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There is a growing focus on understanding the complexity of dietary patterns and how they relate to health and other factors. Approaches that have not traditionally been applied to characterise dietary patterns, such as latent class analysis and machine learning algorithms, may offer opportunities to characterise dietary patterns in greater depth than previously considered. However, there has not been a formal examination of how this wide range of approaches has been applied to characterise dietary patterns. This scoping review synthesised literature from 2005 to 2022 applying methods not traditionally used to characterise dietary patterns, referred to as novel methods. MEDLINE, CINAHL and Scopus were searched using keywords including latent class analysis, machine learning and least absolute shrinkage and selection operator. Of 5274 records identified, 24 met the inclusion criteria. Twelve of twenty-four articles were published since 2020. Studies were conducted across seventeen countries. Nine studies used approaches with applications in machine learning, such as classification models, neural networks and probabilistic graphical models, to identify dietary patterns. The remaining studies applied methods such as latent class analysis, mutual information and treelet transform. Fourteen studies assessed associations between dietary patterns characterised using novel methods and health outcomes, including cancer, cardiovascular disease and asthma. There was wide variation in the methods applied to characterise dietary patterns and in how these methods were described. The extension of reporting guidelines and quality appraisal tools relevant to nutrition research to consider specific features of novel methods may facilitate consistent reporting and enable synthesis to inform policies and programs.
Postoperative wound care after craniotomy is not standardized.
Objective:
Evaluate the impact of a standardized post-craniotomy wound care protocol on surgical site infection (SSI).
Design and Setting:
Prospective quasi-experimental single-center intervention cohort study involving adult patients undergoing craniotomy at a 461-bed academic medical center in Orange County, California from January 2019–March 2023 (intervention) compared to January 2017–December 2018 (baseline).
Methods:
A postoperative neurosurgical wound care protocol was developed involving chlorhexidine cloths to remove incisional clots and to clean the surgical incision and adjacent hair after craniotomy surgery. Protocol adherence was monitored by routine inpatient surveillance of wounds and photo-documentation for real-time feedback to surgeons and nursing staff. Impact of the intervention was assessed using multivariable regression models.
Results:
There were 3560 craniotomy surgeries and 62 (1.7%) SSIs; 1251 surgeries and 30 (2.4%) SSIs during baseline, and 2309 surgeries and 32 (1.4%) SSIs during intervention. Process evaluation after implementation found significant decreases in incisional clots, erythema, drainage, and unclean hair. In multivariable analysis, the intervention was associated with fewer SSI (odds ratio (OR): 0.5 (0.3, 0.9), P = 0.02).
Conclusions:
A standardized post-craniotomy wound care protocol involving cleaning of the incision and adjacent hair, including removal of incisional clots with chlorhexidine cloths was effective in reducing the risk of SSI.
