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In this article I explore partial ectogenesis through the lens of choice in childbirth, framing it as a mode of delivery. In doing so, I refocus discussion about partial ectogenesis, ensuring that this centers upon the autonomy and rights of the birthing person—as the procedure required to facilitate external gestation will be performed upon their body. By drawing a critical comparison between “delivery by partial ectogenesis” and request cesarean sections, I argue that delivery by partial ectogenesis ought to be available on the basis of the pregnant person’s request alone.

Unprecedented photochemical reactions for the diamidocarbene 1 including the double cyclopropanation of 1-bromonaphthalene, the double addition to pyridine, and the activation of sp3 C–H bonds of alkanes are reported.

In this article, we explore how the law has perpetuated the medicalisation of childbirth, and outline why this may limit the ability of birthing persons to access and opt for homebirth. We argue that this is inherently problematic because it restricts choice and autonomy in childbirth. We suggest that the widespread blanket withdrawals of homebirthing services by National Health Service trusts during the Coronavirus (COVID-19) pandemic serves as an illustrative example of the broader failure to recognise, both socially and legally, the significance of homebirth for some. We argue that, if framed correctly, the law has the potential to support, rather than restrict, choice regarding place of birth.

The Affordable Care Act provides Medicare Part B beneficiaries access to cost-free Annual Wellness Visits (AWVs). Patients receive health behavior recommendations from a Personalized Prevention Plan (PPP) during AWV encounters.To identify factors clinical pharmacists can use to influence adoption of PPPs in primary care practices.Utilizing a cross-sectional design, 77 Medicare patients (mean age 74.05 ± 8.04 years) presenting for subsequent AWV completed a theory of planned behavior (TPB) based questionnaire at two primary care practices.66.2% reported they were in the process of implementing PPPs and 51.9% reported implementing recommendations in the previous 12 months. TPB constructs accounted for 35.8% (p .001) of the variation in intention, with subjective norm (SN) (β = 0.359, p = 0.004) as the strongest determinant, followed by attitude (β = 0.195, p = 0.093), and perceived behavioral control (PBC) (β = 0.103, p = 0.384). Intention accounted for 27.1% of the variance for implementing PPPs and was not a significant determinant (β = 0.047, p = 0.917). Addition of past behavior with TPB constructs significantly improved the predictability of the TPB model, accounted for 55% of the variation in intention (p .001), and demonstrated a significant positive influence (β = 0.636, p 0.001) on future PPP implementations.This study demonstrates utility of the TPB in predicting implementation of PPPs.Clinical pharmacists positioned as providers of AWVs can strengthen intention to adopt PPPs by integrating referents into AWV processes, and evaluating past behavior trends to improve future PPP implementation.

The increasing use of lightweight composite materials in structural applications requires the development of new damage monitoring technologies to ensure their safe use and prevent accidents. Although several molecular strategies have been proposed to report damage in polymers through mechanochromic responses, these approaches have not yet been translated into lightweight bioinspired composites for load-bearing applications. Here, we report on the development of bioinspired laminates of alternating polymer and nacre-like layers that combine optical translucency, high fracture toughness, and damage-reporting capabilities. The composites signal damage via a fluorescence color change that arises from the force activation of mechanophore molecules embedded in the material's polymer phase. A quantitative correlation between the applied strain and the fluorescence intensity was successfully established. We demonstrate that optical imaging of mechanically loaded composites allows for the localized detection of damage prior to fracture. This fluorescence-based self-reporting mechanism offers a promising approach for the early detection of damage in lightweight structural composites and can serve as a useful tool for the analysis of fracture processes in bulk transparent materials.

