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Aim: Access to a primary care physician in early psychosis facilitates help‐seeking and engagement with psychiatric treatment. We examined access to a regular primary care physician in people with early psychosis, compared to the general population, and explored factors associated with access. Methods: Using linked health administrative data from Ontario (Canada), we identified people aged 14–35 years with a first diagnosis of nonaffective psychotic disorder (n = 39 449; 2005–2015). We matched cases to four randomly selected general population controls based on age, sex, neighbourhood, and index date (n = 157 796). We used modified Poisson regression to estimate prevalence ratios (PR) for access to a regular primary care physician in the year prior to first diagnosis of psychotic disorder, and the sociodemographic and clinical factors associated with access. Results: A larger proportion of people with early psychosis had a regular primary care physician, relative to the general population (89% vs. 68%; PR = 1.30, 95%CI = 1.30–1.31). However, this was accounted for by a higher prevalence of comorbidities among people with psychosis, and this association was no longer present after adjustment (PR = 0.97, 95%CI = 0.97, 0.98). People with early psychosis who were older, male, refugees and those residing in lower income or high residential instability neighbourhoods were less likely to have a regular primary care physician. Conclusion: Approximately one in ten young people with early psychosis in Ontario lack access to a regular primary care physician. Strategies to improve primary care physician access are needed for management of physical comorbidities and to ensure continuity of care. [ABSTRACT FROM AUTHOR]

Aims: To measure the change in proportion of opioid‐related overdose deaths attributed to people experiencing homelessness and to compare the opioid‐related fatalities between individuals experiencing homelessness and not experiencing homelessness at time of death. Design, setting and participants: Population‐based, time‐trend analysis using coroner and health administrative databases from Ontario, Canada from 1 July 2017 and 30 June 2021. Measurements: Quarterly proportion of opioid‐related overdose deaths attributed to people experiencing homelessness. We also obtained socio‐demographic and health characteristics of decedents, health‐care encounters preceding death, substances directly contributing to death and circumstances surrounding deaths. Findings A total of 6644 individuals (median age = 40 years, interquartile range = 31–51; 74.1% male) experienced an accidental opioid‐related overdose death, among whom 884 (13.3%) were identified as experiencing homelessness at the time of death. The quarterly proportion of opioid‐related overdose deaths attributed to people experiencing homelessness increased from 7.2% (26/359) in July–September 2017 to 16.8% (97/578) by April–June 2021 (trend test P < 0.01). Compared with housed decedents, those experiencing homelessness were younger (61.3 versus 53.1% aged 25–44), had higher prevalence of mental health or substance use disorders (77.1 versus 67.1%) and more often visited hospitals (32.1 versus 24.5%) and emergency departments (82.6 versus 68.5%) in the year prior to death. Fentanyl and its analogues more often directly contributed to death among people experiencing homelessness (94.0 versus 81.4%), as did stimulants (67.4 versus 51.6%); in contrast, methadone was less often present (7.8 versus 12.4%). Individuals experiencing homelessness were more often in the presence of a bystander during the acute toxicity event that led to death (55.8 versus 49.7%); and where another individual was present, more often had a resuscitation attempted (61.7 versus 55.1%) or naloxone administered (41.2 versus 28.9%). Conclusions: People experiencing homelessness account for an increasing proportion of fatal opioid‐related overdoses in Ontario, Canada, reaching nearly one in six such deaths in 2021. [ABSTRACT FROM AUTHOR]

