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AbstractWe reported an outbreak of wild rabies in Potus flavus (choznas), a carnivorous mammal associated with insectivorous bats in Kosñipata, Cusco, Peru, from February 2021 to October 2022. Eight human exposures were reported, with aggressive attacks resulting in injuries. The outbreak prompted a public health response and raised concerns about zoonotic diseases due to habitat fragmentation and urbanization. The study involved antigenic and genetic characterization of the virus in the affected animals, revealing similarities with variants in non-hematophagous bats. This outbreak marked the first time rabies had been reported in choznas in the region, highlighting the need for early intervention programs and wildlife protection. Pre-exposure rabies vaccinations were administered to residents, and community surveillance was established to control the outbreak. The study emphasizes the importance of continuous surveillance and education to prevent rabies transmission from choznas to humans and other animals, as their role as potential secondary transmitters of the virus warrants further investigation.

Martin Kaddumukasa,1 Alyssa M Edwards,2 Josephine Nambi Najjuma,3 Scovia Nalugo Mbalinda,4 Jane Nakibuuka,1 Christopher J Burant,5 Shirley M Moore,6 Carol Blixen,2 Elly T Katabira,1 Martha Sajatovic,2 Mark Kaddumukasa1 1Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 2Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda; 4Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda; 5Louis Stokes VA Medical Center, Geriatric Research Education, and Clinical Center, Cleveland, OH, USA; 6Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USACorrespondence: Martin Kaddumukasa, Email kaddumart@gmail.comAbstract: The study set out to perform a systematic literature review of evidence-based interventions that target the reduction of secondary stroke risk in Africa. The review analyzed longitudinal intervention studies conducted in Sub-Saharan Africa, focusing on adult participants who had suffered a prior stroke. It encompassed publications and peer-reviewed papers sourced from reputable databases, including PubMed, Ovid, Cochrane, and Web of Science. Three randomized clinical trial (RCT) studies were included with sample sizes ranging from 16 to 400 participants, mean age ranged between 50 and 66 years, with 64.5% male participants. All studies applied multidisciplinary team interventions of enhanced patient follow-up involving care givers, nurse educators, physicians, and social workers. Interventions ranged from comprehensive patient education, tracking of medication adherence and enforcing healthy lifestyle behaviors (regular exercise, regular BP checks, and dietary changes). We found a decrease in Systolic Blood Pressure over time in 2 of 3 treatment groups, an improvement in medical adherence in all treatment groups, and a decrease in cholesterol levels in 1 treatment group. Evidence-based interventions involving multidisciplinary teams and comprehensive patient education were found to demonstrate promising results in reducing secondary stroke risk in Africa, leading to significant improvements in medical adherence and reductions in systolic blood pressure in the majority of treatment groups. However, more research is required to confirm the influence of these interventions on cholesterol levels and to establish their lasting advantages in preventing strokes among African communities.Keywords: secondary stroke risk, risk interventions, Sub-Saharan Africa

IntroductionDifferent techniques have been used to identify the brain regions that control sexual motivation and sexual behavior. However, the influence of sexual experience on the activation of these brain regions in the same subject is unknown. Using manganese-enhanced magnetic resonance imaging (MEMRI), we analyzed the activation of brain regions in the sexual incentive motivation (SIM) and the partner preference PP (tests) on weeks 1, 5, and 10 in male rats tested for 10 weeks. AIM. In experiment 1, we analyzed the possible toxic effects of 16 mg/kg of MnCl2 on male sexual behavior, running wheel, and motor execution. In experiment 2, subjects were tested for SIM and PP using MEMRI.MethodsIn both experiments, a dose of 16 mg/kg (s.c) of chloride manganese (MnCl2) was administered 24 h before subjects were tested and placed immediately thereafter in a 7-Tesla Bruker scanner.ResultsIn experiment 1, the dose of 16 mg/kg of MnCl2 did not induce behavioral alterations that could interfere with interpreting the imaging data. In experiment 2, we found a clear preference for the female in both the SIM and PP tests. We found a higher signal intensity in the olfactory bulb (OB) in week 1 of the SIM test compared to the control group. We also found increased signal intensity in the socio-sexual behavior and mesolimbic reward circuits in the SIM test in week 1. In the PP test, we found a higher signal intensity in the ventral tegmental area (VTA) in week 10 compared to the control group. In the same test, we found increased signal intensity in the socio-sexual and mesolimbic reward circuits in week 5 compared to the control group. Cohen's d analysis of the whole brain revealed that as the subjects gained sexual experience we observed a higher brain activation in the OB in the SIM group. The PP group showed higher brain activation in the cortex and subcortical structures as they acquired sexual experience.DiscussionAs the subjects gain sexual experience, more structures of the reward and socio-sexual circuits are recruited, resulting in different, and large brain activations.

Alyssa M Edwards,1 Jordan C Petitt,1 Sanjana Kumar,1 Jennifer B Levin,1,2 Martha Sajatovic1,2 1Case Western Reserve University School of Medicine, Cleveland, OH, USA; 2University Hospitals of Cleveland Medical Center, Department of Psychiatry, Cleveland, OH, USACorrespondence: Martha Sajatovic, University Hospitals of Cleveland Medical Center, Department of Psychiatry, 10524 Euclid Ave, Cleveland, OH, 44106, USA, Email martha.sajatovic@uhhospitals.orgIntroduction: Given the increasing use of telepsychiatry and to serve as a reference point informing future research, our team evaluated the literature on the use of telepsychiatry for medication adherence promotion prior to the COVID-19 pandemic among patients with psychotic disorders.Methods: A search of PubMed, Cochrane, Web of Science, CINAHL, and PsycINFO was conducted using PRISMA guidelines to identify telepsychiatry interventions to enhance medication adherence in patients with primary psychotic disorders. Both quantitative and qualitative data were extracted from the identified articles including study characteristics, interventions, and outcomes.Results: In total, 230 articles were obtained through electronic literature search, and 4 articles were eventually retained that met inclusion criteria. All 4 articles were randomized controlled trials, were adjuncts to in-person usual care, used telephone platforms and targeted medication adherence. Compared to treatment as usual, 3 out of 4 studies found medication adherence was improved and 2 out of 4 studies found improved medication attitudes. Telepsychiatry appeared to be acceptable to patients with psychotic disorders.Discussion: In the pre-Covid-19 literature, telepsychiatry appears promising as an adjunct to usual care for increasing medication adherence among individuals with schizophrenia/schizoaffective disorder. However, given the limited number of papers and exclusive use on telephone-only to deliver telepsychiatry, additional research specific to telepsychiatry for patients with psychosis is needed.Keywords: telemedicine, telehealth, telepsychiatry, remote delivery, virtual delivery, schizophrenia, schizoaffective disorder

This collaborative and reflective inquiry-based paper critically examines accessibility within the research realm. We focus this inquiry on the principles of equity, diversity and inclusion and specifically address the challenges of establishing accessibility as part of the research enterprise. We acknowledge and reflect on the pivotal role accessibility for persons with disabilities play in an equitable research enterprise and reflect on how nuances in language, behavior, and power dynamics all play a role in creating inclusive environments. This reflective inquiry is a result of a facilitated workshop that took place at a conference attended by professionals working within research administration. Using an inquiry-based workshop approach, facilitators worked with workshop colleagues to discuss, regardless of job title, an ability to influence and shape a more inclusive and accessible system at all levels. Our desired outcomes of this workshop were to collate the collective experiences of our colleagues to uncover barriers and facilitators related to accessibility and to support and learn from our colleagues around ways to create an accessible environment that is a norm. What we find is that accessibility impacts everyone in some way, but it is not a one-size-fits-all solution. Collaboration and communication strategies present possible support pathways to more accessible environments.

