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Abstract: In this essay, we approach the question of what it means for something to be symbolic in a different way from the usual answers rooted in philosophy, sociology or anthropology: we argue that the symbolic is, first and foremost, rooted in human biology and human evolution. We discuss how the development of the capability to create and share symbols was a key moment in human evolution that underpins our capability to communicate and store knowledge through language, to think abstractly about problems, and to live and work together effectively in large groups. It also underpins the unique ecological niche – the cognitive niche – that Homo sapiens construct using our capability to create and share symbols. We go on to explore some of the implications of an evolutionary understanding of the symbolic for management and organization research.

We comprehensively review typical problems that people with disabilities face when using local transportation modes. We show how specific problems with each mode can affect many different disability subgroups at once and can affect or be affected by problems with other modes. Academic literature about transportation for adults with disabilities skews toward walking, driving one's own motor vehicle, using a ridehailing or taxi service, using a carsharing service as a driver, and using public transit, so this review focuses primarily but not exclusively on those modes. We frame these problems using the terms that we introduced in a previous work. Provider-view availability refers to where & when a transportation mode is present or legal to use. Immediate usability refers to features of a mode's vehicles or infrastructure, where and when such vehicles and infrastructure are present, that help or hurt a user. User-view availability captures how serious problems with immediate usability for some users can prevent them from using those modes at all, make some aspects of provider-view availability moot for them. Cumulative usability refers to problems with a mode that arise over frequent use, longer trips, or more complicated trips, that may discourage a user from using that mode. We explain how modes that have similar requirements, present or absent, for the user to drive or to make a first-/last-mile connection exhibit consequently similar problems with provider-view availability, immediate usability, user-view availability, and cumulative usability.

IssueWhen frontline employees' voice is not heard and their ideas are not implemented, patient care is negatively impacted, and frontline employees are more likely to experience burnout and less likely to engage in subsequent change efforts.Critical theoretical analysisTheory about what happens to voiced ideas during the critical stage after employees voice and before performance outcomes are measured is nascent. We draw on research from organizational behavior, human resource management, and health care management to develop a multilevel model encompassing practices and processes at the individual, team, managerial, and organizational levels that, together, provide a nuanced picture of how voiced ideas reach implementation.Insight/advanceWe offer a multilevel understanding of the practices and processes through which voice leads to implementation; illuminate the importance of thinking temporally about voice to better understand the complex dynamics required for voiced ideas to reach implementation; and highlight factors that help ideas reach implementation, including voicers' personal and interpersonal tactics with colleagues and managers, as well as senior leaders modeling and explaining norms and making voice-related processes and practices transparent.Practice implicationsOur model provides evidence-based strategies for bolstering rejected or ignored ideas, including how voicers (re)articulate ideas, whom they enlist to advance ideas, how they engage peers and managers to improve conditions for intentional experimentation, and how they take advantage of listening structures and other formal mechanisms for voice. Our model also highlights how senior leaders can make change processes and priorities explicit and transparent.

This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE‐mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE‐mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto‐injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist. As immunomodulatory interventions, omalizumab is suggested for treatment of IgE‐mediated food allergy in children from the age of 1 and adults; and oral allergen‐specific immunotherapy is recommended for children and adolescents with peanut allergy and suggested for milk and egg allergies (generally after 4 years of age for milk and egg). Sublingual and epicutaneous immunotherapy are suggested for peanut allergy but are not yet available at the point of care. Future research into disease modifying treatments for IgE‐mediated food allergy are highly needed, with standardised and patient‐focused protocols and outcomes. [ABSTRACT FROM AUTHOR]

ABSTRACT Regional factors correlated with recruitment of black bass (largemouth bass; Micropterus nigricans and smallmouth bass; Micropterus dolomieu), two important fishes, are rarely studied, despite the importance of recruitment variation in influencing fish populations. We sought to identify factors that drove variation in age‐0 and age‐1 black bass abundance. Age‐0 or age‐1 black bass catch per unit effort (CPUE) in reservoirs in Kansas and Illinois, USA, was positively correlated with local short‐term (i.e., mean April precipitation) environmental variables. In contrast, age‐0 or age‐1 black bass CPUE was generally negatively correlated with long‐term environmental variables and river regulation metrics (i.e., reservoir elevation) in the Mississippi and Missouri river reservoirs. Our findings highlight that consideration of spatiotemporal scale is important when managing black bass populations. [ABSTRACT FROM AUTHOR]

ABSTRACT Isolation by distance and biogeographical boundaries define patterns of population genetic structure for harbour porpoise along the Pacific coast from California to British Columbia. Until recently, inadequate sample sizes in many regions constrained efforts to characterise population genetic structure throughout the coastal waters of Alaska. Here, tissue samples from beachcast strandings and fisheries bycatch were supplemented with targeted environmental DNA (eDNA) samples in key regions of Alaska coastal and inland waters. Using a geographically explicit, hierarchical approach, we examined the genetic structure of Alaska harbour porpoises, using both mitochondrial DNA (mtDNA) sequence data and multilocus SNP genotypes. Despite a lack of evidence of genetic differentiation from nuclear SNP loci, patterns of relatedness and genetic differentiation from mtDNA suggest natal philopatry at multiple geographic scales, with limited gene flow among sites possibly mediated by male dispersal. A priori clustering of sampled areas at an intermediate scale (eastern and western Bering Sea, Gulf of Alaska and Southeast Alaska) best explained the genetic variance (12.37%) among regions. In addition, mtDNA differentiation between the Gulf of Alaska and eastern Bering Sea, and among regions within the Gulf of Alaska, indicated significant genetic structuring of harbour porpoise populations in Southeast Alaska. The targeted collection of eDNA samples from strata within Southeast Alaska was key for elevating the statistical power of our mtDNA dataset, and findings indicate limited dispersal between neighbouring strata within coastal and inland waters. These results provide evidence supporting a population boundary within the currently recognised Southeast Alaska Stock. Together, these findings will prove useful for ongoing management efforts to reduce fisheries conflict and conserve genetic diversity in this iconic coastal species. [ABSTRACT FROM AUTHOR]

Background: Numerous studies reported a higher prevalence of polyneuropathy (PNP) in patients with Parkinson's disease (PD) compared to the general population. Importantly, PNP symptoms can aggravate both motor and sensory disturbances in PD patients and negatively impact the disease course. Recent analyses indicate distinct PNP patterns in PD. Main text: This review aims to provide an overview of the current insights into etiological factors, diagnostic methods, and management strategies of large fiber neuropathy in PD. Despite the higher prevalence, the causes of PNP in PD are still not fully understood. A genetic predisposition can underlie PNP onset in PD. Main research attention is focused on long-term levodopa exposure which is suggested to increase PNP risk by depletion of methylation cofactors such as vitamin B12 and accumulation of homocysteine that altogether can alter peripheral nerve homeostasis. Beyond a potential "iatrogenic" cause, alpha-synuclein deposition has been detected in sural nerve fibers that could contribute to peripheral neuronal degeneration as part of the systemic manifestation of PD. Whereas mild axonal sensory PNP predominates in PD, a considerable proportion of patients also show motor and upper limb nerve involvement. Intriguingly, a correlation between PNP severity and PD severity has been demonstrated. Therefore, PNP screening involving clinical and instrument-based assessments should be implemented in the clinical routine for early detection and monitoring. Given the etiological uncertainty, therapeutic or preventive options remain limited. Vitamin supplementation and use of catechol-O-methyltransferase-inhibitors can be taken into consideration. Conclusion: PNP is increasingly recognized as a complicating comorbidity of PD patients. Long-term, large-scale prospective studies are required to elucidate the causative factors for the development and progression of PD-associated PNP to optimize treatment approaches. The overall systemic role of "idiopathic" PNP in PD and a putative association with the progression of neurodegeneration should also be investigated further. [ABSTRACT FROM AUTHOR]