Background Adverse childhood experiences (ACEs) have been associated with numerous health issues such as shortened lifespan, chronic diseases, mental illness, and low life satisfaction. Yet to date, little research has assessed the effect of social support on health after ACEs. Purpose To assess the role of positive and negative social support as moderators of the association of ACEs with mental health and life satisfaction. Methods Data included the Biopsychosocial Religion and Health Cohort Study participants residing in the U.S. and Canada (2006–2007) (N = 10,194). The generalized linear model was utilized to assess the association of ACEs with mental health and life satisfaction, and the interaction of positive and negative social support in these associations after adjustment for confounders. Result ACEs were negatively associated with mental health and life satisfaction. Positive social support (PSS) was positively associated, and negative social support (NSS) was inversely associated with better mental health and life satisfaction. PSS showed a significant buffering effect on the association between ACEs and low mental health and life satisfaction, while NSS had no deteriorating effect except for the subdomain rejection. Conclusion Potential protective effects of PSS (primarily instrumental support) and debilitating effects of NSS (rejection) were observed when predicting both mental health and life satisfaction after ACEs. Health professionals should be aware of the potential impact of both PSS and NSS when working with those who have experienced ACEs. Additional longitudinal research, especially in more diverse populations, is warranted.

Healthcare providers such as the World Health Organization, transnational and global health initiatives, the national healthcare systems, down to the smallest villages and individual practitioners and professionals could benefit from geo referential data and metadata and 3D digital assets provided by space technology. Health prevention and literacy programs, mortality and morbidity rates, including contextual statistical data about populations and territories are being already produced and accessible. The hypothetical frame of a Digital Health Earth hereto presented could be performed as the interoperability of 3D representations of sectors of territories and geolocalized layers about health and environment. SDG Goals crossed with WHO programs and available data can become the premises for the design and development of a global representation of healthcare situations, highlighting priorities and disseminating data by intuitive and interactive modes of visualization as it is already happening with 2D dashboards about COVID-19 pandemic. Healthcare practitioners, professionals, health managers, but also patients, proxy, social workers, laypeople, stakeholders and media could benefit from visualizing and comparing Digital Earth health data. Concerns about privacy, digital divide and social exclusion from primary care services and how quality of lives might occur are considered here. As a consequence of Space Technology, especially for its connection with the Satellite industry, Digital Health Earth, will contribute to the development of a new added value economic branch inside the increasing market of the Space Economy Revolution.

Background and Objectives: Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used pain medications among US adults with about 70 million people regularly taking NSAIDs annually. Despite clear recommendations from current clinical practice guidelines and recent supporting literature, NSAIDs are continually prescribed inappropriately in patients with chronic kidney disease (CKD), hypertension (HTN), and heart failure (HF). The purpose of this project was to determine the impact of direct pharmacist-led education to providers on rates of inappropriate prescribing of NSAIDs in high-risk populations in a family medicine setting. Methods: This study included all adult (aged 18 years or older) patient charts with NSAIDs prescribed, refilled, or recorded within the specified time periods. We defined inappropriate orders as oral and of chronic duration (at least 90 days) with at least one high-risk International Classification of Diseases-10 chart diagnosis (HTN, HF, CKD). This was a single-center, retrospective chart review of prescribing rates during a 3-month period before and after provider education delivered by a pharmacist. Results: We identified a total of 325 charts from preintervention and 489 charts postintervention that met inclusion criteria. Of those, the charts with orders categorized as inappropriate were 90 versus 44, respectively. The rate of inappropriate prescribing of NSAIDs significantly decreased from 27.7% to 9.0% (P

