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Evolution of WIfI: Expansion of WIfI Notation After Intervention
Full text linkNearly a decade ago, the Society for Vascular Surgery (SVS)'s wound, ischemia, and foot Infection (WIfI) classification was first developed to help assess overall limb threat. However, managing conditions such as diabetic foot ulcer and chronic limb-threatening ischemia can be complex. For instance, certain investigative findings might initially be pending such as the level of ischemia or extent of infection before the final classification is established. In addition, wounds evolve rapidly, and the current classification does not allow for tracking their progression over time during treatment. Therefore, we propose a supplemental consistent notation for scoring WifI re-assessment during treatment of a threatened limb inspired by the cancer staging before and after neoadjuvant treatment classification system. Thus, we describe the re-scoring system and how to use it. Our suggestion supports a coherent method to longitudinally communicate characteristics of a threatened limb. This has potential to support high quality interdisciplinary, patient-centered care and enhance the use of this classification in research. Further work is required to validate this modification of a common language of risk
Late Paleozoic slab rollback events in the southeastern part of the Central Asian orogenic belt: Implications for Paleo-Asian Ocean subduction and continental crust growth
No full textThe Central Asian orogenic belt is considered to be the largest Phanerozoic accretive orogenic belt on Earth. The late Paleozoic magmatic rocks in central Inner Mongolia are crucial for understanding continental crust growth and the tectonic evolution of the southeastern part of the Central Asian orogenic belt. We present comprehensive geochemical, isotopic, and geochronological data from three late Paleozoic magmatic units in the Mandula area, west of the Solonker suture zone. Zircon U-Pb dating indicates that these rocks formed during the late Carboniferous (316–304 Ma). The Mandula high-Mg diorites exhibit high MgO (3.9–6.5 wt%), high Mg# (61–69), and depleted Nd-Hf isotopic compositions, generated through interaction between a metasomatized mantle and slab melts with the overlying sediments. The Mandula granodiorites display adakite geochemical characteristics with high Sr/Y mass ratios (29–52), high MgO (1.7–2.2 wt%), and high Mg# (52–54), formed by partial melting of the oceanic slab with the addition of overlying sediment. Mafic microgranular enclaves have consistent ages, Sr-Nd-Hf isotope compositions, and hornblende temperature-pressure conditions with their host granodiorite, formed from a cognate magma associated with the host granodiorites through cumulate. We propose that two phases of slab rollback took place during the late Paleozoic southward subduction-accretion of the Paleo-Asian Ocean. The first phase corresponded to the transformation of low to medium-angle slab subduction, while the second phase led to subduction-related extension. Considering the tectonic-magmatic evolution, crustal maturity, and thickness variations in the late Paleozoic southeastern part of the Central Asian orogenic belt, we propose that prolonged subduction and slab rollback promoted continental crust growth. The Central Asian orogenic belt coincides temporally and spatially with the Phanerozoic Pangea cycle, suggesting that continuous subduction and supercontinent amalgamation significantly contributed to continental crust growth
A high fall risk patient perspective - Reducing safety challenges in an acute care hospital
Full text linkAims:
This study examined patient perspectives of the factors that contributed to their falls in a medical ward and how patient understanding of the implemented fall prevention strategies influenced their perceptions of their fall risk.
Design:
An exploratory sequential mixed methods design.
Methods:
Quantitative data were obtained from the RiskMan fall database and auditing of the Patient-Centred Care Plan to identify patients who experienced a fall on the ward. From this cohort, seven inpatients were interviewed using a structured interview questionnaire to explore their perceptions of why they fell. Other complexities of fall management in the ward were discussed, including the assessment and identification of high fall risk patients and the effectiveness of patient education.
