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ation of similar methods to achieve this unity. However, integrated care programs did not necessarily lead to the changes intended in experiences and outcomes. We attribute this gap between expectations and results, in part, to significant misalignment between the aspiration for unity underpinning conceptual models on the one hand and the multiplicity of practical application of strategies to integrate care on the other. Conclusions Those looking for universal answers to narrow questions about whether integrated care "works" are likely to remain disappointed. Models of integrated care need to be valued for their heuristic rather than predictive powers, and integration understood as emerging from particular as well as common contexts.Objective H1N1/09 was the first pandemic flu ever responded to with mass vaccinations. Public health nurses (PHNs) were pivotal in implementing the H1N1/09 vaccination clinics. With the ongoing threat of pandemic influenza and other viral outbreaks, much can be learned from these PHNs' H1N1/09 experiences. This study's purpose was to explore PHNs' experiences in the H1N1/09 mass vaccination clinics. Design and sample In a qualitative interpretive description, 23 PHNs (16 immunizers, seven supervisors) who worked in a large Canadian municipal public health agency, participated in semistructured interviews. Results Three overarching themes were identified. 'Anticipating an Emergency' discusses participants' experiences learning about the pandemic response and their role preparation. 'Surviving the Chaos' reflects the challenges of the clinics, particularly during the first few hectic weeks of the response. 'Persevering Over Time' encompasses participants' experiences as they became familiar with clinics' operations and their own responsibilities. Conclusions Participants' experiences have implications for future public health pandemic planning and research. Key recommendations include to communicate with PHNs in a timely manner about their clinic roles, and to provide PHNs with appropriate training to optimize clinics' operations. This will help support PHNs in their roles to protect the public and provide quality population care.Plastic pollution is a global environmental concern. In particular, the endocrine-disrupting chemical bisphenol A (BPA) is nearly ubiquitous in aquatic environments globally, and it continues to be produced and released into the environment in large quantities. BPA disrupts hormone signalling and can thereby have far-reaching physiological and ecological consequences. AXL1717 However, it is not clear whether BPA has consistent effects across biological traits and phylogenetic groups. Hence, the aim of this study was to establish the current state of knowledge of the effect of BPA in aquatic organisms. We show that overall BPA exposure affected aquatic organisms negatively. It increased abnormalities, altered behaviour and had negative effects on the cardiovascular system, development, growth and survival. Early life stages were the most sensitive to BPA exposure in invertebrates and vertebrates, and invertebrates and amphibians seem to be particularly affected. These data provide a context for management efforts in the face of increasing plastic pollution. However, data availability is highly biased with respect to taxonomic groups and traits studies, and in the geographical distribution of sample collection. The latter is the case for both measurements of the biological responses and assessing pollution levels in water ways. Future research effort should be directed towards biological systems, such as studying endocrine disruption directly, and geographical areas (particularly in Africa and Asia) which we identify to be currently undersampled.Introduction The purpose of our study was to compare visual rating and volumetry of brain atrophy in an elderly population over a 5-year period and compare findings with cognitive test results. Materials and methods Two hundred and one subjects were examined with magnetic resonance imaging (MRI) of the brain. Visual rating and volumetry were performed in all subjects at ages 75 and 80. Cognitive function at both time points was assessed with the Mini-Mental State Examination (MMSE) and Trail Making Tests A and B (TMT-A and TMT-B). Changes in visual rating and volumetry were compared with changes in cognitive test. Results A correlation was found between visual rating of medial temporal lobe atrophy (MTA) and hippocampal volumetry at both time points (rs = -.42 and rs = -.49, p less then .001, respectively). The correlation between visual rating of posterior atrophy (PA); frontal atrophy (F-GCA) and volumetry of these brain regions was significant only at age 80 (rs = -.16, p = .02 for PA and rpb = .19, p = .006 for F-GCA). Visual rating showed only a minimal progression of regional atrophy at age 80, whereas volumetry showed 2%-5% decrease in volume depending on brain region. Performance in the MMSE, TMT-A, and TMT-B was virtually unchanged between ages 75 and 80. Conclusion We found a mild age-associated decrease in regional brain volumes in this healthy cohort with well-preserved cognitive functions. Visual assessment may not be sufficient for detecting mild progression of brain atrophy due to normal aging, whereas volumetry is more sensitive to capture these subtle changes.At the essence of developing Pt-based single atom catalyst (SAC) for hydrogen evolution reaction (HER) is to prepare well-defined and stable single Pt sites with desired electro-catalytic efficacy. Herein, we report a facile approach to generate uniformly dispersed Pt sites with outstanding HER performance via photochemical reduction method using polyvinylpyrrolidone (PVP) molecules as the key addictive to significantly simplify synthesis routes and enhance the catalytic performance. The as-prepared catalyst unfolds remarkable kinetic activities (20 times higher in current density than the commercially available Pt/C) with excellent stability (76.3% of its initial activity after 5000 cycles) for HER. EXAFS measurements and DFT calculations demonstrate a synergetic effect, where the PVP ligands and the support together modulate the electronic structure of Pt atoms, which optimize the hydrogen adsorption energy, resulting in a considerably improved HER activity. Our findings push a step towards the industrial application of Pt-based SACs for the hydrogen economy.