Future Plans Research Articles

Exploration of the Challenges of COVID-19 from the Perspective of Emergency Medicine Specialists.

Emergency physicians are at the forefront of the medical system in the face of the COVID-19 crisis. Identifying the challenges, along with the strategies and effective measures implemented by them in the face of the COVID-19 crisis, can be a roadmap for future crisis management planning. This study aims to explain the challenges faced by emergency physicians regarding COVID-19. This study is a qualitative content analysis. Data were collected using individual and semistructured interviews. Twenty-seven emergency medical specialists in Fars University of Medical Sciences, Iran, participated in the study by purposive sampling method and were interviewed using semistructured interviews. Participants' experience of COVID-19 led to the extraction of four main themes, including structural factors, threats to the health of the medical team, fluctuations of extremism and wastage in the face of COVID-19, and the country's policymaking hierarchy. Emergency physicians face challenges such as structural factors, health threats, extreme fluctuations, and national policymaking. To avoid surprises and threats, they must predict acute scenarios, provide necessary equipment, address skilled manpower shortages, and adopt appropriate management policies. This includes culture-building, cross-sector coordination, planning, and efficient management to prevent virus spread.

LGBTQ+ cancer: priority or lip service? A qualitative content analysis of LGBTQ+ considerations in U.S. state, jurisdiction, and tribal comprehensive cancer control plans.

The National Comprehensive Cancer Control Program, a Centers for Disease Control and Prevention funded program, supports cancer coalitions across the United States (US) in efforts to prevent and control cancer including development of comprehensive cancer control (CCC) plans. CCC plans often focus health equity within their priorities, but it is unclear to what extent lesbian, gay, bisexual, transgender, queer/questioning, plus (LGBTQ+) populations are considered in CCC plans. We qualitatively examined to what extent LGBTQ+ populations were referenced in 64 U.S. state, jurisdiction, tribes, and tribal organization CCC plans. A total of 55% of CCC plans mentioned LGBTQ+ populations, however, only one in three CCC plans mentioned any kind of LGBTQ+ inequity or LGBTQ+ specific recommendations. Even fewer plans included mention of LGBTQ+ specific resources, organizations, or citations. At the same time almost three fourths of plans conflated sex and gender throughout their CCC plans. The findings of this study highlight the lack of prioritization of LGBTQ+ populations in CCC plans broadly while highlighting exemplar plans that can serve as a roadmap to more inclusive future CCC plans. Comprehensive cancer control plans can serve as a key policy and advocacy structure to promote a focus on LGBTQ+ cancer prevention and control.

Exploring the correlation of space creation in Suzhou classical gardens and the Chinese calligraphy Yan Zhenqing’s three manuscripts

ABSTRACT Chinese calligraphy and Suzhou classical gardens exhibit unique and distinctive formal attributes and layout styles. This paper examines the interrelationships from a spatial perspective, using classical gardens such as the Humble Administrators’ Garden, the Lingering Garden, and the Master of Nets Garden, alongside Yan Zhenqing’s Three Manuscripts (颜公三稿), as illustrative examples. From the theoretical stance of “Heterogeneous Homology”, this investigation assesses the comparability between calligraphy and garden design. It highlights the shared spatial features of “Emptiness-Substance” and “Denseness-Sparseness”, analyzing their specific applications within each realm. Furthermore, the “Correspondence and Guidance” is fulfilled to effectively integrate the spatial boundary within their respective domains. The findings reveal profound similarities in spatial construction between calligraphy and garden design, highlighting the traditional Chinese aesthetic pursuits of emptiness, distance, and externality. These findings affirm the ancient Chinese pursuit of the natural philosophical concept of “the unity of nature and human”. Consequently, it is proposed that future design and urban spatial planning should emphasize the application of the spatial techniques and cultural meanings embedded in these arts. This approach aims to provide a multidimensional and detailed interdisciplinary perspective on future research concerning Asian architectural culture and art history.

