Multiple studies have highlighted the negative impact of COVID-19 and its particular effects on vulnerable sub-populations. Complementing this work, here, we report on the social patterning of ...self-reported positive changes experienced during COVID-19 national lockdown in Scotland.
The CATALYST study collected data from 3342 adults in Scotland during weeks 9-12 of a national lockdown. Using a cross-sectional design, participants completed an online questionnaire providing data on key sociodemographic and health variables, and completed a measure of positive change. The positive change measure spanned diverse domains (e.g., more quality time with family, developing new hobbies, more physical activity, and better quality of sleep). We used univariate analysis and stepwise regression to examine the contribution of a range of sociodemographic factors (e.g., age, gender, ethnicity, educational attainment, and employment status) in explaining positive change.
There were clear sociodemographic differences across positive change scores. Those reporting higher levels of positive change were female, from younger age groups, married or living with their partner, employed, and in better health.
Overall our results highlight the social patterning of positive changes during lockdown in Scotland. These findings begin to illuminate the complexity of the unanticipated effects of national lockdown and will be used to support future intervention development work sharing lessons learned from lockdown to increase positive health change amongst those who may benefit.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Fear and insight in the ICU bed MacDonald, Bradley
Intensive care medicine,
08/2021, Letnik:
47, Številka:
8
Journal Article
Recenzirano
Odprti dostop
Mid-morning dressing changes, hours wasted, going through each cut methodically. Dressing of, wound cleaned, redressed. The brunt of pain dealt with by nature before giving in. The intensive care ...unit (ICU) nurse offers ketamine and I am obliged to say yes dressings are not even halfway done. My math of the process sways me 7 wounds, 7 drains, an hour in, just halfway. The ketamine tablet tastes like chalk and dissolves in the nurses’ hand before even making it to my mouth. She has to put it in as crumbs 3 or 4 times to ensure some accurate measure of the dose makes it. I swirl it around but it seems to dry up any saliva it comes into contact with. Dry mouth, I cough a little and remnant dust of ketamine sprays out over the starchy bleached sheets of the ICU bed. The water bottle is thrust into my hand and helps it down. The dressing changes continue before I feel the hit. It’s gradual, relief of pain starting earlier than anything. Ten bugs, covering the lights of the ICU room and the walls. The whole place alive with critters crawling around the room, the walls are alive, everywhere I look. I watch as the room breathes in and out, living in a lung that dynamically changes with my breathing.
We used stable isotope (δ13C, δ15N, δ34S) analysis in combination with satellite telemetry to evaluate the foraging areas chosen by 88 loggerhead turtles Caretta caretta nesting in southwestern ...Florida. Nine turtles were tracked and skin-sampled in more than one nesting season to evaluate within-individual consistency in foraging sites and stable isotope values. Turtles migrated to 5 regions: Caribbean, Florida Keys, West Florida Shelf, northern Gulf of Mexico, and Yucatan Peninsula. The stable isotope ratios across these foraging grounds ranged from –21.16 to –7.69 ‰ for δ13C, 3.27 to 13.99 ‰ for δ15N, and 1.91 to 20.64 ‰ for δ34S. We compared bulk skin tissue stable isotope values for all turtles by bioregion, year, body size, depth of putative foraging area, and linear distance from the closest shore; among these factors, only bioregion showed a significant effect on isotope values. There were subtle regional differences in mean δ13C, δ15N, and δ34S, and an apparent north-south isotopic shift aligning strongly with ocean currents adjacent to the Florida Keys. The influence of coastal topography and shifting biogeographic boundaries such as the Loop Current may cause strong ocean water mixing that results in the observed similarities in stable isotope values among regions. These results indicate that stable isotopes alone may be an inadequate tool for identifying fine-scale (<100 km) residency of sea turtles within this ocean region.
Abstract
Background
The impact of young drivers’ motor vehicle crashes (MVC) is substantial, with young drivers constituting only 14% of the US population, but contributing to 30% of all fatal and ...nonfatal injuries due to MVCs and 35% ($25 billion) of the all medical and lost productivity costs. The current best-practice policy approach, Graduated Driver Licensing (GDL) programs, are effective primarily by delaying licensure and restricting crash opportunity. There is a critical need for interventions that target families to complement GDL. Consequently, we will determine if a comprehensive parent-teen intervention, the Drivingly Program, reduces teens’ risk for a police-reported MVC in the first 12 months of licensure. Drivingly is based on strong preliminary data and targets multiple risk and protective factors by delivering intervention content to teens, and their parents, at the learner and early independent licensing phases.
