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Objective To undertake a double blinded randomised placebo-controlled trial to assess the efficacy of vigabatrin, a GABA-transaminase inhibitor, as a benzodiazepine sparing agent in the management of acute alcohol withdrawal syndrome in a residential setting. Methods We enrolled 120 patients with alcohol use disorder who were randomly assigned to either treatment with vigabatrin (2g/day for 4 days) or placebo. The primary outcome was defined as the number of participants in each treatment arm needing diazepam for withdrawal management. A secondary outcome prespecified was the total dose of diazepam received by participants in each treatment arm. Participants were recruited on admission to a residential withdrawal unit at St Vincent's Hospital Melbourne from December 2014 to April 2019. Results No significant difference was observed in the number of participants requiring benzodiazepines during their residential withdrawal stay with 44 participants (78.6%) in placebo arm requiring at least one dose of diazepam compared to 38 (66.7%) in vigabatrin arm (p  = .156). An 18.1% difference was observed between the proportion of participants who received a total dose of >100mg of diazepam during their residential withdrawal stay in placebo arm (32.1%), compared to vigabatrin arm (14.0%, p  = .022). There were higher rates of reported adverse events in placebo arm with nine (15.0%) participants reporting adverse events compared with two (3.3%) participants in vigabatrin arm (p = .027). Conclusion Vigabatrin significantly reduced the number of participants requiring >100mg diazepam over the course of their alcohol withdrawal and was associated with a reduction in adverse effects when compared to placebo. [ABSTRACT FROM AUTHOR]

The result was a CR curriculum map depicting learners' development and application of CR skills in a structured, scaffolded and progressive manner (Table 1). Keywords: clinical reasoning; curriculum development; faculty development EN clinical reasoning curriculum development faculty development 184 194 11 05/12/22 20220501 NES 220501 Background Clinical reasoning (CR) is defined as a process wherein clinicians observe, collect, and interpret data to diagnose and treat patients [[1]], [[2]]. The group constituted individuals with programme leadership roles, knowledge of curriculum development, assessment, and CR, medical students and resident doctors. [Extracted from the article]

Background: An intervention Prescription Opioid Practice Improvement (POPI), addressing opioid prescribing on discharge following orthopaedic surgery, demonstrated improved practice. Here we report the sustainability of improved practice at 12 months, and the impact of a booster education intervention, POPI SOS (Safe Opioid Supply). Methods: Audits were performed using methodology described in previously published studies. Results: High proportion of patients were discharged on opioids, 89.9% 12 months post‐POPI (n = 149) and 82.2% post‐POPI SOS (n = 169). Twelve months post‐POPI there was a significant reduction in combination immediate (IR) and slow release (SR) opioids, 45.7% at the end of POPI program to 34.3% at 12 months (χ2 (1, N = 364) = 4.47, ρ = 0.034); a significant decrease in opioid‐weaning plans, 87.4% at the end of POPI program to 35.8% at 12 months (χ2 (1, N = 365) = 104.19, ρ = <0.001); and a significant increase in provision of full quantities of SR‐opioids, 6.1% after the POPI program to 15.7% (χ2 (1, N = 364) = 8.95, ρ = 0.003). The POPI SOS booster program significantly improved measures including reduction in combination IR and SR, 34.3–22.3% (χ2 (1, N = 273) = 4.87, ρ = 0.028) and an increase in opioid plans in discharge summaries, from 35.8% to 77.7% (χ2 (1, N = 273) = 48.87, ρ < 0.001). Conclusion: Better practice in relation to opioid prescribing is achievable but, for sustained improvement, opioid stewardship activities are needed to reduce the potential harms associated with prescription opioids. [ABSTRACT FROM AUTHOR]

