BACKGROUND: Health and social care regulators are organisations that seek to maintain public trust in professionals and protect the public from harmful practitioners. For example, they ensure that practitioners have the correct qualifications to practice and investigate any concerns raised about them. Serious concerns can result in a fitness to practise (FtP) hearing where a member of the public may be required to give evidence as a witness. Being a witness and being cross-examined is known to often be traumatic, particularly for members of the public in criminal trials. There is some research evidence that registered professionals who are the subject of the proceedings may suffer mental ill health as result of the experience. But there is scant research that specifically explores the experiences of members of the public giving evidence in a FtP hearing. The regulator web pages are an important source of information for public witnesses to prepare themselves for a FtP hearing.
OBJECTIVE: This study aimed to examine the publicly available information for public witnesses from the 13 health and social care regulators in the United Kingdom to evaluate the content, amount, type and format of information available and make recommendations about how regulators can improve these.
METHODS: Regulator websites were searched during November 2021-February 2022 for information for the public on what happens after raising a concern with a regulator. Resources were downloaded and qualitative content analysis conducted. Our findings were validated by interviews (n = 7) with the public including people with experience of FtP and a focus group of the public (n = 5).
RESULTS: One hundred and forty-six resources (97 webpages and 25 public facing documents, 20 videos and 4 easy read documents) were found. Topics included screening and investigation, preparing for a hearing, during a hearing and after a hearing, and support for witnesses.
CONCLUSIONS: We conclude that there are many deficiencies in the information content and its presentation for the public and some exemplars, such as the use of flowcharts and short videos to explain the FtP processes. Recommendations for practice take the form of a framework with three themes, (i) co-production, (ii) preferred content and (iii) format. It may be used by regulators to enhance their support for members of the public as witnesses in FtP hearings.
UNASSIGNED: Our advisory group of people with lived experience of involvement as members of the public in FtP discussed the findings and contributed to the recommendations.

Foreign bodies (FBs) in the digestive tract are common in children, we analyzed the clinical characteristics of children with FBs in the digestive tract and discuss the risk factors for serious complications. We retrospectively reviewed clinical data of 139 children with FBs in the digestive tract. Based on the severity of complications caused by FBs, the patients were divided into risk and general groups for analysis and comparison. Significant differences were observed in the retention sites of FBs, the diameter of FBs retained in the esophagus, FBs retention time exceeding 24 h, and the absence of witnesses between the 2 groups. Inadequate care, button batteries (BBs), ingested mmFBs, FBs retained in the esophagus, long-term retention, and giant gastric bezoars may cause serious complications. In addition to treating FBs and the complications, clinicians should emphasize the importance of childcare to prevent the ingestion of FBs.

UNASSIGNED: The aim of this study was to analyze the well-being and coping strategies of nurses working in an organizational setting perceived as characterized by workplace bullying. The innovative aspect of this study is that we considered only those who perceive to work in an organizational environment characterized by workplace bullying, and not those who see themselves as victims and those who perceive they work in an organizational environment not characterized by workplace bullying.
UNASSIGNED: A questionnaire with the NAQ-R, PGWBI, Val.Mob. and Brief COPE scales was administered to nurses. To better understand this phenomenon, a comparison was made between 331 nurses and 166 workers in other professions who also work in an organizational environment perceived to be characterized by workplace bullying.
UNASSIGNED: In both groups (nurses and workers), the results were approximately the same in terms of personal bullying and workplace bullying episodes and the number of physical and emotive symptoms. The PGWBI score was lower for nurses than for workers in other fields. Among the individual symptoms, nurses and registered nurses were more likely to report gastritis, insomnia and heartburn than workers in other contexts. Workers in other contexts were more likely than nurses to report symptoms of anxiety, fear, feelings of insecurity, inferiority and guilt. In terms of coping strategies, nurses were more likely than other workers to report distraction, substance use, emotional support, disengagement, venting, positive reframing, humor, and religion. Workers in other professional context were more likely than nurses to report active coping, denial, instrumental support, planning, acceptance, and self-blame.
UNASSIGNED: Results suggest that the consequences of working in a perceived organizational environment characterized by workplace bullying are similar for both groups of workers, with nonstatistical differences in perceived workplace bullying episodes and sum of physical and emotive symptoms.
UNASSIGNED: Overall, findings suggest that workplace bullying prevention is a fundamental element in training workers in all types of workplaces and should be an integral part of curriculum activities.