BACKGROUND Confidence in health information access is a measure of the perceived ability to obtain health information. One’s beliefs or perceived ability to access health information is particularly important in understanding trends in health care access. Previous literature has found that access to health information is lowest among society’s most vulnerable population groups. These groups include older, less educated, and low-income populations. While health confidence has previously been used as a scale to measure health outcomes, additional research is needed describing the demographic factors associated with users’ confidence in health information access. This may be a key component of health information seeking that affects beneficial health outcomes such as prevention and treatment. OBJECTIVE This study examines the demographic factors associated with the levels of confidence in using the internet to access health information for adults 18 years and older in the United States. METHODS Using a cross-sectional design, secondary data from the Health Information National Trends Survey (HINTS) 5, Cycle 3 (2019) were analyzed (N=5374). An ordinal regression stratified by internet use was used to determine the association between demographic characteristics and level of confidence in health information access. RESULTS When the internet is the primary source for health information, high school graduates (adjusted odds ratio [AOR] 0.58, 95% CI 0.37-0.89) compared to those with a college degree or more had significantly lower odds of being confident in obtaining health information. In addition, non-Hispanic Asian participants (AOR 0.44, 95% CI 0.24-0.82) compared to non-Hispanic White participants, male participants (AOR 0.72, 95% CI 0.54-0.97) compared to female participants, and those who made between US $20,000-$35,000 annually (AOR 0.55, 95% CI 0.31-0.98) compared to those who made US $75,000 or more annually had significantly lower odds of being confident in obtaining health information via the internet. Moreover, when the internet is the primary source for health information, those with health insurance had significantly higher odds of being confident in obtaining health information (AOR 2.91, 95% CI 1.58-5.34) compared to those who do not have health insurance. Lastly, a significant association was observed between confidence in health information access and primary health information source and frequency of visiting a health care provider. CONCLUSIONS Confidence in accessing health information can differ by individual demographics. Accessing health-related information from the internet has become increasingly more common and can provide insight into health information-seeking behaviors. Further exploration of these factors can inform the science of health education by providing deeper insight into improving access to health information for vulnerable populations.

OBJECTIVE: To identify key beliefs that influence behavior, regarding Medicare's Annual Wellness Visit (AWV) and older patients' willingness to implement personalized prevention plans. DESIGN: Cross-sectional. In-depth semi-structured focus group sessions with Medicare patients in July 2018. SETTING: Two primary care physician-based practices. INTERVENTION: A trained moderator facilitated two focus group sessions, and used open-ended questions based on the theory of planned behavior to elicit behavioral, normative, and control beliefs associated with implementing personalized prevention plans. MAIN OUTCOME MEASURE: Content analysis of the focus groups' transcribed data was used to identify modal salient beliefs. Transcribed focus group sessions were analyzed utilizing grounded-theory methods for emergent themes. RESULTS: A total of 13 older patients participated in the focus group sessions. Prevalent behavioral beliefs among participants influenced by patient-centered care outcomes included improvement in physical activity, adopting a healthy balanced diet, and weight loss. Interpersonal and environmental disparities influenced commonly reported control factors such as lack of support at home and affordable fitness facilities. Macro-level influences such as physicians and social marketing by insurance providers, and health partners and spousal support were identified as important normative factors. CONCLUSION: Identified salient beliefs were congruent to social determinants of health in Medicare patients. Results of the study demonstrate perceived enablers and barriers of elderly patients regarding implementing health-promoting advice. AWV pharmacists should address perceived barriers to improve attitudes and self-efficacy; and incorporate enabling beliefs into adherence strategies to improve adoption of health recommendations.

Was Huck Black? The provocative question that serves as the title of Shelley Fisher Fishkin’s seminal study (1993) remains at the center of debates regarding Twain’s legacy. Did Twain appreciate Bl...

This cross-sectional study examined the association of the number of hours of exergaming along with other activities and body mass index (BMI) among Saudi female adolescents and explored the possibility of exergaming as an alternative to meet the World Health Organization (WHO) physical activity recommendations. A sample of 200 female students age 10-14 years completed a selfadministered lifestyle questionnaire with their parents’ assistance after obtaining parental consent letter. The survey instrument included scales adopted from the validated Adolescent Sedentary Activity Questionnaire (ASAQ) and modified to include questions for exergaming. Anthropometric measurements of height and weight were conducted at school after the completion of the survey. A multiple linear regression model was conducted to examine the association of exergaming with other sedentary activities and BMI. There was a significant association between the number of hours of exergaming and lower BMI (p

