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Recent research syntheses have identified several potentially high-leverage teaching strategies for improving low-attaining secondary school students' learning of mathematics. These strategies include the structured use of representations and manipulatives and an emphasis on derived facts and estimation. This paper reports on 70 semi-structured interviews conducted with low-attaining students in Years 9–10 (ages 13–15) in England. The interviews addressed the students' perceptions of learning mathematics and the teaching strategies that they experienced and believed were most helpful. Many students reported rarely using number lines, not spontaneously estimating answers and being unfamiliar with derived facts. During the interviews, with minimal direction, students often showed that they were well able to make use of these strategies; however, they did not report making spontaneous use of them independently. We conclude that many of the most well-evidenced and recommended strategies to support low-attaining students in mathematics appear to be unfamiliar and unvalued, and we discuss how this might be addressed. [ABSTRACT FROM AUTHOR]

Background Research demonstrates significant gender- and sexual orientation–based differences in orgasm rates from sexual intercourse; however, this "orgasm gap" has not been studied with respect to age. Aim The study sought to examine age-related disparities in orgasm rates from sexual intercourse by gender and sexual orientation. Methods A survey sample of 24 752 adults from the United States, ranging in age from 18 to 100 years. Data were collected across 8 cross-sectional surveys between 2015 and 2023. Outcomes Participants reported their average rate of orgasm during sexual intercourse, from 0% to 100%. Results Orgasm rate was associated with age but with minimal effect size. In all age groups, men reported higher rates of orgasm than did women. Men's orgasm rates ranged from 70% to 85%, while women's ranged from 46% to 58%. Men reported orgasm rates between 22% and 30% higher than women's rates. Sexual orientation impacted orgasm rates by gender but not uniformly across age groups. Clinical Translation The persistence of the orgasm gap across ages necessitates a tailored approach in clinical practice and education, focusing on inclusive sexual health discussions, addressing the unique challenges of sexual minorities and aging, and emphasizing mutual satisfaction to promote sexual well-being for all. Strengths and Limitations This study is the first to examine the orgasm gap with respect to age, and does so in a large, diverse sample. Findings are limited by methodology, including single-item assessments of orgasm and a sample of single adults. Conclusion This study revealed enduring disparities in orgasm rates from sexual intercourse, likely resulting from many factors, including sociocultural norms and inadequate sex education. [ABSTRACT FROM AUTHOR]

Background: Black and white women describe their chronic vulvar pain (CVVP) symptoms differently, indicating a patient–provider communication deficit. This may contribute to the diagnostic delay commonly reported by patients with CVVP and/or pelvic pain. Methods: A pilot study demonstrated CVVP terminology differences between women of color and white women. The present study (N = 488) includes a sample of predominantly cisgender women who identified their race/ethnicity as Black, Hispanic/Latinx, Native American/American Indian, and/or Asian. Participants reported how they describe their CVVP, their healthcare experiences, and characteristics of their diagnostic journey. Results: Descriptions of CVVP were not uniform. Instead, there was great variability in how women described their pain across racial/ethnic identities and pain contexts (e.g., sexual activity, menstrual product use, and pelvic exam). Some pain experiences and descriptors were associated with healthcare outcomes related to diagnostic delay. Conclusions: This study sheds light on the pain communication experiences of women of color with CVVP, an understudied population within the broader CVVP literature. By resisting white and non-white comparative methodologies, this study demonstrates the applicability of intersectionality principles to the study of CVVP and contributes to the existing literature regarding pain communication, race, and ethnicity. [ABSTRACT FROM AUTHOR]

How couples communicate during conflict interactions can have important implications for their relational well-being. The theory of resilience and relational load provides a valuable lens for exploring the associations among couples' language use during conflict conversations and the extent to which such conversations are perceived as threatening to one's relationship, as well as whether genetic markers moderate such associations. Forty-seven mixed-sex couples had a conversation about a topic causing conflict in their relationship and provided saliva samples that were tested for their genotype (GG, AA, or AG) for oxytocin receptor gene rs53576. The results revealed that neither the use of communal language nor positive emotion words were associated with perceiving the conversation as less threatening to their relationship. Genetic variation did not moderate the associations with either positive emotion word use or communal language. However, a three-way interaction between sex, OXTR, and positive emotion word use emerged in the post hoc analyses, indicating that positive emotion word use was negatively associated with threat appraisals for women with a GG genotype, and positively associated with threat appraisals for men with a GG genotype. Implications for mixed-sex couples' communication and research on language use during conflict conversations are discussed. [ABSTRACT FROM AUTHOR]

Adult web camming sites are an increasingly popular outlet for computer-mediated social and sexual connection; specifically, that between clients and paid models. Through the lens of self-determination theory, the current study aimed to analyze how sexual and emotional needs related to perceptions of improvement in domain-general communication skills. Using linear regressions, results showed that both models (n = 327) and clients (n = 2047) reported positive effects on their communication skills when they felt either emotionally fulfilled or sexually satisfied by their online interactions on the camming site. These findings provide support for future research investigating computer-mediated interpersonal interactions on camming sites and their association to the effects of in-person relationships. [ABSTRACT FROM AUTHOR]

