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Background: The mental health and wellbeing of care-experienced children and young people (i.e. foster care, kinship care, residential care) is poorer than non-care-experienced populations. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise the international evidence base for interventions targeting subjective wellbeing, mental health and suicide amongst care-experienced young people aged ≤ 25 years. Methods: For the first phase of the review, we constructed an evidence map identifying key clusters and gaps in interventions and evaluations. Studies were identified through 16 electronic databases and 22 health and social care websites, in addition to expert recommendations, citation tracking and screening of relevant systematic reviews. We charted interventions and evaluations with a summary narrative, tables and infographics. Results: In total, 64 interventions with 124 associated study reports were eligible. The majority of study reports were from the USA (n = 77). Interventions primarily targeted children and young people's skills and competencies (n = 9 interventions), the parental functioning and practices of carers (n = 26), or a combination of the two (n = 15). While theoretically under-specified, interventions were largely informed by theories of Attachment, Positive Youth Development, and Social Learning Theory. Current evaluations prioritised outcomes (n = 86) and processes (n = 50), with a paucity of study reports including theoretical descriptions (n = 24) or economic evaluations (n = 1). Interventions most frequently targeted outcomes related to mental, behavioural or neurodevelopmental disorders, notably total social, emotional and behavioural problems (n = 48 interventions) and externalising problem behaviours (n = 26). There were a limited number of interventions targeting subjective wellbeing or suicide-related outcomes. Conclusions: Future intervention development might focus on structural-level intervention theories and components, and target outcomes related to subjective wellbeing and suicide. In accordance with current methodological guidance for intervention development and evaluation, research needs to integrate theoretical, outcome, process and economic evaluation in order to strengthen the evidence base. Systematic review registration: PROSPERO CRD42020177478. [ABSTRACT FROM AUTHOR]

• Care-experienced young people experience high levels of mental health problems. • System resources, cultures and stakeholder values, impact interventions. • Care-experienced young people valued meaningful relationships in interventions. • Carers felt interventions often overlooked their expertise and experiences. • Future interventions should support carers' time and emotional commitment. The mental health and well-being of care-experienced children and young people remains a concern. Despite a range of interventions, the existing evidence base is limited in scope, with a reliance on standalone outcome evaluations which limits understanding of how contextual factors influence implementation and acceptability. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise evidence of intervention theory, outcome, process and economic effectiveness. This paper reports the process evaluation synthesis, exploring how system factors facilitate and inhibit implementation and acceptability of mental health and wellbeing interventions for care-experienced children and young people. Sixteen databases and 22 websites were searched between 2020 and 2022 for studies published from 1990 and May 2022. This was supplemented with contacting experts in the field, citation tracking, screening of relevant systematic reviews and stakeholder consultations. We drew on framework synthesis of qualitative data and incorporated a systems lens, taking account of contextual influences across socio-ecological domains. Quality appraisal assessed reliability and usefulness. Confidence in synthesised findings was assessed with the GRADE-CERQual tool. We report the review in accordance with relevant elements of both the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) checklist. Searches retrieved 15,068 unique study reports, and 23 of these were eligible for process evaluation synthesis, reporting on sixteen interventions. Studies were published between 2003 and 2021. Nine interventions were from the UK and Ireland, six interventions were from the USA, and one was from Australia. They were largely classified as interpersonal, where the aim was to modify carer-child relationships. Five key context factors were identified that supported and prohibited intervention delivery: (1) lack of system resources; (2) intervention burden, which encompasses the time, cognitive, and emotional burden associated with implementation and participation; (3) interprofessional relationships between health and social care professionals; (4) care-experienced young people's identity; and (5) carer identity. We identified several supportive and restrictive factors across social and health care systems that may impact intervention implementation and acceptability. Key implications include: the importance of involving diverse stakeholders in intervention development and delivery; the need to better resource and support those involved in interventions, particularly training and support for carers; and ensuring future evaluations integrate process evaluations in order to optimise interventions. [ABSTRACT FROM AUTHOR]

