This paper explores recipients’ and professionals’ attitudes towards the Basic Income for Care Leavers in Wales pilot. Qualitative interviews were conducted with forty-one professionals and forty-four basic income recipients in the first year of the scheme (2022/2023). The findings are situated within Van Oorshot’s CARIN framework that aids analysis of attitudes towards the ‘deservingness’ of others. The findings indicate that there was an almost unified agreement among these participants that care leavers deserve additional support but much less agreement on whether the basic income pilot is the right way to provide this support. The findings are situated in a context where strong views have been expressed by a small number of politicians and media outlets who question the deservingness more overtly, especially when considering former unaccompanied child asylum seekers. Meanwhile, the Welsh Government, which implemented the pilot, emphasises the state’s obligations to this population and the opportunities that a basic income might facilitate. Implications of the findings relate to how future basic income schemes are justified to the public, recipients and those administering the scheme at a local level.

Guided by a lifespan developmental perspective, using a network analysis approach, this study compared the structure of daily stress components in mothers of adolescents and adults with developmental disabilities (DD) and a matched sample of mothers of children without DD. We also examined whether components of daily stress were differentially associated with subsequent depression symptoms. Participants (N = 516; 100% female; M = 54.52 years, SD = 10.21; 94.2% White) were drawn from two cohorts: a DD cohort constructed from two linked longitudinal studies of families of adolescents and adults with autism and fragile X syndrome and a comparison group from the Midlife in United States study. Participants completed an 8-day daily telephone interview and reported depressive symptoms two years later. Findings demonstrated that the daily stress network of mothers of individuals with DD was significantly more interconnected than that of the comparison group. Stressor risk appraisal emerged as a central node in both groups, highlighting the role of cognitive appraisal in shaping stress responses. Negative affective reactivity linked daily stress components with later depressive symptoms, particularly in the DD group. Chronic caregiving stress may heighten interconnectivity within daily stress networks, reducing psychological flexibility and increasing vulnerability to daily stressors.

Globally the tropical aquatic aquarium trade is a multi-million-dollar industry. Although marine ornamental fish and invertebrates are the main focus, tropical freshwater ornamental species including invertebrates (classed by the sector as semi-aquatic, such as land crabs) are also traded. Land crabs include both brachyurans (true crabs) and anomurans (false crabs, including hermit crabs). These are sourced from wild populations and/or tank-bred for use as ornamental commodity species. This global trade is unregulated and the full extent of the brachyuran land crab trade is unknown. Land crabs are important ecosystem engineers, and collection for the tropical freshwater/semi-aquatic aquarium industry is believed to be detrimental to their wild populations. We undertook the first systematic survey of the e-commerce of brachyuran land crabs, allowing us to document which species are traded globally and to what extent within the tropical freshwater/semi-aquatic aquarium industry and/or the exotic pet trade. Focusing on English language websites, we identified 15 sellers, based in the UK, USA and continental Europe. Twenty-three species were available for purchase, sold under 61 vernacular names, with listings that could not be identified to species falling into three genera. In five cases, a single vernacular name was used to refer to multiple species within or across genera. We recommend that comprehensive monitoring of this trade should be established, to understand the effects of land crab collection on their populations and whether any of the traded species could become invasive.

Functional neurosurgery can modulate the pathological brain circuits that underlie psychiatric symptoms. For select disorders it is safe, precise and evidence-based; for others, it holds real promise. Nevertheless, referrals remain strikingly low relative to the burden of refractory illness – a gap that could be meaningfully addressed by closer psychiatry–neurosurgery collaboration.

