Large Body Research Articles

Ultrasound-Guided Dorsal Penile Nerve Block in Children: An Anatomical-Based Observational Study of a New Anesthesia Technique.

Dorsal penile nerve block stands out as one of the commonly employed regional anesthetic techniques in children. Despite the large body of experience, failure rates are still significant. We included 20 children (median (SD) age of 73 (31) months) scheduled for circumcision without general anesthesia and secondary airway manipulation in a consecutive case series. Under ultrasound guidance and utilizing an in-plane needle guidance technique, the dorsal penile nerve block was administered with slight sedation, and spontaneous respiration was maintained in all cases. To investigate the underlying anatomy for dorsal penile nerve blockade, we dissected three cadavers. The primary study endpoint was the success rate of surgical blockade, meaning that the surgical procedure could be performed without additional general anesthesia and invasive airway management. The secondary endpoint was the requirement of analgesics until discharge from the post-anesthesia care unit. The primary endpoint was successfully met in all patients according to our strict definition without additional general anesthesia or airway manipulation. In addition, no child received analgesics until discharge from the recovery room. The anatomical investigation clarified the specific anatomy as baseline knowledge for an ultrasound-guided dorsal penile nerve blockade and enabled successful performance in 20 consecutive children where penile surgery was possible in light sedation without additional airway manipulation.

Implementing Measurement-Based Care (MBC) for Mental Health in a Paediatric Hospital Setting

Introduction: Measurement-Based Care (MBC) is the routine, systematic use of validated measures (e.g., patient-reported outcome measures [PROMs]) before or during clinical encounters to inform treatment decision-making. A large body of evidence, including randomized controlled trials, suggest that MBC outperforms usual care in response to treatment, remission rates, time to response and remission for individuals with depression, anxiety and other mental health conditions. MBC is a standard of care for most chronic conditions (e.g., diabetes, hypertension, asthma), however, it is underutilized in pediatric mental healthcare, despite well documented benefits and feasibility. As part of the hospital’s broader mandate to better integrate physical and mental healthcare, the MBC implementation team set out to develop an MBC system for evaluation of mental health concerns across the hospital with the goal to facilitate monitoring and response of mental health metrics at the patient, provider, organizational, and system levels.
 Methods: An environmental scan was conducted to understand the priority areas for health systems’ improvement. Stakeholders engaged in the process were physician leaders, clinical operational directors, clinical staff, Youth and Family Advisory Panel members across hospital departments. The environmental scan and follow-up focus groups (n=57) highlighted the need to prioritize implementation of standardized mental assessment tools hospital-wide for patients at each health system encounter as part of a vision to deliver holistic, integrated care and improve quality of patient care. Early identification of mental health needs of patients across the hospital and the importance of establishing standardized metrics for common mental health conditions were additional key priorities. Hospital surveys highlighted anxiety and depression as the top mental health concerns across the hospital. An extensive review was conducted to identify validated tools available and to understand implementation best practices.
 Learnings: Learnings from our review pointed to some key factors for successful implementation. These included the need for tools that are brief and easy to use, are validated and sensitive to change, are user friendly and visually appealing for the pediatric population and are integrated into the electronic health record with appropriate decision support tools to enable real time review. The need for extensive patient and provider education about the value of MBC and its implementation was also a key learning.
 
 Work in progress & next steps: Work is underway to map out clinical workflows, including ensuring a timely response to results, addressing implementation challenges such as virtual vs. in-person tool completion, and managing accessibility of sensitive data to the patient or their proxy in the electronic health record. Workflows will take an integrated, holistic care approach, whereby, a patient’s care team will action appropriate interventions based on a standardized algorithm that engages an interdisciplinary care team. Voxe, an external, patient-friendly platform to administer the two chosen assessment tools will be trialed. Discussions are underway with Information Management and Technology teams to integrate Voxe and clinical workflows in the hospital’s electronic health record. Evaluation of implementation of MBC in clinical settings will consider both process and outcome measures such as uptake, timely receipt of services, and clinical response.

Bussey systems and Steiner's tactical problem

In 1853, Steiner posed a number of combinatorial (tactical) problems, which eventually led to a large body of research on Steiner systems. However, solutions to Steiner's questions coincide with Steiner systems only for strengths two and three. For larger strengths, essentially only one class of solutions to Steiner's tactical problems is known, found by Bussey more than a century ago. In this paper, the relationships among Steiner systems, perfect binary one-error-correcting codes, and solutions to Steiner's tactical problem (Bussey systems) are discussed. For the latter, computational results are provided for at most 15 points.