Understanding data analysis and interpreting data are key components of teaching interdisciplinary undergraduate students. We detail a semester-long research project that introduces students to long-term data sets, incorporates the use of widely available statistical analysis, and underscores an inquirybased method of teaching climate change. Our learning objectives included analysis of large-scale climate data and interpretation of empirical trends in the context of two climate change phenomena: warming and the urban heat island effect. We demonstrate how small groups of students (n = 2 or 3) were empowered to independently download and analyze long-term temperature data to be aggregated into a class data set. Students used the National Centers for Environmental Information (NCEI) to find the long-term data sets of hourly maximum (TMAX) and minimum (TMIN) temperatures. Students used the open-source statistical software R to manage and summarize data. Students also examined changes in land use cover using Google Earth satellite data to quantify whether stations were urban or rural. Students were assessed in their groups based on a research paper and a class presentation. Approaching climate change education from the inquiry-based learning perspective allows students to understand how scientific research is conducted, apply the scientific method, and experience firsthand the importance of opensource data. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case suggests using dual orexin receptor antagonists to treat alcohol use disorder and comorbid sleep disorders may be effective, commencing treatment in withdrawal and continuing it to prevent relapse. Effective medications for the treatment of alcohol use disorder are limited. This is partially due to the heterogenous nature of the symptomatology associated with alcohol use disorder and the abundance of presenting comorbidities. One common, and often overlooked, symptom that occurs during withdrawal of alcohol use is sleep disruption. Here, we report a case study of a participant with comorbid alcohol use disorder and insomnia. This participant was treated with a dual orexin receptor antagonist, suvorexant (Belsomra®), currently approved to treat insomnia. We demonstrate improvements in alcohol cravings, physical and psychological health, and sleep outcomes with treatment. These data support abundant preclinical and emerging clinical data in this space. The findings from this case report highlight the potential for suvorexant to treat comorbid alcohol use disorder and insomnia with fully powered, randomized controlled trials moving forward. [ABSTRACT FROM AUTHOR]

Objective: EDs are a common source of prescription opioids on discharge. We explored opioid prescribing practices in an ED at a tertiary hospital in Victoria, Australia. Methods: A retrospective audit over a 6 month period of patients discharged from the ED to the community with the maximum allowable quantities of prescription opioids. Results: There was a total of 3301 patient‐episodes discharged with a prescription from the ED. Of these, 766 (23.2%, 95% confidence interval [CI] 21.8–24.6) were prescribed opioids, with over half discharged with the maximum allowable quantities of prescription opioids. Immediate‐release opioids were prescribed in 362 (85.8%, 95% CI 82.5–89.1) patient‐episodes, a combination of immediate‐release and slow‐release preparations were prescribed in 29 (6.9%, 95% CI 4.5–9.3) and 31 (7.3%, 95% CI 4.8–9.8) were prescribed as slow‐release opioids alone. Co‐prescription of other analgesia with opioids occurred in 152 (36.0%, 95% CI 31.4–40.6) patient‐episodes. Possible drug interactions between opioids and other medications were noted in 117 (27.7%, 95% CI 23.4–32.0) patient‐episodes. Discharge summaries were prepared for 360 (85.3%, 95% CI 81.9–88.7) patient‐episodes, but only 171 (40.5%, 95% CI 35.8–45.2) included a plan to address the opioids, be that an opioid‐weaning regimen, analgesia review or referral to a pain specialist on discharge. Conclusion: Opioid prescribing was common in this ED, with almost one‐quarter of discharge prescriptions being for a prescription opioid. This audit highlights potential areas for practice improvement including review of the quantity of opioid tablets prescribed as well as an opioid plan on discharge from the ED. [ABSTRACT FROM AUTHOR]

Summary: Background: Clinical environments can be so stressful to medical students as to be detrimental to their learning and well‐being. Our intervention, Clinical Debrief, integrates learning through clinical experience with the development of positive coping strategies. Students shared cases and experiences during weekly small group classroom discussions, facilitated by general practitioners (from outside their current hospital placement), throughout two consecutive 12‐week blocks of their first clinical year. Alongside enquiry‐based and clinical reasoning learning, we gave students a safe space to reflect on their affect. Our aim was to critically examine students' views in Clinical Debrief. Method: Anonymised quantitative and qualitative evaluation data were collected over 3 years using online questionnaires on completion of each 12‐week block. The data relating to psychological supervision were analysed independently and in parallel, using thematic analysis for qualitative data. We aim to help students develop positive coping mechanisms, promoting empathy,self‐awarenessand wellbeing Results: A total of 1857 evaluations were extracted (response rate 67%). The median (interquartile range) overall rating for Clinical Debrief sessions was 9 (8–10), where 10 indicates 'excellent' and 1 indicates 'significant improvement needed'. The rating for the supervisory aspects of the sessions and free‐text comments were positive. Students appreciated safe environments, the session structure, facilitator role modelling, transitional support and processing of emotional experiences. Discussion: Mandatory integrated longitudinal supervision, using trained clinician facilitators, was positively received by students in transition to clinical placements. Normalising the emotional impact of medical work destigmatises distress. Linking clinical reasoning with affective state awareness to contextualise case management, following Mezirow's transformative learning theory, brings added benefit to learning and well‐being. Student demand for the expansion of Clinical Debrief is evidence of success. [ABSTRACT FROM AUTHOR]

