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Abstract Background Patient-oriented research is now widely regarded as key to improving health systems and patient outcomes. This shift toward meaningful patient involvement in health research has sparked a growing interest in patient-oriented research training across Canada. Yet some barriers to participation, including distance and scheduling constraints, may impede the provision of in-person patient-oriented research training. Virtual course delivery options may help surmount those barriers, as well as offer unique pedagogical advantages. Objective To help increase patient-oriented research training uptake, the research team adapted the Canadian Institutes of Health Research’s (CIHR) Strategy for Patient-Oriented Research’s Foundations for Patient-Oriented Research course to a virtual format. The course consists of three modules, which focus respectively on patient-oriented research, health research methods, and teamwork skills. The current evaluation of this virtual delivery examines how a diverse set of participants received the online course. Methods Course participants from a variety of professional backgrounds, including researchers, patients, clinicians, and policy decision-makers, were recruited from across Canada to participate in the adapted course. Participant and facilitator feedback was solicited via online surveys that were distributed shortly after the delivery of each module. Results Over the span of the current project, the online course was delivered seven times across Canada. A total of 189 learners and 12 facilitators participated in the course. We received 89 completed feedback surveys in total. These included a total of 78 responses from learners, with 22 on Module 1, 32 on Module 2, and 24 on Module 3, in addition to 11 responses from facilitators. Overall, participants and facilitators were very satisfied with the course, indicating a successful adaptation from traditional to online delivery. Survey respondents were especially pleased with the course’s co-learning elements, which exposed them to fresh perspectives and real patient voices, as well as ample opportunity for discussion. Some participants offered recommendations for minor course revisions. Future iterations of the course will reflect participant and facilitator feedback to enhance accessibility via minor changes to course format (e.g., shorter live sessions), content (e.g., more concrete examples), and workload (e.g., reduced pre-work requirements). Conclusions Sustainable and effective health care depends on health research that includes active partnerships across diverse populations. These collaborative relationships are fostered by strong capacity in patient-oriented research, which in turn hinges on widely accessible training opportunities. This online course overcomes common barriers to face-to-face training and offers the accessible, inclusive training environment required for sustained progress in patient-oriented research.

Background: FebriDx is a single-use, analyser-free, point-of-care test with markers for bacterial (C-reactive protein [CRP]) and viral (myxovirus resistance protein A [MxA]) infection, measured on a finger-prick blood sample. Aim: As part of a larger feasibility study, we explored the views of healthcare professionals (HCPs) and patients on the use of FebriDx to safely reduce antibiotic prescriptions for lower respiratory tract infections (LRTIs) in primary care. Design & setting: Remote semi-structured qualitative interviews were conducted in South England. Method: In total, 22 individuals (12 patients who underwent FebriDx testing and 10 HCPs from general practices that conducted testing) participated in interviews, which were analysed thematically. Results: Patients and HCPs expressed positive views about use of the test. They felt FebriDx was a useful tool to inform prescribing decisions and provided a visual aid to support shared decision making and appropriate antibiotic use. Most felt it would be feasible to integrate use into routine primary care consultations. Some practical difficulties with blood collection and interpreting results, which impacted on usability, were identified. Some patients’ reactions to negative test results suggested the need for better communication alongside use of the test. Conclusion: FebriDx was perceived as a useful tool to guide antibiotic prescribing and support shared decision making. Initial practical problems with testing and communicating results are potential barriers to use. Training and practice on using the test and effective communication are likely to be important elements in ensuring patient understanding and satisfaction, and successful adoption.

Mixed-race people in Papua New Guinea (PNG) have long been socially acknowledged as a distinct ethnic group—a group whose individual members sometimes also oscillate between being subsumed by, included within, or excluded from other racial categories like Asian, Black, Brown, Indigenous, and White. It is perhaps this ability to shift between what are often perceived as fixed racial categories that leaves some mixed-race people having to justify, negotiate, or explain the breakdown of their ethnic heritage to strangers, friends, and colleagues, some of whom think it is enlightened to say things like, “But aren’t we all mixed race?” or “Are you sure that’s what you are?” or the far less benign “You’re nothing but a mixed-race bastard.” This article examines historical and contemporary ideas about mixed-race identity in PNG in terms of both the privilege and oppression that members of this category experience. It stresses that racial identity in PNG is strongly connected to notions of peles (one’s place of Indigenous origin)­—a reliance that is beyond the influence of colonialism—and is further shaped by language, behavior, and social relationships. Drawing on the work of Linda Tuhiwai-Smith, Epeli Hau’ofa, and Irma McClaurin, the article decolonizes data collection and analysis techniques and sets Black, Islander, and female perspectives at the core of the methodological approach. In addition, the author’s own socialization as a mixed-race woman of New Zealand Pakeha and PNG descent adds further insight to the topic.

