Black race and lower age at surgery are associated with smoking relapse in a safety-net setting after surgery for stage I non-small cell lung cancer.

Background: Smoking relapse after surgical resection for lung cancer (LC) remains a health concern. This study aims to determine various factors associated with postoperative smoking relapse in patients undergoing surgical resection for stage I non-small cell lung cancer (NSCLC) at an urban safety net hospital. Methods: We analyzed the demographic and clinical variables of all patients who underwent surgical resection for stage I NSCLC from 2002 to 2016 at our institution. Based on the post-operative smoking history, we segregated the cohort into two groups: relapse and abstinent. Chi-squared and analysis of variance tests were used to identify the variables that registered a significant difference between the two groups. Further, we used univariable and multivariable logistic regression to determine association between variables and smoking relapse. Results: We analyzed data from 168 patients, excluding those with inadequate smoking history and never smokers. In total, 64 (38.1%) patients experienced smoking relapse, and 104 (61.9%) remained abstinent. The age, annual income, and race showed significant differences between the two groups. Multivariable logistic regression reflected that black patients had higher odds of relapse than white patients [odds ratio (OR) =3.26, confidence interval (CI): 1.54-6.89, P=0.002] and the chances of relapse decreased as the age increased (5-year age gap, OR =0.70, CI: 0.58-0.85, P<0.001). Conclusions: Black race and younger age at the time of surgery are associated with smoking relapse after surgery for stage I NSCLC. Targeted smoking cessation programs catered towards these patient groups may help reduce the prevalence of post-operative smoking.

The impact of physical environments on outpatient mental health recovery: A design-oriented qualitative study of patient perspectives.

The physical environment has been shown to affect the emotional states of patients receiving mental health treatment, yet it remains unknown whether physical space design may play a role in optimizing the delivery of mental health care. Principles of architectural design and human-centered co-design have been applied to enhance the patient experience of facility environments; however, little is known about how patients view the impact of physical spaces on their recovery. In this qualitative study, we aimed to understand patient perspectives of how physical environments contribute to mental wellbeing and personal experiences of recovery, in the context of informing future design efforts. Semi-structured telephone interviews were conducted with 13 participants receiving outpatient mental health treatment at the Kaiser Permanente San Jose Adult Psychiatry Clinic. Interviews were transcribed and themes were extracted that could inform future design concepts. The sample was comprised of nine female and three male participants, and one unidentified-gender participant, between the ages of 26-64, and across several self-reported racial/ethnic subgroups. We found four dimensions of physical environments that participants reported as impactful: 1) sensory design elements (colors, sounds, and textures), 2) engagement qualities (intensity of distracted activity such as crafting or commuting), 3) social relational aspects (privacy or connection), and 4) affective experiences evoked by being present in the space itself (feeling safe, calm, in control, self-aware, or creative was beneficial). Many of these elements were similarly noted across clinic and non-clinic environments. This study identifies key dimensions of physical environments that can serve as potential metrics of design success in supporting and facilitating mental health recovery. In the midst of the current COVID-19 pandemic, where mental health treatment has increasingly shifted outside of traditional clinics, our findings can support patients and clinicians seeking to harness potential in situ therapeutic benefits of physical environments.

Telemedicine Familiarity and Post-Disaster Utilization of Emergency and Hospital Services for Ambulatory Care Sensitive Conditions.

INTRODUCTION: In this study, we examined the association between telemedicine use before a disaster and utilization of emergency or hospital services for ambulatory care sensitive conditions post-disaster. METHODS: Difference-in-differences analyses were conducted in 2020‒2021 to assess pre- to post-fire changes in emergency or hospital utilization for 5 ambulatory care sensitive conditions: asthma, diabetes, hypertension, coronary artery disease, and heart failure across all Kaiser Permanente Santa Rosa patients (N=108,113) based on telemedicine utilization before the 2017 Tubbs wildfire. Inverse probability of treatment weighting was employed for cohort balancing across telemedicine familiar status. RESULTS: Utilization for any ambulatory care sensitive condition increased from 9.03% pre-fire to 9.45% post-fire across the full cohort. Telemedicine familiarity (ref: not familiar) was associated with decreased absolute risk in pre- to post-fire inpatient and emergency department utilization for 4 conditions: asthma (absolute risk= -1.59%, 95% CI= -2.02%, -1.16%), diabetes (absolute risk= -0.68%, 95% CI= -0.89%, -0.47%), hypertension (absolute risk= -2.07%, 95% CI= -2.44%, -1.71%), and coronary artery disease (absolute risk= -0.43%, 95% CI= -0.61%, -0.24%). Telemedicine familiarity was associated with decreased relative change in pre- to post-fire utilization for 5 conditions: asthma (RRR=0.70, 95% CI=0.64, 0.75), diabetes (RRR=0.54, 95% CI=0.47, 0.63), hypertension (RRR=0.57, 95% CI=0.52, 0.62), heart failure (RRR=0.64, 95% CI=0.50, 0.82), and coronary artery disease (RRR=0.56, 95% CI=0.47, 0.67). Similar results were seen among patients residing in evacuation zones. CONCLUSIONS: Telemedicine familiarity pre-fire was associated with decreased inpatient and emergency department utilization for certain ambulatory care sensitive conditions for 1-year post-fire. These results suggest a role for telemedicine in preventing unnecessary emergency and hospital utilization following disasters.

