Wait time reality check: The convergence of process, perception, and expectation

There are few experiences as ubiquitous to patients as the experience of waiting. It is an occurrence that transcends diagnosis, is common to all demographics, and is shared across the continuum of care. The experience can be frustrating and full of ambiguity for patients and their families. Wait time and delays can lead to patients sensing a loss of control and magnify the feelings of anxiety they may already be suffering. In an effort to improve patient experience, a framework was developed to examine patient satisfaction as a function of expectations, perceptions, and reality. The process domain focused on the objective reality of the pre-surgical lead times; while the expectation and perception domains focused on the family understanding of the timeliness of the pre-surgical process prior to, and directly following the experience. Guided by this framework, data was collected and analyzed at surgical units throughout the Texas Children’s Hospital system. Insights gained from this analysis identified distinct needs where focused improvement approaches could be implemented. Throughout this paper, we will provide insight into the framework developed, case studies illustrating its effectiveness and insights as to how it can be applied at any healthcare organization to improve patient satisfaction

Women and the Future of Work: Report 1 of The Australian Women’s Working Futures Project

This publication reports the findings from a combined quantitative and qualitative study of Australian working women, aged under 40. It draws together four separate data sources: a nationally representative online survey of (n=2,109) working women under 40; a smaller comparative survey of (n=502) working men under 40; additional boosted survey sample among (n=53) Aboriginal and Torres Strait Islander working women aged under 40; and the findings from five focus groups of (n=41) working women under 40. Quantitative fieldwork was conducted between September and October, while qualitative fieldwork was conducted in November 2017. At the time of being surveyed: over half of the women in the sample (55%) were working full-time or part-time for an employer, a fifth (19%) were working on a casual, freelance or short-term contract basis and 6% were self-employed. Half of the women (55%) were working in the private sector, 28% in the public sector and 6% for not-for-profit organisations. Over half (56%) were working in four industry sectors: retail trade, healthcare and social assistance, education and training, and accommodation and food services. A sample profile is included at the end of the Methodology section (Section 2)

VCP/p97 regulates Beclin-1-dependent autophagy initiation

Autophagy is an essential cellular process that removes harmful protein species, and autophagy upregulation may be able to protect against neurodegeneration and various pathogens. Here, we have identified the essential protein VCP/p97 as a novel regulator of autophagosome biogenesis, where VCP regulates autophagy induction in two ways, both dependent on Beclin-1. Utilizing small-molecule inhibitors of VCP ATPase activity, we show that VCP stabilizes Beclin-1 levels by promoting the deubiquitinase activity of Ataxin-3 towards Beclin-1. VCP also regulates the assembly and activity of the Beclin-1-containing phosphatidylinositol-3-kinase (PI3K) complex I, thus regulating the production of PI(3)P, a key signaling lipid responsible for the recruitment of downstream autophagy factors. Decreased levels of VCP, or inhibition of its ATPase activity impairs starvation-induced production of PI(3)P and limits downstream recruitment of WIPI2, ATG16L and LC3, thereby decreasing autophagosome formation, illustrating an important role for VCP in early autophagy initiation.We are grateful for funding from the UK Dementia Research Institute (funded by the MRC, Alzheimer’s Research UK and the Alzheimer’s Society) (UKDRI-2002 to DCR), The Tau Consortium, Alzheimer’s Research UK, an anonymous donation to the Cambridge Centre for Parkinson-Plus, AstraZeneca, the Swedish Natural Research Council (VR) (reference 2016–06605; to S.M.H;) and from the European Molecular Biology Organisation (EMBO long-term fellowships, ALTF 1024-2016 and ALTF 135-2016, to SMH and LW; respectively)

An introduction to Elinor Glyn : her life and legacy

This special issue of Women: A Cultural Review re-evaluates an author who was once a household name, beloved by readers of romance, and whose films were distributed widely in Europe and the Americas. Elinor Glyn (1864–1943) was a British author of romantic fiction who went to Hollywood and became famous for her movies. She was a celebrity figure of the 1920s, and wrote constantly in Hearst's press. She wrote racy stories which were turned into films—most famously, Three Weeks (1924) and It (1927). These were viewed by the judiciary as scandalous, but by others—Hollywood and the Spanish Catholic Church—as acceptably conservative. Glyn has become a peripheral figure in histories of this period, marginalized in accounts of the youth-centred ‘flapper era’. Decades on, the idea of the ‘It Girl’ continues to have great pertinence in the post-feminist discourses of the twenty-first century. The 1910s and 1920s saw the development of intermodal networks between print, sound and screen cultures. This introduction to Glyn's life and legacy reviews the cross-disciplinary debate sparked by renewed interest in Glyn by film scholars and literary and feminist historians, and offers a range of views of Glyn's cultural and historical significance and areas for future research

Metabolic analyses reveal common adaptations in two invasive Haemophilus influenzae strains

Non-typeable Haemophilus influenzae (NTHi) is a major pathogen in upper and lower respiratory tract infections in humans, and is increasingly also associated with invasive disease. We have examined two unrelated NTHi invasive disease isolates, R2866 and C188, in order to identify metabolic and physiological properties that distinguish them from respiratory tract disease isolates such as Hi2019. While the general use of the Hi metabolic network was similar across all three strains, the two invasive isolates secreted increased amounts of succinate which can have anti-inflammatory properties. In addition, they showed a common shift in their carbon source utilization patterns, with strongly enhanced metabolism of nucleoside substrates, glucose and sialic acid. The latter two are major compounds present in blood and CSF. Interestingly, C188 and R2866 also shared a reduced ability to invade or survive intracellularly in 16HBE14 bronchial epithelial cells relative to Hi2019 (4-fold (4 h), 25-fold (24 h) reduction). Altered metabolic properties such as the ones observed here could arise from genomic adaptations that NTHi undergo during infection. Together these data indicate that shifts in substrate preferences in otherwise conserved metabolic pathways may underlie strain niche specificity and thus have the potential to alter the outcomes of host-NTHi interactions

