Patients without colonoscopic follow-up after abnormal fecal immunochemical tests are often unaware of the abnormal result and report several barriers to colonoscopy.

BackgroundThe fecal immunochemical test (FIT) is the second most commonly used colorectal cancer (CRC) screening modality in the United States; yet, follow-up of abnormal FIT results with diagnostic colonoscopy is underutilized. Our objective was to determine patient-reported barriers to diagnostic colonoscopy following abnormal FIT in an academic healthcare setting.MethodsWe included patients age 50-75 with an abnormal FIT result between 1/1/2015 and 10/31/2017 and no documented follow-up diagnostic colonoscopy. We abstracted demographic data from the electronic health record (EHR). Study personnel conducted telephone surveys with patients to confirm colonoscopy completion and elicit data on notification of FIT results and barriers to colonoscopy. We also provided brief verbal education about diagnostic colonoscopy. We calculated frequencies of demographic data and survey responses and compared survey responses by interest in colonoscopy after education.ResultsWe surveyed 67 patients. Fifty-one were aware of the abnormal FIT result, and a majority learned of the abnormal FIT result by direct communication with providers (19, 37.3%) or EHR messaging (11, 21.6%). Overall, fifty-three patients (79.1%) confirmed lack of colonoscopy, citing provider-related (19, 35.8%), patient-related (16, 30.2%), system-related (1, 1.9%), or multifactorial (17, 32.1%) reasons. Lack of knowledge of FIT result (14, 26.4%) was most common. After brief education, 20 (37.7%) patients requested colonoscopy.ConclusionPatients with an abnormal FIT reported various multi-level barriers to diagnostic colonoscopy after abnormal FIT, including knowledge of FIT results. When provided with brief education, participants expressed interest in diagnostic colonoscopy. Future efforts will evaluate interventions to improve colonoscopy follow-up

MyPlace Green Square Community Survey 2023 Final Report

The Green Square urban renewal area stretches across 278 hectares in the City of Sydney Local Government Area, between the Central Business District and Sydney Airport (CoS 2015). It is one of the fastest growing areas in Sydney with 33,000 new residential dwellings built and 63,000 people expected to live in the area when complete. So that the City can identify how it might best support communities’ social wellbeing and resilience associated with environmental, economic and social changes, it is essential to collect information about the experiences and desires of residents and workers. This includes their satisfaction with, and feelings of attachment and belonging to, the places they live and work, the nature of their social interactions and social cohesion, and their plans and desires regarding their local areas. To this end, this report presents the results of a community survey of residents and workers in the Green Square Urban Renewal Area in Sydney, Australia. This survey is undertaken on a recurring basis every 2-3 years, to monitor changes to the social fabric over time as the urban renewal area develops. The study was undertaken by researchers at UNSW Sydney, with the assistance and support of the City of Sydney Council. The aim of this research was to develop a survey tool for on-going assessment of social interactions and social cohesion at a large-scale urban renewal site that could be used to: * Measure the nature of social cohesion and social interaction and identify opportunities and barriers residents face in contributing to social cohesion and community development. * Understand the wellbeing of residents and workers, including their satisfaction with and attachment to the area, their local area preferences and desires, and their plans for the future. In summary, 1,960 residents and 841 workers completed the survey in Green Square (513 respondents both lived and worked in Green Square). The survey results reasonably reflect the total residential population (with a margin of error of less than 3%) once a weighting has been applied to correct for a bias in the age of respondents. However, the survey results for workers also have a similar degree of error, it is based on a potentially outdated workers base population, and as such should not be considered representative of the total working population of the area

Experimental Spinal Fusion With Recombinant Human Bone Morphogenetic Protein-2 Without Decortication of Osseous Elements

Study Design. L4-L5 intertransverse process fusions were produced with 58 μg, 230 μg, or 920 μg of recombinant human bone morphogenetic protein-2 in 20 dogs. Eleven had traditional decortication of posterior elements before insertion of the implant. Nine were left undecorticated. All animals were evaluated 3 months after surgery. Objectives. To determine whether decortication is a prerequisite for successful fusion in the presence of osteoinductive proteins such as bone morphogenetic protein-2. Summary of Background Data. Recombinant osteoinductive proteins can induce de novo bone in ectopic soft-tissue sites in the absence of bone marrow elements. Traditional methods for achieving spinal fusion rely on exposure of bone marrow through decortication to facilitate osteogenesis. It is hypothesized that the presence of an implanted osteoinductive protein obviates the need for exposure and release of host inductive factors. Methods. Recombinant human bone morphogenetic protein-2-induced intertransverse process fusions were performed with and without decortication. Fusion sites were evaluated by computed tomography imaging, high-resolution radiography, manual testing, mechanical testing, and histologic analysis. Results. One hundred percent of decorticated spines and 89% of undecorticated spines were clinically fused by 3 months. Ninety-one percent of decorticated spines and 78% of undecorticated specimens exhibited bilateral transverse process osseous bridging. The only spines that failed to achieve solid bilateral arthrodesis were in the lowest dose group. With the higher two doses, there was histologic evidence of osseous continuity between the fusion mass and undecorticated transverse processes. Conclusions. There were no statistical differences in clinical and radiographic fusion rates between decorticated and undecorticated sites. With higher doses of recombinant human bone morphogenetic protein-2, there was little histologic distinction between fusions in decorticated versus undecorticated spines

The World Health Organization's impacts on age-friendly policymaking: A case study on Australia

This paper reflects on whether and how the World Health Organization (WHO) inspires age-friendly policymaking across different levels of government. This is done via a case study in which we analyse the policies of Australia's three-tiered federated government system against the WHO's eight core age-friendly cities domains. Findings suggest that membership of the Global Network of Age-Friendly Cities and Communities did not appear to overtly inspire the development of age-friendly policies across Australian governments. Content analysis shows there is an overwhelming policy focus on care and support services, with little attention to cultural diversity. This reflects an outdated portrayal of debilitation in later life and a lack of recognition of how diverse circumstances impact the ageing process and corresponding support needs. Our findings also reveal the challenges of a three-tiered federated system, where varying financial and authoritative capacities have influenced how different governments acknowledge and respond to population ageing. Notably, local governments—the main level of implementation targeted by the WHO—are invariably constrained in developing their own age-friendly policies and may opt to adopt those of higher levels of government instead. These challenges will likely impact other resource-limited governments in responding to the needs of their emerging ageing populations

Inhibitory Plasticity in a Lateral Band Improves Cortical Detection of Natural Vocalizations

SummaryThe interplay between excitation and inhibition in the auditory cortex is crucial for the processing of acoustic stimuli. However, the precise role that inhibition plays in the distributed cortical encoding of natural vocalizations has not been well studied. We recorded single units (SUs) and local field potentials (LFPs) in the awake mouse auditory cortex while presenting pup isolation calls to animals that either do (mothers) or do not (virgins) recognize the sounds as behaviorally relevant. In both groups, we observed substantial call-evoked inhibition. However, in mothers this was earlier, longer, stronger, and more stereotyped compared to virgins. This difference was most apparent for recording sites tuned to tone frequencies lower than the pup calls' high-ultrasonic frequency range. We hypothesize that this auditory cortical inhibitory plasticity improves pup call detection in a relatively specific manner by increasing the contrast between call-evoked responses arising from high-ultrasonic and lateral frequency neural populations