Perception versus Policy: Which Is More Important to Animal Welfare Volunteer Satisfaction?

There is a large body of work spanning decades examining the factors that lead to volunteer satisfaction. Much of this work has employed self-administered surveys to gather volunteers' opinions or perceptions of factors important for satisfaction which inherently lie within the individual volunteer. Yet scholars have raised concerns about the validity of studies based on perceptions. This research builds on past work by the author by pairing a survey of animal welfare volunteers with one conducted with the executive directors of the shelters they volunteer with, addressing concerns about the validity of self-administered surveys. It concludes that perceptions appear to conform well to actual policies as described by shelter directors but that volunteer perceptions are most important for satisfaction. Volunteers whose perceptions of shelter policies differ from shelter director reports of policies are more likely to be dissatisfied with their experiences. The findings are critical to animal sheltering because they point to the importance of volunteer perceptions of shelter policies for satisfaction. To retain volunteers, animal welfare organizations need to be concerned about actual policies but also about volunteer perceptions of them.

Functional magnetic resonance imaging study of group independent components underpinning item responses to paranoid-depressive scale.

Our study expand upon a large body of evidence in the field of neuropsychiatric imaging with cognitive, affective and behavioral tasks, adapted for the functional magnetic resonance imaging (MRI) (fMRI) experimental environment. There is sufficient evidence that common networks underpin activations in task-based fMRI across different mental disorders. To investigate whether there exist specific neural circuits which underpin differential item responses to depressive, paranoid and neutral items (DN) in patients respectively with schizophrenia (SCZ) and major depressive disorder (MDD). 60 patients were recruited with SCZ and MDD. All patients have been scanned on 3T magnetic resonance tomography platform with functional MRI paradigm, comprised of block design, including blocks with items from diagnostic paranoid (DP), depression specific (DS) and DN from general interest scale. We performed a two-sample t-test between the two groups-SCZ patients and depressive patients. Our purpose was to observe different brain networks which were activated during a specific condition of the task, respectively DS, DP, DN. Several significant results are demonstrated in the comparison between SCZ and depressive groups while performing this task. We identified one component that is task-related and independent of condition (shared between all three conditions), composed by regions within the temporal (right superior and middle temporal gyri), frontal (left middle and inferior frontal gyri) and limbic/salience system (right anterior insula). Another component is related to both diagnostic specific conditions (DS and DP) e.g. It is shared between DEP and SCZ, and includes frontal motor/language and parietal areas. One specific component is modulated preferentially by to the DP condition, and is related mainly to prefrontal regions, whereas other two components are significantly modulated with the DS condition and include clusters within the default mode network such as posterior cingulate and precuneus, several occipital areas, including lingual and fusiform gyrus, as well as parahippocampal gyrus. Finally, component 12 appeared to be unique for the neutral condition. In addition, there have been determined circuits across components, which are either common, or distinct in the preferential processing of the sub-scales of the task. This study has delivers further evidence in support of the model of trans-disciplinary cross-validation in psychiatry.

Вариабельность биохимических показателей крови и установление референтных интервалов в доклинических исследованиях. Сообщение 11: собаки

Dogs are a common in vivo test system in preclinical studies due to the relatively large body size sufficient for surgical manipulations, as well as the pathophysiology of various diseases similar to humans. A separate point of application of the animal species in question in preclinical studies is the study and therapy of oncological diseases. The aim of the work was to create its own database of reference intervals of biochemical blood parameters of Beagle dogs. These norms are necessary in preclinical studies when asses­sing the state of animal health, monitoring the formed pathological model, as well as checking the safety of the studied drugs. Biological samples used for the formation of reference intervals were obtained from intact animals in research and manufacturing company “Home оf Pharmacy”. All manipulations and experiments carried out were approved by the bioethical commission. The study included 56 males and 48 females. The age of the animals corresponded to the range of 10–18 months, the body weight of females was 7–11 kg, and males 8–14 kg. In order to implement a uniform approach when creating reference intervals, all manipulations were carried out under the same conditions. For the study, blood was used, which was taken from the lateral subcutaneous vein of the leg of the studied animals on an empty stomach, without sedation and anesthesia. The following parameters were recorded in the blood serum of animals: creatinine, urea, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, cholesterol, triglycerides, total protein, albumin, glucose, creatine kinase, lactate dehydrogenase and total bilirubin, the albumin-globulin coefficient was calculated. Statistical outliers were estimated using the Tukey method, the type of distribution was determined using the Shapiro—Wilk criterion, paired comparisons between animals of different sexes were carried out using the Mann—Whitney U-test and the Student t-test. The obtained ranges of values of males and females correlated with each other for all the considered indicators, no statistical difference was revealed. When comparing the obtained intervals with the reference ranges of dogs from other literature sources, it was shown that, in general, the ranges of the considered indicators are similar, but there are also differences that can be explained by a wide list of factors. These include the image of keeping animals, as well as the preanalytical and analytical stages of the study. A comparative analysis of the interindividual variability of the biochemical parameters of the blood of dogs and humans showed the presence of some species differences that need to be taken into account in experimental activities.

