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Pressure ulcer (PU) prevention is a high priority for health professionals in all settings. While PU incidence is expected to rise given the ageing population in the UK and Europe, PUs can occur in people of any age. It is therefore imperative that all practitioners know about the causes and consequences of PUs and be aware of up-to-date guidance on the prevention and management in patients who have developed a PU or who are at risk of developing a PU. Health professionals should also be aware of preventive equipment highlighted in national and local guidance, prevention strategies and protocols. This article discusses these issues and the Devon (Cardinal Health) prevention and repositioning product range.

To evaluate effects of an online education program about weight management for osteoarthritis on physical therapists' self-reported confidence in knowledge and skills in weight management and attitudes toward obesity.In a 2-group randomized controlled trial, 80 physical therapists (58 female physical therapists) were randomized to education or control groups. The theoretically informed and evidence-informed online self-directed training program covered biopsychosocial elements of obesity and weight management. The primary outcome was self-reported confidence in knowledge in weight management using a customized validated tool (scale 14-70, higher scores indicating higher confidence) assessed at baseline and 6 weeks. Secondary measures included confidence in nutrition care, clinical skills in weight management, and weight stigma. Process measures evaluated participant experience. Differences in change between groups were compared using linear regression models adjusted for baseline scores and stratifying variables (clinical setting; confidence in weight management). Moderation analysis was performed using an interaction approach in a linear regression model and multivariable fractional polynomial interaction approach.A total of 79 participants (99%) completed outcome measures at 6 weeks. The education group demonstrated greater improvement in confidence in knowledge than the control group (adjusted mean difference 22.6 units, 95% confidence interval 19.6, 25.5). Greater improvement in knowledge was associated with lower baseline values (interaction P = 0.002). Secondary outcomes showed greater improvements in confidence in skills and nutrition care and in weight stigma domains favoring the education group. Over 90% of participants would recommend the program to peers.An online education program improves physical therapists' short-term confidence in knowledge and skills in weight management for people with osteoarthritis and reduces weight-stigmatized attitudes.

This article offers a close reading of Stendhal’s Lamiel, arguing that the eponymous heroine suffers from, but also manipulates the symptoms of, the quintessentially nineteenth-century disease, consumption. It first establishes Lamiel as a consumptive heroine by comparing the novel to contemporary medical discourse on the disease, most notably to the work of René Laënnec. It then analyses the fausse phtisie scene, a passage in which Lamiel uses the blood of a dead bird to simulate haemoptysis, contending that the performative nature of Lamiel’s illness is of primary importance. Comparing Lamiel to other Stendhal novels, the article highlights that the heroine asserts her own identity by assuming abjection, whereas other characters are threatened by the abject. It further demonstrates that this scene amounts to Lamiel’s rejection of Romantic tropes of passive female patienthood, arguing that the novel forges a new mould for the representation of consumptive heroines. This article contributes to our understanding of how literature can manipulate, undermine, and even reject medical and cultural paradigms of illnesses as ubiquitous to the nineteenth century as tuberculosis. Résumé Cet article propose une analyse littéraire de Lamiel de Stendhal et soutient que l’héroïne éponyme souffre de la maladie par excellence du dix-neuvième siècle, la consomption, alors même qu’elle joue et manipule dans le même temps les symptômes de son mal. Lamiel est ici définie comme une héroïne tuberculeuse à travers la comparaison du roman avec le discours médical de l’époque, notamment les causes occasionnelles qu’identifie René Laënnec. On y critique la scène de la fausse phtisie, un extrait dans lequel Lamiel utilise le sang d’un petit oiseau mort afin de faire semblant d’être atteinte d’hémoptysie: ce passage élucide les aspects abjects et performatifs de la maladie de Lamiel. En comparant Lamiel aux romans stendhaliens, le présent article soutient que l’héroïne affirme son identité en revendiquant sa propre abjection, alors que l’abject est une menace pour d’autres personnages. Cet extrait équivaut à un rejet du trope romantique des maladies féminines: Lamiel forge ainsi une nouvelle représentation des héroïnes tuberculeuses du dix-neuvième siècle. De surcroît, nous élucidons ici les moyens par lesquels la littérature manipule, ébranle — et même rejette — les paradigmes médico-culturels des maladies les plus répandues au dix-neuvième siècle.

