Which obstetrics-gynecology residency programs are training future reproductive endocrinology and infertility fellows? An observational study.

Objective: To identify where reproductive endocrinology and infertility (REI) fellows trained for residency. Design: Observational, cross-sectional study. Setting: Not applicable. Subjects: Reproductive endocrinology and infertility fellows. Interventions: Not applicable. Main Outcome Measures: Percentage of fellows who completed residency training at an institution with an REI fellowship program. Results: A total of 289 fellows were identified among the graduating fellowship classes from 2023-2027. Of those fellows, 69.9% completed residency at an institution that had an associated REI fellowship program, and 19.7% remained at the same institution for residency and fellowship. In the last 5 years, 34.4% of obstetrics and gynecology residency programs have had at least 1 resident enter REI fellowship. Conclusions: Most matriculated REI fellow physicians train at residency programs that have an associated REI fellowship program.

Mortality, Cardiovascular Disease, and Their Associations With Risk Factors in Southeast Asia: A PURE Substudy.

Background: The drivers of cardiovascular disease (CVD) and all-cause mortality may differ around the world. Regional-level prospective data can help guide policies to reduce CVD and all-cause mortality. Objectives: This study examined the incidence of CVD and mortality in Malaysia and the Philippines and estimated the population-level risks attributable to common risk factors for each outcome. Methods: This prospective cohort study included 20,272 participants from Malaysia and the Philippines. The mean follow-up was 8.2 years. The incidences of CVD and mortality rates were calculated for the overall cohort and in key subgroups. For each outcome, population-attributable fractions (PAFs) were calculated to compare risks associated with 12 modifiable risk factors. Results: The mean age of the cohort was 51.8 years (59% women). Leading causes of mortality were CVD (37.9%) and cancer (12.4%). The incidence of CVD (per 1,000 person-years) was higher in the Philippines (11.0) than Malaysia (8.3), and CVD contributed to a higher proportion of deaths in the Philippines (58% vs 36%). By contrast, all-cause mortality rates were higher in Malaysia (14.1) than in the Philippines (10.9). Approximately 78% of the PAF for CVD and 68% of the PAF for all-cause mortality were attributable to 12 modifiable risk factors. For CVD, the largest PAF was from hypertension (24.2%), whereas for all-cause mortality, the largest PAF was from low education (18.4%). Conclusions: CVD and cancer account for one-half of adult mortality in Malaysia and the Philippines. Hypertension was the largest population driver of CVD, whereas low education was associated with the largest burden of overall mortality.

Evidence-Based Certification of Quantum Dimensions.

Identifying a reasonably small Hilbert space that completely describes an unknown quantum state is crucial for efficient quantum information processing. We introduce a general dimension-certification protocol for both discrete and continuous variables that is fully evidence based, relying solely on the experimental data collected and no other unjustified assumptions whatsoever. Using the Bayesian concept of relative belief, we take the effective dimension of the state as the smallest one such that the posterior probability is larger than the prior, as dictated by the data. The posterior probabilities associated with the relative-belief ratios measure the strength of the evidence provide by these ratios so that we can assess whether there is weak or strong evidence in favor or against a particular dimension. Using experimental data from spectral-temporal and polarimetry measurements, we demonstrate how to correctly assign Bayesian plausible error bars for the obtained effective dimensions. This makes relative belief a conservative and easy-to-use model-selection method for any experiment.

The nature of status: Navigating the varied approaches to conceptualizing and measuring status.

Members of small groups fundamentally desire status as status underpins members' self-concept and dictates behavior in groups. Moreover, group members readily orient and update status perceptions that index the social standing of themselves and other members. Yet, our understanding is obscured by variability in how researchers study status. In the current review, we crystallize knowledge regarding the nature of status by characterizing variability in definitions, measures, and analytic frameworks. We advocate a definition of status that draws together attributes of respect, admiration, and voluntary deference. We also distinguish reputational and relational status operationalizations and address implications pertaining to measurement along with downstream decisions involving data management and analysis. We encourage a deliberate approach to ensure congruency in how status is defined, measured, and analyzed within a research program. This review also guides theory and hypothesis generation regarding how status-related processes may vary based on different forms of status or differing contexts.

