Infections and the Kidney

Global infections are very frequent cause of AKI. Often this is due to the non-specific systemic effects of sepsis and volume depletion and therefore can occur with many infectious agents perhaps most searingly brought to our attention with the SARS-CoV-2 pandemic. The kidney can also be damaged by infections directly involving the renal parenchyma, because of persistent infection elsewhere in the body, as a post-infectious response and secondary diseases causing obstruction. Identifying, first, that kidney injury is due to infection and the particular infection causing the patient's presentation is critical to management. Some infections discussed in this chapter are confined to specific areas of the world, but with increasing global travel and migration, patients may present to healthcare facilities anywhere;thus, a thorough travel history is invaluable. © Springer Nature Switzerland AG 2014, 2022.

Virtually the Same? Understanding Virtual and F2F Farmer Audiences

Agricultural and extension educators frequently employ a variety of methods to provide farmers with information about conservation practices. The introduction of virtual programming brought on in response to the COVID-19 pandemic set the stage for analysis of farmer outreach preferences with respect to face-to-face (F2F) versus virtual outreach. Using survey data of individuals who participated in field days in Iowa, we segmented participants based on their F2F or virtual attendance. We compared the groups based on key variables such as water quality concerns, communication behaviors, outreach preferences, and demographics. Our work suggests that a broad and dynamic communication strategy, including both in-person and virtual events, offers greater opportunities for dissemination of ideas and increases access to content © This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License

Antecedents of E-learning in undergraduate entrepreneurship education

This study examines the factors that influence the intention and actual use of e-learning in entrepreneurship education by undergraduate students. The paper relies on a predictive study design and the partial least squares structural equation modelling to analyse data from a cluster sample of 599 students from the University of Cape Coast, Ghana. The results demonstrate that all the independent variables, assessed within a framework of an extended unified theory of acceptance and use of technology, determine students' intention to use e-learning in entrepreneurship education. Of particular importance are the preponderant effects of hedonic motivation, facilitating conditions and social influence on students' intention as well as the effect of intention and facilitating conditions on actual use of e-learning. A key implication of the findings is that students' continuous acceptance and use of e-learning in undergraduate entrepreneurship course delivery is contingent upon adequate presence of all the examined predictors of technology usage. © The Author(s) 2023.

Covid-19 Vaccination in Persons with and without Hiv: Veterans Aging Cohort Study

Background: COVID-19 vaccination is effective at preventing symptomatic infection, hospitalization, and death from COVID-19, but many people have experienced barriers to receiving this life preserving intervention. A study examining COVID-19 vaccination in New York state found that persons with HIV (PWH) were less likely to be vaccinated than the general population. We examined whether PWH are less likely to be vaccinated than persons without HIV (PWoH) in the Veterans Affairs (VA) Healthcare System. Method(s): We examined COVID-19 vaccination receipt by HIV status in the Veterans Aging Cohort Study (VACS), an open cohort of PWH and 1:2 age-, race/ethnicity-, sex-, and site-matched PWoH. Among participants with a VA encounter from 10 December 2020 to 12 September 2022, we calculated the proportion of individuals who were fully vaccinated and boosted. Fully vaccinated was defined as: 14 days after second dose of mRNA vaccine (either Pfizer BNT162b2 or Moderna mRNA-1273) or single dose of a viral vector vaccine (Janssen Ad26.COV2.S). Boosted was defined as an additional vaccination at least 180 days after full vaccination. We assessed differences using chi-square tests. Result(s): Among 109,421 participants, PWH (n=31,337) were more likely than PWoH (n=78,084) to be fully vaccinated (77.6% vs 68.7%, p< 0.001) and boosted (71.1% vs 63.0%, p< 0.001) (Table). Most people received an mRNA vaccine with 6.9% of fully vaccinated PWH and 7.5% of fully vaccinated PWoH receiving the Janssen vaccine. Among PWH, having an undetectable HIV viral load was more common in those fully vaccinated than those not fully vaccinated (79.4% vs 72.0%, p< 0.001). Conclusion(s): In a matched cohort of veterans with and without HIV in VA care, we found that PWH were more likely than PWoH to be fully vaccinated and boosted. These findings contrast with a New York state study which found lower COVID-19 vaccination rates in PWH, possibly due to differential healthcare access;all patients in our cohort have access to VA care. Further studies are needed to understand differences in vaccine acceptance and receipt to prevent COVID-19 hospitalizations and deaths. COVID-19 Vaccination in People with HIV (PWH) and People without HIV (PWoH) - Veterans Aging Cohort Study, as of 12 September 2022.

