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Community advisory boards (CABs) have traditionally been formed in the context of discrete projects and served to support community protections within the confines of the associated investigation(s). However, as funding bodies increasingly prioritize health equity, CABs have shifted – evolving into long-running organizations with broader scope and value. An emerging cornerstone of these project-independent boards (PICABs) has been the formation of “Research Review Boards” (RRBs). While unified in their goal of promoting community protection and representation in health research, it is unknown to what degree RRBs differ on key features including membership, leadership, service reach, and – crucially – impact. A scoping review was conducted according to PRISMA-ScR guidelines to analyze current practices for RRBs. Of screened articles (n= 1878), 25 were included, corresponding to 24 unique RRBs. Findings indicated overlaps in the stated missions, funding structures, and processes of most RRBs. Differences in membership composition, location, service-reach, leadership structures, evaluation procedures, and perceived impact were evident. Where data is available, RRBs receive positive endorsement from both internal members and external users. Standardization of evaluation procedures is needed to fully quantify impact. Additional challenges to sustainability, communication, and conflicts (e.g., of interest, commitment, and power differentials) merit further consideration.
This study investigates the extent to which a group of Australian preservice and early career secondary school music teachers of East Asian heritage are likely to teach aspects of their heritage music. It is positioned against a background of national multiculturalism and approaches to cultural inclusivity in Australian society, as well as the long-standing notion of ‘Asia literacy’ in Australian education and the national cross-curriculum priority (C-CP) of ‘Asia and Australia’s engagement with Asia’. The study’s findings indicate that the participants identified with their ancestral cultures to varying extents, generally had very limited knowledge of and experience with their heritage music and in general were reluctant to teach their heritage music. The authors suggest that the slow rate of progress towards culturally diversifying Australian music classrooms is related to complex matters and attitudes surrounding race in the country. The study proposes developing Cayari’s concept of ‘Asian spaces’ as a means of increasing the presence of East Asian music in Australian schools and of supporting teachers of East Asian heritage in the workplace. Finally, the authors emphasise that culturally diversifying the content of music classrooms can be undertaken by teachers of any cultural background.
Building on the success of the Soft Drinks Industry Levy (SDIL), new tax proposals have been considered in the public health policy debate in the UK. To inform such debate, estimates of the potential impacts of alternative tax scenarios are of critical importance. Using a modelling approach, we studied the effects of two tax scenarios: (1) a hypothetical excise tax designed to tax food products included in the Sugar Reduction Programme (SRP), accounting for pack size to reduce the convenience of purchasing larger quantities at once; (2) an ad valorem tax targeting products based on the UK Nutrient Profile Model (NPM). Simulations of scenario 1 show a reduction in sugar purchased of up to 38 %, with the largest decreases observed for sweet confectionery with a tiered tax, similar in structure to the SDIL. Expected food reformulation in scenario 1 led to further decreases in sugar purchased for all categories. In scenario 2, under the assumption that the tax would not affect purchases of healthier products, a 20 % tax on less healthy products would reduce total sugar purchased by 4·3 % to 14·7 % and total energy by 4·7 % to 14·8 %. Despite some limitations and assumptions, our results suggest that new fiscal policy options hold a significant potential for improving diet quality beyond what has been achieved by the SDIL and SRP. An estimated increase in consumer expenditures in both scenarios suggests that attention needs to be paid to potentially regressive effects in the design of any new food taxes.
Effective allocation of scarce healthcare resources involves complex ethical and technical evaluations, with decision makers sometimes utilizing a societal perspective in health technology assessment (HTA). This study aimed to explore societal perspectives on healthcare resource allocation within Australia’s HTA framework, focusing on the valuation of health gains for children and young people (CYP) compared to adults.
Methods
In-depth, semistructured interviews were conducted with ten young people (aged 15–17) and twenty adults between October 2021 and April 2022. Participants were purposively sampled for diverse characteristics and completed an online information survey prior to the interviews, introducing relevant concepts. Interviews were analyzed using inductive coding, categorization, and constant comparison.
