Baseline demographics were similar between groups. Length of stay, mechanical ventilation hours, and renal failure rate were significantly reduced in the study group. Coronary artery bypass grafting patients observed the greatest improvement in outcomes. CONCLUSIONS Implementation of a dedicated cardiac surgical intensive care service leads to significant improvements in clinical outcomes. The greatest benefit is seen in patients undergoing coronary artery bypass, the most common cardiac surgical operation in the United States. Thus, developing a cardiac surgical intensive care service may be a worthwhile initiative for any cardiac surgical program. © 2020 Wiley Periodicals, Inc.BACKGROUND This study examined whether eye-sparing surgery is associated with better or worse outcomes than exenteration for the treatment of lacrimal gland carcinomas. METHODS Forty-six patients treated for lacrimal gland carcinoma were retrospectively reviewed and compared. A statistical analysis was performed using Kaplan-Meier plots. RESULTS The overall survival rates for eye-sparing surgery were 52% and 37% at 5 and 10 years, and those for exenteration were 37% and 25% at 5 and 10 years, respectively (P = .73). The proportion of patients with local regional control at both 5 and 10 years after eye-sparing surgery was 0.75, and that for exenteration was 0.47 (P = .30). For eye-sparing surgery, the proportions of distant metastasis-free survival at 5 and 10 years were 0.51 and 0.39 for eye-sparing surgery and 0.29 and 0.14 for exenteration (P = .50). CONCLUSION Because the outcomes were not significantly different, the authors suggest that eye-sparing surgery can be proposed as a reasonable approach for lacrimal gland carcinomas in appropriately selected patients. © 2020 Wiley Periodicals, Inc.OBJECTIVE Many therapists are reluctant to conduct exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD). Negative beliefs about the safety and tolerability of ERP are common, especially for harm-related OCD symptoms.  https://www.selleckchem.com/products/ldn193189.html  The study examined the nature and frequency of ERP-related serious negative consequences (SNC) and therapist attitudes and experiences providing ERP for harm-related OCD. METHODS An anonymous survey was completed by 277 therapists with experience treating OCD using ERP. Questions assessed clinical experiences of harm-related exposures, the nature of SNC, and concerns and clinical considerations regarding ERP. RESULTS Therapist's willingness to treat harm-related OCD was high. SNCs were reported for 6 clients (per-client risk adults 0.05%, youth 0.01%) and 13 therapists (per therapist risk 4.73%, therapist per-year risk 0.004%). Qualitative analysis identified themes relating to the conduct of treatment, specific exposure types, professional issues, and negative perceptions of ERP. CONCLUSION SNC associated with ERP for OCD are rare and primarily represent unintended secondary consequences of OCD or misunderstandings regarding the process and rationale behind ERP. Improving access to ERP will require good communication with clients, families, and other professionals regarding the rationale and safety of ERP. © 2020 Wiley Periodicals, Inc.ISSUE ADDRESSED Climate change is one of the greatest challenges to public health and well-being. Steps taken by governments now will have a significant effect on public health outcomes, including the food system and food security. METHOD This study reviewed municipal public health and well-being plans from 79 local government areas (LGAs) in Victoria, Australia. Documents were included if they explicitly mentioned climate change and food insecurity. Of the 79 LGAs, 13 met the selection criteria and a content and framing analysis was conducted to identify the level of recognition of climate change on food security and proposed mitigation actions and strategies. RESULTS Of the 13 LGAs, the documents of six were identified as having a high level of responsiveness to climate change and food insecurity, five were assessed as medium and two low. Framing analysis identified council acknowledgment of how climate change effects food access through availability and price, and growing food locally and sustainably is seen as a common action to improve food security. CONCLUSION The findings of this study suggest that planning for climate change and food insecurity is not a high priority for Victorian LGAs. Given the current political climate in Australia, where many in federal government continue to deny the existence of climate change or are reluctant to implement mitigation strategies, it is now and will be increasingly important into the future that local governments plan for the impact of climate change on food insecurity. SO WHAT? Climate change will impact how people access food and what foods are available to them. Unless all levels of government start to address and plan for climate change, the impact on communities will continue to intensify and grow more costly and damaging. © 2020 Australian Health Promotion Association.Pandanus boninensis, endemic to the Ogasawara Islands, Japan, is distributed on both the older Bonin and younger Volcano Islands. In this study, we conducted population genetic analyses of P. boninensis on these islands to examine the population diversity and structure across old and young islands, to assess potential differences in population demography with island age, and to collect any evidence of migration between old and young islands. We found that the genetic diversity of expressed sequence tag (EST)-based microsatellite (SSR) markers, the nucleotide diversity of nuclear DNA sequences, and the haplotype diversity of chloroplast DNA on young islands were lower than those on old islands. Clustering analyses of EST-SSR indicated that populations on old islands were strongly diverged from those on young islands. Approximate Bayesian computation analysis of EST-SSR suggested that population expansion occurred on old islands while population reduction occurred on young islands. We also found evidence of migration among old islands (mostly from south to north), while it appears that there have been very few migration events between old and young islands. These differences could be due to the fact that young islands tend to be geographically isolated and support smaller populations that began a shorter time ago from limited founders. The P. boninensis populations on the Volcano Islands are interesting from an evolutionary perspective as they constitute a classic example of the early stages of progressive colonization on oceanic islands with small effective population sizes and low genetic diversity. © 2020 John Wiley & Sons Ltd.