Coconut plantations throughout the Asia–Pacific region are generally characterised by the presence of low-productivity senile palms over the age of 60, which have negative impacts on farming communities, coconut processors, and the wider economy. In Fiji, despite numerous senile coconut replacement programs, 60% of coconut palms are considered senile. The purpose of this study is to provide preliminary estimates of the financial viability of a market-based approach to senile coconut palm replacement in Fiji by utilising the palms as a feedstock, for the manufacture of rotary peeled veneer, along with plantation pine and mahogany. A mathematical model capable of supporting deterministic and stochastic dynamic optimisation was developed with an objective function to maximise the gross margin of marketable veneer manufacture per hour (GMpz) by procuring the optimal allocation of logs throughout the landscape. The majority of facility location and log processing scale scenarios evaluated found that utilising large volumes of senile coconut palms for the manufacture of veneer was optimal, whilst veneering mills situated near the coconut plantations in Vanua Levu were found to maximise GMpz. Overall, the results indicate that a coconut veneer and engineered wood product (EWP) value chain could present a financially viable opportunity to support large-scale senile coconut palm replacement in Fiji.

Abstract Background The COVID-19 pandemic and associated social distancing regulations have led to an increased risk of social isolation and physical inactivity, particularly among older adults. The benefits of physical activity for reducing fall risk and improving mood and mental functioning have been well documented. The aim of this trial is to investigate the effect of the MovingTogether programme on psychological distress (primary outcome) and physical activity, social capital, cognition, concern about falling, loneliness, physical functioning, quality of life and physical activity enjoyment (secondary outcomes). Methods A randomised controlled trial with a waitlist control will be conducted, recruiting 80 adults aged 60+ years with access to Facebook and a computer or tablet and not currently meeting the aerobic physical activity guidelines. Randomisation will be completed using REDCap. The intervention group (n = 40) will join a private Facebook group where allied health facilitators will provide targeted healthy lifestyle education throughout the 10-week programme with weekly telehealth group calls. Intervention participants will also be provided access to tailored strength and aerobic exercise guidance and an evidence-based eHealth balance exercise programme. Psychological distress and secondary outcomes will be assessed at baseline, 11 weeks (post-intervention) and 16 weeks (1-month follow-up). Linear mixed models will be applied for each outcome measure as per an intention-to-treat approach to determine the between-group differences. Secondary analyses are planned in people with greater adherence and those with higher psychological distress. Discussion COVID-19 has highlighted the need for scalable, effective and novel methods to improve and protect the health of older adults. The integration of an evidence-based fall prevention programme with a mental health-informed online health promotion programme may help to improve mental and physical health outcomes among older adults. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001322820p. Registered on 29 September 2021

Aims and Background: The spleen is the most frequently injured solid organ after blunt trauma and a trial non-operative management (NOM) has become the standard of care in hemodynamically stable patients. It remains uncertain which patients are at increased risk of non-operative management failure (NOMF) at initial presentation. We explored whether clinical variables including the contemporary rotational thromboelastography (ROTEM) parameters are predictive of NOMF. Materials and Methods: Data for all adult patients with a blunt splenic injury was collected retrospectively at St. Michael's Hospital in Toronto, Canada between 2005 and 2021. Those who underwent a splenectomy within 4 hours of presentation were classified as direct operative management (OM), while those who had a splenectomy after 4 hours of observation were classified as NOM failure. Vital signs on arrival and injury characteristics were collected. Logistic regression was used to identify predictors of OM and predictors of NOM failure. Results: Seven hundred and seventeen patients were identified with splenic injury during our study period. The median Injury Severity Score (ISS) was 27 (IQR 17–36), and 19% (n = 134) had a shock index of 1 or more. One hundred and eleven (15.5%) underwent direct operative management. A shock index above 1 and increasing spleen injury severity were strong predictors of patients undergoing direct OM. The remaining 606 patients underwent NOM of which 59% (n = 357) of these were admitted to the ICU. NOM failure occurred in 7.4% (n = 45) with a median time to NOM failure of 23 (IQR 8–72) hours. The American Association for the Surgery of Trauma (AAST) spleen injury severity was the major factor significantly associated with NOM failure. Conclusions: The only major predictor of NOMF available on arrival is increased spleen injury grade. Other clinical variables such as age, vital signs on arrival, and bloodwork were not significantly able to predict NOM failure. Additional investigation is required to identify novel predictors of NOM failure. [ABSTRACT FROM AUTHOR]

