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The intersection of media, public opinion, politics, and their relationship with public policy is well documented. Taking the issue of active transportation, we examine if media narratives on bicycle and pedestrian crashes appear important in shaping policy. We define positive and negative narratives portraying bicyclists and pedestrians as victims and villains respectively. Our research objective is to understand if media narratives have an effect on the policy tools used by decision-makers to improve pedestrian and bicycle safety. We examine if there is a relationship between the victim versus villain narrative and policy change at the state level. Using a mixed-methods research design, we analyze publication reports on crashes collected from 12 states for the period 2003–2015. We find that the victim narrative remains more prevalent in crash reporting, and the probability of policy change has a positive relationship with crash reporting rate. Greater salience of the issue in media reporting may influence increased policy change.

The biological and clinical significance of the p.E88del variant in the transcobalamin receptor, CD320, is unknown. This allele is annotated in ClinVar as likely benign, pathogenic, and of uncertain significance. To determine functional consequence and clinical relevance of this allele, we employed cell culture and genetic association studies. Fibroblasts from sixteen CD320 p.E88del homozygotes exhibited reduced binding and uptake of cobalamin. Complete ascertainment of newborns with transiently elevated C3 (propionylcarnitine) in New York State demonstrated that homozygosity for CD320 p.E88del was over-represented (7/348, p

Neighborhood socioeconomic conditions (NSECs) are associated with resident diet, but most research has been cross-sectional. We capitalized on a natural experiment in Pittsburgh, Pennsylvania, in which 1 neighborhood experienced substantial investments and a sociodemographically similar neighborhood that did not, to examine pathways from neighborhood investments to changed NSECs and changed dietary behavior. We examined differences between renters and homeowners. Data were from a random sample of households (n = 831) in each of these low-income Pittsburgh neighborhoods that were surveyed in 2011 and 2014. Structural equation modeling tested direct and indirect pathways from neighborhood to resident dietary quality, adjusting for individual-level sociodemographics, with multigroup testing by homeowners versus renters. Neighborhood investments were directly associated with improved dietary quality for renters (β = 0.27, 95% confidence interval (CI): 0.05, 0.50) and homeowners (β = 0.51, 95% CI: 0.10, 0.92). Among renters, investments also were associated with dietary quality through a positive association with commercial prices (β = 0.34, 95% CI: 0.15, 0.54) and a negative association with residential prices (β = −0.30, 95% CI: −0.59, −0.004). Among homeowners, we did not observe any indirect pathways from investments to dietary quality through tested mediators. Investing in neighborhoods may support resident diet through improvements in neighborhood commercial environments for renters, but mechanisms appear to differ for homeowners.

Background Few studies have assessed objectively measured physical activity (PA), active transportation, psychological distress and neighborhood perceptions among residents of a neighborhood before and after substantial improvements in its physical environment. Also, most research-to-date has employed study designs subject to neighborhood selection, which may introduce bias in reported findings. We built upon a previously enrolled cohort of households from two low-income predominantly African American Pittsburgh neighborhoods, matched on socio-demographic composition including race/ethnicity, income and education. One of the two neighborhoods received substantial neighborhood investments over the course of this study including, but not limited to public housing development and greenspace/landscaping. We implemented a natural experiment using matched intervention and control neighborhoods and conducted pre-post assessments among the cohort. Our comprehensive assessments included accelerometry-based PA, active transportation, psychological distress and perceptions of the neighborhood, with assessments conducted both prior to and following the neighborhood changes. In 2013, we collected data from 1003 neighborhood participants and in 2016, we re-interviewed 676 of those participants. We conducted an intent to treat analysis, with a difference-in-difference estimator using attrition weighting to account for nonresponse between 2013 and 2016. In addition, we derived an individual-level indicator of exposure to neighbourhood investment and estimated effect of exposure to investment on the same set of outcomes using covariate-adjusted models. Results We observed no statistically significant differences in activity, psychological distress, satisfaction with one’s neighborhood as a place to live or any of the other measures we observed prior to and after the neighborhood investments between the intervention and control neighborhoods or those exposed vs not exposed to investments. Conclusions Using this rigorous study design, we observed no significant changes in the intervention neighborhood above and beyond secular trends present in the control neighborhood. Although neighborhood investment may have other benefits, we failed to see improvement in PA, psychological distress or related outcomes in the low-income African American neighborhoods in our study. This may be an indication that improvements in the physical environment may not directly translate into improvements in residents’ physical activity or health outcomes without additional individual-level interventions. It is also possible that these investments were not dramatic enough to spur change within the three year period. Additional studies employing similar design with other cohorts in other settings are needed to confirm these results. Trial registration Trial Registration is not applicable since we did not prospectively assign individuals to a health-related intervention.