BackgroundBetween 5-10% of patients discontinue statin therapy due to statin-associated adverse reactions, primarily statin associated muscle symptoms (SAMS). The absence of a clear clinical phenotype or of biomarkers poses a challenge for diagnosis and management of SAMS. Similarly, our incomplete understanding of the pathogenesis of SAMS hinders the identification of treatments for SAMS. Metabolomics, the profiling of metabolites in biofluids, cells and tissues is an important tool for biomarker discovery and provides important insight into the origins of symptomatology. In order to better understand the pathophysiology of this common disorder and to identify biomarkers, we undertook comprehensive metabolomic and lipidomic profiling of plasma samples from patients with SAMS who were undergoing statin rechallenge as part of their clinical care.Methods and findingsWe report our findings in 67 patients, 28 with SAMS (cases) and 39 statin-tolerant controls. SAMS patients were studied during statin rechallenge and statin tolerant controls were studied while on statin. Plasma samples were analyzed using untargeted LC-MS metabolomics and lipidomics to detect differences between cases and controls. Differences in lipid species in plasma were observed between cases and controls. These included higher levels of linoleic acid containing phospholipids and lower ether lipids and sphingolipids. Reduced levels of acylcarnitines and altered amino acid profile (tryptophan, tyrosine, proline, arginine, and taurine) were observed in cases relative to controls. Pathway analysis identified significant increase of urea cycle metabolites and arginine and proline metabolites among cases along with downregulation of pathways mediating oxidation of branched chain fatty acids, carnitine synthesis, and transfer of acetyl groups into mitochondria.ConclusionsThe plasma metabolome of patients with SAMS exhibited reduced content of long chain fatty acids and increased levels of linoleic acid (18:2) in phospholipids, altered energy production pathways (β-oxidation, citric acid cycle and urea cycles) as well as reduced levels of carnitine, an essential mediator of mitochondrial energy production. Our findings support the hypothesis that alterations in pro-inflammatory lipids (arachidonic acid pathway) and impaired mitochondrial energy metabolism underlie the muscle symptoms of patients with statin associated muscle symptoms (SAMS).

IntroductionThe Notch pathway is fundamental for the generation of neurons during development. We previously reported that adult mice heterozygous for the null allele of the gene encoding the Delta-like ligand 1 for Notch (Dll1lacZ) have a reduced neuronal density in the substantia nigra pars compacta. The aim of the present work was to evaluate whether this alteration extends to other brain structures and the behavioral consequences of affected subjects.MethodsBrains of Dll1+/lacZ embryos and mice at different ages were phenotypically compared against their wild type (WT) counterpart. Afterwards, brain histological analyses were performed followed by determinations of neural cell markers in tissue slices. Neurological deficits were diagnosed by applying different behavioral tests to Dll1+/lacZ and WT mice.ResultsBrain weight and size of Dll1+/lacZ mice was significantly decreased compared with WT littermates (i.e., microcephaly), a phenotype detected early after birth. Interestingly, enlarged ventricles (i.e., hydrocephalus) was a common characteristic of brains of Dll1 haploinsufficient mice since early ages. At the cell level, general cell density and number of neurons in several brain regions, including the cortex and hippocampus, of Dll1+/lacZ mice were reduced as compared with those regions of WT mice. Also, fewer neural stem cells were particularly found in the adult dentate gyrus of Dll1+/lacZ mice but not in the subventricular zone. High myelination levels detected at early postnatal ages (P7–P24) were an additional penetrant phenotype in Dll1+/lacZ mice, observation that was consistent with premature oligodendrocyte differentiation. After applying a set of behavioral tests, mild neurological alterations were detected that caused changes in motor behaviors and a deficit in object categorization.DiscussionOur observations suggest that Dll1 haploinsufficiency limits Notch signaling during brain development which, on one hand, leads to reduced brain cell density and causes microcephaly and hydrocephalus phenotypes and, on the other, alters the myelination process after birth. The severity of these defects could reach levels that affect normal brain function. Therefore, Dll1 haploinsufficiency is a risk factor that predisposes the brain to develop abnormalities with functional consequences.

The theory of socially shared regulation of learning (SSRL) suggests that successful collaborative groups can identify and respond to trigger events stemming from cognitive or emotional obstacles in learning. Thus, to develop real-time support for SSRL, novel metrics are needed to identify different types of trigger events that invite SSRL. Our aim was to apply two metrics derived from different data streams to study how trigger events for SSRL shaped group linguistic alignment (based on audio data) and physiological synchrony (based on electrodermal activity data). The data came from six groups of students (N = 18) as they worked face-to-face on a collaborative learning task with one cognitive and two emotional trigger events. We found that the cognitive trigger event increased linguistic alignment in task-description words and led to physiological out-of-synchrony. The emotional trigger events decreased out-of-synchrony and increased high-arousal synchrony at the physiological level but did not affect linguistic alignment. Therefore, different metrics for studying markers and responses to different types of trigger events are needed, suggesting the necessity for multimodal learning analytics to support collaborative learning.

Reparations policies that seek to make amends for a harm incurred face exigent challenges. In this article we focus on what makes reparations successful and what policy components are necessary, if not sufficient, for success. To study the success of reparations policy design we employ a case study approach. Our analysis investigates the motivation, design, implementation, and impact of past policies to understand what has been successful or unsuccessful within each component of the policy in each historical case. Ultimately, our discussion identifies patterns in the creation and execution of reparations policy that offer important considerations for policies that would provide reparations to Black Americans.

Sonography is a highly specialized diagnostic imaging profession facing significant workforce challenges due to increased service delivery demands and a shortage of clinical training opportunities. Developing sustainable solutions is crucial for workforce growth. Using examples from the Australian workforce and education context, this paper explores the current sonography training pathways available and the benefits and challenges of each, highlighting the importance of work-integrated learning (WIL) in facilitating the development of professional identity, clinical competence and the quality of sonographer education. Conclusions are drawn that WIL is integral to the future of the sonography profession to improve patient outcomes and address workforce shortages. However, effective implementation requires careful planning and consideration of many factors, including regulatory requirements, industry partnerships, student and supervisor/tutor support, and issues related to equitable access and participation in WIL. Key recommendations are provided to encourage ethical student learning, university-industry collaboration, effective resource allocation, and WIL-specific research.

As social and emotional learning (SEL) picks up pace in the twenty-first century, it is often presented as a universally progressive and even apolitical phenomenon. At the same time, a growing number of politically conservative groups are attacking SEL as a form of "lib-eral indoctrination." Amidst these layered contexts, there is an urgent need for deep, crit-ical, and culturally humble conversations that recognize SEL as an inevitably political and power-laden phenomenon that must be consciously partnered with a commitment to social justice. In this article, we provide highlights and commentary from an interview podcast with two critical scholars, Clio Stearns and Kathleen Hulton, who shed important light on the sociocultural underpinnings of SEL. These scholars question how far the field of SEL can go in merely improving or reforming current practices, arguing for more radical trans-formations to the ways in which social and emotional humanity is conceptualized.

The purpose of this study was to: 1) examine existing interprofessional pain management curricula in a DPT and MOT program by mapping pain subject matter to the IASP interprofessional content to determine gaps, vertical and horizontal coherence and integration 2) evaluate pain knowledge and attitudes early and late curriculum within the current pre-licensure Doctor of Physical Therapy (DPT) and Master of Occupational Therapy (MOT) students, and 3) to define changes needed within the existing interprofessional pain management curricula to better prepare students for clinical experiences and professional practice. Pain content was mapped to the IASP core competencies to identify gaps in content and coherence. Students were evaluated on existing pain knowledge and attitudes using the City of Boston's Rehabilitation Professional's Knowledge and Attitudes Survey Regarding Pain (COBS). Two hundred and forty physical and occupational therapy students completed the study. The mean percentage of correct responses of 70.6% +/-25.6% did not significantly change across didactic terms. Curricular mapping can inform planning, design, implementation, and evaluation of the curriculum and alignment with IASP guidelines.

Skills in interdisciplinary collaboration are required to address many complex problems facing society. As such, interdisciplinarity is a critical competency for students to develop. However, teachers' effectiveness in teaching interdisciplinarity is often hindered by silo structures within university faculties. To address this in the Experts in Teamwork (EiT) programme, a MSc in a Norwegian university that develops students' interdisciplinary teamwork skills through projects that address real-world challenges, a community of practice (CoP) evolved among teachers from different EiT classes. Over 20 months, CoP members participated in digital and in-person discussions, lecture exchanges, student and professional conferences, and coevaluation of student work, with an aim of better understanding interdisciplinarity and approaches for teaching it to students. The success of the CoP in achieving these aims was evaluated through a series of focus groups consisting of members of the CoP. The CoP achieved some success in fostering pedagogical conversations that were transformative for participants' understanding of interdisciplinarity in their practice. Participants reported that CoP participation influenced their interactions with students, ultimately helping students to develop a better understanding of interdisciplinarity. However, participants reported limitations in the CoP as a professional development resource, citing its newness and the required time commitment. Participants felt that these issues could be addressed via greater institutional support.

This qualitative dissertation aimed to understand if an after-school kinesiology service-learning program changed the relationship between a large Research I institution and a local public school. Eight 7th- and 8th-grade students, three classroom teachers, and one administrator participated. Data collection methods included semistructured individual interviews, observational field notes, and reflective memos. Findings suggested that school staff perceived a positive relationship between the university and the school district but a complicated one between the university and the city. Participating teachers and school leaders believed the service-learning program positively impacted their students and helped strengthen the relationship between the university and the school. The study also highlighted the importance of effective communication in university-school partnerships and uncovered challenges in communication concerning the service-learning program. The middle school students perceived benefits from receiving academic support, and school participants felt that the relationships formed between the university and middle school students were impactful.

Background: Individuals with fetal alcohol spectrum disorder (FASD) experience complex needs that often necessitate support from multiple systems. There is growing evidence that people with FASD may benefit from integrated service delivery (ISD), but little is known about ISD elements and processes for this population. Method: Using a multi-method approach involving a literature review, analysis of programme data, and staff interviews, we examined how ISD is enacted at a rural Canadian FASD centre, and identified facilitators, barriers, and potential impacts of ISD at the centre. Results: We describe key elements of integrated FASD programming and identify important contextual factors and themes related to ISD barriers, facilitators, and impacts: (1) connection, (2) freedom and autonomy, (3) client-centred care, (4) learning and growth, (5) and reframing expectations. Conclusions: This study may help to inform a roadmap for enhancing FASD service delivery and guiding FASD research and policy in Canada and beyond.

People thrive in compassionate environments. For autistic people, their environments are often non-conducive to care and support. We propose that cultivating autistic people's self-compassion may be an antidote to the mental health difficulties arising from environmental causes. The current study aimed to pilot a self-guided online self-compassion program for autistic adults to assess its feasibility, acceptability, and outcomes related to completing this program. The program was co-produced with autistic individuals. Thirty-nine autistic adults aged 20-77 years (M[subscript age] = 45.28, SD[subscript age] = 11.92) completed the online program. They also provided feedback about their self-compassion practices every week. They completed pre- and post-intervention online surveys measuring self-compassion, symptoms of anxiety and depression, positive and negative affect, emotion regulation difficulties, and psychological well-being. As hypothesized, there were significant group improvements in all outcome measures. Preliminary results suggest that the program is feasible and accepted by participants. Approximately half of the autistic participants reported experiences of backdraft, which are adverse reactions associated with self-compassion practices. Based on our findings, we provided clinical recommendations on how self-compassion can be taught to autistic adults.

Objectives: Community sites, including schools, are important settings for interventions to promote children and young people's mental health and wellbeing. A central provision to support mental health in the UK is school- and community-based counselling services. However, the evidence-base for school counselling services is limited by weak evaluation designs, lack of understanding of different counselling approaches in use, and a failure to conceptualise counselling services as part of a wider complex system. To address the last point, this article takes a complex system-focused perspective to explore how a 'system disruption', that is counselling service implementation, can be optimised in the Welsh education system. Design: The approach used in this study is a mixed-method qualitative design. Setting: Participants were recruited from school and community settings. They included children and young people, parents, carers, school staff, counsellors and stakeholders from health and education. Method: Consultations, key system stakeholder interviews and school case studies were conducted. All stakeholders were asked about their experiences of local authority-funded school- and community-based counselling services in Wales. Interview and consultation data were analysed using a thematic analysis approach. Results: Data converged into three main themes focusing on the specifics of counselling sessions, counselling services as part of universal mental health provision and a whole education system approach. These three themes are brought together into a complex systems-focused model of an optimised school- and community-based counselling service. Conclusion: The model offers an opportunity to address issues with current counselling services in Wales and improve outcomes and sustainability by increasing the likelihood they will become embedded in the whole education system.

Purpose: Higher education curriculum development in the construction industry has historically received scant academic attention and often, courses/programmes are largely developed using the tacit knowledge of individual tutors. This research investigates the core interpersonal and technical skills and competencies required of a contemporary construction management graduate. Specifically, the work culminates in the development of a proof-of-concept model that could be incorporated into higher education curriculum development. Methodology: A mixed philosophical stance is implemented using both postpositivism and interpretivism together with inductive and abductive reasoning to examine built environment academics' perceptions of the phenomena under investigation. Descriptive and inferential statistics (i.e., weighted average, relative importance index, one sample t test, Chi-square test and Kruskal-Wallis test) are utilised to formulate a foundational set of core interpersonal skills for construction management curricula. Such knowledge provides a strong foundation for building an optimised course curriculum. Findings: Research findings demonstrate that, whilst technical skills are relatively important for the construction manager's role, they significantly pale in comparison to interpersonal skills. Furthermore, an aggregate ranking of skills and competencies suggests that a substantial number of interpersonal skills and competencies out-rank numerous technical skills and competencies. Surprisingly, digital-esque themes rank towards the bottom of the table, with 'traditional' skills competencies (i.e., workflow, budgeting and costing) ranking higher. Originality: This research constitutes the first attempt to: understand the core interpersonal and technical skills and competencies required of a contemporary construction manager; and premised upon this, generate a construction management education curriculum foundation model. Nascent findings pinpoint the core interpersonal skills and competencies that serve as the curriculum's foundation and expose the inadequacies of digital technical skills in core construction management teaching.