Methods
Eligible participants are aged 16-17.33 years of age, have a learner’s permit in Pennsylvania, have practiced no more than 10 h, and have at least one parent/caregiver supervising. Participants are recruited from the general community and through the Children’s Hospital of Philadelphia’s Recruitment Enhancement Core. Teen-parent dyads are randomized 1:1 to Drivingly or usual practice control group. Drivingly participants receive access to an online curriculum which has 16 lessons for parents and 13 for teens and an online logbook; website usage is tracked. Parents receive two, brief, psychoeducational sessions with a trained health coach and teens receive an on-road driving intervention and feedback session after 4.5 months in the study and access to DriverZed, the AAA Foundation’s online hazard training program. Teens complete surveys at baseline, 3 months post-baseline, at licensure, 3months post-licensure, 6 months post-licensure, and 12 months post-licensure. Parents complete surveys at baseline, 3 months post-baseline, and at teen licensure. The primary end-point is police-reported MVCs within the first 12 months of licensure; crash data are provided by the Pennsylvania Department of Transportation.
Discussion
Most evaluations of teen driver safety programs have significant methodological limitations including lack of random assignment, insufficient statistical power, and reliance on self-reported MVCs instead of police reports. Results will identify pragmatic and sustainable solutions for MVC prevention in adolescence.
Trial Registration
ClinicalTrials.gov # NCT03639753.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Heterotaxy syndromes encompass left and right atrial isomerism (LAI and RAI respectively) and are associated with variable cardiac and non-cardiac anomalies which greatly influence outcomes. RAI is ...usually associated with complex congenital heart disease (CHD), early surgical intervention and increased mortality. LAI is less commonly associated with complex CHD but can be associated with heart block. The objective of this study was to review the clinical features and outcomes of patients with heterotaxy syndromes in Western Australia (WA).
A retrospective review was performed of live born patients diagnosed with heterotaxy from 2003 to 2022 in a statewide tertiary cardiac service, representing all cases in WA with a view to compare the outcomes between LAI and RAI at our centre.
30 patients (53% male) were diagnosed with heterotaxy; 16 (53%) with LAI and 14 (47%) with RAI. Overall incidence was 0.48 per 10,000 live births over the defined period. RAI patients were significantly more likely to have an antenatal diagnosis (81.8% versus LAI 28.6%, p = 0.03). Overall, 5-year survival was 56% for RAI and 87% for LAI. No deaths occurred after the first 12 months of life with a median follow-up of 65 months (IQR 114.8). RAI was associated with asplenia (91%), atrioventricular septal defect (91%) and a functionally univentricular circulation (71%). LAI was associated with polysplenia (100%) and complete heart block in 3 patients (19%). Surgical pathways included repair of anomalous pulmonary venous return (45%), Blalock Taussig shunt (60%), bidirectional cavopulmonary connection (50%) and Fontan completion (30%).
Patients with RAI suffer high mortality and early surgical intervention, with few making it to Fontan completion. By comparison patients with LAI have less morbidity and mortality. The management of heterotaxy continues to be challenging due to widely associated cardiac and extracardiac manifestations.
In the famous early theoretical manifesto of the Frankfurt School, "Traditional and Critical Theory" (1937), Max Horkheimer proclaimed the necessity of rethinking the direction in which theory was ...moving in the context of the circulating intellectual traditions of phenomenology, sociology of knowledge, neo-Kantianism, and positivism. For Horkheimer, while the theoretical terrain associated with 1930s Europe seemed diverse and possibly open to radical directions and progressive articulations, it ultimately conspired to reinforce the socio-economic status quo in which human beings were controlled by the very practices they created and continue to recreate. Drawing on the spirit and concepts of Horkheimer's opening salvo for critical theory published eighty years ago, I argue that it is time to reinvest in the commitments heralded in the problematic of critical theory and continue to promote a critical political science that takes seriously the importance of critique and human emancipation.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Stage durations are integral to wildlife population models that can inform management, as they influence age at maturation and stage-specific survival rates. To refine oceanic stage duration ...estimates for western North Atlantic loggerhead sea turtles Caretta caretta, skeletochronological analysis was conducted on humeri collected in the Azores islands and along the US Atlantic coast. Complementary skeletal growth increment-specific stable isotope analysis was also performed for a sub-set of the humeri, to identify the skeletal growth mark associated with the shift from oceanic to neritic habitat through stable nitrogen isotope (δ15N) values and the presence of turtles in inshore waters. Although the transitional growth mark in this sub-sample corresponded to a range of sizes similar to those described in previous studies, mean size at recruitment (55.3 cm straightline carapace length SCL) for these turtles was larger than previously estimated. Similarly, while the range of ages at recruitment—corresponding both with the transitional growth mark and those yielded by fitting smoothing splines to SCL-at-age data—overlapped almost fully with earlier estimates, the mean age estimate (12.4 yr) differed from previous studies. Validated back-calculation of somatic growth rates from skeletal growth marks yielded means and ranges that encompassed those of previous loggerhead growth studies in this geographic area. Generalized additive models and generalized additive mixed models used to assess the potential influence of discrete and continuous covariates on back-calculated growth rates spanning 1984 to 2009 indicated significant effects of age, SCL, calendar year, and δ15N, but none for sex or location.
