Idaho Department of Health and Welfare Provider Awareness Campaign Evaluation 2023

The Idaho Department of Health and Welfare’s (IDHW) Drug Overdose Prevention Program (DOPP) partnered with Boise State University’s Idaho Policy Institute (IPI) to evaluate the provider awareness campaign that took place from March 2023 to May 2023. The primary goals of the campaign were to encourage compassionate language when talking to and about patients with substance use disorder (SUD) and to increase screening and treatment of SUD. To evaluate the provider awareness campaign’s reach and effectiveness, IPI conducted a survey of health care providers and health center staff at community health centers (CHCs) and Tribal health centers across Idaho. Some analysis in this technical report compares two groups of survey respondents, a test group whose health center received the provider awareness campaign’s collateral or in-clinic materials and a control whose health centers did not receive the campaign’s collateral materials. The survey assessed the knowledge, attitudes, and beliefs surrounding substance use, screening behavior, and prescribing behavior among health care providers within health centers. Key takeaways from this technical report include: The provider awareness campaign reached 27.5% of total respondents, including 36.6% of the test group and 20.0% of the control group. Online and social media advertisements were the most common places respondents saw the provider awareness campaign materials. When asked about the provider awareness campaign’s effectiveness, 55.5% of respondents said the campaign was at least a little effective. Respondents overwhelmingly agreed that SUD is a treatable chronic disease and that anyone can develop SUD. Approximately half of all respondents believe they have enough training and clinical resources to help patients with SUD. A majority of respondents who screen patients for SUD and prescribe medication to treat SUD feel confident in their ability to work with patients with SUD

Idaho Department of Health and Welfare Fentanyl Awareness Campaign Evaluation 2023

The Idaho Department of Health and Welfare’s (IDHW) Drug Overdose Prevention Program (DOPP) partnered with Boise State University’s Idaho Policy Institute (IPI) to conduct an evaluation of the fentanyl awareness campaign that took place from June 2022 to December 2022. The primary goals of the campaign were to increase awareness of risks associated with cross-contamination of drugs with fentanyl and increase use of overdose reversing medication. To evaluate the fentanyl awareness campaign’s reach and effectiveness, IPI conducted a statewide survey that is representative of Idaho’s population. The survey included questions about perceptions of the magnitude of illegal substance use in Idaho, general knowledge related to fentanyl use, familiarity with the fentanyl awareness campaign, and overall impressions of the campaign materials. Key takeaways from this technical report include: Idahoans are largely aware that fentanyl overdose is a critical problem and a majority have knowledge of the drug, but fewer know details about treatments such as naloxone. The fentanyl awareness campaign reached approximately 14.0% of Idahoans. Online and social media advertisements were the most common places respondents saw the fentanyl awareness campaign materials. When asked about the fentanyl awareness campaign’s effectiveness, 73.5% of Idahoans said the campaign was at least a little effective. Approximately 11.3% of Idahoans report using drugs not prescribed by a health care provider and 31.8% of Idahoans say they have friends or family that do so. Respondents who saw the fentanyl awareness campaign materials reported significantly higher rates of seeking information and treatment about substance use

No Al Carbone Brindisi

I am the founding member of the artist-led collective Environmental Resistance. Working under the name of Environmental Resistance, this publication represents a collaboration with the activist group No Al Carbone ('No to Coal'), who are a group of environmental activists from Brindisi, Puglia. This publication was dedicated to No Al Carbone and was intended to provide the activists with a ‘toolkit’ for engaging in advocacy debates with public or state officials in the Brindisi region. In the No Al Carbone, Brindisi publication, meaning in the photographs of the polluted Brindisi Industrial Zone, is anchored to a series of captions alluding to various scientific studies, which point towards Brindisi having elevated rates of cancer, COPD, congenital birth defects, when compared to other regions in Italy and beyond

Understanding employers' graduate recruitment and selection practices. BIS Research Paper 231.

