Contact Points Research Articles

Crosstalk interactions between transcription factors ERRα and PPARα assist PPARα-mediated gene expression

ObjectiveThe peroxisome proliferator-activated receptor α (PPARα) is a transcription factor driving target genes involved in fatty acid β-oxidation. To what extent various PPARα interacting proteins may assist its function as a transcription factor is incompletely understood. An ORFeome-wide unbiased mammalian protein-protein interaction trap (MAPPIT) using PPARα as bait revealed a PPARα-ligand-dependent interaction with the orphan nuclear receptor estrogen-related receptor α (ERRα). The goal of this study was to characterize the nature of the interaction in depth and to explore whether it was of physiological relevance. MethodsWe used orthogonal protein-protein interaction assays and pharmacological inhibitors of ERRα in various systems to confirm a functional interaction and study the impact of crosstalk mechanisms. To characterize the interaction surfaces and contact points we applied a random mutagenesis screen and structural overlays. We pinpointed the extent of reciprocal ligand effects of both nuclear receptors via coregulator peptide recruitment assays. On PPARα targets revealed from a genome-wide transcriptome analysis, we performed an ERRα chromatin immunoprecipitation analysis on both fast and fed mouse livers. ResultsRandom mutagenesis scanning of PPARα’s ligand-binding domain and coregulator profiling experiments supported the involvement of (a) bridging coregulator(s), while recapitulation of the interaction in vitro indicated the possibility of a trimeric interaction with RXRα. The PPARα·ERRα interaction depends on 3 C-terminal residues within helix 12 of ERRα and is strengthened by both PGC1α and serum deprivation. Pharmacological inhibition of ERRα decreased the interaction of ERRα to ligand-activated PPARα and revealed a transcriptome in line with enhanced mRNA expression of prototypical PPARα target genes, suggesting a role for ERRα as a transcriptional repressor. Strikingly, on other PPARα targets, including the isolated PDK4 enhancer, ERRα behaved oppositely. Chromatin immunoprecipitation analyses demonstrate a PPARα ligand-dependent ERRα recruitment onto chromatin at PPARα-binding regions, which is lost following ERRα inhibition in fed mouse livers. ConclusionOur data support the coexistence of multiple layers of transcriptional crosstalk mechanisms between PPARα and ERRα, which may serve to finetune the activity of PPARα as a nutrient-sensing transcription factor.

Ambulance service recognition of health inequalities and activities for reduction: An evidence and gap map of the published literature

Background: Emergency medical services (EMS) are often patients’ first point of contact for urgent and emergency care needs. Patients are triaged over the phone and may receive an ambulance response, with potential conveyance to the hospital. A recent scoping review suggested disparities in EMS patient care in the United States. However, it is unknown how health inequalities impact EMS care in other developed countries and how inequalities are being addressed.Objectives: This rapid evidence map of published literature aims to map known health inequalities in EMS patients and describe interventions reducing health inequalities in EMS patient care.Methods: The search strategy consisted of EMS synonyms and health inequality synonyms. The MEDLINE/PubMed database was searched from 1 January 2010 to 26 July 2022. Studies were included if they described empirical research exploring health inequalities within ambulance service patient care. Studies were mapped on to the EMS care interventions framework and Core20PLUS5 framework. Studies evaluating interventions were synthesised using the United Kingdom Allied Health Professions Public Health Strategic Framework.Results: The search strategy yielded 771 articles, excluding duplicates, with two more studies added from hand searches. One hundred studies met the inclusion criteria after full-text review. Inequalities in EMS patient care were predominantly situated in assessment, treatment and conveyance, although triage and response performance were also represented. Studies mostly explored EMS health inequalities within ethnic minority populations, populations with protected characteristics and the core issue of social deprivation. Studies evaluating interventions reducing health inequalities (n = 5) were from outside the United Kingdom and focused on older patients, ethnic minorities and those with limited English proficiency. Interventions included community paramedics, awareness campaigns, dedicated language lines and changes to EMS protocols.Conclusions: Further UK-based research exploring health inequalities of EMS patients would support ambulance service policy and intervention development to reduce health inequality in urgent and emergency care delivery.

