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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is associated with severe maternal coronavirus disease (COVID-19) and preterm birth and may increase the risk for other complications of [...]

Quality learning for sustainability can have a transformative effect in terms of promoting empowerment, leadership and wise investments in individual and collective lives and regenerating the local economies of cities, making them more inclusive, safe, resilient and sustainable. It can also help cities move towards achieving the United Nations Sustainable Development Goals (SDGs). Effecting the transformation of cities into Learning Cities, however, requires changes in the structure of governance. Drawing on interviews with key informants as well as secondary data, this article examines how collaborative governance has facilitated quality learning for sustainability in Bristol (United Kingdom), Kitakyushu (Japan) and Tongyeong (Republic of Korea). Focusing on a conceptual framework and practical application of learning initiatives, this comparative study reveals how these cities' governance mechanisms and institutional structures supported initiatives premised on cooperative learning relationships. While recognising differences in the scope and depth of the learning initiatives and the need for further improvements, the authors found evidence of general support for the governance structures and mechanisms for learning in these cities. The authors conclude by recommending that (1) to implement the Learning Cities concept based on UNESCO's "Key Features of Learning Cities", recognition should be given to existing sustainability-related learning initiatives in cities; (2) collaborative governance of the Learning Cities concept at both local and international levels should be streamlined; and (3) UNESCO's Global Network of Learning Cities could serve as a hub for sharing education/learning resources and experiences for other international city-related programmes as an important contribution to the implementation of the SDGs.

Literature from various academic disciplines indicates that in recent decades, community resilience (CR) has evolved significantly in conceptualization and operationalization. However, the relevance and empirical inclusion of CR in social and health sciences research remain sparse and fragmented. This scoping review, therefore, aimed to assess the conceptualization of CR in social and health sciences research; determine the availability of tools measuring this construct; and identify the psychometric properties of available instruments. Findings highlight how CR has shifted from a peripheral ecological concept to a central goal in the psychosociological discourse. Though several common core elements were identified in the included literature, results indicated little consensus regarding the conceptual or operational definitions of CR. Furthermore, there is minimal evidence on robust metrics that comprehensively measure CR as a complex psychosocial construct. Review results thus highlight the importance, and provide pragmatic implications, regarding the inclusion of core elements of CR in community-based strategies and development efforts. [ABSTRACT FROM AUTHOR]

The macroscopic appearance of a tumor such as hepatocellular carcinoma (HCC) may be defined as its phenotype which is de facto dictated by its genotype. Therefore, macroscopic characteristics of HCC are unlikely random but rather reflect genomic traits of cancer, presumably acting as a valuable source of information that can be retrieved and exploited to infer prognosis. This review aims to provide a comprehensive overview of the available data on the prognostic value of macroscopic characterization in HCC. A total of 57 studies meeting eligible criteria were identified, including patients undergoing liver resection (LR; 47 studies, 83%) or liver transplant (LT; 9 studies, 16%). The following macroscopic variables were investigated: tumor size (n = 42 studies), number of nodules (n = 28), vascular invasion (n = 24), bile duct invasion (n = 6), growth pattern (n = 15), resection margin (n = 11), tumor location (n = 6), capsule (n = 2) and satellite (n = 1). Although the selected studies provided insightful data with notable prognostic performances, a lack of standardization and substantial gaps were noted in the report and the analysis of gross findings. This topic remains incompletely covered. While the available studies underscored the value of macroscopic variables in HCC prognostication, important lacks were also observed. Macroscopic characterization of HCC is likely an underexploited source of prognostic factors that must be actively explored by future multidisciplinary research. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nImplications for rehabilitationThis scoping review aimed to identify behaviour change strategies influencing rehabilitation adherence in adults with tendinopathy, a common musculoskeletal condition requiring prolonged rehabilitation with poor adherence and variable outcomes.Following the Joanna Briggs Institute (JBI) methodology, seven databases were searched until April 2023. Records included reviews, intervention, and qualitative studies published in English. Behaviour change strategies were deductively coded and mapped to the capability, opportunity, and motivation model of behaviour (COM-B).Eighty-six articles were retained. The primary behaviour change strategies in tendinopathy rehabilitation reports addressed Psychological Capability; from knowledge through education, instruction, and self-monitoring using exercise diaries. Also, Social Opportunity involves demonstration and monitoring of rehabilitation behaviour, and Physical Opportunity focuses on time-efficient programs with access to equipment and health professionals. Few reports addressed Automatic Motivation (positive reinforcement and habit formation). Barriers identified in the reports were Reflective Motivation (negative beliefs and fears), Physical Opportunity (time-constraints), and Physical Capability (pain and comorbidities).Further research should explore the impact of education on beliefs, fears, and pain-management, as well as the effectiveness of teaching habit formation for improved time-management. Implementing these behaviour change strategies may enhance tendinopathy rehabilitation adherence, improving clinical trial efficacy, guiding clinical practice, and impacting patient outcomes.Education, instruction and use of an exercise diary (Psychological Capability), demonstration and monitoring of rehabilitation behaviour (Social Opportunity), and a time-efficient program with access to equipment and a health professional (Physical Opportunity) are common behaviour change strategies to improve rehabilitation adherence.A barrier to adherence we identified was negative beliefs about capabilities and consequences, and fear of pain and causing further damage (Reflective Motivation), which may be addressed by appropriate education.Positive reinforcement and teaching habit formation (Automatic Motivation) is not present in reports and should be considered in the future.Physical Capability of tendinopathy patients to perform the rehabilitation program should not be assumed by rehabilitation professionals when prescribing and delivering rehabilitation.Education, instruction and use of an exercise diary (Psychological Capability), demonstration and monitoring of rehabilitation behaviour (Social Opportunity), and a time-efficient program with access to equipment and a health professional (Physical Opportunity) are common behaviour change strategies to improve rehabilitation adherence.A barrier to adherence we identified was negative beliefs about capabilities and consequences, and fear of pain and causing further damage (Reflective Motivation), which may be addressed by appropriate education.Positive reinforcement and teaching habit formation (Automatic Motivation) is not present in reports and should be considered in the future.Physical Capability of tendinopathy patients to perform the rehabilitation program should not be assumed by rehabilitation professionals when prescribing and delivering rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Timely restoration of cerebral blood flow using reperfusion therapy is the most effective maneuver for salvaging penumbra. We re-evaluated the previously described PROTECT (PRoximal balloon Occlusion TogEther with direCt Thrombus aspiration during stent retriever thrombectomy) Plus technique at a tertiary comprehensive stroke center. Methods: We retrospectively analyzed all patients who underwent mechanical thrombectomy with stentrievers between May 2011 and April 2020. Patients were divided between those who underwent PROTECT Plus and those who did not (proximal balloon occlusion with stent retriever only). We compared the groups in terms of reperfusion, groin to reperfusion time, symptomatic intracranial hemorrhage (sICH), modified Rankin Scale (mRS) score at discharge. Results: Within the study period, 167 (71.4%) PROTECT Plus and 67 (28.6%) non-PROTECT patients which met our inclusion criteria. There was no statistically significant difference in the number of patients with successful reperfusion (mTICI >2b) between the techniques (85.0% vs 82.1%; p = 0.58). The PROTECT Plus group had lower rates of mRS ≤2 at discharge (40.1% vs 57.6%; p = 0.016). The rate of sICH was comparable (p = 0.35) between the PROTECT Plus group (7.2%) and the non-PROTECT group (3.0%). Conclusion: The PROTECT Plus technique using a BGC, a distal reperfusion catheter and stent retriever is feasible for recanalization of large vessel occlusions. Successful recanalization, first-pass recanalization and complication rates are similar between PROTECT Plus and non-PROTECT stent retriever techniques. This study adds to an existing body of literature detailing techniques that use both a stent retriever and a distal reperfusion catheter to maximize recanalization for patients with large vessel occlusions. [ABSTRACT FROM AUTHOR]