The Australian SKA Pathfinder (ASKAP) radio telescope has carried out a survey of the entire Southern Sky at 887.5 MHz. The wide area, high angular resolution, and broad bandwidth provided by the low-band Rapid ASKAP Continuum Survey (RACS-low) allow the production of a next-generation rotation measure (RM) grid across the entire Southern Sky. Here we introduce this project as Spectral and Polarisation in Cutouts of Extragalactic sources from RACS (SPICE-RACS). In our first data release, we image 30 RACS-low fields in Stokes I, Q, U at 25$^{\prime\prime}$ angular resolution, across 744–1032 MHz with 1 MHz spectral resolution. Using a bespoke, highly parallelised, software pipeline we are able to rapidly process wide-area spectro-polarimetric ASKAP observations. Notably, we use ‘postage stamp’ cutouts to assess the polarisation properties of 105912 radio components detected in total intensity. We find that our Stokes Q and U images have an rms noise of $\sim$80 $\unicode{x03BC}$Jy PSF$^{-1}$, and our correction for instrumental polarisation leakage allows us to characterise components with $\gtrsim$1% polarisation fraction over most of the field of view. We produce a broadband polarised radio component catalogue that contains 5818 RM measurements over an area of $\sim$1300 deg$^{2}$ with an average error in RM of $1.6^{+1.1}_{-1.0}$ rad m$^{-2}$, and an average linear polarisation fraction $3.4^{+3.0}_{-1.6}$ %. We determine this subset of components using the conditions that the polarised signal-to-noise ratio is $>$8, the polarisation fraction is above our estimated polarised leakage, and the Stokes I spectrum has a reliable model. Our catalogue provides an areal density of $4\pm2$ RMs deg$^{-2}$; an increase of $\sim$4 times over the previous state-of-the-art (Taylor, Stil, Sunstrum 2009, ApJ, 702, 1230). Meaning that, having used just 3% of the RACS-low sky area, we have produced the 3rd largest RM catalogue to date. This catalogue has broad applications for studying astrophysical magnetic fields; notably revealing remarkable structure in the Galactic RM sky. We will explore this Galactic structure in a follow-up paper. We will also apply the techniques described here to produce an all-Southern-sky RM catalogue from RACS observations. Finally, we make our catalogue, spectra, images, and processing pipeline publicly available.
While in the United Kingdom, the government was initially slow to recognize the profound dangers of the COVID-19 pandemic, soon after Prime Minister Boris Johnson's initial plea to the public to ‘stay at home’, in March 2021, emergency legislation was rushed through parliament. On 25 March, the 350-page Coronavirus Act 2020 received royal assent, bringing the biggest restrictions on civil liberties in a generation into law the following day. Overnight, the Coronavirus Act, along with the broader raft of legal restrictions under The Health Protection (Coronavirus) Regulations 2020, made it unlawful to undertake a wide range of hitherto economically essential, prosocial and noncriminal activities. Even as the Act was rushed through parliament, civil liberties organizations were alerting parliamentarians to its dangers (Gidda, 2020).
As antiracist commentators and academics forewarned (Frazer-Carroll, 2020; Khan, 2020), racial disproportionality in policing has endured and often increased through the pandemic. As the first ‘lockdown’ came into effect, stop and search practices ‘surged’ despite the steep drop in crime rates (Grierson, 2020). Limited and prone to undercounting as they may be, Home Office data show that in the year ending March 2021, stop and search practices (under Section 1 of the Police and Criminal Evidence Act 1984) increased significantly to reach their highest level in seven years, impacting most on racially minoritized men (Home Office, 2022). Home Office data (2021) also show an increase in use of force for the year ending March 2021. This was racially disproportionate too, with Black people accounting for 16 per cent of those affected (though they make up just 3 per cent of the population according to the 2011 Census), and Asian people accounting for 8 per cent (7 per cent of the population according to the 2011 Census). In the summer of 2020, these patterns coalesced with mass global protests against racist police violence. The police murder of George Floyd in the United States catalyzed millions to march under the banner of Black Lives Matter (BLM) and spoke to the ongoing police brutality faced by racially minoritized people in Britain (Joseph-Salisbury et al, 2020).
This roundtable takes up old themes and new perspectives in the field of political history. Scholars engage with six questions across three main categories: the scope of the field, current debates, and teaching. The first two questions ask how we should think about political power and the boundaries of what constitute political history. The section on current debates interrogates the relationship between governing and social movements during the GAPE, and how to situate the political violence of the January 6, 2021, Capitol Hill riot in historical perspective. The final section on teaching takes up two very different challenges. One question is a perennial concern about connecting with students in the classroom about political history. The other dilemma is how to respond to the growing cascade of censorship laws passed by state legislatures that prohibit the teaching of so-called “divisive concepts.”
Changes in antimicrobial use during the pandemic in relation to long-term trends in utilization among different antimicrobial stewardship program models have not been fully characterized. We analyzed data from an integrated health system using joinpoint regression and found temporal fluctuations in prescribing as well as continuation of existing trends.