Conversations in couple relationships: a trustful foundation when making future parenthood “real”

Sociologists often argue that communication in long-term couple relationships is the basis on which expectations, trust, and equality are created in contemporary society. However, what is the role of these everyday conversations in uncertain life situations such as expecting one’s first child? This article examines concerns reported by prospective Swedish parents in order to explain the role of communication to alleviate these. Concerns, related to the formation of new relationships with one’s partner, oneself, and one’s future child, are mitigated by referring to the couple’s “good” communication. In the present prenatal situation, the communication pattern (established in the past) seems to serve three functions in mitigating future concerns: (1) the communication generates a trust capital in the relationship, allowing the couple to venture into the uncertain future, (2) the communication makes social perceptions of family life “real” by constructing a common nomos that is internalized in the individual as an existential motto, and (3) the communication legitimizes family practices as democratic when referring to future plans as emerging from responsive and consensual dialogs. In the article it is emphasized that welfare policy needs to be based on an existential legitimacy, often developed in couple conversations, and particularly shaped in life situations characterized by change. However, the stability offered at the conversational micro level may simultaneously prevent macro level changes, a complexity that needs to be considered when developing a gender equality policy that is to resonate with people’s existential meaning making. With the aim of consensus, and the means of balancing conflicts, there is a risk that the conversation will consolidate the interests of the stronger party. In this way, the responsive conversations in long-term relationships may consolidate gender inequality and counteract the welfare policy goal of equalizing power relationships.

#3142 Evaluation of antipruritic effect of tacrolimus on hemodialysis patients with uremic pruritus, a double-blind, randomized, clinical trial

Abstract Background and Aims Pruritus in patients undergoing hemodialysis is a highly prevalent complication that affects quality of life. Several medications are currently used for the treatment of uremic pruritus, but these are not satisfactory. There are few studies about the beneficial effect of oral Tacrolimus on dermatologic problems such as pruritus. Considering the condition of hemodialysis in ESKD patients and the probable presence of oral Tacrolimus in their future treatment plan, this trial is designed to assess the antipruritic effect of Tacrolimus compared with placebo. Method This multicenter, randomized, double-blind, placebo-controlled clinical trial included 75 patients undergoing hemodialysis. The patients were randomized to a treatment group (Tacrolimus 1 mg/day) or a control group (placebo). The treatment lasted eight weeks, followed by a 2-week observational period. Visual Analogue Scale (VAS), % affected Body Surface Area (%BSA), and 12-Pruritus Severity Scale questionnaire (12-PSS) were measured before and after treatment periods. Moreover, sleep quality and the effect of sex were also evaluated. Results Seventy-five patients under hemodialysis (mean age of 58.18 ± 09.39 years) completed the study. Mean changes in VAS, %BSA, and 12-PSS after the interventions (Tacrolimus vs. placebo, mean ± SD) were as follows, respectively: −3.77 ± 2.13 vs. −1.07 ± 1.17, −18.97 ± 12.20 vs. 2.44 ± 3.23, and −4.67 ± 3.21 vs. −1.32 ± 2.45 (P < 0.0001). An improvement in sleep quality was found in 52.6% (20/38) of patients after Tacrolimus intake (P < 0.01). Overall, Tacrolimus was more effective in women than men (P < 0.016). Conclusion Based on the preliminary results of this study, Tacrolimus can be introduced as an effective drug for the management of pruritus and can be an add-on therapy in uremic patients.

#3078 The utility and cost-effectiveness of embedding geriatric expertise in a tertiary referral renal clinic

