How do we capture child and family goals? Examining the goal setting practices used by community-based allied health professionals.

Purpose: This study aimed to i) identify child and family goals reported in a community allied health service, ii) map goals to ICF domains, and iii) evaluate goal characteristics against child-centred and family-centred practice principles.

Methods: A retrospective study design was used to extract and analyse raw goal data documented for children and families accessing a community-based allied health service. ICF linking rules were used to map goals to the ICF domains.

Systemic Metabolic Alterations after Aneurysmal Subarachnoid Hemorrhage: A Plasma Metabolomics Approach.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) causes systemic changes that contribute to delayed cerebral ischemia (DCI) and morbidity. Circulating metabolites reflecting underlying pathophysiological mechanisms warrant investigation as biomarker candidates.

Methods: Blood samples, prospectively collected within 24 hours (T1) of admission and 7-days (T2) post ictus, from patients with acute aSAH from two tertiary care centers were retrospectively analyzed.

The potential for Safewards to reduce restrictive interventions for people arriving to the emergency Department with police for a mental health assessment.

Unlabelled: Safewards is a complex intervention developed to promote a therapeutic response to minimise conflict and containment in inpatient mental health settings. A pilot study was conducted to adapt Safewards for the emergency department (ED) setting to evaluate its impact on the use of restrictive interventions. This subgroup analysis focusses on patients transported to the ED by police for mental health assessment.

Association of Step Count with Cardiorespiratory Fitness: Results from the Virtual 2-Minute Step Test.

Objective: To test the hypothesis that step count based on a virtual 2-minute step test (2MST) predicts cardiorespiratory fitness (CRF).

Design: Cross-sectional study.

Setting: Veteran Affairs Medical Centers participating in a randomized trial of functional exercise training delivered by videoconferencing.

Protocol for the Generation and 3D Culture of Fluorescently Labeled Multicellular Spheroids.

Spheroid culture systems have been extensively used to model the three-dimensional (3D) behavior of cells in vitro. Traditionally, spheroids consist of a single cell type, limiting their ability to fully recapitulate the complex inter-cellular interactions observed in vivo. Here we describe a protocol for generating cocultured spheroids composed of two distinct cell types, embedded within a 3D extracellular matrix (ECM) to better study cellular interactions.

Torsion-Induced Traumatic Optic Neuropathy (TITON): A physiologically relevant animal model of traumatic optic neuropathy.

Traumatic optic neuropathy (TON) is a common cause of irreversible blindness following head injury. TON is characterized by axon damage in the optic nerve followed by retinal ganglion cell death in the days and weeks following injury. At present, no therapeutic or surgical approach has been found to offer any benefit beyond observation alone.

Estimating the ovarian cancer CA-125 preclinical detectable phase, in-vivo tumour doubling time, and window for detection in early stage: an exploratory analysis of UKCTOCS.

Background: The ovarian cancer (OC) preclinical detectable phase (PCDP), defined as the interval during which cancer is detectable prior to clinical diagnosis, remains poorly characterised. We report exploratory analyses from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).

Methods: In UKCTOCS between Apr-2001 and Sep-2005, 101,314 postmenopausal women were randomised to no screening (NS) and 50,625 to annual multimodal screening (MMS) (until Dec-2011) using serum CA-125 interpreted by the Risk of Ovarian Cancer Algorithm (ROCA).

CFTR mutation is associated with bone differentiation abnormalities in cystic fibrosis.

Background: Cystic Fibrosis-related Bone Disease is an emerging challenge faced by 50 % of adult people with cystic fibrosis (CF). The multifactorial causes of this comorbidity remain elusive. However, congenital bone defects have been observed in animal models with CFTR mutations, suggesting its importance.

Peptide-Mediated Transport Across the Intact Tympanic Membrane Is Intracellular, with the Rate Determined by the Middle Ear Mucosal Epithelium.

The tympanic membrane forms an impenetrable barrier between the ear canal and the air-filled middle ear, protecting it from fluid, pathogens, and foreign material entry. We previously screened a phage display library and discovered peptides that mediate transport across the intact membrane. The route by which transport occurs is not certain, but possibilities include paracellular transport through loosened intercellular junctions and transcellular transport through the cells that comprise the various tympanic membrane layers.

Combining Patient Survey Data With Diagnosis Codes Improved Medicare Advantage Risk-Adjustment Accuracy.

Under the current Medicare Advantage (MA) risk-adjustment system, plans are incentivized to report diagnosis codes on enrollees' medical claims reflecting additional and more severe health conditions to increase enrollees' risk scores and corresponding plan payments. To improve the integrity of risk adjustment, researchers have proposed four alternative methods to construct risk scores: calculate Hierarchical Condition Categories (HCC) scores excluding diagnosis codes from health risk assessments and chart reviews, calculate HCC scores excluding diagnosis codes most subject to score inflation, use pharmaceutical claims alone, and use self-reported survey responses alone or in combination with diagnosis codes. Using 2016-19 medical and pharmaceutical claims linked to Consumer Assessment of Healthcare Providers and Systems survey responses from 151,432 MA enrollees, we compared the predictive accuracy of each alternative strategy with the standard HCC approach.

Investigating protein degradability through site-specific ubiquitin ligase recruitment.

We report targeted protein degradation through the site-specific recruitment of native ubiquitin ligases to a protein of interest conjugation of E3 ligase ligands. Direct comparison of degradation ability of proteins displaying the corresponding bioconjugation handle at different regions of protein surfaces was explored. We demonstrate the benefit of proximal lysine residues and investigate flexibility in linker length for the design of optimal degraders.