Results
Participants expressed nuanced perspectives on HTA processes, generally opposing numeric weighting and preferring a deliberative approach based on committee judgment. Although most participants acknowledged some moral relevance of CYP status in HTA, opinions varied on its operationalization. A sizable minority, including those with extensive health system experience, did not view CYP status as morally relevant, though some noted specific service gaps for CYP (e.g., mental health care, pain management). Participants identified a spectrum of factors, both person-centered and intervention related, that often surpassed the relevance of CYP status, including addressing severity, unmet needs, prevention, and early intervention, with an emphasis on Aboriginal and Torres Strait Islander communities.
Conclusion
Our findings highlight the inherent challenges in navigating the complexities of HTA and the critical need for HTA frameworks to be adaptable and inclusive, effectively integrating societal preferences to enhance healthcare policy’s equity and responsiveness.
Greenwashing cases holding businesses to account for false or misleading eco-claims are an increasingly visible component of the business and human rights landscape globally. In the European Union (EU), the Unfair Commercial Practices Directive is the centrepiece of regulation for business-to-consumer claims. Within the European Green Deal initiative, the EU is revising this framework, first with the Directive to ‘Empower Consumers for the Green Transition,’ and second the pending proposal for a ‘Green Claims Directive,’ introducing detailed requirements on the substantiation and communication of ‘green claims’ to consumers. If fully adopted, this fundamental reform will impose greater restraints on the discretion of any authority charged with the assessment of green claims and provide more uniform criteria across the EU, resulting in more accurate environmental claims and greater clarity for consumers and businesses alike.
Expanded vowel or tone space in IDS has traditionally been interpreted as evidence of enhanced acoustic contrasts. However, emerging evidence from various languages shows that the within-category acoustic variability of vowels and tones also increases in IDS, offsetting the benefit of space expansion and leading to non-enhanced, or reduced acoustic contrasts. This study re-analysed a corpus of Mandarin IDS and ADS, showing that, relative to ADS, vowels and tones in IDS display greater variability, resulting in non-enhanced contrasts. Thus, given increased variability, expanded vowel or tonal space in IDS may not necessarily equate to enhanced acoustic contrasts.
The COVID-19 pandemic showed the vital role of Emergency Medical Teams (EMTs) in international surge responses. The EMTs with their internationally skilled team members were able to meaningfully support countries facing the pandemic, especially those who were suffering from scarcity in the quality and quantity of workforce and financial resources within their health systems. This report summarizes the main operational challenges faced by UK-Med and The Polish Center for International Aid (PCPM) Emergency Medical Teams, based on experiences from their 32 COVID-19 deployments. In particular, the paper discusses the hindrances related to Ministries of Health expectations and the changing roles of EMTs during deployments.
Elder abuse (EA) often remains hidden, and many victims do not interact with formal systems. Concerned persons (CPs) are family, friends, and neighbours who play an essential role in supporting EA victims.
Objective
The aim of this study was to understand CPs’ role and help-seeking experiences.
Methods
Nineteen self-identified CPs shared their experience of being involved in an EA case via an interview and/or survey, with responses analysed qualitatively.
Findings
CPs were primarily the victims’ female relatives, often related to the perpetrator, and had sought help from a wide range of formal and informal sources, facing many barriers in protecting victims from harm. Challenges commonly related to formal services and EA perpetrators. Through knowing about the abuse and/or seeking help, participants experienced negative impacts, particularly psychological ones.
Discussion
Findings suggest that CPs can play a key role in supporting EA victims but require further support and recognition from services to fulfil this role.