OBJECTIVE: To study the effectiveness of whole-scenario embryo identification using a self-supervised learning encoder (WISE) in in vitro fertilization (IVF) on time-lapse, cross-device, and cryo-thawed scenarios.
METHODS: WISE was based on the vision transformer (ViT) architecture and masked autoencoders (MAE), a self-supervised learning (SSL) method. To train WISE, we prepared three datasets including the SSL pre-training dataset, the time-lapse identification dataset, and the cross-device identification dataset. To identify whether pairs of images were from the same embryos in different scenarios in the downstream identification tasks, embryo images including time-lapse and microscope images were first pre-processed through object detection, cropping, padding, and resizing, and then fed into WISE to get predictions.
RESULTS: WISE could accurately identify embryos in the three scenarios. The accuracy was 99.89% on the time-lapse identification dataset, and 83.55% on the cross-device identification dataset. Besides, we subdivided a cryo-thawed evaluation set from the cross-device test set to have a better estimation of how WISE performs in the real-world, and it reached an accuracy of 82.22%. There were approximately 10% improvements in cross-device and cryo-thawed identification tasks after the SSL method was applied. Besides, WISE demonstrated improvements in the accuracy of 9.5%, 12%, and 18% over embryologists in the three scenarios.
CONCLUSIONS: SSL methods can improve embryo identification accuracy even when dealing with cross-device and cryo-thawed paired images. The study is the first to apply SSL in embryo identification, and the results show the promise of WISE for future application in embryo witnessing.

UNASSIGNED: Ketamine (KET) is administered to manage major depression in adolescent patients. However, the long-term effects of juvenile KET exposure on memory-related tasks have not been thoroughly assessed. We examined whether exposure to KET, psychological stress, or both results in long-lasting alterations in spatial memory in C57BL/6 mice. Furthermore, we evaluated how KET and/or psychological stress history influenced hippocampal protein kinase B-mechanistic target of rapamycin (AKT-mTOR)-related signaling.
UNASSIGNED: On postnatal day 35, male and female mice underwent vicarious defeat stress (VDS), a form of psychological stress that reduces sociability in both sexes, with or without KET exposure (20 mg/kg/day, postnatal days 35-44). In adulthood (postnatal day 70), mice were assessed for spatial memory performance on a water maze task or euthanized for hippocampal tissue collection.
UNASSIGNED: Juvenile pre-exposure to KET or VDS individually increased the latency (seconds) to locate the escape platform in adult male, but not female, mice. However, juvenile history of concomitant KET and VDS prevented memory impairment. Furthermore, individual KET or VDS pre-exposure, unlike their combined history, decreased hippocampal AKT-mTOR signaling in adult male mice. Conversely, KET pre-exposure alone increased AKT-mTOR in the hippocampus of adult female mice. Lastly, rapamycin-induced decreases of mTOR in naïve adult female mice induced spatial memory retrieval deficits, mimicking adult male mice with a history of exposure to VDS or KET.
UNASSIGNED: Our preclinical model shows how KET treatment for the management of adolescent psychological stress-induced sequelae does not impair spatial memory later in life. However, juvenile recreational KET misuse, like psychological stress history, results in long-term spatial memory deficits and hippocampal AKT-mTOR signaling changes in a sex-specific manner.

The complexities surrounding aging, dementia, and care are timely issues that transcend beyond institutional boundaries, evincing a critical debate on later life across disciplines. The aim of this study is to offer fresh insights into the intricate paradigms of living and growing older with dementia. The study focuses on the Nobel Prize-winning author Annie Ernaux\'s memoir I Remain in Darkness (1999), which provides a candid account of her mother\'s journey through dementia from its onset to the gradual decline.
This article employs the theoretical frameworks of literary gerontology, illness narratives and life writing to address the challenges of aging, dementia and care that are represented in Ernaux\'s memoir. It also addresses societal attitudes and stigma associated with aging and dementia by exploring the embarrassment that individuals and families experience when confronted with the deteriorating mental health of their loved ones.
Ernaux\'s memoir explores the nuances of dementia and caregiving within both the familial and institutional context, and sheds light on the complex relationship between a mother and a daughter. Through the act of witnessing, Ernaux embarks on a path of healing, which allows her to confront her past wounds and better navigate the challenges that lie ahead. However, Ernaux\'s confessional memoir also troubles the ethics of life writing and identity issues, and seems to perpetuate the pathologizing medical gaze through the exposure of her mother\'s vulnerability and intimacy in the face of dementia and care.
Ernaux\'s account of her mother\'s dementia and aging is both a confessional piece of writing and a narrative therapy, which reveals the challenges of aging, illness, and unresolved family tensions. Her work illuminates the interconnectedness between the past, present, and future, and shows that illness narratives can act as a catalyst for transformative change, identity formation, and self-reflection. The article addresses the intricacies of old age, showcasing how life writing and humanities-based inquiry can bring to the fore key aspects of the latest stages in life, which are often unvoiced because they represent the most unpleasant and feared aspects of aging in contemporary society.