Most academics in philosophy departments accept that the discipline needs to change for the better. In this piece, Rebecca Buxton and Lisa Whiting offer several proposals for how to make philosophy a more inclusive place for everyone.
Young people want to be involved in the decisions that impact on them and their health service provision (Royal College of Paediatrics and Child Health [RCPCH], 2017) – a youth forum is one way of enabling this. This chapter will initially focus on the background and development of youth forums/ councils; secondly, an overview of the National Health Service England Youth Forum (NHSEYF) will be provided with the perspectives of Kath Evans (Experience of Care Lead, NHS England (NHSE) – Maternity, Infants, Children and Young People) and NHSEYF members being integrated. Thirdly, an evaluative mixed methods study (undertaken by the University of Hertfordshire (UH)) will be briefly presented. Finally, the chapter will present the Youth Forum Wheel (YFW) that was developed as a direct result of the research; the YFW is offered to health professionals and young people who may be implementing and/or managing youth forums. It aims to provide insight into the underpinning components of success, each of these will be discussed and their practical application considered.
The development of youth forums
A youth forum has been described as being in existence to:
represent the views of young people, giving young people the opportunity to have a voice, discuss issues, engage with decision makers and contribute to improving and developing services for young people. (NHS England, 2015a, p 5)
One of the longest running youth forums that is widely recognised within the UK is the Northern Ireland Youth Forum which was established in 1979 by the Department of Education; this organisation has continued to develop and has a very active membership (Northern Ireland Youth Forum, 2019). In 1999, a youth forum was held in The Hague to enable 132 young people, representing 111 countries, to offer their thoughts and opinions on a range of key organisations (including the United Nations, as well as governmental and non-governmental bodies) about areas such as health, human rights and education (Youth Forum, 1999). In the same year, UNESCO introduced their first youth forum event – this has since been held every two years at the headquarters in Paris; it is open to all young people and aims to provide:
an innovative, ongoing opportunity for youth to work in dialogue with UNESCO, to shape and direct the Organization's approach and to present their concerns and ideas to Member States. (UNESCO, 2019)
Anecdotal evidence suggests the use of bolus tube feeding is increasing in the long-term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from ten centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding (n 604, 60 % male, age 58 years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients’ complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37 %). Patients were long-term tube fed (4·1 years tube feeding, 3·5 years bolus tube feeding), living at home (71 %) and sedentary (70 %). The majority were head and neck cancer patients (22 %) who were significantly more active (79 %) and lived at home (97 %), while those with cerebral palsy (12 %) were typically younger (age 31 years) but sedentary (94 %). Most patients used bolus feeding as their sole feeding method (46 %), because it was quick and easy to use, as a top-up to oral diet or to mimic mealtimes. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85 % of patients, with 51 % of these being compact-style ONS (2·4 kcal (10·0 kJ)/ml, 125 ml). This survey shows that bolus tube feeding is common among UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.
The US Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program sponsors the development of systematic reviews to inform clinical policy and practice. The EPC program sought to better understand how health systems identify and use this evidence.
Methods:
Representatives from eleven EPCs, the EPC Scientific Resource Center, and AHRQ developed a semi-structured interview script to query a diverse group of nine Key Informants (KIs) involved in health system quality, safety and process improvement about how they identify and use evidence. Interviews were transcribed and qualitatively summarized into key themes.
Results:
All KIs reported that their organizations have either centralized quality, safety, and process improvement functions within their system, or they have partnerships with other organizations to conduct this work. There was variation in how evidence was identified, with larger health systems having medical librarians and central bureaus to gather and disseminate information and smaller systems having local chief medical officers or individual clinicians do this work. KIs generally prefer guidelines, especially those with treatment algorithms, because they are actionable. They like systematic reviews because they efficiently condense study results and reconcile conflicting data. They prefer information from systematic reviews to be presented as short digestible summaries with the full report available on demand. KIs preferred systematic reviews from reputable entities and those without commercial bias. Some of the challenges KIs reported include how to resolve conflicting evidence, the generalizability of evidence to local needs, determining whether the evidence is up-to-date, and the length of time required to generate reviews. The topics of greatest interest included predictive analytics, high-value care, advance care planning, and care coordination. To increase awareness of AHRQ EPC reviews, KIs suggest alerting people at multiple levels in a health-system when new evidence reports are available and making reports easier to find in common search engines.