Background Improving the neighborhood environment may help address chronic disease and mortality. To identify neighborhood features that are predictors of health, objective assessments of the environment are used. Multiple studies have reported on cross-sectional assessments of health-related neighborhood features using direct observation. As study designs expand to better understand causation and predictors of change, there is a need to test whether direct observation methods are adequate for longitudinal assessment. To our knowledge, this is the first study to report on the reliability of repeated measurements of the neighborhood environment, and their stability, over time. Methods The Pittsburgh Hill/Homewood Research on Neighborhood Change and Health (PHRESH) study conducted longitudinal assessments in two low-income, African American neighborhoods at three waves (years 2012, 2015, 2017). The PHRESH audit tool is a modification of earlier validated tools, with an emphasis on environment features relevant for physical activity, sleep, and obesogenic behaviors. Trained data-collector pairs conducted direct observations of a 25% sample of street segments in each neighborhood. At each wave, we audited a sub-sample of street segments twice and assessed reliability using percentage inter-observer agreement and krippendorf’s alpha statistics. Stability of these items was assessed as exhibiting moderate or high agreement at every time point. Results Across waves, a majority (81%) of the items consistently demonstrated moderate to high agreement except for items such as public/communal space, amount of shade, sidewalk features, number of traffic lanes, garden/flower bed/planter, art/statue/monument, amount of trash, and physical disorder. The list of items with poor agreement includes features that are easy to miss (e.g. flower bed/planter), hard to assess from outside (e.g. public/communal space), or may change quickly (e.g. amount of trash). Conclusion In this paper, we have described implementation methods, reliability results and lessons learned to inform future studies of change. We found the use of consistent methods allowed us to conduct reliable, replicable longitudinal assessments of the environment. Items that did not exhibit stability are less useful for detecting real change over time. Overall, the PHRESH direct observation tool is an effective and practical instrument to detect change in the neighborhood environment.

Summary Background Although metformin is increasingly being used in women with type 2 diabetes during pregnancy, little data exist on the benefits and harms of metformin use on pregnancy outcomes in these women. We aimed to investigate the effects of the addition of metformin to a standard regimen of insulin on neonatal morbidity and mortality in pregnant women with type 2 diabetes. Methods In this prospective, multicentre, international, randomised, parallel, double-masked, placebo-controlled trial, women with type 2 diabetes during pregnancy were randomly assigned from 25 centres in Canada and four in Australia to receive either metformin 1000 mg twice daily or placebo, added to insulin. Randomisation was done via a web-based computerised randomisation service and stratified by centre and pre-pregnancy BMI ( ClinicalTrials.gov , NCT01353391 . Findings Between May 25, 2011, and Oct 11, 2018, we randomly assigned 502 women, 253 (50%) to metformin and 249 (50%) to placebo. Complete data were available for 233 (92%) participants in the metformin group and 240 (96%) in the placebo group for the primary outcome. We found no significant difference in the primary composite neonatal outcome between the two groups (40% vs 40%; p=0·86; relative risk [RR] 1·02 [0·83 to 1·26]). Compared with women in the placebo group, metformin-treated women achieved better glycaemic control (HbA1c at 34 weeks' gestation 41·0 mmol/mol [SD 8·5] vs 43·2 mmol/mol [–10]; 5·90% vs 6·10%; p=0·015; mean glucose 6·05 [0·93] vs 6·27 [0·90]; difference −0·2 [–0·4 to 0·0]), required less insulin (1·1 units per kg per day vs 1·5 units per kg per day; difference −0·4 [95% CI −0·5 to −0·2]; p Interpretation We found several maternal glycaemic and neonatal adiposity benefits in the metformin group. Along with reduced maternal weight gain and insulin dosage and improved glycaemic control, the lower adiposity and infant size measurements resulted in fewer large infants but a higher proportion of small-for-gestational-age infants. Understanding the implications of these effects on infants will be important to properly advise patients who are contemplating the use of metformin during pregnancy. Funding Canadian Institutes of Health Research, Lunenfeld-Tanenbaum Research Institute, University of Toronto.

Nurses' knowledge of and attitudes toward treating Veterans with a dual diagnosis of PTSD and SUD were evaluated before and after an educational PowerPoint Presentation. Knowledge was assessed using a brief, 10 question quiz. Attitudes were assessed using the Medical Condition Regard Scale. Results were analyzed according to gender, age range, level of education, years in nursing, and employment on a medical or psychiatric unit.