The current diagnostic criteria for gestational diabetes (GDM) were based on data from women after 24 weeks of gestation, but this may not be equally applicable for earlier gestation. There is insufficient data regarding early pregnancy glycaemia and the associated complications. We retrospectively reviewed 39,483 deliveries and 12,918 with risk factors for GDM underwent oral glucose tolerance test (OGTT) before 24 weeks of gestation. A strong and progressively positive association was observed with any pregnancy complications in both fasting glucose (FG) and 2 h glucose (2hG). The increased risk of developing any pregnancy complications started from FG 4.5–4.7 mmol/L and 2hG of 6.2–6.9mmol/L. Every increase by 1 mmol/L in FG or 2 hG levels increased the risk of developing any complications (aOR 1.614 for FG and 1.131 for 2hG), pre-eclampsia (aOR 1.472 for FG and 1.143 for 2hG), maternal insulin use (aOR 12.821 for FG and 2.366 for 2hG), primary Caesarean section(aOR 1.274 for FG and 1.099 for 2hG), shoulder dystocia (aOR 1.941 for FG and 1.282 for 2hG), macrosomia(aOR 2.203 for FG and 1.072 for 2hG), and large for gestation age(aOR 2.157 for FG and 1.074 for 2hG). Therefore, glycaemic levels in early pregnancy among high-risk women positively associated with pregnancy complications, even at levels below the current recommended diagnostic criteria for GDM. [ABSTRACT FROM AUTHOR]

China was one of the earliest domestication centres for pigs in the Old World. Since their domestication, pigs have been significantly involved in human societies from both economic and ceremonial perspectives, so the investigation of pig domestication is key to understand the development process of ancient communities. However, the pig domestication process has not been fully explored in Shandong, one of the earliest regions for exploiting pig resources, such as canine teeth, in China. We use geometric morphometry to analyse the second lower molars of pigs associated with diverse periods, including the Longshan, Yueshi, and Shang and Zhou, at Dinggong, China. The results show that while there was a relatively consistent pig phenotype in this region from the Longshan to the Shang and Zhou periods, the centroid sizes of pigs experienced a moderate decrease over time. A certain number of wild boars were harvested by humans, but their proportions declined chronologically along with the gradually intensification of pig management. Apart from household refuse, fodders similar to the staple plants for humans were provisioned to those managed pigs, suggesting a close relationship between humans and pigs. In spite of more time and energy required for managing pigs, human societies could have benefited from this investment with a better secured meat supply and more ceremonial materials, which helped strengthen the human–pig bond from the Neolithic period to today. [ABSTRACT FROM AUTHOR]

Approximately 7% of the Earth’s land surface is affected by salinity, resulting in significant agricultural losses. Salt stress is characterized by the presence of an elevated concentration of soluble salts within the root zone, leading to the development of osmotic stress and ion toxicity in the plant throughout its growth. The presence of elevated levels of salt in soil is a significant abiotic stress factor that has a detrimental impact on the growth, development, and production of agricultural crops. The issue of salt stress arises as a significant matter when agricultural fields, which were once fertile and productive, experience a more pronounced salinization due to both human activity and natural factors. Sodic soils have a detrimental impact on plant growth due to elevated soil pH levels and unfavorable physical properties caused by an excessive accumulation of exchangeable sodium ions. Sodium ions (Na+) have been found to exert significant deleterious effects on plant growth due to their harmful impact on plant metabolism via suppressing enzyme activities. The maintenance of plant growth and yield development relies on the activation of enzymatic processes in the cytoplasm, which requires an appropriate ratio of potassium (K+) to sodium (Na+). The reclamation of salt-affected soils is necessary in order to restore their productivity and hence enhance food production. Various strategies have been employed for the effective management of saline-alkali soils. These approaches encompass leaching, incorporation of diverse organic and inorganic amendments, mulching, and the cultivation of salt-tolerant crops. Hence, the current study is centered on multiple facets of salt-affected soils, their impact on plant life, and diverse strategies for rehabilitating salt affected soils in order to improve the capacity for agricultural yield. [ABSTRACT FROM AUTHOR]

Global deforestation and forest degradation threaten the sustainability of natural and human systems. Forest landscape restoration, through active approaches such as plantations, woodlots, boundary planting, and agroforestry, and passive approaches like exclosures, presents an opportunity to mitigate adverse effects, enhance ecosystem service recovery, and associated benefits for livelihoods. Here, using different spatial scales, we compare the contribution of both approaches to the recovery of plant diversity in southern Ethiopia. Using forest inventory data (891 plots) from multi‐aged stands, we estimated and compared alpha (α), beta (β), and gamma (γ) diversity in regeneration and tree layers between the approaches. We observed increasing α‐diversity in the order grazing lands‐active‐passive‐forest sites. β‐Diversity revealed similarity between passively restored sites and natural forests. γ‐Diversity was higher in active restoration for the regeneration layer, but passive restoration had higher γ‐diversity in the tree layer. For both approaches, γ‐diversity was consistently highest in intermediate‐aged stands (10–20 years). Results highlight the potential of active restoration strategies to facilitate vegetation recovery in human‐dominated landscapes, especially when management allows natural regeneration, while stand age variation may be associated with disturbance intensities for both approaches. Our results support a paradigm shift toward implementation of a mixture of these approaches in the landscapes to meet increasing human demands while restoring important ecosystem services like biodiversity. We recommend enhancing species diversity on restored sites to improve performance and ecosystem service recovery. On actively restored sites, we recommend protecting regenerated species; on passively restored sites, enrichment planting, increased protection, and sustainable utilization. [ABSTRACT FROM AUTHOR]

Coral reefs support an incredible abundance and diversity of fish species, with reef-associated fisheries providing important sources of income, food, and dietary micronutrients to millions of people across the tropics. However, the rapid degradation of the world's coral reefs and the decline in their biodiversity may limit their capacity to supply nutritious and affordable seafood while meeting conservation goals for sustainability. Here, we conduct a global-scale analysis of how the nutritional quality of reef fish assemblages (nutritional contribution to the recommended daily intake of calcium, iron, and zinc contained in an average 100 g fish on the reef) relates to key environmental, socioeconomic, and ecological conditions, including two key metrics of fish biodiversity. Our global analysis of more than 1,600 tropical reefs reveals that fish trophic composition is a more important driver of micronutrient concentrations than socioeconomic and environmental conditions. Specifically, micronutrient density increases as the relative biomass of herbivores and detritivores increases at lower overall biomass or under high human pressure. This suggests that the provision of essential micronutrients can be maintained or even increase where fish biomass decreases, reinforcing the need for policies that ensure sustainable fishing, and that these micronutrients are retained locally for nutrition. Furthermore, we found a negative association between micronutrient density and two metrics of fish biodiversity, revealing an important nutrition-biodiversity trade-off. Protecting reefs with high levels of biodiversity maintains key ecosystem functions, whereas sustainable fisheries management in locations with high micronutrient density could sustain the essential supply of micronutrients to coastal human communities. • Fish trophic composition is the most important driver of micronutrient density • Micronutrient density is negatively associated with fish biomass and diversity • Sustainable management remains essential to support nutritious reef fisheries Maire et al. explore how the nutrient quality of reef fish communities changes with environmental, socioeconomic, and ecological conditions, including fish biodiversity. A nutrition-biodiversity trade-off can exist and implies a new target for fisheries management that maximizes nutritional harvest without compromising efforts to reverse biodiversity loss. [ABSTRACT FROM AUTHOR]

