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Aggressive driving is a significant road safety problem and is likely to get worse as the situations that provoke aggression become more prevalent in the road network (e.g. as traffic volumes and density increase and the grey fleet expands). In addition, driver frustration and stress, also recognised as triggers for aggression, are likely to stay high because of the COVID-19 pandemic and associated burdens, leading to increased aggression. However, although drivers report that other drivers are becoming more aggressive, self-report data suggests that the prevalence of aggression has not changed over time. This may be due to the methods used to define and measure aggression. This study sought to clarify whether self-reported aggression has increased over a five-year period and across three different types of aggression: verbal aggression, aggressive use of the vehicle and personal physical aggression. The influence of COVID-19 lockdowns on own and others’ driving styles was also investigated. A total of 774 drivers (males = 66.5%, mean age = 48.7; SD = 13.9) who had been licensed for at least five years (M = 30.6, SD = 14.3), responded to an online survey and provided retrospective frequencies for their current aggression (considered pre-COVID-19 lockdowns) and five years prior. Two open ended questions were included to understand perceived changes in driving styles (own and others) during the COVID-19 pandemic. One third (33%) of drivers believed they were more aggressive now than five years ago but 61% of the sample believed other drivers were more aggressive now than five years ago. Logistic regression analyses on changes in self-reported aggression (same or decreased vs increased) showed the main factor associated with increases in aggressive driving was the perception that other drivers’ aggression had increased. Further, almost half the sample (47%) reported that other drivers had become riskier and more dangerous during, and soon after, the COVID-19 lockdowns. These results show that the driving environment is seen as becoming more aggressive, both gradually and as a direct result of COVID-19 lockdowns. The data indicate that this perceived increase in aggression is likely to provoke higher levels of aggression in some drivers. Campaigns to reduce aggression on the roads need to focus on changing road culture and improving interactions, or perceived interactions, among road users.

Spatial visualisation is an essential component of geometric thinking and measurement sense. It is a particular type of spatial skill that involves manipulation of spatial images and may not be naturally occurring for students. However, research shows that it is malleable and can be developed through instruction. This article presents an open-ended activity to foster spatial visualisation as students explore the relationship between the surface area and volume of cube blocks.

Over three decades of research has shown that spatial reasoning and mathematics performance are highly correlated. Spatial visualization, in particular, has been found to predict mathematics performance in primary and middle school children. This research sought to determine the effectiveness of a spatial visualization intervention program on increasing student spatial reasoning and mathematics performance. Participants were 327 students from 17 classrooms across ten schools with nine experimental and eight control classes. The intervention program was delivered over a three-week period by classroom teachers, while the control classes received standard mathematics instruction. When compared to the control group, participants in the intervention group improved significantly on their spatial reasoning performance, and specifically on spatial visualization and spatial orientation. The intervention group also significantly improved on their mathematics test performance, with those in the intervention group outperforming their control group peers on geometry and word problems but not on mathematics questions requiring the decoding of graphics (non-geometry graphics tasks). These results add to evidence that a spatial reasoning enrichment program implemented by teachers in their own classrooms can enhance both spatial reasoning and mathematics performance. Moreover, the study provides new insights about the aspects of mathematics performance that are most affected by spatial visualization training.

Since the early 70s, there has been recognition that there are specific differences in achievement based on variables, such as gender and socio-economic background, in terms of mathematics performance. However, these differences are not unilateral but rather quite specific and relate strongly to spatial reasoning. This early work has paved the way for thinking critically about who achieves in mathematics and why. This project innovatively combines the strengths of the two Chief Investigators-Lowrie's work in spatial reasoning and Jorgensen's work in equity. The assumptions, the approach and theoretical framing used in the study unite quite disparate areas of mathematics education into a cogent research program that seeks to challenge some of the long-held views in the field of mathematics education.