Background/objectives: Influenza is associated with significant morbidity and mortality, particularly for older adults. Persistent functional decline following hospitalization has important impacts on older adults' wellbeing and independence, but has been under‐studied in relation to influenza. We aimed to investigate persistent functional change in older adults admitted to hospital with influenza and other acute respiratory illness (ARI). Design: Protective observational cohort study. Setting: Canadian Immunization Research Network Serious Outcomes Surveillance Network 2011 to 2012 influenza season. Participants: A total of 925 patients aged 65 and older admitted to hospital with influenza and other ARI. Measurements: Influenza was laboratory‐confirmed. Frailty was measured using a Frailty index (FI). Functional status was measured using the Barthel index (BI); moderate persistent functional decline was defined as a clinically meaningful loss of ≥10 to <20 points on the 100‐point BI. Catastrophic disability (CD) was defined as a loss of ≥20 points, equivalent to full loss of independence in two basic activities of daily living. Results: Five hundred and nineteen (56.1%) were women; mean age was 79.4 (standard deviation=8.4) years. Three hundred and forty‐six (37.4%) had laboratory‐confirmed influenza. Influenza cases had lower baseline function (BI = 77.0 vs 86.9, P <.001) and higher frailty (FI = 0.23 vs 0.20, P <.001) than those with other ARI. A total of 8.4% died, 8.2% experienced persistent moderate functional decline, and 9.9% experienced CD. Higher baseline frailty was associated with increased odds of experiencing functional decline, CD, and death. The experience of functional decline and CD, and its association with frailty, was the same for influenza and other ARI. Conclusion: Functional loss in hospital is common among older adults; for some this functional loss is persistent and catastrophic. This highlights the importance of prevention and optimal management of acute declines in health, including influenza, to avoid hospitalization. In the case of influenza, for which vaccines exist, this raises the potential of vaccine preventable disability. [ABSTRACT FROM AUTHOR]

Self‐harm in young people remains a significant concern. Studies of emergency departments have centred on negative professional attitudes. There has been limited interrogation and theorisation of what drives such attitudes, and the contexts that sustain them. Adopting a complex systems lens, this study aimed to explore how systems shape professional and patient interactions. It draws upon interviews with healthcare and affiliated professionals (n = 14) in a UK case study hospital, with primary focus on the emergency department. Data were analysed using a thematic approach and the principles of grounded theory. Four themes emerged, with the first three centralising how professionals' practices operate within: (1) a framework of risk management; (2) expectations of progressing patients through the care pathway; and (3) a culture of specialist expertise, with resulting uncertainty about who is responsible for self‐harm. The fourth theme considers barriers to system change. A small number of participants described efforts to enact positive modifications to practices, but these were frustrated by entrenched system structures. The potential detrimental impacts for patient care and professional wellbeing are considered. Future practice needs systemic action to support professionals in treating patients experiencing self‐harm, while future research requires more ethnographic explorations of the complex system in situ. [ABSTRACT FROM AUTHOR]

Rates of hospital presentation for self-harm have increased in recent years, and although clinical practice guidelines on clinical provision prioritize positive patient experiences, the quality of provision remains variable. This systematic review provides an updated and extended synthesis of qualitative research on the following: (a) patients' experiences of treatment following presentation to hospital; and (b) patients' perceptions of the impact of treatment on recurrent self-harm and/or suicidal ideation, and future help-seeking. Twenty-six studies were identified for inclusion in the final synthesis. Three meta-themes emerged: (a) individuals undertake extensive identity work when presenting with self-harm, navigating the process of becoming a patient, and negotiating the type of patient they want to be; (b) care ranges from gentle to hostile, with care at admission and discharge being particularly disorientating; and (c) negative experiences of clinical treatment may increase future self-harm. Emerging research gaps include the need for further theoretically informed qualitative research in this area. [ABSTRACT FROM AUTHOR]

Using fine-scale panel data and an econometric model, we predict land use change in the Midwestern United States if a new bioenergy crop, Miscanthus × Giganteus (miscanthus), is introduced. To explain farmers' current crop choices, we use a local, limited dependent variable regression based on soil and weather characteristics. To this model, we add miscanthus as a new crop, based on its place dependent BioCro model-predicted yield. We find that the vast majority of land used to grow miscanthus will come from land now used for non-major crops, pasture, woodland, and other uses. This implies that miscanthus can help mitigate climate change by displacing oil usage without causing food conflict. [ABSTRACT FROM AUTHOR]

