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Abstract This paper examines the ethical considerations surrounding intellectual freedom and social responsibility in public libraries (i.e., municipal and public school libraries) in the post-truth era. While libraries serve a crucial role in fostering an informed democracy, recent events have put public libraries, and front-line librarians themselves, in the “hot seat.” This paper examines the implications of recent campaigns for book bans, considerations around public libraries purchasing harmful and anti-science information, as well as political efforts to restrict the types of information public librarians are able to share with the public. Public librarians are professionally trained to value the role libraries serve as an information institution in a democracy; however, we argue that the contemporary ethical dilemmas public librarians face inflicts moral injury and may actively harm the identity central to public librarians’ motivation to serve their communities. The paper concludes with a sobering discussion of how these ethical dilemmas in public libraries might serve as a cautionary tale for bureaucrats working on the front-lines of public service in the post-truth era. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine if self-stigma-related variables predicted communicative participation and mental health in adults who stutter. A progressive model of self-stigma was theorized and tested. Method: Adults who stutter (N = 344) completed a survey that included measures of communicative participation, global mental health, and a variety of self-stigma-related variables including perceived enacted stigma, stigma awareness, anticipated stigma, felt stigma, stereotype agreement, and stigma application, in addition to demographic and speech-related variables. Hierarchical regression was performed to test whether self-stigma-related variables progressively explained significant variance in both communicative participation and global mental health.c Results: After controlling for demographic and speech-related variables, stigma-related variables were found to be significant predictors of both communicative participation and global mental health among adults who stutter. Most self-stigma-related variables entered later in the model predicted additional unique variance in the outcome variables than the self-stigma-related variables entered in previous steps, thus supporting the trickle-down and progressive nature of the self-stigma model theorized. Conclusions: Accounting for self-stigma in the assessment and treatment of individuals who stutter may identify and ultimately reduce environmental and personal barriers to communicative functioning and well-being in people who stutter. The self-stigma terminology and model described in this study will help practitioners, researchers, and the public better understand the process of selfstigma and how it may be associated with adverse outcomes experienced by people who stutter. [ABSTRACT FROM AUTHOR]

Background: The standard approach for classifying child/youth psychiatric disorder as present or absent in epidemiological studies is lay‐administered structured, standardized diagnostic interviews (interviews) based on categorical taxonomies such as the DSM and ICD. Converting problem checklist scale scores (checklists) to binary classifications provides a simple, inexpensive alternative. Methods: Using assessments obtained from 737 parents, we determine if child/youth behavioral, attentional, and emotional disorder classifications based on checklists are equivalent psychometrically to interview classifications. We test this hypothesis by (1) comparing their test–retest reliabilities based on kappa (κ), (2) estimating their observed agreement at times 1 and 2, and (3) in structural equation models, comparing their strength of association with clinical status and reported use of prescription medication to treat disorder. A confidence interval approach is used to determine if parameter differences lie within the smallest effect size of interest set at ±0.125. Results: The test–retest reliabilities (κ) for interviews compared with checklists met criteria for statistical equivalence: behavioral,.67 and.70; attentional,.64 and.66; and emotional,.61 and.65. Observed agreement between the checklist and interviews on classifications of disorder at times 1 and 2 was, on average, κ =.61. On average, the β coefficients estimating associations with clinical status were.59 (interviews) and.63 (checklists); and with prescription medication use,.69 (interviews) and.71 (checklists). Behavioral and attentional disorders met criteria for statistical equivalence. Emotional disorder did not, although the coefficients were stronger numerically for the checklist. Conclusions: Classifications of child/youth psychiatric disorder from parent‐reported checklists and interviews are equivalent psychometrically. The practical advantages of checklists over interviews for classifying disorder (lower administration cost and respondent burden) are enhanced by their ability to measure disorder dimensionally. Checklists provide an option to interviews in epidemiological studies of common child/youth psychiatric disorders. [ABSTRACT FROM AUTHOR]

Purpose: Speech-language pathologists are influential in shaping identity development for individuals who stutter, particularly as it relates to communication. This study investigated the experiences of lesbian, gay, and bisexual individuals who stutter to learn more about how multiple marginalized identities affect their psychosocial experiences. Method: Semi-structured interviews were conducted with seven individuals who stutter with lesbian, gay, and bisexual identities. Participants ranged in age from 22 to 60 years. Data were analyzed for themes and categories by using interpretive phenomenological analysis. Results: Four primary themes were identified: (a) the importance of visibility and shared social identity connections for affirmation; (b) effects of oppressive social expectations on identity; (c) intersectionality of stuttering, gay, lesbian, and bisexual identities; and (d) effects of not being affirmed for identity. Discussion: Results are discussed in the context of identity affirmation and intersectionality. Through an understanding of identity formation and psychosocial experiences of lesbian, gay, and bisexual individuals who stutter, speechlanguage pathologists can use identity-affirmative practices to support individuals who stutter and mitigate stigmatizing experiences. Implications focus on suggestions for the provision of identity-affirming speech-language pathology practices for students who stutter. [ABSTRACT FROM AUTHOR]

A pair of anti-segregation marches held in Georgia in 1987 provides an opportunity for historical analysis of the role of race in mainstream news coverage of social protest. These protests were somewhat unique in that both anti-segregation marchers and counter-protesters – including KKK members – were on hand for both marches. Analysis of newspaper articles shows that coverage tended to give more space to White counter-protesters than Black protesters, did little to discuss the reasons behind the marches, and cast the primarily Black anti-segregation marchers as outsiders. This reinforces central themes of the protest paradigm – whereby groups that threaten the status quo are treated more critically. Perhaps most importantly, the findings also reinforce patterns of research demonstrating a disparity in news treatment between Black protesters and White counter-protesters. [ABSTRACT FROM AUTHOR]

Under what circumstances do armed groups in conflict choose to use terrorist bombings? This article challenges the conventional wisdom that terrorist bombings are done by either ideologically-driven or weak armed groups who have no reasonable prospect of success on the battlefield. Drawing from Mao's theory of protracted struggle, it argues that terrorist bombings are a weapon of choice for armed groups that have transitioned into capable fighting armies but lack the degree of popular support they need to be a serious political contender. Using data on attributed terrorist bombings from 1998–2005, it finds that Islamist groups and older armed groups with sizeable membership are more likely to use terrorist bombings than smaller or newer groups. [ABSTRACT FROM AUTHOR]

This study aimed to identify what types of major discrimination have been experienced by adults who stutter throughout their lives, and investigate the association between the number of different types of major discrimination events experienced and quality of life. Measures of quality of life (Kemp Quality of Life Scale) and major discrimination (adapted Major Experiences of Discrimination Scale) were completed by 303 adults who stutter. Correlational and regression analyses were conducted with these variables. A majority (56%) of the participants had experienced at least one episode of major discrimination due to stuttering during their lives. The major discrimination experiences most commonly reported included not being hired for a job and being discouraged by a teacher or advisor from pursuing certain careers or jobs because of stuttering. There was a significant negative relationship between quality of life and major discrimination. Increased major discrimination predicted lower quality of life even after taking into account demographic variables and severity of physical speech disruption. The findings of a negative association between major discrimination and quality of life add support to the notion that reducing societal stigma related to stuttering should be a priority of the field. Discriminatory practices of listeners constitute a social-environmental barrier to communicative participation and quality of life in people who stutter and should be addressed by professionals in the field of speech-language pathology and other stakeholders. • Adults who stutter reported what kinds of major discrimination they have experienced in their lives due to stuttering. • Over half of the sample reported experiencing at least one instance of major discrimination due to stuttering. • Increased experiences of major discrimination were significantly correlated with reduced self-reported quality of life. [ABSTRACT FROM AUTHOR]

How should the United States recalibrate its counterterrorism policy for an era of great power competition? With the end of unipolarity, the United States cannot fight terrorists and compete with Russia and China with equal energy, but must instead make hard choices about its priorities and resources. Among those hard choices are what to do with the web of counterterrorism partnerships with other governments that have formed in the post- 9/11 era. This article proposes three broad principles—linkages, license, and legitimacy—that the United States can use to evaluate its policy and these partnerships, with the aim of recasting U.S. counterterrorism policy for an era of great power competition. [ABSTRACT FROM AUTHOR]

Objective: Child and youth mental health problems are often assessed by parent self-completed checklists that produce dimensional scale scores. When converted to binary ratings of disorder, little is known about their psychometric properties in relation to classifications based on lay-administered structured diagnostic interviews. In addition to estimating agreement, our objective is to test for statistical equivalence in the test-retest reliability and construct validity of two instruments used to classify child emotional, behavioural, and attentional disorders: the 25-item, parent completed Ontario Child Health Study Emotional Behavioural Scales-Brief Version (OCHS-EBS-B) and the Mini International Neuropsychiatric Interview for Children and Adolescents-parent version (MINI-KID-P). Methods: This study draws on independent samples (n = 452) and uses the confidence interval approach to test for statistical equivalence. Reliability is based on kappa (κ). Construct validity is based on standardized beta coefficients (β) estimated in structural equation models. Results: The average differences between the MINI-KID-P and OCHS-EBS-B in κ and β were −0.022 and −0.020, respectively. However, in both instances, criteria for statistical equivalence were met in only 5 of 12 comparisons. Based on κ, between-instrument agreement on the classifications of disorder went from 0.481 (attentional disorder) to 0.721 (emotional disorder) but were substantially higher (0.731 to 0.895, respectively) when corrected for attenuation due to measurement error. Conclusions: Although falling short of equivalence, the results suggest on balance that the reliability and validity of the two instruments for classifying child psychiatric disorder assessed by parents are highly comparable. This conclusion is supported by the high levels of agreement between the instruments after correcting for attenuation due to measurement error. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the role of uncertainty and perceived control in predicting the communicative participation and mental health of adults who stutter. Method: Two hundred sixty-nine adults who stutter completed measures of uncertainty about stuttering, perceived control of stuttering, communicative participation, and global mental health. In addition, participants self-reported on a variety of demographic and speech-related measures. Correlational analyses and hierarchical regression were performed to determine associations between variables of interest. Results: Uncertainty accounted for significant variance in communicative participation and global mental health after statistically controlling for the effects of demographic and speech-related variables. Perceived control accounted for significant variance in communicative participation over and above what was accounted for by demographic variables, speech-related variables, and uncertainty. Conclusions: The findings suggest that uncertainty about stuttering and perceived control of stuttering should be accounted for during assessment and intervention with adults who stutter. Interventions that specifically target uncertainty and perceived control may be useful in improving therapeutic outcomes for individuals who stutter. [ABSTRACT FROM AUTHOR]