Hospitals Did Not Increase Acute Occupational Therapy Provision Despite Positive Associations With Hospital Performance Under Medicare's Comprehensive Care for Joint Replacement Program.

Importance: Medicare's Comprehensive Care for Joint Replacement (CJR) program rewards hospitals for reducing total Medicare spending. Despite the benefits of occupational therapy (OT) for patient outcomes and spending, little is known about how CJR affects hospital provision of acute occupational OT services.

Objective: Determine whether CJR changed acute OT provision and whether higher acute OT provision was associated with CJR rewards.

"Busting the hidden curriculum" a realist and innovative perspective to foster professional behaviors.

Contemporary health professions education has long delineated the desired attributes of medical professionalism in the form of standard curricula and their role in forming professional behaviors (PBs) among aspiring doctors. However, existing research has shown the contradictory and powerful role of hidden curriculum (HC) in negatively influencing medical students' PBs through unspoken or implicit academic, cultural, or social standards and practices. These contrasting messages of formal curricula and HC lead to discordance and incongruence in future healthcare professionals developing professional identity formation.

Improving meaningful activity and meaningful engagement for residents in long-term care settings.

During the coronavirus disease 2019 (COVID-19) pandemic, restrictions were placed on social contacts and group activities in long-term care settings. Evidence has suggested that social isolation can lead to the onset of health issues including depression and cognitive decline in older people. This article details a quality improvement project undertaken by the managers of nine long-term care settings in Northern Ireland that aimed to enhance meaningful activity and meaningful engagement for residents following the easing of COVID-19 restrictions.

Plant-Based Diets and Their Associations with Physical Performance in the Baltimore Longitudinal Study of Aging.

Background: Plant-based diets are associated with various health benefits; however, their impact on physical performance in aging populations remains unclear.

Objectives: To investigate the associations between adherence to plant-based diets and physical performance, focusing on their potential protective effects against age-related declines in function.

Methods: Data were obtained from men and women aged 40 years or older in the Baltimore Longitudinal Study of Aging (BLSA) (mean ± SD age: 68 ± 13 years at the first dietary visit; n = 1389).

The Effects of Weight Loss and Aerobic Exercise on Cortisol and Cortisol Suppression in Postmenopausal Women with Overweight and Obesity.

Purpose: The goal of this study was to explore the complex relationship between obesity, dietary content, weight loss, and cortisol concentrations in postmenopausal women with overweight and obesity.

Methods: Women completed basal cortisol testing, a dexamethasone suppression test (DST), DXA scan, 3-hour oral glucose tolerance test (OGTT), and food records before ( = 60) and a subset after 6-months of weight loss (WL;  = 15) or aerobic exercise training+weight loss (AEX+WL,  = 34).

Results: At baseline, plasma cortisol concentrations decreased significantly after DST in the entire group, a 54% suppression which was associated with basal glucose.

Dual gene set enrichment analysis (dualGSEA); an R function that enables more robust biological discovery and pre-clinical model alignment from transcriptomics data.

Gene set enrichment analysis (GSEA) tools can identify biological insights within gene expression-based studies. Although their statistical performance has been compared, the downstream biological implications that arise when choosing between the range of pairwise or single sample forms of GSEA methods remain understudied. We compare the statistical and biological results obtained from various pre-ranking methods/options for pairwise GSEA, followed by a stand-alone comparison of GSEA, single sample GSEA (ssGSEA) and gene set variation analysis (GSVA).

Hospital Payment Caps Could Save State Employee Health Plans Millions While Keeping Hospital Operating Margins Healthy.

State employee health plans are consuming an ever-larger portion of state budgets because of rising health insurance premiums. Often the largest purchaser of commercial health insurance in their state, state employee health plans possess a unique opportunity to implement cost containment strategies. This study estimated potential savings from hospital payment caps among state employee health plans and the impact on commercial hospital operating margins.

Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage.

Background: The United States Food and Drug Administration recently announced a national blood culture (BC) bottle shortage; the exact date of restoration is still being determined.

Aim: Implement a workflow to mitigate the BC bottle shortage at our hospital.

Methods: We created the following clinical decision support workflow in electronic medical record to help mitigate BC bottle use: (a) limit to two BC in 24 hours, (b) only repeat BC if 72 hours have passed from the prior sets, (c) do not repeat BC for coagulase-negative bacteremia when considered a contaminant (i.

Synthesis, Morphology, and Particle Size Control of Acidic Aqueous Polyurethane Dispersions.

A range of charge-stabilized aqueous polyurethane (PU) dispersions comprising hard segments formed from hydrogenated methylene diphenyl diisocyanate (HMDI) with dimethylolpropionic acid (DMPA) and ethylenediamine, and soft segments of poly(tetramethylene oxide) of different molecular weights are synthesized. Characterization of the dispersions by mass spectrometry, gel permeation chromatography, small-angle X-ray scattering, atomic force microscopy, and infrared spectroscopy shows that they are composed of PUs self-assembled into spherical particles (primary population) and supramolecular structures formed by hydrogen-bonded HMDI and DMPA acid-rich fragments (secondary population). Analysis of the scattering patterns of the dispersions, using a structural model based on conservation of mass, reveals that the proportion of supramolecular structures increases with DMPA content.

Evaluating the Impact of a Daylight-Simulating Luminaire on Mood, Agitation, Rest-Activity Patterns, and Social Well-Being Parameters in a Care Home for People With Dementia: Cohort Study.

Background: Living with a diagnosis of dementia can involve managing certain behavioral and psychological symptoms. Alongside cognitive decline, this cohort expresses a suppression in melatonin production which can negatively influence their alignment of sleep or wake timings with the 24 hour day and night cycle. As a result, their circadian rhythms become disrupted.