Summary Much of humanity relies on rice (Oryza sativa) as a food source, but cultivation is water intensive and the crop is vulnerable to drought and high temperatures. Under climate change, periods of reduced water availability and high temperature are expected to become more frequent, leading to detrimental effects on rice yields.We engineered the high‐yielding rice cultivar ‘IR64’ to produce fewer stomata by manipulating the level of a developmental signal. We overexpressed the rice epidermal patterning factor OsEPF1, creating plants with substantially reduced stomatal density and correspondingly low stomatal conductance.Low stomatal density rice lines were more able to conserve water, using c. 60% of the normal amount between weeks 4 and 5 post germination. When grown at elevated atmospheric CO 2, rice plants with low stomatal density were able to maintain their stomatal conductance and survive drought and high temperature (40°C) for longer than control plants. Low stomatal density rice gave equivalent or even improved yields, despite a reduced rate of photosynthesis in some conditions.Rice plants with fewer stomata are drought tolerant and more conservative in their water use, and they should perform better in the future when climate change is expected to threaten food security.

In this study, we explore the experiences of innovative nurses who have developed cross-sector collaborations toward promoting a culture of health, with the aim of identifying lessons that can inform similar efforts of other health care professionals. We used a mixed-methods approach based on data from both an online survey and telephone interviews. A majority of the participants had significant collaborations with health care providers and non-health care providers. Strong partners included mental health providers, specialists, and primary care providers on the health side, and for non-health partners, the strongest collaborations were with community leaders, research institutions, and local businesses. Themes that emerged for successful collaborations included having to be embedded in both the community and in institutions of power, ensuring that a shared vision and language with all partners are established, and leading with strength and tenacity. A focus on building a culture of health will grow as payment policy moves away from fee-for-service toward models that focus on incentivizing population health. Effective efforts to promote a culture of health require cross-sector collaborations that draw on long-term, trusting relationships among leaders. Health care practitioners can be important leaders and "bridgers" in collaborations, but they must possess or develop the knowledge, attitudes, and skills of "bilingual" facilitators, partners, and "relationship builders."

Introduction Many service members experiencing symptoms of mental health conditions do not receive mental health care for these symptoms. The stigma associated with having a mental health condition or seeking treatment is often cited as a specific barrier to mental health care. However, study results bearing on the question of whether and how stigma may reduce treatment-seeking have been inconsistent. Methods We searched 10 databases for sources published between 2004 and 2014 that prospectively linked stigma to treatment-related outcomes (such as treatment seeking, retention, and reports of symptoms) using longitudinal data and predictive models. The searches yielded 2,409 sources. After reviewing titles and abstracts for relevance, we retained 15 sources to undergo full-text review. Results Overall, this review illustrates that evidence exploring the direct effect of stigma on treatment-related outcomes is still scant. We identified two studies whose outcomes conflict when it comes to stigma and treatment-initiation and utilization, and three studies found no relationship between stigma and treatment-initiation and utilization. One study suggested that the relationship between stigma and experience of symptoms is nuanced and may depend on the type of stigma and types of symptoms considered. Meager evidence was available to inform the relationship between stigma and treatment duration, attrition, and quality of life/functioning. The evidence was not sufficient to draw conclusions about the state of these relationships. No conclusions could be made about the direct impact of stigma on treatment-related outcomes among military service members given that only two studies explored this relationship among military service members. Conclusion Current research does not provide a true understanding of the degree to which mental illness stigma affects treatment-related outcomes for service members experiencing mental health challenges. This understanding could only be developed through a longitudinal study assessing prospectively whether stigma affects treatment-utilization in the military. Should such a study show that stigma reduces treatment-utilization, the military would need to consider whether changes to their current approaches to stigma reduction are warranted.

In this paper, I seek to highlight and re-emphasise the ongoing problem of the disconnection between the terms ‘hate’ and linguistic violence against women. Despite the prevalence of violent, misogynistic and sexist actions against women, it was only in 2016 that police forces saw fit to categorise these actions as ‘hate’, and only then in one police force (Nottinghamshire Police) with one forward thinking (female) Chief Constable working in partnership with Nottingham Women’s Centre. As such, I seek here to look in more depth at the disconnection between hate and crimes according to sex – particularly with regard to hate speech, and to unpick some of the reasons behind this, and the problems with failing to acknowledge such matters within law and social policy.

