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This article describes how, the authors, as members of an action research writing group, responded to a comment about feeling vulnerable in risking bringing their work-in-progress to the group and in giving feedback to colleagues by adopting a cooperative inquiry approach to explore vulnerability and risk in the group. In cooperative inquiry group members act as both co-researcher and co-subject in the inquiry and action. The article describes the evolution of the group and how the topic of exploring risk and vulnerability emerged. The group's exploration is grounded in the theory and practice of cooperative inquiry that gives voice to the group members questioning and reflecting. The article concludes by offering three propositions to enhance the work of writing groups.

Racial microaggressions, or subtle race-based insults are associated with negative consequences for receivers. Institutional racism in education directly influences the dissemination of these transgressions in schools, as school personnel may engage in microaggressive behavior toward each other and their students. Given recent calls to address racism, schools and districts may seek to implement trainings to improve school personnel's understanding of these transgressions and their consequences. As part of the current study, we explored factors that might contribute to school personnel's satisfaction with a microaggression training. Participants completed survey items to assess their colorblind racial attitudes, satisfaction with the workshop, and their perceptions surrounding the need for such trainings. We found that colorblind attitudes and perceptions of necessity predicted satisfaction. Implications and future directions for research are discussed. Impact Statement: Calls to address racial injustice in response to the murders of George Floyd and Breonna Taylor during the summer of 2021 have produced an increase in requests for antiracism workshops and trainings across several organizations and professions. In K-12 schools, these trainings may be beneficial in helping school personnel learn about and address racial microaggressions (race-based insults), which may hinder students' success. Although it is imperative that these conversations take place, it is equally important that we are able to understand how school personnel engage in these trainings to increase the likelihood that their behavior will change because of participation. The goal of this study was to understand factors that contribute to school personnel's satisfaction with a microaggression training.

The current study investigated adolescents' (N = 213) decision finding processes and affective reactions to interactions on social media "via" 29 focus groups. As part of a larger study, adolescents participated in focus groups at two time-points across an academic year while participating in a school-based intervention promoting healthy romantic, interpersonal, and family relationships, job readiness, and financial literacy. Qualitative analyses indicated adolescents' experiences and decisions on social media platforms were informed by their "awareness of audiences", namely who they thought would view their posts and anticipated responses from "friends," "family members," "fans," "creeps," and "potential employers." Comprehensive school-based interventions may serve to effectively develop responsibility more broadly, as well as a specific awareness about online risks and behaviors.

