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In the past decade, teachers and researchers have recognized the vital role school climate plays in the public school setting in the United States (Thapa, Cohen, Guffey & Higgins-D'Alessandro, 2013). One of the greatest indicators of achievement is the relationship between school and student socioeconomic status (Sirin, 2005). According to Bryk and Schneider (2003), if schools create positive learning environments, students will achieve at a higher level than what their socioeconomic background would otherwise predict. The purpose of this quantitative study was to identify the relationship between school climate and student academic achievement in reading at the elementary level in public schools in Virginia, USA. The researcher examined extant data from the 2018-2019 school year, which included Grade 5 Reading Virginia Standards of Learning (SOL) pass rates and school climate surveys from two school divisions in the Commonwealth of Virginia. The findings indicated that the school climate dimension had the strongest correlation to the Reading SOL pass rates in both school districts. School leaders and building-level principals could use these findings to better understand the importance of school climate and its impact on student achievement.

We examine and compare the relationship between minimum wage increases and youth homicide rates in three groups: all youth, White youth only, and Black youth only. Using 2001-2019 mortality data from the National Vital Statistics System (NVSS) for all 50 states and Washington DC, we apply a difference in differences (DD) design to compare the change in youth homicides across states with varying changes in the state-specific minimum wage. With the inclusion of state-specific linear time trends, we find that a $1 increase in minimum wage leads to a significant 4% reduction (RR = 0.96, 95%CI [0.92, 0.99]) in homicides among White youth, but no significant reduction among Black youth (RR = 0.98, 95%CI [0.91, 1.04]). Findings are consistent with research on marginalization-related diminished returns for Black youth. While minimum wage increases are a promising step to reduce youth homicides overall, reducing homicide disparities experienced by Black youth requires additional components. Future research should examine policies with the specific intention to dismantle structural racism.

Although there is a plethora of tools available to assess children's movement competence (MC), the literature suggests that many have significant limitations (e.g. not being practical for use in many 'real-world' settings). The FMS[superscript 2] assessment tool has recently been developed as a targeted solution to many of the existing barriers preventing practitioners from utilising MC assessments. The aim of this study was to investigate the structural and convergent validity of this new tool among 8- to 12-year-old Irish primary school children. As part of this study, 102 children (56.8% female, mean = 9.8 years) were assessed using the FMS[superscript 2], the Test of Gross Motor Development (3rd edition) (TGMD-3) (short version) and the Functional Movement Screen™ (FMS™). Structural validity was assessed using confirmatory factor analysis (CFA). The convergent validity between the FMS[superscript 2], the TGMD-3 (short version) and the FMS™ was investigated using the Pearson product-moment correlation coefficient. Results of CFA for the FMS[superscript 2] indicate a good fit model, supporting a three-factor structure (locomotor, object manipulation, and stability). Additional findings indicate a moderate, positive correlation between the FMS[superscript 2] and the TGMD-3 (short version) (r = 0.66), with a low, positive correlation between the FMS[superscript 2] and the FMS™ (r = 0.48). This study presents the first preliminary findings to suggest that the FMS[superscript 2] may be a versatile, time-efficient, and ecologically valid tool to measure children's MC in multiple settings (e.g. research, education, sport, athletic therapy, and physiotherapy). Future research should also seek to continue to implement this solution, consolidate the existing validity findings with a larger and more diverse sample, and further explore the feasibility of the tool in 'real-world' settings.