Kinematics analysis of planetary roller screw mechanism with misalignment

The misalignment is unavoidable for planetary roller screw mechanism (PRSM) in practical application due to many uncertainties. The misalignment has a strong effect on the kinematic characteristics of PRSM. However, the relevant research has been rarely reported in the past. In order to clearly present the motion characteristics, a novel kinematics model of PRSM with misalignment is established in this article. The rotational tensor theory is introduced to obtain the coordinate transformation equations. The position vectors of PRSM with misalignment are acquired to calculate the position of the contact point. The motion model of PRSM with misalignment is derived by analyzing the velocity of the contact point. Compared with some published literature, the kinematic model of PRSM is verified. Moreover, a relationship between the misalignment variates, which are the misalignment angle, the misalignment azimuth angle, and the offset distance of the nut's ending point, respectively, and the kinematic characteristics of PRSM are investigated. The results indicate that those misalignment variates have a great influence on the kinematics of PRSM and lead to fluctuations in the PRSM's transmission velocity and angular velocity ratio. The fluctuation amplitude of transmission velocity is positively correlated with misalignment angle.

User satisfaction with the National Health Insurance Program: A community-based survey from the Ilam district of Nepal.

The Government of Nepal initiated a family-based National Health Insurance Program (NHIP) in April 2016, aiming to ensure universal health coverage (UHC) by enhancing access to and utilization of quality health services. However, NHIP, in its initial years of implementation, encountered challenges such as low population coverage, a high dropout rate, and concerns among the insured regarding the quality of healthcare services. There is a dearth of information regarding user satisfaction with the NHIP in Nepal. This study aimed to assess user satisfaction with NHIP at the household level in Nepal. We conducted a cross-sectional study among 347 households in the Ilam district using a multi-stage random sampling method. Face-to-face interviews were conducted with household heads enrolled in NHIP. A semi-structured questionnaire was used to collect the data. The multivariable logistic regression analysis was done to identify the predictors of satisfaction level. Overall, 53.6% of the insured were satisfied with the NHIP, while 31.1% had comprehensive knowledge about the NHIP. Factors such as gender (AOR: 1.80, 95% CI: 1.08-3.00), distance to the first point of contact (AOR: 2.15, 95% CI: 1.24-3.74), waiting time (AOR: 2.02, 95% CI: 1.20-3.42), availability of diagnostic services (AOR: 1.90, 95% CI: 1.05-3.45), availability of prescribed medicine (AOR: 3.90, 95% CI: 1.97-7.69), perceived service quality (AOR: 2.20, 95% CI: 1.15-4.20), and the behavior of service providers (AOR: 3.48, 95% CI: 1.04-11.63) were significantly associated with user satisfaction. The satisfaction level among NHIP users was deemed moderate. This study highlighted several factors, such as gender, distance to the first point of contact, waiting time, availability of diagnostic services and prescribed medicine, perceived service quality, and the behavior of service providers, as key determinants impacting user satisfaction. Recognizing the pivotal role of user satisfaction, health insurance stakeholders must prioritize it to ensure higher retention rates and coverage within NHIP.

New angles and long walks: building regional networks through union education

PurposeThis article examines the role the Australian Trade Union Training Authority (TUTA) played in international education through the provision of trade union courses and exchanges. We consider how an investigation of trade union networks contributes to a richer understanding of international education linkages.Design/methodology/approachThis paper is based on research conducted for an Australian Research Council (ARC)-funded project: Trade union training: reshaping the Australian industrial landscape (ARC LP180100500). This research involved a critical analysis of 60 semi-structured oral history interviews and textual archives, including the official records held by the National Archives of Australia and papers held by the Noel Butlin Archives, the Australian Council of Trade Unions and in private collections.FindingsTUTA was established primarily as a national union training organisation, but from its inception, it also acted as a hub for the development of regional and international labour networks. The nature of TUTA’s work placed it at the intersection of international trade union and educational domains. Although there were some points of contact with formal international programs (e.g. Japan–Australia and Kellogg Foundations, the Colombo Plan and US Department of Labour exchanges schemes), the specific contribution of TUTA is overlooked in the educational exchange literature. The role of TUTA is revealed through institutional connections and individual experiences.Research limitations/implicationsFurther research is required to gain a deeper understanding of the impact of TUTA from the perspective of former participants in international TUTA course and current and former trade unionists in the Asia–Pacific.Originality/valueThis article builds new knowledge by examining the connections forged in the Asia–Pacific region at the intersection of trade union and educational networks, an area often overlooked in the literature on educational exchange.

