Take Me Out to/of the Ball Game

When should a person leave a baseball game in order to maximize his/her enjoyment? How does this decision depend on the score of the game? Assuming a modified logistic rate of departure from the stadium, and a constant maximum exit rate from the parking lot, we find optimal strategies for leaving games of various scores

An fMRI investigation of the effects of attempted naming on word retrieval in aphasia

In healthy controls, picture naming performance can be facilitated by a single prior exposure to the same picture ("priming"). This priming phenomenon is utilized in the treatment of aphasia, which often includes repeated picture naming as part of a therapeutic task. The current study sought to determine whether single and/or multiple exposures facilitate subsequent naming in aphasia and whether such facilitatory effects act through normal priming mechanisms. A functional magnetic resonance imaging paradigm was employed to explore the beneficial effects of attempted naming in two individuals with aphasia and a control group. The timing and number of prior exposures was manipulated, with investigation of both short-term effects (single prior exposure over a period of minutes) and long-term effects (multiple presentations over a period of days). Following attempted naming, both short-term and long-term facilitated items showed improvement for controls, while only the long-term condition showed benefits at a behavioral level for the participants with aphasia. At a neural level, effects of long-term facilitation were noted in the left precuneus for one participant with aphasia, a result also identified for the equivalent contrast in controls. It appears that multiple attempts are required to improve naming performance in the presence of anomia and that for some individuals with aphasia the source of facilitation may be similar to unimpaired mechanisms engaged outside the language network

Together in Sound: Music therapy groups for people with dementia and their companions – moving online in response to a pandemic

Together in Sound is a partnership project between the Cambridge Institute for Music Therapy Research at Anglia Ruskin University (ARU) and Saffron Hall Trust, an arts charity based in rural Essex, England. Established in Autumn 2017, the project offers music therapy to people living with dementia and their companions and includes a practice-based research element. This co-authored report concerns the impact of the global COVID-19 pandemic on the project and presents the team’s experience of moving music therapy sessions online in March 2020. Continuing online provided continuity, support, and ongoing connection for participants who, because of the national lockdown in the United Kingdom, were isolated in their own homes. After providing some context about the project, the report explores the challenges and benefits of online delivery of sessions with reflections from the Together in Sound team including potential implications for the future

Regimen Simplification to Atazanavir‐Ritonavir Alone as Maintenance Antiretroviral Therapy: Final 48‐Week Clinical and Virologic Outcomes

Simplified maintenance therapy with ritonavir-boosted atazanavir (ATV/RTV) alone is attractive because of nucleoside reverse-transcriptase inhibitor (NRTI)–sparing benefits, low pill burden, once-daily dosage, and safety

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Play, Learn, and Teach Outdoors—Network (PLaTO-Net): terminology, taxonomy, and ontology

Background: A recent dialogue in the feld of play, learn, and teach outdoors (referred to as “PLaTO” hereafter) demonstrated the need for developing harmonized and consensus-based terminology, taxonomy, and ontology for PLaTO. This is important as the feld evolves and diversifes in its approaches, contents, and contexts over time and in diferent countries, cultures, and settings. Within this paper, we report the systematic and iterative processes under‑taken to achieve this objective, which has built on the creation of the global PLaTO-Network (PLaTO-Net). Methods: This project comprised of four major methodological phases. First, a systematic scoping review was conducted to identify common terms and defnitions used pertaining to PLaTO. Second, based on the results of the scoping review, a draft set of key terms, taxonomy, and ontology were developed, and shared with PLaTO members, who provided feedback via four rounds of consultation. Third, PLaTO terminology, taxonomy, and ontology were then fnalized based on the feedback received from 50 international PLaTO member participants who responded to≥3 rounds of the consultation survey and dialogue. Finally, eforts to share and disseminate project outcomes were made through diferent online platforms. Results: This paper presents the fnal defnitions and taxonomy of 31 PLaTO terms along with the PLaTO-Net ontol‑ogy model. The model incorporates other relevant concepts in recognition that all the aspects of the model are interrelated and interconnected. The fnal terminology, taxonomy, and ontology are intended to be applicable to, and relevant for, all people encompassing various identities (e.g., age, gender, culture, ethnicity, ability). Conclusions: This project contributes to advancing PLaTO-based research and facilitating intersectoral and inter‑disciplinary collaboration, with the long-term goal of fostering and strengthening PLaTO’s synergistic linkages with healthy living, environmental stewardship, climate action, and planetary health agendas. Notably, PLaTO terminology, taxonomy and ontology will continue to evolve, and PLaTO-Net is committed to advancing and periodically updating harmonized knowledge and understanding in the vast and interrelated areas of PLaTO

Direct financial assistance for improved maternal and child health data: a pilot study supporting the health management information system in Malawi

Abstract Background The health management information system (HMIS) is an integral component of a strong health care system. Despite its importance for decision-making, the quality of HMIS data remains of concern in low- and middle-income countries. To address challenges with the quality of maternal and child health (MCH) data gathered within Malawi’s HMIS, we conducted a pilot study evaluating different support modalities to district-level HMIS offices. We hypothesized that providing regular, direct financial assistance to HMIS offices would enable staff to establish strategies and priorities based on local context, resulting in more accurate, timely, and complete MCH data. Methods The pilot intervention was implemented in Mwanza district, while Chikwawa, Neno, and Ntchisi districts served as control sites given support received from other institutions. The intervention consisted of providing direct financial assistance to Mwanza’s HMIS office following the submission of detailed budgets and lists of planned activities. In the control districts, we performed interviews with the HMIS officers to track the HMIS-related activities. We evaluated the intervention by comparing data quality between the post- and pre-intervention periods in the intervention and control districts. Additionally, we conducted interviews with Mwanza’s HMIS office staff to determine the acceptability and appropriateness of the intervention. Results Following the 10-month intervention period, we observed improvements in MCH data quality in Mwanza. The availability and completeness of MCH data collected in the registers increased by 22 and 18 percentage points, respectively. The consistency of MCH data between summary reports and electronic HMIS also improved. In contrast, 2/3 control districts noted minimal changes or reductions in data quality after 10 months. The qualitative interviews confirmed that, despite some challenges, the intervention was well received by the participating HMIS office. HMIS staff preferred our strategy to other conventional strategies that fail to give them the independence to make decisions. Conclusions This pilot intervention demonstrated an alternative approach to support HMIS offices in their daily efforts to improve data quality. Given the Ministry of Health’s (MoH) interest in strengthening its HMIS, our intervention provides a strategy that the MoH and local and international partners could consider to rapidly improve HMIS data with minimal oversight