Sarcoptic mange, caused by the Sarcoptes scabiei mite, is a highly transmissible skin condition affecting many mammalian species worldwide. South American camelids (SAC) have the highest reported prevalence of mange in South America, causing economic losses and posing a conservation threat to wild SAC. This study investigated mite diversity in SAC in Argentina and assessed relationships between known outbreak areas. Distinct epidemiologic scenarios were explored: the San Juan-La Rioja region, where a mange outbreak decimated wild SAC populations, and the Puna region of Jujuy, where domestic and wild SAC coexist and infections often occur. The mitochondrial gene cox1 and ten microsatellites were analysed from mites collected in five sampling events in Jujuy and four in San Juan-La Rioja between 2017 and 2023. A single cox1 haplotype was observed regardless of mite origin or host species. Comparison with partial cox1 sequences from other camelids worldwide showed little variation. Microsatellite markers revealed lower diversity in mites from San Juan-La Rioja compared to Jujuy. A single strain common to vicuñas and guanacos was identified in San Juan-La Rioja, while three strains were detected in Jujuy affecting vicuñas and/or domestic llamas. Some mites from Jujuy exhibited mixed genetic composition between the two regions, and results confirmed that domestic and wild SAC shared mite strains. This study enhances understanding of sarcoptic mange transmission among SAC species, contributing to vicuña and guanaco conservation and high-altitude livestock farming. Additionally, these findings provide support for the development of intersectoral management strategies to address this significant threat.
This research aims to assess the prevalence, severity and underlying causes of hearing impairments.
Methods
This cross-sectional study used multistage stratified sampling to select 2148 individuals from Salyan and Surkhet, following the World Health Organization’s Ear and Hearing Survey Handbook.
Results
Among 1946 participants, 38.9 per cent had hearing impairments, including 15.9 per cent with disabling hearing loss, with severity increasing with age. Ear diseases affected 34.3 per cent, including dull or retracted tympanic membranes (18 per cent), impacted wax (8 per cent), perforated tympanic membrane (6.1 per cent), and abnormal tympanometry (23.1 per cent). The major causes were age-related hearing loss (50.5 per cent), Eustachian tube dysfunction (23 per cent), chronic suppurative otitis media (10.8 per cent), and otitis media with effusion (4.7 per cent). Higher education and immunisation were associated with reduced risk, while chronic conditions, earaches, drainage and tinnitus increased the risk.
Conclusion
The high prevalence of hearing impairment, primarily from preventable causes, underscores the importance of early screening and strengthened primary health care.
Archimedes screw generators are a small-scale, eco-friendly hydropower technology. Despite their promise as a sustainable energy technology, the design specifics of the technology are not well documented in the published literature. Existing performance prediction models often fail to accurately forecast power loss, particularly as it relates to the outlet of the screw generator. To address this, a comprehensive computational fluid dynamic model was developed and evaluated using both laboratory-scale experiments and real-world data. This yielded an extensive dataset that covered wide variations in design parameters. The dataset was then used to inform the development and evaluation of an outlet power loss prediction model. The resulting model significantly improved the accuracy of overall performance predictions, reducing average error to 13.68 % compared with nominal experimental data – a substantial improvement over previous models, which averaged around 42.55 % error for the same test cases. Notably, the new model achieved an absolute error of 5 % or less in over 26 % of comparison points, marking a remarkable advancement by predicting outlet power loss by more than 28.8 %.
This case note examines the International Court of Justice’s (ICJ) 2022 reparations judgment in Democratic Republic of the Congo v. Uganda, analyzing the Court’s legal reasoning, its evidentiary approach, and the implications for future reparations cases. The 2022 judgment follows the ICJ’s 2005 ruling that found Uganda responsible for violations of international law during its military intervention in the Democratic Republic of the Congo (DRC). Given the failure of negotiations between the parties, the ICJ determined the amount of reparations owed, awarding a global sum of $325 million – substantially lower than the DRC’s claim. The case addresses complex legal and evidentiary questions, including the causal link between Uganda’s wrongful acts and the damages claimed, the standard and burden of proof for reparations, and categorizing harm. The Court examined four heads of damage, which were damage to persons, damage to property, damage to natural resources and macroeconomic damage, dismissing the latter due to insufficient proof of causation. A key aspect of the judgment was the ICJ’s adoption of a global sum approach – an uncommon approach in the Court’s practice. This case note assesses the lack of clear reasoning and methodology for determining the exact amount awarded for each head of damage.
Additionally, the ICJ’s over-reliance on United Nations reports and its application of standards of proof raise concerns about consistency and clarity in reparations proceedings. This case sets a precedent for State responsibility in mass violations of international law but highlights challenges in quantifying harm and ensuring equitable reparations. The Court’s reasoning and methods in the case may influence future cases involving State responsibility, armed conflicts, and reparative justice under international law.