Despite increased advocacy and investments in mental health systems globally, there has been limited progress in reducing mental disorder prevalence. In this paper, we argue that meaningful advancements in population mental health necessitate addressing the fundamental sources of shared distress. Using a systems perspective, economic structures and policies are identified as the potential cause of causes of mental ill-health. Neoliberal ideologies, prioritizing economic optimization and continuous growth, contribute to the promotion of individualism, job insecurity, increasing demands on workers, parental stress, social disconnection and a broad range of manifestations well-recognized to erode mental health. We emphasize the need for mental health researchers and advocates to increasingly engage with the economic policy discourse to draw attention to mental health and well-being implications. We call for a shift towards a well-being economy to better align commercial interests with collective well-being and social prosperity. The involvement of individuals with lived mental ill-health experiences, practitioners and researchers is needed to mobilize communities for change and influence economic policies to safeguard well-being. Additionally, we call for the establishment of national mental wealth observatories to inform coordinated health, social and economic policies and realize the transition to a more sustainable well-being economy that offers promise for progress on population mental health outcomes. [phrase omitted] Malgre une meilleure sensibilisation et des investissements accrus dans A pesar del aumento de la promocion y las inversiones en sistemas de salud mental en todo el mundo, los avances en la reduccion de la prevalencia de los trastornos mentales han sido limitados. En este documento, sostenemos que para lograr avances significativos en la salud mental de la poblacion es necesario abordar las fuentes fundamentales de la angustia compartida. Mediante una perspectiva sistemica, las estructuras y politicas economicas se identifican como la posible causa de los problemas de salud mental. Las ideologias neoliberales, que priorizan la optimizacion economica y el crecimiento continuo, contribuyen al fomento del individualismo, la inseguridad laboral, el aumento de las exigencias a los trabajadores, el estres parental, la desconexion social y una gran variedad de manifestaciones bien reconocidas que perjudican la salud mental. Insistimos en la necesidad de que los investigadores y los defensores de la salud mental se impliquen cada vez mas en el discurso de la politica economica para atraer la atencion sobre las implicaciones para la salud mental y el bienestar. Pedimos un cambio hacia una economia del bienestar para alinear mejor los intereses comerciales con el bienestar colectivo y la prosperidad social. Para movilizar a las comunidades en favor del cambio e influir en las politicas economicas con el fin de salvaguardar el bienestar, es necesaria la participacion de personas que han padecido enfermedades mentales, profesionales e investigadores. Ademas, pedimos la creacion de observatorios nacionales de bienestar mental que sirvan de base a las politicas sanitarias, sociales y economicas coordinadas y permitan la transicion a una economia del bienestar mas sostenible, que ofrezca perspectivas de progreso en los resultados de salud mental de la poblacion. [phrase omitted] A pesar del aumento de la promocion y las inversiones en sistemas de salud mental en todo el mundo, los avances en la reduccion de la prevalencia de los trastornos mentales han sido limitados. En este documento, sostenemos que para lograr avances significativos en la salud mental de la poblacion es necesario abordar las fuentes fundamentales de la angustia compartida. Mediante una perspectiva sistemica, las estructuras y politicas economicas se identifican como la posible causa de los problemas de salud mental. Las ideologias neoliberales, que priorizan la optimizacion economica y el crecimiento continuo, contribuyen al fomento del individualismo, la inseguridad laboral, el aumento de las exigencias a los trabajadores, el estres parental, la desconexion social y una gran variedad de manifestaciones bien reconocidas que perjudican la salud mental. Insistimos en la necesidad de que los investigadores y los defensores de la salud mental se impliquen cada vez mas en el discurso de la politica economica para atraer la atencion sobre las implicaciones para la salud mental y el bienestar. Pedimos un cambio hacia una economia del bienestar para alinear mejor los intereses comerciales con el bienestar colectivo y la prosperidad social. Para movilizar a las comunidades en favor del cambio e influir en las politicas economicas con el fin de salvaguardar el bienestar, es necesaria la participacion de personas que han padecido enfermedades mentales, profesionales e investigadores. Ademas, pedimos la creacion de observatorios nacionales de bienestar mental que sirvan de base a las politicas sanitarias, sociales y economicas coordinadas y permitan la transicion a una economia del bienestar mas sostenible, que ofrezca perspectivas de progreso en los resultados de salud mental de la poblacion., Introduction Mental health systems are under-resourced, fragmented, inefficient and unable to meet the demands of the growing burden of mental and substance use disorders. Despite the intensive advocacy and action [...]

Abstract Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged

This systematic review aims to describe six types of physical activity interventions utilized with children and young adults ages 5-22 as a treatment for ASD. These interventions include swimming, cycling, neuromuscular training, yoga, sports, and exergaming. This examines the knowledge gaps regarding the details of these interventions via time (sessions, per week, overall length), the severity of ASD in participants (using a 4-point scale), and the outcomes specific to ASD (cognition, social skills, physical fitness, and behavior). A systematic search of peer-reviewed research articles was conducted across five databases focusing on physical activity as an intervention for children and young adults with ASD. From an initial screening of 387 records, 29 of the studies were included in the review. The analysis includes types of intervention, dependent measures, research design, and intervention duration. Types of intervention most studied (swimming, cycling, neuromuscular training, yoga, sports, and exergaming) were further analyzed. All studies found that physical activity as an intervention, improved aspects of physical fitness (endurance, strength, balance), cognition, social skills (language, eye contact, engaging with others), and/or behavior.