Connecting to Community: A Social Identity Approach to Neighborhood Mental Health

Academic Integrative theorizing is needed to advance our understanding of the relationship between where a person lives and their mental health. To this end, we introduce a social identity model that provides an integrated explanation of the ways in which social-psychological processes mediate and moderate the links between neighborhood and mental health. In developing this model, we first review existing models that are derived primarily from a resource-availability perspective informed by research in social epidemiology, health geography, and urban sociology. Building on these, the social identity model implicates neighborhood identification in four key pathways between residents’ local environment and their mental health. We review a wealth of recent research that supports this model and which speaks to its capacity to integrate and extend insights from established models. We also explore the implications of the social identity approach for policy and intervention. Public We need to understand the connection between where people live and their mental health better than we do. This article helps us do this by presenting an integrated model of the way that social and psychological factors affect the relationship between someone’s neighborhood and their mental health. This model builds on insights from social epidemiology, health geography, and urban sociology. Its distinct and novel contribution is to point to the importance of four pathways through which neighborhood identification shapes residents’ mental health. A large body of recent research supports this model and highlights its potential to integrate and expand upon existing theories. We also discuss how our model can inform policies and interventions that seek to improve mental health outcomes in communities.

Driving Mechanism Controlling Cultivated Tropical Peat Physicochemical Characteristics and Stoichiometry: Case Study of a Microtopographical Sequence

Contrasting to the large body of knowledge documenting peatland characteristics and their trends across major rivers, limited study was found in studying peat physicochemical and stoichiometry variability at the drained and cultivated site across microtopographical sequence. This study aimed to investigate peat physicochemical properties and stoichiometry in an old oil palm plantation/OPP in North Sumatra Province, Indonesia, across a 3.1 km of a topo-hydrosequence transect perpendicular to the Leidong River and raised hummock. 20 peat cores (0-50 and 50-100 cm depth) from 10 sampling points were collected to determine their physicochemical properties and stoichiometry and analyze the driving mechanisms controlling them. This current study suggested that the long-term drainage and cultivation practices may partially alter the trends and patterns of peat’s physicochemical properties. It was indicated by diverse trends, in which several peat properties behave oppositely against their natural patterns. The soil’s chemical characteristics and stoichiometry throughout 0-100 cm depth were considered homogeneous, which exhibited oppositely with peat physical parameters. The prominent properties and stoichiometry mainly controlled peat variances were bulk density, pH, total N, available P, C:N, and N:K. Flooding experience and distance from the river were the driving mechanisms controlling peat properties and stoichiometry at the study site. This study’s results demonstrated peat physicochemical characteristics and stoichiometry trends that were observed at microtopographical features with a relatively small tributary may resemble those studies representing the extensive landscapes

Contrasting the response to past and future oriented appeals for help on donation-based crowdfunding platforms

ABSTRACT Despite a large body of research on donation-based crowdfunding platforms, the ways that people appeal for help, and the impact of different appeal types, remain unclear. In particular, it is not clear the extent to which individuals benefit from a temporal orientation on the past, where they can provide personal background, or the future, where they can explain how they will benefit from donors’ help. Building on a novel dataset of 6,282 fundraising campaigns and 44,757 donor comments gathered from a donation-based crowdfunding platform, this study analyzes donors’ financial contributions and expressions of emotional responses in response to past and future oriented appeals. This analysis combines an instrumental variable approach, propensity score matching, natural language processing, and image analysis. The results indicate that verbal responses are similar for past and future oriented appeals, but that future oriented appeals are more effective for fundraising. The results further suggest that, when lower levels of positive affect are used in past oriented appeals, this combination may be linked with more rapidly diminishing financial contributions over time.