This study compared the effects of two types of instruction on the learning of content-area vocabulary words of six middle school students with learning disabilities. A multiple-baseline design across participants was used to evaluate the effectiveness of the two instructional models (i.e., definition and concept model) on the percent of vocabulary questions answered correctly. During the intervention condition, the concept model was implemented as the independent variable and compared with the definition model, the baseline. The concept model utilized a diagram encompassing the vocabulary word, the definition and characteristics, and examples and non-examples. In contrast, the definition model, which is more traditionally used by teachers, involved the students looking up and writing down the definitions of words and writing each word in a sentence. The dependent measure was the percent of vocabulary questions answered correctly after instruction, which indicated the degree of learning. Results showed that the concept model had a greater effect upon the learning of content-area vocabulary words than the definition model for all six of the students with learning disabilities. Limitations of the study, implications for teaching vocabulary instruction for classroom teachers, and future research questions are also discussed. (Contains 3 tables and 3 figures.)

This investigation examines school-family partnership relationships in rural and remote settings. The study highlights the teaching-learning relationships of classroom teachers, parents as instructors/supervisors, and students as they make sense of numeracy and literacy outcomes in distance education contexts. The case study data provide insights into how the distance education provider (the school) interacts with families to facilitate young students' learning experiences. At present, the school and the families they engage with have access to limited technological resources. This investigation considers learning engagement in these increasingly unusual settings and postulates the effect new technologies may have on pedagogical practices in the future.

Background: Anticholinergic burden (ACB), is defined as the cumulative effect of anticholinergic medication which are widely prescribed to older adults despite increasing ACB being associated with adverse effects such as: falls, dementia and increased mortality. This research explores the views of health care professionals (HCPs) and patients on a planned trial to reduce ACB by stopping or switching anticholinergic medications. The objectives were to explore the views of key stakeholders (patients, the public, and HCPs) regarding the potential acceptability, design and conduct of an ACB reduction trial.Materials and Methods: We conducted qualitative interviews and focus groups with 25 HCPs involved in prescribing medication with anticholinergic properties and with 22 members of the public and patients who were prescribed with the medication. Topic guides for the interviews and focus groups explored aspects of feasibility including: 1) views of a trial of de-prescribing/medication switching; 2) how to best communicate information about such a trial; 3) views on who would be best placed and preferred to undertake such medication changes, e.g., pharmacists or General Practitioners (GPs)? 4) perceived barriers and facilitators to trial participation and the smooth conduct of such a trial; 5) HCP views on the future implementability of this approach to reducing ACB and 6) patients’ willingness to be contacted for participation in a future trial. Qualitative data analysis was underpinned by Normalization Process Theory.Results: The public, patients and HCPs were supportive of an ACB reduction trial. There was consensus among the different groups that key points to consider with such a trial included: 1) ensuring patient engagement throughout to enable concerns/potential pitfalls to be addressed from the beginning; 2) ensuring clear communication to minimise potential misconceptions about the reasons for ACB reduction; and 3) provision of access to a point of contact for patients throughout the life of a trial to address concerns; The HCPs in particular suggested two more key points: 4) minimise the workload implications of any trial; and 5) pharmacists may be best placed to carry out ACB reviews, though overall responsibility for patient medication should remain with GPs.Conclusion: Patients, the public and HCPs are supportive of trials to reduce ACB. Good communication and patient engagement during design and delivery of a trial are essential as well as safety netting and minimising workload.

Background Oesophageal cancer remains a common cause of cancer mortality worldwide. Increasingly, oncology centres are treating an older population and comorbidities may preclude multimodality treatment with chemoradiotherapy (CRT). We review outcomes of radical radiotherapy (RT) in an older population treating squamous cell carcinoma (SCC) oesophagus.Methods Patients over 65 years receiving RT for SCC oesophagus between 2013 and 2016 in the West of Scotland were identified. Kaplan-Meier and Cox-regression analysis were used to compare overall survival (OS) between patients treated with radical RT and radical CRT.Results There were 83 patients over 65 years treated with either RT (n=21) or CRT (n=62). There was no significant difference in median OS between CRT versus RT (26.8 months vs 28.5 months, p=0.92). All patients receiving RT completed their treatment whereas 11% of CRT patients did not complete treatment.Conclusion Survival in this non-trial older patient group managed with CRT is comparable to that reported in previous trials. RT shows better than expected outcomes which may reflect developments in RT technique. This review supports RT as an alternative in older patients, unfit for concurrent treatment.