Distinctions in group members' status naturally arise during group interactions. High status tends to be associated with an array of benefits, such as receiving more respect and attention, enjoying better psychological and physical health, and having greater access to valued resources and opportunities. As such, people fundamentally desire status, vigilantly attend to their own and others' status, and actively pursue status. Status also powerfully influences group functioning. Whereas a consensually formed status hierarchy may provide order and increase coordination, disputes over status rank can undermine cooperation and encourage conflict among group members. Despite the critical role status plays in social interactions, researchers continue to disagree about how status should be defined and studied. Without a consistent definition and a measurement guideline, it is difficult to produce cumulative knowledge regarding when, for whom, and why status is afforded to others, and the consequences of gaining, losing, or threats to one's status. In this review, we advocate a status definition that identifies respect, admiration, and voluntary deference as three essential attributes of status. We also distinguish status that is consensually conferred by a group (i.e., reputational status) from status conferred by a particular group member (i.e., relational status). We conclude this paper by providing a guide of measurement options and data management strategies that are suitable for studying distinctive research questions.

Design and fabrication of porous three-dimensional Ag-doped reduced graphene oxide (3D Ag@rGO) composite for interfacial solar desalination.

Solar-driven interfacial desalination technology has shown great promise in tackling the urgent global water scarcity crisis due to its ability to localize heat and its high solar-to-thermal energy conversion efficiency. For the realization of sustainable saline water desalination, the exploration of novel photothermal materials with higher water vapor generation and photothermal conversion efficiency is indispensable. In the current study, a novel 3D interconnected monolithic Ag-doped rGO network was synthesized for efficient photothermal application. The Ultraviolet-Visible-Near Infrared (UV-Vis-NIR) and FTIR analyses demonstrated that the controlled hydrothermal reduction of GO enabled the restoration of the conjugated sp2 bonded carbon network and the subsequent electrical and thermal conductivity through a significant reduction of oxygen-containing functional groups while maintaining the hydrophilicity of the composite photothermal material. In the solar simulated interfacial desalination study conducted using 3.5 wt.% saline water, the average surface temperatures of the 3D material increased from 27.1 to 54.7 °C in an hour, achieving an average net dark-excluded evaporation rate of 1.40 kg m-2 h-1 and a photothermal conversion efficiency of ~ 97.54% under 1 sun solar irradiance. In the outdoor real-world application test carried out, the surface temperature of the 3D solar evaporator reached up to 60 °C and achieved a net water evaporation rate of 1.50 kg m-2 h-1 under actual solar irradiation. The 3D interwoven porous hierarchical evaporator displayed no salt precipitation over the 54-h period monitored, demonstrating the promising salt rejection and real-world application potential for efficient desalination of saline water.

Catalysing global surgery: a meta-research study on factors affecting surgical research collaborations with Africa.

INTRODUCTION: In December 2019, the COVID-19 pandemic highlighted the urgent need for rapid collaboration, research, and interventions. International research collaborations foster more significant responses to rapid global changes by enabling international, multicentre research, decreasing biases, and increasing study validity while reducing overall research time and costs. However, there has been low uptake of collaborative research by African institutions and individuals. AIM: To systematically review facilitating factors and challenges to collaborative surgical research studies conducted in Africa. METHODOLOGY: A meta-research review using PubMed®/MEDLINE and Embase on surgical collaboration in Africa from 1st of January 2011 to 31st of September 2021 in accordance to PRISMA guidelines. Surgical studies by collaborative groups involving African authors and sites were included (55 papers). Data on the study period, geographical regions, and research scope, facilitating factors, and challenges were extracted from the studies retrieved from the search. RESULTS: Most of the collaborations in Africa occurred with European institutions (76%). Of the 54 African countries, 63% (34/54) participated in surgical collaborations. The highest collaboration frequency occurred in South Africa (11%) and Nigeria (8%). However, most publications originated from Eastern Africa (43%). Leveraging synergies between high- and low- to middle-income countries (LMICs), well-defined structures, and secure data platforms facilitated collaboration. However, the underrepresentation of collaborators from LMICs was a significant challenge. CONCLUSION: Available literature provides critical insights into the facilitating factors and challenges of research collaboration with Africa. However, there is a need for a detailed prospective study to explore the themes highlighted further. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2022 CRD42022352115 .

Assessment of clinical pregnancies in up to eight ovarian stimulation with intrauterine insemination treatment cycles in those unable to proceed with in vitro fertilization.