Background: Providing supportive care to long‐term care residents with complex medical conditions generates substantial amounts of health information. This information must be documented, shared and acted upon by the various care providers within the circle of care. Objectives: The purpose of this scoping review is to describe the current digital health information exchange (HIE) processes used within Canadian long‐term care facilities (LTCFs). Methods: The scoping review followed Arksey and O′Malley's approach to the methodology. Electronic databases (e.g. CINAHL, MEDLINE and SCOPUS) were searched between 2010 and 2020 using terms including 'health information exchange', 'communication' and 'health information technology'. Articles were included if they were Canadian‐based and relevant to our definition of health information exchange. Results: The search yielded 2091 citations for title and abstract screening; 78 citations were selected for independent full‐text review, 42 of those met study criteria. The findings revealed gaps between the expectations of HIE for quality health care and the realities of HIE processes that impact the provision of care in long‐term care. Conclusions: We conclude that increased provider engagement and effective use of HIE processes is recommended to improve the safety and quality of health care in the long‐term care sector. Implications for Practice: HIE implementation should be preceded a review of various aspects of workflow to identify information gaps and inefficiencies that can be addressed by digitization. [ABSTRACT FROM AUTHOR]

Background: Recent research has suggested that too much self‐control (overcontrol) underpins a range of mental health disorders including certain Axis I mood and eating disorders, and Axis II presentations such as obsessive compulsive personality disorder and avoidant personality disorder. A novel group therapy intervention, Group Radical Openness (GRO), is proposed as a suitable treatment for overcontrol. Aims: To explore whether appropriate participants for the intervention can be recruited; to investigate whether outcome measures are fit for purpose; to determine whether the intervention is suitable and acceptable to participants; and to determine whether GRO shows promise with the intended population. Method: A mixed‐methods design was chosen, using statistical analysis on two primary measures and three secondary measures to assess pre–post outcomes and 6‐month follow‐up. This was combined with descriptive interpretive analysis of client interviews post‐intervention. Research participants were outpatients who attended GRO. The sample (N = 14; 6 females and 8 males; mean age 44.4 years; age range 18–58) attended 26, three‐hour group sessions. Results: Quantitative data were analysed using repeated‐measures ANOVA. Participant scores on the two primary measures, The Five‐Factor Obsessive–Compulsive Inventory—Short Form (FFOCI‐SF) and the Brief Symptom Inventory (BSI), yielded significant results that were maintained at 6‐month follow‐up. Qualitative data found that participants reported changes across the three themes that are addressed in the GRO programme. Discussion: This feasibility study found that GRO showed promise as a suitable intervention for individuals who are overcontrolled. Further intervention effectiveness research is warranted. [ABSTRACT FROM AUTHOR]

The use of artificial intelligence will transform clinical practice over the next decade and the early impact of this will likely be the integration of image analysis and machine learning into routine histopathology. In the UK and around the world, a digital revolution is transforming the reporting practice of diagnostic histopathology and this has sparked a proliferation of image analysis software tools. While this is an exciting development that could discover novel predictive clinical information and potentially address international pathology workforce shortages, there is a clear need for a robust and evidence‐based framework in which to develop these new tools in a collaborative manner that meets regulatory approval. With these issues in mind, the NCRI Cellular Molecular Pathology (CM‐Path) initiative and the British In Vitro Diagnostics Association (BIVDA) have set out a roadmap to help academia, industry, and clinicians develop new software tools to the point of approved clinical use. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The integration of molecularly crowded microenvironments into membrane‐enclosed protocell models represents a step towards more realistic representations of cellular structure and organization. Herein, the membrane diffusion‐mediated nucleation of either negatively or positively charged coacervate microdroplets within the aqueous lumen of individual proteinosomes is used to prepare nested hybrid protocells with spatially organized and chemically coupled enzyme activities. The location and reconfiguration of the entrapped droplets are regulated by tuning the electrostatic interactions between the encapsulated coacervate and surrounding negatively charged proteinosome membrane. As a consequence, alternative modes of a cascade reaction involving membrane‐ and coacervate‐segregated enzymes can be implemented within the coacervate‐in‐proteinosome protocells. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine the effectiveness of a compassion focused therapy (CFT) group with a transdiagnostic population, as compared to treatment as usual (TAU). A secondary aim was to explore the potential processes of change within the treatment. Design: A non‐randomized control trial was used. Method: Fifty‐eight participants who engaged in group CFT were compared to 29 participants receiving TAU. Group CFT consisted of 14 sessions twice weekly for 5 weeks and once weekly for 4 weeks. Participants completed measures of psychopathology, shame, self‐criticism, fears of self‐compassion, and social safeness, at pre‐treatment, post‐treatment, and 2‐month follow‐up. Potential processes of change were examined using correlations and regression analysis. Results: Significantly greater improvements were found for levels of psychopathology, fears of self‐compassion and social safeness for CFT, compared to TAU. Additionally, analyses showed improvements in shame and self‐criticism within the CFT group but not the TAU group. All improvements were maintained at 2‐month follow‐up. Improvements in psychopathology were predicted by changes in self‐criticism and fears of self‐compassion. Conclusion: Compassion focused therapy appears to be an effective group intervention for a range of mental health difficulties. The positive impact of the CFT model with a transdiagnostic group emphasizes the value of addressing underlying psychological process, rather than symptoms alone. Practitioner points: Compassion focused therapy is a multimodal therapy designed to target high levels of shame and self‐criticism. Compassion focused therapy has been shown previously to have positive results within a range of diagnostic‐specific populations. While there is an emerging research base, limited studies assessing effectiveness with transdiagnostic populations have been published. CFT was shown to have a significant effect in reducing levels of psychopathology, compared to TAU. A number of potential processes of change were identified: Changes in psychopathology were significantly correlated with changes in self‐criticism and fears of self‐compassion. [ABSTRACT FROM AUTHOR]