Tibiofemoral articulation and axial tibial rotation of the knee after a cruciate retaining total knee arthroplasty

PurposeNumerous research has reported that total knee arthroplasty (TKA) cannot reproduce axial tibial rotations of normal knees. The objective of this study was to measure the tibiofemoral articular contact motions and axial tibial rotations of TKA knees to investigate the mechanism causing the knee kinematics change of after TKAs.MethodsEleven patients with unilateral cruciate retaining (CR) TKA were tested for measurements of knee motion during a weight-bearing flexion from 0° to 105° using an imaging technique. The tibiofemoral contact kinematics were determined using the contact points on medial and lateral surfaces of the tibia and femoral condyles. Axial tibial rotations were calculated using the differences between the medial and lateral articulation distances on the femoral condyles and tibial surfaces at each flexion interval of 15°.ResultsOn femoral condyles, articular contact distances are consistently longer on the medial than on the lateral sides (p < 0.05) up to 60° of flexion, corresponding to internal tibial rotations (e.g., 1.3° ± 1.0° at 15–30° interval). On tibial surfaces, the articular contact point on the medial side moved more posteriorly than on the lateral side at low flexion angles, corresponding to external tibial rotations (e.g., −1.4° ± 1.8° at 15–30° interval); and more anteriorly than on the lateral sides at mid-range flexion, corresponding to internal tibial rotations (e.g., 0.8° ± 1.7° at 45–60° interval). At higher flexion, articular motions on both femoral condyles and tibial surfaces caused minimal changes in tibial rotations.ConclusionsThese results indicate that the axial tibial rotations of these TKA knees were mainly attributed to asymmetric articulations on the medial and lateral femoral condyles and tibial surfaces. The data can help understand the mechanisms causing axial tibial rotations of TKA knees and help improve implant designs for restoration of normal knee kinematics.

A new kinematic model for revolute clearance joints with noncircular bushing and pin in planar multibody systems

AbstractDue to manufacturing error and wear, the profiles of bushing and pin in revolute clearance joints are usually non-circular, while traditional kinematic models for revolute clearance joints generally assume a circular profile for the pin or bushing, which may not be able to accurately capture the kinematic behavior of real revolute joints in multibody systems. To this end, a curvature center method was proposed for the kinematic modeling of revolute clearance joints with noncircular bushing and pin. In the proposed method, both the noncircular bushing and pin were discretized, and the curvature center and radius corresponding to each discrete point were then obtained to detect the point of contact between the bushing and pin based on their kinematic constraints. The number of discrete points was determined based on both accuracy and efficiency of the proposed curvature center method, which was then applied to model a revolute clearance joint between the slider and the link of a slider-crank mechanism. Via comparison to the traditional geometric center method and discrete point method, it was validated that the proposed method can achieve a comparable accuracy in modeling revolute joints with a circular pin. The unique advantage of the proposed curvature center method is its ability in modeling revolute joints with noncircular bushing and noncircular pin, which was also demonstrated via a series of simulations. Simulation results show a significant influence of noncircular bushing and noncircular pin on the dynamic response of the multibody system. This implies the promising value of the proposed method in studying the effect of manufacturing error or wear of both bushing and pin on the system’s dynamic performance and/or service life.