Physical health habits including physical activity and nutrition are essential for numerous health benefits. However, beginning in childhood, individuals with intellectual disability engage in lower levels of physical activity and healthy nutrition habits compared to individuals without intellectual disability, a trend that carries on into adulthood. Researchers continue to examine the effectiveness of interventions to increase engagement in physical health habits and improve health outcomes for individuals with intellectual disability, with an increased focus on technology-based interventions. This scoping review aimed to describe how technology was being utilized within interventions to improve health-related outcomes for adults with intellectual disability. We described the technology being used, who used the technology, and the feasibility of the interventions. Forty-one studies met criteria, with a total of 698 adult participants with an intellectual disability. While no studies on nutrition were located, technology was used in various physical activity interventions, with the most common being preferred stimulus access, exergaming, and video-based instruction. Most studies took place at day or rehabilitation centers, were implemented by research teams, and either did not discuss cost or were vague in their description related to cost. Implications, limitations, and future research directions are discussed.

Public opinions are divided on the relative benefits versus harms of allowing mobile phones in schools. When debating the consequences of mobile phones in schools, politicians often argue that students' use of mobile phones distract from their learning, increase cyberbullying and lead to poor mental health outcomes. We conducted a scoping review of the global literature, followed the Preferred Reporting Items for Systematic reviews and meta-Analyses extension for scoping reviews (PRISMA-ScR) and pre-registered our protocol with the Open Science Framework (OSF). Our search and screening process identified 22 studies that met our inclusion criteria and shed light on our research questions: "whether mobile phone use in schools impacts academic outcomes, mental health and wellbeing and cyberbullying." We found an absence of randomized controlled trials with evidence resting on a small number of studies with different designs, samples, operational definitions of mobile phone bans (i.e. partial, or complete bans) and outcome measures, making reconciliation of findings challenging. Nonetheless, we provide a synthesis of the latest evidence for decision-makers tasked with deciding for or against mobile phone bans in schools. Directions for future research are provided and practical implications for schools are discussed.

The gamification of learning has increased in popularity in recent years as a tool for enhancing student engagement and attainment. In undergraduate chemistry courses, hybridization is a fundamental concept that students need to master in order to understand introductory organic and inorganic topics. This study focused on the development of a card game for use as a revision tool (i.e., a learning resource that can be used by students to engage with a topic they have previously encountered and develop their understanding of the topic in advance of an assessment) based on the topic of hybridization for students taking introductory chemistry courses. The game was designed to both engage students and support their learning. Covering the core concepts of hybridization, including molecular geometry, orbital character, and hybridization states, the speed-based game requires students to answer "question cards" before their opponents by placing down the correct "hybridization card". The game was implemented with chemistry cohorts at the University of Birmingham, United Kingdom, and Xi'an Jiatong-Liverpool University, China. The impact of the game on student learning was evaluated through pre- and postintervention quizzes, as well as a survey based on student impressions of the game play experience. Students responded positively about the game play experiences, and a comparison of quiz scores suggests a positive impact on student understanding of the topic.

Skull anatomy is a difficult region for anatomy students to learn and understand but is necessary for a variety of health professional students. To improve learning, a 3D-printed human skull was developed, produced, and distributed to a course of 83 dental students for use as a take-home study tool over the 10-week anatomy course. The 70% scale human skull derived from CT data had a fully articulating mandible, simulated temporomandibular joint, and accurate cranial structures. At the course end, students completed a perception survey and responses were compared with those who made a grade of A, B, or C in the course. Students overall reported using the model less than 3 h per week, but those who scored an A in the course reported using the model more frequently than those who scored a B or C. Free responses revealed that students used the model in a variety of ways, but found that the model was quick and easily accessible to check understanding while studying at home in the absence of direct observation by faculty. Overall, this study provides evidence on the feasibility of large-scale 3D printing and the benefits of the use of a 3D-printed model as a take-home study aid.

Background: At the onset of the COVID-19 pandemic, schools closed across the United States. Given the impact of virtual learning and lost access to school resources, schools eventually reopened with COVID-19 mitigation protocols in place. This qualitative study sought to understand parental perceptions of school-based COVID-19 mitigation strategies. Methods: Using a phenomenology approach, nine focus groups were completed with 40 parents of children in grades K-8 representing eight Maryland counties. Based on acceptance of masking policies (as indicated on a survey), parents were sorted into 2 groups--lower and higher masking acceptance. A thematic analysis was conducted for each group and themes were compared between the 2 groups. Results: The main themes were related to parents' general sentiments regarding COVID-19, compliance, pandemic-related changes over time, changes in personal opinions, and in-person learning. Both groups described challenges related to inconsistent COVID-19 mitigation policies and practices, the challenges of rapid and frequent changes in guidelines during the pandemic, and the benefits of in-person learning. Conclusions: Parents of elementary and middle school children, regardless of general acceptance of masking policies, shared concerns about implementation and guidance regarding school-based mitigation strategies.

Background: Education is often the primary arena for exploring and integrating new technologies. AI and human-machine communication (HMC) are prevalent in the classroom, yet we are still learning how student perceptions of these tools will impact education. Objectives: We sought to understand student perceptions of credibility related to written feedback attributed to a human or an AI grader (Study One). We also investigated how corrective messages containing verbal immediacy and social support influenced student perceptions of an AI grader's credibility based on feedback in an evaluated essay (Study Two). Methods: We used an online experimental design to assess the perceived credibility of a grader. In Study One, we randomly assigned students (N = 155) to a condition that contained a paragraph they were told was evaluated by a human or an AI grader. In Study Two (N = 222), we investigated ways of increasing perceptions of an AI grader's credibility by writing messages with higher/lower levels of immediacy and social support. Results: In Study One, the students rated both the human and AI grader as credible (yet rated the AI grader lower on goodwill). The data suggest that students in Study Two attributed more goodwill (i.e., caring) to the AI grader when the feedback included more verbal immediacy. Conclusions: Our results highlight the importance of student perceptions and communication styles when integrating technology into education. The two studies imply that students viewed the human and AI graders as competent, caring, and trustworthy, specifically when feedback included more immediacy cues.

Introducción: El descanso médico es una figura legal otorgada para reposar ante una lesión que incapacite, sin necesidad de que el trabajador se vea privado de sus haberes o remuneraciones laborales. Objetivo: Caracterizar los días de descanso médico según el tipo de diagnóstico en los pacientes atendidos en la seguridad social de Trujillo, Perú. Material y Métodos: Estudio transversal analítico de datos secundarios, a partir del uso de la base del otorgamiento por incapacidades temporales laborales se obtuvieron las características de los descansos médicos (medido en días), de 2009-2015 en un hospital de la seguridad social del norte del Perú. Se realizó la caracterización según el tipo de patología y la estadística analítica mediante la regresión lineal. Resultados: De los 145 077 descansos otorgados, el falso trabajo de parto fue la condición más frecuente. Los accidentes comunes, la fractura de maléolo externo, la fractura de radio y el trastorno de discos intervertebrales tuvieron más días de descanso, con un promedio superior en relación con otras incapacidades. La diarrea, la faringitis y la deshidratación generaron menos días de descanso con un promedio menor en comparación con otras patologías. En cuanto al sexo, en general, a los hombres se les otorgó más descansos laborales. Todo esto fue estadísticamente significativo. Conclusiones: Existen diferencias marcadas en la asignación de días de descanso según las características de a quién se le dio, esto debería ser evaluado con estudios que permitan encontrar valores estándar.