Exposure to COVID-19 messaging that conflates older age with risk/infirmity has been suggested to have negative effects on older people’s sense of personal agency (i.e., sense of capacity to exercise control over one’s life).
Objectives
This qualitative study sought to determine how older adults perceived this vulnerability narrative within early COVID-19 public messaging and how this may have influenced their personal agency.
Methods
Semi-structured interviews with 15 community-dwelling older adults in Manitoba were completed and analysed using inductive thematic analysis.
Findings
Study findings suggest that early COVID-19 public health messaging created associations between vulnerability and older age that increased the participants’ sense of age-related risk. As a response, many participants described engaging in certain actions (e.g., lifestyle behaviours, following public health protocols, coping mechanisms) to potentially increase their feelings of personal agency.
Discussion
This study suggests that creators of public messaging pertaining to older age must be mindful of the ways that it may fuel a vulnerability narrative.
Patients with chronic insomnia are characterized by alterations in default mode network and alpha oscillations, for which the medial parietal cortex (MPC) is a key node and thus a potential target for interventions.
Methods
Fifty-six adults with chronic insomnia were randomly assigned to 2 mA, alpha-frequency (10 Hz), 30 min active or sham transcranial alternating current stimulation (tACS) applied over the MPC for 10 sessions completed within two weeks, followed by 4- and 6-week visits. The connectivity of the dorsal and ventral posterior cingulate cortex (vPCC) was calculated based on resting functional MRI.
Results
For the primary outcome, the active group showed a higher response rate (≥ 50% reduction in Pittsburgh Sleep Quality Index (PSQI)) at week 6 than that of the sham group (71.4% versus 3.6%) (risk ratio 20.0, 95% confidence interval 2.9 to 139.0, p = 0.0025). For the secondary outcomes, the active therapy induced greater and sustained improvements (versus sham) in the PSQI, depression (17-item Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale), and cognitive deficits (Perceived Deficits Questionnaire-Depression) scores. The response rates in the active group decreased at weeks 8–14 (42.9%–57.1%). Improvement in sleep was associated with connectivity between the vPCC and the superior frontal gyrus and the inferior parietal lobe, whereas vPCC-to-middle frontal gyrus connectivity was associated with cognitive benefits and vPCC-to-ventromedial prefrontal cortex connectivity was associated with alleviation in rumination.
Conclusions
Targeting the MPC with alpha-tACS appears to be an effective treatment for chronic insomnia, and vPCC connectivity represents a prognostic marker of treatment outcome.
Old collections, real or fake, are a basic part of the collection history of an antiquity or artwork. This article is a starting point for a study of the concept: how old collections are employed, what functions they have, and how fictitious old collections are chosen and constructed. To explore these concepts, the article considers the example of Cumberland Clark, an early 20th-century collector who serves as the putative origin of cuneiform tablets in a handful of present-day collections, most notably the Schøyen Collection. This article looks at the life and collections of Cumberland Clark, then argues that the Clark provenance for current collections is a fabrication, and concludes by looking at Clark in the context of other old collections in order to draw some lessons about fabricated provenance.
Moral understanding has typically been defined as grasping the explanation, q, for some proposition, p, where p states that some action is morally right (or wrong). This article deals with an underdiscussed point within the literature on moral understanding: the degree of moral understanding one has deepens with the more moral reasons that one grasps, whereby these reasons not only consist of those that speak in favor of an action’s moral permissibility but also those speaking against. I argue for a surprising and important implication of this: having a deep degree of moral understanding can make it harder to carry out the right action. Furthermore, I propose that we should think of our pursuit of moral understanding in an analogous way as to how some have thought of scientific understanding: There may be good reasons to fail to appreciate all of the actual moral reasons that in fact exist; sometimes we should seek a surfaced-level moral understanding instead of something deeper. Just as idealizations used within science – which can involve deviations from the truth – can help us achieve scientific understanding, so too we might restrict the moral reasons that we seek to grasp in pursuit of moral understanding.
To evaluate and synthesize research that has investigated interventions to train registered health professionals to effectively communicate with patients in acute settings who are establishing their goals of care, to develop an understanding of current practices and their effectiveness.