Pregnancy pathologies including gestational diabetes, intrauterine fetal growth restriction, and pre-eclampsia are common and significantly increase the risk of poor pregnancy outcomes. Research to better understand the pathophysiology and improve diagnosis and treatment is therefore crucial. The ex vivo placenta perfusion model offers a unique system to study pregnancy pathology without the risk of harm to mother or fetus. The presence of a maternal and fetal circulation and intact villus tree, facilitates investigations into maternal-fetal transfer, altered hemodynamics and vascular reactivity in the human placenta. It also provides a platform to test novel therapeutic agents. Here we review the key studies which have utilized the ex vivo placenta perfusion model to study different aspects of such pregnancy pathologies.

There is an urgent need for countries to transition their national food and land-use systems toward food and nutritional security, climate stability, and environmental integrity. How can countries satisfy their demands while jointly delivering the required transformative change to achieve global sustainability targets? Here, we present a collaborative approach developed with the FABLE—Food, Agriculture, Biodiversity, Land, and Energy—Consortium to reconcile both global and national elements for developing national food and land-use system pathways. This approach includes three key features: (1) global targets, (2) country-driven multi-objective pathways, and (3) multiple iterations of pathway refinement informed by both national and international impacts. This approach strengthens policy coherence and highlights where greater national and international ambition is needed to achieve global goals (e.g., the SDGs). We discuss how this could be used to support future climate and biodiversity negotiations and what further developments would be needed.

CERN/NASA “Accelerating the Adoption of Open Science”, from July 10th-14th at CERN in Geneva, Switzerland https://indico.cern.ch/event/1254282/ 11July 2023 (Day 2)Open Data Policies and Practices

The American Academy of Audiology recommends early identification of congenital cytomegalovirus (cCMV) through screening to allow for appropriate early diagnosis, intervention, and monitoring for congenital, progressive, and delayed-onset hearing loss in infants with cCMV.Early identification of cCMV is a valuable component in the diagnostic evaluation of infants with sensorineural hearing loss. The Academy recognizes the important role audiologists serve as clinical care providers and educators and advocates for early identification and audiological management of infants with cCMV.

This article considers discussions of sexual difference in a range of popular prescriptive texts published between 1920 and 1940 in order to explore the relationship between science and American marital advice literature. It demonstrates the particular role science played in shaping, legitimising and enforcing changing discussions about what ‘good sex’ should look like in contemporary advice – supporting a hierarchy of sexual activities and desires that privileged a particular version of marital heterosexual expression. Through this, it also interrogates the ‘popular’ version of sexual science being consumed by the American public at this time. In addition to adding new perspectives to our understanding of contemporary advice and its relationship with science and medicine, it will also act as a provocation for further research into the ways the public engaged with sexual science in early twentieth-century America.

This article outlines how an in-depth engagement with visual archives has transformed the author’s pedagogical practice. It argues that working with visual sources like photographs and illustrations offers students important opportunities to develop key academic skills, and to think critically about archives and sources. It details how working with such rich materials makes space for personal reflection and discovery, especially for students engaging with histories of sex and sexuality for the first time. Outlining the strengths of this approach, it explores some of the tensions and obstacles inherent in doing this kind of work—discussing, for example, the ethical dilemmas faced when reproducing and disseminating sexualized images in the classroom, the complexities of handling student reactions, and the activities students and the instructor have created to negotiate these issues.

BACKGROUND Adolescents with chronic disease engage in sexual activity similar to their healthy peers, with generally low utilization of contraception. Adolescents with rheumatic diseases prescribed teratogenic medications may be at risk for unplanned pregnancy. METHODS Using structured quality improvement (QI) methods with behavior economic (BE) principles, a multidisciplinary team aimed to implement pregnancy prevention processes for females on high-risk medications. We leveraged BE-inspired interventions including improved accessibility of consents, utilizing distinctly colored consent forms, real-time reminders, peer comparison, and audit and feedback. Our primary aim was to increase the number of days between pregnancies for postmenarcheal females followed in rheumatology clinics who were taking teratogenic medications. Phase 1 focused on annual consenting of female adolescents prescribed teratogenic drugs. Phase 2 emphasized sexual history screening and pregnancy prevention planning at every clinic visit for females ≥12 years on teratogenic medications. RESULTS We increased the days between pregnancies for female adolescents prescribed teratogenic medications from 52 days to >900 days by using QI methodology with BE strategies. In phase 1, annual consents for postmenarcheal patients on teratogenic medications improved from 0% in 2017 to 95% in 2021. In phase 2, sexual history screening and pregnancy prevention planning at every clinic visit improved from 2% in 2019 to over 78% in 2021. CONCLUSIONS A multiphase, multidisciplinary QI project with integration of behavior economic strategies can improve patient and caregiver counseling to prevent unplanned pregnancies for adolescents on teratogenic medications.