Navigating health and well-being during the COVID-19 pandemic: Experiences of Latina immigrant mothers in rural Midwestern communities

Objective: In this study, we sought to gain insight into the challenges Latina immigrant mothers in rural Midwest communities encountered during the pandemic, strategies they employed to avoid infection of the virus, and impacts of the pandemic on family health and well-being. Background: In rural Midwestern communities, the pandemic disproportionately affected immigrants, many of whom are Latino and worked in meatpacking and food processing plants. Latina mothers are commonly viewed as caretakers of the family. This prescribed role placed mothers at the center of safeguarding their families' health during the pandemic. Method: In this descriptive study, we conducted individual interviews with 124 Latina immigrant mothers across six rural Midwestern communities who participated in one of two previous studies in the communities. Thematic analyses was used to identify themes that aligned with three areas of interest: challenges experienced, strategies employed to avoid virus infection, and impacts of the pandemic on family health and well-being. Results: Mothers enacted behaviors (e.g., sanitation practices, wore masks, stayed home) to lessen negative impacts of the pandemic on family health and well-being. Factors beyond their control (e.g., public policies, work policies and practices) placed families at greater risk for poor health and well-being. Eleven themes were identified that aligned with the three areas of interest. Conclusion: Findings build upon and extend prior research that reexposed unjust employment conditions, inadequate health-care systems, and an anti-immigrant context during the pandemic that perpetuated health disparities among Latino immigrants and other minoritized populations. Implications: Ethnographic and longitudinal studies that give voice to populations underrepresented in COVID-19 research and at high risk for poor health are warranted to inform policies and practices to protect health during public health crises. © 2023 The Authors. Family Relations published by Wiley Periodicals LLC on behalf of National Council on Family Relations.

Charismatic rhetoric, perceptions of charisma and narcissism, and voting behavior: Leadership Under crisis

Although research recognizes the influence of charismatic leadership and rhetoric, their practice in differing contexts and the moderating role of narcissism is understudied. Using a mixed-methods approach, we explore the effects of crises on the way a narcissistic leader employs charismatic rhetoric, and the way charismatic leadership is viewed by followers as they select leaders during a national crisis. In Study 1, we investigate former President Donald Trump's response to threats to his social power during times of crisis. Content analysis of Trump's speeches revealed that he used less charismatic rhetoric overall and more self-focused rhetoric during crisis periods, an unexpected outcome given existing findings in the literature. In Study 2, we explore followers' responses to Trump's perceived charisma. Three matched waves of data examined responses about perceived charisma, importance placed on the COVID-19 pandemic crisis, and leader choice. Findings from Study 2 suggest that crisis influenced perceptions of charisma and voting behavior, with leader narcissism playing a moderating role. Overall, our findings have implications for understanding the role of crisis in charismatic rhetoric and how narcissism and leader charisma influence followers' voting behavior. © The Author(s) 2023.

Comparison of Dietary Intake in UK Adults Aged 50 to 75 Years During the 2020 UK Covid-19 Lockdown Compared to their 2019 Intakes

The lockdown restrictions imposed as a result of COVID-19 impacted on many areas of daily life including dietary behaviours. A cohort of middle-older age adults (n=17), who had previously provided 3-day food diaries in May 2019 were asked to record their 3 day dietary intake in May 2020 when the UK was under lockdown restrictions. Mean (SD) energy intakes were significantly higher by ~750kilojoules in 2020 (8587kJ (1466.9)) compared to 2019 (7837 kJ (1388.9)). This energy increase is equivalent to ~170kcal;approximately 2 slices of bread. Furthermore, recorded meat/meat products, riboflavin, vitamin B6/B12 and iron intakes were all greater in 2020. No other dietary differences were observed between the two timepoints. This was a small, homogenous but well controlled sample, who exhibited a relatively stable diet during lockdown compared with pre-pandemic intakes 12 months earlier. It can be concluded that there was little evidence of food insecurity in this cohort.

Comparison of Dietary Intake in UK Adults Aged 50 to 75 Years During the 2020 UK Covid-19 Lockdown Compared to their 2019 Intakes.