Background: The 2025 American Thoracic Society Community-acquired Pneumonia (CAP) guidelines conditionally recommend that patients hospitalized with non-severe CAP who reach clinical stability be treated with <5 days (3 day minimum) of antibiotics. To determine whether hospitals were implementing or planning to implement this recommendation, we surveyed 68 hospitals participating in the Michigan Hospital Medicine Safety Consortium (HMS). Methods: Hospitals participating in HMS completed an electronic survey in October and November of 2025. Abstractors were asked to answer (with stewardship team input) whether their hospital recommended (or planned to recommend) 3-day antibiotic treatment for any patients with CAP. If yes, they were asked a) which patient subgroups, b) whether their hospital guideline recommended 3 days, and c) what stewardship interventions they had implemented to increase 3-day durations. All hospitals were asked about barriers. Results: All hospitals (68/68) responded to the survey; 21% (14) reported they currently recommend a 3-day duration for at least some patients with CAP; another 18% (12) do not but are planning to. Hospital characteristics by response category are shown in Figure 1. Of hospitals already recommending or planning to recommend a 3-day duration, 31% (8) recommend it (or plan to) in all patients with CAP. Among the 18 hospitals recommending/planning to recommend a 3-day duration for only a subset of patients, commonly stated criteria were: clinical stability (55%), non-severe CAP (33%), or uncomplicated CAP (33%). Most hospitals (79%) recommending a 3-day duration included the 3-day recommendation in their CAP guideline and 71% reported at least one stewardship intervention in place to increase use of 3-day durations (10, education; 3, audit and feedback; 2, pharmacist bundle; 1, orderset; 1, discharge-specific intervention). Commonly reported barriers or reasons for not recommending a 3-day duration included: focus on 5-day duration (31%), resource/time limitation (14%), EHR transition (12%), and inability to recommend a 3-day duration unless the entire healthcare system did (10%). Notably, 7% expressed confusion about IDSA endorsement of the ATS guidelines (IDSA endorsed the <5 day duration but not the viral pneumonia recommendation). Conclusion: Just over a third (38%) of Michigan hospitals currently recommend or plan to recommend a 3-day antibiotic duration for at least some hospitalized patients with CAP. For the remaining 62% of hospitals, continued focus on 5-day duration, standard barriers around stewardship infrastructure, and concerns about existing evidence, safety, and guidance limit enthusiasm for a 3-day duration.

Background: Empiric extended-spectrum antibiotics are routinely given to patients with cancer despite low risk of infection with multidrug-resistant organisms (MDROs). This secondary analysis of the four INSPIRE (INtelligent Stewardship Prompts to Improve Real-time Empiric Antibiotic Selection) trials evaluated how computerized physician order entry (CPOE) prompts providing patient- and pathogen-specific MDRO risk estimates affected empiric extended-spectrum antibiotic use in patients with cancer. Methods: We identified non-critically ill hospitalized adults (> Results: Including all trials, 36,861 (18,272 baseline; 18,589 intervention) patients had cancer. Mean age was 69.0 (13.6); 48.0% (17,675) were male. Extended-spectrum antibiotic days-of-therapy decreased by 27% (95% CI:20-34%, PPPP Conclusions and Relevance: An antibiotic stewardship bundle that included CPOE prompts recommending standard-spectrum antibiotics for patients at low risk for antimicrobial-resistant infections reduced extended-spectrum antibiotic use in non-critically ill patients with cancer who were hospitalized with community-acquired pneumonia, UTI, abdominal infection, or SST, without observed differences in safety outcomes.

Background: Candida auris, an emerging multidrug-resistant yeast, spreads rapidly in healthcare settings and is associated with difficult-to-control outbreaks. Prevalence has risen significantly in the Metro Detroit area, driven by interfacility transfers and inconsistent communication of colonization status. Patients can remain colonized for prolonged periods and shed the organism into the environment, where it persists for months. Active surveillance testing (AST) can support earlier detection and containment. We describe the implementation of a C. auris AST program across a multi-hospital health system. Methods: Screening for C. auris colonization can be either prevention?based or response?based. Response?based strategies, such as point prevalence surveys (PPS), are recommended by the Centers for Disease Control and Prevention when a new case is identified. Prevention?based AST is also recommended to detect cases early among high?risk groups. In April 2025, we launched a C. auris AST program across five hospitals in Southeast Michigan. Composite axilla–groin swabs were tested by real?time polymerase-chain reaction (PCR). High?risk patients were defined as those presenting from long?term acute care hospitals, skilled nursing facilities, subacute rehabilitation facilities, or inpatient rehabilitation centers who required ED admission or transfer from another healthcare facility (including internal transfers) and had one or more of the following: indwelling devices (e.g., endotracheal or tracheostomy tubes), chronic or non?healing wounds, or colonization/infection with multidrug?resistant or carbapenem?resistant organisms. Upon order signing in the electronic health record, an alert prompted providers to order C. auris PCR and initiate contact precautions. Patients were retested upon readmission. PPS were also performed per state health department recommendations following identification of new cases. Results: During the 6?month surveillance period, 2,710 unique patients underwent AST, with 3,044 total tests completed. Of these tests, 969 (31%) were ordered in the emergency department at the time of admission. Overall, 37 patients (1.2%) screened positive for C. auris colonization (Table). During the same period, 1,354 tests were performed through 77 unit?based PPS, yielding 22 positive results (1.6%). Conclusion: Although AST was implemented as a prevention?based strategy, PPS remained necessary for identifying additional cases. Positivity rates were low across both approaches, yet each required substantial coordination, staff time, and laboratory resources. These findings highlight the need to balance the benefits of early detection with operational demands. Alternative approaches beyond widespread screening should be explored to optimize resource utilization while maintaining effective C. auris prevention and control.