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First-year composition courses must balance a range of writing instruction priorities including genre and audience awareness with language instruction, particularly for second-language writers. Despite the attested efficacy of dynamic written corrective feedback for language gains in intensive English programs, little research has investigated dynamic written corrective feedback in supporting language and discourse development among L2 first-year composition students. In the present study, pre- and post-test writing from 63 second-language first-year composition writers was analyzed for grammatical accuracy as well as lexical and syntactic complexity. Writers with dynamic written corrective feedback intervention (n = 30) failed to outperform a control group on nearly all measures, and in fact made significantly more verb errors and demonstrated significantly less syntactic complexity over time compared to the control group. Results suggest that while dynamic written corrective feedback is efficacious in some settings, it may be at cross purposes with other first-year composition discourse-based goals such as genre and audience awareness. [ABSTRACT FROM AUTHOR]

Background: Currently, the capacity to provide buprenorphine treatment (BT) is not sufficient to treat the growing number of people in the United States with opioid use disorder (OUD). We sought to examine participant retention in care rates of primary care delivered BT programs and to describe factors associated with retention/attrition for participants receiving BT in this setting. Objectives: A PRISMA-guided search of various databases was performed to identify the articles focusing on efficacy of BT treatment and OUD. Method: A systematic literature search identified 15 studies examining retention in care in the primary care setting between 2002 and 2020. Random effects meta-regression were used to identify retention rates across studies. Results: Retention rates decreased across time with a mean 0.52 rate at one year. Several factors were found to be related to retention, including: race, use of other drugs, receipt of counseling, and previous treatment with buprenorphine. Conclusions: While we only investigate BT through primary care, our findings indicate retention rates are equivalent to the rates reported in the specialty care literature. More work is needed to examine factors that may impact primary care delivered BT specifically and differentiate participants that may benefit from care delivered in specialty over primary care as well as the converse. [ABSTRACT FROM AUTHOR]

This article reports a study involving: (1) developing and validating a learning environment instrument, (2) investigating whether reflection on feedback generated using the instrument led to improvements in the learning environment and (3) examining how teachers used the feedback. For the new learning environment instrument, validity was supported for a sample of 10,345 secondary students over 3 years (2,042 students in 2008, 4,467 in 2009 and 3,836 in 2010). To investigate whether reflection on feedback from this instrument led to improvements in the learning environment, multivariate analysis of variance and effect sizes were used to examine pre-post differences. Statistically significant improvements in students' views of the learning environment were found for 8 of the 11 scales. Finally, we examined how teachers used the student feedback. Of the 459 teachers, 45 focus teachers used the feedback as part of a formal action research approach involving entries in reflective journals, written reports, discussions and participation at a forum. These data were analysed to provide an overview of the ways in which the information was used, and to provide a more detailed account of the journey of one of the teachers.

This article reports the development, validation and use of an instrument designed to provide teachers with feedback information, based on students' perceptions, about their classroom environments. The instrument was developed to provide teachers with feedback that they could use to reflect on their teaching practices and, in turn, guide the implementation of strategies to improve their learning environments. To determine the validity and reliability of the new instrument, data from 2043 grade 11 and 12 students from 147 classes in 9 schools were analysed. The Rasch model was used to convert data collected using a frequency response scale into interval data that are suitable for parametric analyses. During an action research process, reflective journals, written feedback, discussions at a forum and interviews with eight teachers helped to illuminate the processes used by teachers during action research. This article reports the views of these teachers in general and examines more closely how one of the teachers used student responses to the learning environment questionnaire as a tool for reflection and as a guide in transforming her classroom environment. This case study helped us to gauge the extent to which action research based on students' perceptions of the learning environment was useful in guiding teachers' improvements of their classroom learning environments.

Summary: Background: The association between physical activity and adiposity in preschool‐aged children is unclear. Objective: To assess the cross‐sectional association between objectively measured physical activity and body fat in preschool‐aged children. Methods: In the preschool review in an Australian birth cohort study (n = 1074), mean duration and time accumulated in ≥1‐min bouts of physical activity at light‐intensity (LPA), moderate‐ to vigorous‐intensity (MVPA) and light‐ to vigorous‐intensity (LMVPA) were computed from accelerometer (ActiGraph GT3X+) data. Percent body fat was assessed by bioelectrical impedance. Associations between physical activity and percent body fat were examined by multiple regression, adjusted for accelerometer wear time, MVPA (in analyses of LPA), maternal body mass index (BMI) and maternal education. Results: A total of 450 participants (n = 450) had valid data. There was evidence of associations between physical activity and adiposity: each additional hour of LVPA was associated with 0.6% (CI95 –0.2%, 1.3%) higher body fat; ≥1‐min bouts of LPA was associated with 1.0% (CI95 0.1%, 1.9%) higher body fat; each additional hour of MVPA was associated with −0.8% (CI95 −1.6%, −0.1%) less body fat; and ≥1‐min bouts of MVPA was associated with −1.3% (CI95 −2.5%, −0.1%) body fat. Conclusions: Among a cohort of preschool‐aged children, there was evidence that more intensive physical activity assessed by an accelerometer is associated with reduced body fat. [ABSTRACT FROM AUTHOR]