Design
Integrative review.
Methods
Medline, Embase, PsycINFO, SCOPUS, CINAHL, and ProQuest, searched from the date each database was available to December 2023. Forty-seven (n = 47) research studies investigating interventions to train registered health professionals to effectively communicate with patients in acute settings who are establishing their goals of care were critically appraised for methodological quality using the Joanna Briggs Institute Quality Appraisal Framework. Minimum essential criteria and scores were agreed prior to appraisal.
Results
Twenty-eight studies were excluded due to methodological quality. The 19 studies included comprised quasi experimental (n = 9), qualitative (n = 4), RCT (n = 2), text and opinion (n = 1), and mixed methods (n = 3). From these included studies 4 themes with embedded sub-themes were derived: (a) delivery of training programs, (b) clinician outcomes, (c) patient outcomes, and (d) system outcomes.
Significance of the results
Communication training is essential and beneficial however its effectiveness depends on overcoming existing barriers, providing continuous learning opportunities, and embedding these into clinical practice. Addressing these factors will ensure that clinicians and healthcare organizations can improve patient and system outcomes. When clinicians and organizations prioritize regular, context-specific communication training, which promotes the use of conversation guides and available technologies, Goals of Patient Care conversations are more likely to be embedded in practice, promoting effective and patient-centered communication.
As part of a broad survey of the trematodes of damselfishes (Pomacentridae) in the tropical Indo-West Pacific, zoogonids were collected from multiple localities in Australia, New Caledonia, and French Polynesia. All zoogonid specimens collected were consistent with the subfamily Lecithostaphylinae, and morphological and molecular data (ITS2 and 28S rDNA, and cox1 mtDNA) were generated for most host-locality combinations to enable an integrative species delimitation. The collection comprised three species: Deretrema stratiotes n. sp. from four species of Abudefduf Forsskål from Ningaloo Reef in Western Australia, and two species consistent with the genus Lecithostaphylus Odhner, 1911 for which Innuptacola n. gen. is proposed based on phylogenetic and morphological distinction, the type-species I. gibsoni (Cribb, Bray & Barker, 1992) n. comb. (= L. gibsoni) from six species of Abudefduf in Ningaloo Reef, Queensland and New Caledonia, and I. torquata n. sp. from 12 pomacentrid species in Ningaloo Reef, the Great Barrier Reef in Queensland, and the Gambier Islands in French Polynesia. The new collection demonstrates that some zoogonid species are geographically widespread (from the Pacific Ocean to the Indian Ocean) and can infect a broad range of hosts (multiple genera within a family), whereas others are apparently geographically restricted and exhibit higher host-specificity (fishes within a single genus).
Particle-laden horizontal turbulent pipe flow is studied experimentally in the two-way coupling regime with a focus on delineating the effects of particle-to-fluid density ratio $\rho _{p}/\rho _{f}=1$ and 1.05 on the fluid and particle statistics. Particle volume fraction $\phi _{v}$ up to $1\,\%$ and viscous Stokes numbers ranging from $St^+ \approx 1.2$ to $St^+ \approx 3.8$ are investigated at friction Reynolds number $Re_\tau \approx 195$ using time-resolved two-dimensional particle image and tracking velocimetry. Substantial differences are observed between the statistics of neutrally buoyant (i.e. $\rho _{p}/\rho _{f}=1$) and denser (i.e. $\rho _{p}/\rho _{f}=1.05$) settling particles (with settling velocities 0.12–0.32 times the friction velocity), which, at most instances, show opposing trends compared to unladen pipe flow statistics. Neutrally buoyant particles show a slightly increased overall drag and suppressed turbulent stresses, but elevated particle–fluid interaction drag and results in elongated turbulent structures compared to the unladen flow, whereas $\rho _{p}/\rho _{f}=1.05$ particles exhibit a slight overall drag reduction even with increased radial turbulent stresses, and shorter streamwise structures compared to the unladen flow. These differences are enhanced with increasing $St^+$ and $\phi _v$, and can be attributed to the small but non-negligible settling velocity of denser particles, which also leads to differing statistics in the upper and lower pipe halves.