Actor‐Network Theory is a research lens that has gained popularity in the nursing and health sciences domains. The perspective allows a researcher to describe the interaction of actors (both human and non‐human) within networked sociomaterial contexts, including complex practice environments where nurses and health technology operate. This study will describe Actor‐Network Theory and provide methodological considerations for researchers who are interested in using this sociotechnical lens within nursing and informatics‐related research. Considerations related to technology conceptualization, levels of analysis, and sampling procedures in Actor‐Network Theory based research are addressed. Finally, implications for future nursing research within complex environments are highlighted. [ABSTRACT FROM AUTHOR]

Since their isolation almost 20 years ago, the callipeltosides have been of long standing interest to the synthetic community owing to their unique structural features and inherent biological activity. Herein we present our full research effort that has led to the synthesis of these molecules. Key aspects of our final strategy include 1) synthesis of the C1-C9 pyran core ( 5) using an AuCl3-catalysed cyclisation; 2) formation of C10-C22 vinyl iodide ( 55) by sequential bidirectional Stille reactions and 3) diastereoselective union of these advanced fragments by means of an alkenylzinc addition (d.r.=91:9 at C9). The common callipeltoside aglycon ( 4) was completed in a further five steps. Following this, all three sugar fragments were appended to provide the entire callipeltoside family. In addition to this, D-configured callipeltose B was synthesised and appended to the callipeltoside aglycon. The 1H NMR spectrum of this molecule was found to be significantly different to the natural isolate, further supporting our assignment of callipeltoside B ( 2). [ABSTRACT FROM AUTHOR]

Objective The protein deacetylase SirT1 positively regulates cartilage-specific gene expression, while the proinflammatory cytokine tumor necrosis factor α (TNFα) negatively regulates these same genes. This study was undertaken to test the hypothesis that SirT1 is adversely affected by TNFα, resulting in altered gene expression. Methods Cartilage-specific gene expression, SirT1 activity, and results of chromatin immunoprecipitation analysis at the α2(I) collagen enhancer site were determined in RNA, protein extracts, and nuclei of human osteoarthritic chondrocytes left untreated or treated with TNFα. Protein extracts from human chondrocytes transfected with epitope-tagged SirT1 that had been left untreated or had been treated with TNFα were analyzed by immunoblotting with SirT1 and epitope-specific antibodies. The 75-kd SirT1-reactive protein present in TNFα-treated extracts was identified by mass spectroscopy, and its amino-terminal cleavage site was identified via Edman sequencing. SirT1 activity was assayed following an in vitro cathepsin B cleavage reaction. Cathepsin B small interfering RNA (siRNA) was transfected into chondrocytes left untreated or treated with TNFα. Results TNFα-treated chondrocytes had impaired SirT1 enzymatic activity and displayed 2 forms of the enzyme: a full-length 110-kd protein and a smaller 75-kd fragment. The 75-kd SirT1 fragment was found to lack the carboxy-terminus. Cathepsin B was identified as the TNFα-responsive protease that cleaves SirT1 at residue 533. Reducing cathepsin B levels via siRNA following TNFα exposure blocked the generation of the 75-kd SirT1 fragment. Conclusion These data indicate that TNFα, a cytokine that mediates joint inflammation in arthritis, induces cathepsin B-mediated cleavage of SirT1, resulting in reduced SirT1 activity. This reduced SirT1 activity correlates with the reduced cartilage-specific gene expression evident in these TNFα-treated cells. [ABSTRACT FROM AUTHOR]

The article evaluates the Recruit Temperament Survey (RTS) as a predictor of psychiatric illness among enlistees designated to work in health care jobs. More specifically, this article identifies those characteristics assessed by the RTS that differentiate significantly between Hospital Corpsman (HMs) who become psychiatric casualties and those who do not; and determines the validity of these characteristics, taken together, for predicting psychiatric illness among HMs. Overall, the results of this study have suggested that non-cognitive measures such as the RTS are potentially useful in the psychiatric screening of candidates for Navy paramedical jobs.

Two forms of the Insel & Moos' Work Environment Scale (WES) were administered to 589 Navy enlisted men and women, one at the beginning of a 14-week paramedical training course (assessing expectations of what the occupational training environment would be like) and one eight weeks later (assessing perceptions of what the environment was actually like). Ten of the factors extracted from student responses to each form were rotated to simple structure and scales were constructed to assess six factors which were represented in the responses to both forms, accounting for 70 per cent of the common variance, and also a seventh factor which was represented only in responses to the second form, accounting for an additional 13 per cent of the common variance. The average interscale correlation and split-half reliability for the factor scales were approximately 0-2I and 0.72 for both forms. Generality and potential uses of the WES in occupational training environments are discussed. [ABSTRACT FROM AUTHOR]

Atlantic salmon Salmo salar, returning to freshwater to spawn, were angled and then terminally sampled to test the hypothesis that angling during warmer summer months (water temperatures of 20 ± 2°C) increases the magnitude of physiological disturbances in the white muscle. Angling immediately reduced white muscle ATP and phosphocreatine stores, but these high-energy phosphates were replenished within 2-4 h. Intramuscular glycogen stores were nearly depleted after angling, but unlike the response by salmon angled in the fall at 6°C, there was no glycogen resynthesis during the 4-h recovery period. Marked increases in white muscle lactate and the postexercise metabolic proton load (▵H+ m) accompanied glycogen depletion. The time course of lactate elimination and ▵H+ m correction, however, was much slower than previously observed in fall-angled salmon. Finally, considerable delayed postangling mortality (40%) was observed in a subgroup of Atlantic salmon that were angled at 22°C. We conclude that angling in warm summer water impairs restorative processes and increases the susceptibility of Atlantic salmon to delayed postangling mortality. We suggest that anglers can mitigate the magnitude of angling-induced physiological disturbances in Atlantic salmon during midsummer by minimizing playing time and postangling air exposure. [ABSTRACT FROM AUTHOR]

A comparison of 1091 black persons, 192 Hispanic persons, 186 Asian persons, and a random sample of 1785 white persons who entered Navy Hospital Corpsman and Dental Technician training revealed significant between-group differences on a number of aptitude, background, and personality measures. When participants in this research were divided into those individuals who had been fully qualified for paramedical training (high aptitude), those who had been only marginally qualified for training (medium aptitude), and those who had been accepted for training despite the fact that they had not been qualified (low aptitude), between-group comparisons revealed that minority group members at the low and medium aptitude levels tended to perform better, both in training and on the job, than did the whites at comparable aptitude levels. The performance of individuals with high aptitude test scores was not related to minority group status. These findings suggest that consideration should be given to minority group membership in screening candidates for these paramedical jobs and that affirmative action programs, at least when they are evaluated in terms of training performance and job turnover, can produce significant benefits for the individuals concerned and for the organization. [ABSTRACT FROM AUTHOR]