Protection of endangered species requires an understanding of their spatial ecology in relation to human activities. Recent improvements in monitoring technologies, such as automated acoustic ...telemetry, have enabled the collection of these data for mobile marine organisms such as sea turtles. The east Pacific green sea turtle Chelonia mydas uses San Diego Bay, CA, a heavily developed ecosystem, as a year-round foraging ground. We used a combination of manual and automated acoustic telemetry from 2009 to 2011 to elucidate the distribution of green turtles throughout South San Diego Bay and to understand their diel behavior. Tracked turtles (n=20) ranged in size from 54.9 to 102.5cm straight carapace length and had fidelity to two sites: the warm-water effluent channel of a waterfront power plant and an eelgrass meadow. Turtles tracked manually during the night were more sedentary (mean swimming speed±SE: 0.38±0.03kmh−1) and generally restricted their activity to waters near the power plant. During the day, turtles swam at higher speeds (0.67±0.07kmh−1) and were mainly found in eelgrass meadows where they are known to forage. Turtles were occasionally found near a shipping terminal, which occurred almost exclusively during the daytime. Turtles in areas of increased boat traffic are at risk of vessel strikes, and future monitoring should investigate the potential for turtle–human interactions in other heavily-used areas of San Diego Bay. Future monitoring should also characterize how turtle behavior may change following the decommissioning of the power plant, which occurred six months before the end of this study.
► Green sea turtles use San Diego Bay as a year-round foraging area. ► We used automated and manual acoustic telemetry to monitor turtle movement. ► Turtles showed fidelity to a power plant thermal outflow and to eelgrass meadows. ► Turtles rarely visited high-boat traffic areas, but did so when traffic is highest. ► Conservation of turtles in San Diego Bay requires protection of eelgrass meadows.
Performing Marx looks at what it means to be a Marxist dealing with contemporary political and theoretical developments in the twenty-first century. Drawing upon Marx's work, Western Marxism, and ...poststructuralist theory, Bradley J. Macdonald explores how a living tradition of Marx's ideas can constructively engage a politics of desire and pleasure, ecological sustainability, a politics of everyday life that takes seriously popular culture, and the nature of globalization and of the radical forces being arrayed against the logics of global capitalism. By engaging such crucial issues, Macdonald also provides important clarifications of the work of William Morris, Guy Debord and the situationists, Michel Foucault, Antonio Negri, Ernesto Laclau, and Chantal Mouffe, as they relate to Marx.
The impact of mitral regurgitation (MR) from pediatric rheumatic heart disease (RHD) and its effect on left ventricular (LV) remodeling and function following surgical intervention is uncertain. The ...objective is to explore the impact of mitral valve (MV) surgeries on myocardial mechanics, remodeling and function and identify pre-operative predictors of post-operative dysfunction which may contribute to the optimal timing of intervention. A retrospective review of echocardiographic data was performed of eighteen pediatric patients with RHD (median 9yrs, IQR 6–12) who underwent MV surgery. Echocardiograms pre-operatively and a median of 13.5 months (IQR 10.2–15) following intervention were compared to controls. Pre-operative LV end-diastolic indexed volumes (LVEDVi) were significantly increased compared to controls and remained persistently larger post-operatively. LV ejection fraction (LVEF) (pre 62.6% ± 6.1, post 51.7% ± 9.7, p = 0.002), and global longitudinal strain (GLS) (pre − 24.3 ± 4.1, post − 18.2 ± 2.6, p < 0.001) decreased post-operatively at mid-term follow-up. Pre-operative LVEDVi was a significant predictor of post-operative LVEF, with a cut-off of ≥ 102 ml/m2 associated with LV dysfunction (LVEF < 55%; sensitivity 70%, specificity 75%). Pre-operative LVEDVi also negatively correlated with GLS (r = − 0.58, p = 0.01). LV dimensions and volumes remain persistently larger than controls while LV function decreases post-surgical alleviation of MR in paediatric RHD. Pre-operative LVEDVi predicted post-operative LV dysfunction and utilising LV indexed volumes in directing timing of surgical planning should be considered. Further studies are required to investigate whether timely alleviation of MR before significant LV dilatation and remodeling occur may substantially prevent LV dysfunction and improve outcomes.
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