Olfactory dysfunction is a common issue in late-life and can be an early indicator for neurodegenerative diseases. Further, olfactory interventions not only improve olfaction but have shown promise for the delay and treatment of dementia. This study aimed to better understand the feasibility and barriers of implementing an olfactory intervention. Participants (N=23) between the ages of 52-86 (mean=71) years were recruited from the community. A demographic questionnaire showed participants were all non-smokers and identified as women (70%), men (26%), and transgender (4%). The majority were married (61%), while some were separated or divorced (17%), widowed (13%), or single (9%). Four focus groups, guided by both structured and open-ended questions, were conducted and audio-recorded with 3-7 unique participants per group. Data were transcribed, thematically analyzed, and independently coded, which resulted in three overarching themes: (1) cognitive, genetic, and environmental factors of smell, (2) methods to reduce barriers and increase the feasibility of an intervention, and (3) flexibility with technology use. Findings suggest that implementing an olfactory intervention is feasible and of interest to older populations especially when provided with detailed training protocols that have flexibility in the amount of technology used within the study. Barriers included sensitivity to smells, allergies, and dexterity issues. Reducing these barriers will facilitate implementation and decrease the likelihood of attrition. Consulting the target population provides insights into barriers, participant interest, and can assist with the development of training and intervention programs.

In this paper I assess the labour ward admission policies introduced by some National Health Service (NHS) trusts during the COVID-19 pandemic, arguing that these intersected with other policies in a manner which may have coerced birthing people into consenting to vaginal examinations they might have otherwise refused. In order to fully understand the potential severity of these policies, I situate this critique in the historical and contemporary context of the problematic relationship between consent and vaginal examinations. Identifying the legal wrongs associated with performing coerced vaginal examinations, I highlight that the law is inadequately equipped to provide appropriate redress. Further, I illustrate that the issue explored in this paper reflects broader problems which exist with regard to the focus of, and the (under)investment in, the maternity services.

It has recently been reported that some hospitals in the UK have placed a blanket restriction on the provision of maternal request caesarean sections (MRCS) as a result of the COVID-19 pandemic. Pregnancy and birthing services are obviously facing challenges during the current emergency, but we argue that a blanket ban on MRCS is both inappropriate and disproportionate. In this paper, we highlight the importance of MRCS for pregnant people’s health and autonomy in childbirth and argue that this remains crucial during the current emergency. We consider some potential arguments—based on pregnant people’s health and resource allocation—that might be considered justification for the limitation of such services. We demonstrate, however, that these arguments are not as persuasive as they might appear because there is limited evidence to indicate either that provision of MRCS is always dangerous for pregnant people in the circumstances or would be a substantial burden on a hospital’s ability to respond to the pandemic. Furthermore, we argue that even if MRCS was not a service that hospitals are equipped to offer to all pregnant persons who seek it, the current circumstances cannot justify a blanket ban on an important service and due attention must be paid to individual circumstances.

Introduction: The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparate populations. The objective of our study was to evaluate the efficacy of the Healthy Eating Lifestyle Program (HELP) for accomplishing weight management in a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino children who were overweight or obese. Methods: Our mixed methods evaluation included: (1) A one arm study to measure changes in body mass index (BMI) from pre- to post-intervention, and (2) A stakeholder analysis of the program staff. Results: For children ages 5&ndash, 12 years who were overweight/obese, we found no evidence of excess weight gain evidenced by BMI Z scores (Zpost-pre = &minus, 0.02, p = 0.11). Among the parent/guardians who were overweight or obese, we found a decrease in BMI that was stronger in men (BMI post-pre = &minus, 0.75 kg/m2, p = 0.01) than in women (BMI post-pre = &minus, 0.12 kg/m2, p = 0.30). A program strength was the cultural tailoring of the plant-based diet choices. Conclusions: The evaluation raises the possibility that incorporating intervention components of HELP (plant-based food choices, family-based, cultural tailoring) into pediatric weight management can improve the standard of care.