Few studies have assessed the risk of adverse pregnancy outcomes in women with multiple sclerosis (MS). We used 2 large US administrative databases, the Truven Health MarketScan Database (2011–2015; Truven Health Analytics Inc. Ann Arbor, Michigan) and the Nationwide Inpatient Sample (2007–2011), to identify delivery cohorts. MS and pregnancy outcomes (infections, cesarean delivery, preterm delivery, poor fetal growth, preeclampsia, chorioamnionitis, postpartum hemorrhage, stillbirth, and infant malformations) were identified during pregnancy and at delivery. We calculated adjusted risk ratios according to MS status and relapse(s) in the year before delivery. Among over 5 million pregnancies, we identified 3,875 pregnancies in women with MS. Women with MS had an increased risk of infections during pregnancy (Truven Health: adjusted risk ratio (aRR) = 1.22, 95% confidence interval (CI): 1.16, 1.27) and preterm delivery (Truven Health: aRR = 1.19 (95% CI: 1.04, 1.35); Nationwide Inpatient Sample: aRR = 1.30 (95% CI: 1.16, 1.44)). The risks of other outcomes were similar for women with and without MS. In the Truven Health database, risk ratios for the pregnancy outcomes in women experiencing relapses versus those without relapses were between 0.9 and 1.4, and confidence intervals overlapped the null. Overall, women with MS had an increased risk of infections and preterm delivery; however, their risks for other adverse pregnancy outcomes were not elevated. Disease activity before delivery was not a strong predictor of outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Potential merits of a social practice perspective for examining the meanings and dynamics of family food include moving beyond individual behaviour, and exploring how practices emerge, develop and change. However, researchers have struggled to encourage reflection on mundane practices, and how to understand associated meanings. Drawing on a study of families in South Wales, this article reflects on the value of the diary‐interview approach in addressing these methodological challenges, and aims to explore and understand the dynamics of control across family contexts. Contemporary practice theories distinguish between practices as ‘performances’ and practices as ‘entities’ and the diary‐interview method facilitated an examination of these dimensions. Detailed accounts of daily ‘performances’ (through diaries), alongside reflection on underlying contexts and ‘entities’ (through interviews), illustrated the entanglement of control, practices and context. The article adds further complexity to the concept of practice ‘bundles’ which facilitated an understanding of how food was interrelated with other practices – across family contexts and across generations. Sociological approaches with a practices perspective at the core, offer potential for developing public health interventions by acknowledging: the relational meaning of food; the embeddedness of food within everyday practices; and the need to consider interventions across a range of policy areas. [ABSTRACT FROM AUTHOR]

Background: Pre-existing conditions are imperfectly recorded in health care databases. We assessed whether pre-existing neurologic conditions (epilepsy, multiple sclerosis [MS]) were differentially recorded in the presence of major obstetric outcomes (Caesarean delivery, preterm delivery, preeclampsia) in delivery records. We also evaluated the impact of differential recording on measures of frequency and association between the conditions and outcomes.Methods: The 2011-2014 Truven Health MarketScan® Commercial Claims Dataset was used to identify pregnancies. We calculated the relative recording of epilepsy and MS at delivery hospitalization compared with a 270-day pre-delivery window both overall and by the presence of major obstetric outcomes. We estimated risk ratios for the association between epilepsy and MS with the outcomes for each ascertainment window.Results: We identified 909 065 pregnancies in women continuously enrolled from 270-days before the delivery date. Of women with epilepsy identified in the pre-delivery window, 73% had the condition coded at delivery. For MS, the proportion was 60%. MS recording at delivery did not vary by obstetric outcomes, however, delivery-coded epilepsy was less likely confirmed in the pre-delivery window in the presence of preeclampsia. Generally, the period of ascertainment did not meaningfully impact risk ratios, however, the risk ratio for preeclampsia associated with epilepsy was 1.67 (95% CI 1.47, 1.90) when epilepsy was ascertained at delivery and 1.26 (95% CI 1.07, 1.48) when epilepsy was ascertained in the pre-delivery window (heterogeneity, P = .007).Conclusions: Ascertainment of epilepsy and MS in delivery hospitalization records underestimated prevalence. However, the window of recording generally did not impact risk ratio estimates of associations with obstetric outcomes. [ABSTRACT FROM AUTHOR]

Eimeria species cause the intestinal disease coccidiosis, most notably in poultry. While the direct impact of coccidiosis on animal health and welfare is clear, its influence on the enteric microbiota and by-stander effects on chicken health and production remains largely unknown, with the possible exception of Clostridium perfringens (necrotic enteritis). This study evaluated the composition and structure of the caecal microbiome in the presence or absence of a defined Eimeria tenella challenge infection in Cobb500 broiler chickens using 16S rRNA amplicon sequencing. The severity of clinical coccidiosis in individual chickens was quantified by caecal lesion scoring and microbial changes associated with different lesion scores identified. Following E. tenella infection the diversity of taxa within the caecal microbiome remained largely stable. However, infection induced significant changes in the abundance of some microbial taxa. The greatest changes were detected in birds displaying severe caecal pathology; taxa belonging to the order Enterobacteriaceae were increased, while taxa from Bacillales and Lactobacillales were decreased with the changes correlated with lesion severity. Significantly different profiles were also detected in infected birds which remained asymptomatic (lesion score 0), with taxa belonging to the genera Bacteroides decreased and Lactobacillus increased. Many differential taxa from the order Clostridiales were identified, with some increasing and others decreasing in abundance in Eimeria-infected animals. The results support the view that caecal microbiome dysbiosis associated with Eimeria infection contributes to disease pathology, and could be a target for intervention to mitigate the impact of coccidiosis on poultry productivity and welfare. This work highlights that E. tenella infection has a significant impact on the abundance of some caecal bacteria with notable differences detected between lesion score categories emphasising the importance of accounting for differences in caecal lesions when investigating the relationship between E. tenella and the poultry intestinal microbiome. [ABSTRACT FROM AUTHOR]

