Objectives:
The Australian government recently rescheduled psilocybin and 3,4-methylenedioxymethamphetamine for limited clinical uses. This change has raised various regulatory concerns and ...challenges for the field of psychedelic-assisted therapy. To provide clarity, we aimed to comprehensively catalogue the matters relating to psychedelic-assisted therapy that are or could be regulated.
Methods:
We conducted a desktop review of the literature and current regulatory sources, semi-structured interviews with professionals who had expertise in fields relating to psychedelic-assisted therapy and a framework analysis to generate a taxonomy of relevant regulatory matters. In relation to each matter, we further identified what type of regulation (if any) currently applies to that matter, any uncertainty as to how the matter should be addressed in clinical practice in the context of current regulation and whether there are conflicting views as to how the matter could or should be further regulated.
Results:
The taxonomy is structured into six main regulatory domains, three of which have a substantial proportion of matters with uncertainty or conflicting views: Service Establishment, Practitioner, and Treatment Delivery. Key examples of such matters include the location of services and facilities required, which professionals are eligible to become psychedelic therapists, and with what qualifications and experience. Matters in the remaining three domains, Patient Evaluation, Drug Supply and Service Oversight, appear by comparison relatively settled, with regulation either well-established or thought unnecessary.
Conclusions:
The taxonomy provides a roadmap for health services establishing and implementing a psychedelic-assisted therapy program, or for government and other policymakers when determining areas that may require further regulation.
The objective of this study was to determine whether increasing levels of dietary safflower oil would alter unsaturated fat (especially CLA) and tocopherol content of lamb, animal performance, ...carcass characteristics, or color stability of lamb muscle tissue. Targhee x Rambouillet wethers (n = 60) were assigned to one of three diets (four pens per treatment with five lambs per pen) in a completely random design. Diets were formulated with supplemental safflower oil at 0 (control), 3, or 6% (as-fed basis) of the diet. Diets containing approximately 80% concentrate and 20% roughage were formulated, on a DM basis, to be isocaloric and isonitrogenous and to meet or exceed NRC requirements for Ca, P, and other nutrients. A subsample of 12 wethers per treatment was selected based on average BW (54 kg) and slaughtered. Carcass data (LM area, fat thickness, and internal fat content) and wholesale cut weight (leg, loin, rack, shoulder, breast, and foreshank), along with fatty acid, tocopherol, and color analysis, were determined on each carcass. The LM and infraspinatus were sampled for fatty acid profile. Increasing safflower oil supplementation from 0 to 3 or 6% increased the proportion of linoleic acid in the diet from 49.93 to 55.32 to 62.38%, respectively, whereas the percentage of oleic acid decreased from 27.94 to 23.80 to 20.73%, respectively. The percentage of oil in the diet did not (P >/= 0.11) alter the growth and carcass characteristics of lambs, nor did it alter the tocopherol content or color stability of meat. Increasing levels of safflower oil in lamb diets decreased (P < 0.01) the weight percentage of oleic acid in the infraspinatus and LM, and increased linoleic acid (P < 0.01). Oil supplementation increased (P < 0.01) the weight percentage of various isomers of CLA in muscle, with the greatest change in the cis-9,trans-11 isomer. Supplementation of sheep diets with safflower oil, up to 6% of the diet, resulted in increasing levels of unsaturated fatty acids and CLA in the lean tissue, without adversely affecting growth performance, carcass characteristics, or color stability of lamb.
Within the foot and ankle literature, there exists only a handful of basic science and clinical articles reporting on the efficacy and clinical utility of platelet-rich plasma (PRP). This article ...discusses the concept and basic science of PRP, and clinical applications of PRP for the augmentation of bone healing in foot and ankle surgery. The authors also provide a classification system that assesses relative risks for poor bone healing and the need for orthobiologic augmentation.
Purpose:
In Gamma Knife radiosurgery, an efficient plan is one that achieves dosimetric quality while minimizing treatment time. Although minimization of treatment time to improve throughput and ...benefit patient comfort is a common and important goal of radiosurgery planning, to date no studies have attempted to specifically quantify efficiency. The aim of this study was to define simple index to score efficiency, and by quantifying time savings achieved by replanning those cases identified as least efficient, so demonstrate the efficacy of the index.