There is a rising demand to expand the successful roles community health workers (CHWs) offer into clinical settings (clinic-based community health worker [cCHW]) to support patient services. Using survey data, we evaluated patient and CHW readiness and intent to adopt cCHW clinical care integration. We found CHW and patient readiness to become or utilize a cCHW significantly predicted CHW and patient intent to become or utilize a cCHW; however, in our study, CHWs experienced greater readiness to serve as cCHWs than did patients to utilize cCHWs.

Background and Purpose: The Patient Protection and Affordable Care Act resulted in establishment of Covered California (Covered CA), a marketplace providing federally subsidized health insurance in California. This study explored whether obtaining Covered CA coverage improves healthcare access and utilization among Latinos, and whether acculturation plays a role in utilization of healthcare. Methods: 270 Latino adults in San Diego community completed a self-report survey. Results: Those with Covered CA were significantly more likely to have a main provider (p

The African American author Elizabeth Keckly has garnered signiicant attention in recent decades as a result of renewed interest in her memoir and exposé of the family of Abraham Lincoln, Behind the Scenes; or, hirty Years a Slave, and Four Years in the White House (1868). Meanwhile, the anonymous author who, writing as “Betsey Kickley,” viciously parodied her book in Behind the Seams; by a Nigger Woman Who Took in Work from Mrs. Lincoln and Mrs. Davis (1868) has remained an enigma. his essay identiies the mysterious author of Behind the Seams as Daniel Ottolengui, a Jewish newspaper correspondent and writer from Charleston, South Carolina. he parody was reprinted in 1945 by another pseudonymous author, identiied here as the Manhattan-based book dealer Charles P. Everitt. he contents and contexts of both editions of Behind the Seams illustrate the enduring inluence of Keckly's challenge to hegemonic narratives of American history.

Background: In response to high levels of tobacco use among university students, the University of California (UC) and California State University (CSU) systems adopted tobacco-free policies in recent years. While few existing studies capture student response to these policies, there is no research that captures campus administrator perceptions on the effectiveness of these policies. This study was conducted to understand campus administrator perceptions of student compliance to tobacco-free policies in California universities.Methods: This was a qualitative study to understand campus administrator perceptions of student compliance to the tobacco-free policies on select California universities. Data collection took place between March-May 2018 and included key informant (KI) interviews and a focus group (FG) with campus administrators from selected universities. Content analysis using Atlas.ti software was conducted to interpret results.Results: Nine campus administrators participated in KI interviews and four further participated in a FG. Overall analysis of the results indicated that all administrators believe tobacco-free policies on their respective campuses are effective in reducing student tobacco use. Additionally, some administrators believed punitive methods were needed, while others felt creation of a cultural norm would be most effective, and all administrators believed smoking cessation programs were helpful resources to ensure policy compliance. Participants further agreed stronger implementation strategies relating to communicating policy provisions are needed to ensure student understanding of policy.Conclusions: Administrators perceive that tobacco-free policies are effective in reducing tobacco use among university students. It is recommended that additional strategies are utilized to increase student awareness of the policy.

Miralda; or The Beautiful Quadroon , a revised version of William Wells Brown’s novel Clotel (1853), was published serially in the Weekly Anglo-African from December 1860 to March 1861. While Clotel has garnered substantial critical attention, Miralda remains obscure, in part due to the fact that its first two installments have been lost. An article published in Washington, D.C.’s Evening Star in January 1861 offers a rare glimpse of this fragmentary text. The article documents the Weekly Anglo-African ’s significance within the antebellum African American community; moreover, it offers a fresh perspective of Miralda as a double-voiced and rhetorically subversive text.

This article provides an overview of addiction workforce development in Aotearoa New Zealand. Workforce development and workforce planning in the Aotearoa New Zealand context are briefly defined an...

We propose a kinetic gelation model of polymer growth with two monomeric types that have distinct functionalities (reaction sites), and can polymerize using different reaction types. The heterotypic aggregation of two monomer types is modeled using a moment generating function approach by tracking the temporal evolution of a closed system of moment equations up until gelation. We investigate several scenarios of polymerization with two distinct monomers that differ in the types of reactions that can occur. We determine numerical and analytical conditions for finite time blow-up (the emergence of an oligomer of infinite size) that depend on initial conditions, reaction rates, and number of reaction sites per monomer.