A hallmark of fetal alcohol spectrum disorders (FASD) is neurobehavioral deficits that still do not have effective treatment. Here, we present that reduction of Apolipoprotein E (APOE) is critically involved in neurobehavioral deficits in FASD. We show that prenatal alcohol exposure (PAE) changes chromatin accessibility of Apoe locus, and causes reduction of APOE levels in both the brain and peripheral blood in postnatal mice. Of note, postnatal administration of an APOE receptor agonist (APOE-RA) mitigates motor learning deficits and anxiety in those mice. Several molecular and electrophysiological properties essential for learning, which are altered by PAE, are restored by APOE-RA. Our human genome-wide association study further reveals that the interaction of PAE and a single nucleotide polymorphism in the APOE enhancer which chromatin is closed by PAE in mice is associated with lower scores in the delayed matching-to-sample task in children. APOE in the plasma is also reduced in PAE children, and the reduced level is associated with their lower cognitive performance. These findings suggest that controlling the APOE level can serve as an effective treatment for neurobehavioral deficits in FASD.

ABSTRACTJustice-impacted persons may inconsistently access HIV testing. This cross-sectional secondary analysis investigates lifetime HIV testing prevalence among adults with prior histories of incarceration in Southern California, United States, participating in health-focused programming (n = 3 studies). Self-reported demographic and lifetime HIV testing data were collected between 2017-2023; descriptive analyses were conducted. Across the three samples, at least 74% of participants were male; Latino and African American individuals accounted for nearly two-thirds of participants. Lifetime HIV testing ranged from 72.8% to 84.2%. Males were significantly more likely than females to report never being tested in two samples and accounted for >95% of those never tested. No statistically significant differences in testing were observed by race/ethnicity. Single young adults (ages 18-26) were less likely than their partnered peers to report testing. HIV testing is critical for ensuring that individuals access prevention and treatment. HIV testing among justice-impacted adults in this study was higher than in the general population, potentially due to opt-out testing in correctional settings. Nevertheless, these findings underscore the importance of implementing targeted interventions to reduce structural (e.g., health insurance, access to self-testing kits) and social barriers (e.g., HIV stigma) to increase HIV testing among justice-impacted males and single young adults.

BACKGROUND: Pediatric depression is a global concern that has fueled efforts for enhanced detection and treatment engagement. As one example, the US Preventive Services Task Force recommends depression screening for adolescents ages 12-18 years. While many health systems have implemented components of depression screening protocols, there is limited evidence of effective follow-up for pediatric depression. A key barrier is timely team communication and coordination across clinicians and staff within and across service areas for prompt service linkage. However, team effectiveness interventions have been shown to improve team processes and outcomes and can be applied in healthcare settings. METHODS: This project aims to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression screening protocol in a large pediatric healthcare system. The team will be defined as part of the study but is expected to include medical assistants, nurses, physicians, and behavioral health clinicians within and across departments. The implementation strategy will target team mechanisms at the team-level (i.e., intra-organizational alignment and implementation climate) and team member-level (i.e., communication, coordination, psychological safety, and shared cognition). First, the project will use mixed methods to refine the team training strategy to fit the organizational context and workflows. Next, a hybrid type 3 implementation-effectiveness pilot trial will assess the initial effectiveness of the team communication training (implementation strategy) paired with the current universal depression screening protocol (clinical intervention) on implementation outcomes (i.e., feasibility, acceptability, appropriateness, workflow efficiency) and clinical/services outcomes (increased frequency of needed screening and reduced time to service linkage). Finally, the study will assess mechanisms at the team and team member levels that may affect implementation outcomes. DISCUSSION: Team communication training is hypothesized to lead to improved, efficient, and effective decision-making to increase the compliance with depression screening and timely service linkage. Findings are expected to yield better understanding and examples of how to optimize team communication to improve efficiency and effectiveness in the pediatric depression screening-to-treatment cascade. This should also culminate in improved implementation outcomes including patient engagement critical to address the youth mental health crisis. TRIAL REGISTRATION: NCT06527196. Trial Sponsor: University of California San Diego.

Background: In the United States, Black and Latino children with asthma are more likely than White children with asthma to require emergency department visits or hospitalizations because of an asthma exacerbation. Although many cite patient-level socioeconomic status and access to health care as primary drivers of disparities, there is an emerging focus on a major root cause of disparities-systemic racism. Current conceptual models of asthma disparities depict the historical and current effects of systemic racism as the foundation for unequal exposures to social determinants of health, environmental exposures, epigenetic factors, and differential healthcare access and quality. These ultimately lead to biologic changes over the life course resulting in asthma morbidity and mortality. Methods: At the 2022 American Thoracic Society International Conference, a diverse panel of experts was assembled to identify gaps and opportunities to address systemic racism in childhood asthma research. Panelists found that to examine and address the impacts of systemic racism on children with asthma, researchers and medical systems that support biomedical research will need to 1) address the current gaps in our understanding of how to conceptualize and characterize the impacts of systemic racism on child health, 2) design research studies that leverage diverse disciplines and engage the communities affected by systemic racism in identifying and designing studies to evaluate interventions that address the racialized system that contributes to disparities in asthma health outcomes, and 3) address funding mechanisms and institutional research practices that will be needed to promote antiracism practices in research and its dissemination. Results: A thorough literature review and expert opinion discussion demonstrated that there are few studies in childhood asthma that identify systemic racism as a root cause of many of the disparities seen in children with asthma. Community engagement and participation in research studies is essential to design interventions to address the racialized system in which patients and families live. Dissemination and implementation studies with an equity lens will provide the multilevel evaluations required to understand the impacts of interventions to address systemic racism and the downstream impacts. To address the impacts of systemic racism and childhood asthma, there needs to be increased training for research teams, funding for studies addressing research that evaluates the impacts of racism, funding for diverse and multidisciplinary research teams including community members, and institutional and financial support of advocating for policy changes based on study findings. Conclusions: Innovative study design, new tools to identify the impacts of systemic racism, community engagement, and improved infrastructure and funding are all needed to support research that will address impacts of systemic racism on childhood asthma outcomes.

By age 40 years, over 90% of adults with Down syndrome have Alzheimer's disease pathology and most progress to dementia. Despite having few systemic vascular risk factors, individuals with Down syndrome have elevated cerebrovascular disease markers that track with the clinical progression of Alzheimer's disease, suggesting a role of cerebrovascular disease that is hypothesized to be mediated by inflammatory factors. This study examined the pathways through which small vessel cerebrovascular disease contributes to Alzheimer's disease-related pathophysiology and neurodegeneration in adults with Down syndrome. One hundred eighty-five participants from the Alzheimer's Biomarkers Consortium-Down Syndrome [mean (SD) age = 45.2 (9.3) years] with available MRI and plasma biomarker data were included in this study. White matter hyperintensity (WMH) volumes were derived from T2-weighted fluid-attenuated inversion recovery MRI scans, and plasma biomarker concentrations of amyloid beta 42/40, phosphorylated tau 217, astrocytosis (glial fibrillary acidic protein) and neurodegeneration (neurofilament light chain) were measured with ultrasensitive immunoassays. We examined the bivariate relationships of WMH, amyloid beta 42/40, phosphorylated tau 217 and glial fibrillary acidic protein with age-residualized neurofilament light chain across Alzheimer's disease diagnostic groups. A series of mediation and path analyses examined statistical pathways linking WMH and Alzheimer's disease pathophysiology to promote neurodegeneration in the total sample and groups stratified by clinical diagnosis. There was a direct and indirect bidirectional effect through the glial fibrillary acidic protein of WMH on phosphorylated tau 217 concentration, which was associated with neurofilament light chain concentration in the entire sample. Amongst cognitively stable participants, WMH was directly and indirectly, through glial fibrillary acidic protein, associated with phosphorylated tau 217 concentration, and in those with mild cognitive impairment, there was a direct effect of WMH on phosphorylated tau 217 and neurofilament light chain concentrations. There were no associations of WMH with biomarker concentrations among those diagnosed with dementia. The findings from this cross-sectional study suggest that among individuals with Down syndrome, cerebrovascular disease promotes neurodegeneration by increasing astrocytosis and tau pathophysiology in the presymptomatic phases of Alzheimer's disease, but future studies will need to confirm these associations with longitudinal data. This work joins an emerging literature that implicates cerebrovascular disease and its interface with neuroinflammation as a core pathological feature of Alzheimer's disease in adults with Down syndrome.