Abstract Background and Aims The demographic of people receiving dialysis is changing with an increasing prevalence of frailty, co-morbidity and geriatric syndromes. To address this, we initiated routine, embedded, consultant geriatric review of a selected group of patients (frail/living with frailty syndromes, age>80 preparing for dialysis, undecided between treatment options, patient/family judged by MDT to have unrealistic perception of treatment benefit) in our renal low clearance (pre-dialysis) clinic alongside our already-established palliative care service to support decision-making about treatment options for end stage kidney disease Method Starting in 2018, 77 patients were reviewed before suspension enforced by the Covid-19 pandemic in March 2020 and a further 56 since resumption between July 2021 and January 2023. We present the short-term results of all 133 patients immediately following geriatric review, plus long-term outcome data for the first 77 patients for whom we have 3 years’ follow up, including health economic analysis and ANOVA of frailty and treatment choice. Results Initially the cohort included 10 patients who had already chosen conservative management (CM) of their renal failure, but after one PDSA cycle only patients choosing dialysis or undecided about treatment choices underwent review in the service (mean age 78 [range 62-92]; 70% male). Following geriatric review, the number of patients uncertain about their future renal treatment plan changed from 43 to 3; the number choosing to have dialysis reduced from 80 to 44 and the number choosing CM increased from 10 to 74. The number of advance care plans made among the group reviewed by the geriatrician increased from 0 to 77, and the number of DNACPR records increased from 6 to 43; there were increased referrals to falls, memory and continence clinics. Overall, 57% of patients left clinic with a different management plan. 36 months after geriatric review, the survival rate in the group choosing dialysis was 46% and in the CM group was 33%; the majority of deaths were unrelated to renal failure. ANOVA indicated that clinical frailty scores impacted outcome more than treatment choice; health economic analysis showed the costs of providing this review (average 193 GBP per patient) were highly likely to be more than off-set by reductions in unnecessary fistula formation alone (average 288 GBP per patient) Conclusion Routine, protocol-supported geriatric review in a tertiary referral renal service is cost effective and associated with increased dialysis decision-making, reduced dialysis uptake, increased advance care-planning, increased CPR decision-making plus recognition and appropriate referral of geriatric syndromes. Outcomes in the group suggest little difference in survival among those choosing dialysis vs CM, and that frailty is more indicative of prognosis than treatment choice.

#898 Acceleration in kidney function decline after COVID-19 infection: the Stockholm CREAtinine Measurements (SCREAM) project

Abstract Background and Aims Severe COVID-19 infection, which usually presents as a viral pneumonia, has been observed to frequently be accompanied by acute kidney injury (AKI). However, possible effects of COVID-19 on long-term kidney function decline are not well quantified. We investigated whether kidney function decline is accelerated after COVID-19 infection, and whether the progression of decline differs from other respiratory tract infections. Method We undertook an observational study using the SCREAM project, including adults from Stockholm who survived COVID-19 infection (February 2020-December 2021), and adults who survived pneumonia caused by other pathogens (February 2018-December 2019, historical comparison cohort). We used generalized estimating equations to examine the age- and sex-adjusted slopes of estimated glomerular filtration rate (eGFR) decline in the 2 years before versus after each infection (i.e., intra-individual changes). We also compared to post-infection eGFR slopes of COVID-19 versus pneumonia (i.e., inter-individual changes) adjusting for a broad range of demographic, socioeconomic and clinical covariates (including pre-infection eGFR slope). We stratified analyses by whether the infection required hospitalization, hypothesizing more severe infection may lead to more rapid eGFR decline. Results We identified 59 267 COVID-19 survivors and 20 138 pneumonia survivors with repeated outpatient eGFR measurements. The pneumonia group was older, with lower income, and more comorbidities and healthcare utilization than the COVID-19 group. Both infections resulted in an accelerated decline of the observed eGFR slope, but with a greater magnitude of intraindividual slope changes after COVID-19 (Fig. 1): eGFR decline was 6.14 (95% confidence interval [95% CI] 5.88-6.41) ml/min/1.73 m2/year faster after COVID-19, and 2.52 (95% CI 2.17-2.88) ml/min/1.73 m2/year faster after pneumonia. When adjusting for pre-infection slope and other identified confounders (Fig. 2), COVID-19 survivors had an eGFR decline that was 0.47 (95% CI 0.29-0.66) ml/min/1.73 m2/year faster than that of pneumonia survivors. Observed intra- and inter-individual differences were larger in magnitude among participants whose infection required hospitalization. Conclusion COVID-19 infection is associated with a subsequent acceleration in eGFR decline, of a larger magnitude than other respiratory tract infections, and particularly among more severe cases that required hospitalization. We propose that survivors of severe COVID-19 receive monitoring of kidney function, and that policymakers consider implications for future healthcare planning and renal service provision.