Improving access to healthy foods in low-income neighborhoods is a national priority. Our study evaluated the impact of opening a supermarket in a ‘food desert’ on healthy food access, availability and prices in the local food environment. We conducted 30 comprehensive in-store audits collecting information on healthy and unhealthy food availability, food prices and store environment, as well as 746 household surveys in two low-income neighborhoods before and after one of the two neighborhoods received a new supermarket. We found positive and negative changes in food availability, and an even greater influence on food prices in neighborhood stores. The supermarket opening in a ‘food desert’ caused little improvement in net availability of healthy foods, challenging the underpinnings of policies such as the Healthy Food Financing Initiative.

Background Civic engagement, including voting, volunteering, and participating in civic organizations, is associated with better psychological, physical and behavioral health and well-being. In addition, civic engagement is increasingly viewed (e.g., in Robert Wood Johnson Foundation’s Culture of Health action framework) as a potentially important driver for raising awareness of and addressing unhealthy conditions in communities. As such, it is important to understand the factors that may promote civic engagement, with a particular focus on the less-understood, health civic engagement, or civic engagement in health-related and health-specific activities. Using data from a nationally representative sample of adults in the United States (U.S.), we examined whether the extent to which individuals feel they belong in their community (i.e., perceived sense of community) and the value they placed on investing in community health were associated with individuals’ health civic engagement. Methods Using data collected on 7187 nationally representative respondents from the 2018 National Survey of Health Attitudes, we examined associations between sense of community, valued investment in community health, and perceived barriers to taking action to invest in community health, with health civic engagement. We constructed continuous scales for each of these constructs and employed multiple linear regressions adjusting for multiple covariates including U.S. region and city size of residence, educational attainment, family income, race/ethnicity, household size, employment status, and years living in the community. Results Participants who endorsed (i.e., responded with mostly or completely) all 16 sense of community scale items endorsed an average of 22.8% (95%CI: 19.8–25.7%) more of the health civic engagement scale items compared with respondents who did not endorse any of the sense of community items. Those who endorsed (responded that it was an important or top priority) all items capturing valued investment in community health endorsed 14.0% (95%CI: 11.2–16.8%) more of the health civic engagement items than those who did not endorse any valued investment in community health items. Conclusions Health civic engagement, including voting and volunteering to ultimately guide government decisions about health issues, may help improve conditions that influence health and well-being for all. Focusing on individuals’ sense of community and highlighting investments in community health may concurrently be associated with increased health civic engagement and improved community and population health.

To better understand sports participation rates for middle and high school–aged youths, the funding landscape, barriers and enablers to youth sports participation, and perceptions of the benefits and challenges of youth sports, RAND researchers launched three large-scale surveys of parents, school administrators, and community sports program leaders.

This infographic provides an overview of the opportunity and attainment gaps between high-and low-income students and how public funding for after-school programs can help address these gaps.

RAND is conducting a longitudinal study that evaluates the effectiveness of voluntary summer learning programs in reducing summer learning loss, which contributes substantially to the achievement gap between low- and higher-income students. Based on evaluations of programs in six school districts, this second report in a series provides research-based advice for school district leaders as they create and strengthen summer programs.

Community improvements -- primarily a new supermarket and new housing -- were associated with health and economic gains among the residents of an underserved, primarily African-American neighborhood in Pittsburgh.

It is often accepted as common knowledge that military personnel benefit from decompression time between a war zone and the home station. To capitalize on the potential benefits of a decompression period paired with support services, the U.S. Air Force established the Deployment Transition Center (DTC) at Ramstein Air Base in Germany in July 2010. The DTC provides airmen returning from combat missions with an opportunity to decompress and share lessons learned before returning to their home stations. The authors of this study evaluate the structure, processes, and outcomes of the DTC program. They find that, although a majority of participants found the DTC program worthwhile, a comparison of DTC participants and similar airmen who did not participate the program shows no evidence that the program helps reduce posttraumatic stress disorder symptoms, depressive symptoms, binge drinking, or social conflicts with family and coworkers. In addition, one of the DTC program elements appears to be similar to posttraumatic debriefing interventions, which several studies have found to be either ineffective or harmful. For these reasons, if the main goals of the DTC program are to improve behavioral health and social conflict outcomes, the authors recommend that the DTC program be discontinued or redesigned and Air Force resources invested in alternative programs. However, if the DTC program has other goals, such as providing rest and relaxation to airmen after a difficult deployment or capturing after-action information, then the authors recommend that these goals be documented and the DTC program be more specifically tailored to them.