SJCIT Transport Management System

Innovative software developed with great care to maximize transportation inside of educational institution called the SJCIT Transport Management System (TMS). Acting as a single point of contact for all student and faculty transportation-related information, including records, routes, diversions, and more, this system includes sophisticated features like effective database management, user-friendly interfaces, and aesthetically pleasing design elements. Its rapid adaptation minimizes transition times by guaranteeing quick user onboarding. A key instrument in coordinating the smooth movement of people across multiple locations and schedules is the SJCIT TMS, which is centred around the promotion of safe, efficient, dependable, and sustainable transportation practices. Its adaptability makes it possible for it to function seamlessly in both standalone and integrated configurations, which makes it an essential tool for improving transportation management in learning environments

Role of Morphology in Improving the Catalytic Performance of ZnCo2O4 for Soot Oxidation

Abstract The extent of interaction between carbon and catalyst profoundly shapes soot oxidation results. The catalyst configuration notably influences the frequency of contact points in solid-solid interactions. This investigation studies the impact of three distinct ZnCo22O4 catalyst morphologies and their redox property on soot oxidation. The formation of the cubic phase of ZnCo2O4via three distinct methods was revealed during XRD analysis. SEM analysis unveiled varying morphologies, including rod-shaped, rose petal-shaped, and bead-like structures. Notably, ZnCo2O4 exhibiting bead-like morphology demonstrated heightened levels of chemisorbed oxygen species which was observed during XPS analysis. The presence of Co2+ and Co3+ occupied at octahedral site ZnCo2O4 acted as the active sites for soot oxidation. With continuous redox property (Co 3+ → Co2+) leading to the generation of active oxygen species and with an added advantage of surface morphology, the M2 sample (with bead-like morphology) exhibited superior soot oxidation activity, which is evident by its T50% value of 402°C. This study underscores the essential role of catalyst morphology in influencing soot oxidation activity. Through a comprehensive array of structural, morphological, and catalytic analyses, this work sheds light on the correlation between catalyst architecture and enhanced soot oxidation performance.&amp;#xD;

Lock Protocol : a new robust workflow for a very high first pass pulmonary vein isolation during atrial fibrillation ablation

Abstract Introduction Pulmonary vein isolation (PVI) is the gold standard for atrial fibrillation (AF) ablation. First pass PVI is often demanding when a raw geometry reconstruction is used in combination with an inaccurate automarks annotation, accounting for discontinuous or non-transmural lesions and related AF recurrences. We hypothesized that a magnetic-post processing of left atrial geometry in combination with an LSI-guided high power short duration (HPSD) automarks annotation could improve procedural efficiency. Purpose The aim of this study was to determine the impact on procedural outcomes of the new "Lock PVI protocol" during AF ablation with the new voxel mode EnSite X mapping system. Methods We included in the study consecutive patients with AF scheduled for pulmonary vein isolation (PVI) at our Departement between January 2021 and December 2022. Patients were divided in two Groups, the Lock-PVI Group and the control No Lock-PVI Group. The "Lock PVI" Group was ablated with the new Ensite X System using the new protocol, which consisted in (1) performing a road map with contact-force annotation at potential PVI sites after High Density reconstruction, (2) shaving the magnetic geometry reconstruction to unearth true 3D location of contact points, (3) Use of 3D-Automarks color-coded with a Lesion Index (LSI) target of 5.5 (anterior) and 4.5 (posterior) (4) Inter-lesion distance &amp;lt;6 mm (5) High Power Short Duration Approach (50 W). The No-Lock PVI was represented by patients ablated with and HPSD ablation with the previous version of the EnSite Precision mapping suit as per local standard practice. Groups were compared in term of procedural duration, radiological exposure and "first pass" isolation. Results Forty-four patients (22 "Lock PVI" and 22 controls mean age 63,3±8 years, 65,9% male, 47,7% persistent AF), for a total of 88 PVI circles were enrolled. Procedural duration was similar between approaches (121,1±43,6 vs 125,3±30,1 min; P=0,72) but RF time was shorter in the "Lock PVI" group (19,6±4 vs 29,55±9,1 min; P&amp;lt;0,001), although with with a longer fluoroscopy (19,5±10,1 vs 13,4±4,9 min; P=0,01). Of note, first pass isolation was significantly higher in the "Lock PVI" group: 40/44 (90,9%) vs 28/44 (63,6%) circles (P=0,002). Conclusion The new "Lock PVI" approach resulted in consistently better first-pass isolation (&amp;gt;90%) with less RF time when compared to standard of care PVI.Graphical AbstractLock PVI