This research examined the approach to graduate recruitment adopted by employers and how this has evolved in recent years. In particular the study aimed to explore patterns in graduate recruitment, behaviours of graduate employers and interactions between graduate employers and universities. It therefore provides a picture of long-term trends in practice from pre-recruitment activities through to entry, induction and beyond, and before, during and after the recession; and indicates the ways in which employers’ thinking about recruitment and selection have, and are, changing and developing. The research was driven by a need to update the evidence and understanding of recruitment practice as the population of graduates has increased dramatically and become more heterogeneous; the labour market has changed, emerging from difficult economic conditions; and there is increasing policy interest in diversity and particularly in social mobility.Department for Business, Innovation and Skills

Knowledge exchange and research capacity building in urban Aboriginal health

The Centre for Research Excellence (CRE) on urban Aboriginal Child Health is linked to this unique base of information on 1600 children and their parents/ caregivers. The Centre is designed to: (a) increase the translation of knowledge arising from the SEARCH program and additional data collection undertaken as part of the CRE; (b) to enable ACCHSs to effectively use the information emerging from SEARCH to improve the quality of primary care, and; (c) enhance research capacity in primary health care within ACCHSs by increasing their capacity to undertake multidisciplinary research and knowledge translation in primary care. This work will provide evidence to support sustainable and transferable improvements in Aboriginal primary health care and, ultimately, health outcomes.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Fibro-inflammatory recovery and type 2 diabetes remission following a low calorie diet but not exercise training: A secondary analysis of the DIASTOLIC randomised controlled trial

AimsTo investigate the relationship between fibro-inflammatory biomarkers and cardiovascular structure/function in people with Type 2 Diabetes (T2D) compared to healthy controls and the effect of two lifestyle interventions in T2D.MethodsData were derived from the DIASTOLIC randomised controlled trial (RCT) and includes a comparison between those with T2D and the matched healthy volunteers recruited at baseline. Adults with T2D without cardiovascular disease (CVD) were randomized to a 12-week intervention either: (1) exercise training, (2) a low-energy (∼810 kcal/day) meal-replacement plan (MRP) or (3) standard care. Principal Component and Fisher's linear discriminant analysis were used to investigate the relationships between MRI acquired cardiovascular outcomes and fibro-inflammatory biomarkers in cases versus controls and pre- and post-intervention in T2D.ResultsAt baseline, 83 people with T2D (mean age 50.5 ± 6.4; 58% male) and 36 healthy controls (mean age 48.6 ± 6.2; 53% male) were compared and 76 people with T2D completed the RCT for pre- post-analysis. Compared to healthy controls, subjects with T2D had adverse cardiovascular remodelling and a fibro-inflammatory profile (20 differentially expressed biomarkers). The 3D data visualisations showed almost complete separation between healthy controls and those with T2D, and a marked shift towards healthy controls following the MRP (15 biomarkers significantly changed) but not exercise training.ConclusionsFibro-inflammatory pathways and cardiovascular structure/function are adversely altered before the onset of symptomatic CVD in middle-aged adults with T2D. The MRP improved the fibro-inflammatory profile of people with T2D towards a more healthy status. Long-term studies are required to assess whether these changes lead to continued reverse cardiac remodelling and prevent CVD

Early development of infants with neurofibromatosis type 1: a case series

Background Prospective studies of infants at familial risk for autism spectrum disorder (ASD) have yielded insights into the earliest signs of the disorder but represent heterogeneous samples of unclear aetiology. Complementing this approach by studying cohorts of infants with monogenic syndromes associated with high rates of ASD offers the opportunity to elucidate the factors that lead to ASD. Methods We present the first report from a prospective study of ten 10-month-old infants with neurofibromatosis type 1 (NF1), a monogenic disorder with high prevalence of ASD or ASD symptomatology. We compared data from infants with NF1 to a large cohort of infants at familial risk for ASD, separated by outcome at age 3 of ASD (n = 34), atypical development (n = 44), or typical development (n = 89), and low-risk controls (n = 75). Domains assessed at 10 months by parent report and examiner observation include cognitive and adaptive function, sensory processing, social engagement, and temperament. Results Infants with NF1 showed striking impairments in motor functioning relative to low-risk infants; this pattern was seen in infants with later ASD from the familial cohort (HR-ASD). Both infants with NF1 and the HR-ASD group showed communication delays relative to low-risk infants. Conclusions Ten-month-old infants with NF1 show a range of developmental difficulties that were particularly striking in motor and communication domains. As with HR-ASD infants, social skills at this age were not notably impaired. This is some of the first information on early neurodevelopment in NF1. Strong inferences are limited by the sample size, but the findings suggest implications for early comparative developmental science and highlight motor functioning as an important domain to inform the development of relevant animal models. The findings have clinical implications in indicating an important focus for early surveillance and remediation in this early diagnosed genetic disorder