The development and patterning of stomata in the plant epidermis has emerged as an ideal system for studying fundamental plant developmental processes. Over the past twenty years most studies of stomata have used the model dicotyledonous plant Arabidopsis thaliana. However, cultivated monocotyledonous grass (or Gramineae) varieties provide the majority of human nutrition, and future research into grass stomata could be of critical importance for improving food security. Recent studies using Brachypodium distachyon, Hordeum vulgare (barley) and Oryza sativa (rice) have led to the identification of the core transcriptional regulators essential for stomatal initiation and progression in grasses, and begun to unravel the role of secretory signaling peptides in controlling stomatal developmental. This review revisits how stomatal developmental unfolds in grasses, and identifies key ontogenetic steps for which knowledge of the underpinning molecular mechanisms remains outstanding.

Background Crashes between bicyclists/vehicles and pedestrians/vehicles are events that elicit emotions, opinions and values about what ought to be the “best” policy intervention. Several instruments, or policy tools, can be utilized to create healthy, livable transportation environments that support the needs of bicyclists and pedestrians along with motorists. However, in the policy decision-making realm, narratives and the underlying values become intertwined with facts to influence problem definition and produce an emphasis on certain types of tools to address safety. The details, reports, accusations and opinions expressed surrounding crashes are important as they shape the policy narrative that defines the event. Thus, casting bicyclists and pedestrians as “guilty-victims” may suggest a propensity to select one set of policy tools and this may be different than the policy tools selected if the target population is cast as “innocent victims.” This study investigates media coverage rates and the factors contributing to the emergence of a victim versus a villain narrative in fatal bicyclist and pedestrian crashes. Methods The research design uses a mixed-methods design that utilizes quantitative techniques to analyze qualitative, coded data. The study uses media accounts, including traditional print sources, television, and social media, as the primary data source. The analysis uses the content of different media sources to generate the qualitative, coded independent variable, Blame-the-victim. The data is collected for bicycle and pedestrian fatality crashes with media reports from 12 states in four different regions from 2004–2015. The study compares media reporting and villain versus victim characterization as variables of interest when comparing differences between the bicyclist and pedestrian crashes, and regions in the United States. Results While the victim narrative appears more prevalent in crashes, the media accounts portray pedestrians as victims at a significantly higher rate than bicyclists who are more frequently portrayed as villains. Overall, neither bicyclist nor pedestrian crashes regularly appear in media accounts; however, the media reporting of pedestrian crashes occurs significantly more often as a proportion of total fatal crashes than bicyclist crashes. Conclusions The overall coverage in media appears rather low; eight of the sampled states have media accounts for fewer than 2% of bicycle fatalities, and five states have media accounts for fewer than 3% of pedestrian fatalities. This infrequent coverage appears to indicate a lack of public engagement/concern regarding bicycle and pedestrian deaths. Future research will explore the impact of characterizing the victim as guilty/innocent on policies and infrastructure improvements.

Major depressive disorder (MDD) is a prevalent condition associated with significant burden in terms of reduced quality of life, lower productivity, increased prevalence of other conditions and increased health care costs. We conducted a systematic review and qualitative summary of randomized controlled trials (RCTs) that assessed the effectiveness and safety of acupuncture for the treatment of MDD. We searched the databases PubMed, CINAHL, PsycINFO, Web of Science, Embase, CDSR, CENTRAL, clinicaltrials.gov, DARE, and PILOTS for English-language RCTs published through January 2015. Two independent reviewers screened the identified literature against inclusion and exclusion criteria, abstracted study level data, and assessed the risk of bias and methodological quality of included studies. The quality of the evidence was assessed using GRADE. Eighteen studies met inclusion criteria. Eleven assessed acupuncture as monotherapy, seven as adjunct depression treatment. Intervention approaches and comparators varied. Evidence on the effectiveness and comparative effectiveness of acupuncture to treat MDD for the outcomes depression improvement, measured as scale score differences and the number of responders, is very weak. Acupuncture may be superior to waitlist (low quality of evidence) but findings for effect estimates compared to other comparators are inconclusive. Few studies reported on patients achieving remission. The effect of acupuncture on relapse rates could not be determined. Too few studies assessed quality of life to estimate treatment effects. Reported adverse events were typically mild in nature, but the assessment lacked rigor and studies were not designed to detect rare events.