Exploring the contribution of interpersonal emotion regulation to pre-service EFL teachers' sustainable professional development and wellbeing

There is a large body of research endorsing the role of interpersonal skills and emotion regulation in English as a foreign language teachers’ professionalism and psychological states. However, scant research has been done on pre-service EFL teachers’ interpersonal emotion regulation (IER) and the way it can contribute to their sustainable professional development (SPD) and sense of wellbeing. To bridge the gap, this qualitative study examined the perceptions of 34 Chinese pre-service EFL teachers regarding such an interplay using a semi-structured interview. The results of content and thematic analysis revealed that IER strategies used by pre-service EFL teachers had different contributions to their SPD and wellbeing by establishing ‘a supportive learning environment’, ‘strong classroom rapport’, ‘interpersonal communication’, and ‘emotional literacy’. Furthermore, it was indicated that the participants used different activities and practices to regulate and balance their IER strategies to gain SPD and wellbeing including ‘self-oriented’, ‘other-oriented’, and ‘professional development’ activities. The study ends in a discussion of the findings and presents a number of conclusions and future lines of research considering the impact of interpersonal emotions and their regulation on EFL teachers’ professionalism and wellbeing.

Corruption and government revenue: Evidence of a non-linear relationship driven by crises

ABSTRACT A large body of literature studies the relationship between corruption and economic outcomes, including government revenue mobilization, but there is little evidence on how this relationship changes during times of crisis. Using a comprehensive panel dataset covering up to 194 countries in the period 1996 to 2020, we find evidence of a negative link between corruption and revenue that is amplified in times of crisis. The amplification appears to be driven by countries with lower average income levels, non-democratic governments, and higher natural resource dependency. Our findings are helpful in assessing different views of corruption offered in the literature. Overall, we find our results to be more consistent with a rent seeking view of corruption whereby, in times of crisis, corruption becomes more pervasive and government revenue declines. In contrast, we find no empirical support for the view that crises represent times of social improvement associated with increases in revenues.

THE IMPACT OF HEALTH-RELATED QUALITY OF LIFE ON CLINICAL OUTCOMES IN ATRIAL FIBRILLATION POPULATIONS

Abstract Although there is a large body of literature linking atrial fibrillation (AF) to adverse clinical outcomes, little is known with regards to the potential links between health-related quality of life (HRQoL) and AF related clinical events. To address this gap, individuals with AF aged ≥ 65 years were recruited from clinics in Massachusetts and Georgia between 2016-18 and followed until 2020. HRQoL was assessed via the Atrial Fibrillation Effect on Quality of Life (AFEQT). The AFEQT is a validated HRQoL measure that quantifies the effect of AF on patients’ daily life on a scale of 0 to 100. AFEQT scores < 80 indicated poor HRQoL and ≥ 80 indicated good HRQoL. The clinical events included major bleeding, stroke, and death. Of the 1,244 participants, the mean age was 75.5 (SD: 7.1), 49% identified as female, 13% were non-White, and 57% were married. After 2 years, 105 major bleeding events (49% poor HRQoL), 19 strokes (42% poor HRQoL) and 108 deaths (59% poor HRQoL) occurred. Our composite outcome included 200 participants (53% poor HRQoL). After adjusting for key covariates, poor HRQoL was associated with an increased risk of our composite outcome (adjusted hazard ratio [AHR]= 1.34, 95% CI: 1.00, 1.80) and death (AHR= 1.58, 95% CI: 1.05, 2.38). We found no significant differences between poor and good HRQoL in major bleeding and strokes. HRQoL is important when assessing health of AF patients. Health providers who treat patients with AF should consider HRQoL when evaluating the risk of death and other adverse outcomes.

MARITAL BIOGRAPHY AND ACCELERATED AGING: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY

Abstract It is well-established that marriage promotes health and longevity. While a large body of research has examined marital status differences in health, no studies have focused on how marital status is linked to biological age. Moreover, the association between marital biography – transitions in and out of marriage across the life course – and biological aging also remains to be explored. Biological age, which refers to the “physiological functioning relative to the average physiological state at a specific chronological age,” has been steadily gaining attention as a measure indicative of an individual’s health status. In this study, we advance the literature on marital status and health by examining how marital status and marital transitions are associated with biological aging among a representative sample of U.S. older adults. We use an expanded measure of biological age that incorporates 22 biological indicators, more than half of which were not used in previous studies, to better assess how marital experiences shape accelerated aging. Using data from the 2016 Health and Retirement Study, we find that the pace of aging of those who have experienced one disruption is not statistically different from those continuously married. However, for both currently and previously married individuals, the experience of multiple marital disruptions is associated with accelerated aging. Health behaviors account for the association between multiple marital disruptions and accelerated aging for previously married older adults but not for currently married older adults. Psychosocial resources did not mediate the influence of marital biography on accelerated aging.