Advanced nerve regeneration enabled by neural conformal electronic stimulators enhancing mitochondrial transport

Addressing peripheral nerve defects remains a significant challenge in regenerative neurobiology. Autografts emerged as the gold-standard management, however, are hindered by limited availability and potential neuroma formation. Numerous recent studies report the potential of wireless electronic system for nerve defects repair. Unfortunately, few has met clinical needs for inadequate electrode precision, poor nerve entrapment and insufficient bioactivity of the matrix material. Herein, we present an advanced wireless electrical nerve stimulator, based on water-responsive self-curling silk membrane with excellent bioabsorbable and biocompatible properties. We constructed a unique bilayer structure with an oriented pre-stretched inner layer and a general silk membrane as outer layer. After wetting, the simultaneous contraction of inner layer and expansion of outer layer achieved controllable super-contraction from 2D flat surface to 3D structural reconfiguration. It enables shape-adaptive wrapping to cover around nerves, overcomes the technical obstacle of preparing electrodes on the inner wall of the conduit, and prevents electrode breakage caused by material expansion in water. The use of fork capacitor-like metal interface increases the contact points between the metal and the regenerating nerve, solving the challenge of inefficient and rough electrical stimulation methods in the past. Newly developed electronic stimulator is effective in restoring 10 mm rat sciatic nerve defects comparable to autologous grafts. The underlying mechanism involves that electric stimulation enhances anterograde mitochondrial transport to match energy demands. This newly introduced device thereby demonstrated the potential as a viable and efficacious alternative to autografts for enhancing peripheral nerve repair and functional recovery.

Ultrahigh thermal conductance of the point contact between amorphous nanowires

Amorphous interfaces/contacts are ubiquitous in numerous micro/nanoelectronic devices and functional composite materials. Traditionally, the thermal resistance of interfaces/contacts was believed to be the primary impediment to heat transport. However, in this study, through measuring thermal resistance between crystalline-amorphous core-shell Ge nanowires, we unveil an ultrahigh thermal conductance across the point contact between the amorphous shell of Ge nanowires with a room-temperature value of 892 MW/m2-K. This value surpasses the typical values observed in point contacts between crystalline nanowires/nanoribbons by one to three orders of magnitude and even exceeds that of epitaxial interfaces between well-lattice-matched materials. Molecular and lattice dynamic simulations further reveal that the observed ultrahigh thermal conductance is attributed to the broadened vibrational bandwidths within the amorphous contact, which facilitates the redistribution of phonon energy into a state conductive to more effective interfacial energy transmission, leading to an enhanced overlap of phonon modes and, consequently, a heightened thermal conductance.

A Comprehensive Framework for Hospital@Home Care Models.

To develop a framework of relevant features for describing hospital@home care models. The framework was developed based on a literature review and thematic analysis. We considered 42 papers describing hospital@home care approaches. Extracted features were grouped and aggregated in a framework. The framework consists of nine dimensions: Persons involved, target patient population, service delivery, intended outcome, first point of contact, technology involved, quality, and data collection. The framework provides a comprehensive list of required roles, technologies and service types. The framework can act as a guide for researchers to develop new technologies or interventions to improve hospital@home, particularly in areas such as tele-health, wearable technology, and patient self-management tools. Healthcare providers can use the framework as a guide or blueprint for building or expanding upon their hospital@home services.

Acute Autonomic Nervous System Response to Direct Sacral Nerve Root Stimulation in Lower Urinary Tract Dysfunction: A New Approach to Understand the Mechanism of Action of Sacral Nerve Modulation.

