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2.
J Phys Chem C Nanomater Interfaces ; 128(31): 13108-13120, 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39140097

RESUMEN

Improved knowledge of the influence of temperature upon layered perovskites is essential to enable perovskite-based devices to operate over a broad temperature range and to elucidate the impact of structural changes upon the optoelectronic properties. We examined the Ruddlesden-Popper layered perovskite 2-thiophenemethylammonium lead iodide (ThMA2PbI4) and observed a structural phase transition between a high- and a low-temperature phase at 220 K using temperature-dependent X-ray diffraction, UV-visible absorption, and photoluminescence (PL) spectroscopy. The structural phase transition altered the tilt pattern of the inorganic octahedra layer, modifying the absorption and PL spectra. Further, we found a narrow and intense additional PL peak in the low-temperature phase, which we assigned to radiative emission from a defect-bound exciton state. In both phases we determined the thermal expansion coefficient and found values similar to those of cubic 3D perovskites, i.e., larger than those of typical substrates such as glass. These results demonstrate that the organic spacer plays a critical role in controlling the temperature-dependent structural and optoelectronic properties of layered perovskites and suggests more widely that strain management strategies may be needed to fully utilize layered perovskites in device applications.

3.
Internet Interv ; 37: 100759, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39149135

RESUMEN

Little is known about the effectiveness of online preventive interventions for paternal perinatal depression (PPD). This systematic review (SR) and meta-analysis (MA) of randomized controlled trials (RCTs) evaluated the effectiveness of online psychological interventions to prevent PPD in fathers and non-birthing partners. The PRISMA 2020 guidelines were followed. The search was conducted in eight electronic databases and other sources from inception to 12 May 2023. The pooled standardized mean difference (SMD) was computed using random-effect models. Seven RCTs were included in the SR and 6 were included in the MA, representing 1.042 fathers from five different countries. No trials focused on non-birthing partners were found. The pooled SMD was -0.258 [95 % confidence interval - 0.513 to -0.004; p < 0.047]. The heterogeneity was moderate (I2 = 51 %; 95%CI [0 % to 81 %]) and nonsignificant (p = 0.070). However, sensitivity analyses showed that the effectiveness was stable only when the fixed effect model and the Egger's g were used to estimate the pooled SMD. No publication bias was found. Only two RCTs had an overall low risk of bias assessed by using the Cochrane ROB 2.0 tool. The quality of evidence based on GRADE was very low. In conclusion, online psychological interventions may be effective for the prevention of PPD. More high-quality evidence is warranted.

4.
Diagnostics (Basel) ; 14(13)2024 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-39001220

RESUMEN

Takayasu arteritis is a chronic inflammatory vasculitis with granulomatous panarteritis particularly impacting large vessels including the aorta and its branches, especially the subclavian arteries, with clinical manifestation dependent on the involved artery. Sequelae of the active disease vary, including stenosis, occlusions, or aneurysmal dilatations of the large vessels. The prevalence of Takayasu arteritis is higher in the Asian population and in Japan, but quite low in the United States, varying from 0.9-8.4 per million people. Ocular manifestations are rare and lead to a delay in diagnosis and appropriate treatment. Ocular manifestations include Takayasu retinopathy, anterior ischemic optic neuropathy (AION), retinal artery occlusion (RAO) and retinal vein occlusion (RVO). We present two cases in which central retinal artery occlusion (CRAO) was associated with Takayasu arteritis. CRAO is an ophthalmic emergency with an incidence of 1.9 per 100,000 person years in the United States; only 5% of cases are arteritic, which can be observed with inflammatory vasculitides secondary to the formation of immune deposits.