A comparison of the sexes in Navy Hospital Corpsman (HM) and Dental Technician (DT) rating groups showed that men and women entering these Navy paramedical specialties differed on a number of background, aptitude, and personality dimensions. The same proportion of men and women completed training in the HM group, but significantly more DT women completed training than did DT men. The proportion of men and women who were still in the Navy one year after completion of training was the same in both rating groups. Among those who failed to complete training, the women were more likely than the men to be in the Navy one year later. These findings show that women were just as successful as men in both of these rating groups when success is defined as completion of training and remaining on active duty for a period of one year after completion of training. The results are contrary to those of earlier Navy studies which showed higher discharge rates and lower reenlistment rates for women than for men. It is suggested that the results may represent changes in values, roles, and expectations for the sexes, and changes in Navy policies for women. [ABSTRACT FROM AUTHOR]

The article discusses the study concerning the personality and attitudes of effective hospital corpsmen (HMs) of the U.S. Navy. The study evaluated the Recruit Temperament Survey (RTS) as a classification instrument for identifying effective HMs. The study was conducted to identify personality and attitudinal characteristics which discriminate significantly between HMs and noneffective HMs and between effective HMs and other navy enlisted personnel. It also aims to determine the usefulness of these variables in identifying effective HMs. The study indicated that the effective HM is a well adjusted individual who tends to focus more on health-related problems.

Describes the legal framework and institutional forms of worker participation in occupational health and safety in Great Britain. Mechanisms of worker participation; Conclusion.

Aptitude, age at enlistment, years of schooling completed prior to service entry, and number of suspensions or expulsions from school were considered as potential predictors of effectiveness among 2,835 Hospital Corpsmen (HMs) and 848 Dental Technicians (DTs). Effective performance in these occupational groups was defined as completion of H M or DT training, remaining on the job for at least 2 years, and advancing in job responsibility beyond a minimum apprenticeship level during the 2-year post-training criterion period. The composite validity of these four variables was .46 for predicting HM effectiveness and .35 for predicting DT effectiveness; the crossvalidities for these composites were .48 for HMs and .35 for DTs. Occupation-specific odds-for-effectiveness (OFEs) that provide a means for standardizing the use of age and school experience variables in evaluating an individual's chances for performing effectively in these paramedical jobs were generated from the regression equations developed in these analyses. The Validities of these occupationspecific OFEs as predictors of performance effectiveness were not enhanced by considering either the minority status or sex of job candidates. [ABSTRACT FROM AUTHOR]

Background information, Comrey Personality Scale scores, and a standard Navy aptitude test score were obtained on 600 Navy enlisted men and 600 Navy enlisted women prior to beginning Naval Hospital Corps School training. A comparison of the men and women indicated that the sexes differed on a number of background and personality dimensions. A double-split cross-validation design with multiple regression was then employed in the development of a test battery for predicting school completion. Results indicated that the men were more predictable than the women with cross-validities on the order of .53 for men and .41 for women. For the total sample, cross-validities were approximately .47. An empirical comparison of the utility of these equations for screening candidates for paramedical training suggested that the use of separate equations with the sexes would not produce results which were substantially different from use of the single equation developed on both sexes combined. [ABSTRACT FROM AUTHOR]

The synthesis of callipeltosides A, B and C has been achieved in a highly convergent manner. Key to this was the synthesis of the common callipeltoside aglycon by means of an ambitious diastereoselective alkenyl metal addition of the entire bottom fragment to the pyran core, followed by Yamaguchi macrolactonisation. Following this, the endgame was in sight, with each callipeltoside picked off in turn by attachment of the appropriate sugar and unequivocal completion of the series. It’s the bullseye! For more information see the Full Paper by S. V. Ley, J. R. Frost, et al. on page 13261 ff. [ABSTRACT FROM AUTHOR]