Complete Genome Sequence of Rhodococcus qingshengii Strain CL-05, Isolated from Concrete.

Here, we report the complete genome sequence of Rhodococcus qingshengii strain CL-05, which was isolated from pavement concrete in Newark, Delaware. The genome consists of a 6.29-Mbp chromosome and one plasmid (123,183 bp), encodes a total of 5,859 predicted proteins, and has a GC content of 62.5%.

Reducing hospitalisation among people living with severe mental illness.

Objective People with severe mental illness have high rates of hospitalisation. The present study examined the role that permanent housing and recovery-oriented support can play in reducing the number and length of psychiatric hospital admissions for people with severe mental illness. Methods The study examined de-identified, individual-level health records of 197 people involved in the New South Wales Mental Health Housing and Accommodation Support Initiative (HASI) to compare changes in hospitalisation over a continuous 4-year period. Results On average, HASI consumers experienced significant reductions in the number of psychiatric hospital admissions and length of stay after entering the HASI program, and these reductions were sustained over the first 2 years in HASI. Male consumers and consumers under 45 years of age experienced the largest reductions in the number and length of hospital admissions. Conclusions The findings of the present study add support to the hypothesis that supported housing and recovery-oriented support can be effective approaches to reducing hospital admissions for people with chronic mental illness, and that these changes can be sustained over time. What is known about this topic? People living with severe mental illness are heavy users of health and hospitalisation services. Research into the effects of partnership programs on preventing unnecessary admissions is limited because of short periods of comparison and small sample sizes. What does this paper add? The present study extends previous research by analysing de-identified individual-level health records over a continuous 4-year period and showing that reductions in hospitalisation among people with severe mental illness can be sustained over time. What are the implications for practitioners? These findings provide further evidence that community-based recovery-oriented supported housing programs can assist consumers to manage their mental health and avoid hospital admissions. Although the provision of recovery-oriented community services requires an investment in community mental health, the reduction in consumers' use of hospital services makes this investment worthwhile.

Enabling self-determination for older workers with intellectual disabilities in supported employment in Australia.

BACKGROUND: Promoting self-determination is recognized to be an essential element of disability service provision; however, the extent to which older people with intellectual disability working in supported employment are enabled to make intentional decisions about retirement is not well understood. METHODS: This research explored the views of older people with disability and service providers to understand the elements that impact on people's decision to retire. Seventy-six people participated in semi-structured interviews, including 33 older people with intellectual disability working in supported employment, 10 people who had retired and 30 service providers. RESULTS: Service providers strongly supported the right of people to retire; however, people with disability almost never reported the ability to make self-determined choices about retirement. Barriers to self-determination included an association between retirement, poor health and meaningless activities, which was perpetuated through structural service gaps. CONCLUSION: Although disability services and service providers emphasize the importance of promoting self-determination for people with disability, those working in supported employment are not currently enabled to make self-directed choices about retirement. To address this requires more flexible services, better information about retirement, exposure to real experiences and assistance to express preferences and participate in problem solving throughout the lifespan.

'They don't treat you like a virus': youth-friendly lessons from the Australian National Youth Mental Health Foundation.

Young people experience high rates of mental health problems, but very few access professional mental health support. To address the barriers young people face in accessing mental health services, there is growing recognition of the importance of ensuring services are youth-friendly. Indeed, almost a decade ago, the World Health Organisation developed a youth-friendly framework for services to apply. Yet, this framework has rarely been evaluated against health initiatives for young people. This article begins to address this gap. Using 168 semi-structured, qualitative interviews with young service users, this paper explores the extent to which the Australian National Youth Mental Health Foundation, also called headspace, applied the WHO's youth-friendly framework which emphasises accessibility, acceptability and appropriateness (AAA). It argues that headspace was largely successful in implementing an AAA youth-friendly service and provides evidence of the importance of tailoring services to ensure they are accessible, acceptable and appropriate for young people. However, it also raises questions about what youth-friendly service provision means for different young people at different times. The findings suggest that youth friendliness should be applied across different stages of interaction (at initial engagement and in the ongoing relationship between patient and clinician) and at different levels (the environment the care is provided in, within policies and procedures and within and between relationships from receptionists to clinicians).

Witnessing Phenotypic and Molecular Evolution in the Fruit Fly.