Introduction: Total volumes of physical activity and sedentary behaviour have been associated with cardio-metabolic risk profiles; however, little research has examined whether patterns of activity (e.g., prolonged bouts, frequency of breaks in sitting) impact cardio-metabolic risk. The aim of this review was to synthesise the evidence concerning associations between activity patterns and cardio-metabolic risk factors in children and adolescents aged 5–19 years. Materials and methods: A systematic search of seven databases was completed in October 2017. Included studies were required to report associations between objectively-measured activity patterns and cardio-metabolic risk factors in children and/or adolescents, and be published between 1980 and 2017. At least two researchers independently screened each study, extracted data, and undertook risk of bias assessments. Results: From the 15,947 articles identified, 29 were included in this review. Twenty-four studies were observational (cross-sectional and/or longitudinal); five were experimental. Ten studies examined physical activity patterns, whilst 19 studies examined sedentary patterns. Only one study examined both physical activity and sedentary time patterns. Considerable variation in definitions of activity patterns made it impossible to identify which activity patterns were most beneficial to children’s and adolescents’ cardio-metabolic health. However, potential insights and current research gaps were identified. Discussion and conclusion: A consensus on how to define activity patterns is needed in order to determine which activity patterns are associated with children’s and adolescents’ cardio-metabolic risk. This will inform future research on the impact of activity patterns on children’s and adolescents’ short- and longer-term health. [ABSTRACT FROM AUTHOR]

Background: Psychological therapy services are often required to demonstrate their effectiveness and are implementing systematic monitoring of patient progress. A system for measuring patient progress might usefully 'inform supervision' and help patients who are not progressing in therapy. Aims: To examine if continuous monitoring of patient progress through the supervision process was more effective in improving patient outcomes compared with giving feedback to therapists alone in routine NHS psychological therapy. Method: Using a stepped wedge randomized controlled design, continuous feedback on patient progress during therapy was given either to the therapist and supervisor to be discussed in clinical supervison (MeMOS condition) or only given to the therapist (S-Sup condition). If a patient failed to progress in the MeMOS condition, an alert was triggered and sent to both the therapist and supervisor. Outcome measures were completed at beginning of therapy, end of therapy and at 6-month follow-up and session-by-session ratings. Results: No differences in clinical outcomes of patients were found between MeMOS and S-Sup conditions. Patients in the MeMOS condition were rated as improving less, and more ill. They received fewer therapy sessions. Conclusions: Most patients failed to improve in therapy at some point. Patients' recovery was not affected by feeding back outcomes into the supervision process. Therapists rated patients in the S-Sup condition as improving more and being less ill than patients in MeMOS. Those patients in MeMOS had more complex problems. [ABSTRACT FROM AUTHOR]

Background Morquio A syndrome (or mucopolysaccharidosis IVa) is an ultra-rare multi-organ disease, resulting in significantly impaired functional capacity, mobility and quality of life (QoL). Methods This patient-reported outcomes survey evaluated the global burden of Morquio A among adults (⩾18 years, N = 27) and children (7-17 years, N = 36), including the impact on mobility, QoL, pain and fatigue. QoL was assessed using the general Health-Related Quality of Life (HRQoL) questionnaire (the EuroQol [EQ]-5D-5L). Pain and pain interference with daily activities were assessed using the Brief Pain Inventory Short Form (BPI-SF) in adults and the Adolescent Pediatric Pain Tool (APPT) in children. Fatigue was assessed by questioning the patients on the number of evenings in a week they felt extremely tired. Results The clinical data showed a wide heterogeneity in clinical manifestations between patients, with the majority of patients showing differing levels of endurance, short stature, bone and joint abnormalities, abnormal gait and eye problems. Mobility was considerably impaired: 44.4% of children and 85.2% of adult patients were using a wheelchair. High wheelchair reliance significantly reduced QoL. This was mainly driven by reduced scores in the Mobility, Self-care, and Usual Activity domains. The HRQoL utility values were 0.846, 0.582 and 0.057 respectively in adults not using a wheelchair, using a wheelchair only when needed and always using a wheelchair; values were 0.534, 0.664 and -0.180 respectively in children. Employed adult patients had a better HRQoL than unemployed patients (HRQoL utility value 0.640 vs. 0.275, respectively). 64% of children and 74% of adult patients had joint pain; fatigue was reported by 69% of children and 63% of adults. Overall, increased mobility was associated with more severe and widespread pain and more fatigue. Conclusions The HRQoL of Morquio A patients is mainly driven by the ability to remain independently mobile without becoming wheelchair dependant. Their QoL reduces dramatically if they always have to use their wheelchair. Even a slightly better mobility (wheelchair use only when needed) greatly improves QoL. Maintenance of functional capacity and mobility paired with better pain management are likely to improve QoL. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the characteristics and referral pattern of children and adolescents with mental health problems, substance misuse and comorbidity presenting to the emergency department (ED) of a large public hospital. Method: A file audit of the ED information system was conducted over a 12 month period. Outcome measures included age, gender, diagnostic presentation, assessment, referral and disposal. Results: Forty-four substance misuse, 128 mental health and 82 comorbidity presentations were identified; 80% required treatment within 30 minutes. Few substance misuse cases were seen by mental health services and no substance misuse cases were referred for mental health service assessment. All mental health and comorbidity cases were seen by mental health services; 41% were referred to outpatient and 18% to inpatient services. Those with mental health problems displayed high levels of self-mutilation, and those with comorbidity displayed high levels of self-mutilation and substance misuse. Alcohol use was common in the substance misuse group, and over the counter or prescription medications were abused by the mental health and comorbidity groups. Conclusions: This age group places a high demand on the ED. All children and adolescents with recognized mental health symptoms were seen by mental health services, but those with substance misuse were not. Given the long-term problems associated with substance misuse, this is a missed opportunity for intervention. [ABSTRACT FROM AUTHOR]