OBJECTIVE: The International Mission on Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) and Corticosteroid Randomization After Significant Head Injury (CRASH) prognostic models for mortality and outcome after traumatic brain injury (TBI) were developed using data from 1984 to 2004. This study examined IMPACT and CRASH model performances in a contemporary cohort of US patients. METHODS: The prospective 18-center Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study (enrollment years 2014-2018) enrolled subjects aged ≥ 17 years who presented to level I trauma centers and received head CT within 24 hours of TBI. Data were extracted from the subjects who met the model criteria (for IMPACT, Glasgow Coma Scale [GCS] score 3-12 with 6-month Glasgow Outcome Scale-Extended [GOSE] data [n = 441]; for CRASH, GCS score 3-14 with 2-week mortality data and 6-month GOSE data [n = 831]). Analyses were conducted in the overall cohort and stratified on the basis of TBI severity (severe/moderate/mild TBI defined as GCS score 3-8/9-12/13-14), age (17-64 years or ≥ 65 years), and the 5 top enrolling sites. Unfavorable outcome was defined as GOSE score 1-4. Original IMPACT and CRASH model coefficients were applied, and model performances were assessed by calibration (intercept [< 0 indicated overprediction; > 0 indicated underprediction] and slope) and discrimination (c-statistic). RESULTS: Overall, the IMPACT models overpredicted mortality (intercept -0.79 [95% CI -1.05 to -0.53], slope 1.37 [1.05-1.69]) and acceptably predicted unfavorable outcome (intercept 0.07 [-0.14 to 0.29], slope 1.19 [0.96-1.42]), with good discrimination (c-statistics 0.84 and 0.83, respectively). The CRASH models overpredicted mortality (intercept -1.06 [-1.36 to -0.75], slope 0.96 [0.79-1.14]) and unfavorable outcome (intercept -0.60 [-0.78 to -0.41], slope 1.20 [1.03-1.37]), with good discrimination (c-statistics 0.92 and 0.88, respectively). IMPACT overpredicted mortality and acceptably predicted unfavorable outcome in the severe and moderate TBI subgroups, with good discrimination (c-statistic ≥ 0.81). CRASH overpredicted mortality in the severe and moderate TBI subgroups and acceptably predicted mortality in the mild TBI subgroup, with good discrimination (c-statistic ≥ 0.86); unfavorable outcome was overpredicted in the severe and mild TBI subgroups with adequate discrimination (c-statistic ≥ 0.78), whereas calibration was nonlinear in the moderate TBI subgroup. In subjects ≥ 65 years of age, the models performed variably (IMPACT-mortality, intercept 0.28, slope 0.68, and c-statistic 0.68; CRASH-unfavorable outcome, intercept -0.97, slope 1.32, and c-statistic 0.88; nonlinear calibration for IMPACT-unfavorable outcome and CRASH-mortality). Model performance differences were observed across the top enrolling sites for mortality and unfavorable outcome. CONCLUSIONS: The IMPACT and CRASH models adequately discriminated mortality and unfavorable outcome. Observed overestimations of mortality and unfavorable outcome underscore the need to update prognostic models to incorporate contemporary changes in TBI management and case-mix. Investigations to elucidate the relationships between increased survival, outcome, treatment intensity, and site-specific practices will be relevant to improve models in specific TBI subpopulations (e.g., older adults), which may benefit from the inclusion of blood-based biomarkers, neuroimaging features, and treatment data.

Purpose: Competence in fundamental movement skills (FMS) is purported to be linked with increased physical activity participation. Yet, recent research suggests a low level of FMS proficiency in children. The aim of this study was to evaluate the efficacy, impact on gender, and influence of teacher fidelity on the Moving Well-Being Well intervention. Method: The intervention was delivered in 18 primary schools (n = 925, M[subscript age] = 7.55 years). Data were gathered on six FMS and two balance skills pre- and postintervention using the Test of Gross Motor Development--Third Edition and Bruininks--Oseretsky Test of Motor Proficiency 2. Results: The mean postintervention FMS score was higher than preintervention, with a mean increase of 7.85 (23%). A two-way analysis of covariance found gender was not statistically significant (p = 0.74), but teacher fidelity was statistically significant (p = 0.000; moderate effect size). Conclusions: The intervention significantly improved children's FMS, having a similar effect on boys and girls. Teacher fidelity of implementation had a significant impact on FMS improvement.

OBJECTIVES: An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort. METHODS: Data from hospitalized subjects with Glasgow Coma Scale score of 3-12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014-2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-3 (vs. 4-8)) at 3, 6, and 12 months after injury. RESULTS: Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01-4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months. CONCLUSIONS: After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed. LEVEL OF EVIDENCE: IV. TRIAL REGISTRATION NUMBER: NCT02119182.

Marine growth can substantially affect the hydrodynamic properties of subsea infrastructure. The ability to accurately quantify this growth is essential for designing and maintaining subsea structures. Traditionally, quantifying marine growth has been done by applying simple ratio equations putting in relationship the known distance of an object and its length observed in the image to the length of an unknown object only observed in an image. This method is very sensitive if measurements are not taken in the same plane. Hence, this study aims to establish a method for creating a 3D model of a subsea pipeline segment based on Structure from Motion (SfM). The proof of concept is done using a case study. For this study, Remotely Operated Vehicle (ROV) footage from a 2019 inspection survey is utilised. The scenario in which the procedure is tested represents a difficult, but realistic test case. Despite the lack of metadata, video quality and obstructions (e.g. watermarks), meaningful results were produced. The SfM workflow included masking obstructions (e.g. watermarks), and an iterative camera alignment procedure to generate 3D models, enabling the measurement of marine growth using either the models or ortho images created. While the resulting models were sufficiently accurate to provide meaningful measurements for harder growth types, the method faced challenges in accurately modelling softer growth types, suggesting the need for further refinement. Nevertheless, SfM was proven to be a more reliable method of measuring biofouling than the ratio approach that been traditionally used.

