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Jansen Frantzen posted an update 8 months ago
Agriculture and food security are predicted to be significantly impacted by climate change, though the impact will vary by region and by crop. Combined with the increasing global population, there is an urgent need for agriculture to adapt to ensure future food security for this growing population. Adaptation strategies include changing land and cropping practices, the development of improved crop varieties and changing food consumption and waste. Recent advances in genomics and agronomy can help alleviate some of the impacts of climate change on food production; however, given the timeframe for crop improvement, significant investment is required to realise these changes. Ultimately, there is a limit as to how far agriculture can adapt to the changing climate, and a political will to reduce the impact of burning of fossil fuels on the global climate is essential for long term food security. PURPOSE Patients with unilateral cleft lip and palate (UCLP) may require Le Fort I advancement to correct maxillary hypoplasia after reaching skeletal maturity. The underlying cleft anatomy, previous operations, and scarring can affect nostril changes after maxillary advancement. The purpose of the present study was to determine whether Le Fort I advancement affects the nostril configuration (ie, width, axis, shape) in patients with UCLP. The specific aims were to (1) compare cleft and noncleft nostrils in patients with UCLP after maxillary advancement and (2) compare the changes in nostril configuration in patients with UCLP with those in noncleft controls after Le Fort advancement. PATIENTS AND METHODS A retrospective case-control study of nonsyndromic, skeletally mature patients with UCLP and a case-matched control group without UCLP who had undergone single-piece Le Fort I advancement with alar cinch suture from 2010 to 2014. Patients were included if they had undergone pre- and postoperative 3-dimensionas of maxillary advancement. Similarly, no differences were found in the nostril changes between the cleft and noncleft controls. Ipatasertib These findings can aid proper surgical planning for cleft nasal revisions. BACKGROUND Concerns have been expressed regarding a “leadership crisis” in pharmacy. Previous research has identified potential barriers to pharmacists assuming leadership roles and signposted opportunities for further exploration of leadership issues in the profession related to psychological comfort with use of power. OBJECTIVES This study explored community pharmacists’ perceptions of the effectiveness and impact of power leveraged by formal and informal pharmacy leaders. METHODS A theoretical framework based on Raven’s 7 Sources of Power model was used to guide this research. Semi-structured interviews with community pharmacists in Ontario, Canada were undertaken, and data were coded and categorized using this framework. FINDINGS 29 pharmacists participated in this study. Participants in this study highlighted over-reliance on charismatic power, underuse of rewards and punishments, and general lack of effectiveness or impact in use of informational, expertise, positional, and relational powers amongst pharmacy leaders. Opportunities to broaden the power repertoire of pharmacy leaders, including leadership education, were identified as potentially valuable for individual leaders and the profession as a whole. CONCLUSIONS Effectively leveraging power is important for leaders. This study has highlighted patterns of power use amongst community pharmacy leaders and identified opportunities for further research in this area and for continuing professional development for leaders. BACKGROUND The SF-6D is a generic, six-dimensional health-related quality of life (HRQoL) measure derived from a selection of items from the SF-36. OBJECTIVES To translate, culturally adapt and validate the SF-6D for use in Arabic-speaking countries. METHODS The International Quality of Life Assessment (IQOLA) methodology was followed. Two forward translations, one consensus and one backward translation were undertaken. Difficulties encountered were categorized as grammatical, idiomatic, semantic/conceptual, and cultural. The content validity of the final version was tested and Cronbach’s alpha test of internal consistency was used for assessing reliability. Confirmatory factor analysis (CFA), was also used to assess construct validity and to test a pre-specified relationship of observed measures. RESULTS Minor changes were made to the forward translation to improve cultural appropriateness. The Backward translation did not reveal major problems and equivalence to the original was confirmed following committee review. A total of 470 participants from Jordan, Egypt, UAE, Qatar and Palestine completed the translated SF-6D. All the incremental indices values are ≥0.90 and close to 1. Item loading values ranged from 0.52 to 0.87. The measurement model weight for those with chronic health conditions ranged from 0.68 to 0.91, and from 0.42 to 0.73 for those without. The percentage of variation in self-reported health state was about 55%. The measurement weight of SF-6D on self-reported health state among chronic responders was 0.87 while among responders reporting no chronic disease was 0.61. The t-value for the difference in measurement weight was -8.93 (p ≤ 0.01). CONCLUSION Arabic translation and cultural adaptation of SF-6D has resulted in an acceptable and culturally-adapted version that can be used in Arabic-speaking countries. Reliability and validity have been confirmed as well as ability to assess the difference in quality of life between patients with chronic health conditions and healthy individuals. RATIONALE Spinal cord injury/dysfunction (SCI/D) is an exemplar condition with a high prevalence of secondary complications, chronic conditions and use of multiple medications (polypharmacy). Optimizing medication self-management is important for persons with SCI/D to improve outcomes; however, there is a lack of research on how healthcare/service providers and persons with SCI/D experience medication self-management. OBJECTIVE To explore attitudes and experiences of medication self-management from the perspectives of persons with SCI/D and providers, and to explore the extent to which the Taxonomy of Everyday Self-management Strategies (TEDSS) framework captured participants’ experiences with medication self-management. METHODS In-depth, semi-structured interviews were conducted by telephone until data saturation was reached. Interviews were transcribed verbatim and analyzed using constant comparative approaches. The TEDSS framework was adapted and applied deductively. RESULTS Fifty-one individuals participated in this study, 32 providers and 19 persons with SCI/D.