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Design of an adaptive anti-unwinding finite time sliding mode algorithm for attitude control system of a three-axis satellite is approached in this paper. In the designed controller, some parameters updating laws are proposed to simultaneously obtain the accurate values of inertia moments, the upper values of reaction wheels' failures and disturbances. Accordingly, the combined finite time stability of the control system and convergence of the satellite parameters has been demonstrated. Also, a new sliding surface is suggested to avoid the unwinding problem which is common in sliding mode techniques. It is proved by the Lyaponov methodology that the satellite quaternions and angular velocities always approach to the nearest equilibrium point and so it prevents the excessive satellite slews. Furthermore, the proposed algorithm has been modified in such a way that the singularity problem does not occur, especially when the system states reach around the equilibrium point. Therefore, the finite time convergence of system states and parameters estimation errors are guaranteed subjected to disturbances and actuator failures without occurring singularity and unwinding problems. Besides rigorous theoretical proofs by the Lyapunov theory, different simulations are exhibited to demonstrate the merits of the developed control schemes. PURPOSE Prescription opioid misuse has become a public health concern globally. In Canada, little is known about the national prescription patterns in children. The purpose of the present study was to evaluate the opioid prescribing practices of pediatric surgeons in Canada. METHODS Following ethical approval, an electronic questionnaire was administered to all pediatric surgeons currently practicing in Canada. Questions included surgeon practice information, patterns of opioid prescription at discharge based on the type of surgery, type of opioid prescribed, and availability of training for surgeons/families. RESULTS Fifty-eight questionnaires were completed (response rate 84%) by surgeons from 8 out of 8 Canadian provinces with pediatric surgery coverage. 33% of responders prescribed opioids (most commonly morphine) for day surgeries and 73% of Pediatric Surgeons prescribed opioids for major surgeries. Most responders (84%) declared that at their institution there was no formal training for residents/fellows in pain control and opioid prescribing. Similarly, 57% reported no education for families about opioids at discharge. CONCLUSION This first national survey on opioid prescribing practices across Canada reveals that opioids were prescribed to pediatric patients following a broad range of minor and major surgical procedures. Moreover, there seems to be a lack of education for surgeons and families about opioid use. selleck chemicals TYPE OF STUDY Descriptive, cross-sectional, practice survey. LEVEL OF EVIDENCE Level 5. Sometimes care is provided to a cognitively impaired person against the person's will, referred to as involuntary treatment. We developed the PRITAH intervention, aimed at prevention and reduction of involuntary treatment at home. PRITAH consists of a policy discouraging involuntary treatment, workshops, coaching by a specialized nurse and alternative interventions. A feasibility study was conducted including 30 professional caregivers. Feasibility was assessed by attendance lists (reach), a logbook (dose delivered and fidelity), evaluation questionnaires and focus group interviews (dose received, satisfaction & barriers). The workshops and coach were positively evaluated and the average attendance rate was 73%. Participants gained more awareness and knowledge and received practical tips and advice to prevent involuntary treatment. Implementation of the intervention was feasible with minor deviations from protocol. Recommendations for improvement included more emphasis on involvement of family caregivers and general practitioners and development of an extensive guideline to comply with the policy. Radiology is participating in the recent consolidation trend. Larger practices can invest in the infrastructure and teams to help improve the clinical value of the services they deliver. An example of national practice is provided that leverages its scale to promote clinical best practices aimed at reducing variability in the recommendations radiologists make for common imaging findings. This is accomplished by promoting the culture of learning and collaboration. In some initiatives, developing a machine learning tool to facilitate the application of clinical algorithms at the point of dictation facilitates the adoption of the recommendations. Regular feedback on practice and individual performance promotes improvement in performance and personal satisfaction of the clinicians. Cost savings through the reduction of unnecessary imaging studies or invasive procedures as well as improved outcomes through evidence-based follow-up have been achieved. In some cases, reductions in the rupture rate of abdominal aortic aneurysms have been realized through clinical follow-up programs. Embracing a culture of continuous learning through peer learning can lay the foundation for sharing clinical best practices. Having access to the benefits of scale in the form of investment in data, analytics, project management, and machine learning tools can facilitate the process of creating clinical value for our patients. PURPOSE Radiology, like many medical specialties, has experienced an increase in nationalized corporatization. The most vulnerable cohorts affected by this trend are early-career radiologists (ECRs), including trainees and recent graduates, particularly those entering or who have recently entered private practice. The aims of this study were to examine the awareness and perspectives of ECRs regarding this trend and to share salient examples of the impact of corporatization. METHODS From February 20, 2019, through May 28, 2019, an online survey of the members of the ACR's Resident and Fellow Section and Young and Early Career Professional Section was conducted. Respondents were queried about their awareness of corporatization, their opinions of how it affects radiology, their preferred practice type, whether they know other ECRs affected by corporatization, and whether they worry about their practices or future practices being acquired. A free-response opportunity was also provided for respondents to share their relevant personal experiences.