Methods:
To quantify efficiency, it is necessary to determine treatment times expected for specified lesions. However, because of numerous case-specifics, efficiency cannot be quantified in terms of treatment times alone. This study defines a new quantity, the attenuation-corrected normalized treatment time-dose rate product,nTRPcorr, to account for differing dose rates, prescriptions, and attenuation. A plan efficiency index (PEI) is then defined for lesions of similar volume and shape in terms of expected and planned nTRPcorr. nTRPcorr was retrospectively calculated for metastatic lesions of comparable shape. A curve fitted to data describing how nTRPcorr typically varied with volume for these lesions was then used to determine expected nTRPcorr. For each lesion, PEI was calculated as the ratio of expected-to-planned nTRPcorr. Plans with the lowest PEI were replanned, with the aim of maintaining dosimetric quality while minimizing treatment time. Dosimetric quality was defined in terms of coverage, conformity, and gradient index. Statistical significance of differences between original and replans was quantified via paired t-tests.
Results:
The mean(standard deviation) PEI of all reviewed lesions was 1.08(0.28). The 14 least efficient plans across the range of investigated volumes (45–19 800 mm3) had a mean PEI of 0.64, versus 1.18 when replanned (p < 0.0001). This corresponded to a mean(range) time saving of 42%(19%–62%), 29(8–52) min at date of treatment with no statistically significant (p > 0.05) change in dosimetric quality.
Conclusions:
The PEI is a viable metric for identifying those plans that benefit from a more efficient planning strategy.
Background: Patients with advanced renal failure are increasingly opting for conservative treatment, yet little is known of their palliative care needs. Methods: We performed a cross-sectional study, ...examining symptom burden and quality of life in patients with advanced renal failure (estimated GFR < 17 mL/min; n = 11). A contemporary cohort with terminal malignancy acted as comparators (n = 11). Symptom burden was scored using an extended Memorial Symptom Assessment Scale Short Form questionnaire. Quality of life was assessed using the Euroqol-5Q questionnaire. Demographic and pathological data, performance status and co-morbidity were also recorded. Results: Baseline characteristics were similar for the two groups. Symptom burden (renal 17; cancer 15; P =NS) and quality of life scores (renal 60; cancer 60; P =NS) were remarkably similar. Both groups reported high levels of psychological distress. Conclusions: Patients with advanced renal failure experience a symptom burden and impairment of quality of life similar to that of patients with terminal malignancy.
Annual spring-seeded forage crops use less water than cereal grains, including durum (Triticum turgidum L. var. durum), and may be suitable to replace summer fallow. We conducted an experiment from ...2002 through 2006 comparing yield, quality, and water and N use of durum and three annual forages, barley (Hordeum vulgare L.), barley interseeded with pea Pisum sativum L. ssp. arvense (L.) Poir., and foxtail millet Setaria italica (L.) Beauv. in 2-yr rotations. Durum in rotation with summer fallow and alfalfa (Medicago sativa L.) were included. Averaged over 5 yr, alfalfa had higher forage yield and quality, water use, and N accumulation compared to annual forages. Annual forages had similar preplant and postharvest soil water contents, but barley and barley–pea had higher yields and water use compared to millet. Barley–pea intercrop had superior forage crude protein (CP), neutral detergent fiber (NDF) and N accumulation compared to barley and millet, but acid detergent fiber (ADF) and nitrogen recovery index (NRI) were similar among annual forages. Averaged over 4 yr, preplant soil water and residual N content were greater for durum following fallow than for durum following annual forages, resulting in reduced fertilizer N requirement and greater yield, water use, grain N accumulation and NRI following fallow. Replacing summer fallow with annual forages reduced durum grain yield by 727 kg ha–1 but provided forage yield of 4.9 Mg ha–1. Annualized net returns in annual forage-durum systems were $127 ha–1, $77 and $34 ha–1 greater than for fallow-durum and alfalfa, respectively. Replacing summer fallow with annual forages reduced durum yield but improved profitability.
ABSTRACT
BACKGROUND
Whole school, whole community, whole child (WSCC) approaches to education address contexts beyond school that influence young people's academic and life outcomes. These ...recommended approaches demand mobilization of an array of actors, but such mobilization is challenging. Little research has explored strategies for convening national experts to support local communities.
METHODS
This paper presents a case narrative of Every School Healthy (ESH), a grant‐funded effort to support organizations/school districts in 6 communities building WSCC initiatives by engaging national youth development organizations as expert advisors to ESH and communities. A thematic analysis of the narrative yielded 3 key learnings.