AMPylation, the post-translational modification with adenosine monophosphate (AMP), is catalyzed by effector proteins from a variety of pathogens. Legionella pneumophila is thus far the only known pathogen that, in addition to encoding an AMPylase (SidM/DrrA), also encodes a deAMPylase, called SidD, that reverses SidM-mediated AMPylation of the vesicle transport GTPase Rab1. DeAMPylation is catalyzed by the N-terminal phosphatase-like domain of SidD. Here, we determined the crystal structure of full length SidD including the uncharacterized C-terminal domain (CTD). A flexible loop rich in aromatic residues within the CTD was required to target SidD to model membranes in vitro and to the Golgi apparatus within mammalian cells. Deletion of the loop (Δloop) or substitution of its aromatic phenylalanine residues rendered SidD cytosolic, showing that the hydrophobic loop is the primary membrane-targeting determinant of SidD. Notably, deletion of the two terminal alpha helices resulted in a CTD variant incapable of discriminating between membranes of different composition. Moreover, a L. pneumophila strain producing SidDΔloop phenocopied a L. pneumophila ΔsidD strain during growth in mouse macrophages and displayed prolonged co-localization of AMPylated Rab1 with LCVs, thus revealing that membrane targeting of SidD via its CTD is a critical prerequisite for its ability to catalyze Rab1 deAMPylation during L. pneumophila infection., Author summary The frequency of Legionnaires' disease outbreaks, a serious pneumonia caused by the intracellular pathogen Legionella pneumophila, has increased more than 4-fold between the years 2000 and 2015 [CDC, Summary of Notifiable Diseases, United States, 2015]. L. pneumophila secretes hundreds of bacterial effectors to manipulate host cell processes. Rab GTPases, which control intracellular vesicle trafficking in eukaryotes, are a known target of Legionella effectors. SidM and SidD both target host cell Rab1, but with opposing activities. While SidM catalyzes the attachment of adenosine monophosphate (AMP) to Rab1, SidD catalyzes AMP removal from Rab1, a process known as deAMPylation. Here we present the crystal structure of full length SidD, including the previously uncharacterized C-terminal domain (CTD). We discovered that the CTD assumed a unique fold that was critical for membrane localization of SidD within host cells, and that this localization was dependent on two structural elements: a stretch of hydrophobic amino acid residues that represents a general membrane targeting determinant, and a two-helix bundle that functions as the specificity determinant. Deletion of either of these elements interfered with the correct localization of SidD within mammalian cells, confirming that positioning of bacterial effectors is critically important for their biological function.

In the contemporary public health workforce environment, public health social workers (PHSW) bring integrated skills, from both fields, to meet the needs of vulnerable and underserved populations. They receive training in their Master of Public Health/Master of Social Work dual-degree programs, such as the one at New Mexico State University, which serves the U.S./Mexico border region. During their studies, dual-degree students are equipped to address health and human service issues at the micro, mezzo, and macro levels and complete field experience and practicum hours in their communities. Along with practical skills, these students learn culturally responsive/humble ways of being with communities of color and marginalized individuals. After graduation, these emerging career PHSWs enter the workforce in a variety of settings: nonprofit, educational, government, primary care, and more. In this article, the field of public health social work is described in its historic and present forms, followed by PHSWs’ utility to the U.S./Mexico border region, in particular. Finally, we make the call to action for future career PHSWs to engage with this integrated, dynamic, innovative field, and its unique combination of community- and individual-based services and rewards.