OBJECTIVE: To study the primary objective of clinical pregnancy (CP) rate per ovarian stimulation with intrauterine insemination (OS-IUI) treatment cycle in patients with repetitive cycles up to a maximum of 8 cycles. DESIGN: Retrospective cohort. SETTING: Large fertility clinic. PATIENTS: A total of 37,565 consecutive OS-IUI cycles from 18,509 patients were included in this study. INTERVENTIONS: Those with anovulatory diagnoses, tubal factor infertility, male factor infertility, using donor sperm, canceled cycles, and those with missing data for either baseline characteristics or outcome were excluded. The CP rate was analyzed using generalized estimating equations and controlled for age, stimulation protocol, and body mass index. MAIN OUTCOMES MEASURES: Clinical pregnancy was defined as intrauterine gestation with fetal heartbeat visible on ultrasound. RESULTS: A total of 37,565 consecutive OS-IUI cycles from 2002 through 2019 at a private practice facility were evaluated. All cycles met inclusion criteria and were used in generalized estimating equation modeling. Patients aged <35 years comprised 47.6% of the cohort. After adjustment for confounders, the mean predicted probability of CP for cycles one to 8 was 15.7% per cycle. The mean predicted probability of CP in aggregated data from cycles 2 to 4 was only 1.7% lower compared with cycle 1 as the referent (16.7% vs. 15.0%, 95% confidence interval [CI] 2nd: 0.88 {0.82, 0.95}, 3rd: 0.86 {0.79, 0.93}, 4th: 0.88 {0.79, 0.98}). However, the 15.0% mean predicted probability of CP for the second through the fourth cycle was concordant with the mean for all included cycles (15.7%). The mean predicted probability of CP of cycles 5 to 8 was not significantly different compared with the referent (16.7% vs. 16.1%, 95% CI 5th: 0.97 [0.85, 1.11], 6th: 0.93 [0.79, 1.10], 7th: 1.01 [0.81, 1.26], 8th: 1.01 [0.76, 1.34]). The modeling of consecutive cycles suggested that the adjusted cumulative predicted probability of CP from OS-IUI continues to increase with each of the 8 successive cycles. CONCLUSION: Clinical pregnancy rates are satisfactory in up to 8 consecutive OS-IUI treatment cycles. These data are useful for counseling, especially in those patients for whom in vitro fertilization is not financially or ethically feasible.

Risk factors for recognized and unrecognized SARS-CoV-2 infection: a seroepidemiologic analysis of the Prospective Urban Rural Epidemiology (PURE) study.

There are limited data on individual risk factors for SARS-CoV-2 infection (including unrecognized infection). In this seroepidemiologic substudy of an ongoing prospective cohort study of community-dwelling adults, participants were thoroughly characterized pre-pandemic. The SARS-CoV-2 infection was ascertained by serology. Among 8,719 participants from 11 high-, middle-, and low-income countries, 3,009 (35%) were seropositive for SARS-CoV-2. Characteristics independently associated with seropositivity were younger age (odds ratio, OR; 95% confidence interval, CI, per five-year increase: 0.95; 0.91-0.98) and body mass index >25 kg/m2 (OR, 95% CI: 1.16, 1.01-1.34). Smoking (as compared with never smoking, OR, 95% CI: 0.83, 0.70-0.97) and COVID-19 vaccination (OR, 95% CI: 0.70, 0.60-0.82) were associated with a reduced risk of seropositivity. Among seropositive participants, 83% were unaware of having been infected with SARS-CoV-2. Seropositivity and a lack of awareness of infection were more common in lower-income countries. The COVID-19 vaccination reduces the risk of SARS-CoV-2 infection (including recognized and unrecognized infections). Overweight or obesity is an independent risk factor for SARS-CoV-2 infection. Infection and lack of infection awareness are more common in lower-income countries.IMPORTANCEIn this large, international study, evidence of SARS-CoV-2 infection was obtained by testing blood specimens from 8,719 community-dwelling adults from 11 countries. The key findings are that (i) the large majority (83%) of community-dwelling adults from several high-, middle-, and low-income countries with blood test evidence of SARS-CoV-2 infection were unaware of this infection-especially in lower-income countries; and (ii) overweight/obesity predisposes to SARS-CoV-2 infection, while COVID-19 vaccination is associated with a reduced risk of SARS-CoV-2 infection. These observations are not attributable to other individual characteristics, highlighting the importance of the COVID-19 vaccination to prevent not only severe infection but possibly any infection. Further research is needed to understand the mechanisms by which overweight/obesity might increase the risk of SARS-CoV-2 infection.