Abstract Background Engaging in physical activity (PA) during adolescence is beneficial for health and positive development. However, most adolescent girls have low PA levels, and there is a need for interventions outside of school hours. This pilot randomised controlled trial aimed to explore the preliminary effectiveness of three different remote PA interventions in increasing adolescent girls’ moderate-to- vigorous PA (MVPA), fitness and psychosocial outcomes. Methods Girls living in the UK or Ireland, aged between 13 and 16 years old, who wished to increase their activity levels, were eligible for the study. Using a random number generator, participants (n = 153; 14.8y ± 1.4) were randomised into one of three 12-week intervention groups (i) PA programme, (ii) Behaviour change support, or (iii) Combined PA programme and Behaviour change support, or (iv) a Comparison group. Outcome measures included accelerometer and self-reported PA, physical fitness (cardiorespiratory fitness; 20 m shuttle run, muscular endurance; push up, muscular strength; long jump), and psychosocial assessments (perceived competence; body appreciation; self-esteem; behavioural regulation). Linear mixed models were used to analyse differences between each intervention arm and the comparison group immediately postintervention (12 weeks) and at follow up (3-months post-intervention), while adjusting for potential confounders. Results Participation in the PA programme group was associated with higher perceived competence (0.6, 95% CI 0.1 to 1.2), identified regulation (0.7, 95% CI 0.2 to 1.1) and intrinsic motivation (0.9, 95% CI 0.2 to 1.6) at post-intervention. Participation in the Behaviour change group was associated with higher perceived competence at post-intervention (0.6, 95% CI 0.1 to 1.2), and higher push-up scores at the 3-month follow-up (4.0, 95% CI 0.0 to 7.0). Participation in the Combined group was also associated with higher perceived competence at post-intervention (0.8, 95% CI 0.2 to 1.4), and higher push-up scores at the 3-month follow-up (5.0, 95% CI 1.0 to 8.0). No other significant differences were found between the intervention arms and the comparison group. Conclusion Results suggest perceived competence increased across all intervention arms, while the PA programme group enhanced autonomous motivation in the short term. Intervention arms with behaviour change support appear most promising in improving muscular endurance. However, a larger scale trial is needed for a better understanding of between-group differences and the impact of intervention arms on MVPA and fitness, given the small sample size and short-term follow-up.

Ignoring technology in teaching English language in EFL contexts persuaded the researchers to do this study. In fact, this research looked at how Saudi Arabian EFL learners' academic achievement (AA), creativity, and academic buoyancy (AB) were affected by vocabulary acquisition with and without the use of technology. Fifty intermediate EFL students were chosen based on the convenience sampling method to accomplish this goal, and they were split into two groups: control and experimental. Subsequently, the three questionnaires were given out to evaluate the participants' AB, AA, and creativity before the treatment. Next, utilizing the WhatsApp application to teach new words to the experimental group (EG) and the control group using the conventional technique, the research completed a 16-session treatment. At the end of the course, the post-tests for the AB, AA, and creativity for both groups were administered. The results of this research revealed that on three post-tests, the EG outperformed the control group. In other words, the technology-based treatment helped the EG to develop their AA, AB, and creativity. There are implications for English teachers, students, researchers, and other stakeholders from the current study. The implications of this research can encourage EFL teachers to incorporate technology into their English classes.

We empirically examined the effectiveness of how the Analysis of Competing Hypotheses (ACH) technique structures task information to help reduce confirmation bias (Study 1) and the portrayal of intelligence analysts as suffering from such bias (Study 2). Study 1 (N = 161) showed that individuals presented with hypotheses in rows and evidence items in columns were significantly less likely to demonstrate confirmation bias, whereas those presented with the ACH-style matrix (with hypotheses in columns and evidence items in rows) or a paragraph of text (listing the evidence for each hypothesis) were not less likely to demonstrate bias. The ACH-style matrix also did not confer any benefits regarding increasing sensitivity to evidence credibility. Study 2 showed that the majority of 62 Dutch military analysts did not suffer from confirmation bias and were sensitive to evidence credibility. Finally, neither judgmental coherence nor cognitive reflection differentiated between better or worse performers in the hypotheses evaluation tasks.

Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children's Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities.

Abstract Research projects, initiatives and conferences that include patients as partners rather than as participants are becoming more common. Including patients as partners (what we will call ‘patient partners’) is an approach called patient engagement or involvement in research, and we will call it patient engagement throughout this paper. Patient engagement moves traditional health research conferences and events to include a broader audience for their knowledge exchange and community building efforts, beyond academics and healthcare professionals. However, there are few examples of conferences where patients are given the opportunity to fully lead. Our conference went beyond patient engagement – it was patient-led. Patient partners conceived, planned, and decided on all aspects of a virtual conference. We present the work and processes we undertook throughout 2023 to create and produce a free conference called “PxP: For patients, by patients” or PxP for short, with a tagline of “Partnering to make research stronger.” PxP was patient-led and about patient engagement in research rather than a specific disease or condition. PxP was supported by the Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis. The PxP website, known as the PxP Hub, now houses the conference recordings along with resources about patient engagement in research. These resources were recommended by the PxP Steering Committee members, speakers, and others who attended the 2023 conference. Here we lead you through how the idea for PxP was generated; how the international patient partner Steering Committee was convened and supported; how PxP was brought to life over nine months; the PxP 3-day event and feedback collected to improve future efforts; trade-offs, challenges and learnings; and resources required to support this type of event. We close with what the future holds for PxP in 2024 and beyond. It’s time to elevate patients into leadership roles for conferences and events, and we encourage you to adopt the PxP ethos by using or adapting our approach and resources to support your opportunity.

IntroductionAquatic foods, particularly fish, are essential for addressing malnutrition, especially in vulnerable populations like children and women. In India, traditional aquaculture practices centered around carp species often overlooked the production of nutrient-rich small fish. To address this, nutrition-sensitive aquaculture approaches advocate for integrating species like mola carplet (Amblypharyngodon mola) rich in micronutrients, into existing systems. In Odisha, India, where poverty and food insecurity are prevalent, the government initiated a program to empower women through aquaculture, focusing on nutrition-sensitive carp-mola polyculture in community ponds through Women Self-Help Groups (WSHGs).MethodsThis study evaluates the effectiveness of this government program in enhancing income, household nutrition, and women’s empowerment. Data from field surveys conducted across all 30 districts of Odisha were analyzed to assess participation, capacity building, adoption of better management practices (BMPs), productivity of carp-mola polyculture, household fish consumption, and profitability.Results and discussionThe study found widespread participation and adoption of BMPs among WSHGs, leading to increased productivity and income. Carp-mola polyculture systems showed higher productivity and consumption rates, contributing to improved nutrition among WSHGs and their communities. Despite challenges such as input costs and limited mola availability, WSHGs reported profitability from fish farming, with carp-mola polyculture systems yielding higher net income. Factors influencing productivity and profitability included water retention period, stocking density, feed application, and training. The program’s impact extended beyond economic benefits, encompassing environmental improvement, women’s empowerment, and enhanced nutrition outcomes.The study highlights the success of the government program in promoting sustainable aquaculture practices and improving nutrition outcomes in Odisha. Continued support, capacity building, and collaboration among stakeholders are essential for scaling up nutrition-sensitive aquaculture interventions and ensuring long-term sustainability. Strengthening dissemination processes, addressing challenges, and further research on small indigenous fish production techniques are crucial for maximizing the program’s impact on food security and rural development.

Background: Meeting the physical activity (PA) guidelines for children, as set out by the World Health Organisation (WHO), has a range of physical and mental health benefits. For children who are blind or vision impaired (BVI), additional benefits include social inclusion and reduced falls risk. While previous research has demonstrated low PA levels across most demographics, little research has been done in the Irish context to quantify PA in children who are BVI. Two potential methods of increasing PA levels, active travel (AT) and physical education (PE), have additionally never been assessed in this group. Methods: Consenting parents of children who are BVI (n = 53, 55 % boys, mean age of children 12.92 ± 2.76 years) completed a questionnaire regarding PA levels, and participation in AT and PE. Results: PA levels were low, with 9.6 % achieving WHO guidelines (60 min MVPA/day). There was no statistically significant differences between genders completing either no PA in the last week (p = 1.00) or MVPA on each of the last 7 days (p = 0.157). 14.4 % used AT to get to school. Mean PE times in minutes/week were lower than the general population (58.63 min), with a low proportion of respondents meeting PE guidelines (32.1 %). Regarding barriers to PA, 17.0 % of respondents stated they were very likely to be “too tired after school to be active”. 13.5 % stated they were very likely to feel “my day is so busy now I just do not think I can make time to include PA in my regular schedule”. Conclusion: This study provides a valuable insight into the low levels of PA that prevail amongst BVI children. Increasing PA levels would provide individual benefits (including physical and mental health benefits) as well as population benefits (including reduced health expenditure). Future qualitative research should seek to gain a deeper understanding of the PA barriers, motivators and facilitators in this cohort.