This multi-day exercise is designed for a college Genetics and Evolution laboratory to demonstrate concepts of inheritance and phenotypic and molecular evolution using a live model organism, Drosophila simulans. Students set up an experimental fruit fly population consisting of ten white eyed flies and one red eyed fly. Having red eyes is advantageous compared to having white eyes, allowing students to track the spread of this advantageous trait over several generations. Ultimately, the students perform PCR and gel electrophoresis at two neutral markers, one located in close proximity to the eye-color locus, and one located at the other end of the chromosome. Students observe that most flies have red eyes, and these red-eyed flies have lost variation at the near marker, but maintained variation at the far marker, hence observing a "selective sweep" and the "hitchhiking" of a nearby neutral variant. Students literally observe phenotypic and molecular evolution in their classroom!

Genetics of hybrid male sterility among strains and species in the Drosophila pseudoobscura species group.

Taxa in the early stages of speciation may bear intraspecific allelic variation at loci conferring barrier traits in hybrids such as hybrid sterility. Additionally, hybridization may spread alleles that confer barrier traits to other taxa. Historically, few studies examine within- and between-species variation at loci conferring reproductive isolation. Here, we test for allelic variation within Drosophila persimilis and within the Bogota subspecies of D. pseudoobscura at regions previously shown to contribute to hybrid male sterility. We also test whether D. persimilis and the USA subspecies of D. pseudoobscura share an allele conferring hybrid sterility in a D. pseudoobscura bogotana genetic background. All loci conferred similar hybrid sterility effects across all strains studied, although we detected some statistically significant quantitative effect variation among D. persimilis alleles of some hybrid incompatibility QTLs. We also detected allelism between D. persimilis and D. pseudoobscura USA at a second chromosome hybrid sterility QTL. We hypothesize that either the QTL is ancestral in D. persimilis and D. pseudoobscura USA and lost in D. pseudoobscura bogotana, or gene flow transferred the QTL from D. persimilis to D. pseudoobscura USA. We discuss our findings in the context of population features that may contribute to variation in hybrid incompatibilities.

The role of meiotic drive in hybrid male sterility.

Meiotic drive causes the distortion of allelic segregation away from Mendelian expected ratios, often also reducing fecundity and favouring the evolution of drive suppressors. If different species evolve distinct drive-suppressor systems, then hybrid progeny may be sterile as a result of negative interactions of these systems' components. Although the hypothesis that meiotic drive may contribute to hybrid sterility, and thus species formation, fell out of favour early in the 1990s, recent results showing an association between drive and sterility have resurrected this previously controversial idea. Here, we review the different forms of meiotic drive and their possible roles in speciation. We discuss the recent empirical evidence for a link between drive and hybrid male sterility, also suggesting a possible mechanistic explanation for this link in the context of chromatin remodelling. Finally, we revisit the population genetics of drive that allow it to contribute to speciation.

The devil is in the details: self-neglect in Australia.

Although elder self-neglect is of significant concern to adult protective service (APS) workers in the United States, minimal research has been conducted on this topic in Australia. Using qualitative research methods, this article examines how 24 Australian professionals understand situations of self-neglect. Unlike in the United States, where the term self-neglect is used in a broad and all-encompassing manner, participants in this research differentiated among self-neglect (the neglect of self), squalor (extreme neglect of environment), collecting (the accumulation of certain objects), and hoarding (the inability to throw objects away). It is argued that separating out the various behaviors that are classified under the broad umbrella of neglect can be useful in fostering reflective interventions in these situations.

Estimation of isolation times of the island species in the Drosophila simulans complex from multilocus DNA sequence data.

BACKGROUND: The Drosophila simulans species complex continues to serve as an important model system for the study of new species formation. The complex is comprised of the cosmopolitan species, D. simulans, and two island endemics, D. mauritiana and D. sechellia. A substantial amount of effort has gone into reconstructing the natural history of the complex, in part to infer the context in which functional divergence among the species has arisen. In this regard, a key parameter to be estimated is the initial isolation time (t) of each island species. Loci in regions of low recombination have lower divergence within the complex than do other loci, yet divergence from D. melanogaster is similar for both classes. This might reflect gene flow of the low-recombination loci subsequent to initial isolation, but it might also reflect differential effects of changing population size on the two recombination classes of loci when the low-recombination loci are subject to genetic hitchhiking or pseudohitchhiking METHODOLOGY/PRINCIPAL FINDINGS: New DNA sequence variation data for 17 loci corroborate the prior observation from 13 loci that DNA sequence divergence is reduced in genes of low recombination. Two models are presented to estimate t and other relevant parameters (substitution rate correction factors in lineages leading to the island species and, in the case of the 4-parameter model, the ratio of ancestral to extant effective population size) from the multilocus DNA sequence data. CONCLUSIONS/SIGNIFICANCE: In general, it appears that both island species were isolated at about the same time, here estimated at approximately 250,000 years ago. It also appears that the difference in divergence patterns of genes in regions of low and higher recombination can be reconciled by allowing a modestly larger effective population size for the ancestral population than for extant D. simulans.