Our goal was to assess acute autonomic nervous system (ANS) response to direct sacral nerve root (SNR) stimulation in the context of lower urinary tract dysfunction. In this retrospective monocentric study, patients undergoing 2-stage sacral nerve modulation for overactive bladder, nonobstructive urinary retention, or chronic bladder pain syndrome between March 2022 and June 2023 were analyzed. A standardized stimulation protocol was applied during the lead implantation, each of the 4 contact points being sequentially stimulated at the amplitude required to elicit anal motor response. Stimulations were labeled as StimA, StimB, StimC, and StimD, ordered by ascending order of minimum amplitude required for anal motor response. Heart rate variability parameters were collected using PhysioDoloris Monitor, and computed through the time-domain (standard deviation of normal-to-normal intervals [SDNN], root mean square of successive differences), the frequency-domain (low frequency, high frequency) and the graphical (Analgesia Nociception Index [ANI]) methods. Fifty patients were analyzed, including 35 females. Twelve patients had an underlying neurological disease. Efficacy was deemed achieved in 54% of patients. SDNN variability significantly increased during StimA to StimC, while maximum SDNN significantly increased only during StimA. ANI variability significantly increased during all 4 stimulations, while maximum ANI significantly increased only during StimA. Direct stimulation of SNR is responsible for a significant increase in ANS and relative parasympathetic nervous system activity, with a greater effect observed when the stimulation was delivered closer to the SNR. These results shed light on potential mechanisms underlying sacral nerve modulation, particularly regarding the treatment of ANS dysregulation in lower urinary tract dysfunction.

Precision Gait Stability Analysis Combining Hardware and Software

Maintaining stable gait and avoiding falls require effective control of the body’s center of mass (CoM) relative to the base of support (BoS), defined by the feet's contact points with the floor. Quadrupeds have an advantage over bipeds but share common spinal neural control mechanisms. Human walking poses stability challenges since the CoM often extends beyond the BoS. This project aims to monitor gait stability by integrating advanced hardware and software solutions. Machine learning algorithms, such as Random Forest, will be employed to predict gait instability by capturing foot positions and sensor data. Inertial measurement sensors will track stability changes, and hardware outputs will be validated against software predictions for accuracy. A mobile app developed using React Native will display predicted parameters and indicate gait instability (yes/no). In case of detected instability, a wearable buzzer will alert the user. This system promises a more accurate solution for monitoring gait stability compared to existing models, by combining real-time data collection and sophisticated algorithms

Implementing dietary counselling in family practice for diabetes control and prevention

The importance of dietary counselling in family practice for managing and preventing diabetes is the focal point of this review, highlighting its integral role in chronic disease management. With diabetes increasingly prevalent worldwide, there is a critical need for effective management strategies, with dietary interventions playing a key role. Family practitioners, often the initial point of contact for patients, have a unique opportunity to implement these dietary changes, which are pivotal in influencing diabetes outcomes and averting long-term complications. Despite facing challenges such as limited time and the need for specialized knowledge, dietary counselling in family practice stands as a proactive measure focused on prevention and early intervention. It adopts a patient-centered approach, where dietary habits and preferences are assessed, and personalized, evidence-based advice is provided. The inclusion of dietitians in primary care teams, utilization of technology for support, and advocacy for policy reforms are recommended to enhance the effectiveness of dietary counselling. Despite various obstacles, integrating dietary counselling into routine care remains a significant advantage, promoting healthier lifestyle choices and effectively managing the increasing burden of chronic diseases.

Single German centre experience with patient journey and care-relevant needs in amyloidosis: The German AMY-NEEDS research and care program.

Amyloidosis is a rare multi-system disorder associated with frequently delayed diagnosis, enormous disease burden and psychosocial distress. Systematic assessment of needs was performed by a subtype-spanning questionnaire-based survey within the AMY-NEEDS research and care program. 118 patients with proven amyloidosis (62.7% ATTR, 22.0% AL, 15.3% other forms) were included in August 2020 until February 2021 (mean age 71.2 ±11.3 years; 30% women). The median diagnostic delay between onset of symptoms and diagnosis was 9.0 (range: 2.5; 33.0) months. Local health care providers (HCPs) play a central role on the way to diagnosis. Diagnosis itself typically requires a clinical but not necessarily a university setting. In the treatment phase, the focus moves to the amyloidosis centre as primary contact and coordinator, with general practitioners (GPs) acting predominantly as a contact point in crisis and link to additional services. About half of patients reported impaired quality of life and one third suffering from anxiety and depressed mood, respectively. The majority of patients talk about their concerns with close caregivers and local HCPs. Advance care planning is a relevant, yet insufficiently met need. The journey of patients with amyloidotic disease, their contact partners and needs at different stages were characterized in detail within the German health care system. An amyloidosis-specific care concept has to master the multitude of interfaces connecting the numerous treatment providers involved with the amyloidosis centre and GPs as key players. Telemedical approaches could be a promising and well-accepted option allowing optimal coordination and communication.