University reputation is the result of the assessments that the stakeholders make of the university, especially the user of the education service, the student. The literature has shown an important impact of reputation on the student's perception of the university, and it has been related to success, competitiveness, sustainability, stakeholder decision-making and the differential of the value offer. Therefore, its evaluation has been the subject of several studies that seek to measure and assess reputation in higher education to understand how to manage it. This article evaluates the psychometric properties of the reputation scale in students at private universities in Colombia. The methodology used included an adaptation of the scale to the Spanish language, content validity analysis, reliability analysis, exploratory factor analysis and confirmatory factor analysis. The results showed the validity and reliability of the scale and, through the analyses carried out, provided evidence of the scale's robustness. [ABSTRACT FROM AUTHOR]

The global COVID-19 pandemic has presented a significant, ongoing challenge since its emergence in late 2019. Today, the Omicron strain, which is less lethal but more contagious than the original outbreak strain, continues to pose substantial health risks. In this background, the management of psoriatic comorbidities has become even more complex, particularly for patients with underlying inflammatory, metabolic, or cardiovascular diseases. This review aims to summarize current research on comorbid COVID-19 and psoriasis, and provide insights into the development of evidence-based management strategies. By providing appropriate patient instruction, implementing protective measures, and re-evaluating medication prescriptions based on each patient's unique situation, healthcare professionals can effectively address the challenges faced by patients with comorbid psoriasis in the COVID-19 era. [ABSTRACT FROM AUTHOR]

Due to the heterogeneous nature of depression, the underlying etiological mechanisms greatly differ among individuals, and there are no known subtype-specific biomarkers to serve as precise targets for therapeutic efficacy. The extensive research efforts over the past decades have not yielded much success, and the currently used first-line conventional antidepressants are still ineffective for close to 66% of patients. Most clinicians use trial-and-error treatment approaches, which seem beneficial to only a fraction of patients, with some eventually developing treatment resistance. Here, we review evidence from both preclinical and clinical studies on the pathogenesis of depression and antidepressant treatment response. We also discuss the efficacy of the currently used pharmacological and non-pharmacological approaches, as well as the novel emerging therapies. The review reveals that the underlying mechanisms in the pathogenesis of depression and antidepressant response, are not specific, but rather involve an interplay between various neurotransmitter systems, inflammatory mediators, stress, HPA axis dysregulation, genetics, and other psycho-neurophysiological factors. None of the current depression hypotheses sufficiently accounts for the interactional mechanisms involved in both its etiology and treatment response, which could partly explain the limited success in discovering efficacious antidepressant treatment. Effective management of treatment-resistant depression (TRD) requires targeting several interactional mechanisms, using subtype-specific and/or personalized therapeutic modalities, which could, for example, include multi-target pharmacotherapies in augmentation with psychotherapy and/or other non-pharmacological approaches. Future research guided by interaction mechanisms hypotheses could provide more insights into potential etiologies of TRD, precision biomarker targets, and efficacious therapeutic modalities. [ABSTRACT FROM AUTHOR]

Odontoid fractures (OFs) represent up to 15% of all cervical fractures encountered and present most commonly amongst elderly patients, typically in the setting of low energy trauma such as falls. The Anderson and D'Alonzo classification and Roy-Camille subtype description are the most clinically noteworthy descriptions of OFs used. Even though most patients will not present with neurological injury, mechanical instability can occur with type II and type III (Anderson and D'Alonzo) fractures, particularly if the transverse ligament of the atlas is ruptured; however, this is very rare. Conservative treatment is usually employed for type I and type III injuries, and to a varying degree for non-displaced type II injuries. Surgical treatment is typically reserved for type II fractures, patients with neurological injury, and in the setting of other associated fractures or ligamentous injury. Anterior screw fixation is a viable option in the setting of a favorable fracture line orientation in type II fractures, whereas posterior C1–C2 screw fixation is an option for any type II or type III fracture presentation. There is evidence that surgery for type II fractures has higher rates of union and lower mortality than nonoperative treatments. While surgical options have increased over the decades and the management of OF has been optimized by considering fracture subtypes and patient factors, there remains a significant morbidity and mortality associated with OFs. The aging population and changing demographics suggest that there will be an ongoing rise in the incidence of OFs. Therefore, the appropriate management of these cases will be essential for ensuring optimization of health care resources and the quality of life of affected patients [ABSTRACT FROM AUTHOR]

Patients' beliefs about their illness are of central importance in understanding how a person adjusts to their condition and adheres to self-management recommendations. No previous studies have set out to quantitatively examine Illness beliefs in patients with kidney stones (KS). 112 patients with radiological confirmation of KS (59% male, mean (x̄) age = 50.1 years [sd14.15 years], 50.5% previous surgical treatment) attending for clinical consultation completed the Brief-Illness Perception Questionnaire alongside a range of demographic and illness related variables. Template analysis was undertaken on the free text responses of patients' beliefs about what had caused their KS. Almost a third (31.2%) of patients did not know what had caused their KS. Of those who cited a cause, dietary factors, fluid intake, medical risk factors (e.g. Inflammatory bowel disease), genetics, and psychological factors were ranked as the most important. Patients generally believed they had a reasonable understanding of KS (x̄=6.32 [sd3.21]), but reported poor levels of personal control over their KS (x̄=2.90 [sd2.93]) and high confidence in the effectiveness of treatments (x̄=8.64 [sd1.90]). Patients with a recurrence believed KS had a significantly greater impact on their life (z=-2.56, p = 0.01) and had greater emotional consequences (z=-2.77, p < 0.01). Perceptions of poor personal control over KS and a strong belief in medical/surgical treatment was evident regardless of first or recurrent stone, gender, age, previous surgical management of KS or time since diagnosis. Results highlight the need to actively increase patients' perceptions of personal control in the management and prevention of KS. [ABSTRACT FROM AUTHOR]

Despite abundant clinical innovation and burgeoning scientific investigation, pulmonary embolism (PE) has continued to pose a diagnostic and management challenge worldwide. Aging populations, patients living with a mounting number of chronic medical conditions, particularly cancer, and increasingly prevalent health care disparities herald a growing burden of PE. In the meantime, navigating expanding strategies for immediate and long-term anticoagulation, as well as advanced therapies, including catheter-based interventions for patients with more severe PE, has become progressively daunting. Accordingly, clinicians frequently turn to evidence-based clinical practice guidelines for diagnostic and management recommendations. However, numerous international guidelines, heterogeneity in recommendations, as well as areas of uncertainty or omission may leave the readers and clinicians without a clear management pathway. In this review of international PE guidelines, we highlight key areas of consistency, difference, and lack of recommendations (silence) with an emphasis on critical clinical and research needs. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion The skin is the largest and most visible organ of the human body. As such, skin infections can have a significant impact on overall health, social wellbeing and self‐image. In 2019, we published a systematic review of the treatment, prevention and public health control of skin infections including impetigo, scabies, crusted scabies and tinea in resource‐limited settings where skin infections are endemic. This current review serves as an update to assess the evidence for treatment of these conditions as well as atopic dermatitis, molluscum contagiosum and head lice in endemic settings. The data from this systematic review have supported an update to the Australian National Healthy Skin guidelines.A systematic review was conducted using two separate searches in MEDLINE, PubMed, Embase, CINAHL, Cochrane and Web of Science. The first search was an update of the 2018 systematic review using the same search strategy for the same skin conditions to identify emerging literature from 2018 to 2022. The second search strategy used the same key terms but with the addition of atopic dermatitis, head lice and molluscum contagiosum from 1960 to 2022. Eligible studies included Indigenous peoples and populations in resource‐limited settings with a diagnosis of impetigo, scabies, crusted scabies, tinea capitis, atopic dermatitis, molluscum contagiosum or who presented with head lice. Studies conducted in high‐income countries were excluded. Articles were screened for inclusion independently by one author with a second group of reviewers independently double screening. Data extraction and an in‐depth quality assessment conducted by one author and checked by two others.Of 1466 original articles identified, 68 studies were included and key findings outlined for impetigo, scabies, crusted scabies, atopic dermatitis, head lice and molluscum contagiosum. Recommendations for each condition based on the available evidence are provided.The importance of assessing literature relevant to the populations with heavy burden of skin infections is outlined in this systematic review. We have summarised updates to this literature, which may benefit in developing guidelines for skin infection management similar to the National Healthy Skin Guidelines for Australia. [ABSTRACT FROM AUTHOR]