5.
Dalton Trans ; 53(28): 11884-11894, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-38953525

RESUMEN

Synthesis and reactivity with carbon dioxide (CO2) of divalent samarium in the bis-tris(pyrazolyl)borate ligand environment has been reported. In addition, CO2 activation and functionalisation by lanthanide silylamides in the bis-tris(pyrazolyl)borate ligand environment was demonstrated. Reduction of the Sm(III) precursor [Sm(Tp)2(OTf)] (Tp = hydrotris(1-pyrazolyl)borate; OTf = triflate) with KC8 yielded the insoluble Sm(II) multi-metallic coordination polymer [{Sm(Tp)2}n] 1-Sm. Addition of 1,2-dimethoxyethane (DME) to 1-Sm enabled isolation of the monomeric complex [Sm(Tp)2(DME)] 1-Sm(DME). Complex 1-Sm(DME) reduced CO2 to yield the oxalate-bridged dimeric Sm(III) complex [{Sm(Tp)2}2(µ-η2:η2-O2CCO2)] 2-Sm. The reactions of heteroleptic Ln(III) silylamide complexes [Ln(Tp)2(N'')] (Ln = Y, Sm; N'' = N(SiMe3)2) with CO2 yielded monomeric Ln(III) silyloxides [Ln(Tp)2(OSiMe3)] 3-Ln and trimethylsilyl isocyanate (OCNSiMe3). Complexes 3-Ln are the first crystallographically characterised examples of Ln(III)-OSiMe3 bonds accessed via CO2 activation and functionalisation. Full characterisation data are presented for all complexes, including solid-state molecular structure determination by single-crystal X-ray diffraction.

6.
Artículo en Inglés | MEDLINE | ID: mdl-39033352

RESUMEN

OBJECTIVE: Representation of women and minority groups is traditionally low in Otolaryngology-Head & Neck Surgery (OHNS). This cross-sectional study aims to assess the difference in gender and racial/ethnic representation within Academic North American pediatric OHNS. STUDY DESIGN: Cross-sectional study of North American pediatric OHNS faculty websites. SETTING: North America. METHODS: Canadian and American residency program registries were searched for accredited OHNS programs. Pediatric OHNS faculty were identified through program websites. Information regarding gender, race/ethnicity, time in practice, research productivity, academic title, and leadership positions was extracted from public profiles and Scopus. Demographic and academic data was also extracted for OHNS and pediatric OHNS department/division chairs. RESULTS: North American academic pediatric OHNS websites listed 516 surgeons, of whom 39.9% were women. Most surgeons were perceived as White (69.0%), followed by Asian (24.0%), Hispanic (3.7%), and Black (3.3%). Women surgeons had lower h-indices, less publications, and less citations than men (P < .001). Despite women surgeons having fewer years in practice (median 8.0 vs 13.0, P < .001), gender-differences in h-index persisted when controlling for years in practice (P < .05). Men surgeons had higher academic titles (P < .001), but there was no gender difference in leadership roles while accounting for years in practice (P = .559). White surgeons had higher academic titles than non-White surgeons (P = .018). There was no racial/ethnic difference in leadership roles (P = .392). CONCLUSION: Most pediatric OHNS surgeons are men and/or White. Significant gender-differences in research productivity and academic title exist, however surgeons of racial/ethnic minority have similar research productivity as their racial/ethnic majority counterparts.

7.
Semin Perinatol ; : 151942, 2024 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-39048414

RESUMEN

Perinatal mental health care differs around the world. We provide a global perspective on the current status of service provision, barriers and facilitators to access, and strategies to improve access in high-income and low- and middle-income countries across five continents (Asia, Africa, Europe, North America and South America). Many of the countries considered do not have universal healthcare coverage. This poses a challenge to perinatal mental health care access. However, there are other social and structural barriers to access, including stigma and other sources of marginalization and discrimination. Yet there are opportunities discussed herein to learn more about what perinatal mental health services work for what populations* and in what circumstances, by adopting a global lens to examine innovative solutions utilized across geographical settings.