Experiences of living with idiopathic pulmonary fibrosis in relation to physical activity - “How the hills became steeper and steeper”: a qualitative interview study

IntroductionIdiopathic pulmonary fibrosis (IPF) is a progressive disease presenting with symptoms like dyspnoea, dry cough, and fatigue, which affect physical function and quality of life. No earlier qualitative studies have investigated physical activity in IPF. This study aims to explore experiences of living with IPF in relation to physical activity.Materials and methodsQualitative interviews were conducted with 14 participants living with IPF. The participants were 77 years old (range: 56–86) and diagnosed with IPF between 2 and 9 years ago. The analysis was performed by qualitative content analysis according to Graneheim and Lundman.ResultsThe results indicated that life and one’s ability to be physically active is affected by IPF. Despite this, it seems possible to navigate past obstacles, which was illustrated by an overall theme: “My life is constrained, but I am hanging on”. Two major categories cover topics of IPF being a life changing diagnosis with changes in self-image and changed future plans regarding physical activity, as well as life. Physical activity was perceived to be challenging, yet in many ways used as a strategy, developed to manage life.ConclusionsIPF affects physical activity as well as life, from onset onwards. By developing strategies for facilitating physical activity as well as identifying barriers, it seems possible to maintain an active life despite the disease. The healthcare system needs to create support systems that meet different needs during different phases of the disease.Trial registration“FoU in Sweden” Research and Development in Sweden (id: 227081).

Australian strategic planning and socio-spatial vulnerability: the case of metropolitan Adelaide

ABSTRACT This article explores the correlation between contemporary strategic planning and socio-spatial disadvantage, utilizing data from five censuses conducted within the Adelaide metropolitan region. To assess how these two dynamics manifest across Australian cities, we introduce a vulnerability assessment methodology. Taking a historical perspective, the study delves into how ongoing socio-spatial transformations have impacted the Index of Relative Socio-economic Disadvantage (IRSD) over several decades. Employing mixed methods, we analyse the temporal progression of the IRSD from 1991 to 2021 and interpret the implications in the context of contemporary strategic plans. The research findings reveal that strategic plans in metropolitan Adelaide have become linked to the establishment of five interconnected/consolidated regional centres, as well as the relocation of areas of disadvantage from the traditional inner cities to the middle and outer suburbs. This has led to residents experiencing enduring socio-spatial vulnerability for several decades. The investigation illustrates the evolving nature of urban disadvantage in post-industrial Australian cities. This article introduces an innovative method for evaluating strategic plans, specifically monitoring progress in achieving their objectives. This could guide future plans to uplift disadvantaged suburbs from a state of permanent vulnerability.

The Impact of College Students' Career Decision Self-Efficacy on Career Adaptation from the Perspective of High-Quality Employment: The Mediating Role of Career Preparation Behavior

This study primarily analyzes the impact of career decision self-efficacy and career preparation behavior on career adaptation, discussing the mediating role of career preparation behavior among 522 college students. The results show significant positive correlations among career decision self-efficacy, career preparation behavior, and career adaptation. Career decision self-efficacy significantly positively influences career preparation behavior, with the sub-factors of influence in descending order being problem-solving, future planning, and goal-setting. Self-evaluation and career information do not have a significant impact on career decision self-efficacy. Career decision self-efficacy also has a significant positive effect on career adaptation, with future planning and problem-solving having the highest influence. Self-evaluation, career information, and goal-setting do not significantly impact career adaptation. Career preparation behavior has a significant positive effect on career adaptation, with the sub-factors in descending order being information gathering behavior, goal achievement behavior, and tool preparation behavior. In the mediation test, career preparation behavior partially mediates the effects, mainly through problem-solving and future planning influencing information gathering and goal achievement behaviors, thereby enhancing students' interest in careers, self-behavioral control, curiosity about future developments, and confidence. Thus, problem-solving and future planning in career decision self-efficacy are critical for enhancing students' career adaptation and achieving high-quality employment.