Abstract Phenomenon : There is a paucity of research reporting the experiences of general practitioner clinical educators. Providing education for students could lead to better clinical skills and greater job satisfaction for the educator. However, it could also result in increased stress and mental fatigue, adding to what is an already pressured situation in the current primary care climate. Clinical Debrief is a model of case-based learning with integrated supervision developed to prepare medical students for clinical practice. This study aimed to explore the experiences of general practitioners who facilitate Clinical Debrief. Approach : Eight general practitioner educators with experience of facilitating Clinical Debrief participated in semi-structured qualitative interviews. Results were analyzed using Reflexive Thematic Analysis, and four main themes were developed. Findings : Themes included: Personal enrichment: psychological "respite" and wellbeing; Professional enrichment: Clinical Debrief as a "two-way" door; Becoming a facilitator: a journey; and, Relationships in teaching: blurred boundaries and multiple roles. Insights : Being a Clinical Debrief facilitator had a transformative impact on the personal and professional lives of the GPs who participated in this study. The implications of these findings for individual GPs, their patients, and the wider healthcare system, are discussed. [ABSTRACT FROM AUTHOR]

Objective: An important but neglected consequence of the AIDS pandemic that continues across sub-Saharan Africa is the phenomenon of child-headed households (CHH). This study aims to describe the challenges to health and well-being for young people living in child-headed households. Methods: A mixed-methods research approach linked common themes using qualitative and quantitative instruments to provide a broad picture of the location and challenges of CHH in Kabira, Kyotera and Kamuganja in the Rakai District of southern Uganda. Local knowledge was used to locate CHH. Results: 163 children living in 40 CHH were traced: 42·5% of the household heads were double orphans caring for younger siblings, and 43% were also caring for chronically ill or disabled grandparents who were economically unproductive and largely dependent on the eldest child for survival. It was found that those heading households were more likely not to attend school than children living at home with a parent. Their immediate needs ranged from food and shelter to health-care and education. Fear was a major theme: 38% of those interviewed reported fear of ‘violence’. Children as young as 13 were responsible for navigating through complex decision-making processes from everyday basic necessities to decisions on the health care of younger siblings and grandparents. Conclusion: Children and young people living in CHH are a largely invisible and highly vulnerable population. Clear, officially accepted definitions of CHH are a first step in recognising this vulnerable group for whom safeguards will be necessary as social work develops in lower- and middle-income countries (LMICs). The precise numbers of CHH are unknown and further examination of this undocumented group is needed. [ABSTRACT FROM AUTHOR]

This paper describes the use of a validated quality of life assessment tool (described elsewhere) to identify environmental and management factors that may affect quality of life in dogs kennelled in rehoming centres. Dogs were allocated to one of the four treatment groups, all of which had a positive (0.0–1.0) average quality of life score: long stay dogs with an enriched routine had a mean score of 0.477; long stay dogs with a standard routine had a mean score of 0.453; newly admitted dogs with an enriched routine had a mean score of 0.399; and newly admitted dogs with a standard routine had a mean score of 0.362. Only 2% of the dogs had a negative score (−1.0–0.0). Thirteen rehoming centre managers completed a questionnaire relating to the kennel environment and management practices of their rehoming centres. The environmental and management factors’ associations with quality of life scores, collected from 202 dogs from the 13 rehoming centres using this scoring system, were analysed as fixed factors in a linear mixed-effect model, with rehoming centre fitted as a random factor, and a multiple linear regression model. There was a statistically significant association between quality of life scores and rehoming centre ( H (12) = 54.153, p < 0.001), however, the fitted linear mixed-effect model did not improve upon the null model and therefore cannot be used to explain the 29% variance in quality of life scores attributed to rehoming centre. The multiple linear regression model explained 42% of the variation in quality of life scores ( F (10,131) = 9.318, p < 0.001): the provision of bunk beds increased quality of life scores by 0.3 ( t = 3.476, p < 0.001); provision of 30 min or more of staff or volunteer interaction increased scores by 0.26 ( t = −2.551, p = 0.012); grooming dogs decreased scores by 0.404 ( t = 3.326, p = 0.001); exercising dogs more than once a day decreased scores by 0.173 ( t = −3.644, p = <0.001), whereas exercising dogs for 30 min or more increased quality of life scores by 0.213 ( t = −2.374, p = 0.019) and the provision of less common types of exercise increased scores by 0.504 ( t = 5.120, p < 0.001); training dogs for 30 min or more every day increased scores by 0.688 ( t = 3.040, p = 0.003) and training dogs less than daily decreased scores by 0.393 ( t = −4.245, p < 0.001); feeding a diet of dry and wet food compared to dry food alone decreased scores by 0.08 ( t = −2.331, p = 0.021); and a quiet environment increased scores by 0.275 ( t = −3.459, p < 0.001). These results suggest that environmental design and kennel management have an impact on the quality of life of kennelled dogs and should be considered carefully in decision-making processes. However, further study may be required as grooming and exercising dogs more than once per day decreased quality of life scores, which are not obviously intuitive results. [ABSTRACT FROM AUTHOR]