Effect of a Perioperative, Cardiac Output-Guided Hemodynamic Therapy Algorithm on Outcomes Following Major Gastrointestinal Surgery A Randomized Clinical Trial and Systematic Review

Importance: small trials suggest that postoperative outcomes may be improved by the use of cardiac output monitoring to guide administration of intravenous fluid and inotropic drugs as part of a hemodynamic therapy algorithm.Objective: to evaluate the clinical effectiveness of a perioperative, cardiac output–guided hemodynamic therapy algorithm.Design, setting, and participants: OPTIMISE was a pragmatic, multicenter, randomized, observer-blinded trial of 734 high-risk patients aged 50 years or older undergoing major gastrointestinal surgery at 17 acute care hospitals in the United Kingdom. An updated systematic review and meta-analysis were also conducted including randomized trials published from 1966 to February 2014.Interventions: patients were randomly assigned to a cardiac output–guided hemodynamic therapy algorithm for intravenous fluid and inotrope (dopexamine) infusion during and 6 hours following surgery (n=368) or to usual care (n=366).Main outcomes and measures: the primary outcome was a composite of predefined 30-day moderate or major complications and mortality. Secondary outcomes were morbidity on day 7; infection, critical care–free days, and all-cause mortality at 30 days; all-cause mortality at 180 days; and length of hospital stay.Results: baseline patient characteristics, clinical care, and volumes of intravenous fluid were similar between groups. Care was nonadherent to the allocated treatment for less than 10% of patients in each group. The primary outcome occurred in 36.6% of intervention and 43.4% of usual care participants (relative risk [RR], 0.84 [95% CI, 0.71-1.01]; absolute risk reduction, 6.8% [95% CI, ?0.3% to 13.9%]; P?=?.07). There was no significant difference between groups for any secondary outcomes. Five intervention patients (1.4%) experienced cardiovascular serious adverse events within 24 hours compared with none in the usual care group. Findings of the meta-analysis of 38 trials, including data from this study, suggest that the intervention is associated with fewer complications (intervention, 488/1548 [31.5%] vs control, 614/1476 [41.6%]; RR, 0.77 [95% CI, 0.71-0.83]) and a nonsignificant reduction in hospital, 28-day, or 30-day mortality (intervention, 159/3215 deaths [4.9%] vs control, 206/3160 deaths [6.5%]; RR, 0.82 [95% CI, 0.67-1.01]) and mortality at longest follow-up (intervention, 267/3215 deaths [8.3%] vs control, 327/3160 deaths [10.3%]; RR, 0.86 [95% CI, 0.74-1.00]).Conclusions and relevance: in a randomized trial of high-risk patients undergoing major gastrointestinal surgery, use of a cardiac output–guided hemodynamic therapy algorithm compared with usual care did not reduce a composite outcome of complications and 30-day mortality. However, inclusion of these data in an updated meta-analysis indicates that the intervention was associated with a reduction in complication rate

Early differences in auditory processing relate to Autism Spectrum Disorder traits in infants with Neurofibromatosis Type I

Abstract: Background: Sensory modulation difficulties are common in children with conditions such as Autism Spectrum Disorder (ASD) and could contribute to other social and non-social symptoms. Positing a causal role for sensory processing differences requires observing atypical sensory reactivity prior to the emergence of other symptoms, which can be achieved through prospective studies. Methods: In this longitudinal study, we examined auditory repetition suppression and change detection at 5 and 10 months in infants with and without Neurofibromatosis Type 1 (NF1), a condition associated with higher likelihood of developing ASD. Results: In typically developing infants, suppression to vowel repetition and enhanced responses to vowel/pitch change decreased with age over posterior regions, becoming more frontally specific; age-related change was diminished in the NF1 group. Whilst both groups detected changes in vowel and pitch, the NF1 group were largely slower to show a differentiated neural response. Auditory responses did not relate to later language, but were related to later ASD traits. Conclusions: These findings represent the first demonstration of atypical brain responses to sounds in infants with NF1 and suggest they may relate to the likelihood of later ASD

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden