Simulation of arbitrary shaped boundaries for hemodynamic studies

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Reconceptualising the standard of care in sport: The case of youth rugby in England and South Africa

Sport is an important area of civil society in both South Africa and England, and this article is broadly concerned with the relationship between sport and personal injury. More specifically, the article compares how rugby is regulated by the tort of negligence in England and delict in South Africa respectively. Regarding liability, for sport there are very specific factors that need to be taken into account. The article is concerned with, firstly, the broader context of sport as an important social and cultural activity, and secondly the specific sporting context that includes the rules of the game as well as the playing culture, with a focus on rugby at junior level. Through a critical and comparative analysis of how the standards of care in sport have been developed in both jurisdictions, the aim of this article is to consider how sport specific elements can be incorporated into the traditional legal principles. This comparative analysis contextualises the various discussions in the light of the differences between the English tort of negligence and the South African law of delict. Our argument is that the context and specificity of rugby should be more explicitly taken into account when evaluating potential liability. To establish a standard of care for sport is complex, with many factors to be taken into account and balanced against one another. The law of negligence/delict therefore needs to be adaptable and flexible to resolve new situations where injuries have occurred. Even in established situations where liability has been previously determined, novel events do occur and knowledge develops that requires a reconsideration of the principles that govern liability. In junior rugby, the risk of very serious injuries is relatively small and the law needs to tread a cautious path through liability, ensuring it is a vehicle that promotes sport rather than creating barriers to its enjoyment and practice. A greater understanding of sport, informed by detailed research, can unearth new areas of potential liability that will need to be considered in the future

A Gateway Framework to Guide Major Health System Changes Comment on “‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration”

Recent events – on both a global scale and within individual countries – including the lockdowns associated with COVID-19 pandemic, inflation concerns, and political tensions, have increased pressure to reconfigure social services for ongoing sustainability. Healthcare services across the world are undergoing major system change (MSC). Given the complexity and different contextual drivers across healthcare systems, there is a need to use a variety of perspectives to improve our understanding of the processes for MSC. To expand the knowledge base and develop strategies for MSC requires analysing change projects from different perspectives to distil the elements that drove the success. We offer the Gateway Framework as a collaborative transformational system tool to assess and reorganise operations, services, and systems of healthcare organisations. This framework and guiding questions, accounts for past events whilst being proactive, future orientated, and derived from externally defined and a standardised requirements to promote safe, high-quality care. Keywords: Major System Change, Restructuring, Health Systems, Healthcare Safety, Healthcare Quality Copyright: © 2023 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/ licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Eljiz K, Greenfield D, Derrett A. A gateway framework to guide major health system changes: Comment on “‘Attending to history’ in major system change in healthcare in England: specialist cancer surgery service reconfiguration.” Int J Health Policy Manag. 2023;12:7681. doi:10.34172/ijhpm.2023.7681

Decline in Methylmercury in Museum-Preserved Bivalves from San Francisco Bay, California

There are ongoing efforts to manage mercury and nutrient pollution in San Francisco Bay (California, USA), but historical data on biological responses are limited. We used bivalves preserved in formalin or ethanol from museum collections to investigate long-term trends in methylmercury (MeHg) concentrations and carbon and nitrogen isotopic signatures. In the southern reach of the estuary, South Bay, MeHg in the Asian date mussel (Musculista senhousia) significantly declined over the study duration (1970 to 2012). Mean MeHg concentrations were highest (218 ng/g dry weight, dw) in 1975 and declined 3.8-fold (to 57 ng/g dw) by 2012. This decrease corresponded with closure of the New Almaden Mercury Mines and was consistent with previously observed declines in sediment core mercury concentrations. In contrast, across all sites, MeHg in the overbite clam (Potamocorbula amurensis) increased 1.3-fold from 64 ng/g dw before 2000 to 81 ng/g dw during the 2000s and was higher than in M. senhousia. Pearson correlation coefficients of the association between MeHg and δ13C or δ15N provided no evidence that food web alterations explained changing MeHg concentrations. However, isotopic composition shifted temporally. South Bay bivalve δ15N increased from 12‰ in the 1970s to 18‰ in 2012. This increase corresponded with increasing nitrogen loadings from wastewater treatment plants until the late 1980s and increasing phytoplankton biomass from the 1990s to 2012. Similarly, a 3‰ decline in δ13C from 2002 to 2012 may represent greater utilization of planktonic food sources. In a complimentary 90 day laboratory study to validate use of these preserved specimens, preservation had only minor effects (\u3c 0.5‰) on δ13C and δ15N. MeHg increased following preservation but then stabilized. These are the first documented long-term trends in biota MeHg and stable isotopes in this heavily impacted estuary and support the utility of preserved specimens to infer contaminant and biogeochemical trends

Body representation difficulties in children and adolescents with autism may be due to delayed development of visuo-tactile temporal binding