The lockdown restrictions imposed as a result of COVID-19 impacted on many areas of daily life including dietary behaviours. A cohort of middle-older age adults (n=17), who had previously provided 3-day food diaries in May 2019 were asked to record their 3 day dietary intake in May 2020 when the UK was under lockdown restrictions. Mean (SD) energy intakes were significantly higher by ~750kilojoules in 2020 (8587kJ (1466.9)) compared to 2019 (7837 kJ (1388.9)). This energy increase is equivalent to ~170kcal; approximately 2 slices of bread. Furthermore, recorded meat/meat products, riboflavin, vitamin B6/B12 and iron intakes were all greater in 2020. No other dietary differences were observed between the two timepoints. This was a small, homogenous but well controlled sample, who exhibited a relatively stable diet during lockdown compared with pre-pandemic intakes 12 months earlier. It can be concluded that there was little evidence of food insecurity in this cohort.

The Evolution and Evaluation of Matthew's Friends KetoCollege, A Training Programme for Professionals

Objective: Matthew's Friends KetoCollege is a unique training programme developed by an international board of expert medical and dietetic mentors who specialise in ketogenic diet (KD) therapies. Established in 2016, KetoCollege aimed to meet the demand for credible, unbiased training, improving delegates confidence with KD and enabling them to enhance the service provided to their patients. It offers training in the scientific background and practical aspects of the implementation of KD therapies for international professionals new to KD or those requiring a refresher. Here we aimed to evaluate the programme and look to future development. Method(s): KetoCollege is a 3-day education programme of lectures, workshops and networking, run yearly since 2016, approved by the British Dietetic Association and Royal College of Paediatrics and Child Health. It quickly adapted to the COVID pandemic restrictions and moved online in the past 2 years. Delegates complete an evaluation form, providing feedback which informs future developments. Result(s): KetoCollege has trained 885 professionals from 51 countries across seven programmes. Participant evaluations report improved knowledge, understanding and confidence with KD therapy. Delegates develop ideas and set goals to inform local service development and changes to clinical practice. Feedback consistently identifies the need for a follow-on advanced education programme in KD therapies to address more complex topics, advanced fine tuning and clinical case scenarios. Conclusion(s): KetoCollege is a unique, unbiased and well-respected education programme which successfully enhances delegates' knowledge and confidence to implement KD therapies. This enhances accessibility to KD therapies for families and adults internationally. KetoCollege Advanced is currently under development, ready for launch in 2023 in response to delegate feedback.

Making it up as you go along

This article recounts the founding of the Southern Food & Beverage Museum in New Orleans, LA with a special emphasis on the obstacles that the organization faced and the commitment to overcome those obstacles through tenacity and creativity. The journey to the present goes from the concept and kitchen table brainstorming to a functioning and growing institution that has begun to be recognized within the industry. The obstacles include Hurricane Katrina, the BP Oil Spill, and the COVID 19 pandemic.

Using discrete-event simulation to address COVID-19 health and safety guidelines in outpatient laboratory clinic

Simulation has, over multiple decades, achieved a remarkable record of improving operational efficiency and effectiveness in many areas - manufacturing, supply chains (including commercial transportation and logistics), health care, public-sector transport, service industries, and military operations. About 2/3 through the twentieth century, simulation's earliest successes appeared in the manufacturing sector. These successes began with attention to value-added operations (e.g., at machines often entailing high capital investments) and rapidly spread to the non-value-added but very necessary material-handling requirements within factories. SARS-CoV-2, (COVID-19) has caused a rapid, widespread change in patient care across the globe. New health and safety guidelines have been established by the Centers for Disease Control and Prevention (CDC) (Health Care Guidelines, 2020). Still, it has been left to individual facilities to address and implement solutions to new standards for social distancing and cleanliness. Here we develop a discrete-event simulation model to simulate an outpatient laboratory clinic, including check-in and patient interaction, to determine if changes lead to increased efficiency and reduce patient wait times, without increasing staffing or additional resources. Under the aegis of the University of Michigan Medical Group (UMMG), this simulation is validated against real data of waiting time at the University of Michigan Canton Health Center (UMCHC) during the height of the pandemic. © 2021 The Authors.