8.
PLOS Glob Public Health ; 4(7): e0003031, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38976687

RESUMEN

Evidence from low- and middle-income countries suggests that non-specialist-delivered interventions effectively improve access to perinatal mental health care. However, there have been no systematic attempts to synthesize the evidence on effectiveness, relevance, and application of this strategy to resource-limited settings such as rural areas. The aim of this review is to synthesize the evidence about the effectiveness of non-specialist delivered interventions in improving depression and related outcomes in women with perinatal depression living in rural communities. Seven electronic databases were searched using the following search concepts: perinatal depression (e.g., puerperal depression, antenatal depression), rural areas (e.g., remote, nonmetropolitan, underserved), and non-specialist workers (e.g., lay worker, volunteer aide, informal caretaker. The risk of bias was assessed using RoB-2 and ROBINS-I tools. A narrative synthesis was performed as the high degree of study heterogeneity precluded a meta-analysis. Nine unique studies were eligible for inclusion. Psychoeducation and problem-solving techniques were the most used intervention elements. Two interventions significantly reduced the prevalence of perinatal depression compared to usual care, and three interventions reported effectiveness in reducing depression symptom severity. There was little to no consistent evidence for other outcomes, including but not limited to maternal health care utilization, breastfeeding behaviors, and child health. This review provides limited evidence to suggest that non-specialist delivered interventions effectively improved outcomes among women with perinatal depression living in rural communities. The paucity of high-quality studies included in this review demonstrates that this rural demographic is frequently neglected in the context of maternal mental health research.

9.
Surgery ; 176(3): 692-699, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38987094

RESUMEN

BACKGROUND: Although most general surgery residency interviews remain virtual, the effect of this format remains understudied. Single-institution data have shown an increase in the number of applications received and interviews conducted with virtual interviewing but no change in the geographic backgrounds of interviewed or matched applicants. This study sought to compare national trends in geographic characteristics of general surgery applicants, interviewed applicants, and matched applicants between in-person and virtual application cycles. STUDY DESIGN: A retrospective review of 7 general surgery residency programs from application years 2016-2019 (in-person) and 2020-2021 (virtual) was conducted. Data collected included birth year, sex, race, medical school state, and contact location at the time of application. Data were analyzed using generalized mixed effects linear models. RESULTS: A total of 52,742 applicants, 4,550 interviewed applicants, and 329 matched applicants were included. During virtual application cycles, there were no increases in the average number of applicants (P = .25), interviewed applicants (P = .36), or matched (P = .84) applicants per year. Virtual cycles were associated with a larger proportion of interviews conducted with applicants from out-of-state medical schools (P < .01) and listing out-of-state contact locations (P < .01) compared with in-person application cycles. There were no significant geographic differences in matched applicants between virtual and in-person application cycles. CONCLUSION: Virtual application cycles had greater geographic diversity among interviewed applicants. However, similar differences were not seen in the geographic diversity of matched applicants. Additional efforts should focus on why no changes in the geographic diversity of matched applicants were identified.


Asunto(s)
Cirugía General , Internado y Residencia , Entrevistas como Asunto , Humanos , Internado y Residencia/estadística & datos numéricos , Estudios Retrospectivos , Cirugía General/educación , Masculino , Femenino , Entrevistas como Asunto/métodos , Estados Unidos , Selección de Personal/métodos , Selección de Personal/tendencias , Evaluación de Programas y Proyectos de Salud
10.
J Surg Educ ; 81(8): 1075-1082, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38834433

RESUMEN

OBJECTIVES: Previous literature has consistently documented harassment and discrimination in surgery. These experiences may contribute to the continuing gender inequity in surgical fields. The objective of our study was to survey Canadian surgeons and surgical trainees to gain a greater understanding of the experience of harassment across genders, career stage, and specialty. METHODS: A cross-sectional, online survey was distributed to Canadian residents, fellows, and practicing surgeons in general surgery, plastic surgery, and neurosurgery through their national society email lists and via social media posts. RESULTS: There were 194 included survey respondents (60 residents, 11 fellows, and 123 staff) from general surgery (44.8%), plastic surgery (42.7%), and neurosurgery (12.5%). 59.8% of women reported having experienced harassment compared to only 26.0% of men. Women were significantly more likely to be harassed by colleagues and patients/families compared to men. Residents (62.5%) were two times more likely to report being harassed compared to fellows/staff (38.3%). Residents were significantly more likely to be harassed by patients/families while fellows/staff were more likely to be harassed by colleagues. There were no significant differences in self-reported harassment across the three surgical specialties. There was no significant difference in rates of reported harassment between current residents (62.5%), and fellow/staff recollections of their experiences of harassment during residency (59.2%). CONCLUSIONS: The prevalence of gender-based discrimination remains high and harassment prevalence remains largely unchanged from when current staff were in residency. Our findings highlight a need to implement systemic changes to support the increasing number of women entering surgery, and to improve surgical culture to continue to attract the best and brightest to the field.


