A novel approach to expedite evidence to impact in pre-eclampsia: co-developed policy labs in Zambia and Sierra Leone.

Pre-eclampsia is a leading cause of maternal and neonatal mortality; 30,000 pre-eclampsia-related maternal deaths occur annually, with 70% in Sub-Saharan Africa (SSA) and 16% in South Asia. We have shown that early, accurate detection of hypertension combined with planned early delivery in women with late preterm pre-eclampsia significantly reduces stillbirth and severe maternal hypertension. We describe co-development and delivery of policy labs, working with The Policy Institute (King's College London), and local stakeholders in Sierra Leone and Zambia, to expedite integration of new knowledge into pre-eclampsia care pathways, to improve care for women and babies with the worst outcomes. Policy labs are a unique, user-centric engagement approach, bringing diverse stakeholders together in co-designing strategies for translation of evidence into policy and impact. Both labs were facilitated by local, well-respected female team members, and addressed co-developed questions: 'How can we improve timely detection and appropriate action in women with pre-eclampsia?' (Sierra Leone); 'What are enablers and barriers to offering planned early delivery between 34 and 37 weeks?'(Zambia). Participants at both labs identified lack of pre-eclampsia awareness as a key barrier, and recommended local co-design of community-based strategies to increase access to timely pre-eclampsia management. We demonstrated  policy labs as an effective approach in two low-and middle income settings to facilitate transfer of new knowledge into policy and action

Infection Prevention and Control Response and Escalation Framework – evaluation and application beyond a pandemic

BACKGROUND The COVID-19 pandemic resulted in constant changes to Infection Prevention and Control (IPAC) recommendations, impacting clinician capacity to stay up to date. The COVID-19 IPAC Response and Escalation Framework (IPAC Framework), rarely reported or evaluated was developed to provide scalable IPAC guidance during the pandemic to health care in New South Wales (NSW), Australia. METHODS Using a thematic analysis approach, a qualitative study using an online, cross-sectional survey comprising 27 questions was sent to 248 key stakeholders. Participants were health workers with broad clinical and system representation with responsibilities for risk assessment, communicating, implementing, or monitoring the IPAC Framework. RESULTS The IPAC Framework provided a useful IPAC tool for the management of COVID-19 as perceived by 93 of respondents. The overwhelming majority (91 ) reported the Framework provided enough information on IPAC strategies needed for COVID-19 that were aligned with transmission risk. Resources supporting the IPAC Framework were reported by most respondents (84 ) as being widely accepted as the authoritative guidance. CONCLUSIONS An IPAC Framework is perceived as invaluable by clinicians and administrators to manage IPAC requirements in health care during a pandemic. The IPAC Framework can be applied more generally to support ongoing IPAC requirements

Experienced academy soccer coaches' perceptions of evaluating talented youth soccer players' skilfulness in small-sided games: a mixed-methods study.

Academy soccer coaches evaluate players' skilfulness to inform talent identification and development, focusing on technical proficiency, adaptability, decision-making, and influence. However, limited research has explored coaches' perceptions of skilfulness after completing an assessment. Furthermore, little is known about the potential overlap between current skill performance and future potential, or how coaches consider the skilfulness sub-dimensions. This mixed methods study explored how experienced Australian male youth soccer coaches (n = 5) and academy directors (n = 10) (Mage = 42.5 ± 13.8 years; Mexperience = 19.2 ± 9.8 years) rated players' skill performance and potential, their emphasis on sub-dimensions, and perceptions of evaluating them. Participants completed an online survey with pre-recorded small-sided game videos. Quantitatively, they rated players' skill performance and potential and emphasis on each sub-dimension using five-point Likert scales. Qualitatively, they responded to open-ended questions. Quantitative data were analysed using Spearman Rank Correlations and a Wilcoxon Signed Rank Test. Qualitative responses were explored via content analysis. Coaches' ratings were partially supported by their reflections on evaluating skill, as they reported feeling competent in rating players' skill performance but required more information on players' backgrounds to assess potential. Given a high overall correlation between coaches' ratings of skill performance and potential (r = 0.79, p =  < .001), coaches may have inferred potential from players' performance, possibly explaining their desire for contextual information. While all sub-dimensions were rated as equally important for performance and potential, coaches described using unique criteria for each, highlighting the need for distinct information from skill assessments

Drawing strength: evaluating the Tidda Talk programme through comparative body mapping with young Aboriginal and Torres Strait Islander women

This study explored changes in understanding and self-perception among participants involved in the Tidda Talk programme (i.e. a culturally tailored physical activity and psychosocial education intervention for young Aboriginal and Torres Strait Islander women), focusing on its influence on mental health, social and emotional wellbeing, and health beliefs. Due to its cultural alignment, the arts-based research method of body mapping was used to explore participants’ health and identity perceptions before and after completing the programme. Reflexive thematic analysis situated at the cultural interface (i.e. the space where Aboriginal and Torres Strait Islander and Western knowledge systems meet and interact) was conducted on body maps and their accompanying testimonios to identify shifts in understanding and self-perception. A total of 25 young Aboriginal women (M = 13.69 years old) completed both body maps and testimonios. Data analysis revealed three key themes: Embracing Culture: Pride, Knowledge, and Identity Journeys highlighted participants’ growing cultural pride and self-acceptance; Navigating Life Challenges: Finding Strength in Connection and Resilience described coping strategies and life skills used to navigate social and emotional challenges; and Holistic Health: Expanding Beyond the Physical demonstrated a shift in health perspectives from a narrow focus on physical health behaviours to a more holistic understanding. Tidda Talk is an encouraging culturally safe intervention that has the potential to enhance resilience, strengthen cultural connections, and improve mental health literacy. As a data generation method, body mapping offered a valuable tool for capturing perceived changes, providing a culturally relevant approach to understanding personal transformations

Free-standing bimetallic Co/Ni-MOF foams toward enhanced methane dry reforming under non-thermal plasma catalysis.