Trap and transport, the capture and subsequent translocation of fish during the freshwater phase of their migration, is becoming more common as a management intervention. Although the technique can be successful, it is costly and can have unintended effects on the fish being transported. This study investigates whether trap and transport can be used to increase the migration success of Atlantic salmon, Salmo salar, smolts in naturally flowing rivers. Seaward‐migrating S. salar (n = 294) from two UK rivers were tracked using acoustic telemetric techniques. Outmigration success and timing were compared between non‐transported (released at the original in‐river capture site) and transported (released ca. 23 km downstream of the capture site) individuals. Downstream translocation increased the proportion of fish that successfully migrated to marine waters, and there was no indication that transport reduced post‐release survival. The post‐release migration speed of transported fish was slower than expected but this was likely a function of their advanced migration timing rather than an inhibition of their capacity to migrate. These results suggest that trap and transport can increase the outmigration success of S. salar smolts, but the earlier river exit dates of transported fish could negatively affect their survival at sea. [ABSTRACT FROM AUTHOR]

This article concerns the management of the Polish mining company Lubelski Węgiel (LW) Bogdanka S.A. The main aim of this paper was to describe the whole process of implementing a process approach to management in one of the most important mining companies in Poland. The objective of the research presented was the incorporation of the process approach in LW Bogdanka S.A. to enhance its management and to improve the effectiveness of its mining process. This paper uses a case study method and presents a practical incorporation of the process approach and its results. The first phase of the proposed solution included building a map of business processes. Then, the research consisted of an analysis of existing processes; the introduction of new solutions, mainly in the field of infrastructure and IT systems; and changing the awareness of key process owners. The motivation for applying this approach was to achieve greater efficiency and continuous improvement in LW Bogdanka S.A. The main results and achievements were not merely limited to the development of a map of processes and subprocesses, but also led to an improvement in organizational structure, changes in approach to company management, a diagnosis of problems in the most important company departments, and the proposal of solutions to them. [ABSTRACT FROM AUTHOR]

Multiple primary lung cancer (MPLC), can be categorized as synchronous multiple primary lung cancer (sMPLC) and metachronous multiple primary lung cancer (mMPLC), which are becoming increasingly common in clinical practice. A precise differential diagnosis between MPLC and intrapulmonary metastases (IPM) is essential for determining the appropriate management strategy. MPLC is primarily diagnosed through histology, imaging, and molecular methods. Imaging serves as an essential foundation for preoperative diagnosis, while histology is a critical tool for establishing a definitive diagnosis. As molecular biology advances, the diagnosis of MPLC has stepped into the era of molecular precision. Surgery is the preferred treatment approach, with stereotactic radiotherapy and ablation being viable options for unresectable lesions. Targeted therapy and immunotherapy can be considered for specific patients. A multidisciplinary team approach to evaluation and the application of combination therapy can benefit more patients. Looking ahead, the development of more authoritative guidelines will be instrumental in streamlining the diagnosis and management of MPLC. [ABSTRACT FROM AUTHOR]

The article discusses the challenges faced by esketamine nasal spray in China regarding its use and management. Esketamine nasal spray was approved in China in April 2023, but strict regulations are expected due to its potential for addiction and abuse. The drug's administration and monitoring will be closely supervised by medical professionals to prevent misuse. Additionally, concerns about adverse drug events and the high cost of treatment may limit the accessibility of esketamine nasal spray, especially in rural areas with limited medical resources. The article highlights the need for pragmatic prevention and management strategies to address these challenges and improve patient access to treatment. [Extracted from the article]

Background: Healthcare waste (HCW) poses a global hazard, particularly in developing country hospitals where mismanagement is common due to poor practices among staff. Training healthcare workers has shown promise in enhancing practices and behaviors. The aim of this study was to assessHCW management at Sahloul University Hospital (2019–2021) before and after training sessions. Methods: This study was conducted at Sahloul University in Sousse, Tunisia, spanned two years (2019–2021) and consisted of three distinct stages. Two audits of Healthcare Waste Management (HCWM) were conducted using a predetermined assessment framework derived from ANGED's guidelines, with an educational session separating the two audits. Results: In terms of sorting practicesthere was a substantial improvement in sorting practices following training. Specifically, the overall compliance rate for sorting sharps increased from 60.3 to 77.6% (p < 10 − 3), and for sorting soft and solid waste, it rose from 32.5 to 72.4% (p < 10 − 3) in 2021. Overall, resource indicators demonstrated improvement between 2019 and 2021, the compliance rate for the intra-service collection step increased from 31.3 to 58.2%. However, we observed persistent inadequacies in container and bag labeling, as well as challenges in tracing the time of healthcare waste collection. Conclusion: Training led to significant improvements in HCW management practices among healthcare workers, though some areas still need enhancement. [ABSTRACT FROM AUTHOR]

Background Methods Result Conclusion The clinical characteristics and management of late‐onset chylothorax after lung cancer surgery remained unknown. Here we aimed to provide evidence on the management of late‐onset chylothorax by analysis of several cases with the largest sample size.We retrospectively collected clinical data of patients who developed late‐onset chylothorax after lung cancer surgery and were re‐admitted by a single surgeon in our center from 2016 to 2022. The clinical characteristics and management for these patients were analysed. The role of Hem‐o‐lok clipping after lymphadenectomy in preventing late‐onset chylothorax was further explored by comparing the surgical outcomes between treated group and control group.A total of six patients who were re‐admitted for late‐onset chylothorax after lung cancer surgery were included for analysis. The mean age of them was 60.7 years old. The symptom of late‐onset chylothorax was mainly dyspnea and cough and the diagnosis was all made by Sudan III staining between postoperative day 17 to 42. All patients were firstly treated with thoracocentesis and low‐fat diet with intravenous nutrition. Four patients were successfully managed with low‐fat diet and thoracocentesis, while the other two patients were further managed with pleurodesis with 50% glucose fluid solution. We found a significantly decreased risk of late‐onset chylothorax in the treated group with improved procedure of applying Hem‐o‐lok clipping after lymphadenectomy than in the control group (0% versus 2.6%, P < 0.01).Late‐onset chylothorax after lung cancer surgery was a rare and negligible complication, which may usually be managed by non‐surgical methods. Hem‐o‐lok clipping during lymphadenectomy seemed to be an effective method to prevent late‐onset chylothorax after lung cancer surgery. [ABSTRACT FROM AUTHOR]