Assembly of heterotrophic communities during spontaneous succession in quarries: invertebrates model groups and macromycetes

Quarrying has a crucial impact on the environment, but it could enhance species diversity. Mining sites represent important refuges for countless species disappearing from homogenous landscapes. Our study focused on assemblages of heterotrophic communities such as moths (Lepidoptera), carabid beetles (Coleoptera: Carabidae), spiders (Araneae), and macromycetes (fungi: Basidiomycota, Ascomycota) in an active part of kaolin quarries and their immediate surroundings in the Pilsen region, Czech Republic. We compared differences between mined and unmined sites, sites with spontaneous succession and sites with replanted pine trees. In total, we recorded 178 moth, 63 spider, 27 carabid beetle, and 81 macromycetes species, including 21 Red‐listed species. The moths, carabid beetles, and macromycetes tended to inhabit unmined sites; on the contrary, open habitat spiders preferred open sites with replanted pine trees. Based on the life history traits analyses, moth species feeding on forbs and grasses prevail at the active part of kaolin quarries, where higher plant diversity was detected. Large body carabid beetles such as Carabus spp. favored unmined sites, as well as macromycetes with long‐lived fruit bodies. Open habitat and xerophilous spiders inhabited the replanted sites by pine trees where the sparse vegetation was obvious. Our results indicated that groups with radically different life histories such as moths, carabids, and macromycetes may react to mining remarkably similarly, although spiders, despite sharing predatory habits with the majority of carabids, reacted differently.

Transdiagnostic skills training group of dialectical behavior therapy: a long-term naturalistic study

IntroductionDialectical Behavior Therapy (DBT) has assembled a large body of evidence for the treatment of emotional dysregulation in borderline personality disorder (BPD), but also in other disorders characterized by emotional dysregulation (e.g., bipolar disorder (BD) and ADHD). Standalone skills learning groups address the problem of limited resources in several clinical settings. Furthermore, transdiagnostic skills groups facilitate the recruitment and decrease the scattering of resources in psychiatric settings. However, few studies have focused on the pertinence of transdiagnostic standalone skills groups in naturalistic settings as well as their long-term outcomes. The goal of this study is to assess the impact of participation in a transdiagnostic DBT skills group one year after its completion.MethodTransdiagnostic DBT skills training groups were provided for BPD, BD and ADHD patients in a University Psychiatric Department (Strasbourg, France), between 2019 and 2020. They consisted of 16 group sessions of 2.5 h and 3 individual sessions. At 1-year follow-up, ad-hoc questionnaires were proposed to all participants to assess the perceived impacts, the changes in symptomatology, and the maintenance of skills learned.Result22 of the 31 participants were interviewed at the one-year post-group session (64% BPD, 41% ADHD and 27% BD). 73% participants estimated that group impact was important or very important, 64% stated using the skills learned often or very often, mainly emotion regulation skills. An improvement in emotional instability, substance use, impulsivity and suicidal thoughts was reported by respectively 100%, 91%, 86% and 85% of participants. Quality of life improved according to 90% participants. All patients reported an improvement in suicidality during the post-group year, especially in suicide attempts. Psychotropic medication decreased in 59% of participants.DiscussionOur one-year naturalistic study suggests that transdiagnostic DBT skills training groups are promising for the treatment of emotional dysregulation in people with BPD, BD and/or ADHD. The observational design and the lack of control group are the main limitations. Randomized controlled studies are required to confirm the long-term efficacy of transdiagnostic skills learning groups in naturalistic settings.

Exercise as a behavioral approach to improve mood in persons with traumatic brain injury.

Mood disturbance is a common, long-term, negative consequence of traumatic brain injury (TBI) that is insufficiently addressed by most traditional treatment modalities. A large body of evidence supports the efficacy of exercise training (ET) to broadly improve mood, as measured most often by the Profile of Mood States (POMS). However, this behavioral approach is not used nearly enough in the TBI population, and when it is, mood is rarely measured. This scoping review will evaluate the use of POMS as a mood measure in TBI research and to establish a rationale for using ET as a behavioral approach to broadly improve mood in persons with TBI.

Emotionality in domestic water use in the global south: Who cares who is deprived of?

