Participants were randomly assigned to begin the exercises with or without the app.ResultsResults show that during VOR exercises, participants achieved the prescribed frequency of head motion for the yaw plane (p ≤ 0.001) and reduced variability of head movement frequency in both the yaw (p ≤ 0.001) and pitch plane (p ≤ 0.001) in the app compared to the no-app condition. During weight-shifting exercises, a larger range of body motion was noted in the anteroposterior and mediolateral directions in the app compared to the no-app condition (p

A 38-year-old woman with sinus venosus atrial septal defect and partial anomalous return of the right upper pulmonary vein underwent a Warden procedure but experienced a large residual defect after patch dehiscence. Image-derived 3D modeling informed novel device closure with a Gore Cardioform atrial septal occluder. (Level of Difficulty: Advanced.)

It’s a familiar point in anthropology that many norms areparochial, meaning they apply to people in certain groups (e.g.,one’s ingroup) and not to others (e.g., one’s outgroup). Oneexplanation for such parochialism is that people are justinnately biased against outsiders. But it’s also possible that,given the evidence, people infer the parochiality of norms instatistically appropriate ways. This paper uses a Bayesianlearning framework to investigate inferences of normativescope both experimentally and computationally. Anexperiment in which adult participants (n = 480) viewedsample violations of a novel rule among novel groups revealsthat both sensitivity to statistical evidence and prior knowledgeof relevant social categories are integral to computations ofnormative scope. In tandem with the experimental results,computational analysis supports the notion that degree of priorinclusivity bias (i.e., an expectation that a norm will be broad,rather than narrow, in scope) is another key factor. Together,these novel insights raise intriguing possibilities for integratingperspectives on norms research.

Abstract Background In people, the cardiovascular effects of obesity include systemic hypertension, cardiac remodelling and both systolic and diastolic dysfunction, whilst weight reduction can reverse myocardial remodelling and reduce risk of subsequent cardiovascular disease. To date, variable results are reported in studies of the effect of obesity and controlled weight reduction on cardiovascular morphology and function in dogs. This prospective study aimed to assess cardiac function, heart rate variability, cardiac biomarkers and body composition before and after weight reduction in pet dogs with obesity. Twenty-four client-owned dogs referred for weight management due to obesity were recruited. To assess the cardiac effects of obesity, body composition analysis (by dual energy X-ray absorptiometry, DEXA) and cardiovascular assessment (echocardiography, Doppler blood pressure, electrocardiography, cardiac biomarkers) were performed prior to weight management. Twelve dogs completed the study and reached target weight, receiving a further cardiovascular assessment and DEXA. A Wilcoxon-signed rank test was used to compare each variable pre- and post- weight reduction. Results Median (interquartile range) duration of weight loss was 224 days (124–245 days), percentage weight loss was 23% (18–31%) of starting weight. Median change in body fat mass was -50% (-44% to -55%; P = 0.004), whilst median change in lean mass was -7% (+ 1% to -18%, P = 0.083). Before weight reduction, diastolic dysfunction (evidence of impaired relaxation in all dogs), increased left ventricular wall thickness and mildly elevated systolic blood pressure (14/24 ≥ 160 mmHg, median 165 mmHg (140–183)) were common features in dogs with obesity. However, systolic left ventricular wall dimensions were the only variables that changed after weight reduction, with a decrease in both the systolic interventricular septum (P = 0.029) and systolic left ventricular free wall (P = 0.017). There was no evidence of decreased heart rate variability in dogs with obesity (P = 0.367), and no change in cardiac biomarker concentrations with weight reduction (N-terminal proBNP, P = 0.262; cardiac troponin I P = 0.657). Conclusions Canine obesity results in diastolic dysfunction and left ventricular hypertrophy, the latter of which improves with significant weight and fat mass reduction. Further studies are required to clarify the clinical consequences of these findings.

Introduction Addressing clinical variation in elective surgery is challenging. A key issue is how to gain consensus between largely autonomous clinicians. Understanding how the consensus process works to develop and implement perioperative pathways and the impact of these pathways on reducing clinical variation can provide important insights into the effectiveness of the consensus process. The primary objective of this study is to understand the implementation of an organisationally supported, consensus approach to implement perioperative care pathways in a private healthcare facility and to determine its impact.Methods A mixed-methods Effectiveness-Implementation Hybrid (type III) pre–post study will be conducted in one Australian private hospital. Five new consensus-based perioperative care pathways will be developed and implemented for specific patient cohorts: spinal surgery, radical prostatectomy, cardiac surgery, bariatric surgery and total hip and knee replacement. The individual components of these pathways will be confirmed as part of a consensus-building approach and will follow a four-stage implementation process using the Exploration, Preparation, Implementation and Sustainment framework. The process of implementation, as well as barriers and facilitators, will be evaluated through semistructured interviews and focus groups with key clinical and non-clinical staff, and participant observation. We anticipate completing 30 interviews and 15–20 meeting observations. Administrative and clinical end-points for at least 152 participants will be analysed to assess the effectiveness of the pathways.Ethics and dissemination This study received ethical approval from Macquarie University Human Research Ethics Medical Sciences Committee (Reference No: 520221219542374). The findings of this study will be disseminated through peer-reviewed publications, conference presentations and reports for key stakeholders.

For some professionally, vocationally, or technically oriented careers, curricula delivered in higher education establishments may focus on teaching material related to a single discipline. By contrast, multidisciplinary, interdisciplinary, and transdisciplinary teaching(MITT) results in improved affective and cognitive learning and critical thinking, offering learners/students the opportunity to obtain a broad general knowledge base. Chemistry is a discipline that sits at the interface of science, technology, engineering, mathematics, and medicine(STEMM) subjects (and those aligned with or informed by STEMM subjects). This article discusses the significant potential of inclusion of chemistry in MITT activities in higher education and the real-world importance in personal, organizational, national, and global contexts. It outlines the development and implementation challenges attributed to legacy higher education infrastructures (that call for creative visionary leadership with strong and supportive management and administrative functions), and curriculum design that ensures inclusivity and collaboration and is pitched and balanced appropriately. It concludes with future possibilities, notably highlighting that chemistry, as a discipline, underpins industries that have multibillion dollar turnovers and employ millions of people across the world.