Sustainable water resource management by business organisations: empirical investigation applying stimulus-organism-response theoretical perspective

PurposeThe purpose of this research was to study sustainable water resource management using a stimulus-organism-response (SOR) perspective.Design/methodology/approachThis research study was an exploratory qualitative study. Thematic content analysis was used based on semi-structured interviews with 30 experts operating in the USA, representing 26 water-intensive organisations across different industries. The study was anchored in the theoretical foundations of SOR perspectives.FindingsThe results of this study revealed several fundamental factors, processes and forces that were considered by organisations for sustainable water resource management. Managers evaluated risks relative to water resources and developed strategic initiatives regarding water management. The authors found that often organisations considered water resources management aspects while deciding business operations. This was especially true for substantive water resource-consuming organisations with wide geographical operations.Research limitations/implicationsThrough this study, the authors explained how the interrelationship between organisations and water resources presented risks and challenges. The authors applied SOR theoretical perspective in this research study. This was while factoring in an organisation’s present considerations and future plans regarding sustainable water resource management. Thus, the study findings were expected to further interdisciplinary research at the intersection of organisational and environmental studies.Practical implicationsThe finding that water sustainability challenges and efforts could act as strong motivating forces for innovation and technology was significant. Water sustainability challenges could also be a catalyst for synergistic collaborations amongst organisations and diverse groups of institutions. The study insights were relevant to organisational scholars, the water management industry regulators and managers involved with organisational sustainability programmes.Originality/valueOrganisational challenges regarding sustainable water resource management have been influenced by growing populations and climate change. Furthermore, the increasing context of scarcity was compounded by increased pressures from numerous stakeholders. Although critical water management issues were recognised by organisations, relatively little was known about how organisational managers were planning for and responding to these issues. This research study contributed towards addressing the mentioned research gap.

A study on the image of Guilin’s urban central space from multidimensional views

In the context of high-quality urban development, strengthening the distinct characteristics of the city itself has become a hot topic. This study focuses on the present Guilin’s urban central space as its research object, aiming to explore the characteristics of Guilin city image through three dimensions: traditional method, spatial syntax, and big data analysis. By exploring the differences presented across these dimensions, the study seeks to analyze the influence of human activities on the spatial form of the city. The investigation reveals that the current development of Guilin’s urban central space manifests a diverse cognitive image characterized by large dispersion, small aggregation, and weak systematicity. The influence of natural landscape on the development of city images in Guilin’s urban central space lies in its ability to facilitate the outlanders’ macroscopic cognition of Guilin’s unique landscape characteristics. However, it also hinders the development of the road network in the urban area, resulting in reduced spatial accessibility and cognitive intensity. In short, Guilin’s urban central space requires systematic integration of the development of multiple images in its future development. This approach entails strengthening the accessibility of public transportation and effectively enhancing the coordination of its unique landscape and natural elements with the development of other urban spaces. Moreover, this study attempts to provide insights into the future planning of cities from the perspective of integrated image development. In addition, it represents a pioneering effort to acquire data and analyze methodologies for cognitive research on city morphology and city image.

Landslide susceptibility assessment through multi-model stacking and meta-learning in Poyang County, China