The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparity populations. The objective of our study was to evaluate the efficacy and scalability of the Healthy Eating Lifestyle Program (HELP) – a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino pediatric obesity patients and their families. Our evaluation methods included: 1) a quasi-experimental, one group, longitudinal study to measures changes in BMI at 0, 6, and 18 weeks of follow-up, and 2) A stakeholder analysis consisting of six key informant interviews of HELP program staff. We found a significant decrease in body mass index across all adults (-0.2 kg/m2 p=0.0047), that was much stronger in men. For children ages 5-12 years, there was also a significant decrease in BMI Z score from pre- to post- intervention (p=0.04). Program strengths were the cultural tailoring of the plant-based diet choices, and allowing a tiered approached that did not require adherence to strict vegetarianism. Our pilot study findings from HELP raise the possibility that incorporating plant-based diet choices into the treatment of pediatric obesity patients and their families can be an effective addition to a culturally responsive care model.

Purpose The purpose of this paper is to assess perceptions of organizational readiness to integrate clinic-based community health workers (cCHWs) between traditional CHWs and potential cCHW employers and their staff in order to inform training and implementation models. Design/methodology/approach A cross-sectional mixed-methods approach evaluated readiness to change perceptions of traditional CHWs and potential employers and their staff. Quantitative methods included a printed survey for CHWs and online surveys in Qualtrics for employers/staff. Data were analyzed using SPSS software. Qualitative data were collected via focus groups and key informant interviews. Data were analyzed with NVIVO 11 Plus software. Findings CHWs and employers and staff were statistically different in their perceptions on appropriateness, management support and change efficacy (p Originality/value Community health workers serve to fill the gaps in the social and health care systems. They are an innovation as an emerging workforce in health care settings. Health care organizations need to learn how to integrate paraprofessionals such as cCHWs. Understanding readiness to adopt the integration of cCHWs into clinical settings will help prepare systems through trainings and adapting organizational processes that help build capacity for successful and sustainable integration.

The issue of sexuality for young disabled women is not often talked about in society. Our study aimed to explore four young physically disabled women’s experiences and perspectives regarding sexuality and disability. We used PhotoVoice, a participatory action research method which uses photographs, to capture and convey our participants’ concerns. Through their photographs they showed that everyday interactions with others, particularly strangers or meeting people for the first time, were made difficult by how they were always seen as having a disability. Other parts of their identity were not recognised. The change the young women wanted was for people to see them as young women and not just as disabled.

Purpose The purpose of this paper is to explore and develop appropriate responses to the workforce development needs of Aotearoa New Zealand Therapeutic Communities (TC). Design/methodology/approach Matua Raki took a workforce development design approach using principles of participatory/co-design. Findings A scoping exercise undertaken to explore the workforce development needs of Aotearoa New Zealand TC concluded that there was a shortage of addiction practitioners ready, willing and able to work in the TC environment and that a workforce development solution was desired by stakeholders. Following the scoping exercise a demand analysis found that there was a need for a TC training programme to be delivered in the Aotearoa New Zealand context. Outcome: a culturally appropriate TC training programme was developed in consultation with a wide range of stakeholders. The training programme was then piloted with a group of 23 practitioners. Evaluation of participant engagement and satisfaction indicated that the training programme was appropriate to both the needs of the workforce and the TC context. Originality/value The TC training, developed as a result of this workforce development design approach provides unique content and processes to meet the needs of the TC workforce in the New Zealand context.

Multiple ingredient pre-workout supplements (MIPS) are purported to offer favorable acute metabolic changes potentially leading to improvements in body composition and training adaptations over time. However, there is limited information available regarding the long-term benefits and safety of consuming MIPS, specifically in female populations. Therefore, the purpose of this study was to investigate the effects of pre-workout ingestion on body composition, training adaptations and select markers of clinical health in recreationally active females after 7 weeks of supplementation and resistance training. Nineteen participants participated in a randomized, double-blind, placebo controlled study. Experimental testing included resting heart rate and blood pressure, blood lipid panels, body composition, resting metabolic testing and performance measurements before and after a seven-week resistance training program while ingesting either a MIPS or placebo once daily. There were no significant group x time interactions for changes in body fat percentage (p=0.66), fat-free mass (p=0.87), fat mass (p=0.63) or resting metabolic rate (p=0.52). Both groups showed significant improvements in upper (p