Abstract Continued spread of chronic wasting disease (CWD) through wild cervid herds negatively impacts populations, erodes wildlife conservation, drains resource dollars, and challenges wildlife management agencies. Risk factors for CWD have been investigated at state scales, but a regional model to predict locations of new infections can guide increasingly efficient surveillance efforts. We predicted CWD incidence by county using CWD surveillance data depicting white-tailed deer (Odocoileus virginianus) in 16 eastern and midwestern US states. We predicted the binary outcome of CWD-status using four machine learning models, utilized five-fold cross-validation and grid search to pinpoint the best model, then compared model predictions against the subsequent year of surveillance data. Cross validation revealed that the Light Boosting Gradient model was the most reliable predictor given the regional data. The predictive model could be helpful for surveillance planning. Predictions of false positives emphasize areas that warrant targeted CWD surveillance because of similar conditions with counties known to harbor CWD. However, disagreements in positives and negatives between the CWD Prediction Web App predictions and the on-the-ground surveillance data one year later underscore the need for state wildlife agency professionals to use a layered modeling approach to ensure robust surveillance planning. The CWD Prediction Web App is at https://cwd-predict.streamlit.app/ .

Abstract Background The impact of social frailty on older adults is profound including mortality risk, functional decline, falls, and disability. However, effective strategies that respond to the needs of socially frail older adults are lacking and few studies have unpacked how social determinants operate or how interventions can be adapted during periods requiring social distancing and isolation such as the COVID-19 pandemic. To address these gaps, we conducted a scoping review using JBI methodology to identify interventions that have the best potential to help socially frail older adults (age ≥65 years). Methods We searched MEDLINE, CINAHL (EPSCO), EMBASE and COVID-19 databases and the grey literature. Eligibility criteria were developed using the PICOS framework. Our results were summarized descriptively according to study, patient, intervention and outcome characteristics. Data synthesis involved charting and categorizing identified interventions using a social frailty framework. Results Of 263 included studies, we identified 495 interventions involving ~124,498 older adults who were mostly female. The largest proportion of older adults (40.5%) had a mean age range of 70-79 years. The 495 interventions were spread across four social frailty domains: social resource (40%), self-management (32%), social behavioural activity (28%), and general resource (0.4%). Of these, 189 interventions were effective for improving loneliness, social and health and wellbeing outcomes across psychological self-management, self-management education, leisure activity, physical activity, Information Communication Technology and socially assistive robot interventions. Sixty-three interventions were identified as feasible to be adapted during infectious disease outbreaks (e.g., COVID-19, flu) to help socially frail older adults. Conclusions Our scoping review identified promising interventions with the best potential to help older adults living with social frailty.

One of the most straightforward and affordable ways to produce hydrogen is by alkaline water electrolysis. In order to split water molecules into hydrogen and oxygen, an electrolyser is often subjected to current levels of 1.23V. The electrodes in an electrolytic cell are the primary structural component. The cathode electrode type is the one where hydrogen is created via the reduction reaction between the two types of electrodes. LPG is combined with hydrogen at a 4:1 ratio to lower the combustion energy because hydrogen cannot be used directly in a traditional SI engine due to its higher energy production during combustion. With the aid of a vaporizer unit, the hydrogen and LPG are combined in the necessary ratio. Through the bypass line created on the input manifold before the carburettor, where air is also mixed with the hydrogen-LPG fuel with the A/F ratio of 17:1 (stoichiometric ratio) for complete combustion, the fuel mixture is transported to the engine's combustion chamber. Due to the usage of LPG and hydrogen, full combustion may occur as a result of the production of a blue flame during combustion. Better mixing of the fuel and air can be achieved since the fuel mixture is conveyed in va-por state instead of semi-liquid form as in a conventional SI engine. This approach of using mix fuel (LPG+H2) for con-ventional SI engines can lower nitrogen oxide and hydrocarbon values in the exhaust gas more effectively.