Introduction: The implementation of fall prevention interventions in homecare services is crucial for reducing falls among older adults and effective leadership could determine success. Norwegian homecare services provide home nursing, rehabilitation, and practical assistance, to residents living in private homes or assisted living facilities. This study aims to explore how managers in Norwegian homecare services experience implementation of fall prevention interventions and how they perceive their roles. Methods: We conducted 14 semi-structured individual interviews with managers from different levels of homecare services in five city districts. The interviews were transcribed verbatim and reflexive thematic analysis was used to analyze the material. Results: The analysis resulted in three main themes: (1) understanding organizational mechanisms to facilitate new practices, (2) practicing positive leadership behavior to facilitate implementation, and (3) demonstrating persistence to sustain implementation. Our results showed the importance of clear leadership across all levels of the organization and the value of devoting time and utilizing existing systems. Managers described using recognition and positive attitudes to motivate employees in the implementation process. They emphasized listening to and involving employees, providing trust, and being flexible. However, the implementation process could be challenging, highlighting the need for managers to be persistent. Conclusion: Managers at all levels play an important role in the implementation of fall prevention, but there is a need to define and align their specific roles in the process. Understanding how to use existing systems and influence through positive leadership behavior seem to be vital for success. Recognizing the demanding nature of implementation, managers emphasized the importance of systems for long term support. The study findings may influence how managers in clinical practice engage in the implementation process and inform future researchers about managers' roles in implementation in homecare services. [ABSTRACT FROM AUTHOR]

Introduction: Given the increasing global population of older adults, it is essential and inevitable that healthcare centers and nursing homes address and accommodate diversity in their support systems as interventions for healthy aging. The active aging and the inclusion of all people regardless of their religion, origin, and/or sexual orientation is essential to create a climate of safety. Discrimination must be addressed from all angles, at the social level, at the business level and by all workers in nursing homes. Methodology and results: This study provides a comprehensive review of existing literature to systematize information on diversity among older adults in healthcare centers and nursing homes. Out of 1.458 articles identified, 10 were analyzed in depth, revealing that addressing diversity among older adults is crucial to overall mental and physical healthy aging. The findings underscore the need for a multidisciplinary approach and effective management through the Person-Centered Care Model (PCCM). Discussion and conclusion: This study highlights the critical role of the Person-Centered Care Model (PCCM) in addressing diversity in aging needs. It highlights the necessity of tailoring care based on individual life histories and experiences. Additionally, it calls for the implementation of inclusive policies in nursing homes and emphasizes the need for professional training on diversity to ensure these facilities are safe and supportive for all residents. [ABSTRACT FROM AUTHOR]

Promoting resilience is highly relevant to preserving biodiversity and ecosystem functioning. For coral reefs, parrotfish protection emerged as a mainstream action for reversing the degradation experienced by these systems. The rationale is that restoring their populations will increase grazing activity and reinforce control of fast‐growing macroalgae, facilitating coral cover recovery. A lack of a link between parrotfish trends and macroalgae and coral cover trends at a large scale has, however, often been the case. Suggesting more complex underlying dynamics that should be reexamined. In this review, we discuss how lumping parrotfish species as if they were functionally redundant may obscure trends. And how a lack of appreciation of other functions around the parrotfish paradigm, specifically bioerosion, may have unforeseen and potentially adverse effects on degraded reefs. We show that bioerosion responded more directly and quickly to spatial and temporal changes in parrotfish assemblages than macroalgae consumption, arguably due to the varying vulnerability among Caribbean parrotfishes to fisheries and habitat loss. For highly degraded reefs, positive changes in parrotfish populations could hence compromise the remaining coral skeleton structures and the reef framework, further accentuating reef degradation, where increases in macroalgae consumption could not necessarily compensate for higher rates of bioerosion. [ABSTRACT FROM AUTHOR]

Latent Autoimmune Diabetes in Adults (LADA) is a type of diabetes mellitus often overlooked in clinical practice for its dual resemblance to Type 1 Diabetes Mellitus (T1DM) in pathogenesis and to Type 2 Diabetes Mellitus (T2DM) in clinical presentation. To better understand LADA's distinctiveness from T1DM and T2DM, we conducted a comprehensive review encompassing etiology, pathology, clinical features, treatment modalities, and prognostic outcomes. With this comparative lens, we propose that LADA defies simple classification as either T1DM or T2DM. The specific treatments for the disease are limited and should be based on the therapies of T1DM or T2DM that address specific clinical issues at different stages of the disease. It is crucial to identify LADA cases potentially misdiagnosed as T2DM, warranting prompt screening for poor blood sugar control, short-term blood sugar deterioration, and other conditions. If the prognosis for LADA is similar to T2DM, it can be managed as T2DM. However, if the prognosis fundamentally differs, early LADA screening is crucial to optimize patient outcomes and enhance research on tailored treatments. The pathogenesis of LADA is clear, so the prognosis may be the key to determining whether it can be classified as T2DM, which is also the direction of future research. On the one hand, this paper aims to provide suggestions for the clinical screening and treatment of LADA based on the latest progress and provide worthy directions for future research on LADA. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Patient or Public Contribution Reporting Method The aim of this study was to investigate the point prevalence and the rate of adherence to evidence‐based guidelines for patients who had indwelling urinary catheters in three Australian acute care hospitals.A cross‐sectional observational design was used.A multisite cross‐sectional observational design was utilised in three acute hospitals across Australia. Data were collected from each site in a single day directly from observation of the patient, the bedside notes and medical records. The data collected included observations of clinical care and scrutiny of the documentation of the insertion details and catheter care using best practice guidelines.Of the 1730 patients audited, 47% were female. The mean point prevalence of catheters in situ across three sites was 12.9%. Correct documentation compliance was reported to be, on average, 40%. Documentation was significantly better when a template was available to guide information recorded: this was regardless of whether it was hard copy or electronic. Overall, clinical care compliance with best practices was 77%. Of note for improvement was the fixing of the urinary catheter to the thigh in highly dependent patients.It was identified that there is a need for improvement across all three sites: specifically regarding securement of the urinary catheter to the patient’s thigh within the ICU. In addition, it was identified that there is a need for documentation of the urine bag change in ward areas. Documentation may be improved by incorporating templates into healthcare documentation systems in the future. Further work is needed to ensure nurses are aware of the adverse effects of urinary catheters and thus, the need to adhere to best practice guidelines.There has been no patient or public contribution.We have adhered to the STROBE guidelines for reporting. [ABSTRACT FROM AUTHOR]

Introduction: Cataract is a leading cause of visual impairment and blindness, mainly affecting older adults in sub-Saharan Africa (SSA). This scoping review aims to map evidence on the prevalence, contextual factors, and management strategies for cataracts among older adults in SSA. Method: Four central databases (PubMed, Scopus, Medline, and Google Scholar) were searched, yielding 383 records. Additional searches produced eight records. After screening and applying inclusion criteria, 26 full-text articles were eligible for further review. Finally, seven full-text records were included in the thematic analysis and synthesis. Results: Cataract prevalence among older adults in SSA ranged from 13.5–62.5% across different countries. Surgery remains the primary management strategy, but cataract surgical coverage varies widely (12.1–96%). Significant barriers to effective management include lack of awareness, limited access to healthcare, economic constraints, gender disparities, and cultural misconceptions about cataract surgery. Conclusion: There is a significant burden of cataracts among older adults in SSA, with considerable variations in prevalence and surgical coverage across the region. Comprehensive strategies addressing awareness, accessibility, affordability, and cultural factors are needed to improve cataract management and reduce visual impairment in SSA. [ABSTRACT FROM AUTHOR]