Understanding how community assembly processes drive biodiversity patterns is a central goal of community ecology. While it is generally accepted that ecological communities are assembled by both stochastic and deterministic processes, quantifying their relative importance remains challenging. Few studies have investigated how the relative importance of stochastic and deterministic community assembly processes vary among taxa and along gradients of habitat degradation. Using data on 1645 arthropod species across seven taxonomic groups in Malaysian Borneo, we quantified the importance of ecological stochasticity and of a suite of community assembly processes across a gradient of logging intensity. The relationship between logging and community assembly varied depending on the specific combination of taxa and stochasticity metric used, but, in general, the processes that govern invertebrate community assembly were remarkably robust to changes in land use intensity. [ABSTRACT FROM AUTHOR]

Introduction: Self‐completed checklists measuring youth mental health problems produce dimensional scale scores and can be converted to categorical classifications representing the presence/absence of psychopathology. We test whether categorical classifications from scale scores are equivalent psychometrically to categorical classifications of the same problems obtained by lay‐administered standardized structured diagnostic interviews. Methods: The sample of n = 325 youth aged 12–18 (44% male) and their parent/caregivers come from combined test–retest reliability studies conducted in Ontario, Canada, from 2011 to 2015. Ontario Child Health Study Emotional Behavioural Scales‐Brief Version (OCHS‐EBS‐B) scores converted to categorical classifications of emotional and behavioral problems were compared with interview classifications. We test hypotheses of statistical equivalence and inferiority, using a confidence interval approach to detect if differences lie within the smallest effect size of interest of ±0.18. We compare categorical classifications on: (1) test–retest reliability (ҡ), (2) content validity (between‐instrument agreement), and (3) construct validity (strength of association with three mental health‐related constructs). Results: Average test–retest reliabilities were 0.695 (checklists) and 0.670 (interviews). The reliability of checklist emotional problem classifications was not inferior to interview classifications and the difference in reliability between instruments for behavioral problems was small (−0.036). Average between‐instrument agreement was ҡ = 0.586 (observed) and ҡ = 0.841 (corrected for attenuation due to measurement error) indicating high content overlap. Statistical equivalence criteria were met in 5 of 6 construct validity comparisons. Conclusions: Categorical classifications of emotional and behavioral problems from youth‐reported checklists are, on balance, equivalent to interview classifications. Checklists represent a simple, brief, inexpensive alternative to interviews. [ABSTRACT FROM AUTHOR]

Reference [1] defined spin-weighted spherical functions as functions on the spin group Spin(3) SU(2) or the rotation group SO(3), and described an operator I K i analogous to the usual angular-momentum operator I L i . The equation defining the raising and lowering operators of I K i SB I z i sb contained a typo. Erratum: "How should spin-weighted spherical functions be defined?". [Extracted from the article]

• Board Certified Specialists in Fluency Disorders reported their self-efficacy for providing treatment. • Self-efficacy for providing multidimensional therapy for children who stutter was high. • Self-efficacy was correlated with several cognitive, affective, and behavioral variables. • Specialists reported that seeking and maintaining specialty certification increased their self-efficacy. The purpose of this study was to document fluency specialists' self-efficacy beliefs for providing multidimensional treatment to children who stutter and to identify cognitive, affective, and behavioral correlates of self-efficacy. Sixty-six Board Certified Specialists in Fluency in the United States completed an online survey measuring self-efficacy in providing multidimensional stuttering therapy, perceived importance of multidimensional aspects of therapy, feelings of comfort in providing therapy, perceived treatment success, and employment and demographic questions. Open-ended questions were also asked for participants to describe why they chose to specialize and what benefits they received from it. Participants reported high levels of self-efficacy (averages above 9 on a scale from 0 to 10) in speech-related, cognitive, emotional, and social domains of stuttering therapy, as well as high levels of comfort and clinical success. Higher ratings of overall self-efficacy were significantly correlated with beliefs about the importance of multidimensional treatment, τ = 0.27, treatment comfort, τ = 0.25, and self-reported treatment success, τ =.49. Responses indicated that many participants believed that their self-efficacy grew because of specialty certification. Although not the same as treatment outcome data, self-efficacy among clinical service providers is an important variable to consider. Board Certified Specialists in Fluency in the United States report very high levels of self-efficacy for school-age stuttering treatment. The process of certification helps to increase self-efficacy and provides a means for advertising competence in stuttering treatment. This information could help in recruiting the next generation of fluency specialists. [ABSTRACT FROM AUTHOR]

