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In current and next-generation weed control technologies, sequential applications of contact and systemic herbicides for POST control of troublesome weeds are needed to mitigate the evolution of herbicide resistance. A clear understanding of the impact auxin herbicide symptomology has on Palmer amaranth groundcover will aid optimization of sequential herbicide applications. Field and greenhouse experiments were conducted in Fayetteville, AR and a laboratory experiment was conducted in Lonoke, AR, in 2020 to evaluate changes in Palmer amaranth groundcover following an application of 2,4-D and dicamba with various nozzles, droplet sizes, and velocities. Field experiments utilized three nozzles: Extended Range (XR), Air Induction Extended Range (AIXR), and Turbo TeeJet Induction (TTI), to assess the effect of spray droplet size on changes in Palmer amaranth groundcover. Nozzle did not affect Palmer amaranth groundcover when dicamba was applied. However, nozzle selection did impact groundcover when 2,4-D was applied; the following nozzle order XR>AIXR>TTI reduced Palmer amaranth groundcover the greatest in both site-years of the field experiment. This result (XR>AIXR> TTI) matches percent spray coverage data for 2,4-D and is inversely related to spray droplet size data. Rapid reductions of Palmer amaranth groundcover from 100% at time zero to 39.4 to 64.1% and 60.0 to 85.8% were observed 180 minutes after application in greenhouse and field experiments, respectively, regardless of herbicide or nozzle. In one site-year of the greenhouse and field experiments, regrowth of Palmer amaranth occurred 10080 minutes (14 days) after an application of either 2,4-D or dicamba to larger than labeled weeds. In all experiments, complete reduction of live Palmer amaranth tissue was not observed 21 days after application with any herbicide or nozzle combination. Control of Palmer amaranth escapes with reduced groundcover may potentially lead to increased selection pressure on sequentially applied herbicides due to a reduction in spray solution contact with the targeted pest.
Coronavirus disease 2019 (COVID-19) has seen a shift in remote work from being a discretionary flexible work policy to a mandatory requirement for several workplaces. This ‘forced flexibility’ has meant that organisations and their employees have had to adapt swiftly to new requirements and arrangements for how work is done. Working remotely, often at home in ‘virtual workspaces’, has become commonplace for many employees across Australia and globally. Drawing on findings from two qualitative phases of research in an Australian resources company, we use conservation of resources theory to explore the factors influencing processes related to wellbeing and productivity for employees working remotely in the COVID-19 environment. We identify challenges associated with working remotely, as well as important resources for wellbeing and productivity. Practical implications are also discussed.
An outbreak of SARS-CoV2 infection in a Barcelona prison was studied. One hundred and forty-eight inmates and 36 prison staff were evaluated by rt-PCR, and 24.1% (40 prisoners, two health workers and four non-health workers) tested positive. In all, 94.8% of cases were asymptomatic. The inmates were isolated in prison module 4, which was converted into an emergency COVID unit. There were no deaths. Generalised screening and the isolation and evaluation of the people infected were key measures. Symptom-based surveillance must be supplemented by rapid contact-based monitoring in order to avoid asymptomatic spread among prisoners and the community at large.
Structure M13-1 is a public monumental building in the heart of ancient El Perú-Waka’, Petén, Guatemala, and is the location of Burial 61, an entombed Late Classic (seventh-century) ruler. In this report, we discuss mortuary evidence that we believe permits identification of the interred as the historically known queen, Lady K'abel.
ABSTRACT IMPACT: Implementing a team science approach with broad engagement from academic researchers, healthcare payers, providers, patients, and community-based organizations is complex, yet critical to implementing evidence into real world settings. OBJECTIVES/GOALS: 1. Participants will be able to deploy novel strategies for creating and training a regional multi-stakeholder consortium to improve the quality and value of healthcare.
2. Participants will be to examine ways in which team science provides holistic sustainable strategies to improve care and outcomes in real-world settings. METHODS/STUDY POPULATION: The Quality & Value Innovation Consortium (QVIC) has created a network of hospitals and other stakeholders (providers, payers, purchasers, patients, community-based organizations, and researchers) to collaborate and innovate on healthcare delivery. This initiative began with a team of a physician researcher, a health services researcher, and a nurse researcher first identifying healthcare systems’ priorities through individual meetings with leadership from 14 regional hospitals. Concurrently, meetings were held with other stakeholders. These interviews identified 32 key quality improvement topics.