Asunto(s)
Internado y Residencia , Humanos , Femenino , Estudios Transversales , Canadá , Masculino , Encuestas y Cuestionarios , Adulto , Acoso Sexual/estadística & datos numéricos , Especialidades Quirúrgicas , Cirugía General/educación , Sexismo , Médicos Mujeres/estadística & datos numéricos , Médicos Mujeres/psicología
11.
Artículo en Inglés | MEDLINE | ID: mdl-38853466

RESUMEN

ISSUE ADDRESSED: The Healthy Me, Healthy Planet program was an evidence-informed pilot program conducted by a local libraries to promote the health co-benefits of action on climate change. BACKGROUND: An impact evaluation of the Healthy Me, Healthy Planet program was conducted using a mixed methods research design including pre-, during, and post-program surveys and online focus groups. METHODS: The evaluation included 136 participants aged 18+ years who were able to understand and communicate in English or simplified Chinese language. Descriptive analyses of the survey data were integrated with thematic analyses of focus group (N = 2) data to generate key themes. RESULTS: Key impacts included individual and organisational capacity building, personal and social well-being, and pro-environmental knowledge, attitudes, and behaviour. Impacts on program participants included increased confidence, motivation, positive feelings, and personal well-being after taking part in the Healthy Me, Healthy Planet program. Participants reported enhanced social connections, mental well-being, and environmental benefits such as engaging within the community on environmental issues and feeling inspired to make sustainable lifestyle changes. CONCLUSION: Libraries play a key role in promoting the health of people and planet in the community because they are a trusted, safe, and supportive community setting, a curator of credible and reliable evidence-based information on health and planetary topics and a local and free provider for skills and literacy development. SO WHAT: The evaluation of the pilot suggests that participants improved their capacity to practice sustainable living and it is recommended that this program be expanded to other library settings to enhance community connection and support local planetary health initiatives.

12.
HERD ; : 19375867241251832, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38742749

RESUMEN

OBJECTIVE: To identify, examine, and map the characteristics of knowledge of nature-based design in stroke rehabilitation facilities, examine how research in this field has been conducted and identify gaps in knowledge. BACKGROUND: Many stroke survivors have wide ranging impacts, resulting in long hospital stays to undertake rehabilitation. The physical environment can influence brain recovery; however, there is limited evidence to support the design of effective rehabilitation environments. Conversely, the health benefits available from connection with nature are well established. A nature-based design approach may have benefits and implications for the physical environment of inpatient stroke rehabilitation facilities; however, it is unclear what evidence exists in this field. METHOD: This scoping review followed the JBI methodological guidance for the conduct of scoping reviews, with systematic searches of six databases. RESULTS: Twenty-eight studies were included in the review. Aims and research methods varied widely. Investigations in 19 studies related to gardens and other designed outdoor nature-based environments. Other studies explored natural analogues, nature inside, inside/outside connections, and the natural environment. Findings from the studies were spread across the fields of design, use, exposure to, and engagement in nature-based environments. CONCLUSION: The characteristics of knowledge underpinning nature-based design in stroke rehabilitation environments are highly diverse, and significant gaps exist in the evidence base. A framework developed during this review for mapping knowledge on the intentions and impacts for spaces and services in this field assisted to identify these gaps and may be applied to other areas of healthcare design research.