Modelling Age-Varying Associations among Group Memberships, Neighborhood Connectedness, and Well-Being.

Individuals who maintain group memberships in their community tend to experience improved well-being relative to those who participate in few or no groups. There are, however, few investigations targeting variability in the correlates of group membership across the lifespan. The present examination probed age-related variability in the association between group memberships and subjective connectedness as well as well-being. Participants included 3,940 (mean age = 45.61 years, standard deviation [SD] = 15.62) Canadian and American respondents who completed an online survey during August of 2020 (i.e., amidst the COVID-19 pandemic). Time-varying effects modelling was used to estimate coefficients for group membership at each age within the sample. Memberships in social groups positively predicted connectedness, and this association was strongest in middle-to-older age; a similar association was also evident when predicting well-being. Connectedness was also a positive predictor of well-being throughout most ages. These findings build on emerging research conveying how group memberships have significance for people currently in middle-to-older age.

A compartment model to predict in vitro finite dose absorption of chemicals by human skin.

Dermal uptake is an important and complex exposure route for a wide range of chemicals. Dermal exposure can occur due to occupational settings, pharmaceutical applications, environmental contamination, or consumer product use. The large range of both chemicals and scenarios of interest makes it difficult to perform generalizable experiments, creating a need for a generic model to simulate various scenarios. In this study, a model consisting of a series of four well-mixed compartments, representing the source solution (vehicle), stratum corneum, viable tissue, and receptor fluid, was developed for predicting dermal absorption. The model considers experimental conditions including small applied doses as well as evaporation of the vehicle and chemical. To evaluate the model assumptions, we compare model predictions for a set of 26 chemicals to finite dose in-vitro experiments from a single laboratory using steady-state permeability coefficient and equilibrium partition coefficient data derived from in-vitro experiments of infinite dose exposures to these same chemicals from a different laboratory. We find that the model accurately predicts, to within an order of magnitude, total absorption after 24 h for 19 of these chemicals. In combination with key information on experimental conditions, the model is generalizable and can advance efficient assessment of dermal exposure for chemical risk assessment.

Academic clinician frontline-worker wellbeing and resilience during the COVID-19 pandemic experience: Were there gender differences?

Prior research suggests COVID-19 has amplified stress on Academic Clinician Frontline-Workers (ACFW). The aim of this paper is: (1) to better understand the experiences of ACFW during the COVID-19 pandemic including their mental-emotional wellbeing, academic productivity, clinical experiences, and (2) to examine any gender differences. A cross-sectional survey was administered to University of Minnesota/M Health Fairview systems' faculty February-June 2021. Of the 291 respondents, 156 were clinicians, with 91 (58 %) identifying as Frontline-Workers (ACFW). Faculty wellbeing was assessed using validated measures in addition to measures of productivity and sociodemographics. For example, ACFW reported a higher Work-Family Conflict (WFC) scores compared to non-ACFW (26.5 vs. 24.1, p = 0.057) but did not report higher Family-Work Conflict (FWC) scores (17.7 vs. 16.3, p = 0.302). Gender sub-analyses, revealed that women ACFW compared to men ACFW reported higher WFC scores (27.7 vs. 24.1, p = 0.021) and FWC (19.3 vs. 14.3, p = 0.004). Academically, ACFW reported submitting fewer grants and anticipated delays in promotion and tenure due to the COVID-19 (p = 0.035). Results suggest COVID-19 has exacerbated ACFW stress and gender inequities. Reports of anticipated delay in promotion for ACFW may pose a challenge for the long-term academic success of ACFW, especially women ACFW. In addition, women may experience higher FWC and WFC as compared to men. Schools of academic medicine should consider re-evaluating promotion/tenure processes and creating resources to support women ACFW as well as ACFW caregivers.

The endodontic-periodontal juncture: Where two worlds meet. An overview of endo-perio lesions.

Endodontic and periodontal infections can be difficult to differentiate from one another and often share common clinical features making diagnosis challenging. The aim of this review is to discuss endodontic and periodontal infections in situations where they occur concurrently, or where one influences the other. The available literature investigating endodontic and periodontal infections was examined for contemporary knowledge regarding endodontic-periodontal interactions. Strategies to facilitate diagnosis and treatment planning are discussed. When endodontic and periodontal infections occur together, or signs and symptoms are similar, diagnosis can be challenging. Determining the primary source of infection is imperative to ensure appropriate treatment planning. The pulp and periodontal tissues are intimately related, with many possible pathways for infection from one to the other. Diagnosis of the primary source of the infection can be difficult and sometimes an inter-disciplinary approach to treatment is required. © 2023 Australian Dental Association.