Focus groups and surveys reduced these to 11 topics that were then selected for community forums. Through a mixed methods approach, two priority topics were selected for regional implementation. RESULTS/ANTICIPATED RESULTS: The QVIC meetings have prioritized two topics and highlighted novel information sharing across entities, and strategies to address the social determinants of health. The QVIC efforts have been recognized as a community asset for helping build collaboration and partnerships among diverse stakeholders. Ultimately, two regional initiatives, opioid management, and transitions in heart failure care were selected for implementation. Both of these initiatives aim to reduce readmissions by addressing social determinants of health. Implementation strategies and evaluation metrics are being customized for pragmatic integration within each system, utilizing a collaborative team science approach. DISCUSSION/SIGNIFICANCE OF FINDINGS: While the entire country is grappling with the challenge of improving the quality of care, while lowering its costs, Kansas City has modeled a unique culture and strategy for achieving this goal, important for learning health systems and communities.
This study aimed to explore barriers and facilitators of the provision of dairy and plant-based dairy alternatives (PBDA) by parents of preschool-age children, a previously unexplored area of research.
Five focus groups of parents were conducted and audio-recorded. Verbatim transcripts were analysed using thematic analysis.
University of Guelph, in Guelph, ON, Canada in 2019.
Thirty-two (n 19 mothers, 13 fathers) parents of preschool-age children. Most (59 %) were university or college educated.
Facilitators common to both dairy and PBDA provision included perceived nutritional benefits, such as dairy’s Ca, protein and fat content, and PBDA’s protein content, and the perception that PBDA adds variety to the diet. Facilitators unique to dairy v. PBDA provision included the taste of, familiarity with, and greater variety and accessibility of dairy products, specifically child-friendly products. A facilitator unique to PBDA v. dairy provision was ethical concerns regarding dairy farming practices. Barriers common to both dairy and PBDA provision included perceived cost, concerns regarding the environmental impact of production, and high sugar content. Barriers specific to dairy included use of antibiotics and hormones in dairy production. A barrier specific to PBDA was the use of pesticides.
Behaviour change messages targeting parents of preschoolers can emphasise the nutrition non-equivalence of dairy and some PBDA and can educate parents on sources of affordable, unsweetened dairy and PBDA.
Patient safety is a complex systems issue. In this study, we used a scoping review of peer-reviewed literature and a case study of provincial and territorial legislation in Canada to explore the influence of mandatory reporting legislation on patient safety outcomes in hospital settings. We drew from a conceptual model that examines the components of mandatory reporting legislation that must be in place as a part of a systems governance approach to patient safety and used this model to frame our results. Our results suggest that mandatory reporting legislation across Canada is generally designed to gather information about – rather than respond to and prevent – patient safety incidents. Overall, we found limited evidence of impact of mandatory reporting legislation on patient safety outcomes. Although legislation is one lever among many to improve patient safety outcomes, there are nonetheless several considerations for patient safety legislation to assist in broader system improvement efforts in Canada and elsewhere. Legislative frameworks may be enhanced by strengthening learning systems, accountability mechanisms and patient safety culture.
Established and emerging technologies—such as wearable sensors, smartphones, mobile apps, and artificial intelligence—are shaping positive healthcare models and patient outcomes. These technologies have the potential to become precision health (PH) innovations. However, not all innovations meet regulatory standards or have the required scientific evidence to be used for health applications. In response, an assessment framework was developed to facilitate and standardize the assessment of innovations deemed suitable for PH.
A scoping literature review undertaken through PubMed and Google Scholar identified approximately 100 relevant articles. These were then shortlisted (n = 12) to those that included specific metrics, criteria, or frameworks for assessing technologies that could be applied to the PH context.
The proposed framework identified nine core criteria with subcriteria and grouped them into four categories for assessment: technical, clinical, human factors, and implementation. Guiding statements with response options and recommendations were used as metrics against each criterion.
The proposed framework supports health services, health technology innovators, and researchers in leveraging current and emerging technologies for PH innovations. It covers a comprehensive set of criteria as part of the assessment process of these technologies.
Within a medical home, primary care providers can identify needs, provide services, and coordinate care for children with heart conditions. Using parent-reported data from the 2016–2017 National Survey of Children’s Health, we examined receipt of preventive care in the last 12 months and having a medical home (care that is accessible, continuous, comprehensive, family-centred, coordinated, compassionate, and culturally effective) among US children aged 0–17 years with and without heart conditions. Using the marginal predictions approach to multivariable logistic regression, we examined associations between presence of a heart condition and receipt of preventive care and having a medical home. Among children with heart conditions, we evaluated associations between sociodemographic and health characteristics and receipt of preventive care and having a medical home. Of the 66,971 children included, 2.2% had heart conditions. Receipt of preventive care was reported for more children with heart conditions (91.0%) than without (82.7%) (adjusted prevalence ratio = 1.09, 95% confidence interval: 1.05–1.13). Less than half of children with heart conditions (48.2%) and without (49.5%) had a medical home (adjusted prevalence ratio = 1.02, 95% confidence interval: 0.91–1.14). For children with heart conditions, preventive care was slightly more common among younger children and less common among those with family incomes 200–399% of the federal poverty level. Having a medical home was less common among younger children, non-Hispanic “other” race, and those with ≥2 other health conditions. Most children with heart conditions received preventive care, but less than half had a medical home, with disparities by age, socioeconomic status, race, and concurrent health conditions. These findings highlight opportunities to improve care for children with heart conditions.