13.
JBMR Plus ; 8(6): ziae053, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38715931

RESUMEN

Diabetes predisposes to spine degenerative diseases often requiring surgical intervention. However, the statistics on the prevalence of spinal fusion success and clinical indications leading to the revision surgery in diabetes are conflicting. The purpose of the presented retrospective observational study was to determine the link between diabetes and lumbar spinal fusion complications using a database of patients (n = 552, 45% male, age 54 ± 13.7 years) residing in the same community and receiving care at the same health care facility. Outcome measures included clinical indications and calculated risk ratio (RR) for revision surgery in diabetes. Paravertebral tissue recovered from a non-union site of diabetic and nondiabetic patients was analyzed for microstructure of newly formed bone. Diabetes increased the RR for revision surgery due to non-union complications (2.80; 95% CI, 1.12-7.02) and degenerative processes in adjacent spine segments (2.26; 95% CI, 1.45-3.53). In diabetes, a risk of revision surgery exceeded the RR for primary spinal fusion surgery by 44% (2.36 [95% CI, 1.58-3.52] vs 1.64 [95% CI, 1.16-2.31]), which was already 2-fold higher than diabetes prevalence in the studied community. Micro-CT of bony fragments found in the paravertebral tissue harvested during revision surgery revealed structural differences suggesting that newly formed bone in diabetic patients may be of compromised quality, as compared with that in nondiabetic patients. In conclusion, diabetes significantly increases the risk of unsuccessful lumbar spine fusion outcome requiring revision surgery. Diabetes predisposes to the degeneration of adjacent spine segments and pseudoarthrosis at the fusion sites, and affects the structure of newly formed bone needed to stabilize fusion.

14.
PLoS One ; 19(5): e0304019, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38771748

RESUMEN

Climate change can have direct and indirect effects on human health. Direct effects can include an increase in extreme weather events, such as heatwaves and floods, as well as an increase in the spread of vector-borne and infectious diseases, which may lead to a set of health problems and diseases. Indirect effects can include changes in air quality, water availability, and food production and distribution. These changes can lead to an increase in respiratory problems, malnutrition, and increased food insecurity. There is a perceived need to investigate the extent to which Higher Education Institutions (HEIs) are engaged in efforts to foster a greater understanding of the connections between climate change and health. In this context, this preliminary investigation offers an overview of the relationships between climate change and health. By means of a survey among teaching staff and researchers at HEIs from 42 countries across all continents working on the connection between climate change and health. The study has investigated the extent to which current provisions for education and training on the connection between climate change and health are being considered and how current needs in terms of policy development, research, and training are being met. A series of case studies illustrate how universities worldwide are actively developing strategies and implementing measures to address climate change and health. The study concludes by providing specific recommendations aimed at facilitating the handling of issues related to climate change and health in a higher education context.


Asunto(s)
Cambio Climático , Humanos , Universidades , Encuestas y Cuestionarios
15.
Pediatr Blood Cancer ; 71(7): e31026, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38679864

RESUMEN

PURPOSE: Our objectives were to compare overall survival (OS) and pulmonary relapse between patients with metastatic Ewing sarcoma (EWS) at diagnosis who achieve rapid complete response (RCR) and those with residual pulmonary nodules after induction chemotherapy (non-RCR). PATIENTS AND METHODS: This retrospective cohort study included children under 20 years with metastatic EWS treated from 2007 to 2020 at 19 institutions in the Pediatric Surgical Oncology Research Collaborative. Chi-square tests were conducted for differences among groups. Kaplan-Meier curves were generated for OS and pulmonary relapse. RESULTS: Among 148 patients with metastatic EWS at diagnosis, 61 (41.2%) achieved RCR. Five-year OS was 71.2% for patients who achieved RCR, and 50.2% for those without RCR (p = .04), and in multivariable regression among patients with isolated pulmonary metastases, RCR (hazards ratio [HR] 0.42; 95% confidence interval [CI]: 0.17-0.99) and whole lung irradiation (WLI) (HR 0.35; 95% CI: 0.16-0.77) were associated with improved survival. Pulmonary relapse occurred in 57 (37%) patients, including 18 (29%) in the RCR and 36 (41%) in the non-RCR groups (p = .14). Five-year pulmonary relapse rates did not significantly differ based on RCR (33.0%) versus non-RCR (47.0%, p = .13), or WLI (38.8%) versus no WLI (46.0%, p = .32). DISCUSSION: Patients with EWS who had isolated pulmonary metastases at diagnosis had improved OS if they achieved RCR and received WLI, despite having no significant differences in rates of pulmonary relapse.


