Extending the Biopsychosocial Conceptualisation of Chronic Post Surgical Pain in Children and Adolescents: The Family Systems Perspective.

A substantial number of children and adolescents undergoing surgical procedures, as many as 40% in some estimates, will go on to develop chronic postsurgical pain (CPSP). Because of the significant negative impact of CPSP on social and emotional milestones, as well as the child's quality of life, it is important to identify modifiable factors that are associated with the onset and maintenance of the condition. Research has demonstrated that parent factors can play a role in pediatric chronic pain; however, there has been little examination of parent and family influences on the transition to CPSP. Family systems theories, which consider the influence of the family unit overall on the behavior of individuals members, have been applied to the eating disorders literature for decades. This narrative review proposes a novel application of family systems theory to pediatric CPSP and, in particular, highlights the role that parental dyadic factors may play in the development and maintenance of persistent pain following surgery in children and adolescents

Apps for Older People's Pain Self-Management: Perspectives of Primary Care and Allied Health Clinicians.

BACKGROUND: Chronic arthritic pain is one of the major causes of physical suffering and disability among older people. Primary care and allied health clinicians use various approaches to help their older clients better manage their arthritic pain. The growing uptake of technology among older people offers the potential for clinicians to integrate an arthritic pain app into their patients' self-management plans. This study explored the perspectives of Australian primary care and allied health clinicians regarding the use of pain self-management apps to help their older patients/clients better manage their arthritic pain. METHODS: Qualitative design using a semistructured interview approach. Interviews were conducted via telephone with primary and allied health clinicians (N = 17) across Australia. RESULTS: The overarching theme underlying participants' views on integration of apps into older people's pain self-management strategy was that this approach is an idealistic but uniquely challenging endeavor. Four subthemes emerged, namely: 1) self-management apps are a potentially useful tool but require careful consideration; 2) clinicians' involvement is crucial yet potentially onerous; 3) no single app is right for every older person with arthritic pain; and 4) patient data access is beneficial, but caution is needed for real-time data access. DISCUSSION: The predominant clinician perspective of integrating apps into their older patients/clients' pain self-management strategies was that this approach is an idealistic but uniquely challenging endeavor. Apps were seen as having potential to support various aspects of patients' self-management behaviors; however, there were notable concerns with regards to the challenges inherent in this approach for both clinicians and older users (patients/clients)

Monitoring Greater Sage Grouse Populations and Habitat Use in the Southeast Montana Sage-Grouse Core Area

Sage grouse (Centrocercus urophasianus) core areas support Montana’s highest densities of sage grouse, and are deemed vitally important to sage grouse conservation long term. The Southeast Montana Sage Grouse Core Area (SEMT SGCA) consists of large expanses of intact sagebrush-steppe habitat and is important for connectivity among populations in Montana, South Dakota and Wyoming. Relatively little development has occurred in the area, but there is potential for energy development to have large-scale impacts on the area in the near future. Little was known about sage-grouse use of the area during critical periods outside of the breeding season or factors underlying local sage-grouse population dynamics. Therefore, we radio collared 94 sage grouse hens between 2009-2011 to quantify movements, habitat use, and population vital rates. Overall, hen locations tended to be within the SEMT SGCA during spring-summer and expanded to adjacent areas of Wyoming and South Dakota during winter. Wide annual fluctuations in weather conditions drove annual variation in population demographic rates, habitat conditions, and habitat use. Apparent nest success (34-68%) and average chick production per hen that began the breeding season (0.72-1.12 chicks/hen) varied among years with extreme to mild weather. Annual hen survival varied from a low of 46 percent under extreme winter conditions to > 60 percent under milder weather. Vegetation characteristics at nest, brood-rearing, and winter locations will be presented. Results from this project will aid in land use planning, prioritization of conservation efforts, and provide information to assess the effects of future land use change. The project is conducted by MFWP and funded by the BLM

Broadening Responsibilities: Consideration Of The Potential To Broaden The Role Of Uniformed Fire Service Employees

What is this report about? This report, commissioned by the National Joint Council for Local Authority Fire and Rescue Services (NJC), aims to identify what impact, if any, firefighters can have on the delivery of emergency medical response and wider community health interventions in the UK. What are the overall conclusions? Appropriately trained and equipped firefighters co-responding1 to targeted, specific time critical medical events, such as cardiac arrest, can improve patient survival rates. The data also indicate that there is support from fire service staff – and a potential need from members of the public, particularly the elderly, isolated or vulnerable – to expand ‘wider work’. This includes winter warmth assessments, Safe and Well checks, community defibrillator training and client referrals when staff believe someone may have dementia, are vulnerable or even, for example, have substance dependencies such as an alcohol addiction. However, there is currently insufficient data to estimate the net benefit of this work