A prominent source of mutation in cancer is single-stranded DNA cytosine deamination by cellular APOBEC3 enzymes, which results in signature C-to-T and C-to-G mutations in TCA and TCT motifs. Although multiple enzymes have been implicated, reports conflict and it is unclear which protein(s) are responsible. Here we report the development of a selectable system to quantify genome mutation and demonstrate its utility by comparing the mutagenic activities of three leading candidates—APOBEC3A, APOBEC3B, and APOBEC3H. The human cell line, HAP1, is engineered to express the thymidine kinase (TK) gene of HSV-1, which confers sensitivity to ganciclovir. Expression of APOBEC3A and APOBEC3B, but not catalytic mutant controls or APOBEC3H, triggers increased frequencies of TK mutation and similar TC-biased cytosine mutation profiles in the selectable TK reporter gene. Whole genome sequences from independent clones enabled an analysis of thousands of single base substitution mutations and extraction of local sequence preferences with APOBEC3A preferring YTCW motifs 70% of the time and APOBEC3B 50% of the time (Y = C/T; W = A/T). Signature comparisons with breast tumor whole genome sequences indicate that most malignancies manifest intermediate percentages of APOBEC3 signature mutations in YTCW motifs, mostly between 50 and 70%, suggesting that both enzymes contribute in a combinatorial manner to the overall mutation landscape. Although the vast majority of APOBEC3A- and APOBEC3B-induced single base substitution mutations occur outside of predicted chromosomal DNA hairpin structures, whole genome sequence analyses and supporting biochemical studies also indicate that both enzymes are capable of deaminating the single-stranded loop regions of DNA hairpins at elevated rates. These studies combine to help resolve a long-standing etiologic debate on the source of APOBEC3 signature mutations in cancer and indicate that future diagnostic and therapeutic efforts should focus on both APOBEC3A and APOBEC3B. Author summary: A large source of mutation in cancer is attributable to single-stranded DNA cytosine to uracil (C-to-U) deamination by APOBEC3 family enzymes. Chromosomal DNA U's directly template the insertion of adenine (A), which results in C/G-to-T/A mutations. Chromosomal U's also trigger error-prone DNA repair processes, which less directly result in C/G-to-T/A mutations, C/G-to-G/C mutations, and more complex events such as insertion/deletion mutations. We report a human cell line for cancer mutation studies, where mutations can be identified selectively or by genomic DNA sequencing. Only APOBEC3A and APOBEC3B proved capable of inflicting the aforementioned types of single base substitution mutations. Interestingly, 70% and 50% of the single base substitution mutations attributable to APOBEC3A and APOBEC3B, respectively, occurred in TCA and TCT trinucleotide motifs preceded by a pyrimidine (T or C). This is significant because most APOBEC3-positive breast tumors exhibit an intermediate percentage of signature mutations in these broader tetranucleotide motifs, which supports the idea that both APOBEC3A and APOBEC3B contribute in a combinatorial manner to the overall mutation landscape in these tumors. [ABSTRACT FROM AUTHOR]

In the U.S., the COVID‐19 pandemic has been highly politicized and has been the subject of large‐scale media misinformation. Personal ideologies—including religiosity and political leanings (i.e., conservative, liberal)—have heavily guided responses to the pandemic, particularly in the Southern United States. However, microenvironments like Southern U.S. universities provide a unique perspective into the juxtaposition of larger societal conservatism and the liberalism associated with higher education. In the current study, we examined Southern university students' political beliefs, religiosity, and social media exposure in association with their COVID‐19 attitudes, cognitions, and behaviors. Participants' political beliefs were associated with their COVID‐19 concern, myth acceptance, vaccination status, and likelihood to receive a future vaccination. Religiosity and social media exposure were more nuanced. Future research into personal ideologies as emerging adults develop their independent identities away from their parents, and how this process can impact health behaviors, is needed. [ABSTRACT FROM AUTHOR]

The nucleation, nano-platelet growth, and optical properties under quantum confinement are investigated in the topological semimetal superlattice Bi2–Bi2Se3 as a function of thickness and Ar + ion pressure in sputtered growths. Quantum confinement and evolution of the band structure with a series of reduced dimensionality and surface terminations are studied by density functional theory corroborating the observed optical properties. An initial Volmer–Weber growth mode of nano-platelets is observed until a pressure-dependent critical thickness, where a transition to Frank–van der Merwe growth occurs. Nucleation statistics characterized using atomic force microscopy find the nearest-neighbor ordering of nano-platelets. Optical properties using ultraviolet to visible light spectroscopy measurements in transmission mode reveal a marked increase in optical bandgap below a nano-platelet critical volume reaching a maximum of 2.21 eV. Raman vibrational spectroscopy is performed, revealing softening of vibrational modes as the nano-platelet volume decreases. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine housing need for older people and people with dementia, with reference to Scotland. This paper also examines policy responses and tensions arising from such need and looks critically at the evidence of care needs and what older people want in relation to later life conditions, including dementia. Design/methodology/approach: Taking the Being Home: Housing and Dementia in Scotland report (2017) as a baseline descriptor, the authors have collated evidence from a range of sources to help them examine what has changed in terms of policy, practice and population ageing. Set against this backdrop, using desk-based analytical methods, the authors interrogate existing planning processes and systems in Scotland. Findings: Scottish Spatial Planning has a policy blindness on the overwhelming evidence of the housing needs derived from an ageing population. Policy focus is geared towards the amount of housing supplied, rather than appropriate types of housing, leaving older people with little choice of suitable accommodation. A key area to improve is in establishing greater co-operation and policy synthesis between health, social, housing and planning functions. Broad policy ambition must be transferred into detailed reality for older people and people with dementia to benefit. Originality/value: The integrated approach and in-depth analysis, linked to planning policy and housing need, is highly original and much needed. [ABSTRACT FROM AUTHOR]