There is currently no objective and validated quality of life assessment tool available to assess the quality of life of domestic dogs in kennels. This study aimed to develop a validated scoring system to assess the quality of life of dogs kennelled in rehoming centres. Objective animal-based measures of welfare and quality of life, identified from the scientific literature, were included in the scoring system to indicate negative and positive quality of life. Each item was scored using a binary system to minimise subjectivity in scoring. Dogs were recruited from 13 rehoming centres into four different treatment groups: group NS consisted of dogs that had newly arrived at the shelter and received a standard husbandry routine; group NE consisted of dogs that had newly arrived at the shelter and received an enrichment programme; group LS consisted of dogs that had been in the centre for more than 30 days and received a standard husbandry routine; and group LE consisted of dogs that had been in the shelter for more than 30 days and received an enrichment programme. Inter-observer reliability of each item was established and internal consistency of the entire score was assessed: seven unreliable items were removed and the scoring system was refined. 26.7% (ICC1 = 0.267) of the variation in quality of life scores was explained by rehoming centre group membership, and rehoming centre groups could reliably be differentiated in terms of quality of life scores (ICC2 = 0.832). Therefore, quality of life scores varied between rehoming centres but other factors must exist to explain the remaining 73.3% of the variation in quality of life scores. The addition of an enrichment programme and later recruitment onto the study increased quality of life scores by 0.035 ± 0.027 (SE) and 0.086 ± 0.027 (SE), respectively. These increases represent an 8.27% and a 20.33% improvement on the overall (across all treatment groups) mean QoL score (0.423). Evidence of good content, construct and criterion validity was established, however, internal consistency was found to be poor, indicating that the reliability of the score could be improved. [ABSTRACT FROM AUTHOR]

Abstract: Tissue damage may result in pain, inducing protective behaviour such as lameness. Because we cannot directly measure an animal's subjective experience, pain research and veterinary assessment rely on these behavioural indicators when quantifying pain. This assumes that pain expression is proportional to damage but this has not been tested in animals and ignores the possible effects of personality and coping style. First, we assessed whether lameness accurately predicted the severity of tissue damage, or whether there is variance in how “stoical” individuals are. An experienced equine veterinarian scored horses for lameness and then the severity of tissue damage using either x-ray or ultrasound during the course of normal diagnostics in a clinical setting. Contrary to assumptions, we found no relation between scores for lameness and severity. Consequently, “stoicism” was calculated as severity score minus lameness score. We tested hypotheses founded on previous work concerning how personality would be expected to link with stoicism and pain behaviour. Personality was quantified using a validated questionnaire, completed by owners. Owners also gave their subjective opinion on how tolerant the horse was to pain using a 1–5 likert scale. This is the first paper to assess the relationships between pain behaviour and personality in animals. We found that neuroticism is negatively related to “stoicism” whereas extroversion was positively related to levels of lameness, which may mean that pain in more easily identified in highly extrovert individuals. Future work to clarify these findings and their major implications for accurate assessment of damage and pain in animals are discussed. [Copyright &y& Elsevier]

Red squirrels (Sciurus vulgaris) declined in Great Britain and Ireland during the last century, due to habitat loss and the introduction of grey squirrels (Sciurus carolinensis), which competitively exclude the red squirrel and act as a reservoir for squirrelpox virus (SQPV). The disease is generally fatal to red squirrels and their ecological replacement by grey squirrels is up to 25 times faster where the virus is present. We aimed to determine: (1) the seropositivity and prevalence of SQPV DNA in the invasive and native species at a regional scale; (2) possible SQPV transmission routes; and, (3) virus degradation rates under differing environmental conditions. Grey (n = 208) and red (n = 40) squirrel blood and tissues were sampled. Enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qPCR) techniques established seropositivity and viral DNA presence, respectively. Overall 8% of squirrels sampled (both species combined) had evidence of SQPV DNA in their tissues and 22% were in possession of antibodies. SQPV prevalence in sampled red squirrels was 2.5%. Viral loads were typically low in grey squirrels by comparison to red squirrels. There was a trend for a greater number of positive samples in spring and summer than in winter. Possible transmission routes were identified through the presence of viral DNA in faeces (red squirrels only), urine and ectoparasites (both species). Virus degradation analyses suggested that, after 30 days of exposure to six combinations of environments, there were more intact virus particles in scabs kept in warm (25°C) and dry conditions than in cooler (5 and 15°C) or wet conditions. We conclude that SQPV is present at low prevalence in invasive grey squirrel populations with a lower prevalence in native red squirrels. Virus transmission could occur through urine especially during warm dry summer conditions but, more notably, via ectoparasites, which are shared by both species. [ABSTRACT FROM AUTHOR]