Verbal fluency functional magnetic resonance imaging detects anti-seizure effects and affective side effects of perampanel in people with focal epilepsy

Perampanel, a noncompetitive antagonist of the postsynaptic a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic (AMPA) receptor, is effective for controlling focal to bilateral tonic-clonic seizures but is also known to increase feelings of anger. Using statistical parametric mapping-derived measures of activation and task-modulated functional connectivity (psychophysiologic interaction), we investigated 14 people with focal epilepsy who had verbal fluency functional magnetic resonance imaging (fMRI) twice, before and after the add-on treatment of perampanel. For comparison, we included 28 people with epilepsy, propensity-matched for clinical characteristics, who had two scans but no change in anti-seizure medication (ASM) regimen in-between. After commencing perampanel, individuals had higher task-related activations in left orbitofrontal cortex (OFC), fewer task-related activations in the subcortical regions including the left thalamus and left caudate, and lower task-related thalamocaudate and caudate-subtantial nigra connectivity. Decreased task-related connectivity is observed between the left OFC and precuneus and left medial frontal lobe. Our results highlight the brain regions associated with the beneficiary therapeutic effects on focal to bilateral tonic-clonic seizures (thalamus and caudate) but also the undesired affective side effects of perampanel with increased anger and aggression (OFC)

Link between foot pain severity and prevalence of depressive symptoms

OBJECTIVE: Associations between pain and depression are well known, yet foot pain, common in populations, has been understudied. This cross-sectional study examined foot pain and severity of foot pain with depressive symptoms in adults. METHODS: Framingham Foot Study (2002-2008) participants completed questionnaires that included questions about foot pain (yes/no; none, mild, moderate, or severe pain) and the Center for Epidemiologic Studies Depression Scale (scores ≥16 indicated depressive symptoms). Age and body mass index (BMI) were also assessed. Sex-specific logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations of foot pain with depressive symptoms, adjusting for age and BMI. In a subset, further models adjusted for leg pain, back pain, or other joint pain. RESULTS: Of 1,464 men and 1,857 women, the mean ± SD age was 66 ± 10 years. Depressive symptoms were reported in 21% of men and 27% of women. Compared to those with no foot pain and independent of age and BMI, both men and women with moderate foot pain had approximately a 2-fold increased odds of depressive symptoms (men with severe foot pain OR of 4 [95% CI 2.26-8.48], women with severe foot pain OR of 3 [95% CI 2.02-4.68]). Considering other pain regions attenuated ORs, but the pattern of results remained unchanged. CONCLUSION: Even after we adjusted for age, BMI, and other regions of pain, those reporting worse foot pain were more likely to report depressive symptoms. These findings suggest that foot pain may be a part of a broader pain spectrum, with an impact beyond localized pain and discomfort

Ferroelectric orthorhombic ZrO2 thin films achieved through nanosecond laser annealing

A new approach for the stabilization of the ferroelectric orthorhombic ZrO2 films is demonstrated through nanosecond laser annealing (NLA) of as-deposited Si/SiOx/W(14 nm)/ZrO2(8 nm)/W(22 nm), grown by ion beam sputtering at low temperatures. The NLA process optimization is guided by COMSOL multiphysics simulations. The films annealed under the optimized conditions reveal the presence of the orthorhombic phase, as confirmed by X-ray diffraction, electron backscatter diffraction, and transmission electron microscopy. Macroscopic polarization-electric field hysteresis loops show ferroelectric behavior, with saturation polarization of 12.8 mu C cm(-2), remnant polarization of 12.7 mu C cm(-2) and coercive field of 1.2 MV cm(-1). The films exhibit a wake-up effect that is attributed to the migration of point defects, such as oxygen vacancies, and/or a transition from nonferroelectric (monoclinic and tetragonal phase) to the ferroelectric orthorhombic phase. The capacitors demonstrate a stable polarization with an endurance of 6.0 x 10(5) cycles, demonstrating the potential of the NLA process for the fabrication of ferroelectric memory devices with high polarization, low coercive field, and high cycling stability.A.P.S.C. and M.C.I. contributed equally to this work. This work was supported by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding Contract UIDB/04650/2020. This work has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 958174 (M-ERA-NET3/0003/2021-NanOx4EStor). M. C. I. and C. G. acknowledge the financial support by a grant of the Ministry of Research, Innovation and Digitization, CNCS/CCCDI - UEFISCDI, project number COFUND-M-ERANET-3-NanOx4Estor, within PNCDI III and POC 332/390008/29.12.2020-SMIS 109522. The authors acknowledge the CERIC-ERIC Consortium for access to experimental facilities and financial support under proposals 20202037, 20202038, and 20192055. The authors would also like to thank Jose Santos for technical support in the Thin Film Laboratory at CF-UM-UP. J.L.M-D. thanks the ERC grant, EU-H2020-ERC-ADG #882929, EROS. And the Royal Academy of Engineering, grant CIET1819_24. MOH thanks the Herchel Smith foundation of Cambridge for a research fellowship. This work made use of the University of Cambridge Wolfson Electron Microscopy Suite