Background: Suicide is currently the second leading cause of death among adolescents ages 10–14, and third leading cause of death among adolescents ages 15–19 in the United States (U.S). Although we have numerous U.S. based surveillance systems and survey data sources, the coverage offered by these data with regard to the complexity of youth suicide had yet to be examined. The recent release of a comprehensive systems map for adolescent suicide provides an opportunity to contrast the content of surveillance systems and surveys with the mechanisms listed in the map. Objective: To inform existing data collection efforts and advance future research on the risk and protective factors relevant to adolescent suicide. Methods: We examined data from U.S. based surveillance systems and nationally-representative surveys that included (1) observations for an adolescent population and (2) questions or indicators in the data that identified suicidal ideation or suicide attempt. Using thematic analysis, we evaluated the codebooks and data dictionaries for each source to match questions or indicators to suicide-related risk and protective factors identified through a recently published suicide systems map. We used descriptive analysis to summarize where data were available or missing and categorized data gaps by social-ecological level. Results: Approximately 1-of-5 of the suicide-related risk and protective factors identified in the systems map had no supporting data, in any of the considered data sources. All sources cover less than half the factors, except the Adolescent Brain Cognitive Development Study (ABCD), which covers nearly 70% of factors. Conclusions: Examining gaps in suicide research can help focus future data collection efforts in suicide prevention. Our analysis precisely identified where data is missing and also revealed that missing data affects some aspects of suicide research (e.g., distal factors at the community and societal level) more than others (e.g., proximal factors about individual characteristics). In sum, our analysis highlights limitations in current suicide-related data availability and provides new opportunities to identify and expand current data collection efforts. [ABSTRACT FROM AUTHOR]

Stevens‐Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare and life‐threatening mucocutaneous diseases that occur almost exclusively as a result of adverse drug reactions, although there are rare cases attributed to infection, immunization, or malignancy.1,2 Given the low incidence of these diseases as well as the high level of morbidity and mortality, randomized controlled clinical trials are difficult to perform, making it difficult to establish a "gold‐standard" treatment. To date, there are only five published articles in the literature detailing evidence‐based guidelines for the treatment of SJS and TEN, one of which is specifically tailored to pediatric and young adult patients.3–7 These guidelines have significant overlap in regards to the importance of prompt discontinuation of the offending drug and the need for supportive care, but there are differences in regards to the ideal supportive care measures. Additionally, there is still no clear consensus agreement on the pharmacological treatment of SJS and TEN.4–7 Herein, we aim to compare the international treatment guidelines for management of SJS and TEN as well as promote continued discussion and a multidisciplinary approach to establish consensus recommendations for these mucocutaneous emergencies. [ABSTRACT FROM AUTHOR]

The law does not require health professionals to provide medical treatment that is of no benefit to the patient. Despite this, medical staff who are caring for patients at the end of their lives frequently experience pressure from the patients' families to prolong their lives. This article considers the Australian law relating to the right to demand treatment when a loved one is dying, and whether an increasing emphasis on shared decision-making has introduced uncertainty. It discusses factors that affect the application of the law, including widespread ignorance of the law, the difficulty of deciding whether a treatment is futile and the need to ration scarce health care resources. It also introduces the perspectives of three senior medical practitioners on disputes with families of dying patients. The article concludes that community education is needed on legal and medical issues at the end of life, including conversations about advance care directives. [ABSTRACT FROM AUTHOR]

Preliminary evidence suggests that communication during and after sexual activity is linked to positive sexual and relational assessments, but the process of communication during sexual activity (i.e., predictors and outcomes of such behavior) has yet to be explicated. As such, the current study puts forth the Communication During Sexual Activity model, which posits that one's propensity for affectionate communication, sexual self-esteem, and sexual assertiveness predict verbal communication during sexual activity, which in turn is associated with sexual and relationship satisfaction. Within a sample of emerging adults, structural equation modeling revealed that sexual self-esteem and trait affection were positively associated with communication during sexual activity. However, sexual assertiveness did not significantly predict communication during sexual activity. Communication during sexual activity was also positively associated with sexual satisfaction, and indirectly associated with relationship satisfaction through sexual satisfaction. The implications of the findings for future sexual communication research and interventions are addressed. [ABSTRACT FROM AUTHOR]

Background: Climate change has been shown to be directly linked to multiple physiological sequelae and to impact health consequences. However, the impact of climate change on mental health globally, particularly among vulnerable populations, is less well understood. Objective: To explore the mental health impacts of climate change in vulnerable populations globally. Methods: We performed an integrative literature review to identify published articles that addressed the research question: What are the mental health impacts of climate change among vulnerable populations globally? The Vulnerable Populations Conceptual Model served as a theoretical model during the review process and data synthesis. Findings/Results: One hundred and four articles were selected for inclusion in this review after a comprehensive review of 1828 manuscripts. Articles were diverse in scope and populations addressed. Land-vulnerable persons (either due to occupation or geographic location), Indigenous persons, children, older adults, and climate migrants were among the vulnerable populations whose mental health was most impacted by climate change. The most prevalent mental health responses to climate change included solastalgia, suicidality, depression, anxiety/eco-anxiety, PTSD, substance use, insomnia, and behavioral disturbance. Conclusions: Mental health professionals including physicians, nurses, physician assistants and other healthcare providers have the opportunity to mitigate the mental health impacts of climate change among vulnerable populations through assessment, preventative education and care. An inclusive and trauma-informed response to climate-related disasters, use of validated measures of mental health, and a long-term therapeutic relationship that extends beyond the immediate consequences of climate change-related events are approaches to successful mental health care in a climate-changing world. [ABSTRACT FROM AUTHOR]