Background: We investigated the effectiveness of Nurse‐Family Partnership (NFP), a prenatal‐to‐age‐two‐years home‐visiting programme, in British Columbia (BC), Canada. Methods: For this randomised controlled trial, we recruited participants from 26 public health settings who were: <25 years, nulliparous, <28 weeks gestation and experiencing socioeconomic disadvantage. We randomly allocated participants (one‐to‐one; computer‐generated) to intervention (NFP plus existing services) or comparison (existing services) groups. Prespecified outcomes were prenatal substance exposure (reported previously); child injuries (primary), language, cognition and mental health (problem behaviour) by age two years; and subsequent pregnancies by 24 months postpartum. Research interviewers were masked. We used intention‐to‐treat analyses. (ClinicalTrials.gov, NCT01672060.) Results: From 2013 to 2016 we enrolled 739 participants (368 NFP, 371 comparison) who had 737 children. Counts for child injury healthcare encounters [rate per 1,000 person‐years or RPY] were similar for NFP (223 [RPY 316.17]) and comparison (223 [RPY 305.43]; rate difference 10.74, 95% CI ‐46.96, 68.44; rate ratio 1.03, 95% CI 0.78, 1.38). Maternal‐reported language scores (mean, M [SD]) were statistically significantly higher for NFP (313.46 [195.96]) than comparison (282.77 [188.15]; mean difference [MD] 31.33, 95% CI 0.96, 61.71). Maternal‐reported problem‐behaviour scores (M [SD]) were statistically significantly lower for NFP (52.18 [9.19]) than comparison (54.42 [9.02]; MD ‐2.19, 95% CI −3.62, −0.75). Subsequent pregnancy counts were similar (NFP 115 [RPY 230.69] and comparison 117 [RPY 227.29]; rate difference 3.40, 95% CI ‐55.54, 62.34; hazard ratio 1.01, 95% CI 0.79, 1.29). We observed no unanticipated adverse events. Conclusions: NFP did not reduce child injuries or subsequent maternal pregnancies but did improve maternal‐reported child language and mental health (problem behaviour) at age two years. Follow‐up of long‐term outcomes is warranted given that further benefits may emerge across childhood and adolescence. [ABSTRACT FROM AUTHOR]

Purpose: This project sought to develop consensus guidelines for clinically meaningful, comprehensive assessment procedures for people who stutter across the lifespan. Method: Twelve expert clinicians and researchers who have written extensively about stuttering provided detailed descriptions of the type of data that they routinely collect during diagnostic evaluations of preschool children, schoolage children, adolescents, and adults who stutter. Iterative content analysis, with repeated input from the respondents, was used to identify core areas that reflect common domains that these experts judge to be important for evaluating stuttering for varying age groups. Results: Six core areas were identified as common components of a comprehensive evaluation of stuttering and people who stutter. These areas should be included to varying degrees depending upon the age and needs of the client or family. The core areas include the following: (a) stuttering-related background information; (b) speech, language, and temperament development (especially for younger clients); (c) speech fluency and stuttering behaviors; (d) reactions to stuttering by the speaker; (e) reactions to stuttering by people in the speaker’s environment; and (f) adverse impact caused by stuttering. Discussion: These consensus recommendations can help speech-language pathologists who are uncertain about appropriate stuttering assessment procedures to design and conduct more thorough evaluations, so that they will be better prepared to provide individualized and comprehensive treatment for people who stutter across the lifespan. [ABSTRACT FROM AUTHOR]

Aplasia cutis congenita (ACC) is one of several congenital malformations associated with antithyroid/thiourylene drug use in pregnancy. While uncommon among the general population (1-3/100 000 cases), the risk among those on thiourylenes is between 1.6% and 3%. The scalp is the most common site for this congenital anomaly. We present the case of a male infant with multifocal ACC of the scalp discovered at birth and born to a mother with Graves disease that was controlled during pregnancy using carbimazole. Thyroid function tests were normal throughout the pregnancy. There was no involvement of underlying subcutaneous tissue or structures. At age 18 months, the single largest lesion remained with only partial coverage. Prospective management involved periodic surveillance with planned 2-stage repair. This case reinforces the association between the antithyroid drugs carbimazole (CMZ) and methimazole (MMI) and supports the proposition of an MMI/CMZ embryopathy. It adds to a literature of case reports in which malformations arise in offspring of such mothers whose thyrotoxicosis is controlled antenatally, thereby challenging the suggestion that ACC is attributable to poorly controlled disease rather than thiourylenes. As yet the underlying mechanism is not understood, nor is it known why MMI and CMZ may cause potentially significant embryopathy while congenital defects attributable to the structurally similar propylthiouracil are typically less severe. [ABSTRACT FROM AUTHOR]