Background: FebriDx is a single-use, analyser-free, point-of- care test with markers for bacterial (C-reactive protein [CRP]) and viral (myxovirus resistance protein A [MxA]) infection, measured on a finger-prick blood sample. Aim: As part of a larger feasibility study, we explored the views of healthcare professionals (HCPs) and patients on the use of FebriDx to safely reduce antibiotic prescriptions for lower respiratory tract infections (LRTIs) in primary care. Design & setting: Remote semi-structured qualitative interviews were conducted in South England. Method: In total, 22 individuals (12 patients who underwent FebriDx testing and 10 HCPs from general practices that conducted testing) participated in interviews, which were analysed thematically. Results: Patients and HCPs expressed positive views about use of the test. They felt FebriDx was a useful tool to inform prescribing decisions and provided a visual aid to support shared decision making and appropriate antibiotic use. Most felt it would be feasible to integrate use into routine primary care consultations. Some practical difficulties with blood collection and interpreting results, which impacted on usability, were identified. Some patients' reactions to negative test results suggested the need for better communication alongside use of the test. Conclusion: FebriDx was perceived as a useful tool to guide antibiotic prescribing and support shared decision making. Initial practical problems with testing and communicating results are potential barriers to use. Training and practice on using the test and effective communication are likely to be important elements in ensuring patient understanding and satisfaction, and successful adoption. [ABSTRACT FROM AUTHOR]

Finger jointing has long been a method of extending the longitudinal span of short-length timber pieces through a tooth-like profile of a nominated length and bonded with adhesive. With the high-density hardwood resource in the sub-tropics, local industries have found it difficult to obtain adequate bond integrity for high moisture areas and outdoor applications, where a good bond is governed by the dry modulus of rupture (MOR) and the percentage of wood fibre present in the separated joint after exposure to water impregnation. This paper presents the finger joint performance in terms of MOR, stiffness (MOE), and wood fiber amount (WFA) under different variables, joint profile (10 and 20 mm long fingers) using two structurally rated adhesives (a single-component polyurethane (1C-PUR) and resorcinol formaldehyde (RF)) on spotted gum (Corymbia citriodora) and Darwin stringybark (Eucalyptus tetrodonta) jointed boards. Dry bending strength or MOR testing indicated the 20 mm joints with the PUR adhesive had the best performance across both tested species compared to the RF adhesive. The measured MOE of the joints showed the RF samples to have higher MOE (7% to 13%) than the PUR samples for both joint sizes and species. Testing of joint durability through water impregnation resulted in MOR and MOE values decreasing by up to 50% for the RF and PUR joints. Conversely, the performance of water-impregnated joints after being allowed to re-condition to a 12% equilibrium moisture content produced a regain of MOR for the PUR joints across both species of 30% to 40%. Furthermore, it was found that the WFA increased for the PUR samples between the water-impregnated samples and the re-conditioned samples.

This paper presents an investigation on the influence of various factors on rolling shear (RS) properties of timber feedstock for cross laminated timber (CLT) available from Australian plantation forest resources. Comparison of RS properties between three softwood species namely southern pine, radiata pine and hoop pine are presented. Furthermore, the effect of modulus of elasticity (MOE), equilibrium moisture content (EMC), aspect ratio, knots and projection length on rolling shear behaviour were investigated. Mean RS modulus for radiata pine, southern pine and hoop pine samples were 74.7 MPa, 87.1 MPa and 99.7 MPa, whilst the RS strength of those species were 2.6 MPa, 3.1 MPa and 3.7 MPa, respectively. Radiata pine samples exhibited the lowest values for RS modulus and strength, almost 30% less than those of hoop pine samples. The study confirmed that the density and MOE had a very weak correlation with RS properties for all pine species. There was an obvious decrease in RS modulus (by 18%) when the woods’ conditioned EMC changed from 8% to 12%. A further 33% decrease was observed when the woods’ conditioned EMC increased from 12% to 16%. However, the percentage increase in RS strength was found to be 23% higher in wood with 12% conditioned EMC while compared against wood conditioned to 16% EMC. RS strength improved with increased aspect ratio; however, RS modulus remained almost unaffected. Moreover, the projection length that resulted in the load passing through the centroid of the specimen resulted in lower RS modulus values, but the presence of knots improved both RS strength and modulus for all three tested species.