A Business Process Reengineering of the Surgical Path through Lean Technique: The Real Case Study of a Midsize Italian Hospital

This period of pandemic has had important consequences on the flow and the entire organization of any hospital. In particular, the number of accesses to the emergency room has increased, with the consequent urgent need to reorgani ze it quickly. The model proposed in this paper allows to respond to these needs by freeing not only shifts of nursing staff but also surgical staff. This workforce can then be relocated in the emergency room or of the intensive care unit who are in fact at the forefront of emergency management. The aim of this study conducted by the authors is to analyze, inside the context of a midsize Italian hospital, the actual organization model, and then to approach it by Business Process Reengineering (BPR) methodology with the goal to propose a KPI management system that evaluates the efficiency of the whole surgical path. The second objective of the study is to verify if the Operating Rooms (ORs) are properly sized to cover the surgical workload or if it would be necessary to build new ORs (answer to this question is the project mandate by Surgical Wards Chiefs). The last objective is to implement a flexible to cope with emergency situations such as a pandemic. The main result is the approximate maintenance of surgical annual activity (8169 vs 7889). The fewer resources required can be reallocated to deal with emergencies such as the current COVID-19 pandemic. In fact, the surgical shifts decreased during the test case from 464 versus 365 (-15,32%). The rooms’ utilization coefficient rose from 41% to over 52%, whereas the surgeons’ utilization coefficient rose to 61% (with values over 68% for parallel shifts). The results achieved demonstrate that improving efficiency of surgical processes is feasible and a systematic approach allows to respond to new global health challenges. © 2022, AIDI - Italian Association of Industrial Operations Professors. All rights reserved.

Remote delivery of a resistance exercise and protein intervention to improve muscle parameters in 40-65-year-olds: a feasibility study. The REMEND trial

Sarcopenia is the reduction of muscle mass and strength associated with ageing(1). Resistance exercise alone and in combination with protein is thought to lead to increased muscle protein synthesis and may help combat sarcopenia(2). Resistance exercise is traditionally undertaken in a gym setting, using fixed-machines and free weights, however, this environment can be unappealing to middle-older age adults. Access to gyms was also prohibited during COVID-19 UK lockdowns leading us to explore alternative approaches to delivering nutrition and exercise intervention trials. The aim of this study was to evaluate the feasibility of remote delivery of a homebased resistance exercise and protein intervention. This was a six week, 3-arm parallel intervention trial. Participants aged between 40-65 years were recruited via a social media advertising campaign and randomised to one of 3 treatment arms: i) resistance exercise, ii) resistance exercise and 15 g of protein/day (taken alongside lunch) or iii) resistance exercise and 30 g of protein/day (15 g taken alongside breakfast and 15 g taken alongside lunch.) The home-based resistance exercise intervention was conducted using resistance bands and consisted of 50-minute exercise sessions delivered live via videoconferencing. Participants were asked to participate in two exercise sessions per week. Protein was consumed as a gel supplement (Pro-source Plus) supplied by Nutrinovo (www.nutrinovo.com). Participants were asked to record their engagement and experience in a trial logbook and took part in semi-structured interviews at the end of the intervention period. In-person assessments of muscle strength and function, physical activity and diet were made at baseline and end of the intervention. Thirty-two individuals responded to the recruitment campaign within a three-week timeframe and a final total of eleven volunteers were eligible to participate and gave informed consent (all female, age range 40-61). No participants dropped out of the trial;however, one participant engaged in only 3 out of the 12 exercise classes and the same participant consumed only 14% of the protein supplement supplied. The remaining 10 participants had good compliance with both the exercise and protein intervention, and overall, there was 87% adherence to exercise sessions (2 or more classes a week) and adherence of 68% and 88% to the protein supplement in the 15 g and 30 g protein intervention arms respectively. Acceptability and adherence were in line with the study requirements for most participants. These findings are encouraging and support the feasibility of a remote exercise and protein intervention trial. Qualitative analysis of the semi-structured interviews will provide further information to inform the design of a larger intervention trial.

Looking over our shoulders at disaster

In a journey spanning almost 20 years the Southern Food & Beverage Museum has become established as a solid and reliable museum and attraction in New Orleans, Louisiana. Its journey to established museum has been fraught with disaster and determination - from Hurricane Katrina in 2005, the financial crisis of 2008, the BP Oil Spill, and COVID - to more local disasters like floods and hurricanes. Today it is ready for whatever may happen, as well as prepared with a plan to pivot, innovate, and re-invent itself, all the while deepening its mission and continuing to be the Southern Food & Beverage Museum.