Simple Summary: Frustration is a negative emotional state implicated in a range of canine behaviour problems. The Canine Frustration Questionnaire (CFQ) is an owner questionnaire developed to measure frustration tendencies in dogs. This study looks at behavioural and physiological measures and their relationship with the CFQ. A series of tests were designed to induce frustration in dogs, and these were completed by 44 dogs; each dog owner completed a CFQ. Specific behavioural measures were coded from the test footage, and the relationships with the CFQ scores were assessed. In addition, a saliva sample was collected before and after the test in 39 dogs so that cortisol, a measure of physiological arousal, could be measured. Various behavioural test measures (e.g., vocalising and lunging) were associated with CFQ scores. Cortisol change and cortisol levels after the tests were greater in dogs who were more highly frustrated. These results support the use of owner report through the CFQ to measure frustration tendencies. Frustration is a negative emotional state implicated in a range of canine behaviour problems. The Canine Frustration Questionnaire (CFQ) is the first psychometric tool developed to assess frustration tendencies in dogs based on owner report. However, to date, no published studies have assessed behavioural and physiological correlates of this trait. A novel behaviour test battery was developed to induce frustration in dogs, mapping onto the CFQ. Forty-four dogs were recruited and filmed whilst undertaking the test battery, and a CFQ was completed by each owner. Targeted behavioural measures were assessed from this footage, based on hypotheses aimed at evaluating convergent and discriminant validity with facets of the CFQ. In addition, a saliva sample was collected pre- and post-testing for 39 dogs, and a cortisol assay performed using ELISA to provide a physiological measure of arousal. A range of predicted behavioural test measures (e.g., vocalising and lunging) positively correlated with CFQ scores. For 22 dogs with pre-test salivary cortisol levels of <4 ng/mL (indicative of normal arousal at baseline), cortisol change and post-test cortisol levels positively correlated with the CFQ PC5 'Frustration coping' score. These results provide further evidence of the validity of frustration tendencies as measured by owner report through the CFQ. [ABSTRACT FROM AUTHOR]

Abstract: Animals in groups behave cohesively, even when those animals are domesticated and are housed in limited environments. But how is such group cohesion maintained? Do animals move in an independent manner, according to their own motivations, or in a social manner, with respect to the movements of others? Here, we use a mathematical model to consider the contributions of social and independent factors in determining group cohesion in clustering hens. The model was based on observed data of singly housed laying hens with additional social attraction factors imposed. We examined the resulting group-cohesiveness when agents were homogenous or heterogeneous in: (i) their attraction towards group members (flockmates) and (ii) their attraction towards resources (food). Provided member agents had similar motivations, groups could maintain high levels of clustering when social attraction was weak. In modelled leader–follower groups, the likelihood of dispersal increased as motivational differences between members increased. Model-fit was tested against clustering observed in twelve replicates of small groups of laying hens housed in the same environment as the singly housed hens used to construct the model. Overall hen clustering most closely matched models of distributed leadership, where all group member agents were independently resource-motivated for the same resource: so hens flocked for food and not for flockmates. In space- or resource-limited environments many of the benefits of group living could be achieved through a combination of conspecific-tolerance and shared motivations, without need for leadership or consensus decision-making. [Copyright &y& Elsevier]

The use of models in the life sciences has greatly expanded in scope and advanced in technique in recent decades. However, the range, type and complexity of models used in farm animal welfare is comparatively poor, despite the great scope for use of modeling in this field of research. In this paper, we review the different modeling approaches used in farm animal welfare science to date, discussing the types of questions they have been used to answer, the merits and problems associated with the method, and possible future applications of each technique. We find that the most frequently published types of model used in farm animal welfare are conceptual and assessment models; two types of model that are frequently (though not exclusively) based on expert opinion. Simulation, optimization, scenario, and systems modeling approaches are rarer in animal welfare, despite being commonly used in other related fields. Finally, common issues such as a lack of quantitative data to parameterize models, and model selection and validation are discussed throughout the review, with possible solutions and alternative approaches suggested. [ABSTRACT FROM AUTHOR]