The rate of anaphylaxis following COVID-19 vaccinations is estimated to be 2–11 cases per million doses administered. However, adrenaline is occasionally used in individuals who are later diagnosed with immunisation stress-related responses, as their initial presenting signs and symptoms can appear similar to that of anaphylaxis. This study aims to describe the clinical profile of individuals who had received adrenaline following a COVID-19 vaccine and their subsequent revaccination outcomes. We examined notifications of cases who had received adrenaline following a COVID-19 vaccine in New South Wales, Australia. The cases were classified into Brighton Collaboration Case Definition (BCCD) for anaphylaxis, their clinical presentation, management and subsequent revaccination outcomes were compared. From 22 February 2021 to 30 September 2021, there were 222 cases where adrenaline was administered. Of these, 32 (14 %) fulfilled Level 1 BCCD, 59 (27%) Level 2, 2 (1%) Level 3, 97 (44%) Level 4 and 32 (14 %) Level 5. The most commonly reported symptoms were sensation of throat closure (n = 116, 52%), difficulty breathing (n = 82, 37%) and nausea (n = 55, 25 %). Of the 176 (79%) individuals who proceeded to further vaccination, 89 (51%) received the same vaccine formulation and only 14 (8%) experienced another allergic adverse event with 9 (5%) receiving adrenaline. Less than one in five individuals who received adrenaline met Level 1 BCCD criteria for anaphylaxis. Many reactions that were treated with adrenaline had little to no diagnostic certainty of anaphylaxis and in such cases repeat vaccination had a high likelihood of being tolerated. Increased awareness and education on objective signs and symptoms of anaphylaxis is required to ensure appropriate use of adrenaline. [ABSTRACT FROM AUTHOR]

Aim: The full blood count (FBC) is commonly measured as part of a partial septic work‐up in asymptomatic infants at increased risk of early‐onset neonatal sepsis (EOS). To determine the impact of FBC parameters on infants' subsequent management a retrospective cross‐sectional study was performed. Methods: Infants, born at ≥34 weeks gestation, asymptomatic at birth, undergoing a partial septic work‐up and receiving prophylactic antibiotics due to increased risk of EOS in a single centre over a 2‐year period, were included. The primary outcome measure was frequency of FBC result impacting on duration of antibiotic therapy. Secondary outcome measures included frequency of FBC parameters outside of the reference range and incidental diagnoses. Results: In total, 16 726 live‐born infants were delivered during the study period. A total of 802 (4.8%) were included. Thirteen infants (1.6%) received a prolonged course of antibiotics due to suspicion for EOS. Two of these infants had elevated white cell counts. All had normal neutrophil counts. In no case did the FBC result influence the decision to prolong the antibiotic course. Conclusion: In a cohort of 802 infants, asymptomatic at birth and at increased risk of EOS, the FBC result did not impact on the decision to prolong the course of antibiotics for suspicion of EOS. [ABSTRACT FROM AUTHOR]

Previous research focusing on pelagic gastropods in the open ocean has demonstrated that many morphospecies comprise multiple distinct clades or cryptic species that can be distinguished with DNA sequence data. To date, the genetic diversity of the pelagic gastropod fauna of the tropical East Pacific, especially in shallow coastal waters, remains largely unexplored. To document the diversity of pterotracheoids (formerly heteropods) from the coastal waters of the Bay of Panama, we collected, photographed and sequenced fragments of mitochondrial cytochrome c oxidase subunit I (COI) and 16S ribosomal DNA for 60 atlantids, 3 carinariids and 6 pterotracheids. In addition to the COI barcode, our results include the first published 16S sequences for these groups. We found 11 operational taxonomic units (OTUs): 9 in the genus Atlanta, 1 Carinaria and 1 Firoloida. We report the presence of Atlanta oligogyra (Clades A and B), Atlanta turriculata, Atlanta lesueurii, Atlanta helicinoidea (Clade B), Atlanta plana, Atlanta echinogyra, Atlanta inflata and Atlanta frontieri through comparisons of our sequences with previously published sequences. We did not find Atlanta gaudichaudi, Atlanta inclinata, Atlanta tokiokai, Atlanta gibbosa, Atlanta peronii, or Oxygyrus inflatus, which have previously been reported from the region. Haplotype networks and estimates of ΦST illustrate how some species show population differentiation across the tropical Indo‐Pacific region, whereas others show little apparent population structure. For example, the most common haplotypes of A. inflata and of A. turriculata occur in the Indian Ocean, the Central and West Pacific and the tropical East Pacific, whereas individuals of A. frontieri from the Indian Ocean do not share haplotypes with individuals of A. frontieri from the Pacific Ocean. Analyses were limited by sample sizes, but these data suggest that population genetics approaches may be useful for reconstructing population histories of these important, but overlooked, components of the plankton. [ABSTRACT FROM AUTHOR]