Exposure to toxic heavy metals has been associated with the development of attention-deficit/hyperactivity disorder (ADHD). However, fewer studies have examined the associations between abnormal levels of essential trace metals and ADHD, and none have done so using saliva. We investigated whether salivary metals were associated with ADHD in adolescents aged 12 from the Family Life Project (FLP) using a nested case-control study design that included 110 adolescents who met diagnostic criteria for inattentive (ADHD-I), hyperactive-impulsive (ADHD-H), or combined type ADHD (ADHD-C) (cases) and 173 children who did not (controls). We used inductively coupled plasma optical emission spectrophotometry to measure chromium, copper, manganese, and zinc in saliva samples. We employed logistic regression models to examine associations between quartile levels of individual metals and ADHD outcomes by subtype. Salivary copper levels were significantly associated with increased odds of any ADHD diagnosis (OR = 3.31, 95% CI: 1.08-10.12; p = 0.04) and with increased odds of ADHD-C diagnosis (OR = 8.44, 95% CI: 1.58-45.12; p = 0.01). Salivary zinc levels were significantly associated with increased odds of ADHD-C diagnosis (OR = 4.06, 95% CI: 1.21-13.69; p = 0.02). Salivary manganese levels were also significantly associated with increased odds of ADHD-C diagnosis (OR = 5.43, 95% CI: 1.08-27.27, p = 0.04). This is the first study using saliva to assess metal exposure and provide a potential link between salivary levels of copper, manganese, and zinc and ADHD diagnoses in adolescents. Public health interventions focused on metal exposures might reduce ADHD incidence in low-income, minority communities.

Optical illumination of quantum dot qubit devices at cryogenic temperatures, while not well studied, is often used to recover operating conditions after undesired shocking events or charge injection. Here, we demonstrate systematic threshold-voltage shifts in a dopant-free Si/Si0.7Ge0.3 field-effect transistor using a near-infrared (780-nm) laser diode. We find that illumination under an applied gate voltage can be used to set a specific, stable, and reproducible threshold voltage that, over a wide range in gate bias, is equal to that gate bias. Outside this range, the threshold voltage can still be tuned, although the resulting threshold voltage is no longer equal to the applied gate bias during illumination. We present a simple and intuitive model that provides a mechanism for the tunability in the gate bias. The model presented also explains why cryogenic illumination is successful at resetting quantum dot qubit devices after undesired charging events.

Laura Bartels-Peculis,1 Ajay Sharma,2 Alison M Edwards,2 Anirudh Sanyal,2 Erin Connolly-Strong,1 Winnie W Nelson1 1Mallinckrodt Pharmaceuticals, Inc., Bedminster, NJ, USA; 2Healthagen LLC, New York, NY 10017, USACorrespondence: Laura Bartels-Peculis Email laura.bartels@mnk.comObjective: To describe the characteristics, treatment patterns, health care resource utilization (HCRU), and cost of care for members of a large United States (US) health insurance plan with lupus nephritis (LN).Methods: A retrospective observational study was conducted using a health insurance plan database to identify adult members with a diagnosis of LN. Medical and pharmacy claims were used to describe demographics, comorbidities, HCRU, and cost patterns over a 12-month follow-up period for each patient, between January 1, 2014, and December 31, 2016. All study variables were examined descriptively.Results: A total of 1039 patients were available for analysis (median age, 47 years; 83% female). The median Charlson Comorbidity Index (CCI) was 3.3. Less than half (41%) of patients received immunosuppressive therapies commonly used to treat LN. Evidence indicated that 58% of the study population were prescribed corticosteroid therapy, in most cases (73%) for more than 60 days. Adverse events known to be associated with corticosteroid therapy were recorded in 58% of patients. Guideline-recommended preventive therapy with hydroxychloroquine was prescribed for 54% of members with LN. Nearly half (47%) of members with LN did not see a nephrologist and more than one-third (36%) did not see a rheumatologist over 1 year of follow-up. Rates of all-cause hospitalization and emergency department (ED) use were 25% and 35%, respectively. The mean all-cause per-member-per-month (PMPM) medical cost for the study population was $2801, with LN-specific costs accounting for $1147 PMPM.Conclusion: Patients with LN who are insured through a large US health plan appeared to underutilize outpatient specialist services and guideline-recommended hydroxychloroquine therapy. Corticosteroid use and adverse events known to be associated with corticosteroids were common in this cohort.Keywords: lupus nephritis, provider visits, health care resource utilization, health care costs, real-world evidence

Introducción: La enfermedad cardiovascular (infarto de miocardio, muerte cardíaca y accidente cerebrovascular fatal o no fatal) es la principal causa de muerte prematura y de discapacidad en el mundo. Es responsable de más de 17 millones de muertes anuales y afecta principalmente a la población que se ubica en los países de ingresos bajos y medios. Se estima que el 80% de la carga mundial se produce en estos países. Objetivo: Establecer la prevalencia de obesidad y riesgo cardiovascular mediante los criterios de Framingham en una población de trabajadores de la industria de producción de hidrocarburos. Método: Se desarrolló un estudio observacional descriptivo, epidemiológico, en el que se tuvo en cuenta la población de los trabajadores de la empresa Montajes JM, Cerritos CPE6, Proyecto 176, en el departamento del Meta (Puerto Gaitán). Se representaron las variables en promedio, intervalos de confianza y desviación estándar, procediendo a desarrollar un análisis por sexo para cada uno de los factores de riesgo. Resultados: En la población del programa de riesgo cardiovascular se encontró un promedio de edad de 38.11 años y un índice de masa corporal de 26.00 m2/kg. El 7.58% presentó hipertensión arterial, el 1.08% diabetes mellitus y el 24.91% tabaquismo. El riesgo cardiovascular calculado con la escala de Framingham fue del 4.48%. El índice de masa corporal, la edad y la presión arterial sistólica no son estadísticamente significativos para la valoración del riesgo con la escala Framingham. Conclusiones: La prevalencia de obesidad fue del 64.9%, en tanto que el 75% de las personas que trabajan en hidrocarburos tenían riesgo leve de enfermedad cardiovascular.

12/15-lipoxygenase (12/15-LOX) plays an essential role in oxidative conversion of polyunsaturated fatty acids into various bioactive lipid molecules. Although 12/15-LOX's role in the pathophysiology of various human diseases has been well studied, its role in weight gain is controversial and poorly clarified. Here, we demonstrated the role of 12/15-LOX in high-fat diet (HFD)-induced weight gain in a mouse model. We found that 12/15-LOX mediates HFD-induced de novo lipogenesis (DNL), triglyceride (TG) biosynthesis and the transport of TGs from the liver to adipose tissue leading to white adipose tissue (WAT) expansion and weight gain via xanthine oxidase (XO)-dependent production of H2O2. 12/15-LOX deficiency leads to cullin2-mediated ubiquitination and degradation of XO, thereby suppressing H2O2 production, DNL and TG biosynthesis resulting in reduced WAT expansion and weight gain. These findings infer that manipulation of 12/15-LOX metabolism may manifest a potential therapeutic target for weight gain and obesity.

