Capacity Building and Institutional Development Partnership: University of Florida and Tshwane University of Technology, South Africa

Capacity building and institutional development through training is a key component for the vitality and sustainability of the tourism industry in South Africa. The overall advancement of qualified, trained and skilled labor force is crucial, given the rate of growth and future trends. In order to address this major need, the University of Florida and Tshwane University of Technology have formulated a three-year partnership (2009-2012) to strengthen curriculum, research, and faculty enhancement initiatives in tourism management in South Africa. This presentation will outline and expand the partnership objectives and accomplishments. This example can be a model for international academic partnerships

Weight-based discrimination in financial reward and punishment decision making: causal evidence using a novel experimental paradigm

Background/Objectives: Cross-sectional research has demonstrated weight-related stigma and discrimination, however experimental research providing causal evidence of financial-based weight discrimination is lacking. The aim of these preregistered experiments was to examine whether a novel paradigm in which participants attributed financial rewards and punishments could be used to detect weight bias. Subjects/Methods: One-hundred and twenty-one individuals participated in experiment 1 and one-hundred and sixty-six individuals participated in experiment 2. Both studies were conducted online, and participants were provided with biographies of hypothetical individuals in which weight-status was manipulated (normal weight vs. overweight/obesity) before being asked to provide rewards and punishments on their cognitive performance. In experiment 1 (within-participants design) participants observed one individual they believed to be normal weight and one individual they believed to be overweight/have obesity. In experiment 2 (between-participants design) participants observed one individual whilst also being provided with information about food addiction (Food addiction is real + individual with overweight/obesity vs. food addiction is a myth + individual with overweight/obesity vs control + individual with normal weight). Results: In experiment 1, participants punished individuals who were described as having overweight/obesity to a greater extent to individuals who were normal weight (Hedge’s g = −0.21 [95% CI: −0.02 to −0.41], p = 0.026), but there was no effect on rewards. They were also less likely to recommend individuals with overweight/obesity to pass the tasks (X2(1) = 10.05, p = 0.002). In experiment 2, participants rewarded individuals whom they believed were overweight/obese to a lesser extent than normal-weight individuals (g = 0.49 [95% CI: 0.16 to 0.83]. There was no effect on punishment, nor any impact of information regarding food addiction as real vs a myth. Conclusion: Using a novel discrimination task, these two experiments demonstrate causal evidence of weight-based discrimination in financial decision making

N-acetylcysteine for smoking cessation among dual users of tobacco and cannabis: Protocol and rationale for a randomized controlled trial.

BACKGROUND: Tobacco and cannabis co-use is a growing public health problem. The synergistic effects of cannabis and nicotine on neurobiological systems that mediate reward and shared environmental cues reinforcing use may make tobacco smoking cessation more difficult. N-acetylcysteine (NAC), an FDA-approved medication and over-the-counter supplement, has shown promise in animal studies and randomized controlled trials (RCTs) in reducing tobacco and cannabis craving and use. NACs potential efficacy in treating addiction may be attributable to its central nervous system effects in reducing excessive glutamatergic activity, oxidative stress, and inflammation. To date, no RCT has examined NAC for smoking cessation among dual users of tobacco and cannabis. METHOD: In a double-blind, placebo-controlled RCT, we will examine NAC for smoking cessation among dual users of tobacco and cannabis. Sixty adult cigarette-cannabis co-users are randomized to receive NAC 3600 mg per day or placebo over 8 weeks. Participants in both groups receive 8 weekly cognitive behavioral therapy sessions addressing smoking cessation and cannabis reduction. Outcomes are assessed at Weeks 0, 4, 8, and 12. Primary aims are to determine NACs efficacy in decreasing cigarette craving, nicotine dependence, and use; and cannabis craving and use. Exploratory aims include examination of changes in neurocognition with NAC and their potential mediational effects on cigarette and cannabis use outcomes. CONCLUSION: Results will inform smoking cessation treatment among dual users of tobacco and cannabis. CLINICALTRIALS: gov Identifier: NCT04627922

Careless Responding in Online Studies is Associated With Alcohol Use: A Mega-Analysis

Objective: The prevalence of research conducted online in the addiction field has increased rapidly over the past decade. However, little focus has been given to careless responding in these online studies, despite the issues it may cause for statistical inference and generalizability. Our aim was to examine whether alcohol use is associated with careless responses. Method: Raw data were requested from online studies examining alcohol use and related problems which also addressed careless responding. We obtained 13 data sets of 12,237 participants (Mage = 42.16, SD = 15.65, 50.5% female). The sample had an average Alcohol Use Disorders Identification Test (AUDIT) score of 10.88 (SD = 7.77). Predictors included demographic information (age, gender) and AUDIT total scores. The primary outcome was whether an individual was classed as a careless responder, for example, by failing an explicit attention check question. Results: AUDIT total scores were associated with careless responding (OR = 1.07, 95% CI [1.06, 1.08], p < .001). Hazardous drinking or worse was associated with 2.21 greater odds (OR = 2.21, 95% CI [1.81, 2.71] of careless responding, whereas harmful drinking or worse was associated with 3.43 greater odds (OR = 3.43, 95% CI [2.83, 4.17]) and probable dependence was associated with 3.63 greater odds (OR = 3.63, 95% CI [2.95, 4.48]). Conclusions: Alcohol use and related problems are positively associated with careless responding in online research. Removal of individuals identified as careless responders may lead to issues of generalizability, and more care should be taken to identify and handle careless responder data

Perioperative mental health intervention bundle for older surgical patients: Protocol for an intervention development and feasibility study