The Daytime Sextantids meteor shower, part of the Phaethon-Geminid Stream Complex (PGC), is closely related to the Geminids, currently the strongest meteor shower visible at the Earth. The Daytime Sextantids (DSX) share a similar orbit to asteroid 2005 UD, but the nature of the association remains unclear. From optical data we find that DSX meteors ablate similarly to Geminids, suggesting that they are also high density and consistent with a common origin. From radar data we have isolated 19 007 DSX orbits through application of a novel convex hull approach to determine stream membership. We find at the peak the mean semimajor axis is near 1 au, eccentricity is 0.86 and that both decrease as a function of solar longitude. The inclination averages 25 deg at the peak but increases over time. Noticeable DSX activity extends from solar longitude 173–196° with a flux plateau between 186 and 189°. The peak flux is 2 ± 0.05 × 10−3 km−2 hr−1, equivalent to a ZHR of 20. We estimate a true differential mass index for the shower of s  = 1.64 ± 0.06 at the time of peak and an average of 1.70 ± 0.07 for days surrounding the peak. The mass of the DSX stream is estimated to be 1016 g, the same order as 2005 UD, suggesting the stream is too massive to have been created by recent meteoroid production from 2005 UD. We propose that the DSX and 2005 UD were created in the same break-up event that created 3200 Phaethon. [ABSTRACT FROM AUTHOR]

We consider dispersing billiard tables whose boundary is piecewise smooth and the free flight function is unbounded. We also assume there are no cusps. Such billiard tables are called type D in the monograph of Chernov and Markarian [ 9 ]. For a class of non-degenerate type D dispersing billiards, we prove exponential decay of correlation and several other statistical properties. [ABSTRACT FROM AUTHOR]

Meteor showers and their outbursts are the dominant source of meteoroid impact risk to spacecraft on short time-scales. Meteor shower prediction models depend on historical observations to produce accurate forecasts. However, the current lack of quality and persistent world-wide monitoring at optical meteoroid sizes has left some recent major outbursts poorly observed. A novel method of computing meteor shower flux is developed and applied to Global Meteor Network data. The method is verified against previously published observations of the Perseids and the Geminids. The complete mathematical and algorithmic details of computing meteor shower fluxes from video observations are described. As an example application of our approach, the flux measurements of the 2021 Perseid outburst, the 2020–2022 Quadrantids, and 2020–2021 Geminids are presented. The flux of the 2021 Perseids reached similar levels to the 1991–1994 and 2016 outbursts (ZHR ∼ 280). The flux of the Quadrantids shows high year-to-year variability in the core of the stream while the longer lasting background activity is less variable, consistent with an age difference between the two components. The Geminids show a double peak in flux near the time of peak. [ABSTRACT FROM AUTHOR]

The police shooting of Kumunjayi Walker in Yuendumu in November 2019 instigated an immediate and determined response from Warlpiri families who were shocked and saddened by the death of a loved one in the prime of his life and enraged by this latest event in a long string of colonial injustices. This article collates perspectives as expressed in interviews and public statements from Warlpiri spokespeople who have been on the frontline of the fight for Justice for Walker. Incorporating the initial responses in the days after the shooting, the links to the Coniston massacre in Warlpiri and neighbouring country in 1928, the ongoing horror of Aboriginal deaths in custody and the escalating energy behind the Black Lives Matter campaigns across the world, this article illustrates, through Warlpiri voices, the ways in which people from Yuendumu have expertly used the techniques of activist campaigns in their resolute fight for justice for Walker, for all Aboriginal people across Australia and for Black and First Nations people world‐wide. [ABSTRACT FROM AUTHOR]