RESULTS
Three themes emerged as key learnings regarding implementation of national‐local initiatives: (1) baseline assessment of local communities should be conducted to identify opportunities for maximizing strengths; (2) national organizations must be flexible with the expertise they bring to the initiative; (3) national organizations should prioritize community‐cultivated solutions and meet communities where they are.
CONCLUSIONS
The 3 themes presented in this case narrative offer insights for effectively mobilizing national organizations to support healthy, equitable school environments at the local level.
Neonatal lamb mortality is a major factor affecting profitability in the sheep industry, and lamb thermogenesis is a key element in neonatal lamb survival. Increased lamb vigor has been reported when ...ewes were supplemented during late gestation with algae-derived docosahexaenoic acid (DHA); however, the effects of DHA on lamb thermogenesis and immunocompetence have not been investigated. Eighty twin-bearing Targhee ewes (ages 2 to 5 yr; 68.5 ± 3 kg) were assigned randomly to 1 of 2 supplement treatments to determine the effects of feeding DHA to ewes during late gestation and early lactation on lamb thermogenesis, serum metabolites and hormones, and lamb growth. Supplement treatments were 12 g•ewe–1•d–1 of algae-derived DHA (DHA Gold Advanced Bionutrition Corp., Columbia, MD; algae-derived DHA); and no algae-derived DHA (control). Supplements were individually fed daily during the last 30 d (±7 d) of gestation and pen fed (6 pens/treatment with 6 or 7 ewes/pen) during the first 38 d (±7 d) of lactation. One hour after lambing and before nursing, twin-born lambs were weighed, blood sampled via jugular puncture, and placed in a dry cold chamber for 30 min (0°C), and rectal temperatures were recorded every minute for 30 min. Lambs were removed from the cold chamber, blood sampled, warmed for 15 min, and returned to their dam. Ewes were blood sampled, and colostrum samples were collected 1 h postpartum. Ewe and lamb sera were assayed for glucose, NEFA, cortisol, and leptin. Lamb rectal temperature, glucose, NEFA, cortisol, leptin, and birth weights did not differ between treatments. The BW at 38 d was greater (P = 0.03) for lambs born to control ewes than for lambs born to algae-derived DHA-supplemented ewes; however, the colostrum of algae-derived DHA-supplemented ewes had a greater specific gravity (P = 0.05) than for control ewes. Overall, despite a potentially positive effect on ewe colostral IgG concentrations, supplementation of algae-derived DHA during late gestation and early lactation had a negative effect on lamb BW and did not affect indices of lamb thermogenesis.
Abstract Objective To describe correlates of physical activity (PA) in structured exercise and structured sports sessions among low-income, overweight children participating in a community-based PA ...program. Methods A total of 93 children (55% male; 91% Hispanic) aged 8–14 years were included. Participants wore pedometers in a sample of 10 of 59 total sessions offered; mean steps per minute were calculated for structured exercise and sports sessions. Separate multivariable regression models tested associations between steps per minute in exercise and sports sessions and 5 potential correlates: baseline body mass index z -score, aerobic fitness (Progressive Aerobic Cardiorespiratory Endurance Run laps), perceived athletic competence (Harter self-perception profile), sex, and age. Results Only age (ß = –2.9; P = .02) significantly predicted steps per minute in exercise sessions. Age (ß = –4.3; P = .007), fitness (ß = 0.45; P = .03), and male sex (ß = 8.7; P = .02) significantly predicted steps per minute in sports. Conclusion and Implications In structured exercise and sports, perceived competence may not influence overweight and obese children’s PA. However, girls and older or less fit children may engage less actively, especially in sports.
Abstract The ability of the immune system to effectively respond to human tumours is a matter of long-term controversy. There is an increasing body of recent evidence to support a role for the immune ...system in eliminating pre-clinical cancers, an old concept termed ‘immunosurveillance’. ‘Immunoediting’ is an updated hypothesis, in which selection pressures applied by the immune response to tumours modulate tumour immunogenicity and growth. Tumour infiltration by immune cells has been shown to have powerful prognostic significance in a host of cancer types. Paradoxically, in some circumstances the immune system can promote tumour development. Cytotoxic therapies, including radiotherapy and chemotherapy, induce potentially immunogenic cell death, releasing tumour-associated antigens in the context of a ‘danger’ signal to the immune system. An understanding of the interaction between immune cells, tumour cells and treatment modalities will therefore guide the future combination of immunotherapy with conventional therapy to achieve optimal anti-tumour effects.
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