Introduction: Discrepancies between parental and child perceptions of problems and their therapeutic expectations can negatively impact mental health treatment efficacy. Aims: We sought to explore concordance and discrepancy in families receiving brief, client-centered, and strengths-based mental health services, specifically by contrasting parents’ and children’s perceptions of the child’s presenting issues; treatment expectations; and levels of concern pre- and post-treatment. We also examined the psychometric properties of a therapeutic scaling question on the level of concern, by examining associations with scores from the Strengths and Difficulties Questionnaire. Methods: Using a mixed-methods approach, we examined data from openand closed-ended questions, some used as part of the treatment. This included brief descriptions of perceived presenting issues and treatment expectations, and levels of concern on a scale of 1 to 10. Results: Parent and child descriptions of issues were judged generally congruent 66% of the time. Respectively, minor and major non-congruence was observed 25% and 9% of the time. In terms of treatment expectations, parents were more likely to express a desire to understand the issues and improve communication in the family. Children were more likely to express no expectancies or respond with simple statements (e.g., feel better). Parents initially rated their children’s problems as more severe than did their children. We found that the scaling question demonstrated a modest association with the level of concern from the Strength and Difficulties Questionnaire (SDQ). Conclusions: Even though most parents and their children broadly agree on presenting mental health issues for which they seek counseling, important differences manifest in how they perceive them and what they want accomplished during sessions. Practitioners need to consider, assess, and accommodate such discrepancies.

Abstract Background Retinopathy of prematurity (ROP) is a disease that affects preterm infants born younger than 30 weeks of gestation. The pathophysiology of ROP involves an initial vaso-obliterative phase followed by vaso-proliferative phase that leads to disease progression. The use of supplemental oxygen during the vaso-proliferative phase of ROP has been associated with reduced disease progression, but how this impacts the need for ROP treatment is unclear. The goal of this study was to compare the rate of laser or intravitreal bevacizumab after implementation of a new supplemental oxygen therapy protocol in preterm infants with stage 2 ROP. Methods This is a retrospective chart review of preterm infants diagnosed with stage 2 ROP at Riley Hospital for Children between 1/2017 and 12/2022. Patients diagnosed between 1/2017 and 6/2020 were classified as Cohort A, preprotocol implementation. Patients diagnosed from 8/2020 to 12/2022 were classified as Cohort B, postprotocol implementation. In Cohort A, oxygen saturation was kept at 91-95% through the entire hospitalization. In Cohort B, oxygen saturation was increased to 97–99% as soon as Stage 2 ROP was diagnosed. Statistical analyses were performed using chi-square and Student’s T test, followed by multivariate analyses to determine the impact of the oxygen protocol on the need for ROP treatment. Results A total of 211 patients were diagnosed with stage 2 ROP between 1/2017 and 12/2022. Of those patients, 122 were before protocol implementation therapy (Cohort A), and 89 were after implementation of supplemental oxygen protocol (Cohort B). Gestational age was slightly higher in Cohort B (Cohort A 25.3 ± 1.9, Cohort B 25.8 ± 1.84, p = 0.04). There was no difference in birth weight, NEC, BPD, or survival. Cohort B had lesser need for invasive mechanical ventilation and higher days on CPAP during hospitalization. Notably, Cohort A had 67 (55%) patients treated with laser photocoagulation or intravitreal bevacizumab versus 20 (22%) patients in Cohort B (OR 0.19, 0.08–0.40). Conclusion The need for laser photocoagulation or intravitreal bevacizumab was significantly decreased in high-risk patients treated with the supplemental oxygen protocol. This result supports the idea that targeted supplemental oxygen therapy to keep saturations between 97 and 99% can reduce disease progression in infants with stage 2 ROP and potentially decrease the burden of additional procedures.