Recent research suggests visuo-tactile binding is temporally extended in autism spectrum disorders (ASD), although it is not clear whether this specifically underlies altered body representation in this population. In the current study children and adolescents with ASD, and typically developing controls, placed their hand into mediated reality system (MIRAGE) and saw two identical live video images of their own right hand. One image was in the proprioceptively correct location (veridical hand) and the other was displaced to either side. While visuotactile feedback was applied via brushstroke to the participant’s (unseen) right finger, they viewed one hand image receiving synchronous brushstrokes and the other receiving brushstrokes with a temporal delay (60, 180 and 300ms). After brushing, both images disappeared from view and participants pointed to a target, with direction of movement indicating which hand was embodied. ASD participants, like younger mental aged-matched controls, showed reduced embodiment of the spatially incongruent, but temporally incongruent, hand compared to chronologically age-matched controls at shorter temporal delays. This suggests development of visuo-tactile integration may be delayed in ASD. Findings are discussed in relation to atypical body representation in ASD and how this may contribute to social and sensory difficulties within this population

DNA barcoding reveals micro-evolutionary changes and river system-level phylogeographic resolution of African silver catfish, Schilbe intermedius (Actinopterygii: Siluriformes: Schilbeidae) from seven populations across different African river systems

Background. Under the tropics, less than 40% of known fishes are identified to species-level. Further, the ongoing global change poses unprecedented threat to biodiversity, and several taxa are likely to go extinct even before they could be described. Traditional ecological theory suggests that species would escape extinction risk posed by global threats (e.g., climate change) only by migrating to new environments. In this study, we hypothesise that micro-evolutionary changes (evolution within species and populations) are also important mechanisms for the survival of Schilbe intermedius in Africa, a continent subjected to uneven distribution of climate severity. Materials and methods. Using the mitochondrial cytochrome c oxidase subunit I (COI) gene, known as animal DNA barcode, we tested this hypothesis by analysing the genetic diversity and phylogenetic relations between seven populations of S. intermedius across different African river systems. Results. We reveal a clear geographical patterning in genetic variations, with three clear clusters (southern Africa, eastern Africa, and western Africa). In southern Africa, the South African population is distinct from that of Namibia and Botswana. In addition, within Nigerian populations of silver catfish, two sub-clusters emerged from two isolated river systems. We suggest that the phylogeographic pattern within African silver catfish populations mirror the past effects of selection and gene flow, and that the split within Nigerian silver catfish populations might be the result of micro-evolutionary adaptive responses to local selection pressures. Conclusion. We suggest that the strong genetic difference in African silver catfish among geographically isolated river systems might be the result of in situ micro-evolutionary adaptive responses to changing environments, and that DNA barcode has potential beyond species delimitation

Optimising outcomes for complex trauma survivors: assessing the motivators, barriers and enablers for implementing trauma informed practice within a multidisciplinary health setting

Background: Complex trauma is a significant public health issue with detrimental health, interpersonal and psychological impacts, which can impede client recovery and result in multiple representations. ‘Trauma Informed Practice’ (TIP) is an evidence-based model which ensures safe and effective services for clients and staff. This study examines health professional’s use of TIP, and the motivators, enablers and barriers to implementation in a multidisciplinary setting. Methods: A mixed methods study with 24 front-line clinicians and managers within a community health setting in Australia. A purpose designed, expert validated TIP checklist was completed, followed by semi-structured focus groups. Survey data was reported using descriptive statistics. Focus group data was digitally recorded, transcribed and thematically analysed. Results: Ten key factors were identified motivating, restricting or enabling TIP implementation. Seven were organisational factors including supportive and informed management, flexibility of service models, levels of service demands, resource availability, education opportunities, good client outcomes, and reporting requirements. Philosophical approach, team orientation, and vicarious trauma/stress management were three individual professional factors. Critically, alignment in two ways was necessary for successful implementation, that is: in knowledge and understanding across organisational role levels - clinician, manager and executive; and, in professional philosophy and team orientation of individual clinicians. Conclusion: Providing TIP is essential for ensuring optimum client outcomes for trauma survivors and for maintaining workforce wellbeing. Although the increasing uptake to TIP is evident within the health setting, further attention is required to address the tension between service models focused on efficiently servicing whole populations and those attuned to effectively meeting the needs of high risk groups. A complex strategy to unite therapeutic and managerial goals is necessary if client, professional and organisational needs are to be effectively met

Retrospective Evaluation of the COVID-19 Contact Tracing Program at the Maine Center for Disease Control and Prevention

Introduction: Despite the widespread use of contact tracing efforts throughout the COVID-19 pandemic, there are limited findings available about best practices and recommendations. The Maine Center for Disease Control and Prevention contracted staff to conduct COVID-19 contact tracing from August 2020 through February 2022. A retrospective evaluation of this program was conducted to share lessons learned with public health and health care leaders for future use. Methods: Contracted contact tracing staff participated in facilitated discussions structured by the Strengths, Weaknesses, Opportunities, and Threats analysis framework. Three sessions were recorded and transcribed, and qualitative analysis through thematic review and evaluation coding was conducted. Results: The thematic review identified 27 codes of participant responses. Codes were categorized into 4 overarching themes: pandemic collective, organizational placement, team structure, and team environment. These themes led to several recommendations for future efforts. Discussion: External networks and partnerships, strong engaged leadership, staff specialization, and use of innovative technology to foster regular communication were identified as contributors to the program’s success. The supportive team environment and collective purpose found in COVID-19 work were also important to the contact tracing team experience. Conclusion: This study is a retrospective evaluation of the Maine Center for Disease Control and Prevention’s COVID-19 contact tracing team. Best practices in hiring, staff engagement and retention, and collaboration were identified. These lessons are valuable for future public health emergencies and more broadly for contract tracing of other infectious diseases. Building a national consensus of best practices through systematic review or larger evaluation efforts is an important next step