World's Best Practice management of locusts and grasshoppers requires accurate forecasting that helps determine where and when surveys are preferentially conducted so that infestations can be found quickly as part of ensuring early intervention treatments. Using survey data downloaded directly into a Geographic Information System (GIS), as well as rainfall and other factors important in the population dynamics of the species concerned, models within the GIS provide forecasts of future developments. The GIS provides forecasts of likely events and is used by locust and grasshopper experts to make decisions; that is, the forecasting is part of a Decision Support System for improved locust and grasshopper management. Surveys are generally conducted by ground vehicles, but for locusts, surveys by aircraft can be an important way to rapidly find bands. In Australia, dense bands can often be seen from an aircraft flying overhead at a height of 300 m, and similar detection of bands of the desert locust by aircraft has been conducted in Somalia. Swarms can be detected by ground vehicles, but because swarms move, surveying by aircraft is also an important way of locating swarms for treatment. When locust infestations are found, they are rapidly treated as part of early intervention preventive management. However, it is generally recognized that it is extremely difficult for landholders alone to protect crops against locusts and grasshoppers, so government intervention is often necessary. These organizations use a variety of treatment techniques to reduce the amount of chemical pesticide applied either by strip spraying or treating very dense infestations, such as roosting swarms, or using biopesticides. These techniques, as used in a number of countries, have proven to be very effective in managing locust populations while reducing the risk to the natural environment and human health. [ABSTRACT FROM AUTHOR]

Introduction: Research has found that a high percentage of people with diabetes experience stigma, with perceptions of stigma being significantly higher among people with Type 1 diabetes compared to those with Type 2 diabetes. These experiences of diabetes stigma can lead to psychological, behavioural and medical consequences. The aim of the current study was to explore the perceptions of diabetes stigma and propose strategies for addressing this from the perspective of key stakeholders. Methods: A mixed methods design was used, commencing with an online qualitative survey (n = 128) and followed by a World Café (n = 11), where attendees reflected on their own experiences with stigma and discussed the survey findings. Results: The survey indicated that 75% of those with Type 1 diabetes and 51% with Type 2 had experienced diabetes stigma. The World Café identified three main areas that participants felt impacted their experiences with stigma or had the potential to help improve stigma: healthcare interactions, public awareness and media representations. Conclusions: The findings supported previous research showing that diabetes stigma is prevalent among people with diabetes. The World Café was an excellent means of sharing knowledge and experiences among stakeholders, the findings of which will inform strategies to bring about change. Patient or Public Contribution: World Café is a collaborative method where stakeholders contribute to the production and analysis of data through rounds of discussion and feedback. [ABSTRACT FROM AUTHOR]

Tinnitus affects millions of people around the world and causes significant negative impacts on their quality of life (QoL). Tinnitus is rarely examined in Saudi Arabia. This study aimed to estimate the prevalence of tinnitus among adults, explore their experience with tinnitus, investigate the impact of tinnitus on their QoL, and discover their tinnitus management methods. A descriptive cross-sectional study design was performed utilizing a non-probability purposive sampling technique and a face-to-face in-person administered questionnaire. Descriptive statistics and a chi-square test were used to assess the data and find any correlation between the variables. Out of 4860 adults, 320 (males: n = 172; females: n = 148; age range = 18–90 years) had tinnitus, mainly described as a daily, gradual, continuous, whistling, and ringing tinnitus in both ears. Tinnitus prevalence was estimated at 6.54% with a slight predominance in males (6.9%) compared with females (6.2%). Most of the participants were unaware of the cause of their tinnitus. The modal value of the severity of tinnitus signals was severe for both genders. The modal value of the impact of tinnitus on the QoL was moderate for males and severe for females. Sleep, social activities, quiet settings, and concentration were largely affected by tinnitus. Significant associations (p < 0.05) between the impact of tinnitus on the QoL and risk factors, such as gender, age, hearing loss, and hyperacusis were determined. Also, the impact of tinnitus on the QoL was significantly associated (p < 0.05) with the duration of complaints and the severity of tinnitus signals. Approximately, 61% of the participants did not use any tinnitus treatment, while the remaining participants usually used hearing aids, medications, and counseling to manage their tinnitus. By increasing awareness, establishing standard practice, developing guidelines for managing tinnitus, expanding access to suitable interventions, and carrying out additional research, adults living with tinnitus in Saudi Arabia will have better support and, ultimately, an enhancement of their overall well-being. [ABSTRACT FROM AUTHOR]

Simple Summary: The sweet potato whitefly is a major global pest in vegetable production. The management of this pest has typically relied heavily on insecticide treatments. Many populations of sweet potato whitefly are now resistant to insecticides. Therefore, alternative means to control this pest are needed. Many predatory insects consume sweet potato whiteflies, so helping lure and attract both predators and the pest to the same location could improve control. This study investigates attractive odors for sweet potato whiteflies and two predator species that could be used to improve sweet potato whitefly pest management. Traditionally, olfaction was thought to play a minor role in the behavioral ecology of the sweet potato whitefly, Bemisia tabaci (Gennadius). However, recent research is uncovering significant potential for whitefly management based on olfaction. Incorporating chemical attractants with standard whitefly management programs could significantly improve control. The integration of attractants with biological control is exceptionally promising. Therefore, the behavioral response of B. tabaci and two generalist predators to the green leaf volatiles (E)-2-hexenal, (Z)-3-hexenal, (Z)-3-hexenyl acetate, and (Z)-3-hexe-1-ol were investigated in Y-tube olfactometers. Three of the four green leaf volatiles resulted in the attraction of female B. tabaci. Blend optimization indicated a two-chemical blend to be the most attractive blend for female B. tabaci. In addition, this blend was attractive to female Macrolophus praeclarus (Distant) but did not elicit a behavioral response from either male or female Delphastus catalinae (Horn). The two-chemical blend of green leaf volatiles could be further developed as a lure to attract B. tabaci and its predator, M. praeclarus. [ABSTRACT FROM AUTHOR]

The treatment of arteritic anterior ischemic optic neuropathy (AAION), non-arteritic ischemic optic neuropathy (NAAION), and posterior ischemic optic neuropathy (PION) is a topic of ongoing research with mixed evidence on some pharmacotherapies and a need for more consensus. This manuscript provides an overview of these conditions' current, potential future, and attempted pharmacotherapies. AAION's current treatment regimen consists of high-dose steroids, with methotrexate, tocilizumab, and abatacept, being the most viable steroid-sparing therapy candidates. As for NAAION, the treatments being tried are vast, with mixed evidence supporting each modality. Similarly, despite the various treatment options explored, there still needs to be a universally effective therapy for PION. More research is needed to formulate an agreed-upon treatment regimen for these conditions. [ABSTRACT FROM AUTHOR]

Although there is an approved indication for venetoclax and hypomethylating agents (VenHMA) and its use in different AML settings will be expanded in the following years, the management of the adverse events (AEs) lacks of harmonized algorithms during treatment of these patients. We have studied the incidence of relevant AEs of 43 patients who achieved a response to VenHMA and its management. Median overall survival of our cohort was 19 months. No patients discontinued treatment due to AEs after C3D1, Regarding severe AEs, high rates of grade 4 neutropenia (97.6%) and grade 4 thrombocytopenia (65.1%) were observed. Severe infectious AEs rate was 16%. Due to severe myelotoxicity, most patients required a progressive dose reduction of both venetoclax and hypomethylating agents during follow-up, being 87.8% at C6D1. Transfusional dependence rate was 91% and G-CSF was prescribed to 86% of the patients. Finally, there was not a significant difference in hemoglobin, platelets and absolute neutrophil count after achieving complete response comparing paired samples during follow-up, although cytopenia rate was high during initial follow-up. We conclude that dose reduction of VenHMA after achieving a response in patients diagnosed with AML is required in most patients and essential to avoid prolonged cytopenia-related adverse events and a rapid and standardized method on how to perform it might decrease the AEs rate. [ABSTRACT FROM AUTHOR]