Results:
Five contributing factors were seen to have led to inpatient falls in the medical ward: (1) there seems to be little, if any, patient engagement with the advice in the fall prevention brochure distributed on admission; (2) insufficient patient awareness of the various fall prevention strategies; (3) inadequate bathroom supervision provided by nurses; (4) patient call bells not answered promptly, which encouraged patients engaging in risk-taking behaviour and (5) a breakdown in communication between nursing staff and patients. The study identified several factors that should be included in fall administrative data, such as the duration of call-bell response, the quality of nurse–patient communication and the determinants influencing patient response to fall prevention strategies. The study findings offer valuable insights to enhance the efficacy and implementation of fall prevention strategies to improve patient outcomes.
Patient Contribution:
Patients who had experienced a fall during their current hospital admission were interviewed. For each patient, the interview was a communication medium to explore the factors surrounding the occurrence of their fall and their knowledge of their fall risk
Situating Narratives of Decline: Surveying the Literature of Crisis from a Regional Humanities Student Perspective
Full text link[Extract] As first-in-family university graduates from regional northern and far-northern Queensland, both of us have found the work of this essay to be a challenging—and upsetting—exercise. We care deeply for the regional university which has provided us with educations in the humanities, but the feelings of anger, disappointment, and despondency we endure when considering the future of our disciplines at regional institutions such as the one we attended are difficult to translate into clear-headed academic prose. Our stories are different, but our lived experiences demonstrate what will be—and has already been—lost when regional Bachelor of Arts programs are repeatedly restructured, reoriented, refocused, refreshed, or cut entirely.
Jade was born in Cairns, in the far-north of Queensland, but was raised in the smaller, regional town of Innisfail. Her father had left high school after Year 10 to pursue employment and Jade’s mother had been unable to continue schooling at the age of fourteen. Despite the interruption, Jade’s mother had taken a less-conventional pathway to completing her high school education later in life and subsequently worked her way up into professional roles. Straight out of school, Jade moved south to Townsville to start a double degree in arts and science. She struggled to adjust to university studies and found herself failing subjects for the first time in her life. Away from home and dealing with difficult personal circumstances in addition to the challenges of university, Jade returned home to Innisfail. In 2021 she decided to follow her passion for literature and transitioned into a Bachelor of Arts with a major in English, remaining enrolled at the same regional university but now studying externally. Settling into her work, Jade gained momentum. Maintaining good grades and finally having an opportunity to network with like-minded people, she even had the chance to co-author a paper with a lecturer and fellow classmates as an undergraduate. Earlier this year at her graduation, she was recognised for achieving the highest aggregate result for first-year English literature
Community-based approaches to biodiversity finance
Full text linkIndigenous peoples and local communities live in, manage, and own large regions and require investment to finance their biodiversity management strategies. Their approaches are proactive and powerful, with clear agency to drive futures that include consistent biodiversity finance. Our literature review and illustrative case studies highlight five factors that influence how communities forge pathways based on their world views and knowledge systems, underpinned by recognition of rights, compensation for damage by colonizers, and establishment of organizations with culturally valid governance to leverage biodiversity finance. Global actors, such as the Parties to the Convention on Biological Diversity implementing the Kunming-Montreal Global Biodiversity Framework, need to understand the history and characteristics of these pathways and tailor their finance to suit — for example, to finance governance and organizational development for some and protected area management for others
LEAVES: An open-source web-based tool for the scalable annotation and visualisation of large-scale ecoacoustic datasets using cluster analysis
Full text linkEcoacoustics has emerged as a pivotal discipline in the conservation and monitoring of ecosystems, offering insights into species’ behaviour and ecosystem health through soundscape analysis. Central to this is the need for accurate annotations of environmental audio recordings, which underpin the computational models used in ecological monitoring. However, due to the increasingly large scale of datasets, annotation using existing tools and techniques cannot be performed at feasible speeds or with the necessary accuracy required for real-world application. The LEAVES (Large-scale Ecoacoustics Annotation and Visualisation with Efficient Segmentation) platform addresses this gap by leveraging unsupervised clustering techniques optimised for the high-throughput annotation of large-scale ecoacoustics datasets. Our evaluation across six real-world datasets shows that LEAVES improves annotation efficiency by up to 7.12 times compared to manual annotation while maintaining 79%–90% label similarity to validated data. We expect that our proposed tool will greatly accelerate the annotation process when generating high-quality labelled datasets, supporting larger-scale studies with broader community engagement in ecoacoustics research
Lower limb gait joint coordination variability in people with diabetes-related foot ulcers
Full text linkBackground: Diabetes-related foot ulcers pose substantial health risks globally, yet the biomechanical intricacies underlying their development remain incompletely understood. This study aimed to evaluate lower limb gait joint coordination variability in individuals with diabetes-related foot ulcers compared to those with diabetes (without diabetes-related foot ulcers) and healthy controls.