Suicide exposure is associated with an increased risk for suicide. There is limited research on the mechanisms that increase this risk. This study aims to: (1) compare suicide exposure and associated variables in veteran, active duty, and civilian participants, (2) examine the extent to which fearlessness about death and suicide risk factors differ as a function of group membership and suicide exposure, and (3) determine the degree to which relationship to the decedent, perceived closeness, and reported impact of the death are associated with fearlessness about death and suicide-related outcomes. 1,533 participants were included, of whom 48% of active duty service members, 65% of veterans, and 58% of civilians reported knowing someone who died by suicide. A series of regressions were conducted. There were group differences by military service on the suicide exposure variables. Furthermore, there were significant main effects for military service group and suicide exposure on the outcome variables. In general, civilians reported greater suicide risk and active duty service members reported greater fearlessness about death. Fearlessness about death mediated the associations between perceived closeness and a history of suicide attempts. The loss of a military colleague to suicide was found to be unique and distinguishable from other important relationships. Results suggest the need to consider suicide exposure and closeness as salient variables associated with fearlessness about death and suicide risk factors. Inquiring about suicide exposure, closeness to the decedent, fearlessness about death, and beyond familial losses to suicide may indicate important avenues of intervention. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death among youth ages 10–19 in the USA. While suicide has long been recognized as a multifactorial issue, there is limited understanding regarding the complexities linking adverse childhood experiences (ACEs) to suicide ideation, attempt, and fatality among youth. In this paper, we develop a map of these complex linkages to provide a decision support tool regarding key issues in policymaking and intervention design, such as identifying multiple feedback loops (e.g., involving intergenerational effects) or comprehensively examining the rippling effects of an intervention. We use the methodology of systems mapping to structure the complex interrelationships of suicide and ACEs based on the perceptions of fifteen subject matter experts. Specifically, systems mapping allows us to gain insight into the feedback loops and potential emergent properties of ACEs and youth suicide. We describe our methodology and the results of fifteen one-on-one interviews, which are transformed into individual maps that are then aggregated and simplified to produce our final causal map. Our map is the largest to date on ACEs and suicide among youth, totaling 361 concepts and 946 interrelationships. Using a previously developed open-source software to navigate the map, we are able to explore how trauma may be perpetuated through familial, social, and historical concepts. In particular, we identify connections and pathways between ACEs and youth suicide that have not been identified in prior research, and which are of particular interest for youth suicide prevention efforts. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic raises questions about curation, collecting, and the ethics of documenting a traumatic event as it occurs in real time. Such concerns became clear as the co-authors embarked on a multi-sited study of the pandemic's impact on four communities in two different countries. Defining an 'artefact' or what is archaeological, for instance, became a complicated exercise; do chalk artworks on the sidewalk, painted rocks lining a neighbourhood trail, posters stapled on community billboards, and stuffed animals in someone's window count as archaeological artefacts? Determining the temporal boundaries of the pandemic is also difficult; while it is fairly clear when the pandemic first began, it continues to have an impact on our post-lockdown world. Its global impact also means that the material changes and landscape alterations the co-authors witnessed were not confined or isolated to one place and one time, but rather exist in multitudes across the globe. [ABSTRACT FROM AUTHOR]

This study explored the role of the hormone oxytocin in 49 emerging adult couples' communication after sexual activity. Guided by the post sex disclosures model, the findings indicated that post sex oxytocin levels, but not increases in pre to post sex oxytocin, were associated with men's general assessments of the benefits and risks of disclosing after sexual activity (measured separately from the sexual episode). Additionally, women's and men's benefit assessments were positively associated, and their risk assessments were negatively associated, with positive disclosures after sex. The findings offer the first known test of couples' oxytocin levels during a naturally occurring sexual episode in the home environment and have implications for researchers interested in the links between oxytocin and human behavior. [ABSTRACT FROM AUTHOR]

Supported housing has been highlighted as a potential way to facilitate independent living for people with dementia by integrating housing with support or care services. However, the benefits and challenges of living with dementia in supported housing are not fully understood. This systematic review and thematic synthesis sought to understand how living in supported housing influences the lives of people with dementia, from the perspectives of people with dementia, their supporters, health and social care professionals. Seven databases were searched for qualitative research, date range: 1 January 2000–31 July 2021. Eleven published articles were included in the thematic synthesis. One core theme was generated, Maintaining Independence and Autonomy, divided into three subthemes – Support and Care, Social Relationships and the Physical Environment. Factors like person‐centred care, social interaction and good environmental design contributed to the maintenance of independence and autonomy. Barriers like low staff ratios, stigma and limited access to the community led to a loss of independence and autonomy – often leading to people with dementia being referred or managed out of the settings. Although the articles acknowledged the importance of maintaining independence and autonomy for people with dementia, it appeared that supported housing settings often lacked the resources and facilities to make this a reality. More high‐quality research is needed, particularly from the perspectives of people with dementia and their supporters, to understand if supported housing can delay care home admission, promote independence and autonomy and facilitate social networks and community connections for this population. [ABSTRACT FROM AUTHOR]

Background. In South Australian hospitals, 'Do Not Resuscitate' orders have been replaced by '7-Step Pathway Acute Resuscitation Plans', a standardised form and approach that encourages shared decision-making while providing staff with clarity about goals of care. This initiative has led to increased rates of documentation about treatment preferences, including 'Not-For- Cardiopulmonary Resuscitation'. Aim. To quantify any effect of the 7-Step Pathway form versus previous 'Do Not Resuscitate' orders on cardiopulmonary resuscitation, mechanical ventilation, and/or intensive care unit admission during hospitalisation. Methods. We completed a retrospective, observational study in two Australian tertiary hospitals using interrupted time-series analysis. We examined the number of medical inpatients aged 70 years and over who received one or more Intensive Treatments-cardiopulmonary resuscitation, mechanical ventilation, or intensive care unit admission-in the 2 years before and 2 years after the introduction of the form. Results. There were 2759 Intensive Treatments across 66 051 inpatient admissions; 1304/32 489 (4.0%) pre-intervention and 1455/33 562 post-intervention (4.3%). Sub-group analysis of those who died in hospital showed 400/1669 (24%) received Intensive Treatments pre-intervention and 382/1624 post-intervention (24%). Interrupted time-series analysis suggested that the intervention did not significantly alter Intensive Treatments over time at Hospital 1 and was associated with a significant slowing of the already decreasing use of Intensive Treatments at Hospital 2. Among patients who died in hospital, there was minimal change at either site. Conclusions. There was no reduction in Intensive Treatments in older medical inpatients following the introduction of standardised goals of care documentation. [ABSTRACT FROM AUTHOR]