Highlights: [•] We test validity of a subjective assessment against a battery of behaviour tests in horses. [•] Subjective personality assessment can predict behaviour. [•] Combining objective behaviour testing and subjective questionnaire outlines complex suites of behaviour. [•] We found novel evidence for coping style in horses. [Copyright &y& Elsevier]

It is often suggested that stereotypic behaviour represents a coping response to suboptimal environmental conditions. However, individuals of many species show different coping styles depending on their personality type. Therefore, personality is an important consideration when investigating why only certain individuals become stereotypic under suboptimal conditions. Thus, the aim of this review is to explore the possibility that personality, in particular coping style, may explain why certain individuals are predisposed to stereotypy. We review behavioural and physiological similarities between proactive and stereotypic individuals and suggest that they may in fact be the same phenotype. We also explore how these characteristics might predispose proactive individuals to stereotypy and how this is triggered by the environment. We conclude that personality factors relating to proactivity may mediate whether an animal expresses stereotypic behaviour and that the alternative strategy in such conditions is depression and emotional blunting. We conclude by outlining the animal welfare implications if this hypothesis is correct. [ABSTRACT FROM AUTHOR]

Abstract: Behavioural synchrony has been a popular topic of research in group living animals, but has so far lacked a standard approach. Previous studies have varied greatly in the number of behavioural states they have considered and the size of groups investigated. Here, a model of behavioural synchrony was used to test four measures of synchrony commonly used (proportion observations 100% conforming, mean proportion of conforming individuals, Ruckstuhl''s group mean and the kappa coefficient). The model used scan samples of the behaviour of laying hens, originally categorised in 10 different behavioural states, as a basis for determining the agents’ probability of performing behaviour states. We systematically varied the group size and the number of behavioural states in the model. The measures calculated from the behaviour of the model agents were compared against a synchrony factor that determined the ‘motivation’ of agents in the model to conform to the behaviour of other agents, for model runs with different group sizes and behavioural categories. The results of the model suggest that, of the measures considered, the kappa coefficient is the most suitable measure of synchrony. The kappa coefficient was the only measure of the four tested to control for expected levels of synchrony. Expected levels of synchrony are sensitive to both the number of behaviour states being examined and the size of the group, therefore observed levels of synchrony should be compared against expected levels to provide meaningful standardised measures. [Copyright &y& Elsevier]

The issue of inherited disorders in pedigree dogs is not a recent phenomenon and reports of suspected genetic defects associated with breeding practices date back to Charles Darwin's time. In recent years, much information on the array of inherited defects has been assimilated and the true extent of the problem has come to light. Historically, the direction of research funding in the field of canine genetic disease has been largely influenced by the potential transferability of findings to human medicine, economic benefit and importance of dogs for working purposes. More recently, the argument for a more canine welfare-orientated approach has been made, targeting research efforts at the alleviation of the most suffering in the greatest number of animals. A method of welfare risk assessment was initially developed as a means of objectively comparing, and thus setting priorities for, different welfare problems. The method has been applied to inherited disorders in pedigree dogs to investigate which disorders have the greatest welfare impact and which breeds are most affected. Work in this field has identified 396 inherited disorders in the top 50 most popular breeds in the UK. This article discusses how the results of welfare risk assessment for inherited disorders can be used to develop strategies for improving the health and welfare of dogs in the long term. A new risk assessment criterion, the Breed-Disorder Welfare Impact Score (BDWIS), which takes into account the proportion of life affected by a disorder, is introduced. A set of health and welfare goals is proposed and strategies for achieving these goals are highlighted, along with potential rate-determining factors at each step. [ABSTRACT FROM AUTHOR]