Background: Advanced ovarian cancer surgery presents anaesthetists with the challenge of managing patients with potential multiple co-morbidities undergoing major open or extended laparoscopic surgeries. The disease has overall amongst the poorest overall survival rates of all malignancies, with an estimated 5-year survival rate of <43%, and the patients being of a generally older age group present specific challenges in terms of their accumulated co-morbidities. Aim and objective: To study the management of patients with ovarian tumours at a tertiary health care centre Methodology: This study was carried out over a period of 1 years from 2023 to 2024 and includes 50 patients with ovarian tumour. Data was collected with pretested questionnaire. Data included sociodemographic data, clinical history and clinical examination. Management was done as per type of ovarian tumours. The complications of ovarian tumour were observed. Data analysed with appropriate statistical tests. Results: The incidence of ovarian tumour was 5.14. In the study 68% were benign tumours, whereas 32% were malignant. Most common mode of management of ovarian tumour was cystectomy (46%). [ABSTRACT FROM AUTHOR]

Introduction: Staphylococcus aureus is a common cause of community acquired and health care associated infections. The aim of present study is to assess prevalence of MRSA infections and antimicrobial susceptibility pattern for appropriate management of MRSA infections. Methodology: This cross-sectional observational study was conducted from June 2021 to June 2022 in Department of Microbiology, Dr SCGMC, Nanded. 3247 clinical specimens were included in our study. The antimicrobial susceptibility of all Staphylococcus aureus isolates was determined by Kirby Bauer disc diffusion method as per CLSI guidelines 2022. Methicillin resistance was detected by cefoxitin disc diffusion test. Results: Out of 752 Staphylococcus aureus isolates, Methicillin resistance was shown by 337(44.8%) isolates. Maximum MRSA isolates were detected from pus specimens 187(55.5%), followed by respiratory infection 79(23.4%), blood stream infection 31(9.2%). Out of 337 MRSA isolates 100% were sensitive to Vancomycin, 93.1% to Linezolid, 58.2% to Gentamycin, 52.2% to Cotrimoxazole, 43.9% to Clindamycin, 12.8% to Amikacin & 12.5% to Erythromycin. Conclusion: Strict adherence and judiciary use of antimicrobial drugs according to National Treatment Guidelines for Antimicrobial Use in Infectious Diseases is necessary for management of MRSA infections. [ABSTRACT FROM AUTHOR]

This article explores the application of actor‐network theory (ANT) to the nursing profession, proposing a novel perspective in understanding nursing in the context of modern digital healthcare. Traditional grand nursing theories, while foundational, often fail to encapsulate the dynamic and complex nature of nursing, particularly in an era of rapid technological advancements and shifting societal dynamics. ANT, with its emphasis on the relationships between human and nonhuman actors, offers a framework to understand nursing beyond traditional paradigms. This article makes two key arguments: first, that nursing can be viewed as a highly organised social assemblage, where both human (nurses, patients and policymakers) and nonhuman actors (technologies, medical equipment, institutional policies) play a crucial role, and second, that ANT can be used to enhance existing nursing theory to better understand the role of technology in nursing practice. The article considers how ANT can provide a more holistic and adaptable model for describing the nursing profession, particularly in an era where technology plays an integral role in healthcare delivery. It discusses the implications of viewing nursing through ANT, highlighting the need for nursing education and practice to adapt to the interconnected and technologically advanced nature of modern healthcare. The article also acknowledges the limitations of ANT, particularly its potential oversimplification of the complex ethical dimensions inherent in nursing and its focus on observable phenomena. [ABSTRACT FROM AUTHOR]

Aims: The number of older people with diabetes requiring care from district nursing teams is increasing. The role of district nursing teams in diabetes management has expanded to involve diagnosis, treatment and medication administration. As the complexity of caseloads increases, the current model is likely unsustainable. This study aims to understand the current diabetes workload of district nursing teams. Methods: An online survey was distributed via social media and key stakeholder networks to district nursing teams. Survey items were designed by the researchers prior to pilot testing with potential participants. Descriptive statistical and qualitative analyses were conducted. Data are median ± IQR. Results: 159 district nursing teams completed the survey. The median caseload per team was 300 (IQR 176–407) patients including 21 with diabetes (IQR 14–40; 8.7% (4–20%)). 1.09 home visits per day per person with diabetes lasting 13.8 minutes (excluding travel time) were needed, with most requiring insulin administration. 96% of nursing teams undertake multiple daily visits for some patients. 91% reported workloads relating to diabetes management had increased over the last 2 years; 76% stated current diabetes workloads were unsustainable. More insulin usage, more referrals and a lack of ability or willingness to self‐administer insulin has increased the diabetes workload. Possible solutions include better collaboration between healthcare professionals, simplification of insulin administration and glucose monitoring, better training and upskilling of healthcare assistants and promotion of self‐efficacy. Conclusions: Diabetes management forms an increasing component of district nursing workload and is likely to be unsustainable unless new models are found. [ABSTRACT FROM AUTHOR]

Background: There is insufficient data on orofacial pain related to the COVID‐19 outbreak in Thailand. Objective: To investigate the incidence, diagnosis and management of orofacial pain among new patients over the last 6 years, before and during the COVID‐19 outbreak. Methods: Medical records from new patients who first visited Chulalongkorn Dental Hospital between 2017 and 2022 were retrospectively investigated. The sample size was determined, and proportional stratified random sampling was employed to distribute the sample number proportionally across each year. The hospital number of each patient was randomised using online software as a sampling strategy. A data collection form was developed and used to gather information from the digital data system. Results: At the first visit, 770 out of 1359 patients (56.7/100 people, 95% CI: 54.0–59.3) reported orofacial pain defined as acute, chronic and unclassified pain. The most common chief complaints based on the AAOP classification were odontogenic pain (90.00%) and temporomandibular disorders (6.10%). The top three provisional modified ICD‐10‐TM diagnoses among these patients were pulp diseases (21.95%), impacted teeth (20.65%) and dental caries (9.09%). 81.87% of dental students' provisional diagnoses matched the final diagnoses given by dental specialists. Only 63.38% of orofacial pain patients were completely managed during the COVID‐19 pandemic with common procedures being surgical removal, extraction and root canal therapy. Conclusion: Half of Thai dental patients seeking tertiary care at a university dental hospital reported orofacial pain, which was not impacted by the COVID‐19 pandemic. In contrast, dysfunction‐related problems in the orofacial area significantly increased during the pandemic. [ABSTRACT FROM AUTHOR]

Social capital is a concept in sociology that has applications across various human sciences, including economics, management, social sciences, and political sciences. It refers to relationships within and between groups. Social capital, or the spiritual dimension of a community, is a historical legacy that encourages individuals to "cooperate" and "participate" in social interactions, thereby enabling the community to overcome its challenges and progress toward growth and development in economic, political, cultural, and other domains. With the formation of the Islamic government under the Messenger of Allah (PBUH), the need to preserve Islamic capital and making informed decisions regarding it became particularly critical . Due to the fact that the enemies of Islam sought to undermine the government and reduce social capital by various soft and hard tactics, the Prophet (PBUH) implemented specific strategies. This article explores the actions of the Holy Prophet (PBUH) aimed at maintaining and enhancing the social capital of the nascent society of Sadr Islam in the face of hard and soft social injuries, utilizing a descriptive-analytical method, with an interpretive approach and a phenomenological view of Social issues. [ABSTRACT FROM AUTHOR]