Abstract Objectives The objective of this study was to conduct a formative evaluation of the Art Your Service (AYS) arts-based program to determine the program’s potential for improving the social and physical well-being of older adults during the COVID-19 pandemic. Design, settings and participants An online questionnaire was administered to the AYS members who consented to be invited to participate in the study. Questionnaire items consisted of a Likert scale and open-ended questions delivered using an online platform (SurveyMonkey). Participants provided feedback on their perceptions and experiences of the AYS program, such as its impact on their health and well-being during the COVID-19 pandemic, the benefits and challenges of participating, and any suggestions for program improvement. Outcome measures and analysis Quantitative data were analyzed using descriptive statistics (frequencies, means with standard deviations), and open-ended questions (qualitative data) were analyzed using content analysis. Outcomes included participant demographics, perceptions about the program, usability (System Usability Scale [SUS]), eHealth literacy (eHealth Literacy Scale), and social isolation (Lubben Social Network Scale; LSNS-6). Results Program participants revealed consistent patterns of their perceptions and experiences about the program, including a high satisfaction rate (95%) and a perceived positive impact on participants’ health and well-being. The program sessions were perceived to be a well-organized, convenient, and safe way to engage with one another socially during the COVID-19 pandemic. The program usability was also perceived to be high (SUS mean score 86.2). Participants felt a sense of connectedness and had reduced feelings of social isolation. Most participants (75%) reported that the program improved their physical health. Conclusions Findings from this formative evaluation study identified key strengths and opportunities to improve the Art Your Service arts-based program, which can be used to help enhance the program’s functioning and long-term sustainability potential.

Abstract Background Diabetic cardiomyopathy (DCM) is a serious health-threatening complication of diabetes mellitus characterized by myocardial fibrosis and abnormal cardiac function. Human umbilical cord mesenchymal stromal cells (hUC-MSCs) are a potential therapeutic tool for DCM and myocardial fibrosis via mechanisms such as the regulation of microRNA (miRNA) expression and inflammation. It remains unclear, however, whether hUC-MSC therapy has beneficial effects on cardiac function following different durations of diabetes and which mechanistic aspects of DCM are modulated by hUC-MSC administration at different stages of its development. This study aimed to investigate the therapeutic effects of intravenous administration of hUC-MSCs on DCM following different durations of hyperglycemia in an experimental male model of diabetes and to determine the effects on expression of candidate miRNAs, target mRNA and inflammatory mediators. Methods A male mouse model of diabetes was induced by multiple low-dose streptozotocin injections. The effects on severity of DCM of intravenous injections of hUC-MSCs and saline two weeks previously were compared at 10 and 18 weeks after diabetes induction. At both time-points, biochemical assays, echocardiography, histopathology, polymerase chain reaction (PCR), immunohistochemistry and enzyme-linked immunosorbent assays (ELISA) were used to analyze blood glucose, body weight, cardiac structure and function, degree of myocardial fibrosis and expression of fibrosis-related mRNA, miRNA and inflammatory mediators. Results Saline-treated diabetic male mice had impaired cardiac function and increased cardiac fibrosis after 10 and 18 weeks of diabetes. At both time-points, cardiac dysfunction and fibrosis were improved in hUC-MSC-treated mice. Pro-fibrotic indicators (α-SMA, collagen I, collagen III, Smad3, Smad4) were reduced and anti-fibrotic mediators (FGF-1, miRNA-133a) were increased in hearts of diabetic animals receiving hUC-MSCs compared to saline. Increased blood levels of pro-inflammatory cytokines (IL-6, TNF, IL-1β) and increased cardiac expression of IL-6 were also observed in saline-treated mice and were reduced by hUC-MSCs at both time-points, but to a lesser degree at 18 weeks. Conclusion Intravenous injection of hUC-MSCs ameliorated key functional and structural features of DCM in male mice with diabetes of shorter and longer duration. Mechanistically, these effects were associated with restoration of intra-myocardial expression of miRNA-133a and its target mRNA COL1AI as well as suppression of systemic and localized inflammatory mediators.

Abstract Reef cores are a powerful tool for investigating temporal changes in reef communities. Radiometric dating facilitates the determination of vertical accretion rates, which has allowed for examination of local-regional controlling factors, such as subsidence and sea level changes. Coral reefs must grow at sufficient rates to keep up with sea level rise, or risk ‘drowning.’ As sea level is expected to rise significantly in the next 100 years and beyond, it is important to understand whether reefs will be able to survive. Historical records of reef accretion rates extracted from cores provide valuable insights into extrinsic controlling factors of reef growth and are instrumental in helping predict if future reefs can accrete at rates needed to overcome predicted sea level changes. While extensive research exists at local and regional scales, limited attention has been given to identifying global patterns and drivers. To address this, we present “RADReef”: A global dataset of dated Holocene reef cores. RADReef serves as a foundation for further research on past, present and future reef accretion.