Abstract: Moored sediment traps were deployed from January 2004 through December 2007 at depths of 550 and 800m in San Pedro Basin (SPB), CA (33°33.0′N, 118°26.5′W). Additionally, floating sediment traps were deployed at 100 and 200m for periods of 12–24h during spring 2005, fall 2007, and spring 2008. Average annual fluxes of mass, particulate organic carbon (POC), δ13Corg, particulate organic nitrogen (PON), δ15N-PON, biogenic silica (bSiO2), calcium carbonate (CaCO3), and detrital material (non-biogenic) were coupled with climate records and used to examine sedimentation patterns, vertical flux variability, and organic matter sources to this coastal region. Annual average flux values were determined by binning data by month and averaging the monthly averages. The average annual fluxes to 550m were 516±42mg/m2 d for mass (sdom of the monthly averages, n=117), 3.18±0.26mmolC/m2 d for POC (n=111), 0.70±0.05mmol/m2 d for CaCO3 (n=110), 1.31±0.21mmol/m2 d for bSiO2 (n=115), and 0.35±0.03mmol/m2 d for PON (n=111). Fluxes to 800 and to 550m were similar, within 10%. Annual average values of δ13Corg at 550m were −21.8±0.2‰ (n=108), and δ15N averages were 8.9±0.2‰ (n=95). The timing of both high and low flux particle collection was synchronous between the two traps. Given the frequency of trap cup rotation (4–11 days), this argues for particle settling rates ≥83m/d for both high and low flux periods. The moored traps were deployed over one of the wettest (2004–2005, 74.6cm rainfall) and driest (2006–2007, 6.6cm) rain years on record. There was poor correlation (Pearson''s correlation coefficient, 95% confidence interval) of detrital mass flux with: Corg/N ratio (r=0.10, p=0.16); δ15N (r=−0.19, p=0.02); and rainfall (r=0.5, p=0.43), suggesting that runoff does not immediately cause increases in particle fluxes 15km offshore. δ13Corg values suggest that most POC falling to the basin floor is marine derived. Coherence between satellite-derived chlorophyll a records from the trap location (±9km2 resolution) and SST data indicates that productivity and export occurs within a few days of upwelling and both of these parameters are reasonable predictors of POC export, with a time lag of a few days to 2 weeks (with no time lag—SeaWiFS chlorophyll a and POC flux, r=0.25, p=0.0014; chlorophyll a and bSiO2 flux, r=0.28, p=0.0002). [Copyright &y& Elsevier]

Abstract: Laying hens generally choose to aggregate, but the extent to which the environments in which we house them impact on social group dynamics is not known. In this paper the effect of pen environment on spatial clustering is considered. Twelve groups of four laying hens were studied under three environmental conditions: wire floor (W), shavings (Sh) and perches, peat, nestbox and shavings (PPN). Groups experienced each environment twice, for five weeks each time, in a systematic order that varied from group to group. Video recordings were made one day per week for 30 weeks. To determine level of clustering, we recorded positional data from a randomly selected 20-min excerpt per video (a total of 20min×360 videos analysed). On screen, pens were divided into six equal areas. In addition, PPN pens were divided into an additional four (sub) areas, to account for the use of perches (one area per half perch). Every 5s, we recorded the location of each bird and calculated location use over time, feeding synchrony and cluster scores for each environment. Feeding synchrony and cluster scores were compared against unweighted and weighted (according to observed proportional location use) Poisson distributions to distinguish between resource and social attraction. Clustering was greater than expected in all environments under both weighted and unweighted distribution assumptions. In all environments, singleton hens were observed less than expected, and groups of two or more were observed in the feeding location more than expected in an unweighted distribution. In conclusion, it was found that hens in all environments clustered; however clustering appeared to result from resource-use rather than social cohesion. [ABSTRACT FROM AUTHOR]

Abstract: Unlike several other farm animal species, the broiler chicken remains unprotected by species-specific legislation. The densities at which broilers should be kept is a highly contentious issue—some studies have demonstrated increased welfare problems at higher densities, whilst a few others have, contrary to expectations, suggested that broilers may actually find crowds of other birds attractive. A tracking method was developed and used to provide an insight into the social preferences of commercial broiler chickens in situ—inside commercial, closed-system broiler houses. The aim was to simultaneously assess the relative impact of global measures of density, such as target and actual stocking densities and local measures of the social environment on the behaviour and route taken to feed by focal birds. Birds were tracked inside 20 commercial broiler houses across the UK. Results from this study show that stocking density per se seems to have little direct effect on the individual behaviours of focal broiler chickens. However, there may still be an indirect effect of stocking density on broiler behaviour, mediated through the local social environment. [Copyright &y& Elsevier]

The article discusses the Black Arts and Feminist Art Movements in the United States under various dimensions. The supporters of these black power and the Feminist Movements in the 1960s and the 1970s tried to create a world where they would be safe and influential. However, these participants tried various ways to pursue their goals. The activists of both these movements considered that their goal was to defeat their opponents such as the Black power activists tried to overpower the "White supremacy," and the feminist activists aimed to overthrow the "Male supremacy." These two movements shared some similarities during their struggle including their traits, strategies and goals. According to activist and writer Audre Lorde, there is a pretense to homogeneity of experience covered by the word sisterhood, which in fact does not exist.

Examines the Afro-American visual arts which involve the people, land and culture of the South Carolina and Georgia Sea Islands. Relationships between art, anthropology and history; Metanarratives of loss and invention; Participation of female cultural workers in the search for cultural origins and legacies; Project by Martha Jackson-Jarvis that goes looking for a usable past along the southeastern coast.