The problem of low attainment in mathematics has been an increasingly prominent feature of the policy discourse in England over the last 60 years; however, evidence from comparative studies indicates that little progress has been made in finding a solution. In this paper, we analyse the changing policy discourse of low attainment in mathematics through the main reports and speeches published in England, beginning with the Newsom Report, Half Our Future, in 1963, and continuing to the present day. We chart the evolving perspectives on the nature of ability, expectations, curriculum ideology and frame of reference through the changing language used in these documents, noting tensions and inconsistencies which arise through continuing lack of clarity about definitions and assumptions. [ABSTRACT FROM AUTHOR]

Background: This educational innovation describes the implementation of a telehealth supportive counseling center for psychiatric/mental health nurse practitioner (PMHNP) students at a small graduate school. The free, nurse-run, health care center was at risk due to the coronavirus disease 2019 (COVID-19) in-person care restrictions. Method: Due to COVID-19, PMHNP faculty and students pivoted to offer services via telehealth for the summer 2020 semester. Planning and implementation strategies regarding this pivot are presented. Results: PMHNP students conducted a total of 82 visits, recording a 150% increase in clients served during the telehealth implementation. On average, students accrued between 39 and 73 supervised clinical hours. Conclusion: Given the COVID-19 pandemic, clinical placements as well as access to health care services were jeopardized. Through innovation and flexibility, PMHNP students were able to continue accruing supervised clinical hours, and an identified need in the community was continued to be met. [J Nurs Educ. 2021;60(11):651–654.] [ABSTRACT FROM AUTHOR]

The Bi 4 Se 3 system is an intrinsic superlattice of two topological materials, a 2D Bi 2 sheet and a quintuple layer (QL) slab of Bi 2 Se 3. Both the QL slab and 2D sheet host distinct topologically protected states; this, in turn, allows for the selection of the topologically protected electronic state with the choice of surface layer termination. The Bi 4 Se 3 films were grown by direct current magnetron sputtering under an additional external magnetic field to further confine the plasma region. We developed a recipe to transition from an atomically smooth layered growth to a smooth faceted granular growth. We characterized the morphology, composition, and local crystal orientation of grown films via scanning electron microscopy, energy dispersive x-ray spectroscopy, and electron backscattered diffraction. Additionally, characterization by scanning tunneling microscopy/spectroscopy confirmed the presence of the topologically protected surface states in these films. This work buttresses the commercial scalability of sputtering materials with tunable Bi 4 Se 3 morphology, which provides the option of tuning the surface topological state and thus expanding the possibilities for the production of devices with this material systems. [ABSTRACT FROM AUTHOR]

We present a new mathematical model to investigate the transmission dynamics of cholera under disease control measures that include education programs and water sanitation. The model incorporates the impact of education programs into the disease transmission rates and that of water sanitation into the environmental pathogen dynamics. We conduct a detailed analysis to the autonomous system of the model and establish the local and global stabilities of its equilibria that characterize the threshold dynamics of cholera. We then perform an optimal control study on the general model with time-dependent controls and explore effective approaches to implement the education programs and water sanitation while balancing their costs. Our analysis and simulation highlight the complex interaction among the direct and indirect transmission pathways of the disease, the intrinsic growth of the environmental pathogen and the impact of multiple control measures, and their roles in collectively shaping the transmission dynamics of cholera. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study on the status of palliative care for patients with advanced case of dementia. Topics mentioned include some issues regarding end of life care for people with advanced dementia, the best practice for practitioners providing care for patients with dementia, the use of open communication, clear information and a person-centered technique as an early intervention of dementia, and the types of advance care plans in the United Kingdom.

Not for Cardiopulmonary Resuscitation (No-CPR) orders, or the local equivalent, help prevent futile or unwanted cardiopulmonary resuscitation. The importance of unambiguous and readily available documentation at the time of arrest seems self-evident, as does the need to establish a patient's treatment preferences prior to any clinical deterioration. Despite this, the frequency and quality of No-CPR orders remains highly variable, while discussions with the patient about their treatment preferences are undervalued, occur late in the disease process, or are overlooked entirely. This review explores the evolution of hospital patient No-CPR/Do Not Resuscitate decisions over the past 60 years. A process based on standardized resuscitation plans has been shown to increase the frequency and clarity of documentation, reduce stigma attached to the documentation of a No-CPR order, and support the delivery of medically appropriate and desired care for the hospital patient. [ABSTRACT FROM AUTHOR]

The article presents a study which outlined learning opportunities about advanced dementia and what developments are needed. Topics include the place of care for those living with advanced dementia, dementia knowledge and skills framework, and positive learning and leadership in advanced dementia care.