Inborn errors of metabolism are an individually rare but collectively significant cause of mortality and morbidity in the neonatal period. They are identified by either newborn screening programmes or clinician-initiated targeted biochemical screening. This study examines the relative contribution of these two methods to the identification of inborn errors of metabolism and describes the incidence of these conditions in a large, tertiary, neonatal unit. We also examined which factors could impact the reliability of metabolic testing in this cohort. This is a retrospective, single-site study examining infants in whom a targeted metabolic investigation was performed from January 2018 to December 2020 inclusive. Data was also provided by the national newborn screening laboratory regarding newborn screening diagnoses. Two hundred and four newborns received a clinician-initiated metabolic screen during the time period examined with 5 newborns being diagnosed with an inborn error of metabolism (IEM) (2.4%). Of the 25,240 infants born in the hospital during the period examined, a further 11 newborns had an inborn error of metabolism diagnosed on newborn screening. This produced an incidence in our unit over the time described of 6.34 per 10,000 births. This number reflects a minimum estimate, given that the conditions diagnosed refer to early-onset disorders and distinctive categories of IEM only. Efficiency of the clinician-initiated metabolic screening process was also examined. The only statistically significant variable in requiring repeat metabolic screening was early day of life (z-score = - 2.58, p = 0.0098). A total of 28.4% was missing one of three key metabolic investigation parameters of blood glucose, ammonia or lactate concentration with ammonia the most common investigation missing. While hypoglycemia was the most common clinical rationale for a clinician-initiated metabolic test, it was a poor predictor of inborn error of metabolism with no newborns of 25 screened were diagnosed with a metabolic disorder.Conclusion: Clinician-targeted metabolic screening had a high diagnostic yield given the relatively low prevalence of inborn errors of metabolism in the general population. Thoughts should be given to the rationale behind each targeted metabolic test and what specific metabolic disease or category of inborn error of metabolism they are concerned along with commencing targeted testing.What Is Known: • Inborn errors of metabolism are a rare but potentially treatable cause of newborn mortality and morbidity. • A previous study conducted in a tertiary unit in an area with limited newborn screening demonstrated a diagnostic yield of 5.4%.What Is New: • Clinician-initiated targeted metabolic screening has a good diagnostic performance even with a more expanded newborn screening programme. • Further optimisation could be achieved by examining the best timing and also the rationale of metabolic testing in the newborn period. [ABSTRACT FROM AUTHOR]

In 2021, the International Union for Conservation of Nature (IUCN) introduced a novel method for assessing species recovery and conservation impact: the IUCN Green Status of Species. The Green Status standardizes recovery using a metric called the Green Score, which ranges from 0% to 100%. This study focuses on one crucial step in the Green Status method—the division of a species' range into so-called "spatial units"—and evaluates whether different approaches for delineating spatial units affect the outcome of the assessment (i.e., the Green Score). We compared Green Scores generated using biologically based spatial units (the recommended method) to Green Scores generated using ecologically based or country-based spatial units for 29 species of birds and mammals in Europe. We found that while spatial units delineated using ecoregions and countries (fine-scale) produced greater average numbers of spatial units and significantly lower average Green Scores than biologically based spatial units, coarse-scale spatial units delineated using biomes and countries above a range proportion threshold did not differ significantly from biologically based results for average spatial unit number or average Green Score. However, case studies focusing on results for individual species (rather than a group average) showed that, depending on characteristics of the species' distribution, even these coarse-scale delineations of ecological or country spatial units often over- or under-predict the Green Score compared to biologically based spatial units. We discuss cases in which the use of ecologically based or country-based spatial units is recommended or discouraged, in hopes that our results will strengthen the new Green Status framework and ensure consistency in application. [ABSTRACT FROM AUTHOR]