Grapevine leafroll disease (GLD) is considered to be one of the most economically destructive viral diseases of grapevines worldwide, resulting in reduced vine vigor, yield reductions, and poor fruit quality. Five pathogens (grapevine leafroll-associated viruses) are recognized as causal agents of this disease, of which Grapevine leafroll-associated virus 3 (GLRaV-3) is the most common. Although there is no cure for the disease, management strategies (including vigilant removal of infected vines) can drastically limit its spread and economic impact. Comprehensive mapping (total population sampling) of disease presence on the ground is cumbersome and cost prohibitive in many situations. In addition, the practice of identifying diseased vines requires individuals to be highly trained to recognize symptoms. Compared to more traditional detection methods, airborne hyperspectral imaging offers a potentially valuable alternative for monitoring the disease that is cost effective, reliable and automatable. This study tests the use of hyperspectral imaging to aid in the management of GLD. Over the span of two years we monitored five Cabernet Sauvignon vineyards: ground surveys recorded the incidence of visual symptoms of disease in the field during the same months in which hyperspectral maps recorded disease incidence from the air. A customized Geographic Information System (GIS) methodology was developed to compare the visual symptoms to the results of the hyperspectral imaging technique. For a select number of vines, disease incidence was then confirmed by laboratory assays. On average, detection sensitivity was 94.1%, with a range of 88% to greater than 99% per vineyard. Various vineyard-specific factors appear to compromise detection sensitivity. Overall, our results show that remote hyperspectral imaging of GLRaV-3 infected Cabernet Sauvignon vineyards can be a useful and cost-effective approach to mapping diseased vines. Future studies should focus on the use of this tool for detecting GLRaV-3 in other grape varieties, as well as other grapevine pathogens. [ABSTRACT FROM AUTHOR]

The phylum Apicomplexa includes parasites of medical, zoonotic and veterinary significance. Understanding the global distribution and genetic diversity of these protozoa is of fundamental importance for efficient, robust and long-lasting methods of control. Eimeria spp. cause intestinal coccidiosis in all major livestock animals and are the most important parasites of domestic chickens in terms of both economic impact and animal welfare. Despite having significant negative impacts on the efficiency of food production, many fundamental questions relating to the global distribution and genetic variation of Eimeria spp. remain largely unanswered. Here, we provide the broadest map yet of Eimeria occurrence for domestic chickens, confirming that all the known species ( Eimeria acervulina , Eimeria brunetti , Eimeria maxima , Eimeria mitis , Eimeria necatrix , Eimeria praecox , Eimeria tenella ) are present in all six continents where chickens are found (including 21 countries). Analysis of 248 internal transcribed spacer sequences derived from 17 countries provided evidence of possible allopatric diversity for species such as E. tenella (F ST values ⩽0.34) but not E. acervulina and E. mitis , and highlighted a trend towards widespread genetic variance. We found that three genetic variants described previously only in Australia and southern Africa (operational taxonomic units x, y and z) have a wide distribution across the southern, but not the northern hemisphere. While the drivers for such a polarised distribution of these operational taxonomic unit genotypes remains unclear, the occurrence of genetically variant Eimeria may pose a risk to food security and animal welfare in Europe and North America should these parasites spread to the northern hemisphere. [ABSTRACT FROM AUTHOR]

Visual artists and photographers believe that a viewer's gaze can be guided by selective use of image clarity and blur, but there is little systematic research. In this study, participants performed several eye-tracking tasks with the same naturalistic photographs, including recognition memory for the entire photo, as well as recognition memory and personality ratings for individual people in the photos (Experiments 1-3). The results showed that fixations occurred more rapidly and frequently to a local region of clarity than to a comparable blurred region in all tasks, independent of the content of the photo in the local region, and even under instructions to look equally at both regions. However, this bias was reversed when the content of the photos was no longer task-relevant. In Experiment 4, participants located target regions defined by either clarity or blur. Fixations and manual responses were faster for blurred than for sharp targets. These findings imply that the saliency of both image clarity and image blur depends on viewers' goals. Focusing on photo content prioritizes regions of clarity whereas focusing on photo quality prioritizes attention to regions of blur. [ABSTRACT FROM AUTHOR]