One of the limiting factors for the analysis of minor elements in multiphase materials by electron probe microanalysis is the effect of secondary fluorescence (SF), which is not accounted for by matrix corrections. Although the apparent concentration due to SF can be calculated numerically or measured experimentally, detailed investigations of this effect for fine-grained materials are scarce. In this work, we use the Monte Carlo simulation program PENEPMA to examine and correct the effect of SF affecting micron-sized mineral inclusions hosted by other minerals. A concentration profile across an olivine [(Mg,Fe)2SiO4] inclusion in chromite (Fe2+Cr2O4) is measured and used to assess the reliability of calculations, where different boundary geometries are examined. Three application examples are presented, which include the determination of Cr in olivine and serpentine [Mg3Si2O5(OH)4] inclusions hosted by chromite and of Fe in quartz (SiO2) inclusions hosted by almandine garnet (Fe3Al2Si3O12). Our results show that neglecting SF leads to concentrations that are overestimated by ~0.1–0.8 wt%, depending on inclusion size. In addition, assuming a straight boundary yields to an underestimation of SF effects by a factor of ~2–4. Because its long-range nature, SF severely compromises trace element analyses even for phases as large as 1 mm in size.
The Day Hospital (DH) provides an intensive, multidisciplinary, coordinated, group and customized care for patients admitted for treatment. The therapeutic approach improve their clinical situation, their quality of life and facilitate their reintegration into everyday life. Our objective is to evaluate overall clinical improvement and perceived quality of life of patients admitted in a general hospital DH (2010–2012). Clinical diagnosis (DSM-IV-R) grouped (NSUD, SUD and DUAL), clinical variables, baseline/ high clinical situation (CGI-S), global impression of improvement (CGI-I) and related quality of life perceived (EQ5) at baseline / high were recorded. Data were analyzed using SPSS v15. 174 patients were evaluated, 58% women, mean age 47 years and schooling medium-high (76%). The average stay (DT) was 35 days. Patients came from 47%: acute hospitalization, 51%: Mental Health Center (MSC) or outpatient and 4%: other units. The reasons for admission were detoxification (34.5%), stabilization (33.3%), consolidation of detoxification (15.5%), decompensation (9.2%) and re-structuring of treatment (7.5%). The overall clinical improvement of the whole sample at the end of stay assessed by the CGI-I was: 35% = “much better” 38% = “moderately better”, 5% = “slightly better”, 21% = “no change” and only 1% “worse” (p = 0.001). An overall clinical improvement and quality of life perceived was observed in the three groups of patients. While it remains to know the persistence of these parameters in the long term, the Day Hospital proved to be an important therapeutic resource for overall clinical improvement of patients towards their incorporation into daily life.
The growing concern about cannabis use, the most used illicit drug worldwide, has led to an increase in the number of cannabis studies using neuroimaging techniques to determine its effect on brain structure and function.
We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents.
Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered.
One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks also in both groups, which may indicate compensatory effects in response to chronic cannabis exposure. The results pointed out methodological limitations among studies and high heterogeneity in the findings.
Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent and multimodal methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives. Grants: PNSD/2011/050, PNSD2006/101, SGR2009/1435.
Neuropsychological and neuroimaging studies of response inhibition in cannabis users have reported inconsistent results. The age of onset of cannabis use and individual genetic differences may play a critical role in the regulation of inhibition in cannabis users.
We examine the influence of COMT Val158Met functional polymorphism on the response inhibition brain network in a group of early-onset chronic cannabis users compared with healthy controls.
fMRI data was acquired from 27 chronic cannabis users who began use cannabis before 16 years of age, and 29 non-using control subjects matched in terms of age, educational level and intelligence quotient while undergoing the Multi-Source Interference Task (MSIT). Participants were male, Caucasians aged between 18 and 30 years. All were assessed by a structured psychiatric interview (PRISM) to exclude any lifetime Axis-I disorder (DSM-IV). COMT genotyping was performed and resonance imaging data was analysed by voxel-based morphometry (VBM).
