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This case illustrates an example of a patient with mild asthma who experiences a severe life-threatening exacerbation. This patients experience is one of many that challenges the common misperception that mild, well-controlled asthma is not at risk for severe life-threatening exacerbations. The case exploration highlights the data fueling the new 2019/2020 Global Initiative for Asthma (GINA) guidelines, pharmaco-inequity, and barriers to healthcare access which can increase the risk for poor asthma outcomes. The graphic illustrates when patients with asthma, including those with mild asthma, may benefit from referral to an allergist-immunologist. Overall, this case underscores the importance of bridging the gap between generalists and allergist-immunologists to better serve an oft-overlooked patient population.

This chronological review of the literature is a summary of primarily non-empirical articles that explore the specific approach of dyadic (paired individuals or conjoint) interviewing. The evolution of dyadic interviewing is highlighted including the strengths and cautions of this approach beginning in 1942. The review of the literature is organized around the evolution from defining the dyad in the interviewing context to redefining the unit of analysis in the most recent articles in 2016. From this chronology, we make specific recommendations for using dyadic interviewing, as well as present ethical and analytical considerations culled from the collective knowledge and experience of multidisciplined scholars across the literature. Impacts on the dyad as well as the researcher are also addressed. Considerations of identity such as gender and ethical consideration of location, confidentiality, dynamics of the dyad, and issues of transference and countertransference are addressed in the presented recommendations.

Background: Appendicectomy is a common procedure in children. Regional anaesthesia helps reduce requirements for opioids and hospital stay and enhances recovery. Laparoscopic-assisted Transversus Abdominus Plane block (L-TAP) was shown to be efficient and potentially superior to port site infiltration (PSI); however, this was not previously studied in paediatric appendicitis. This study aimed to evaluate the effectiveness of L-TAP compared to PSI in children undergoing laparoscopic appendicectomy (LA). Methods: A single-blinded RCT was performed to compare L-TAP to PSI with 0.25% plain bupivacaine at the end of an LA. Patients aged 6–16 years diagnosed with uncomplicated acute appendicitis (AAST grade 1) were randomised to either group in a 1:1 fashion. Complicated appendicitis, open or Lap-converted to open appendicectomies, were excluded. Outcome measures included the total amount and number of doses of opiates and clonidine required, length of stay (LOS), and visual analogue score (VAS) of pain. Results: 49 patients in the PSI group and 41 in the L-TAP group were included; the mean age was 11.3 ± 2.4 years. There was no significant difference in age and weight between the groups. One patient in each group required opioid-based patient-controlled analgesia (PCA) in the theatre recovery room; however, on retrospective review, this was not clinically warranted. Seven patients in each group required morphine while in recovery (p = 0.4). There was no significant difference in total morphine (PSI 0.12 vs L-TAP 0.04 mg/kg body weight, p = 0.1) and clonidine (PSI 0.57 vs L-TAP 0.59 micro gm/kg body weight, p = 0.5) requirement during the hospital stay. Patients in the L-TAP group had two hours shorter LOS than the PSI group (38.0 ± 3.9 vs 39.7 ± 4.1, p = 0.38). There was no significant difference in VAS scores. Conclusion: There was no difference between L-TAP and PSI. L-TAP was feasible, easy to earn, and safe. We recommend that it be considered in clinical protocols and local guidelines as part of the peri-operative analgesia regimen, especially when ultra-sound guided blocks are unavailable. Overall, patients with uncomplicated appendicitis who undergo LA have low VAS scores and require mostly simple analgesia. [ABSTRACT FROM AUTHOR]