Abstract Background Acquired myasthenia gravis (AMG) is increasingly recognized in cats, yet information regarding the natural history of the disease, treatment, and outcome including occurrence of immune and spontaneous remission remains limited. Objective To determine the long‐term outcome of cats with AMG without evidence of a cranial mediastinal mass (CMM). Animals Eight cats diagnosed with AMG without evidence of a CMM. Methods Retrospective case series. The medical records of cats diagnosed with AMG between 2005 and 2018 from 2 veterinary referral hospitals were reviewed for inclusion. Inclusion criteria consisted of a diagnosis of AMG, thoracic imaging, serum biochemistry including measurement of creatine kinase, and a CBC. Exclusion criteria were the presence of an identifiable CMM, or administration of methimazole or carbimazole. Results All cats had an excellent long‐term outcome, achieving immune remission within 6 months of diagnosis, including 4 cats that did not receive any treatment and whose natural course of disease involved spontaneous remission. Clinical presentation was heterogeneous, and skeletal muscle weakness and fatigability induced or exacerbated by the wheelbarrow exercise stress test were the most consistent abnormalities associated with AMG. Conclusion and Clinical Importance Cats diagnosed with AMG without evidence a CMM have a favorable outcome and frequently achieve immune remission. Moreover, the natural history of AMG in cats includes spontaneous remission when there is no evidence of a CMM. Attempting to rule out the presence of a CMM therefore refines prognosis, and treatment is not always necessary in this disease population.

Abstract Background Paramyotonia congenita and Brody disease are well‐described conditions in humans, characterized by exercise‐induced myotonic‐like muscle stiffness. A syndrome similar to Brody disease has been reported in cattle. Reports of a similar syndrome in dogs are scarce. Objectives To define and describe the clinical, diagnostic, and genetic features and disease course of paradoxical pseudomyotonia in Spaniel dogs. Animals Seven client‐owned dogs (4 English Springer Spaniels and 3 English Cocker Spaniels) with clinically confirmed episodes of exercise‐induced generalized myotonic‐like muscle stiffness. Methods Sequential case study. Results All dogs were

Paroxysmal dyskinesias (PDs) are a group of involuntary, hyperkinetic movement disorders that recur episodically and may last seconds to hours. An important feature of PD is that there is no loss of consciousness during the episode. Using a clinical classification, three main types of PDs have been distinguished in canine PD: (1) paroxysmal kinesigenic dyskinesia (PKD) that commences after (sudden) movements, (2) paroxysmal non-kinesigenic dyskinesia (PNKD) not associated with exercise and can occur at rest, and (3) paroxysmal exertioninduced dyskinesia (PED) associated with fatigue. Canine PDs are diagnosed based on the clinical presentation, history, and phenomenology. For the latter, a video recording of the paroxysmal event is extremely useful. An etiological classification of canine PDs includes genetic (proven and suspected), reactive (drug-induced, toxic, metabolic, and dietary), structural (neoplasia, inflammatory, and other structural causes), and unknown causes. In this review, an overview of all reported canine PDs is provided with emphasis on phenotype, genotype, and, where possible, pathophysiology and treatment for each reported canine PD. [ABSTRACT FROM AUTHOR]