This study aims to evaluate the effectiveness of various individual machine learning and their ensemble techniques such as Stacking, Voting and Meta-learning in landslide susceptibility assessment taking Poyang, Jiangxi, China as an example. Multi-source geo-environmental data including field surveys, Sentinel-2A/B satellite images, Digital Elevation Models (DEM), and geological and hydrological data were utilized to construct and validate landslide susceptibility models. Results show that the Stacking Classifier outperformed other models, achieving the highest F1 Score of 0.846 and AUC (Area Under ROC Curve) of 0.923, demonstrating its strong predictivity, followed by the Voting Classifier with the F1 Score of 0.829 and AUC of 0.922. Among the individual models, the Multi-Layer Perceptron (MLP) performed best with the F1 Score of 0.828 and AUC of 0.904. Furthermore, the explainable Artificial Intelligence (XAI) technique was applied to better understand the mechanism of classifiers in predicting landslide susceptibility and it suggests a significant correlation between land use, distance to fault, and landslide occurrences. In conclusion, Stacking and Voting hybrid learning models show clear advantages over the individual ones for landslide risk zoning. The results of study may provide technical support for disaster mitigation efforts and future urban planning in areas prone to landslides in Poyang.

Rising risks of hydroclimatic swings: A large ensemble study of dry and wet spell transitions in North America

Hydroclimatic swings between dry and wet spells are increasing globally, raising concerns due to their severe impacts on society, agriculture, infrastructure systems, and water resource management. These extremes and their projected changes are traditionally assessed in isolation, which can underestimate associated risks and future resilience and adaptation plans. This study investigates climate change projections of such lagged compound dry and wet spells across North America using a single model initial-condition large ensemble (SMILE). Three dry-wet spell indices are merged into an integrated indicator to provide a comprehensive perspective on changing risks. We apply an ensemble pooling approach using the Canadian Regional Climate Model version 4 Large Ensemble (CanRCM4-LE) to enhance sample size for index estimation. Results suggest that hydroclimatic swings across North America are expected to become more frequent and intensified in a warmer climate. Trends of spatial fraction and aggregation during transitions between dry and wet spells indicate future water resource management challenges. Hot spots for intensified transitions with higher frequency, such as Northern Central America, and the southern part of Eastern and Western North America, including Mexico and the state of California, overlap with larger spatial extent and higher aggregation during transitions. The seasonal analysis of spatial characteristics indicates winter may become wetter and summer drier at higher warming levels, potentially intensifying transitions between dry and wet extremes. Clustered hydroclimatic swings may lead to severe environmental, hydrological, and socio-economic consequences, necessitating appropriate mitigation and adaptation measures.

Impact of COVID-19 pandemic on breast cancer screening in a large midwestern United States academic medical center.

Access to breast screening mammogram services decreased during the COVID-19 pandemic. Our objectives were to estimate: 1) the COVID-19 affected period, 2) the proportion of pandemic-associated missed or delayed screening encounters, and 3) pandemic-associated patient attrition in screening encounters overall and by sociodemographic subgroup. We included screening mammogram encounter EPIC data from 1-1-2019 to 12-31-2022 for females ≥40 years old. We used Bayesian State Space models to describe weekly screening mammogram counts, modeling an interruption that phased in and out between 3-1-2020 and 9-1-2020. We used the posterior predictive distribution to model differences between a predicted, uninterrupted process and the observed screening mammogram counts. We estimated associations between race/ethnicity and age group and return screening mammogram encounters during the pandemic among those with 2019 encounters using logistic regression. Our analysis modeling weekly screening mammogram counts included 231,385 encounters (n = 127,621 women). Model-estimated screening mammograms dropped by >98% between 03-15-2020 and 05-24-2020 followed by a return to pre-pandemic levels or higher with similar results by race/ethnicity and age group. Among 79,257 women, non-Hispanic (NH) Asians, NH Blacks, and Hispanics had significantly (p < .05) lower odds of screening encounter returns during 2020-2022 vs. NH Whites with odds ratios (ORs) from 0.70 to 0.91. Among 79,983 women, those 60-69 had significantly higher odds of any return screening encounter during 2020-2022 (OR = 1.28), while those ≥80 and 40-49 had significantly lower odds (ORs 0.77, 0.45) than those 50-59 years old. A sensitivity analysis suggested a possible pre-existing pattern. These data suggest a short-term pandemic effect on screening mammograms of ~2 months with no evidence of disparities. However, we observed racial/ethnic disparities in screening mammogram returns during the pandemic that may be at least partially pre-existing. These results may inform future pandemic planning and continued efforts to eliminate mammogram screening disparities.