Background: The prevalence of cow's‐milk protein allergy (CMPA) is between 2% and 3% and symptoms vary depending on underlying immune mechanism at play. Breast milk is the optimal nutrition for premature infants and breast milk fortifiers (BMF) are commonly used to optimise growth and nutrition. BMF are typically derived from cow's milk and, as such, preterm infants are exposed to cow's milk in the first weeks of life. Previously, preterm infants were suspected to have a higher risk of allergen development because of early antigen exposure and increased gut permeability. The primary aim of the present study was to evaluate the prevalence of CMPA among very preterm (<32 weeks) and/or very low birth weight (VLBW) infants. The secondary aim was to describe feeding practices, specifically the breastfeeding rates and specialist, non‐standard formula use in this cohort over the first 6 months of life. Methods: This was a retrospective study performed in a large tertiary maternity hospital (8500 deliveries/year and 110 very preterm infants/year) in Dublin, Ireland over a 3‐year period, 2017–2020. Infants born very preterm and/or VLBW who were followed in the outpatient clinic until 6 months corrected gestational age (CGA) were included. Hospital ethical approval was obtained. Results: One hundred and forty‐four infants were included with a median birth weight of 1338 g. No infant had a diagnosis of CMPA when leaving the neonatal intensive care unit (NICU) but, by 6 months CGA, this increased to 1.4% (n = 2). Upon discharge from the NICU, 88 infants (61%) were receiving at least some breast milk, decreasing to 13 (9.1%) at 6 months CGA. Those who were receiving exclusive breast milk at discharge were significantly more likely to still be receiving any breast milk at three (p ≤ 0.001) and 6 months (p ≤ 0.001) CGA compared to those combined feeding or exclusively formula feeding. At 6 months CGA, 18.9% (n = 27) were attending a dietician and 31.5% (n = 45) were using specialist, non‐standard infant formula. Conclusions: The prevalence of CMPA in this cohort was 1.4%, which is similar to the reported prevalence of CMPA in the general paediatric population. Infants who were discharged from NICU exclusively breastfeeding were more likely to be receiving any breast milk at outpatient follow‐up. This highlights the importance of on going dietetic and lactation support in the outpatient setting for this vulnerable cohort. Key points: The prevalence of CMPA in our cohort was similar to the previously determined prevalence in the general paediatric population.The significant use of specialist formula among ex preterm/VLBW infants during the first year of life conveys the need for accessible dietetic services.Breastfeeding rates were lower in the ex preterm cohort compared to term infants in Ireland. Breastfeeding initiation and support in the NICU is extremely important for sustaining breastfeeding rates at home following discharge. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effect of an intimate partner violence intervention education component on nurses' attitudes in addressing intimate partner violence; complementary aims included understanding nurses' perceptions of the education and how it influenced their attitudes and confidence to address intimate partner violence in practice. Design: An explanatory sequential mixed methods design embedded within a 15‐site cluster randomized clinical trial that evaluated an intimate partner violence intervention within the Nurse‐Family Partnership programme. Methods: Data were collected between February 2011 and September 2016. Quantitative assessment of nurses' attitudes about addressing intimate partner violence was completed by nurses in the intervention (n = 77) and control groups (n = 101) at baseline, 12 months and at study closure using the Public Health Nurses' Responses to Women Who Are Abused Scale. Qualitative data were collected from nurses in the intervention group at two timepoints (n = 14 focus groups) and focused on their perceptions of the education component. Data were analysed using content analysis. Results: Nurses in the intervention group reported large improvements in their thoughts, feelings and perceived behaviours related to addressing intimate partner violence; a strong effect of the education was found from baseline to 12 months and baseline to study closure timepoints. Nurses reported that the education component was acceptable and increased their confidence to address intimate partner violence. Conclusion: Nurses reported improved attitudes about and confidence in addressing intimate partner violence after receiving the education component. However, these findings need to be considered together with trial results showing no main effects for clients, and a low level of intervention fidelity. Impact: These evaluation findings underscore that improvement in nurses' self‐reported educational outcomes about addressing intimate partner violence cannot be assumed to result in adherence to intervention implementation or improvement in client outcomes. These are important considerations for developing nurse education on intimate partner violence. [ABSTRACT FROM AUTHOR]

This study aimed to adapt the Self-Stigma of Stuttering Scale (4S) into Turkish and evaluate its factor structure, reliability, and validity in Turkish culture. The original 4S scale was translated into Turkish (4S-TR) using a forward-backward translation technique and was administered to 350 adults who stutter (AWS). To discover latent variables evaluated on the scale, two-factor analyses were performed. Internal consistency and temporal stability were calculated to ensure reliability. Test-retest reliability correlation scores were calculated with multiple applications of the scale within about two weeks. To verify construct validity, participants also completed the Turkish versions of the Self-Esteem Rating Scale-Short Form (BSDÖ-KF) and the Satisfaction with Life Scale(YDÖ). The explanatory factor analysis showed three factors explaining 74.76 % of the total variance. The findings were also validated by confirmatory factor analysis. High levels of internal consistency (r =.89) and test-retest reliability (r =.96) were obtained. In terms of construct validity, our findings revealed that self-stigma has a significant negative correlation with self-esteem (r = −.41) and life satisfaction (r = −. 38) as was predicted. The findings demonstrate preliminary evidence that the 4S-TR is a viable and valid instrument for self-stigma evaluation in three domains (stigma awareness, stereotype agreement, and self-concurrence). The 4S-TR can be applied for research and clinical purposes in Turkish. • Self-stigma resulted in decrease in self-esteem and life satisfaction. • Stigma application scores have the largest effect on the negative scores of self-esteem and life satisfaction. • 4S-TR is a valid and reliable tool for assesing self- stigma of stuttering in Turkish population. [ABSTRACT FROM AUTHOR]

This study aims to develop a short Japanese version of the Self-Stigma of Stuttering Scale (4S), which assesses the self-stigma of adults who stutter (AWS) in a self-completed form, and evaluate its psychometric properties and reliability and validity. After translating the original 4S scale into Japanese (4S-J) through a forward-backward translation process, it was administered to 123 Japanese adults who stutter. A short version of the 4S-J was developed through factor analysis and eliminating items with low loadings to original factors. Reliability was verified by calculating internal consistency and test-retest reliability. Participants also completed the Japanese-translated version of the Rosenberg Self Esteem Scale, General Self-Efficacy Scale, and Subjective Happiness Scale to verify construct validity. As a secondary analysis, our results regarding psychological properties of the short version of the 4S were then compared to those of studies from other countries. Sixteen items were selected for the short version of the scale (4S-J-16), and confirmatory factor analysis verified the original structure of the 4S. We obtained good internal consistency and test-retest reliability. Regarding construct validity, our results showed similar correlation with the other selected scales. The value of all scores on the stigma scale in the Japanese cohort was significantly higher than that in the foreign cohort. Overall, the 4S-J-16 has good internal consistency, test-retest reliability, and construct validity with a three-factor structure of self-stigma in Japanese AWS. The findings suggest that Japanese cultural background increases the stigma scores, thereby enabling us to briefly assess the psychosocial issues of AWS. • We developed the Japanese short version of Self-Stigma of Stuttering Scale (4S-J-16). • 123 Japanese adults who stutter completed Web-based survey. • 4S-J-16 had the good internal consistency, test-retest reliability, and construct validity. • Stigma score of Japanese speakers were significantly higher than those of non-Japanese speakers [ABSTRACT FROM AUTHOR]