While access to safe and reliable water for domestic purposes is the basic need of human beings, inequality in access to reliable water is a major challenge in Global South (GS). Drawing on sociology of emotion, this article aims to explore the struggles of low-income communities in water acquisition in Global South, focusing on a case study of New Delhi. Although a large body of literature has analyzed the emotional distress of local communities in access to drinking water in GS, the discourse of ‘why and who’ triggers such emotional distress in contemporary cities has largely remained unappreciated. It was argued that influential elites and high-income residents, who wield significant influence in decision-making processes concerning water supply system in major cities including New Delhi, contribute to the marginalization and exclusion of underprivileged communities, thereby fueling the emotional distress of the disenfranchised communities.

COGNITIVE MISPERCEPTION, DISABILITY, AND MORTALITY AMONG OLDER ADULTS IN 25 COUNTRIES

Abstract Despite a large body of literature on cognitive ability and health, less is known about the health consequences of biased cognitive perception. Using harmonized and nationally representative longitudinal surveys from 25 countries spanning Asia, Europe and the Americas, we document the growing gap between actual and perceived cognitive ability that appears to increase with age, and construct a standardized measure of cognitive misperception. Linking this novel measure with mortality and disability, we model the cognitive misperception – health gradient. Results show that being in the upper quartile of cognitive misperception (i.e., showing heightened overconfidence in cognition) leads to higher mortality rates within 1 year, 3 years, and 5 years. Conditional on survival, being overconfident in cognition also greatly increases the risks of incident disability and frailty, especially for older adults receiving less family support. We identify two possible pathways inducing poorer outcomes: the first stemming from increased risk taking and financial vulnerability; the second associated with suboptimal use of preventive services and declines in health-promoting behaviors. Given the large and profound impacts of cognitive misperception on older adults’ health and well-being, more family and social supports, public investment in education and health literacy, and better healthcare access and affordability are needed to increase the timely awareness of cognitive decline.

Biopsychosocial contributors to irritability in individuals with shoulder or low back pain

ABSTRACT Objectives Irritability is a foundational clinical reasoning concept in rehabilitation to evaluate reactivity of the examination and treatment. While originally theorized to reflect tissue damage, a large body of evidence supports pain is a biopsychosocial experience impacted by pain sensitivity and psychological factors. Therefore, the purpose of this study was to examine biopsychosocial contributors to irritability. Methods 40 patients with shoulder (n = 20) and low back (n = 20) pain underwent Quantitative Sensory Testing (QST) (Pressure Pain Threshold, Heat Pain Threshold, Conditioned Pain Modulation, Temporal Summation), completed pain-related psychological questionnaires, an Exercise-Induced Hypoalgesia protocol, and standardized irritability assessment based on Clinical Practice Guidelines. Participants were then categorized as irritable or not irritable based on Maitland’s criteria and by irritability level based on Clinical Practice Guidelines. An independent samples t-test examined for differences in QST and psychological factors by irritability category. A MANOVA examined for differences in QST and psychological factors by irritability level (high, moderate, low). Results Significantly lower heat and pressure pain thresholds at multiple locations (p < 0.05), as well as less efficient conditioned pain modulation (p = 0.02), were demonstrated in individuals categorized as irritable. Heat and pressure pain thresholds were also significantly lower in patients with high irritability compared to other levels. Significantly higher depression and anger, as well as lower self-efficacy, were reported in individuals with an irritable presentation. Discussion/Conclusion Biopsychosocial factors, including widespread hyperalgesia and elevated psychological factors, may contribute to an irritable presentation.

The Reality of Antimicrobial Resistance and Antibiotic Usage Data in Asia: The CAPTURA Experience.

Antimicrobial resistance (AMR), particularly in low- and middle-income countries, is threatening to undermine advances in health and development. Scarce technical and human resources in these countries limit the collection of quality AMR data for evidence-based decision-making. The CAPTURA consortium, funded by the Fleming Fund, was implemented across 7 countries in the South and Southeast Asian region. The program focused on collating historical bacteriological data for qualitative and quantitative analyses. The team gathered standard data on the quality of laboratories and clinics and the quality and quantity of retrospective historical AMR data. In addition, retrospective data on antimicrobial use and consumption were analyzed. While standard protocols guided the project, a tailored approach for stakeholder engagement was implemented to work with countries and secure data-sharing agreements. The program also had to navigate the challenges of the COVID-19 pandemic, making some innovative adaptations to overcome logistical barriers. From 2018 through 2022, a large body of data was collected that was used to base a series of recommended key measures for strengthening the development of standardized national surveillance programs and to support alignment with international efforts.