Soft control: Furthering the case for Modified Interventionist Theory.

Not all testing interventions that we might want to perform, or need to be performable in principle, fail to cause off-path variables. This is a problem for Woodward's Orthodox Interventionist Theory of causation, but not the 'Modified Interventionist Theory', which I proposed in a previous issue of this journal (Friend, 2021). As I explain here, this is because only the modified theory permits 'soft control'.

: Multispecies Fauna Reconstruction Requires Thinking Outside the Box.

Conservation translocations have become increasingly popular for 'rewilding' areas that have lost their native fauna. These multispecies translocations are complex and need to consider the requirements of each individual species as well as the influence of likely interactions among them. The Dirk Hartog Island National Park Ecological Restoration Project, , aspires to restore ecological function to Western Australia's largest island.

ACO Spending and Utilization Among Medicare Patients at the End of Life: an Observational Study.

Background: End-of-life (EOL) costs constitute a substantial portion of healthcare spending in the USA and have been increasing. ACOs may offer an opportunity to improve quality and curtail EOL spending.

Objective: To examine whether practices that became ACOs altered spending and utilization at the EOL.

Intervening on time derivatives.

Interventionism analyses causal influence in terms of correlations of changes under a distribution of interventions. But the correspondence between correlated changes and causal influence is not obvious. I probe its plausibility with a problem-case involving variables related as time derivative (velocity) to integral (position), such that the latter variable must change given an intervention on the former unless dependencies are introduced among the testing and controlling interventions.

Profiling circulating tumour cells and cell free DNA together in metastatic colon cancer.

The characterisation of CTCs (circulating tumour cells) and cfDNA (circulating free DNA) by Salvianti et al. highlight critical aspects of these approaches' relative strengths, weaknesses, and interdependencies in this study.

Adding A Climate Lens To Health Policy In The United States.

Climate change increasingly threatens the ability of the US health care system to deliver safe, effective, and efficient care to the American people. The existing health care system has key vulnerabilities that will grow more problematic as the effects of climate change on Americans' lives become stronger. Thus, health care policy makers must integrate a climate lens as they develop health system interventions.

Ambulatory Follow-up and Outcomes Among Medicare Beneficiaries After Emergency Department Discharge.

Importance: Ambulatory follow-up care is frequently recommended after an emergency department (ED) visit. However, the frequency with which follow-up actually occurs and the degree to which follow-up is associated with postdischarge outcomes is unknown.

Objectives: To examine the frequency and variation in ambulatory follow-up among Medicare beneficiaries discharged from US EDs and the association between ambulatory follow-up and postdischarge outcomes.

Diurnal Body Temperature and Rate of Passage of Loggers in Lions.

The documentation of diurnal patterns in body temperature in lions could be important because disruption of circadian patterns can be a useful measure of distress. This study quantified changes in body temperature of seven African lions at 5 min intervals during cold conditions from noon until the ingested body temperature loggers were expelled the next day. Thirteen loggers were fed to 11 lions during their daily noon feeding, while ambient temperatures were also recorded using six data loggers.

Comparison of two case difficulty assessment methods on cohorts of undergraduate dental students - a multi-centre study.

Aim: To compare the educational benefits and user friendliness of two anonymized endodontic case difficulty assessment (CDA) methods.

Methodology: A cohort (n = 206) of fourth-year undergraduate dental students were recruited from four different Dental Schools and divided randomly into two groups (Group A and B). The participants assessed six test endodontic cases using anonymized versions of the American Association of Endodontists (AAE) case difficulty assessment form (AAE Endodontic Case Difficulty Assessment Form and Guidelines, 2006) and EndoApp, a web-based CDA tool.

Improving Operating Room Efficiency via Reduction and Standardization of Video-Assisted Thoracoscopic Surgery Instrumentation.

Being the economic powerhouses of most large medical centers, operating rooms (ORs) require the highest levels of teamwork, communication, and efficiency in order to optimize patient safety and reduce hospital waste. A major component of OR waste comes from unused surgical instrumentation; instruments that are frequently prepared for procedures but are never touched by the surgical team still require a full reprocessing cycle at the conclusion of the case. Based on our own previous successes in the perioperative domain, in this work we detail an initiative that reduces surgical instrumentation waste of video-assisted thoracoscopic surgery (VATS) procedures by placing thoracotomy conversion instrumentation in a standby location and designing a specific instrument kit to be used solely for VATS cases.

Optimizing Endoscope Reprocessing Resources Via Process Flow Queuing Analysis.