Examines the existence of smoking policies in businesses in Florida. Telephone surveys of the `Top 200' businesses ranked by `Florida Trend' magazine; Differences between the policies of small and large businesses; Three levels of restrictiveness of smoking policies.

The article presents an obituary for notable figures in the medical sector in Great Britain including general practitioner Martin Peter Bell, consultant physician Robert Marius Foster, and former Colchester General Hospital consultant radiologist Eugene Alexander Gannushkin.

Background: Morquio A syndrome (or mucopolysaccharidosis IVa) is an ultra-rare multi-organ disease, resulting in significantly impaired functional capacity, mobility and quality of life (QoL).Methods: This patient-reported outcomes survey evaluated the global burden of Morquio A among adults (≥18 years, N = 27) and children (7-17 years, N = 36), including the impact on mobility, QoL, pain and fatigue. QoL was assessed using the general Health-Related Quality of Life (HRQoL) questionnaire (the EuroQol [EQ]-5D-5L). Pain and pain interference with daily activities were assessed using the Brief Pain Inventory Short Form (BPI-SF) in adults and the Adolescent Pediatric Pain Tool (APPT) in children. Fatigue was assessed by questioning the patients on the number of evenings in a week they felt extremely tired.Results: The clinical data showed a wide heterogeneity in clinical manifestations between patients, with the majority of patients showing differing levels of endurance, short stature, bone and joint abnormalities, abnormal gait and eye problems. Mobility was considerably impaired: 44.4% of children and 85.2% of adult patients were using a wheelchair. High wheelchair reliance significantly reduced QoL. This was mainly driven by reduced scores in the Mobility, Self-care, and Usual Activity domains. The HRQoL utility values were 0.846, 0.582 and 0.057 respectively in adults not using a wheelchair, using a wheelchair only when needed and always using a wheelchair; values were 0.534, 0.664 and -0.180 respectively in children. Employed adult patients had a better HRQoL than unemployed patients (HRQoL utility value 0.640 vs. 0.275, respectively).64% of children and 74% of adult patients had joint pain; fatigue was reported by 69% of children and 63% of adults. Overall, increased mobility was associated with more severe and widespread pain and more fatigue.Conclusions: The HRQoL of Morquio A patients is mainly driven by the ability to remain independently mobile without becoming wheelchair dependent. Their QoL reduces dramatically if they always have to use their wheelchair. Even a slightly better mobility (wheelchair use only when needed) greatly improves QoL. Maintenance of functional capacity and mobility paired with better pain management are likely to improve QoL. [ABSTRACT FROM AUTHOR]

Introduction: Adverse childhood experiences contribute to both short- and long-term health issues and negative health behaviors that affect the individual as well as families and communities. Exposure to ≥4 of the 11 adverse childhood experiences (high adverse childhood experiences) compounds the problems in later life. This study assesses the associations among tobacco use, adverse childhood experiences, mental health, and community health.Methods: This study was a secondary data analysis utilizing a large 2019 data set from a Community Health Needs Assessment in Florida (N=14,056). Investigators utilized inferential statistics to determine adverse childhood experiences as a predictor of tobacco use (vaping and cigarette use). In addition, they examined whether a shorter, 2-question adverse childhood experience scale was equivalent to the full scale when predicting tobacco use.Results: The results indicated that parental divorce was the most common household stressor, followed by mental illness and alcoholism. High adverse childhood experiences were found to be most prominent in marginalized individuals. For those individuals experiencing ≥4 adverse childhood experiences, parental divorce continued to rank high, followed by mental illness. Household stressors included emotional and physical abuse as the most prevalent in the ≥4 adverse childhood experience group. High adverse childhood experiences were associated with current cigarette smoking (AOR=1.56) after controlling for individual mental health and social/community health variables. High adverse childhood experiences were also associated with E-cigarette use (AOR=1.81) but not dual cigarette/E-cigarette use. Social and community health was inversely associated with tobacco use. A 2-item adverse childhood experiences measure was sufficient in identifying tobacco users.Conclusions: Including adverse childhood experiences in community needs assessments provides important information for tobacco control efforts and prevention of chronic disease. [ABSTRACT FROM AUTHOR]