The impact of spoken language skills on the social inclusion of children with hearing loss is of interest for listening and spoken language early intervention providers. This study used spoken language assessments and a parent-report social inclusion survey to investigate this impact for 95 children with hearing loss (M = 5.1 years of age). The survey focused on two facets of social inclusion: education and interacting with society and fulfilling social roles. The majority of participants demonstrated language, vocabulary and speech skills commensurate with peers with typical hearing. Vocabulary and speech skills had an impact on only a few aspects of social inclusion. Specifically, this was primary caregiver satisfaction with the level of teacher support; and children being invited to social activities or using computer or mobile technology devices. Spoken language skills were shown to have some impact on a few aspects of social inclusion. Areas were suggested where early intervention providers could offer additional support to children with hearing loss and their families.

Importance: Children with autism spectrum disorder (ASD) face school-related occupational challenges. Attending a mainstream school offers benefits for children's learning and their development of social skills; however, parents express frustration with ensuring their child's unique needs and preferences are met. Objective: To gain insight into parents' experiences with the mainstream preschool and primary educational system for their children with ASD. Data Sources: Eleven electronic databases were systematically searched, and processes were followed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Study Selection and Data Collection: Study eligibility was determined through the use of selection criteria and paired independent reviewers. Critical appraisal was conducted using a qualitative research hierarchy and a modified version of the Critical Appraisal Skills Programme tool. Two reviewers synthesized the data into themes, following the Joanna Briggs Institute meta-aggregation process. Twenty-six qualitative studies, representing the voices of 397 parents, are presented in this review (spanning 2013–2021). Articles were set in Westernized and non-Westernized settings and represented culturally and linguistically diverse population groups. Findings: Parents of children with ASD reported a lack of awareness and understanding of their children's unique learning needs in the mainstream school system at all levels. Conclusions and Relevance: This review has various occupational therapy practice implications for supporting school-age children with ASD, their parents, and school staff. These include adopting family-centered and ecological approaches, raising awareness, influencing policy, and facilitating collaboration. What This Article Adds: This review provides guidance for occupational therapists working in schools about their practice in working at the individual, targeted, and whole-school levels to address occupational barriers faced by children with ASD. The main implication of this review is that parents perceive a lack of awareness and understanding of the unique learning needs of their children with autism spectrum disorder (ASD) at all school levels. This review offers practice recommendations for occupational therapists working with school-age children with ASD, their parents, and school staff. [ABSTRACT FROM AUTHOR]

Program evaluation is intended to systematically determine the merit and worth of a program. We broadly define "merit" and "worth" to include economic perspectives obtained through the analysis of the finances of a program--both the costs and the benefits. A study reported here addressed the cost and benefit of investing in an educational intervention to change and improve processes in a health care setting. The potential economic impact of a training intervention intended to improve the uptake of a new purchasing process was evaluated. The study illustrates economic evaluation that anticipates the future value of educational interventions, a prospective view. (Contains 3 tables.)