The Massachusetts General Hospital (MGH) is merging its older endoscope processing facilities into a single new facility that will enable high-level disinfection of endoscopes for both the ORs and Endoscopy Suite, leveraging economies of scale for improved patient care and optimal use of resources. Finalized resource planning was necessary for the merging of facilities to optimize staffing and make final equipment selections to support the nearly 33,000 annual endoscopy cases. To accomplish this, we employed operations management methodologies, analyzing the physical process flow of scopes throughout the existing Endoscopy Suite and ORs and mapping the future state capacity of the new reprocessing facility.

Communication Patterns in the Perioperative Environment During Epic Electronic Health Record System Implementation.

In April 2016, Massachusetts General Hospital (MGH) went live with the Epic electronic health records (EHR) system, replacing a variety of EHRs that previously existed in different departments throughout the hospital. At the time of implementation, the Vocera® Badge Communication System, a wireless hands-free communication device distributed to perioperative team members, had increased perioperative communication flow and efficiency. As a quality improvement effort to better understand communication patterns during an EHR go-live, we monitored our Vocera call volume and user volume before, during and after our go-live.

Implementation of the Vocera Communication System in a Quaternary Perioperative Environment.

In the hospital, fast and efficient communication among clinicians and other employees is paramount to ensure optimal patient care, workflow efficiency, patient safety and patient comfort. The implementation of the wireless Vocera® Badge, a hands-free wearable device distributed to perioperative team members, has increased communication efficiency across the perioperative environment at Massachusetts General Hospital (MGH). This quality improvement project, based upon identical pre- and post-implementation surveys, used qualitative and quantitative analysis to determine if and how the Vocera system affected the timeliness of information flow, ease of communication, and operating room noise levels throughout the perioperative environment.

Prospective study on dental extractions carried out for paediatric patients under general anaesthetic in a district general hospital.

Background: The first line approach to managing healthy anxious children requiring dental extractions should include behavioural management and treatment under local anaesthetic. This can be coupled with conscious sedation.

Aim: To evaluate alternative methods attempted prior to treatment under general anaesthesia (GA), to establish the incidence of repeat GA procedures.

Validation of Single and Pooled Manure Drag Swabs for the Detection of Salmonella Serovar Enteritidis in Commercial Poultry Houses.

Single swabs (cultured individually) are currently used in the Food and Drug Administration (FDA) official method for sampling the environment of commercial laying hens for the detection of Salmonella enterica ssp. serovar Enteritidis (Salmonella Enteritidis). The FDA has also granted provisional acceptance of the National Poultry Improvement Plan's (NPIP) Salmonella isolation and identification methodology for samples taken from table-egg layer flock environments.

Hematologic and Serum Biochemical Reference Intervals for the Bilby (Macrotis lagotis).

Hematologic and serum biochemistry blood reference intervals were established for the endangered marsupial, the bilby (Macrotis lagotis). Blood samples were collected from 135 bilbies that were housed in a captive breeding colony or were free ranging in a 10-ha exclosure. Statistical analyses were undertaken, and significant differences in parameters were found depending on age, sex, and captive or free-ranging status of animals.

Effects of repeated transport on Holstein calf post-transport behavior and feed intake.

Previous studies have determined that stress causes decreases in feed intake and efficiency in livestock, but the effect of repeated transport on these parameters has not been well studied. This study determined how repeated transport affected calf post-transport behavior, feed intake, ADG, and feed conversion. Thirty-six 4-mo-old Holstein steer calves were housed in groups of 6 with each group randomly assigned to either transport or control treatments.

Modeling the effect of reflective calf hutch covers on reducing heat loss.

This study determined if a reflective film could theoretically be useful in moderating the rate of heat loss from calves housed in polyethylene hutches during cold weather. An engineering approach was used in which rate of heat loss was modeled using 38-l steel drums filled with body temperature water and covered by fresh calf hide. The reflective film (cover) consisted of aluminized 0.

Effect of four different reflective barriers on black-globe temperatures in calf hutches.

Polyethylene hutches are a popular method of housing dairy calves from 0 to 60 or more days of age, although these hutches get hot when in full sun. This study characterized the relative differences in the ability of four different types of radiant barriers to reduce black-globe temperature within these hutches. Treatments included three different types of covers (two types of laminates (Cadpak P and Cadpak ESD) and an aluminized 3.

Usefulness of an aluminized polyester film for reducing heat in polyethylene calf hutches.

This study determined the efficacy of a radiant barrier material used in the construction industry to moderate summer temperatures in polyethylene calf hutches. The cover consisted of a single layer of two-sided reflective aluminized polyester film with a center polyester scrim reinforcement (reflectivity = 95%). At each of two dairies, six hutches containing a young calf were either uncovered (control) or had reflective covers across the top and sides of the hutch, leaving the front, back, and 1.