‛It's all communication': Family members' perspectives on the communication needs for themselves and their relatives with primary progressive aphasia.

Communication disabilities, such as primary progressive aphasia (PPA), impact family members as well as the individuals with the condition. To provide adequate communication care to people with PPA (PwPPA) and their family members, it is crucial to understand the communication needs from the family members' perspectives. To date, research on the communication needs of people with primary progressive aphasia and their family members from the perspectives of family members has been limited. The specific research objectives were to explore (a) the communication needs pertaining to PwPPA in the early, middle and late stages; and (b) the communication needs pertaining to family members of PwPPA in the early, middle and late stages, from the perspectives of family members. This study employed a qualitative description approach, underpinned by the pragmatic paradigm. Data collection involved semi-structured qualitative interviews with eight family members (relatives of four individuals with the logopenic variant of PPA, of two individuals with the nonfluent variant of PPA, of one individual with the semantic variant of PPA and of one individual with mixed PPA). Qualitative content analysis was used to identify codes and categories in relation to the research objectives. Qualitative content analysis revealed eight categories of communication needs pertaining to the PwPPA: person-specific needs; diagnosis and disclosure; general communication difficulties; impact on communication in everyday life; impact on cognition; impact on psychosocial well-being; impact on person's dignity and autonomy; and future planning. Six categories were identified pertaining to the family members: information about and awareness of PPA; impact of communication difficulties on family/others; increased responsibilities for the family in everyday life; impact on psychosocial well-being; and future planning. This investigation has expanded our knowledge in the area by providing insights about communication needs which speech-language pathologists and other health professionals should be aware of and take into account when providing communication care to PwPPA and their families. What is already known on the subject Person- and family-centred communication care is optimally guided by the person's and family's needs and values. Research on communication care for people with primary progressive aphasia has underscored the inclusion of family members. Previous research has investigated the impact and experiences of living with primary progressive aphasia from the family member perspective. What this paper adds to existing knowledge To date, research focusing on identifying the communication needs of people with primary progressive aphasia and their family members from the perspective of family members is limited. This study adds the family members' perspectives on the communication needs pertaining to themselves and their relatives with primary progressive aphasia in the early, middle and late stages of primary progressive aphasia. What are the potential or clinical implications of this work? Several clinical implications have been raised. Family members experience communication needs for themselves and should be included as recipients of communication care. Clinicians supporting people with primary progressive aphasia should be cognizant of the impact of communication fatigue on everyday life and therapy tasks. Communication care for this population should include communication partner training, support for psychosocial well-being and support with communication around future planning.

Analysis and mapping of global research publications on point-of-care testing for infectious diseases.

This study presents the first comprehensive analysis and mapping of scientific research on point-of-care testing (POCT) in infectious diseases, filling a gap in understanding the evolving landscape of this field. The identification of research themes and global contributions offers valuable insights. This manuscript aims to analyse and map scientific research on POCT in the context of infectious diseases. The study employed a comprehensive search strategy using terms related to POCT and infectious diseases. The search was conducted on the Scopus database, refining results based on inclusion and exclusion criteria. The dataset of 1719 research articles was then subjected to descriptive analysis and mapping using VOSviewer. The research findings indicate an exponential growth in POCT-related publications, with 46.8% published post the COVID-19 pandemic. Plos One journal led in publication frequency, and Biosensors and Bioelectronics received the highest citations per article. North America and Western Europe dominated contributions, with notable participation from China, South Africa, and India. The research landscape revealed the following research themes: detection technologies, human immunodeficiency virus (HIV)/sexually transmitted infection (STI) diagnosis, antibiotic optimisation, and schistosomiasis. Clinical trials focused on antibiotic prescribing, HIV, STIs, and specific infections. The findings suggest a shifting landscape towards POCT, emphasising the need for future planning and investment in healthcare systems. The research identifies areas for future exploration, such as the impact of POCT on antibiotic prescribing and its role in combating infectious diseases in low- and middle-income countries. Implementation of POCT has the potential to revolutionise infectious disease management, improve patient outcomes, and reduce the global burden of diseases. Better public awareness, healthcare team management, and planning for POCT at entry points are crucial for societal benefit. Results demonstrated the evolving role of POCT in infectious disease management and prevention.