Introduction: Acne remains one of the most common inflammatory dermatoses seen worldwide. There are significant challenges when managing acne relating to a variety of factors, including (1) lack of consensus on the use of the numerous available grading systems and outcome measures, (2) appreciation of the numerous areas that relate to severity, (3) the chronic nature of acne which requires a longitudinal approach to management (including both facial and truncal disease), and (4) the need to target acne early to avoid physical and psychosocial scarring. Consideration of these aspects when managing acne should result in improved outcomes. Acne guidelines review the available evidence based on robust clinical trials and are usually supplemented with some expert opinion when evidence is not available. Methods: In this paper, the UK Acne Working Group reflects on the latest National Institute for Health and Care Excellence (NICE) acne guidelines with a goal of providing additional practical insights. Conclusion: The group have identified areas where new evidence has now become available since the formulation of the NICE acne guidelines. This publication considers newly approved acne medications in the UK, guidance on assessing acne severity, approaches to managing truncal acne, acne sequelae, and adult female acne with hormonal therapies. Plain Language Summary: The National Institute for Health and Care Excellence (NICE) produced acne guidelines in June 2021 for clinicians and patients. New evidence and information on practical aspects of acne management have emerged since this time. A panel of clinicians with expertise in acne discuss herein some areas of interest that may support acne management, some of which could be considered in a second iteration of NICE acne guidelines. These areas include how to assess acne, the medical approach to truncal acne, how clinicians may manage the long-lasting acne sequelae of scarring and darkly pigmented spots, and the use of medical hormonal therapies for women (such as birth control pills) to manage acne that may have a causative contribution of hormone imbalances. [ABSTRACT FROM AUTHOR]

The incidence of culture-negative NVO (CN-NVO) cases is increasing, presenting significant diagnostic and therapeutic challenges due to the inability to isolate causative organisms with conventional microbiological methods. Factors influencing the diagnosis of CN-NVO include prior antimicrobial therapy, low pathogen burden, fastidious or intracellular organisms, technical issues, and non-infectious mimickers. Diagnosis often relies on imaging modalities like magnetic resonance imaging (MRI) and computed tomography (CT)-guided biopsy, though these methods can sometimes fail to yield positive microbiological results. Advanced diagnostic tools, such as polymerase chain reaction (PCR), metagenomic next-generation sequencing (mNGS), and cell-free DNA analysis, may be necessary to identify the pathogen. The causative pathogen cannot be isolated in some patients, among which an empirical antimicrobial therapy should be initiated. This narrative review discusses the management, monitoring, surgical indications, and outcomes for patients with CN-NVO. [ABSTRACT FROM AUTHOR]

Background: Tourette disorder (TD) is a neurodevelopmental disorder characterized by childhood onset of tics lasting more than one year, with multiple motor tics and at least one phonic tic at some point during the course of the symptoms. Treatment of tics may include psychoeducation, non-pharmacologic treatment, or pharmacologic treatment. We review pharmacologic treatment here. Methods: We performed a literature review on pharmacologic treatments for TD. Results: There is no current evidence to suggest that medications impact the prognosis of tic disorders, so current clinical guidelines recommend reassurance of the patient and family and monitoring if there is no change in function or quality of life due to tics. If treatment is indicated, it must be chosen based on the needs of each individual patient. Comprehensive behavioral intervention for tics (CBIT) is considered first-line management for most individuals with bothersome tics, especially if they are mild to moderate in severity. Pharmacotherapy should be considered when tics are impairing daily functioning, causing social problems, accompanied by other neuropsychiatric symptoms, or when the patient is not likely to benefit from CBIT. Current recommended pharmacotherapy options include alpha-2 adrenergic agonists, dopamine modulators, GABAergic medications, dopamine depleters, and botulinum toxin injections. Additionally, there are other novel medications that are being studied in ongoing clinical trials. Conclusions: This review summarizes available pharmacotherapy options for TD in children. It provides an overview of new medications and offers guidance to physicians when selecting appropriate treatments. If medications are indicated for tic management, treatment should be chosen based on the needs of the individual patient. [ABSTRACT FROM AUTHOR]

Behcet disease (BD) is a systemic vasculitis which can involve many different organ systems. Neurological involvement (NBD) occurs in 5.3% to 59% of BD patients. The diagnosis is challenging especially in case of inaugural neurological presentation, and is based on a constellation of clinical, laboratory, and neuroimaging findings. NBD can be subdivided into parenchymal NBD through an immune mediated meningoencephalitis with a predilection to the brainstem, basal ganglia, thalamus, cranial nerves, and spinal cord involvement, and extraparenchymal NBD encompassing cerebral veinous thrombosis and intracranial arterial involvement. Brain magnetic resonance shows ill-defined areas of oedema with high signal intensity on T2-FLAIR images, isointense or hypointense in T1-weighted images in the basal ganglia area or in the brainstem, which may extend to the diencephalic structures. Swelling might be noticed. Hemorrhages can be seen, such as contrast enhancement (blood brain barrier disruption). Magnetic resonance venography and computerized tomographic angiography can be used to diagnose extraparenchymal NBD. Treatment of parenchymatous forms is based on glucocorticoids associated with oral immunosuppressants (azathioprine, mycophenolate mofetil or methotrexate) in mild forms, and intravenous cyclophosphamide or infliximab in severe forms. The management of cerebral thrombosis consists of steroids course associated with an oral anticoagulation. An early recognition of this condition is mandatory to initiate adequate therapies in order to improve outcomes and limit the risk of sequelae, relapses, or death. The aim of this review is to summarize a comprehensive review on the various neurological presentations of BD with emphasizes on diagnostic tools, prognosis, and therapeutic issues. [ABSTRACT FROM AUTHOR]

Children and young people who live in out-of-home care (OoHC) can display aggressive behaviours when their emerging self-regulation and executive functioning systems are overwhelmed. Consequently, their carers can experience incidents that may cause some carers' ongoing stress symptoms. Early intervention with occupational health supports is important; however, including a specific trauma treatment such as Eye-Movement Desensitisation and Reprocessing (EMDR) is unusual. EMDR supports the resolution of stress symptoms and helps carers promote a stable home environment. Stability contributes to calm home environments and incident reduction. The purpose of this mixed methods study was to better understand the inclusion of EMDR into a workforce wellbeing model and explore changes in incident numbers in houses, staff retention, and time-loss injury. Interviews with senior managers and focus groups with therapeutic practitioners from two Australian states were conducted. Descriptive statistics for administrative data were calculated after a quantitative audit. Several programs including EMDR and occupational health policies were working towards enhanced workplace safety. A reduction in the monthly average incident rate from 11.9 (2019–2020) to 6.9 (2022–2023) was identified. Offering an effective treatment to staff that promotes wellbeing, retention, and stability in care homes may be a critically important policy recommendation for organisations with staff at risk of traumatic incidents. IMPLICATIONS Eye -Movement Desensitisation and Reprocessing (EMDR) is an effective trauma therapy that works for residential out-of-home care staff. EMDR enhances carers' emotional wellbeing and capacity when working with the young people in their care. More stable relationships between carers, children, and young people can lead to reductions in stressful workplace incidents and a more stable workforce. [ABSTRACT FROM AUTHOR]

How the World Ran Out of Everything: Inside the Global Supply Chain Peter S. Goodman. London and New York: Mariner Books, 2024. £25.00/$30.00. 416 pp. The Assault on the State: How the Global Attack on Modern Government Endangers Our Future Stephen E. Hanson and Jeffrey S. Kopstein. Cambridge: Polity, 2024. £20.00. 182 pp. How a Ledger Became a Central Bank: A Monetary History of the Bank of Amsterdam Stephen Quinn and William Roberds. Cambridge: Cambridge University Press, 2023. £25.99. 400 pp. Seven Crashes: The Economic Crises That Shaped Globalization Harold James. New Haven, CT: Yale University Press, 2023. $32.50/£20.00. 376 pp. The Future of the Factory: How Megatrends Are Changing Industrialization Jostein Hauge. Oxford and New York: Oxford University Press, 2023. £35.00/$45.00. 240 pp. [ABSTRACT FROM AUTHOR]