Background: Consumer involvement in health-care policy and quality management (QM) programming is a key element in making health systems people-centered. Involvement of health-care consumers in these areas, however, remains underdeveloped and under-prioritized. When consumer involvement is actively realized, few mechanisms for assessing its impact have been developed. The New York State Department of Health (NYSDOH) embraces consumer involvement of people with HIV in QM as a guiding principle, informed by early HIV/AIDS advocacy and a framework of people-centered quality care.Method: HIV consumer involvement is implemented statewide and informs all quality of care programming as a standard for QM in health-care organizations, implemented through four key several initiatives: (i) a statewide HIV Consumer Quality Advisory Committee; (ii) leadership and QM trainings for consumers; (iii) specific tools and activities to engage consumers in QM activities at state, regional and health-care facility levels and (iv) formal organizational assessments of consumer involvement in health-care facility QM programs.Results: We review the literature on this topic and place the methods used by the NYSDOH within a theoretical framework for consumer involvement.Conclusion: We present a model that offers a paradigm for practical implementation of routine consumer involvement in QM programs that can be replicated in other health-care settings, both disease-specific and general, reflecting the priority of active participation of consumers in QM activities at all levels of the health system. [ABSTRACT FROM AUTHOR]

Not for Cardiopulmonary Resuscitation (No-CPR) orders, or the local equivalent, help prevent futile or unwanted cardiopulmonary resuscitation. The importance of unambiguous and readily available documentation at the time of arrest seems self-evident, as does the need to establish a patient's treatment preferences prior to any clinical deterioration. Despite this, the frequency and quality of No-CPR orders remains highly variable, while discussions with the patient about their treatment preferences are undervalued, occur late in the disease process, or are overlooked entirely. This review explores the evolution of hospital patient No-CPR/Do Not Resuscitate decisions over the past 60 years. A process based on standardized resuscitation plans has been shown to increase the frequency and clarity of documentation, reduce stigma attached to the documentation of a No-CPR order, and support the delivery of medically appropriate and desired care for the hospital patient. [ABSTRACT FROM AUTHOR]

The article discusses the meaningful activity in advanced dementia. Topics include examples of evidence-informed, creative interventions for people living with advanced dementia care, definition of complementary therapies, and the need of care settings to respect the rights of people with advanced dementia to participate in meaningful activity.

AUTH Why you should read this article: • To recognise that meeting the increasing fundamental care needs of people living with advanced dementia is essential to their well-being • To be aware of the need for partnership working with people living with advanced dementia and their families in care planning, implementation and evaluation • To identify strategies to deliver asset-based personal care interventions This is the second article in a six-part series in Nursing Older People exploring the nursing care of people living with advanced dementia. This article considers the complexity of providing personal care, including the need for expert nursing practice to assess and lead the fundamentals of care: washing, dressing, continence care, nutrition and hydration. The contemporary evidence base for effective assessment, care planning, partnership working and evaluation of personal care for people with advanced dementia is presented, supported by sources of further information. [ABSTRACT FROM AUTHOR]

This is the first article in a six-part series in Nursing Older People exploring the nursing care of people living with advanced dementia. This article discusses the changes that may occur as dementia progresses, from the perspective of the individual, their family and other carers. A person living with advanced dementia is likely to experience physical, cognitive and social changes that can be profound and debilitating. Healthcare needs intensify as new and co-existing issues result in increasing dependency on others for support with activities of daily living. These activities can include eating, drinking, mobility and personal care. Consequently, family carers may find their role has to develop and change to provide increasing support in response to these complex needs. These increasing needs can result in care transitions to hospitals or care homes. Careful and collaborative management of care is crucial to maintain quality of life for the person with dementia and family carers. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death among high school-aged youths 14-18 years after unintentional injuries. This report summarizes data regarding suicidal ideation (i.e., seriously considered suicide) and behaviors (i.e., made a suicide plan, attempted suicide, and made a suicide attempt requiring medical treatment) from CDC's 2019 Youth Risk Behavior Survey. Results are reported overall and by sex, grade, race/ethnicity, sexual identity, and sex of sexual contacts, overall and within sex groups. Trends in suicide attempts during 2009-2019 are also reported by sex, race/ethnicity, and grade. During 2009-2019, prevalence of suicide attempts increased overall and among female, non-Hispanic white, non-Hispanic black, and 12th-grade students. Data from 2019 reflect substantial differences by demographics regarding suicidal ideation and behaviors. For example, during 2019, a total of 18.8% of students reported having seriously considered suicide, with prevalence estimates highest among females (24.1%); white non-Hispanic students (19.1%); students who reported having sex with persons of the same sex or with both sexes (54.2%); and students who identified as lesbian, gay, or bisexual (46.8%). Among all students, 8.9% reported having attempted suicide, with prevalence estimates highest among females (11.0%); black non-Hispanic students (11.8%); students who reported having sex with persons of the same sex or with both sexes (30.3%); and students who identified as lesbian, gay, or bisexual (23.4%). Comprehensive suicide prevention can address these differences and reduce prevalence of suicidal ideation and behaviors by implementing programs, practices, and policies that prevent suicide (e.g., parenting programs), supporting persons currently at risk (e.g., psychotherapy), preventing reattempts (e.g., emergency department follow-up), and attending to persons who have lost a friend or loved one to suicide. [ABSTRACT FROM AUTHOR]