During the COVID-19 pandemic, virtual observations were utilised in teacher education programmes internationally (Murtagh, 2022; Mynott et al., 2022; Ó Grádaigh et al., 2021). In Scotland, virtual observations have been continued as part of teacher education programmes and this article explores student perspectives on their continued use. A situative analysis (Clarke et al., 2018) was used to explore questionnaire and interview data from student teachers. The analytical process examined the data and utilised memoing to consider emergent themes against the situation of virtual observations in teacher education. There is a duality to the findings. On the one hand, students express preference for in-person observation when they consider the process to be assessment-focused. Conversely, when not considering virtual observations as assessment, the ability to reflect more deeply on their practice, increase their control and agency over the observation and reduce the stress surrounding observations are all themes that emerged from the data. Therefore, the data suggests that further innovation moving from summative to formative observations might increase the benefits of virtual observations. Limited research exists on virtual observations. The literature that is available often focuses on university staff. This article considers virtual observations from the student perspective and provides clear feedback on how a pandemic response has been developed for post-pandemic purposes. The findings of this article can be further explored and built upon, and this will enhance the use of virtual observations within teacher education.

How can elementary students use Google Slides to enhance their math problem-solving skills and creativity? Usable Math offers slideshows that pose a problem, provide hints, and ultimately reveal a solution. The intent of these slideshows is to provide extended opportunities to understand and practice mathematics skills. In this fourth-grade classroom, slideshow making became a way for students to learn mathematics problem solving by designing mathematics problems to solve.

The World Bank has been called the most influential organization in education reform globally. Not only is it the single largest funder of education for international development, but it also produces knowledge, circulates discourse, and structures policymaking processes in ways that extend its influence far beyond its primary role as a bank. However, while much literature has been produced about the World Bank, the field of education lacks a systematic discussion of what has been reported about how the World Bank influences policy formation at the country level. Through the conduct of a theoretically informed systematic literature review of 70 publications, this article clarifies and provides examples for the numerous ways that the World Bank influences policy formation. In all, the article documents 11 pathways through which the World Bank influences policymaking. The article concludes by suggesting areas where research on the World Bank can be improved, namely, through more explicit attention to the theoretical and methodological approaches employed. The goal of this review is to encourage scholars to be more specific in their conceptualizations and discussions of World Bank influence, to go beyond general claims of policy imposition or agenda shaping.

A student's socioeconomic status (SES) has a significant relation to their academic achievement. Much of this work has explored this in math and reading, but less is known about how SES relates to science achievement, particularly in the early grades. Using quantile regression with nationally representative data, we explored this relation in 12,676 kindergarten students (51.2% boys, 52.2% White, 21.8% Hispanic, 12.7% Black and 6.6% Asian) and 10,339 fifth-grade students (51.3% boys, 49.4 White, 27.2% Hispanic, 9.4% Black and 8.2% Asian). We found less variability in science achievement scores for those high on SES than those low on SES. The scores of the high SES students cluster together on the high end of science achievement, whilst those from low SES score across the distribution. These findings highlight the need to explore what can mitigate the relation between SES and science achievement and where resources to support science achievement are most needed.

Purpose: We investigated and compared the outcomes from two standardized, norm-referenced screening assessments of language (i.e., Clinical Evaluation of Language Fundamentals Preschool--Second Edition [CELFP-2], Diagnostic Evaluation of Language Variation--Screening Test [DELV-ST]) with African American preschoolers whose spoken dialect differed from that of General American English (GAE). We (a) described preschoolers' performance on the CELFP-2 Core Language Index (CLI) and its subtests with consideration of degree of dialect variation (DVAR) observed, (b) investigated how the application of dialect-sensitive scoring modifications to the expressive morphology and syntax Word Structure (WS) subtest affected CELFP-2 CLI scores, and (c) evaluated the screening classification agreement rates between the DELV-ST and the CELFP-2 CLI. Method: African American preschoolers (N = 284) completed the CELFP-2 CLI subtests (i.e., Sentence Structure, WS, Expressive Vocabulary) and the DELV-ST. Density of spoken dialect use was estimated with the DELV-ST Part I Language Variation Status, and percentage of DVAR was calculated. The CELFP-2 WS subtest was scored with and without dialect-sensitive scoring modifications. Results: Planned comparisons of CELFP-2 CLI performance indicated statistically significant differences in performance based on DELV-ST--determined degree of language variation groupings. Scoring modifications applied to the WS subtest increased subtest scaled scores and CLI composite standard scores. However, preschoolers who demonstrated strong variation from GAE continued to demonstrate significantly lower performance than preschoolers who demonstrated little to no language variation. Affected-status agreement rates between assessments (modified and unmodified CELFP-2 CLI scores and DELV-ST Part II Diagnostic Risk Status) were extremely low. Conclusions: The application of dialect-specific scoring modifications to standardized, norm-referenced assessments of language must be simultaneously viewed through the lenses of equity, practicality, and psychometry. The results of our multistage study reiterate the need for reliable methods of identifying risk for developmental language disorder within children who speak American English dialects other than GAE.

Despite decades of sociolinguistic research, African American Language (AAL) remains stigmatized throughout the United States education system. There have been proposals to counteract this through curricula and/or ideological interventions targeted at teachers that seek to validate AAL while maintaining Dominant American English (DAE) as an educational target. However, such approaches have been criticized for giving limited attention to combating the racism that underlies much linguistic marginalization. We used a mixed-methods approach to explore the benefits and limitations of a dialect-shifting curriculum in shaping teachers' language ideologies. Participants (n = 40) were K-1 teachers in a predominantly Black mid-Atlantic city. They were participating in an efficacy study of a dialect-shifting curriculum; schools were randomly assigned to teach the curriculum (intervention condition) or continue with business as usual. Before and after the intervention, teachers completed a survey of their language attitudes, and a subset (n = 16) participated in semi-structured interviews. On the survey, teachers displayed more favorable attitudes toward language variation at the end of the school year, regardless of condition. The interviews revealed a range of perspectives, revealing a tension between a belief in the utility of DAE for their students and an understanding that many students will wish to use AAL in their communities. The curriculum provided shared vocabulary to discuss this tension and increased some teachers' acceptance of AAL in non-academic settings, but many did not view dialect variation as relevant to their priorities as K-1 teachers. These findings clarify the trade-offs involved in work toward a more (linguistically) inclusive education system.

The need to make evidence and implications of educational research widely available has prompted a burgeoning interest in knowledge mobilisation, which is a set of strategies supporting the active and intentional dissemination of research knowledge. For this, it is important to consider who might be the intended audience and end-users of this knowledge, as this impacts decisions throughout the research process. Researcher-teacher collaborations are effective contexts for knowledge-building and sharing, where both partners have different but equally valuable roles and contributions to make to the conduct, analysis and dissemination of research. This paper illustrates the value and uses of teacher-composed written and video cases of colleague coaching. The cases were generated as part of the Zooming project, a seven-school, 3-year research-practice partnership focused on developing teachers' data literacy and capacity to coach colleagues in this. To craft the cases, the teachers reflected on their coaching practices and relationships and identified what would be most useful for new coaches to know. The cases proved to be engaging tools for research dissemination, especially to a professional audience. In addition, the case writing challenged teachers to reflect on and analyse their coaching actions and the assumptions they brought to collegial coaching. The cases as data also provided researchers with a deeper level of insights into what teachers viewed as salient when coaching colleagues in data use. Teacher case composition offers a useful approach to knowledge co-production and a pathway to research dissemination by and for teachers and researchers.