Extensive research seeks to understand the intergenerational impact of child maltreatment. However, it remains unclear how parent's history of child maltreatment (PCM) is associated with child mental health, after accounting for children's experiences of maltreatment and other proximal risk factors. This study examines the associations between PCM and youth internalizing and externalizing problems, while accounting for youth experiences of maltreatment (YM), and parent mental health and positive parenting. Youth aged 14 to 17 years (N = 2266) participated in the 2014 Ontario Child Heath Study. Parents and youth reported their experiences of child maltreatment. Parent-report and self-reports of youth internalizing and externalizing problems were also collected. Number of subtypes of maltreatment and specific subtypes of maltreatment were examined. Parents reported their own mental health problems and positive parenting practices. Regarding number of maltreatment subtypes, initially PCM was associated with parent-reported, but not self-reported, youth internalizing and externalizing problems. After accounting for YM, parent mental health problems and positive parenting, only YM remained significant. Regarding specific subtypes of maltreatment, both parent and youth emotional abuse were related to parent- and youth-reported internalizing and externalizing problems, after controlling for other maltreatment subtypes. However, the effects of parent emotional abuse became nonsignificant after accounting for YM and proximal risk factors. Findings indicate: 1) the unique associations between specific PCM and YM subtypes and youth mental health problems; 2) the role of proximal risk factors in explaining the association between PCM and youth mental health; and 3) the importance of multiple informants of youth mental health problems. [ABSTRACT FROM AUTHOR]

The neonatal intensive care unit can be a stressful environment for parents. The Beads of Courage program is an arts-in-medicine, psychosocial intervention, designed to strengthen and support children and families who are coping with serious or life-threatening illness. We hypothesised that the program would improve the parent experience in the neonatal unit. Infants less than 32 weeks' gestation were eligible for enrolment on the program. The study was conducted from 2016 to 2018. A 13 point questionnaire was sent to participating parents post discharge from the unit including a combination of Likert scale and open-ended questions. During the study period 123 infants were enrolled. Mean gestational age was 27.7(±2.2) weeks and median length of stay was 49 days (lower quartile 34; upper quartile 76). All respondents rated the program as "helpful and enjoyable" with 72.5% rating it "extremely helpful and enjoyable", 85% felt the program made their stay in the neonatal unit easier. The Beads of Courage program was found to be an extremely popular initiative for parents in a neonatal unit setting and was found to be a useful adjunct to communication and inclusion of parents in the care of their infants. The Beads of Courage program in a NICU setting was found to be very helpful for parents in improving awareness of procedures and understanding overall care of their infants. Parents felt their journey was made easier with the additional engagement and communication with being in the program. • The Beads of Courage program was found very helpful in improving awareness and overall understanding of their infants care. • Parents felt the journey was made easier with the extra engagement and communication attendant with being in the program. • The nicu staff did not feel that it was an additional burden to their workload and was easy to introduce. [ABSTRACT FROM AUTHOR]

Aim: The neonatal intensive care unit can be a stressful environment for parents. The Beads of Courage program is an arts-in-medicine, psychosocial intervention, designed to strengthen and support children and families who are coping with serious or life-threatening illness. We hypothesised that the program would improve the parent experience in the neonatal unit.Methods: Infants less than 32 weeks' gestation were eligible for enrolment on the program. The study was conducted from 2016 to 2018. A 13 point questionnaire was sent to participating parents post discharge from the unit including a combination of Likert scale and open-ended questions.Results: During the study period 123 infants were enrolled. Mean gestational age was 27.7(±2.2) weeks and median length of stay was 49 days (lower quartile 34; upper quartile 76). All respondents rated the program as "helpful and enjoyable" with 72.5% rating it "extremely helpful and enjoyable", 85% felt the program made their stay in the neonatal unit easier.Conclusion: The Beads of Courage program was found to be an extremely popular initiative for parents in a neonatal unit setting and was found to be a useful adjunct to communication and inclusion of parents in the care of their infants.Summary: The Beads of Courage program in a NICU setting was found to be very helpful for parents in improving awareness of procedures and understanding overall care of their infants. Parents felt their journey was made easier with the additional engagement and communication with being in the program. [ABSTRACT FROM AUTHOR]