Harnessing selenium nanoparticles (SeNPs) for enhancing growth and germination, and mitigating oxidative stress in Pisum sativum L.

Selenium, an essential micronutrient for plants and animals, can cause selenium toxicity as an oxyanion or at elevated doses. However, the toxic selenite (SeO32-) oxyanion, can be converted into less harmful elemental nano-selenium (Se0), with various practical applications. This research aimed to investigate two methods for reducing SeO32-: abiotic reduction using cell-free extract from Enterococcus spp. (abiotic-SeNPs) and chemical reduction involving L-ascorbic acid (chemical-SeNPs). Analysis with XPS confirmed the presence of Se0, while FTIR analysis identified surface functional groups on all SeNPs. The study evaluated the effects of SeO32-, abiotic-SeNPs, and chemical-SeNPs at different concentrations on the growth and germination of Pisum sativum L. seeds. SeO32- demonstrated detrimental effects on germination at concentrations of 1 ppm (germination index (GI) = 0.3). Conversely, both abiotic- and chemical-SeNPs had positive impacts on germination, with GI > 120 at 10 ppm. Through the DPPH assay, it was discovered that SeNPs exhibited superior antioxidant capabilities at 80 ppm, achieving over 70% inhibition, compared to SeO32- (less than 20% inhibition), therefore evidencing significant antioxidant properties. This demonstrates that SeNPs have the potential to be utilized as an agricultural fertilizer additive, benefiting seedling germination and development, while also protecting against oxidative stress.

Genotoxicity Assessment of Haloacetaldehyde Disinfection Byproducts via a Simplified Yeast-Based Toxicogenomics Assay.

Haloacetaldehydes (HALs) represent the third-largest category of disinfection byproducts (DBPs) in drinking water in terms of weight. As a subset of unregulated DBPs, only a few HALs have undergone assessment, yielding limited information regarding their genotoxicity mechanisms. Herein, we developed a simplified yeast-based toxicogenomics assay to evaluate the genotoxicity of five specific HALs. This assay recorded the protein expression profiles of eight Saccharomyces cerevisiae strains fused with green fluorescent protein, including all known DNA damage and repair pathways. High-resolution real-time pathway activation data and protein expression profiles in conjunction with clustering analysis revealed that the five HALs induced various DNA damage and repair pathways. Among these, chloroacetaldehyde and trichloroacetaldehyde were found to be positively associated with genotoxicity, while dichloroacetaldehyde, bromoacetaldehyde, and tribromoacetaldehyde displayed negative associations. The protein effect level index, which are molecular end points derived from a toxicogenomics assay, exhibited a statistically significant positive correlation with the results of traditional genotoxicity assays, such as the comet assay (rp = 0.830 and p < 0.001) and SOS/umu assay (rp = 0.786 and p = 0.004). This yeast-based toxicogenomics assay, which employs a minimal set of gene biomarkers, can be used for mechanistic genotoxicity screening and assessment of HALs and other chemical compounds. These results contribute to bridging the knowledge gap regarding the molecular mechanisms underlying the genotoxicity of HALs and enable the categorization of HALs based on their distinct DNA damage and repair mechanisms.

Clinical and medico-legal considerations in endodontics.

Endodontic treatment can be challenging for a number of reasons, including the microscopic nature of the clinical environment, reliance on tactile sensation and lack of direct visualization of the work being performed. Commonly, endodontic patients present with pain and distress, which can exacerbate an already difficult clinical situation. Complications may might arise prior to, or during treatment, despite practising with the utmost care and skill. Preventing and managing these complications can take considerable time and energy, and oftentimes assistance from or referral to more experienced colleagues is required. The aim of this review is to discuss medico-legal considerations in endodontics, with clinical correlations and a focus on the Australian legal landscape. [Correction added on 18 October 2023, after first online publication: The abstract was amended from a structured to an unstructured abstract.].

Self-assembled micro and nano rod-shaped porphyrin@Bi12O17Cl2 composite as an efficient photocatalyst for degradation of organic contaminants.