The U.S. Department of Defense has highlighted the importance of preparing health care leaders to succeed in joint, performance-based environments. The current wartime environment, rising health care costs, and an increased focus on joint operations have led to recommendations for Military Health System (MHS) transformation. Part of that transformation will involve improving the identification and development of potential MHS leaders. An examination of how candidates are identified for leadership positions, the training and education opportunities offered to them, and the competencies they are expected to achieve revealed both a range of approaches and several commonalities in the military, civilian, and government sectors. A conceptual framework guided a series of interviews with senior health care executives from a wide range of organizations and military health care leaders from the Army, Navy, and Air Force, as well as a case study of the leader development approaches used by the Veterans Health Administration. Several themes emerged in terms of how leaders are developed in each sector, including the importance of mentoring, career counseling, 360-degree feedback, self-development, and formal education and training programs. Lessons learned in the civilian and government sectors hold importance for transforming the way in which MHS identifies and develops health care officers with high leadership potential for senior executive positions.

This brief summarizes findings from case studies of three innovative nurse-designed care models, and it discusses lessons learned from these case studies that might inform our understanding of the health sector's role in building a Culture of Health.

To better understand the value and effectiveness of out-of-school-time (OST) programs, RAND researchers examined programs through the lenses of content, dosage (the hours of content provided), and outcomes measured. They conclude that OST programs are generally effective at producing the primary outcomes that would be expected based on their programming but that the primary benefits of such programs are often understudied or underreported.

Cross-sector collaborations and partnerships are an essential component of the strategy to improve health and well-being in the United States. While their importance is unquestioned, their impact on population health has not yet been fully observed. Cross-sector collaboration also is the second Action Area of the Robert Wood Johnson Foundation's four-part Action Framework to build a Culture of Health in the United States. This Action Area has three constituent parts or drivers: the number, breadth, and quality of successful cross-sector partnerships; the adequacy of investment in these partnerships; and the adoption of policies needed to support them. In this article we analyze outstanding examples of partnership-driven work. We also study the challenges of how partner sectors outside the formal health system, such as organizations working in the education or housing sectors, can effectively lead collaborations. We identify models of leadership that maximize the potential of all participants. We also propose the adoption of models better suited to supporting effective cross-sector collaborations. The analysis builds the evidence base for understanding and sustaining the impact of cross-sector collaboration on population health.

This chapter reflects on the findings from the author’s ethnographic study in a prison for adult males. The author’s focus is on the men’s changing visions and expectations of their futures as men, which she frames as ‘aspirational masculinities’. The experience of time in prison may encourage negative and aggressive forms of masculinity on the one hand, but does allow opportunity for reflection and a reappraisal of life priorities on the other. In particular, she highlights shifts over time in the ‘audiences’ that men consider important for the performance of their masculinity, reflecting changes in values, attachments and expectations of life and identities beyond the prison wall.

This article addresses the common omission and/or obfuscation of men in accounts of crime and particularly accounts of violence, despite the overwhelming presence of men in violent activities and, indeed, crime per se. In doing so it identifies key themes that frame masculine identities. Using the case of Raoul Moat, the piece analyses the discourses available in British newspapers to account for male violence. Raoul Moat killed one man, injured his ex-partner and a police officer and finally shot himself dead in the Northumbrian wilderness. Whereas most accounts of male violence blame ‘bad’ women, race, youth, terror, gangs and madness, here news stories evoked different tales of domestic, institutional and elemental masculinity. The themes of those tales, we argue, constitute broad contexts for constructing masculine identities and our analysis offers new insights into how masculine identity is constructed through discourse and why violence is a significantly male-dominated activity; insights which address some of the lacks in current theoretical work on both masculinity and violence.

In this article, consideration is given to the concept of cleanliness and tidiness from the perspective of the masculine prisoner. Themes related to processes of maintaining, and perceptions of, cleanliness emerged, related to the self, personal space, and the cleanliness of others. Running through these were overarching elements of control, differentiation and processes of normalisation, which can be seen to relate concepts of cleanliness directly to the negotiation of the adult male prisoner's gendered identity, implying that keeping clean and tidy relates directly to individuals’ senses of masculine self and perceptions of others.

Drawing on a statewide study of Florida middle-school reading coaches, this article examines what constitutes, contributes to, and is associated with high-quality coaches and coaching. Authors find that coaches generally held many of the qualifications recommended by state and national experts and principals and teachers rated their coaches highly on many indicators of quality. However, several common concerns about recruiting, retaining, and supporting high-quality coaches emerged. Estimates from models indicate that a few indicators of coach experience, knowledge, and skills had significant associations with perceived improvements in teaching and higher student achievement, although the magnitude of the latter relationship was quite small. Findings suggest that although possessing strong reading knowledge and instructional expertise may be important for coaching, it may not be sufficient.

