To use normalization process theory (NPT) to build a strategy for the implementation of goal-oriented care (GOC) in primary care in Flanders, Belgium.

Herpes zoster infection (HZ) is an important public health problem due to its high incidence and frequent complications, especially post-herpetic neuropathy . The incidence of HZ increases with age and is more frequent in immunocompromised patients. It is estimated that at least 60,000 people develop HZ each year in Spain. The usual forms of HZ are so clinically characteristic that they do not usually require microbiological confirmation, which is reserved for cases without cutaneous manifestations or with atypical presentation. There are currently two vaccines approved by the regulatory agencies and marketed in Spain to prevent the onset of HZ and its complications. The first (Zostavax®) was marketed by the company MSD and licensed in Europe in 2006 and is a live attenuated virus vaccine that is administered in a single dose, while the second (Shingrix®) is a recombinant vaccine, marketed in 2017 and requires two doses. While the former cannot be administered to immunocompromised persons, the latter can be prescribed to any group of adults. The criteria for the indication and financing of these vaccines have not been uniform in the various autonomous communities of Spain. These and other aspects of HZ have been discussed by a group of experts from the Illustrious Official College of Physicians of Madrid (ICOMEM) whose criteria and opinions are included in this paper.

In recognition of the often poor experience of people living with dementia in general hospitals and the lack of dementia curricular content for health and social care professionals, the Scottish Government commissioned a dementia workforce development programme (Dementia Champions) for qualified health and social care professionals in 2011. This constructivist grounded theory study aimed to construct a theory of the learning experienced by the dementia champions before, during and after the programme. The reported experience of change in the champions' professional and personal perspectives about people with dementia was the focus of this study. The findings contribute to a deeper understanding of the long-term negative impact of knowledge and skills gaps in dementia education and on people living with dementia and health and social care professionals. This negative impact has implications for individual professionals, service leaders and health and social care systems internationally. Data was co-produced through intensive interviewing, a focus group and email interviewing with nineteen Dementia Champions. Construction of the theory emerged from direct engagement with the data using the constructivist grounded theory approach. The findings illuminate how, before the programme, professionals were educated, socialised and defined to fail people with dementia. On the programme, multiple learning interventions in which interacting with the lived experience of people living with dementia, their families and colleagues became the stimulators of change. These learning interventions stimulated a disrupted self-definition and actions to resolve this disruption. Once the self-definition was restored, the participants faced the complexity of working with people living with dementia with passion, pride and new thinking. These findings further illuminate the importance of expert facilitation and the inclusion of people with dementia and their families as peer educators in health and social care dementia education. Further research on the negative outcomes of gaps in initial professional education is important.

Children with congenital heart disease (CHD) are at increased risk for neurodevelopmental challenges across the lifespan. These are associated with neurological changes and potential acquired brain injury, which occur across a developmental trajectory and which are influenced by an array of medical, sociodemographic, environmental, and personal factors. These alterations to brain development lead to an array of adverse neurodevelopmental outcomes, which impact a characteristic set of skills over the course of development. The current paper reviews existing knowledge of aberrant brain development and brain injury alongside associated neurodevelopmental challenges across the lifespan. These provide a framework for discussion of emerging and potential interventions to improve neurodevelopmental outcomes at each developmental stage.

Although the Satisfaction with Life Scale strives to capture a single dimension, describing respondents' satisfaction with life as a whole, individual items might also capture unique aspects of life satisfaction leading to some form of multidimensionality. Such systematic item-specific variance can be viewed as a content-laden secondary trait. Information on the nomological net and predictive validity can be useful to aid the interpretation of these item-specific effects. Therefore, the present study on N = 2,543 Dutch respondents adopts revised latent state-trait theory to disentangle common construct variance, random measurement error, and person-specific item effects in the Satisfaction with Life Scale across three measurement occasions. The reported analyses not only demonstrate how to examine item-specific multidimensionality in longitudinal data but also emphasize how different identification constraints for the latent variable lead to different interpretations. Moreover, the predictive validity of item effect variables for the prediction of psychological and physical health is examined. A cross-validation with the same sample at a later measurement period and robustness checks with incomplete data, support our findings on the substantive value of a multidimensional specification of the Satisfaction with Life Scale for substantive analyses. Finally, the contributions of person-specific item effects for psychological assessments are discussed.

Opioid use during pregnancy impacts the health and well-being of two generations: the pregnant person and the child. The factors that increase risk for opioid use in the adult, as well as those that perpetuate risk for the caregiver and child, oftentimes replicate across generations and may be more likely to affect child neurodevelopment than the opioid exposure itself. In this article, we review the prenatal opioid exposure literature with the perspective that this is not a singular event but an intergenerational cascade of events. We highlight several mechanisms of transmission across generations: biological factors, including genetics and epigenetics and the gut-brain axis; parent-child mechanisms, such as prepregnancy experience of child maltreatment, quality of parenting, infant behaviors, neonatal opioid withdrawal diagnosis, and broader environmental contributors including poverty, violence exposure, stigma, and Child Protective Services involvement. We conclude by describing ways in which intergenerational transmission can be disrupted by early intervention.

Primary splenic or hepatic angiosarcomas are ultra-rare and aggressive malignancies associated with poor prognosis. The mainstay treatments are surgical resection and chemotherapy. We report a case of angiosarcoma in a 50-year-old woman who presented with bruising, fatigue, ecchymosis, and hepatosplenomegaly. She was treated with the multi-kinase inhibitor sunitinib for 4 weeks before developing a splenic hemorrhage and succumbing. Recent studies have demonstrated the clinical benefit of immunotherapies in angiosarcomas. Additionally, sequencing techniques have showcased the diverse molecular aberrations involved in angiosarcomas, which offer opportunities for precision-matched targeted therapies such as inhibitors of the VEGF/VEGFR axis and PI3K/Akt/mTor pathway.

Cardiolipin (CL) is a mitochondria-exclusive phospholipid, primarily localised within the inner mitochondrial membrane, that plays an essential role in mitochondrial architecture and function. Aberrant CL content, structure, and localisation have all been linked to impaired mitochondrial activity and are observed in the pathophysiology of cancer and neurological, cardiovascular, and metabolic disorders. The detection, quantification, and localisation of CL species is a valuable tool to investigate mitochondrial dysfunction and the pathophysiological mechanisms underpinning several human disorders. CL is measured using liquid chromatography, usually combined with mass spectrometry, mass spectrometry imaging, shotgun lipidomics, ion mobility spectrometry, fluorometry, and radiolabelling. This review summarises available methods to analyse CL, with a particular focus on modern mass spectrometry, and evaluates their advantages and limitations. We provide guidance aimed at selecting the most appropriate technique, or combination of techniques, when analysing CL in different model systems, and highlight the clinical contexts in which measuring CL is relevant.

Little is known about Chinese American dementia caregivers' attitudes toward tube feeding.