Methods: A total of 99 participants (diabetes-related foot ulcers cases – 16, Diabetes controls – 50, Health controls – 33) compared three self-paced walking trials. Vector coding, a technique quantifying movement coordination, was employed, analysing hip-knee, knee-ankle, and hip-angle joint couplings in the sagittal plane.
Findings: No significant differences in coordination variability were found among the groups. However, distinct coupling pattern frequencies emerged, with diabetes-related foot ulcers cases exhibiting unique anti-phase hip and ankle coupling frequency counts compared to healthy controls.
Interpretation: These findings challenge conventional understandings of diabetes-related foot ulcers biomechanics and underscore the complexity of gait in this population
Leveraging subordinates for performance how managers benefit from mentoring relationships
No full textUsing multisource data from 37 countries encompassing a sample of 9,039 managers and their subordinates, we find that managers who provide more career mentoring receive higher performance ratings. This relationship holds true in all cultures but is more salient in more assertive than less assertive cultures. Conversely, managers who provide psychosocial mentoring receive higher performance ratings only in more assertive cultures. By understanding how the two types of mentoring behaviors affect managers' performance across cultures with different levels of assertiveness, this study provides insight into how managers (especially expatriates and managers of cross-cultural teams) can adapt their mentoring behaviors across cultures
Does the travel career pattern model work for repeat tourists?
Full text linkTourism researchers and practitioners have an interest in understanding tourists’ travel patterns, and one of the most used models applied to reach this goal is the seminal Travel Career Pattern (TCP) model. However, repeat tourism is underexplored and in the present research, the authors provide an initial investigation of repeat tourists using the TCP model. Based on survey data from 500 international tourists in India the present research found that the TCP model is valuable for exploring repeat tourists’ travel patterns and motives. Within the TCP model results show that middle-level motives were found to be most important for tourists with more diverse travel experiences which include nature, self-development and self-actualization. Significant relationships were also found among the origin of tourists, their travel experiences and their motivational pattern
Organizational and service support for boys' pathways out of commercial sexual exploitation in Nepal: Key learning for an under-recognized population
Full text linkBoys are a group who experience commercial sexual exploitation (CSE) but are often less visible than girls with the same experience. There is limited evidence regarding the experiences of organizational support from the perspectives of boys with CSE experience. This study, conducted in Kathmandu, Nepal, adopted a mixed-method approach, combining data from actor mapping, survey, and in-depth case studies. It explores (1) what services are available for boys with CSE experience; (2) how services help boys to exit the commercial sex sector; and (3) what the future service needs are for boys with CSE experience. In our sample, most of the boys who had been involved in the CSE industry as minors, identified themselves as sexual minorities. The findings suggest that despite the inadequacy of the services available for boys with CSE experience, around half of the boys who successfully exited the industry reported that support from non-governmental organization (NGOs) was crucial to their pathways out. The findings indicate the continuity of follow-up services is needed. This study underscores the importance of organizational and service support. It highlights ongoing needs regarding economic determinants. This study sheds light on future NGO service programme development and policy initiatives on protecting boys with CSE experience