This is the introductory article in a six-part series in Nursing Older People exploring the nursing care of people living with advanced dementia. It discusses the complex and progressive array of nursing required to meet the needs of individuals, the provision of personal care, learning and leadership, meaningful activity, and palliative and end of life care. A main theme of the series is the exceptional nursing skills and knowledge required to deliver evidence-informed care with compassion and respect for people living with advanced dementia. This introductory article provides background information to contextualise advanced dementia and identify the main challenges facing nurses, nurse educators and nurse leaders. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Measurement-based care (MBC) uses standardized measurement to systematically monitor treatment response over time. Although MBC is underutilized in mental health settings, primary care–mental health integration (PC-MHI) settings are expected to provide MBC. This article describes a quality improvement (QI) process to increase Patient Health Questionnaire-9 (PHQ9) utilization within a PC-MHI setting. AIMS: Pre-intervention, rates of baseline and follow-up PHQ9 administration for veterans with a depressive disorder were 76% and 35%, respectively. This article describes a QI process to increase PHQ9 utilization rates within a PC-MHI setting, with the goal to improve provider PHQ9 utilization rates at baseline and within 4-week follow-up to 90%. METHOD: An educational intervention and weekly motivational enhancement sessions were implemented in 2017. Chart review data compared PHQ9 utilization rates from fall 2016 and 2017. RESULTS: Following intervention, provider PHQ9 utilization rates increased to 98% and 88% at baseline and follow-up. CONCLUSIONS: These findings demonstrate that a brief education-based intervention can increase clinician use of MBC within a PC-MHI setting. Meaningful use of MBC to inform treatment was not evaluated in this QI project and is an area for future investigation. [ABSTRACT FROM AUTHOR]

In the first paper of this series, we examined existing methods of optical meteor trajectory estimation and developed a novel method which simultaneously uses both the geometry and the dynamics of meteors to constrain their trajectories. We also developed a simulator which uses an ablation model to generate realistic synthetic meteor trajectories which we use to test meteor trajectory solvers. In this second paper, we perform simulation validation to estimate radiant and velocity accuracy, which may be achieved by various meteor observation systems as applied to several meteor showers. For low-resolution all-sky systems, where the meteor deceleration is generally not measurable, the multi-parameter fit method assuming a constant velocity better reproduces the radiant and speed of synthetic meteors. For moderate field of view systems, our novel method performs the best at all convergence angles, while multi-parameter fit methods generally produce larger speed errors. For high-resolution, narrow field of view systems, we find our new method of trajectory estimation reproduces radiant and speed more accurately than all other methods tested. The ablation properties of meteoroids are commonly found to be the limiting factor in velocity accuracy. We show that the true radiant dispersion of meteor showers can be reliably measured with moderate field of view (or more precise) systems provided appropriate methods of meteor trajectory estimation are employed. Finally, we compare estimated and real angular radiant uncertainty and show that for the solvers tested the real radiant error is on average underestimated by a factor of two. [ABSTRACT FROM AUTHOR]

It has recently been shown by Egal et al. that some types of existing meteor in-atmosphere trajectory estimation methods may be less accurate than others, particularly when applied to high-precision optical measurements. The comparative performance of trajectory solution methods has previously only been examined for a small number of cases. Besides the radiant, orbital accuracy depends on the estimation of pre-atmosphere velocities, which have both random and systematic biases. Thus, it is critical to understand the uncertainty in velocity measurement inherent to each trajectory estimation method. In this first of a series of two papers, we introduce a novel meteor trajectory estimation method that uses the observed dynamics of meteors across stations as a global optimization function and that does not require either a theoretical or an empirical flight model to solve for velocity. We also develop a 3D observational meteor trajectory simulator that uses a meteor ablation model to replicate the dynamics of meteoroid flight, as a means to validate different trajectory solvers. We both test this new method and compare it to other methods, using synthetic meteors from three major showers spanning a wide range of velocities and geometries (Draconids, Geminids, and Perseids). We determine which meteor trajectory solving algorithm performs better for all-sky, moderate field-of-view, and high-precision narrow-field optical meteor detection systems. The results are presented in the second paper in this series. Finally, we give detailed equations for estimating meteor trajectories and analytically computing meteoroid orbits, and provide the python code of the methodology as open-source software. [ABSTRACT FROM AUTHOR]

Introduction: Resuscitation clinical care plans (resuscitation plans) are gradually replacing 'Not for Cardiopulmonary Resuscitation' orders in the hospital setting. The 7-Step Pathway Resuscitation Plan and Alert form (7-Step form) is one example of a resuscitation plan. Treatment recommendations in resuscitation plans currently lack standardised language, creating potential for misinterpretation and patient harm. Aims: To explore how terminology used in resuscitation plans is interpreted and applied by clinicians. Method: A mixed methods study surveyed 50 general medical doctors, who were required to interpret and apply a 7-Step form in three case vignettes and define seven key terms. Statistical analysis on multiple choice and thematic analysis on free-text responses was performed. Results: Terminology was inconsistently interpreted and inconsistently applied, resulting in clinically significant differences in treatment choices. Three key themes influenced the application of a resuscitation plan: in-depth discussion, precise documentation and personal experience of the bedside deciding doctor. Discussion: This study highlights persistent communication deficiencies in resuscitation plan documentation and how this may adversely affect patient care; findings unlikely to be unique to Australia or South Australia. Conclusion: Removing ambiguity by standardising and defining the terminology in resuscitation plans will improve bedside decision-making, while also supporting the rights of the patient to receive appropriate and desired care. [ABSTRACT FROM AUTHOR]

The article presents a case study of dyshidrotic-like contact dermatitis and paronychia in a patient following a dip powder manicure. It describes the presentation, diagnosis, and treatment of the dermatological effects caused by the dip powder manicure technique. It further highlights the potential risks associated with this manicure technique, including the use of acrylates in the nail polish and inadequate sanitation practices at nail salons.