Both groups did not differ on their behavioural performance and brain responses during the MSIT task. A significant group-by-genotype interaction was observed on task-related brain activation (and on MSIT reaction times), in which met carrier load was associated with increased activation in cannabis users and val carrier load with increased activation in controls. The interaction pattern included the medial frontal cortex, ACC, inferior frontal gyrus, ventral striatum, anterior mesencephalon, inferior parietal and superior temporal cortices and the PCC.
Chronic cannabis exposure interacts with the genetically driven dopamine function in the modulation of the neural mechanisms related to response inhibition.
The aim of the study was to assess the effect of exposure to selective serotonin reuptake inhibitors (SSRI) in utero on child IQ and psychopathological syndromes.
A two cohorts study was designed. A cohort of 40 mother-child pairs with depressive or anxiety disorders (DSM-IV criteria) attended at a Perinatal Psychiatry Program between 2004 and 2006 and exposed in utero to SSRI was compared with a healthy cohort of 40 mother-child pairs, paired by gender and gestational age. The two groups were compared in terms of children's IQ between ages 60 and 72 months, assessed blindly through Kaufman Assessment Battery for Children (K-ABC). The Early Childhood Inventory teachers’ and parents’ versions (ECI-4) were used to assess psychopathological syndromes. Statistical analysis were done with paired t-test, Chi square test, and Fisher's exact test.
There were no differences among the groups in maternal IQ, socioeconomic status and obstetric variables. There were no differences among the groups (exposed vs. non-exposed) in the Mental Processing Composite (101.20 vs. 106.95; p = 0.07), the Sequential Processing Scale (97.78 vs. 103.00; p = 0.11), the Simultaneous Processing Scale (103.90 vs. 109.23; p = 0.13) and the Achievement Scale (98.80 vs. 103.13; p = 0.13). The ECI-4 psychopathological syndromes rates of exposed children were slightly higher than non-exposed children, but these differences were only significant on Adjustment Disorder in parents’ reports (30% vs. 10%; p = 0.04).
Exposure to SSRI during pregnancy does not appear to adversely affect cognitive functioning. Exposed children showed slightly higher rates of psychopathology, especially Adjustment Disorder.
Behavioural, psychological and cognitive disturbance have been associated with hypothyroidism, even it has been suggested that this symptoms may remain despite adequate replacement therapy with thyroxine.
To describe prevalence, sociodemographics and clinical features of patients with hypothyroidism in an acute psychiatric unit.
To know about the relation between hypothyroidism and psychiatric symptoms.
Data base collection of all patients admitted between 2010 and 2014 in the acute unit of our psychiatric hospital in Barcelona, was analyzed using SPSS program.
In all 3.1% of the 4536 total patients had hypothyroidism. Among them, 46% were duplicate cases. Mean age was 53 ± 14.27 years. A total of 82.7% were woman. Patients having a TSH lower than 0.30 were 12%, TSH normal were 60.2%, TSH higher than 5 were 27.8%. Most frequent Levothyroxine dosage was: 75 μg (22.1%), 100 μg (19%), 25 μg (12.5%) and 125 μg (12.5%). Diagnosis more frequently associated with hypothyroidism was: Bipolar (26.5%), Schizophrenia (20%), Depression (15.1%), Unspecified psychosis (10%), Personality disorder (10%), Schizoaffective disorder (7.2%), Paranoia 4.3%.
Most of patients were stable of thyroid condition when had been admitted to our hospital. Hypothyroidism could be a relapse factor, even when treatment is adequate. Affective disorders are more frequently related with hypothyroidism (lithium has to be consider a confounding factor).
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Novel psychoactive substances (NPS) use is progressively increasing year on year. The new analogues of phencyclidine are frequently sold as legal dissociative anesthetic drug with hallucinogenic and sedative effects, a legal alternative to ketamine, acting as a high affinity and selective ligand of NMDA receptor antagonists.
To describe the presence of 3- and 4-MeO-PCP in samples delivered to Energy Control from 2009 to 2015 in Spain.
A total of 21,198 samples were analyzed from august 2009 to august 2015. Only those samples containing 4-MeO-PCP or 3-MeO-PCP were studied. They were analyzed by Energy Control, a Spanish harm reduction NGO that offers the possibility of analyzing the substances that users report. Analysis was done by gas chromatography–mass spectrometry.
All the samples resulted to be the acquired drug of the consumer. Three samples were adulterated with substances as tramadol, cocaine, acetone among others.
Three and 4-MeO-PCP consumption is not found to be an emerging issue according to the results of our samples. Even the potential harmful effects of these dissociative drugs, our indirect indicator seems to show that consumption has not increased. A more precise monitoring would make a better approach to the real consumption and the impact of these substances in our society.
Disclosure of interest
The authors declare that they have no competing interest.