Bi12O17Cl2 is a potential photocatalyst in practical applications due to its excellent photostability, visible light activity, and competitive bandgap energy. However, the fast recombination of photogenerated charge carriers makes it impractical for pollution mitigation. Recently, aggregated porphyrins have emerged as photosensitizers in light-dependent applications such as photocatalysis. Although Bi12O17Cl2 and porphyrin can function as separate photocatalysts, their photocatalytic properties in terms of visible light adsorption, charge separation and transport, can be improved when they are combined to form heterostructure. In this study, rod-shaped aggregated 5,10,15, 20-Tetrakis (4-carboxyphenyl) porphyrin was synthesized by CTAB-assisted, self-assembly strategy and Bi12O17Cl2 by a facile microwave method. The porphyrin and Bi12O17Cl2 were combined to generate a series of x%Porphyrin@Bi12O17Cl2 having 0.02% wt., 0.1% wt., 0.4% wt., 1% wt. and 10% wt. as compositions of porphyrin. The materials' photocatalytic degradation efficiency was tested on Rhodamine B dye as a representative pollutant. The best and worst performances were reported for 1%Porphyrin@Bi12O17Cl2 and 10%Porphyrin@Bi12O17Cl2, respectively, which are 3.1 and 0.5 times increases in efficiency compared to pure Bi12O17Cl2. From the radical trapping experiment, electrons and superoxide were the dominant reactive species in the degradation process. The enhanced photocatalytic capability of the materials was attributed to the photosensitizing property of porphyrin and the heterojunction formation, which promotes the separation of photogenerated charge carriers. A plausible step-scheme (S-scheme) was proposed for the photocatalytic degradation mechanism. The S-scheme provided the high redox potential of the photogenerated charge carriers. The findings herein offer a new option for improving the photocatalytic performance of Bi12O17Cl2 for environmental applications through the photosensitization strategy.

Antagonism between co-infecting gastrointestinal nematodes: A meta-analysis of experimental infections in Sheep.

Gastrointestinal nematodes (GIN) have enormous global impacts in humans, wildlife and grazing livestock. Within grazing livestock, sheep are of particular global importance and the economics and sustainability of sheep production are greatly constrained by GIN infections. Natural infections are composed of co-infections with multiple species, and while some past work suggests species can interact negatively with one another within the same host, there is wide variation in reported patterns. Here, we undertook a systematic literature search and meta-analysis of experimental GIN co-infections of sheep to determine whether these experimental studies support the hypothesis of antagonistic interactions between different co-infecting GIN, and test whether aspects of parasite biology or experimental design influence the observed effects. A systematic search of the literature yielded 4848 studies, within which, we identified 19 experimental sheep studies comparing post-mortem worm counts across two co-infecting GIN species. Meta-analysis of 67 effects obtained from these studies provides strong evidence for interactions between GIN species. There was wide variation in the strength and direction of these interactions, but the global effect was significantly antagonistic. On average, there was a decrease in the number of worms of one species when a co-infecting species was also present, relative to a mono-infection with that species alone. This effect was dependent on the infectious dose and was rapidly lost after anthelmintic treatment, suggesting that live worms are required for the effect to occur. Individual parasite species varied in the extent to which they both exerted, and were subject to, these interspecies interactions, and these differences are more complex than simply co-localisation within the gastrointestinal tract. Antagonistic interactions between co-infecting GIN may feedback into their epidemiology as well as potentially affecting the clinical impacts of infection. Furthermore, the consequences of these interactions may be heightened when clinical interventions affect only one species within the co-infecting network. Whilst it was not possible to identify the causes of variation between GIN species in the impact of co-infection, these findings point to new avenues for epidemiological, clinical and mechanistic research on GIN co-infections.

I AM FAMILY: Understanding the adapted sport experiences of family members of military personnel with physical and psychological illnesses and injuries through the lens of the Invictus Games.

Family are influential actors in adapted sport participation. However, little is known about their experiences with adapted sport. The current study sought to explore the experiences of families in adapted sport through the context of the Invictus Games, an international adapted sport competition for military personnel with physical and psychological illnesses and injuries that is unique in its inclusion of family programming. Family members (n = 21; partners, parents, siblings, and children) of Invictus Games Toronto 2017 competitors participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis. Three themes were identified: recognition of family experiences during service and after onset of disability; creating a sense of belonging; and improving family knowledge and perceptions. This study provides insight regarding how adapted sport events can support the well-being of both individuals with illnesses and injuries and their families.