Understanding of the structure and interfacial merits that reactive metal-organic frameworks (MOFs) undergo is critical for constructing efficient catalysts for non-thermal plasma-assisted conversion of greenhouse gases. Herein, we proposed a free-standing bimetallic (Co/Ni) MOFs supported on bacterial cellulose (BC) foams (Co/Ni-MOF@BC) toward the coaxial dielectric barrier discharge (DBD) plasma-catalytic system, of which the Co/Ni ions coordination demonstrated an intriguing textual uplifting of the malleable BC nanofiber network with abundant pores up to micrometer-scale, which could impart a more intensive predominant filamentary microdischarge current to 180 mA with stronger plasma-catalytic interaction. Remarkably, compared to the monometallic MOF@BC foams, this bimetallic Co/Ni-MOF@BC also delivered a substantially improved alkaline absorption ability as further confirmed by the CO2- temperature-programmed desorption (TPD) result. Benefiting from its 3D superiority and synergy of Co/Ni dual-regulation, the Co/Ni-MOF@BC, therefore, displayed the highest CO2 and CH4 conversion rates to 52.31 % and 71.50 %, which was above 1.5 and 1.3 times higher than those of monometallic counterparts and Co/Ni-MOF powder. Additionally, its robust cycling performance has also been evidenced by the excellent long-time DRM performance, unchanged crystallinity, morphology, and surface chemical states. By taking both the catalyst existing form and interfacial optimization of MOFs into consideration for designing a unique DRM catalyst, we believed this free-standing 3D Co/Ni-MOF@BC foams could inspire more research outputs on the design of functional catalysts with abundant pores and alkaline absorption sites to accelerate the redox kinetics of CO2/CH4 conversion

An evaluation of a one-day pain science education event in a 16-18 years school setting targeting pain-related beliefs, knowledge, and behavioural intentions: A mixed-methods, non-randomised controlled trial.

BACKGROUND: Public understanding of persistent pain is fraught with misconceptions. Pain education in schools may improve public understanding long-term. This study evaluated the impact of a one-day Pain Science Education (PSE) public health event delivered in a 16-18 year old school setting. METHODS: This was a multi-site, non-randomised controlled, mixed-methods study with three data collection time points: baseline, post intervention, and three-month follow-up. Participants were high school students ≥16 years old. Pain beliefs, knowledge, and behavioural intentions were assessed with the Pain Beliefs Questionnaire (PBQ [organic and psychological subscales]), Concepts of Pain Inventory (COPI-Adult), a case vignette, and reflexive thematic analysis of semi-structured interviews. RESULTS: Thirty intervention (mean age 16.6 years, 37 % female, 63 % male) and 24 control group participants (16.9 years, 63 % female, 37 % male) were recruited. Attending the pain education event was associated with reductions in Organic Beliefs [mean difference -4.4 (95 % CI, -6.0, -1.9)] and increases in Psychological Beliefs [4.6 (2.7, 6.4)] compared to the control group. This represents a shift away from biomedical beliefs in the intervention group compared to the control group. This shift was partially sustained at 3 months. A similar pattern was seen for the COPI-Adult and case vignette assessments. Semi-structured interviews (n = 13) identified an increased awareness of chronic pain and varying degrees of reconceptualisation of pain towards a biopsychosocial understanding. CONCLUSIONS: Attendance at a one-day PSE-based public health event was associated with improved knowledge, beliefs, and behavioural intentions regarding persistent pain. This exploratory study supports the need for a robust mixed-methods RCT of pain education for school children with long-term follow-up

'I think it's wrong, but it helps' - a focused ethnography of benzodiazepine practices in specialist palliative care.

Benzodiazepines are a class of drug extensively used in palliative care. Their use has predominantly been studied within a biomedical framework. Our study instead focused on the sociocultural aspects of benzodiazepine practices. We aimed to explore clinicians, patients and family members' values, beliefs, knowledge and feelings regarding use of benzodiazepines, including in-situ clinical decision-making processes, affects and actions. Social theory understandings of affect, the body and of suffering provided the theoretical lens through which data were analysed. Analysis generated the following themes: (1) A special specialty; (2) The suffering body and the moral imperative to 'settle; (3) The liminal body - living and dying; and (4) Organizational realities. Use of benzodiazepines were largely governed by social and moral norms, cultural expectations and organizational realities as part of affective assemblages of care

TREM2 promotes lung fibrosis via controlling alveolar macrophage survival and pro-fibrotic activity.

Lung macrophages play a pivotal role in pulmonary fibrosis, with monocyte-derived alveolar macrophages driving disease progression. However, the mechanisms regulating their pro-fibrotic behavior and survival remain unclear, and effective therapeutic strategies are lacking. Here we show that triggering receptors expressed on myeloid cells 2 are predominantly expressed on monocyte-derived alveolar macrophages in fibrotic mouse lungs and are significantly elevated in lung macrophages from patients with idiopathic pulmonary fibrosis. Deletion or knockdown of this receptor disrupts intracellular survival signaling, promotes macrophage apoptosis, and attenuates their pro-fibrotic phenotype. We further demonstrate that a lipid mediator and a high-avidity ligand of this receptor, encountered by macrophages in the alveolar milieu, enhance macrophage survival and activity. Ablation of TREM2 or blocking this receptor with soluble receptors or specific antibodies effectively alleviates lung fibrosis in male mice. These findings identify this receptor as a critical regulator of macrophage-mediated fibrosis and a promising therapeutic target for intervention