Emotional deception is a common behaviour that can have major consequences if undetected. For example, the sincerity of an offender's expressed remorse is an important factor in sentencing and parole hearings. The present study was the first to investigate the nature of true and false remorse. We examined facial, verbal and body language behaviours associated with emotional deception in videotaped accounts of true personal transgressions accompanied by either genuine or falsified remorse. Analyses of nearly 300,000 frames indicated that descriptions of falsified remorse were associated with a greater range of emotional expressions. Further, sequential analyses revealed that negative emotions were more commonly followed by other emotions--rather than a return to neutral emotion--in falsified versus sincere remorse. Participants also exhibited more speech hesitations while expressing deceptive relative to genuine remorse. In general, the results suggest that falsified remorse may be conceived as an emotionally turbulent display of deliberate, falsified expressions and involuntary, genuine, emotional leakage. These findings are relevant to judges and parole board members who consider genuine remorse to be an important factor in sentencing and release decisions. [ABSTRACT FROM AUTHOR]

Aims To demonstrate the importance of identifying adolescent preferences for smoking cessation in order to inform the design of effective adolescent cessation services. Design Structured qualitative interviews drawing on means-end theory. Setting Three youth-clubs and two secondary schools in south-east Wales. Participants Twenty-five male and female 13–18-year-olds, mainly daily smokers. Findings Interviewees did not assume immediately that a smoking cessation service is something that will be available to them, and therefore they initially encountered difficulties in identifying attributes of such support. With further prompting interviewees were able to express a preference for support attributes, but these were not attributes that traditionally form part of cessation provision. Their main preference was for support from friends and family, access to nicotine replacement therapy and non-school-based, flexible support and guidance. Conclusion The results re-emphasize the inadequacies of existing cessation provision for meeting adolescent preferences and suggest that developing more adolescent-appropriate support requires a reconceptualization of existing interventions, with service users situated at the core of intervention design. The study highlights a number of service development points for intervention planners including: rethinking the timing and location of provision; placing more emphasis on the selection of facilitators; harnessing support from friends and family; and rooting these developments in broader tobacco control strategies. [ABSTRACT FROM AUTHOR]

Background: Higher numbers of family physicians (FPs) stopped practicing or retired during the COVID-19 pandemic, worsening the family doctor shortage in Canada. Our study objective was to determine which factors were associated with FPs' plans to retire earlier during the COVID-19 pandemic. Methods: We administered two cross-sectional online surveys to Ontario FPs asking whether they were "planning to retire earlier" as a result of the pandemic during the first and third COVID-19 pandemic waves (Apr-Jun 2020 and Mar-Jul 2021). We used logistic regression to determine which factors were associated with early retirement planning, adjusting for age. Results: The age-adjusted proportion of FP respondents planning to retire earlier was 8.2% (of 393) in the first-wave and 20.5% (of 454) in the third-wave. Planning for earlier retirement during the third-wave was associated with age over 50 years (50–59 years odds ratio (OR) 5.37 (95% confidence interval (CI):2.33–12.31), 60 years and above OR 4.18 (95% CI: 1.90-10.23)), having difficulty handling increased non-clinical responsibilities (OR 2.95 (95% CI: 1.79–4.94)), feeling unsupported to work virtually (OR 1.96 (95% CI: 1.19–3.23)) or in-person (OR 2.70 (95% CI: 1.67–4.55)), feeling unable to provide good care (OR 1.82 (95% CI: 1.10–3.03)), feeling work was not valued (OR 1.92 (95% CI: 1.15–3.23)), feeling frightened of dealing with COVID-19 (OR 2.01 (95% CI: 1.19–3.38)), caring for an elderly relative (OR 2.36 (95% CI: 1.69–3.97)), having difficulty obtaining personal protective equipment (OR 2.00 (95% CI: 1.16–3.43)) or difficulty implementing infection control practices in clinic (OR 2.10 (95% CI: 1.12–3.89)). Conclusions: Over 20% of Ontario FP respondents were considering retiring earlier by the third-wave of the COVID-19 pandemic. Supporting FPs in their clinical and non-clinical roles, such that they feel able to provide good care and that their work is valued, reducing non-clinical (e.g., administrative) responsibilities, dealing with pandemic-related fears, and supporting infection control practices and personal protective equipment acquisition in clinic, particularly in those aged 50 years or older may help increase family physician retention during future pandemics. [ABSTRACT FROM AUTHOR]