Patient-Reported Experiences of Supportive Cancer Care during the COVID-19 Pandemic

Background. During the COVID-19 pandemic, people affected by cancer were in need of information about the virus and about the (self-) management of cancer symptoms and treatment. It is important to understand how patients with cancer navigated through the pandemic and to explore their experience relating to their supportive care needs. Aim. This study aimed to describe the experience of Swiss oncological patients during the COVID-19 pandemic with additional supportive cancer care. Methods. A single-center study was conducted in 2021. Patients with melanoma, breast, lung, or colon cancer who received active systemic anticancer treatment at the time of the COVID-19 pandemic and who were additionally seeing either oncology clinical nurse specialists, integrative medicine physicians, or both were included. We conducted semistructured interviews alongside the patient-reported quantitative assessment of distress and resilience. Thematic analysis was performed for the qualitative data and descriptive statistics for the quantitative data. Results. Eighteen patients with cancer were interviewed. Patients seeing an integrative medicine physician highlighted that they positively felt being addressed as a whole person during the consultations. The oncology clinical nurse specialists were perceived as the first point of contact for the patients and had more time during the pandemic compared to what the patients normally received. In general, patients did not experience delays or disruptions in their cancer treatment. As immunosuppressed and fatigued patients with cancer, they felt supported by the restrictions and hygienic measures. Access to vaccination reassured patients against the risk of infection. These results were reflected in the quantitative data, as we found moderate distress levels (M = 4.1; SD = 2.5) and high resilience scores (M = 7.5; SD = 0.9) in this patient population. Conclusion. During the COVID-19 pandemic, patients with cancer felt particularly supported by integrative medicine and cancer nurse consultations. Secured resources for nursing consultations and integrative medicine services can help to address the supportive care needs of patients with cancer.

Parental Perspectives on Principals’ Responses to Homophobic, Biphobic, and Transphobic Bullying in Australian High Schools: An Exploratory Study

AbstractSchool principals may be well-placed to establish safe and affirming school climates for gender and sexuality diverse students by upholding zero-tolerance policies for homophobic, biphobic, and/or transphobic (HBT) bullying. Few qualitative investigations have examined how leaders are perceived, by those with vested interest, to be exercising their powers in this regard. Parents and caregivers (N = 16) completed a qualitative online questionnaire about their experiences navigating school responses to the HBT bullying of their child. Responses were analysed using reflexive thematic analysis. Findings indicate that principals were often either a first point of contact or an option for escalation. Intervention efforts were favourably appraised where empathy for the targeted student was accompanied by quick and decisive action. When this did not occur, participants described the injurious effects of inaction, prejudiced attitudes, and minimisation of the impact of non-physical bullying on both them and their child. We discuss implications for principals and schools with respect to the significant consequences of non-intervention.

Postdigital Storytelling: Storytelling (Within or Across) the Digital and Transmedia Field

AbstractThe term postdigital implies a rupture and continuity of the digital paradigm, which allows us to analyse the challenges implied by a largely digitalised society. At the same time, the term transmedia goes completely unnoticed in the postdigital literature, despite sharing key elements in its reflection on the digital paradigm. For this reason, this article reflects on the points of contact between transmedia and postdigital storytelling, as well as the differences identified between postdigital storytelling and its precedents: digital storytelling and transmedia storytelling. It is discussed that postdigital storytelling becomes an evolution of digital storytelling in congruence with the challenges posed by the postdigital paradigm and, simultaneously, that transmedia storytelling can adopt a postdigital perspective under which to balance the media it uses, while maintaining its essence of narrative expansion, which is a dispensable condition in digital and postdigital storytelling. Finally, an analogous reflection to the digital term emerges that more and more the transmedia nature is intertwined and diluted in the context that surrounds us to the point that it ceases to make sense.