Asunto(s)
Neoplasias Óseas , Neoplasias Pulmonares , Sarcoma de Ewing , Humanos , Sarcoma de Ewing/mortalidad , Sarcoma de Ewing/terapia , Sarcoma de Ewing/patología , Femenino , Masculino , Niño , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/secundario , Estudios Retrospectivos , Adolescente , Neoplasias Óseas/mortalidad , Neoplasias Óseas/terapia , Neoplasias Óseas/secundario , Neoplasias Óseas/patología , Preescolar , Tasa de Supervivencia , Pronóstico , Estudios de Seguimiento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Adulto Joven , Inducción de Remisión , Lactante , Recurrencia Local de Neoplasia/mortalidad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/terapia , Quimioterapia de Inducción
16.
Cardiovasc Res ; 120(8): 927-942, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38661182

RESUMEN

AIMS: In patients with heart failure (HF), concomitant sinus node dysfunction (SND) is an important predictor of mortality, yet its molecular underpinnings are poorly understood. Using proteomics, this study aimed to dissect the protein and phosphorylation remodelling within the sinus node in an animal model of HF with concurrent SND. METHODS AND RESULTS: We acquired deep sinus node proteomes and phosphoproteomes in mice with heart failure and SND and report extensive remodelling. Intersecting the measured (phospho)proteome changes with human genomics pharmacovigilance data, highlighted downregulated proteins involved in electrical activity such as the pacemaker ion channel, Hcn4. We confirmed the importance of ion channel downregulation for sinus node physiology using computer modelling. Guided by the proteomics data, we hypothesized that an inflammatory response may drive the electrophysiological remodeling underlying SND in heart failure. In support of this, experimentally induced inflammation downregulated Hcn4 and slowed pacemaking in the isolated sinus node. From the proteomics data we identified proinflammatory cytokine-like protein galectin-3 as a potential target to mitigate the effect. Indeed, in vivo suppression of galectin-3 in the animal model of heart failure prevented SND. CONCLUSION: Collectively, we outline the protein and phosphorylation remodeling of SND in heart failure, we highlight a role for inflammation in electrophysiological remodelling of the sinus node, and we present galectin-3 signalling as a target to ameliorate SND in heart failure.


Asunto(s)
Modelos Animales de Enfermedad , Insuficiencia Cardíaca , Canales Regulados por Nucleótidos Cíclicos Activados por Hiperpolarización , Ratones Endogámicos C57BL , Proteómica , Síndrome del Seno Enfermo , Nodo Sinoatrial , Animales , Insuficiencia Cardíaca/metabolismo , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/genética , Insuficiencia Cardíaca/patología , Canales Regulados por Nucleótidos Cíclicos Activados por Hiperpolarización/metabolismo , Canales Regulados por Nucleótidos Cíclicos Activados por Hiperpolarización/genética , Nodo Sinoatrial/metabolismo , Nodo Sinoatrial/fisiopatología , Fosforilación , Síndrome del Seno Enfermo/metabolismo , Síndrome del Seno Enfermo/fisiopatología , Síndrome del Seno Enfermo/genética , Masculino , Mediadores de Inflamación/metabolismo , Inflamación/metabolismo , Inflamación/fisiopatología , Inflamación/patología , Frecuencia Cardíaca , Canales de Potasio/metabolismo , Canales de Potasio/genética , Simulación por Computador , Modelos Cardiovasculares , Humanos , Transducción de Señal , Potenciales de Acción
17.
Inorg Chem ; 63(21): 9390-9394, 2024 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-38682828

RESUMEN

Molecular heterobimetallic hydride complexes of lanthanide (Ln) and main-group (MG) metals exhibit chemical properties unique from their monometallic counterparts and are highly reactive species, making their synthesis and isolation challenging. Herein, molecular Ln/Al heterobimetallic trihydrides [Ln(Tp)2(µ-H)2Al(H)(N″)] [2-Ln; Ln = Y, Sm, Dy, Yb; Tp = hydrotris(1-pyrazolyl)borate; N″ = N(SiMe3)2] have been synthesized by facile insertion of aminoalane [Me3N·AlH3] into the Ln-N amide bonds of [Ln(Tp)2(N″)] (1-Ln). Thus, this is a simple synthetic strategy to access a range of Ln/Al hydrides. Reactivity studies demonstrate that 2-Ln is a heterobimetallic hydride, with evidence for the cooperative nature of 2-Ln shown by the catalytic amine-borane dehydrocoupling under ambient conditions in contrast to its monomeric counterparts.

