Implementing integrated care infrastructure: A longitudinal study on the interplay of policies, interorganizational arrangements and interoperability in NHS England.

Background: New models of care that integrate health and social care provision around the patient require a supportive infrastructure, including interorganizational arrangements and information systems. While public policies have been designed to facilitate visions of integrated care, these often neglect the implementation of effective and efficient delivery mechanisms.

Method: This study examines a decade of attempts to move from fragmented health and care delivery to integrated care at scale in NHS England by developing and implementing a support infrastructure.

Cohort trends in intrinsic capacity in England and China.

To understand how the health of older adults today compares to that of previous generations, we estimated intrinsic capacity and subdomains of cognitive, locomotor, sensory, psychological and vitality capacities in participants of the English Longitudinal Study of Ageing and the China Health and Retirement Longitudinal Study. Applying multilevel growth curve models, we found that more recent cohorts entered older ages with higher levels of capacity, while subsequent age-related declines were somewhat compressed compared to earlier cohorts. Trends were most evident for the cognitive, locomotor and vitality capacities.

Implementation and sustainment of virtual reality stroke workflow training for physician trainees at comprehensive stroke centres: a quantitative and qualitative study.

Background: Variation in stroke treatment metrics highlight a need for approaches to improve clinical processes. Training interventions can improve outcomes, but Australian physician trainees do not currently receive formal process-directed stroke training. Virtual reality (VR) stroke workflow training has proven acceptable, usable, useful and feasible in trial contexts, but how to integrate VR training into physician training remains unclear.

Acquisition of musical skills and abilities in older adults-results of 12 months of music training.

Background: Older adults can acquire new skills across different domains. Practicing a musical instrument has been identified as a promising activity for improving cognition, promoting well-being, and inducing brain plasticity in older individuals. However, the mechanisms of these changes are still poorly understood.

Brain volumes, cognitive, and adaptive skills in school-age children with Down syndrome.

Background: Down syndrome (DS) is the most common congenital neurodevelopmental disorder, present in about 1 in every 700 live births. Despite its prevalence, literature exploring the neurobiology underlying DS and how this neurobiology is related to behavior is limited. This study fills this gap by examining cortical volumes and behavioral correlates in school-age children with DS.

Lisdexamfetamine in the treatment of methamphetamine dependence: A randomised, placebo-controlled trial.

Aims: This study tested the efficacy and safety of a 12-week course of lisdexamfetamine in reducing methamphetamine use, an outcome which is associated with improvements in health and wellbeing, in people dependent on methamphetamine.

Design, Setting And Participants: This study was a randomised double-blind placebo-controlled trial conducted in six specialist outpatient clinics in Adelaide, Melbourne, Newcastle and Sydney, Australia (2018-2021). Participants were164 adults with methamphetamine dependence, reporting at least 14 use days out of the previous 28 days (62% male, 38% female, < 1% other; mean age 39 years).

Experiments outside the lab come with new responsibilities.

St. Ives is an idyllic seaside town on the southwest tip of England. It is a magnet for holidaymakers and artists.

How can effective communication help radiographers meet the expectations of patients-COMMUNICATION-a joint statement by the ESR & EFRS.

The Patient Advisory Group (PAG) of the European Society of Radiology, in collaboration with the European Federation of Radiographer Societies (EFRS), aims to highlight, in this short paper, the important role that communication plays when trying to meet patients' expectations throughout their imaging journey in a radiology department. The interactions with radiography professionals carrying out diagnostic or interventional procedures are critical in supporting high-quality patient care and patients' expectations. The key areas of consideration have been summarised in an easy-to-remember mnemonic: COMMUNICATION.

Breastfeeding interventions and programs conducted in the Islamic Republic of Iran: a scoping review.

The purpose of this review was to identify interventions promoting breastfeeding (BF), BF practices and their outcomes in Iran. Using the PRISMA-ScR Guidelines, we searched across 14 databases for publications published between 2010 and February 2024 to identify studies published in English or Farsi language in peer-reviewed journals, using search terms 'breastfeeding', 'lactation', 'education', 'promotion', 'intervention' and 'program'. Inclusion criteria included intervention-based studies with quantitative outcomes of pregnant women/mothers receiving education, training or other intervention that promoted BF or exclusive BF.

Effect of Proximal Blood Flow Arrest During Endovascular Thrombectomy (ProFATE): A Multicenter, Blinded-End Point, Randomized Clinical Trial.

Background: The effect of temporary blood flow arrest during endovascular thrombectomy for acute ischemic stroke is uncertain due to the lack of evidence from randomized controlled trials. We aimed to investigate whether temporary blood flow arrest during endovascular thrombectomy using a balloon guide catheter improves intracranial vessel recanalization compared with nonflow arrest.

Methods: The ProFATE trial (Proximal Blood Flow Arrest During Endovascular Thrombectomy) was a multicenter, randomized, participant- and outcome-blinded trial at 4 thrombectomy centers in the United Kingdom.