Objectives Atrazine is a triazine herbicide with endocrine-disrupting properties and is used widely in the United States. Atrazine causes mammary tumours in rats, but the mechanism does not appear to operate in humans. Few epidemiologic studies have provided evidence for an association. Here, we extend a previous analysis of cancer risk associated with self-reported atrazine use in the Agricultural Health Study, a prospective cohort that includes 57 310 licensed pesticide applicators, with six additional years of follow-up and over twice as many cancer cases (n=3146). Methods Using Poisson regression, we calculated RR estimates and 95% CI for lifetime days of use of atrazine and intensity-weighted lifetime days, which accounts for factors that impact exposure. Results Overall, 68% of applicators reported using atrazine. There was no increased risk among atrazine users for cancer overall or at most sites. Based on 29 exposed cases of thyroid cancer, there was a significant risk in the highest category of intensity-weighted lifetime days (RR=4.86; 95% CI: 1.31 to 17.99, p-trend=0.01). There was a similar pattern for lifetime days (RR=2.31; 95% CI: 0.65 to 8.19, p-trend=0.27), but neither the risk estimates nor the trend were statistically significant, and for neither metric was the trend monotonic. For ovarian cancer, there was a suggestion of increased risk among female applicators who ever used atrazine, but numbers were small (n=4). Conclusions There was a suggestion of increased risk of cancers of the thyroid and ovaries, sites of a priori interest due to their hormonal involvement, but with minimal supporting evidence.

Because demographic shifts will affect their labor forces in the immediate future, rich societies will have to face up to the challenge of integrating the children of low-status immigrants, such as Mexicans in the United States and Turks in western Europe. The performance of educational systems is critical to meeting this challenge. We consider how three features of such systems—the division of labor among schools, families, and communities; tracking; and inequalities among schools—impact immigrant-origin children. In general, children from low-status immigrant families lag behind the children from native families but for reasons that differ from one system to another. Each system can profit from the experiences of the others in attempting to ameliorate this disparity.

Many policymakers suggest that school-based reading coaches can improve teachers’ practice, which consequently will improve students’ literacy skills. Although reading coaches are increasingly prevalent in schools nationwide, empirical evidence for their effects on student achievement is scarce. This article helps to address this gap by conducting an evaluation of a statewide reading coach program in Florida middle schools. Using achievement data from nearly 1,000 Florida middle schools from the 1997–1998 through 2005–2006 school years, we find that receiving a state-funded coach was associated with statistically significant improvements in average annual reading achievement gains for two of the four cohorts of schools analyzed. We examine implications for state and district policy and future research.

Objective Prenatally diagnosed confined placental trisomy is associated with increased risk for intrauterine growth restriction (IUGR) and preeclampsia. However, it is unclear how often this might underlie pregnancy complications. Our objective was to evaluate the frequency and distribution of trisomic cells in placentae ascertained for IUGR and/or preeclampsia. Method Comparative genomic hybridization was applied to two uncultured biopsies from each of 61 placentae referred with maternal preeclampsia and/or IUGR, 11 cases with elevated maternal serum hCG and/or AFP but no IUGR or preeclampsia, and 85 control placentae. Results Trisomy was observed in four placentae among the IUGR group (N = 43) but in no case of preeclampsia in the absence of IUGR (N = 18). Trisomy was observed in 1 of the 11 cases ascertained for abnormal maternal serum screen. Each of these five cases was mosaic and not all sampled sites showed the presence of trisomy. None of the 84 control placentas showed mosaic trisomy, although 1 case of nonmosaic 47,XXX was identified in this group. Conclusion In cases in which diagnosis of the cause of IUGR may provide some benefit, testing should be performed using uncultured cells from multiple placental biopsies for the accurate diagnosis of trisomy mosaicism. Copyright © 2009 John Wiley & Sons, Ltd.

Expansins are cell wall proteins associated with the process of plant growth. However, investigations in which expansin gene expression has been manipulated throughout the plant have often led to inconclusive results. In this article, we report on a series of experiments in which overexpression of expansin was targeted to specific phases of leaf growth using an inducible promoter system. The data indicate that there is a restricted window of sensitivity when increased expansin gene expression leads to increased endogenous expansin activity and an increase in leaf growth. This phase of maximum expansin efficacy corresponds to the mid phase of leaf growth. We propose that the effectiveness of expansin action depends on the presence of other modulating factors in the leaf and we suggest that it is the control of expression of these factors (in conjunction with expansin gene expression) that defines the extent of leaf growth. These data help to explain some of the previously observed variation in growth response following manipulation of expansin gene expression and highlight a potential linkage of the expression of modifiers of expansin activity with the process of exit from cell division.