Presents information on a study conducted in an attempt to develop a self-report measure of spontaneity. Assessment of spontaneity; Methodology of the study; Discussion on the results.

Introduction: This phase I open-label study examined pharmacokinetics, safety, and tolerability of escalating doses of a novel combination cannabinoid medication (1:1 tetrahydrocannabinol [THC]/cannabidiol [CBD]) in patients with chronic non-cancer pain (CNCP) on high dose opioid analgesia. Methods: Nine people with CNCP and oral morphine equivalent daily dose of 60 mg or higher were recruited. Blood concentrations of THC, 11-hydroxytetrahydrocannabinol (OH-THC), 11-nor-9-carboxy-tetrahydrocannabinol (COOH-THC), and CBD were assayed weekly. Concentrations were measured after a single dose of 2.5 mg THC/2.5 mg CBD on day 1, and daily escalating doses up to a single dose of 12.5 mg THC/12.5 mg CBD on day 29. Follow-up was on day 36 after a 7-day washout. Secondary outcome data encompassed pain, mood, and sleep parameters. Results: The parent compounds THC, and CBD, and metabolites OH-THC and COOH-THC were detected at most time points. In general, the concentration of all analytes increased until 2 h post-administration, decreasing to approximately pre-dose concentrations by 8 h. There was considerable inter- and intra-individual variability. The study medication was well tolerated. Eight participants reported at least one adverse event (AE), with a total of 62 AEs; most common were euphoric mood, headache, and agitation, none classified as severe. There was no significant change to pain severity self-ratings, nor use of pain medications. Improvements in pain interference scores, mood, and some sleep parameters were observed. Conclusion: The THC/CBD formulation was tolerated well in a group of patients with CNCP. Between-participant variability supports personalized dosing and "start low–go slow" titration. To validate and quantify improvements in secondary efficacy outcomes a randomized placebo-controlled study is needed. Trial Registration: Australian New Zealand Clinical Trials Register (CT-2019-CTN-01224-1). Plain Language Summary: Many studies use healthy volunteers when they look at the way medicines are absorbed in the body and their clinical effects. The aim of this project was to examine a new formulation of medicinal cannabis in people who have chronic pain and other health conditions to help us to plan a larger study. We wanted information on how quickly it was absorbed and whether there were any negative effects of the medicine. We wondered whether the fact that participants were on a number of other medications might mean that we see different results to those seen with healthy volunteers. We found that the results of our group were very similar to those seen in other studies. Although we only tested a small number of participants we did not observe serious negative effects of the medication, and saw some positive effects on mood and sleep. We now have the data to assist us in planning a larger study which should provide important guidance to prescribers of medicinal cannabis in the future. [ABSTRACT FROM AUTHOR]

Presents an update on the second phase of the revised Moreno social atom test (MSAT-R). Standardization of the administration process of the MSAT-R; Modification of the visual/projective component of the MSAT-R; Results of testing on clinical and non-clinical populations.

The author reflects on the effort by animal welfare scientists and veterinarians to assess the quality of life (QoL) assessors for determining animal health and welfare status. She suggests the main purpose of QoL assessment tools. He also explores a study by Dr. Robert Lavan, published in this issue, which assessed QoL in healthy dogs using the information provided by their owners.

Background: To understand patterns of opioid prescribing on discharge in the orthopaedic and neurosurgical wards of a tertiary metropolitan hospital. Methods: A retrospective audit of medical records and discharge summaries for all orthopaedic and neurosurgical patients admitted for at least 2 days on two surgical wards over a 6‐month period between 1 January and 30 June 2017. Results: A combined total of 355 patients (281 orthopaedic and 74 neurosurgical patients) were included in the audit. Approximately 82% were discharged on opioids. Of patients discharged on opioids, 71.4% of the orthopaedic group and 73.8% of the neurosurgical group were discharged on combinations of two or more opioids (immediate release together with slow release). Around 65% of the sample discharged on opioids was opioid naïve on admission. About 32.5% of the orthopaedic patients and 68.9% of the neurosurgical patients were discharged on a combination of opioid and other pharmacotherapy that could potentiate the central nervous system depressant effect of the opioids. Only 6.9% of orthopaedic patients and 11.5% of the neurosurgical patients had discharge summaries that included any reference to opioid management after discharge. Conclusion: Orthopaedic and neurosurgical units had high opioid prescribing rates on discharge from hospital. This highlights the need for clear communication of the intended medication management plan post‐discharge in order to minimize inappropriate and ongoing use of opioids post‐surgery. [ABSTRACT FROM AUTHOR]