Background: Dietary modification is critical for the management of polycystic ovary syndrome (PCOS), yet few women with PCOS report receiving nutrition education. Nutrition knowledge may translate to dietary behaviors and diet quality, but nutrition knowledge among women with PCOS is unknown. Purpose: Using a descriptive design, we assessed nutrition knowledge, diet quality, and eating disorder risk among university students with PCOS. Methods: Following clinical and biochemical analysis, 12 university students with PCOS were admitted to the study. Participants completed validated questionnaires (Nutrition Knowledge Questionnaire, Eating Disorder Examination-Questionnaire 6.0 (EDE-Q 6.0), 3-day food records, and body composition testing. Results: Participants were obese (75%), insulin resistant (58%), and consumed an unbalanced diet (41% carbohydrate, 43% fat). Bread or fruit were avoided by 27.3%. Nutrition knowledge was poor (48% correct) and inversely related to fruit intake (r(9) = -0.689, p < 0.05). Nearly half (41.6%) were at increased risk for eating disorders (EDE-Q score [greater than or equal to] 4). Discussion: University students with PCOS demonstrate poor nutrition knowledge, consume an unbalanced and limited diet, and exhibit an increased risk for eating disorders. Translation to Health Education Practice: University-health service programs targeting nutrition education and behavior modification are needed to improve the management and mitigation of PCOS-related symptoms in students.

Over the past two decades, with recognition that the ocean's sea-ice cover is neither insensitive to climate change nor a barrier to light and matter, research in sea-ice biogeochemistry has accelerated significantly, bringing together a multi-disciplinary community from a variety of fields. This disciplinary diversity has contributed a wide range of methodological techniques and approaches to sea-ice studies, complicating comparisons of the results and the development of conceptual and numerical models to describe the important biogeochemical processes occurring in sea ice. Almost all chemical elements, compounds, and biogeochemical processes relevant to Earth system science are measured in sea ice, with published methods available for determiningbiomass, pigments, net community production, primary production, bacterial activity, macronutrients, numerous natural and anthropogenic organic compounds, trace elements, reactive and inert gases, sulfur species, the carbon dioxide system parameters, stable isotopes, and water-ice-Atmosphere fluxes of gases, liquids, and solids. For most of these measurements, multiple sampling and processing techniques are available, but to date there has been little intercomparison or intercalibration between methods. In addition, researchers collect different types of ancillary data and document their samples differently, further confounding comparisons between studies. These problems are compounded by the heterogeneity of sea ice, in which even adjacent cores can have dramatically different biogeochemical compositions. We recommend that, in future investigations, researchers design their programs based on nested sampling patterns, collect a core suite of ancillary measurements, and employ a standard approach for sample identification and documentation. In addition, intercalibration exercises are most critically needed for measurements of biomass, primary production, nutrients, dissolved and particulate organic matter (including exopolymers), the CO2 system, air-ice gas fluxes, and aerosol production. We also encourage the development of in situ probes robust enough for long-Term deployment in sea ice, particularly for biological parameters, the CO2 system, and other gases.

The COVID‐19 pandemic and widely depicted incidents of racial injustice in the United States caused marked stress and shifts in society in 2020, leading to an acceleration of discussions related to promoting diversity, equity, inclusion, and justice (DEIJ) in family‐oriented mental health professions, including through training. Despite the consequential role leaders of academic programs play in overseeing didactic and clinical training, little research has examined approaches for supporting academic leaders in promoting DEIJ in family science‐related academic training programs. In this collaborative autoethnography, we, six participants in a diversity and anti‐racism peer consultation group for leaders of couple/marriage and family therapy (C/MFT) programs, present our experiences participating in the group over the past two years. At the start of the group, many of us were experiencing profound isolation and stress due to intensified responsibilities subsequent to the COVID‐19 pandemic and broadcast depictions of racial injustice. We experienced the group as a safe, inclusive space to grow personally and professionally, which subsequently inspired us to make changes in our programs. We also recognized the need for greater infrastructure to support program directors in developing DEIJ leadership skills. Future directions for research include examining experiences and outcomes of director‐initiated DEIJ change, as well examination of DEIJ‐focused peer consultation groups among family systems‐oriented academic leaders of diverse disciplines and nations. [ABSTRACT FROM AUTHOR]