This research demonstrates the impact of equitable management as a protective factor against workplace sexual harassment (WSH) and its consequences on labor productivity. It also shows that there are invisible costs for colleagues who witness WSH, through counterproductive behaviors, such as sabotage or production deviance, with an indirect decrease in labor productivity. We used a structured questionnaire that was answered by 827 women from 37 small, medium, and large private companies in the Lima Metropolitan Area, Peru. We designed a conceptual model and tested it using structural covariance equations. The results indicate that 33.5 % of women have been sexually harassed over the last 12 months, an average of 6.6 times, while 18.9 % of women have supported co-workers who were victims of WSH. Being sexually harassed at work decreases labor productivity by 43.1 % and increases the intention to desert the company by 15.2 %. Witnessing WSH increases the intention to drop out by 11.3 % and increases counterproductive behaviors by 39.6 %. We found that equitable management is a preventative factor for WSH. Equitable management not only decreases the probability of the occurrence of WSH by 2.2 times but also-if it exists-reduces its pernicious impact on productivity through various indirect effects. Equitable management can reduce the labor productivity costs caused by WSH by 4.6 times.

OBJECTIVE: To develop a prediction model for emergency medical technicians (EMTs) to identify trauma patients at high risk of deterioration to emergency medical service (EMS)-witnessed traumatic cardiac arrest (TCA) on the scene or en route.
METHODS: We developed a prediction model using the classical cross-validation method from the Pan-Asia Trauma Outcomes Study (PATOS) database from 1 January 2015 to 31 December 2020. Eligible patients aged ≥18 years were transported to the hospital by the EMS. The primary outcome (EMS-witnessed TCA) was defined based on changes in vital signs measured on the scene or en route. We included variables that were immediately measurable as potential predictors when EMTs arrived. An integer point value system was built using multivariable logistic regression. The area under the receiver operating characteristic (AUROC) curve and Hosmer-Lemeshow (HL) test were used to examine discrimination and calibration in the derivation and validation cohorts.
RESULTS: In total, 74,844 patients were eligible for database review. The model comprised five prehospital predictors: age <40 years, systolic blood pressure <100 mmHg, respiration rate >20/minute, pulse oximetry <94%, and levels of consciousness to pain or unresponsiveness. The AUROC in the derivation and validation cohorts was 0.767 and 0.782, respectively. The HL test revealed good calibration of the model (p = 0.906).
CONCLUSIONS: We established a prediction model using variables from the PATOS database and measured them immediately after EMS personnel arrived to predict EMS-witnessed TCA. The model allows prehospital medical personnel to focus on high-risk patients and promptly administer optimal treatment.

We sought to examine the impact of the COVID-19 pandemic on the incidence and survival outcomes of emergency medical service (EMS)-witnessed out-of-hospital cardiac arrest (OHCA) in Victoria, Australia.
We performed an interrupted time-series analysis of adult EMS-witnessed OHCA patients of medical aetiology. Patients treated during the COVID-19 period (1st March 2020 to 31st December 2021) were compared to a historical comparator period (1st January 2012 and 28th February 2020). Multivariable poisson and logistic regression models were used to examine changes in incidence and survival outcomes during the COVID-19 pandemic, respectively.
We included 5,034 patients, 3,976 (79.0%) in the comparator period and 1,058 (21.0%) in the COVID-19 period. Patients in the COVID-19 period had longer EMS response times, fewer public location arrests and were significantly more likely to receive mechanical CPR and laryngeal mask airways compared to the historical period (all p < 0.05). There were no significant differences in the incidence of EMS-witnessed OHCA between the comparator and COVID-19 periods (incidence rate ratio 1.06, 95% CI: 0.97-1.17, p = 0.19). Also, there was no difference in the risk-adjusted odds of survival to hospital discharge for EMS-witnessed OHCA occurring during COVID-19 period compared to the comparator period (adjusted odd ratio 1.02, 95% CI: 0.74-1.42; p = 0.90).
Unlike the reported findings in non-EMS-witnessed OHCA populations, changes during the COVID-19 pandemic did not influence incidence or survival outcomes in EMS-witnessed OHCA. This may suggest that changes in clinical practice that sought to limit the use of aerosol generating procedures did not influence outcomes in these patients.

Forensic odontology is an expanding field within the domain of forensic sciences, where dental knowledge is applied in identification of individuals through analysis of the dental-related records. The study goal was to determine if undergraduate students were aware of the forensic dentistry course. A cross-sectional survey was initiated about the need for forensic courses in UG program. Nearly 100 students participated in this survey, data have been collected, and graph has been plotted. Data have been collected with the help of SPSS software; data have been analyzed and plotted as graph. One hundred students responded the survey; only limited people\'s opinions have been collected. The result varies among the students; 58% knows about the importance of forensic odontology in dentistry using Chi-square value, P = 0.09. The majority of students, who replied to this poll, had some understanding and awareness of forensic odontology in dentistry, but they need to learn more about how it is practiced.