18.
BJPsych Bull ; : 1-6, 2024 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-38639203

RESUMEN

AIMS AND METHOD: Our team of core and higher psychiatry trainees aimed to improve secondary mental health service detection of and response to gender-based violence (GBV) in South East London. We audited home treatment team (HTT), drug and alcohol (D&A) service and in-patient ward clinical records (n = 90) for female and non-binary patients. We implemented brief, cost-neutral staff engagement and education interventions at service, borough and trust levels before re-auditing (n = 86), completing a plan-do-study-act cycle. RESULTS: Documented enquiry about exposure to GBV increased by 30% (HTT), 15% (ward) and 7% (D&A), post-intervention. We identified staff training needs and support for improving GBV care. Up to 56% of records identified psychiatric symptoms related to GBV exposure. CLINICAL IMPLICATIONS: Moves to make mental healthcare more trauma-informed rely on services first being supportive environments for enquiry, disclosure and response to traumatic stressors. Our collaborative approach across clinical services increased GBV enquiry and documentation. The quality of response is more difficult to measure and requires concerted attention.

19.
Front Glob Womens Health ; 5: 1347388, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38449695

RESUMEN

Introduction: The COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal) were exposed to a number of risk factors for mental ill health, including alterations to the way in which their perinatal care was delivered. Methods: A consensus statement was derived from a cross-disciplinary collaboration of experts, whereby evidence from collaborative work on perinatal mental health during the COVID-19 pandemic was synthesised, and priorities were established as recommendations for research, healthcare practice, and policy. Results: The synthesis of research focused on the effect of the COVID-19 pandemic on perinatal health outcomes and care practices led to three immediate recommendations: what to retain, what to reinstate, and what to remove from perinatal mental healthcare provision. Longer-term recommendations for action were also made, categorised as follows: Equity and Relational Healthcare; Parity of Esteem in Mental and Physical Healthcare with an Emphasis on Specialist Perinatal Services; and Horizon Scanning for Perinatal Mental Health Research, Policy, & Practice. Discussion: The evidence base on the effect of the pandemic on perinatal mental health is growing. This consensus statement synthesises said evidence and makes recommendations for a post-pandemic recovery and re-build of perinatal mental health services and care provision.

20.
J Pediatr Surg ; 59(5): 768-773, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38368196

RESUMEN

BACKGROUND: Social media is one of the most common sources of information for parents seeking information on their child's health. The purpose of this study was to better understand the social media habits of parents of paediatric surgery patients through surveys and focus groups. METHODS: An online survey was distributed to parents visiting paediatric surgery clinics at a tertiary care hospital. Surveys were distributed via QR code and social media. Two virtual focus groups were conducted with parents of paediatric patients. Descriptive statistics were used for survey analysis and focus group transcripts were thematically analyzed. RESULTS: A total of 107 respondents completed the online survey. Median age of respondents was 36 (interquartile range: 32-41). 81.3% of the respondents were female. Facebook was the preferred social media platform (47.2%), followed by Instagram (41.5%) then other platforms (4.7%). Respondents indicated that their preferred length of video was 30 s (41.2%). When asked which type of video content they prefer, participants indicated animated video as most popular (66.0%) followed by a physician speaking (60.0%), and slides with voiceover (45.0%). The focus groups revealed themes of: (1) functionality and content; (2) branding, aesthetic and legitimacy; (3) unmasking of physicians; (4) peer and community support. CONCLUSION: Creating a successful social media account for parents must take into consideration their social media habits. A Facebook account that features brief videos may be most likely to engage parents. Additionally, physicians need to establish credibility and legitimacy of their content to attract their target audience. LEVEL OF EVIDENCE: III.


Asunto(s)
Médicos , Medios de Comunicación Sociales , Especialidades Quirúrgicas , Humanos , Niño , Femenino , Masculino , Padres , Encuestas y Cuestionarios
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