INTRODUCTION: The perioperative period is high risk for older adults. Depression and anxiety are common perioperative problems, frequently coexisting with cognitive impairment. Older patients with these conditions are more likely than younger patients to experience postoperative delirium, long hospital stays, poor quality of life and rehospitalisation. These experiences can, in turn, exacerbate anxiety and depressive symptoms. Despite these risks, little is known about how to treat perioperative anxiety and depression among older adults. METHODS AND ANALYSIS: We designed a feasibility study of a perioperative mental health intervention bundle to improve perioperative mental health, specifically depression and anxiety. The overarching goals of this study are twofold: first, to adapt and refine an intervention bundle comprised of behavioural activation and medication optimisation to meet the needs of older adults within three surgical patient populations (ie, orthopaedic, oncological and cardiac); and second, to test the feasibility of study procedures and intervention bundle implementation. Quantitative data on clinical outcomes such as depression, anxiety, quality of life, delirium, falls, length of stay, hospitalisation and pain will be collected and tabulated for descriptive purposes. A hybrid inductive-deductive thematic approach will be employed to analyse qualitative feedback from key stakeholders. ETHICS AND DISSEMINATION: The study received approval from the Washington University Institutional Review Board. Results of this study will be presented in peer-reviewed journals, at professional conferences, and to our perioperative mental health advisory board. TRIAL REGISTRATION NUMBER: NCT05110690

Quality Improvement Intervention for Reduction of Redundant Testing

Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (−) test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced. The main outcome was the percentage of cardiac marker studies performed within guidelines. Nonguideline orders dominated at baseline. Creatine kinase M and B isoenzyme testing in 7496 order sets failed to detect additional myocardial infarctions but was associated with 42 potentially preventable admissions/quarter. Interruptive computerized soft stops improved guideline compliance from 32.3% to 58% (P \u3c .001) in services not receiving peer leader intervention and to \u3e80% (P \u3c .001) with peer leadership that featured dashboard feedback about test order performance. This successful experience was recapitulated in interrupted time series within 2 additional services within facility 1 and then in 2 external hospitals (including a critical access facility). Improvements have been sustained postintervention. Laboratory cost savings at the academic facility were estimated to be ≥US$635 000 per year. National collaborative data indicated that facility 1 improved its order patterns from fourth to first quartile compared to peer norms and imply that nonguideline orders persist elsewhere. This example illustrates how pathologists can provide leadership in assisting clinicians in changing laboratory ordering practices. We found that clinicians respond to local laboratory data about their own test performance and that evidence suggesting harm is more compelling to clinicians than evidence of cost savings. Our experience indicates that interventions done at an academic facility can be readily instituted by private practitioners at external facilities. The intervention data also supplement existing literature that electronic order interruptions are more successful when combined with modalities that rely on peer education combined with dashboard feedback about laboratory order performance. The findings may have implications for the role of the pathology laboratory in the ongoing pivot from quantity-based to value-based health care

Perioperative mental health intervention for depression and anxiety symptoms in older adults study protocol: Design and methods for three linked randomised controlled trials

INTRODUCTION: Preoperative anxiety and depression symptoms among older surgical patients are associated with poor postoperative outcomes, yet evidence-based interventions for anxiety and depression have not been applied within this setting. We present a protocol for randomised controlled trials (RCTs) in three surgical cohorts: cardiac, oncological and orthopaedic, investigating whether a perioperative mental health intervention, with psychological and pharmacological components, reduces perioperative symptoms of depression and anxiety in older surgical patients. METHODS AND ANALYSIS: Adults ≥60 years undergoing cardiac, orthopaedic or oncological surgery will be enrolled in one of three-linked type 1 hybrid effectiveness/implementation RCTs that will be conducted in tandem with similar methods. In each trial, 100 participants will be randomised to a remotely delivered perioperative behavioural treatment incorporating principles of behavioural activation, compassion and care coordination, and medication optimisation, or enhanced usual care with mental health-related resources for this population. The primary outcome is change in depression and anxiety symptoms assessed with the Patient Health Questionnaire-Anxiety Depression Scale from baseline to 3 months post surgery. Other outcomes include quality of life, delirium, length of stay, falls, rehospitalisation, pain and implementation outcomes, including study and intervention reach, acceptability, feasibility and appropriateness, and patient experience with the intervention. ETHICS AND DISSEMINATION: The trials have received ethics approval from the Washington University School of Medicine Institutional Review Board. Informed consent is required for participation in the trials. The results will be submitted for publication in peer-reviewed journals, presented at clinical research conferences and disseminated via the Center for Perioperative Mental Health website. TRIAL REGISTRATION NUMBERS: NCT05575128, NCT05685511, NCT05697835, pre-results

Sheridan School of Architectural Technology Volume 1 [W2017]

Welcome to Sheridan’s School of Architectural Technician/Technology inaugural printed portfolio. This volume is a celebration of the architectural achievements of Sheridan students. Much of the content presented here has been incubated in CADD39788, Architectural Computer Visualisation. Inside you will find an amalgamation of student and faculty work put together into a publication that reflects the rich theatre of creativity and complexity that is architectural education here at Sheridan. Student work within the magazine is from the last year of studies in the Architectural Technology program. Each student has selected their best work to represent some of the skills that they have learned over the years as part of Sheridan. Faculty work is a selection of research, teaching, and professional projects that represents that quality and diversity of educators that serve not only as teachers, but also as mentors to our students. They showcase the talent and skill of some of the individuals that make the Sheridan program a reality.https://source.sheridancollege.ca/fast_books/1001/thumbnail.jp