Objective: This study sought to determine if a presacral nerve (PSN) block affects early postoperative pain, opioid use, and rates of urinary retention after laparoscopic hysterectomy. Materials and Methods: Patients who had elective total laparoscopic hysterectomy (TLH) without histories of chronic pain or opioid use were assigned randomly to either a PSN block of 10 mL of 0.5% bupivacaine or a sham block of 10 mL normal saline post surgery. The primary outcome was pain assessed on a visual analogue scale (VAS) at 3 hours postoperatively and secondary outcomes included pain at 1, 2, and 3 hours, and opioid use post surgery. Participant recruitment was halted due to cancellation of elective surgeries during the COVID-19 pandemic, and, therefore, the data of the patients who were already recruited, was analyzed as an interim analysis for a pilot study design. Results: Thirty-four patients were recruited, with 21 in the intervention group and 13 in the sham-block group. Operative times were similar between both groups. Postoperative pain (measured at 1, 2, and 3 hours post surgery) was not significantly different between the 2 groups. Fewer patients in the PSN group required fentanyl for pain control in the recovery room (28.6% versus 53.8%; p = 0.041), although there was no statistically significant difference in terms of overall opioid consumption. There were no complications related to PSN-block administration. Conclusions: PSN block appears to be feasible and may contribute to decreased opioid use following laparoscopic hysterectomy. As participant recruitment was halted, a robust, well-powered, randomized control trial is necessary. (J GYNECOL SURG 20XX:000) [ABSTRACT FROM AUTHOR]

Introduction FebriDx® is a CE-marked, single-use point-of-care test with markers for bacterial [C-reactive protein (CRP)] and viral [myxovirus resistance protein A (MxA)] infection, using finger-prick blood samples. Results are available after 10–12 min. We explored the usability and potential impact of FebriDx® in reducing antibiotic prescriptions for lower respiratory tract infection (LRTI) in primary care, and the feasibility of conducting a randomized controlled trial (RCT). Methods Patients (aged ≥1 year) with LRTI deemed likely to receive antibiotic prescription were recruited at nine general practices and underwent FebriDx® testing. Data collection included FebriDx® results, antibiotic prescribing plan (before and after testing) and re-consultation rates. Staff completed System Usability Scale questionnaires. Results From 31 January 2023 to 9 June 2023, 162 participants participated (median age 57 years), with a median symptom duration of 7 days (IQR 5–14). A valid FebriDx® result was obtained in 97% (157/162). Of 155 patients with available results, 103 (66%) had no detectable CRP or MxA, 28 (18%) had CRP only, 5 (3%) had MxA only, and 19 (12%) had both CRP and MxA. The clinicians' stated management plan was to prescribe antibiotics for 86% (134/155) before testing and 45% (69/155) after testing, meaning a 41% (95% CI: 31%, 51%) difference after testing, without evidence of increased re-consultation rates. Ease-of-use questionnaires showed 'good' user-friendliness. Conclusions Use of FebriDx® to guide antibiotic prescribing for LRTI in primary care was associated with a substantial reduction in prescribing intentions. These results support a fully powered RCT to confirm its impact and safety. [ABSTRACT FROM AUTHOR]

The highly evolutionarily conserved transport protein particle (TRAPP) complexes (TRAPP II and III) perform fundamental roles in subcellular trafficking pathways. Here we identified biallelic variants in TRAPPC10, a component of the TRAPP II complex, in individuals with a severe microcephalic neurodevelopmental disorder. Molecular studies revealed a weakened interaction between mutant TRAPPC10 and its putative adaptor protein TRAPPC2L. Studies of patient lymphoblastoid cells revealed an absence of TRAPPC10 alongside a concomitant absence of TRAPPC9, another key TRAPP II complex component associated with a clinically overlapping neurodevelopmental disorder. The TRAPPC9/10 reduction phenotype was recapitulated in TRAPPC10-/- knockout cells, which also displayed a membrane trafficking defect. Notably, both the reduction in TRAPPC9 levels and the trafficking defect in these cells could be rescued by wild type but not mutant TRAPPC10 gene constructs. Moreover, studies of Trappc10-/- knockout mice revealed neuroanatomical brain defects and microcephaly, paralleling findings seen in the human condition as well as in a Trappc9-/- mouse model. Together these studies confirm autosomal recessive TRAPPC10 variants as a cause of human disease and define TRAPP-mediated pathomolecular outcomes of importance to TRAPPC9 and TRAPPC10 mediated neurodevelopmental disorders in humans and mice.