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Purpose: Intensive support teams (ISTs) are often poorly understood, despite reports of their effectiveness in managing behaviour that challenges for individuals with an intellectual disability. This paper aims to contribute to the understanding of ISTs through evaluating one IST's process and their use of positive behaviour support (PBS) as an intervention. Design/methodology/approach: Participants were obtained from the ISTs discharge database, and pre- and post-intervention data from these participants was used for analysis. Findings: Three-paired sample t-tests found that there were significant differences between pre- and post-scores on the behaviour problem inventory, Health of the Nation Outcomes Scale for people with Learning Disabilities and periodic service reviews, which measure quality of targeted, individualised support. This indicates that challenging behaviour frequency and severity were lower post-intervention, quality of life improved post-intervention and staff teams implemented recommended strategies more consistently by the end of the intervention. Originality/value: This service evaluation captured data over seven-year period, which helps to contribute to the understanding of the effectiveness of ISTs and the PBS framework. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused graduate medical education (GME) programs to pivot to virtual interviews (VIs) for recruitment and selection. This systematic review synthesizes the rapidly expanding evidence base on VIs, providing insights into preferred formats, strengths, and weaknesses. PubMed/MEDLINE, Scopus, ERIC, PsycINFO, MedEdPublish, and Google Scholar were searched from 1 January 2012 to 21 February 2022. Two authors independently screened titles, abstracts, full texts, performed data extraction, and assessed risk of bias using the Medical Education Research Quality Instrument. Findings were reported according to Best Evidence in Medical Education guidance. One hundred ten studies were included. The majority (97%) were from North America. Fourteen were conducted before COVID-19 and 96 during the pandemic. Studies involved both medical students applying to residencies (61%) and residents applying to fellowships (39%). Surgical specialties were more represented than other specialties. Applicants preferred VI days that lasted 4–6 h, with three to five individual interviews (15–20 min each), with virtual tours and opportunities to connect with current faculty and trainees. Satisfaction with VIs was high, though both applicants and programs found VIs inferior to in-person interviews for assessing 'fit.' Confidence in ranking applicants and programs was decreased. Stakeholders universally noted significant cost and time savings with VIs, as well as equity gains and reduced carbon footprint due to eliminating travel. The use of VIs for GME recruitment and selection has accelerated rapidly. The findings of this review offer early insights that can guide future practice, policy, and research. [ABSTRACT FROM AUTHOR]

Globally cannabis regulations are rapidly changing. In recent years social and political pressure, not science, has driven this change. Experience from jurisdictions that have implemented regulatory change, although relatively new, should be used to inform future policy development for other jurisdictions, assisting in addressing the wicked problem that cannabis regulations present. This review aimed to elicit underlying themes from a broad range of literature exploring the effects of regulatory change relating to cannabis. To achieve this a meta-narrative theoretical approach using inductive constant comparative analysis was used to synthesize data until thematic saturation was reached. Following a systematic literature search, 92 papers were analyzed before thematic saturation was complete. Five super-ordinate themes emerged that observed the societal and health effects following legislative and regulatory change: Normalization; Economics; Gatekeeping; Community and Health. These themes, empirically derived through a formal qualitative approach, were considered regarding cultural contexts, providing an understanding of how cannabis regulation is changing the social landscape. Consideration of the themes during future research may provide a focus point for the discussion of legislation and policy, not only relating to cannabis, but also other broad-ranging areas such as social policy, welfare, education and health. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors (ICIs) are an important treatment for metastatic renal cell carcinoma (mRCC). These agents may cause immune‐related adverse events (irAEs), and the relationship between irAEs and outcomes is poorly understood. We investigated the association between irAEs and clinical outcomes in patients with mRCC treated with ICIs. Methods: We performed a retrospective study of 200 patients with mRCC treated with ICIs at Winship Cancer Institute from 2015 to 2020. Data on irAEs were collected from clinic notes and laboratory values and grades were determined using Common Terminology Criteria in Adverse Events version 5.0. The association with overall survival (OS) and progression‐free survival (PFS) was modeled by Cox proportional hazards model. Logistic regression models were used to define odds ratios (ORs) for clinical benefit (CB). Landmark analysis and extended Cox models were used to mitigate lead‐time bias by treating irAEs as a time‐varying covariate. Results: Most patients (71.0%) were male, and one‐third of patients (33.0%) experienced at least one irAE, most commonly involving the endocrine glands (13.0%), gastrointestinal tract (10.5%), or skin (10.0%). Patients who experienced irAEs had significantly longer OS (hazard ratio [HR], 0.52; p =.013), higher chance of CB (OR, 2.10; p =.023) and showed a trend toward longer PFS (HR, 0.71; p =.065) in multivariate analysis. Patients who had endocrine irAEs, particularly thyroid irAEs, had significantly longer OS and PFS and higher chance of CB. In a 14‐week landmark analysis, irAEs were significantly associated with prolonged OS (p =.045). Patients who experienced irAEs had significantly longer median OS (44.5 vs. 18.2 months, p =.005) and PFS (7.5 vs. 3.6 months, p =.003) without landmark compared with patients who did not. Conclusion: We found that patients with mRCC treated with ICIs who experienced irAEs, particularly thyroid irAEs, had significantly improved clinical outcomes compared with patients who did not have irAEs. This suggests that irAEs may be effective clinical biomarkers in patients with mRCC treated with ICIs. Future prospective studies are warranted to validate these findings. Implications for Practice: This study found that early onset immune‐related adverse events (irAEs) are associated with significantly improved clinical outcomes in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs). In this site‐specific irAE analysis, endocrine irAEs, particularly thyroid irAEs, were significantly associated with improved clinical outcomes. These results have implications for practicing medical oncologists given the increasing use of ICIs for the treatment of mRCC. Importantly, these results suggest that early irAEs and thyroid irAEs at any time on treatment with ICIs may be clinical biomarkers of clinical outcomes in patients with mRCC treated with ICIs. This study investigated the association between immune‐related adverse events and clinical outcomes in patients with metastatic renal cell carcinoma treated with immune checkpoint inhibitors. [ABSTRACT FROM AUTHOR]