This article examines the convergence of two popular school improvement policies: instructional coaching and data-driven decision making (DDDM). Drawing on a mixed methods study of a statewide reading coach program in Florida middle schools, the article examines how coaches support DDDM and how this support relates to student and teacher outcomes. Authors find that although the majority of coaches spent time helping teachers analyze student data to guide instruction, data support was one among many coach activities. Estimates from models indicate that data analysis support, nevertheless, has a significant association with both perceived improvements in teaching and higher student achievement.

Despite recent progress in reading achievement among elementary school children, literacy levels among U.S. adolescents remain low. Many middle schoolers struggle to develop advanced reading skills, such as the ability to analyze and synthesize complex ideas or to comprehend multiple points of view within a text. Possessing such advanced literacy skills is increasingly becoming a key to success. A popular approach for improving students' literacy skills is school-based literacy or reading coaches--specially trained master teachers who provide leadership for the school's literacy program and offer onsite and ongoing professional development support for teachers so they can improve the literacy skills of their students. Unlike other staff who support reading (e.g., reading resource teachers), coaches generally don't work directly with students and, in most cases, serve in a nonevaluative, support role for teachers. Using the coaching model to improve adolescent literacy is compelling because middle and high school students generally receive instruction from content-area teachers who have received minimal preservice training in how to teach reading. Coaching models are designed to fit the best practices suggested by the literature on professional development and learning theory. Research has suggested that traditional one-shot workshops result in little instructional change and little to no improvement in student learning (Garet et al. 1999; Garet et al. 2001; Hawley and Valli 1999; Showers and Joyce 1996). Instead, learning theory suggests that learners should have opportunities to discuss and reflect with others, to practice applying new ideas and receive feedback from an expert, and to observe modeling (Vaughn 1996; Lave and Wenger 1991; Rogoff 1990; Tharp and Gallimore 1988; Brown, Collins, and Duguid 1989; Lave 1988). As on-site personnel who interact with teachers in their own workplaces, coaches should theoretically be able to facilitate learning that is context-embedded, site-specific, and sensitive to teachers' actual work experiences (Toll 2007; Walpole and McKenna 2004; Hasbrouck and Denton 2005). With strong theoretical and intuitive appeal, coaching has become increasingly prevalent. But there is little empirical evidence about coaching's effectiveness in changing teacher practice and improving student achievement, particularly at the secondary level (Marsh et al. 2008). RAND, with funding from the Carnegie Corporation of New York, sought to address this gap in knowledge by studying a statewide reading-coach program in Florida middle schools. To understand the implementation and effects of coaching, researchers surveyed principals, coaches, and reading and social studies teachers in 113 middle schools in eight large Florida school districts; conducted interviews, focus groups, and observations; interviewed state officials and coach coordinators; and examined results from state middle school examinations in reading and mathematics (Marsh et al. 2008). Coaching in Florida may be distinct from similar interventions elsewhere because of the presence of reading teachers and reading courses in middle schools, and because Florida middle school coaches often prioritize work with these reading teachers (as opposed to content-area teachers). Despite the potential difference in target audience, Florida coaches face many of the same goals, pressures, and constraints as coaches elsewhere. Thus, even though we lack definitive evidence to suggest that our findings from this study can be generalized to other states or districts, we believe the experiences and effects of Florida reading coaches nonetheless provide important insights for policy makers and practitioners interested or involved in similar coaching efforts. Key Findings Administrators voiced common concerns about recruiting and retaining high-quality coaches. Some administrators voiced concerns about a short-age of qualified candidates (as one coach supervisor noted, middle school teachers are generally not "reading people"). …

Men dominate crime, criminal justice, and imprisonment. More men commit crime, and more men work in the criminal justice system, than women. Whichever side of the law men find themselves upon, they can be sure to accrue some masculine credentials by virtue of being part of a system that is suffused with institutional masculinity (see Ellis et al. 2013). Yet, the very nature of being a man and the masculine identities of prisoners are often taken for granted in analyses of prison and imprisonment, rather than being key variables in the experience (Wykes and Welsh 2009).

The research aimed to provide insights into the manner in which imprisonment is experienced by men. By better understanding how men ‘do’ being in prison, where many normalising contexts and resources for performing socially legitimate masculine identities are unavailable, such as liberty, goods and services, autonomy, heterosexual relationships, and security (Sykes 1958), where men are placed into feminising positions, and where such men are literally ‘captive’ in such a context for the researcher, it may help to enhance the understandings of masculinities more broadly, and to help to explain its association with crime. A key focus is upon interpersonal interactions between prisoners, based upon the concept of gender and the gendered body (and its use through gestures) being ‘performative’ (Butler 1990: 173).