Background/Objectives: Hybrid palliation (HP) procedures for hypoplastic left heart syndrome (HLHS) are increasing. Our objective was to compare mortality and morbidity following HP and NP (Norwood palliation) procedures. Methods: Systematic review and meta-analysis of HLHS patients of peer-reviewed literature between 2000 and 2023. Mortality and/or heart transplantation in HP versus NP in the neonatal period, interstage period, and at 1, 3 and 5 years of age, and morbidity including completion of Stage II and Stage III palliation, unexpected interventions, pulmonary artery pressures, right ventricle function, neurodevelopmental outcomes and length of hospital stay were evaluated. Results: Twenty-one (meta-analysis: 16; qualitative synthesis: 5) studies evaluating 1182 HLHS patients included. HP patients had higher interstage mortality (RR = 1.61; 95% CI: 1.10–2.33; p = 0.01) and 1-year mortality (RR = 1.22; 95% CI: 1.03–1.43; p = 0.02) compared to NP patients without differences in 3- and 5-years mortality. HP procedure in high-risk HLHS patients had lower mortality (RR = 0.48; 95% CI: 0.27–0.87; p = 0.01) only in the neonatal period. HP patients underwent fewer Stage II (RR = 0.90; 95% CI: 0.81–1.00; p = 0.05) and Stage III palliation (RR = 0.78; 95% CI: 0.69–0.90; p < 0.01), had more unplanned interventions (RR = 3.38; 95% CI: 2.04–5.59; p < 0.01), and longer hospital stay after Stage I palliation (weighted mean difference = 12.88; 95% CI: 1.15–24.62; p = 0.03) compared to NP patients. Conclusions: Our study reveals that HP, compared to NP for HLHS, is associated with increased morbidity risk without an improved survival rate. [ABSTRACT FROM AUTHOR]

Abstract Background Although thoracic hemivertebra can cause neurological signs, they occur commonly in neurologically normal dogs. Objectives To evaluate whether computed tomography (CT) findings and factors associated with signalment can be used to differentiate between dogs with and without neurological signs associated with hemivertebra. Animals One hundred sixty dogs with ≥1 hemivertebrae were retrospectively studied. This group consisted of 40 dogs with clinical signs caused by hemivertebra and 40 French Bulldogs, 40 Pugs, and 40 English Bulldogs that underwent CT for reasons unrelated to neurological disease. Methods All dogs underwent CT and affected dogs also underwent magnetic resonance imaging. All CT studies were randomly evaluated by an observer blinded to signalment and clinical status. The following variables were evaluated: presence, number, location, and subtype of hemivertebra; presence of vertebral subluxation; severity of vertebral canal stenosis; presence, location, and severity of kyphosis, and number of vertebrae involved in the kyphotic segment. Statistical modeling was performed to identify factors associated with clinical status. Results Pug breed (odds ration [OR], 10.8; P = .01), more severe kyphosis (OR, 1.1 per grade increase; P

Background: Epidemiological studies focused on primary healthcare needs of persons experiencing homelessness (PEH) are often based on data from specialist homeless healthcare services. Aim: To explore the presentation of PEH, coding of homelessness, and associated health conditions in mainstream primary care general practices in England. Design & setting: EMIS electronic database search of medical records was conducted across 48 general practices in a clinical commissioning group (CCG), representing one of the most socioeconomically deprived regions in England, which also lacks a specialist primary healthcare service for PEH. Method: Key terms and codes were used to identify PEH, their respective diagnoses across 22 health conditions, and prescribed medications over the past 4 years. Results: From a population of approximately 321 000, 43 (0.013%) people were coded as PEH, compared with a homelessness prevalence of 0.5% in the English general population. Mental health conditions were the most prevalent diagnoses among the PEH registrants (56.6%); the recorded prevalence of other common long-term conditions in PEH was lower than the levels observed in PEH registered with specialist homelessness health services. Conclusion: In a population with approximately four times higher rate of statutory homelessness, PEH representation in mainstream general practices was under-represented by several folds. As homelessness overlaps with mental health, substance misuse, and long-term health conditions, consistent coding of homelessness in medical records is imperative in order to offer tailored support and prevention actions when patients present for services.