Adult referrals to specialist autism spectrum disorder diagnostic services have increased in recent years, placing strain on existing services. It was proposed that the Ritvo Autism Asperger’s Diagnostic Scale could be used as a screening tool, in order to identify and prioritise patients most likely to receive an ASD diagnosis. This study evaluates the validity of the RAADS-R as a screening tool for ASD in an adult population. Retrospective case note analysis was used to evaluate the efficacy of the RAADS-R as a screening tool to predict ASD diagnostic outcomes in 50 service users of a NHS specialist autism service. Results indicate no association between RAADS-R scores and clinical diagnostic outcome, suggesting the RAADS-R is not an effective screening tool for identifying service users most likely to receive an ASD diagnosis. In conclusion, used as a self-report measure pre-full diagnostic assessment, the RAADS-R lacks predictive validity and is not a suitable screening tool for adults awaiting autism assessments. Future research should aim to identify reliable screening tools for this purpose.

Recent evidence confirming cat-to-human SARS-CoV-2 transmission has highlighted the importance of monitoring infection in domestic cats. Although the effects of SARS-CoV-2 infection on feline health are poorly characterized, cats have close contact with humans, and with both domesticated and wild animals. Accordingly, they could act as a reservoir of infection, an intermediate host and a source of novel variants. To investigate the spread of the virus in the cat population, serum samples were tested for SARS-CoV-2 antibodies by ELISA and a pseudotype-based virus neutralization assay, designed to detect exposure to variants known to be circulating in the human population. Overall seroprevalence was 3.2%, peaking at 5.3% in autumn 2021. Variant-specific neutralizing antibody responses were detected with titers waning over time. The variant-specific response in the feline population correlated with and trailed the variants circulating in the human population, indicating multiple ongoing human-to-cat spill-over events.

Fundamental research addressing the challenges of weather forecasts and climate monitoring is required in order to steadily improve the quality of meteorological and climatological services. However, the potential of transferring results from this research into operations increases significantly if carried out in collaboration with national meteorological and hydrometeorological services (NMHS). Out of this motivation and experience, the German “Hans-Ertel-Centre for Weather Research” (HErZ) has been established in 2011 as a virtual competence centre. HErZ develops and organizes a lasting national consortium along common objectives between the German Meteorological Service (DWD), German universities and scientific institutes to accelerate innovation in DWD’s weather, climate and environmental services. HErZ carries out excellent research, strengthens university education and promotes early career scientists, ensures personnel and strategical development, and facilitates the establishment and success of new cooperation, also outside of Germany. Moreover, HErZ grants access to DWD’s infrastructure, including (global) observation data and prediction models. With the strong support of the German Federal Ministry of Digital and Transport, HErZ was able to overcome the difficulties within initiating a cooperation between partners of different institutional communities and established an unprecedented sustainable and national transdisciplinary network. The current research and objectives of HErZ cover the whole value chain expected from this year’s EMS Annual Meeting’s additional focus on “Connecting Communities”: Bringing together fundamental and applied research, observations with prediction models, research institutions with NHMS, and developers with end-users. This intertwined and progressive structure in science and communication ultimately results in acquiring value for society as a whole. Establishing and managing HErZ and its scientific, strategic and structural goals is challenging. The complex tasks of achieving excellence in science and long-term success require a suitable balance between demands and needs of all institutions involved as well as an independent and strong governance by national and international high-level experts. In the future, HErZ must respond to new societal challenges in a targeted but flexible manner with new topics and competences, national and international partners, and a strengthened dialog with stakeholders and users. With this contribution, we would like to share with the audience the establishment, structure and peculiarities of HErZ, the lessons learnt from a transdisciplinary consortium connecting NHMS, universities and research institutes, and our visions towards future seamless science and services.