Experimental environment for testing the shattered pellet injection of KSTAR

The dual shattered pellet injection (SPI) systems installed at the KSTAR (Korean Superconducting Tokamak Advanced Research) have been operational since 2019 to conduct disruption mitigation studies in support of ITER DMS (Disruption Mitigation System) design activities. The system has the advantage of firing pellets simultaneously from the two identical pellet injectors installed at 180-degree opposite positions on KSTAR. Each injector is capable of fabricating and firing three pellets of different sizes (diameter, length). The characteristics of the initial pellet (geometry, velocity, etc.) can be verified using a microwave cavity (MWC) system and an imaging optical pellet diagnostics (OPD) system.Each SPI system must achieve specific conditions related to pellet fabrication and firing prior to plasma experiments. We realized that we didn't have the sufficient time and conditions to do off-line testing in 2022, so we have developed a suitable solution. First, we have to disconnect the SPI system from the KSTAR vacuum vessel and build a separate test chamber in the injection line. Inside the new test chamber, we have to install the same shatter tube used in the current experiments and equip it with measuring devices to observe the fragmented pellets. We also have to switch the fabrication process of the pellets from manual to semi-automatic using a feedback pressure controller on the barrel pressure. In this paper, we will describe the new experimental environment for independent SPI testing and the future plan.

Possible Ways to Help Raise China's Fertility Rate

This paper explores the reasons why the current problem of fertility reduction in China is mainly due to the unclear future family planning of women and young people and the incomplete inclusion of the responsibility of raising children in their future planning. By comparing the three types of countries in the world - backward countries, developing countries and developed countries - as "three small islands" and comparing the welfare they provide to their citizens, as well as their demands for different productive forces and human resources, we gradually determine the orientation of China and its future development direction. Finally, by citing and learning from the fertility policies of Japan and South Korea, the article gives several feasible plans to help China raise its fertility rate. With mild encouragement and some financial support, young families can be helped to settle down in their plans to start a family.

Voices of the unhoused from Santa Fe, New Mexico: A mixed methods study of health status, substance use, and community harm reduction program perspectives

No published studies have examined the community service priorities and harm reduction perspectives of unhoused people in Santa Fe, New Mexico. We conducted a mixed methods pilot study of 56 unhoused people at community locations in Santa Fe to: (1) assess the current prevalence of chronic medical conditions and substance use; (2) highlight community service priorities; and (3) explore views of innovative community harm reduction programs. Our first hypothesis was there would be high prevalence of chronic medical conditions, for which we found high prevalence of post-traumatic stress disorder, major depression, substance use disorders, chronic pain, and hypertension. Our second hypothesis was that we would find top community service priorities of housing, food, and health care. We found long- and short-term housing and food, but not healthcare, top priorities. Our third hypothesis was that we would find mixed support for community harm reduction initiatives like managed alcohol programs and overdose prevention centers. We found positive, not mixed, support for these community harm reduction programs among Santa Fe’s unhoused. Unhoused study participants ranged in age 27–77 years, with lifetime years unhoused from less than one year to 63 years. Study limitations included small sample size, convenience sampling, and descriptive results. Policies and program initiatives supporting additional Housing First options, managed alcohol programs, and overdose prevention centers in the Santa Fe community are clearly indicated to increase engagement with this vulnerable population. Future research should focus on inclusion of the perspectives of the unhoused in the design, conduct, evaluation, and dissemination of community programs to meet the needs of the unhoused, with re-defined outcomes to include changes in quality of life, program engagement, demarginalization, and future goals and plans, beyond currently utilized health and social service program outcome measures.