Students minoritised because of their race and/or ethnicity have a different university experience from their peers, which is reflected in degree completion statistics, awarding gaps, and graduate outcomes. One factor influencing these outcomes is students' sense of inclusion and belonging with the university, which is lower in minoritised students. We aimed to identify whether barriers to inclusion were present across students and alumni in one university, and whether this varied according to ethnic and/or racial backgrounds. Three-hundred and twenty-three students and alumni completed an online questionnaire measuring students' belonging, experience of the curriculum and microaggressions, and 14 students and alumni attended focus groups to further explore the barriers to inclusion and belonging, and proposed recommended actions to reduce these barriers. From the questionnaire, ethnicity and/or race did not influence students' sense of belonging, experience of the curriculum or microaggressions, though having a long-term health condition was consistently associated with these outcomes. However, students' culture and ethnicity/race were consistently reported as factors associated with experiencing obstacles in academia and microaggressions. From the focus groups, three key themes emerged: 1) Hidden racism at the university, which included a prevailing nature of microaggressions and 2) Eurocentric curriculum; that representation is valued in the community and curriculum; and 3) The role of diversity and inclusion initiatives for building community. These findings are discussed in terms of their impact for Higher Education institutions.

As mental health concerns coupled with inadequate supports have been described as reaching crisis proportions in autistic people, there is a pressing need for accessible and effective support systems. While self-compassion has shown various benefits in the general population, its application in supporting autistic individuals remains limited. This study investigated the experiences of 39 autistic adults who participated in an autism-specific online self-compassion program. The program included a series of five modules which incorporated psychoeducation, meditation, and self-reflective exercises that were completed over a 5-week period. Qualitative data was collected through weekly check-ins and a post-program survey, which underwent thematic analysis through the lens of an autistic researcher resulting in four key themes: the positive impact of self-compassion, challenges faced during the program, recognizing self-compassion as a journey, and the value of program adaptations. These findings shed light on the experiences of autistic adults engaging with self-compassion interventions, highlighting both the benefits and barriers they encountered. The study underscores the importance of developing tailored interventions that consider the unique needs and perspectives of autistic individuals to promote improved mental health outcomes and foster inclusivity.

Playgroups are a unique form of early childhood provision involving parents and their children attending together. Parents' attendance at playgroups provides opportunities for involvement in play. However, little is known about parents' practices of co-play in playgroups and the potential for these practices to enhance children's play experiences in early childhood. Drawing on practice architectures theory, this paper identifies parents' practices of co-play in a community playgroup, and the enablers and constraints on those practices. Data were collected through ethnographic methods, which included participant observation and informal individual interviews. The findings show that parents' practices of co-play consider the child's needs and interests in ways that support development and enhance children's play in the community playgroup. This research contributes new knowledge about the range of co-play practices engaged in by parents with children in community playgroups.

Despite well-documented benefits for students--particularly students belonging to minorized groups--all tenets of Culturally Relevant Pedagogy (CRP) are rarely fully enacted in practice. This study examines the interrelationship between the race-related beliefs of Servant Leader Interns (SLIs) who facilitated class sessions during a summer, Children's Defense Fund (CDF) Freedom School program and their subsequent instructional practices. We also documented the relationship between these beliefs, practices, and students' self-reported exeriences. In particular, we drew on the interest convergence and understanding of racism tenets of Critical Race Theory (CRT) to inform our grounded theory analysis using constant comparative methods to integrate data collected through SLI interviews, virtual classroom observations, and student surveys. We observed high alignment between SLI's race-related beliefs and their instructional practices. However, despite some slightly more positive experiences among students taught by SLIs with more evolved race-related beliefs, ultimately many of the same programmatic structures that helped SLIs deepen their understanding of racism (and its connection to their lives) ensured that all students benefited from the enactment of CRP-aligned curriculum, assignments, and family involvement activities.

A plethora of services in early childhood care and education has not sufficiently resulted in equitable practice for families and, specifically, families of Color across the globe. Despite numerous programs geared toward alleviating literacy challenges, families of Color worldwide continue to experience Eurocentric approaches to addressing the literacies of their children, as well as the practices they hold dear. This insistence on programming that is focused on family literacy and not "family literacies" has created a context where the playing field remains unlevel, and all students are not provided with equal opportunities. Moreover, even with largely sanctioned programming, the potentiality of the multiple literacies of families of Color has been left untapped and thus obscured, making it impossible to identify the meaningful contributions that such families can provide to the field. The authors argue in this article that this obscured potentiality, engendered through centuries of assumptions made about the supposed 'illiteracy' of families of Color, and inadvertently reinforced by the silencing of parents and families of Color in drawing from the imagination of their children and on the extant narratives of their daily lives, continues to be maintained through Eurocentric mechanisms that tout a false notion of what young children of Color can and cannot do. In response, parent-of-Color stories is presented as a mechanism for recognizing and restoring the potentiality of families of Color worldwide.

Kate J Lifford,1 Adrian Edwards,1 Maria Burton,2 Helena Harder,3 Fiona Armitage,4 Jenna L Morgan,4 Lisa Caldon,5 Kirsty Balachandran,6 Alistair Ring,7 Karen Collins,2 Malcolm Reed,8 Lynda Wyld,4 Kate Brain1 1Division of Population Medicine, Cardiff University, Cardiff, UK; 2Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK; 3Sussex Health Outcomes Research and Education in Cancer, Brighton and Sussex Medical School, University of Sussex, Brighton, UK; 4Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK; 5Department of General Surgery, The Rotherham NHS Foundation Trust, Rotherham, UK; 6Department of Medical Oncology, Imperial College London, London, UK; 7Breast Unit, Royal Marsden Hospital NHS Foundation Trust, Sutton, UK; 8Brighton and Sussex Medical School, Brighton, UK Background: Around one-third of breast cancers diagnosed every year in the UK are in women aged ≥70 years. However, there are currently no decision support interventions (DESIs) for older women who have a choice between primary endocrine therapy and surgery followed by adjuvant endocrine therapy (surgery+endocrine therapy), or who can choose whether or not to have chemotherapy following surgery. There is also little evidence-based guidance specifically on the management of these older patients. A large UK cohort study is currently underway to address this lack of evidence and to develop two DESIs to facilitate shared decision-making with older women about breast cancer treatments. Here, we present the development and initial testing of these two DESIs. Methods: An initial prototype DESI was developed for the choice of primary endocrine therapy or surgery+endocrine therapy. Semi-structured interviews with healthy volunteers and patients explored DESI acceptability, usability, and utility. A framework approach was used for analysis. A second DESI for the choice of having chemotherapy or not was subsequently developed based on more focused development and testing. Results: Participants (n=22, aged 75–94 years, 64% healthy volunteers, 36% patients) found the primary endocrine therapy / surgery+endocrine therapy DESI acceptable, and contributed to improved wording and illustrations to address misunderstandings. The chemotherapy DESI (tested with 14 participants, aged 70–87 years, 57% healthy volunteers, 43% patients) was mostly understandable, however, suggestions for rewording sections were made. Most participants considered the DESIs helpful, but highlighted the importance of complementary discussions with clinicians. Conclusion: It was possible to use a template DESI to efficiently create a second prototype for a different treatment option (chemotherapy). Both DESIs were acceptable and considered helpful to support/augment consultations. Development of acceptable additional DESIs for similar target populations using simplified methods may be an efficient way to develop future DESIs. Further research is needed to test the effectiveness of the DESIs. Keywords: patient decision aids, decision support, shared decision-making, breast cancer, older patients