Conclusions:
Systematic reviews are valued by health system leaders. To be most useful they should be easy to locate and available in different formats targeted to the needs of different audiences.
Focused electron beam-induced deposition (FEBID) is capable of producing metal-containing nanostructures with lateral resolution on the sub-nanometer scale. Practical application of this nanofabrication technique has been hindered by ligand-derived contamination from precursors developed for thermal deposition methods. Mechanistic insight into FEBID through surface science studies and gas-phase electron–molecule interactions has begun to enable the design of custom FEBID precursors. These studies have shown that precursors designed to decompose under electron irradiation can produce high-purity FEBID deposits. Herein, we highlight the progress in FEBID precursor development with several examples that incorporate this mechanism-based design approach.
In investigations of the question of whether or not Universal Grammar (UG) is available in non-primary language acquisition, a number of researchers have tried to isolate situations where the way principles of UG operate in the first language (L1) could not help the learner acquire the relevant properties of the second language (L2). If learners show evidence of acquiring properties of the L2 that could not be acquired from the input alone and could not be reconstructed via the L1, this suggests that UG is available in non-primary acquisition; in contrast, if learners fail under such circumstances, this supports the claim that UG is no longer directly accessible. In particular, there has been a tradition of looking at island constraints in this light, using L1s and L2s which differ radically in terms of the surface effects of principles like Subjacency and the Empty Category Principle (ECP) (e.g., Bley-Vroman et al 1988; Johnson and Newport 1991; Martohardjono 1991a, 1991b; Martohardjono and Gair 1992; Schachter 1989, 1990; White 1989, 1992).
We present the results of two 2.3 μm near-infrared (NIR) radial velocity (RV) surveys to detect exoplanets around 36 nearby and young M dwarfs. We use the CSHELL spectrograph (R ~ 46,000) at the NASA InfraRed Telescope Facility (IRTF), combined with an isotopic methane absorption gas cell for common optical path relative wavelength calibration. We have developed a sophisticated RV forward modeling code that accounts for fringing and other instrumental artifacts present in the spectra. With a spectral grasp of only 5 nm, we are able to reach long-term radial velocity dispersions of ~20–30 m s−1 on our survey targets.
Interventions that prevent healthcare-associated infection should lead to fewer deaths and shorter hospital stays. Cleaning hands (with soap or alcohol) is an effective way to prevent the transmission of organisms, but rates of compliance with hand hygiene are sometimes disappointingly low. The National Hand Hygiene Initiative in Australia aimed to improve hand hygiene compliance among healthcare workers, with the goal of reducing rates of healthcare-associated infection.
Methods
We examined whether the introduction of the National Hand Hygiene Initiative was associated with a change in infection rates. Monthly infection rates for healthcare-associated Staphylococcus aureus bloodstream infections were examined in 38 Australian hospitals across 6 states. We used Poisson regression and examined 12 possible patterns of change, with the best fitting pattern chosen using the Akaike information criterion. Monthly bed-days were included to control for increased hospital use over time.
Results
The National Hand Hygiene Initiative was associated with a reduction in infection rates in 4 of the 6 states studied. Two states showed an immediate reduction in rates of 17% and 28%, 2 states showed a linear decrease in rates of 8% and 11% per year, and 2 showed no change in infection rates.
Conclusions
The intervention was associated with reduced infection rates in most states. The failure in 2 states may have been because those states already had effective initiatives before the national initiative’s introduction or because infection rates were already low and could not be further reduced.