Spatial working memory, not IQ or executive function, discriminates early psychosis and clinically vulnerable creative individuals

© 2020 John Wiley & Sons Australia, Ltd Aim: While associations between creativity and psychopathology have been well researched, the specific cognitive processes that distinguish highly creative from those with psychopathology warrant further investigation. This study will examine whether IQ, executive function, cognitive inhibition or spatial working memory differentiate individuals with early psychosis, clinically vulnerable creative individuals, creative controls and non-creative controls. Methods: The study sample consisted of 110 participants: early psychosis (n = 21); clinically vulnerable creative controls (n = 25); creative controls (n = 30) and non-creative control (n = 34). The Diagnostic Interview for Psychosis assessed early psychosis participants and the Mini Neuropsychiatric Interview was used to screen for psychopathology in the remaining groups. Several cognitive tests were administered: IQ, neurocognitive measures of executive function and spatial working memory. Creativity was assessed using the Torrance Test of Creativity and Creative Achievement Questionnaire. A measure of vividness of mental imagery was also given. Results: Across all cognitive tests, spatial working memory differentiated the early psychosis group from both creative and non-creative control groups. Spatial working memory predicted group membership but vivid imagery was a better predictor of creative achievement. The early psychosis, clinically vulnerable creative and creative groups all recorded significantly higher results on creative achievement and creative cognition compared to non-creative controls. Conclusions: Our results provide further support for spatial working memory as an early neuro-cognitive marker for early psychosis. Spatial working memory, rather than IQ or executive function, may also be an early protective factor for clinically vulnerable young creative individuals

Correction: Incorporating patient perspectives in the development of a core outcome set for reproductive genetic carrier screening: a sequential systematic review.

In Fig. 2 of this article, there is no references included; the figure should have appeared as shown below

Systematic review of outcomes in studies of reproductive genetic carrier screening: Towards development of a core outcome set.

PURPOSE: Current practice recommendations support the widespread implementation of reproductive genetic carrier screening (RGCS). These consensus-based recommendations highlight a research gap, with findings from current studies being insufficient to meet the standard required for more rigorous evidence-based recommendations. This systematic review assessed methodological aspects of studies on RGCS to inform the need for a core outcome set. METHODS: We conducted a systematic search to identify peer-reviewed published studies offering population-based RGCS. Study designs, outcomes, and measurement methods were extracted. A narrative synthesis was conducting using an existing outcome taxonomy and criteria used in the evaluation of genetic screening programs as frameworks. RESULTS: Sixty-five publications were included. We extracted 120 outcomes representing 24 outcome domains. Heterogeneity in outcome selection, measurement methods and time points of assessment was extensive. Quality appraisal raised concerns for bias. We found that reported outcomes had limited applicability to criteria used to evaluate genetic screening programs. CONCLUSION: Despite a large body of literature, diverse approaches to research have limited the conclusions that can be cumulatively drawn from this body of evidence. Consensus regarding meaningful outcomes for evaluation of RGCS would be a valuable first step in working towards evidence-based practice recommendations, supporting the development of a core outcome set

Genetic counseling and testing practices for late-onset neurodegenerative disease: a systematic review

ObjectiveTo understand contemporary genetic counseling and testing practices for late-onset neurodegenerative diseases (LONDs), and identify whether practices address the internationally accepted goals of genetic counseling: interpretation, counseling, education, and support.MethodsFour databases were systematically searched for articles published from 2009 to 2020. Peer-reviewed research articles in English that reported research and clinical genetic counseling and testing practices for LONDs were included. A narrative synthesis was conducted to describe different practices and map genetic counseling activities to the goals. Risk of bias was assessed using the Qualsyst tool. The protocol was registered with PROSPERO (CRD42019121421).ResultsSixty-one studies from 68 papers were included. Most papers focused on predictive testing (58/68) and Huntington's disease (41/68). There was variation between papers in study design, study population, outcomes, interventions, and settings. Although there were commonalities, novel and inconsistent genetic counseling practices were identified. Eighteen papers addressed all four goals of genetic counseling.ConclusionContemporary genetic counseling and testing practices for LONDs are varied and informed by regional differences and the presence of different health providers. A flexible, multidisciplinary, client- and family-centered care continues to emerge. As genetic testing becomes a routine part of care for patients (and their relatives), health providers must balance their limited time and resources with ensuring clients are safely and effectively counseled, and all four genetic counseling goals are addressed. Areas of further research include diagnostic and reproductive genetic counseling/testing practices, evaluations of novel approaches to care, and the role and use of different health providers in practice