Demographics and Health Characteristics Associated With the Likelihood of Participating in Digitally Delivered Exercise Rehabilitation for Improving Heart Health Among Breast Cancer Survivors: Cross-Sectional Survey Study.

Background: Strong evidence supports the benefits of exercise following both cardiovascular disease and cancer diagnoses. However, less than one-third of Australians who are referred to exercise rehabilitation complete a program following a cardiac diagnosis. Technological advances make it increasingly possible to embed real-time supervision, tailored exercise prescription, behavior change, and social support into home-based programs.

Assessment of an eye-tracking tool to discriminate between concussed and not concussed professional male rugby players: a cohort study.

Objectives: Concussion is a common injury in rugby union ('rugby') and yet its diagnosis is reliant on clinical judgment. Oculomotor testing could provide an objective measure to assist with concussion diagnosis. NeuroFlex® evaluates oculomotor function using a virtual-reality headset.

An investigation into the relationships between technical collision behaviours and physical characteristics in world-class, international female rugby players.

This study first investigated how the probability of winning collision events is affected by technical characteristics among world-class, international female rugby union players, and second, whether enhanced performance of these technical characteristics was related to physical attributes. Carry and tackle events from 16 international matches played by a top-two world ranking team were coded according to technical characteristics and performance outcomes. Binary classification tree models revealed that carry performance was successfully predicted ( < 0.

Detecting and classifying eco-anxiety: development of clinical cut-off scores for the climate change anxiety scale.

Background: Climate change anxiety, that is worry and fear in relation to the awareness of the impacts of climate change, is widely observed around the world. Some evidence suggests that while climate change anxiety can, at times, be adaptive, a growing body of research has reported that climate change anxiety is also related to a range of negative mental health outcomes and psychological distress. Currently, however, there is limited ability to assess for elevated levels of climate change anxiety and to identify those who may need support.

Implementing and sustaining dementia care coordinators across integrated care systems: a realist evaluation.

Background: Globally, dementia care is under strain. Rising rates across ageing populations, coupled with overstretched health and care systems, mean that people living with dementia and their carers are missing out on crucial support. Addressing dementia care is a key priority for the UK government.

Evaluating the home-based intervention strategy (HIS-UK) to reduce new chlamydia infection among young men aged 16-25 years by promoting correct and consistent condom use: findings from a randomised controlled trial.

Background: Correct and consistent condom use is the most effective method to reduce transmission of sexually transmitted infections (STIs).

Objective: To compare the HIS-UK intervention to usual condom information and distribution care for effect on chlamydia test positivity.

Methods: Trial design A 3-parallel arm randomised controlled trial (1:1:1 allocation, two intervention arms vs.

Digital learning of clinical skills and its impact on medical students' academic performance: a systematic review.

Background: The constraints imposed by the COVID-19 pandemic has led to the rapid development and implementation of digital methods for teaching clinical skills in medical education. This systematic review presents both the benefits, challenges, and effectiveness of this transition.

Methods: A systematic search of six electronic databases (SCOPUS, Medline, CINAHL, PsycINFO, ERIC & Informit) was conducted on 1st October 2023 and updated on 1st April 2024 to identify peer- reviewed articles, from 2019 onwards, which used any type of digital tool (online or otherwise) to teach clinical skills to medical trainees (undergraduate or postgraduate) and were published in English language.

QTL mapping provides new insights into emamectin benzoate resistance in salmon lice, Lepeophtheirus salmonis.

Background: The salmon louse (Lepeophtheirus salmonis) is a parasite of wild and farmed salmonid fish, causing huge economic damage to the commercial farming of Atlantic salmon (Salmo salar) in the northern hemisphere. The avermectin emamectin benzoate (EMB) is widely used for salmon delousing. While resistance to EMB is widespread in Atlantic populations of L.

Efficient reinterpretation of rare disease cases using Exomiser.

Whole genome sequencing has transformed rare disease research; however, 50-80% of rare disease patients remain undiagnosed after such testing. Regular reanalysis can identify new diagnoses, especially in newly discovered disease-gene associations, but efficient tools are required to support clinical interpretation. Exomiser, a phenotype-driven variant prioritisation tool, fulfils this role; within the 100,000 Genomes Project (100kGP), diagnoses were identified after reanalysis in 463 (2%) of 24,015 unsolved patients after previous analysis for variants in known disease genes.

New metabolic insights into the mechanism of ifosfamide encephalopathy.

Ifosfamide causes neurotoxicity, including sometimes fatal encephalopathy, in a small number of patients. Why and how this occurs is not fully understood. It is generally believed that N-dechloroethylation of ifosfamide to 2-chloroacetaldehyde is the cause.

Community Emergency Medicine Clinicians' Pediatric Sepsis Readiness.

Background/objective: Pediatric sepsis is a significant cause of morbidity and mortality in the United States, and its early recognition is crucial but challenging. This study assessed clinicians' self-reported preparedness for recognizing and managing pediatric sepsis in the Rhode Island region.

Methods: A cross-sectional, survey was developed and sent to community emergency medicine clinicians in greater Rhode Island.