IntroductionNeuroworsening may be a sign of progressive brain injury and is a factor for treatment of traumatic brain injury (TBI) in intensive care settings. The implications of neuroworsening for clinical management and long-term sequelae of TBI in the emergency department (ED) require characterization.MethodsAdult TBI subjects from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot Study with ED admission and disposition Glasgow Coma Scale (GCS) scores were extracted. All patients received head computed tomography (CT) scan

Physical literacy (PL) is highlighted as a construct that can positively impact physical activity (PA). Measurement methods and definitions for PL exist, but vary between research groups. This variation affects the ability to compare research findings. The purpose of this study was to assess the construct validity of PL in children. PL was operationalised according to Whitehead's (2001) definition, comprising confidence, motivation, physical competence, and knowledge and understanding. Participants (n = 1073; mean age 10.86 ± 1.20 years: 53% male) were measured on: (i) confidence (Physical Activity Self-Efficacy Scale; Bartholomew et al., 2006), (ii) motivation (Behavioural Regulation in Exercise-Adapted; Sebire et al., 2013), (iii) physical competence (health-related fitness: 20 m shuttle run, back-saver sit-and-reach, handgrip strength, plank); balance (Bruininks-Oseretsky Test of Motor Proficiency 2; Bruininks, 2005); object-control and locomotor skills (Test of Gross Motor Development-3rd edition (TGMD-3); Ulrich, 2016); and (iv) knowledge and understanding (PA and sedentary guidelines). Confirmatory factor analysis (CFA) was conducted to analyse the factor structure of PL. The best-fitting model (X[superscript 2] = 209.8, df = 99, p < 0.001; comparative fit index = 0.95, normed fit index = 0.91, Tucker-Lewis index = 0.93, root mean square error of approximation = 0.032, 95% confidence interval: 0.026-0.038) was a three-component model containing the domains of motivation, confidence, and physical competence. The knowledge and understanding domain did not fit the model well. Factor loadings were highest for confidence and motivation. Findings support the adoption of a pragmatic approach to PL measurement. CFA results indicated a similar factor structure as has been identified in other studies which have used different tools to measure PL domains.

In line with the Healthy Campus framework, this study explored the health, health literacy, and wellbeing landscape for students at an Irish third level institution using a participatory action research approach with the aim to identify potential need, and inform future health promotion action(s). Methods. This mixed-method study involved three phases; (1) a scoping review to audit what activities are currently available to support student health and wellbeing on campus, (2) assessment of students’ current health literacy using the Health Literacy Questionnaire, analysed using Cohen's d to investigate the magnitude of differences between student groups, (3) qualitative discussions with university stakeholders, analysed using reflexive thematic analysis, to provide greater understanding and context to the results of the previous phases. Results. The scoping review identified 151 activities on campus to support students’ holistic health, with the majority focused on individual support. Students’ health literacy scores were in line with the broader literature. A number of themes were identified within the qualitative data; i) the need for an ‘opt-in’ approach to support a health-integrated culture, ii) barriers and facilitators to health information, iii) the importance of ‘walking the walk’, iv) the specific university experience of 2022 as society emerged from Covid-19, and v) factors that influence student engagement. Conclusion. Insight into the participatory action approach undertaken in this study may be useful to inform other higher education institutions (HEIs) interested in undertaking similar work. Thorough description of the findings may also allow these to be transferred to other contexts. The findings of this study can help inform and direct the current university's, and potentially other HEIs, future actions in regards to enhancing the health and wellbeing of its stakeholders. To foster an authentic ‘Healthy Campus’, a whole-university approach is needed HEIs, supported by open dialogue between stakeholders and senior leadership commitment.

Summary: Background: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery. Methods: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014–2018; ClinicalTrials.gov #NCT02119182) enrolled subjects who presented to trauma centre and received head computed tomography within 24-h (h) post-TBI. We performed a secondary data analysis in subjects aged ≥17-years with hospitalisation. Clinical characteristics, surgery type/timing, hospital and six-month outcomes were reported. Findings: Of 2032 subjects (age: mean = 41.4-years, range = 17–89-years; male = 71% female = 29%), 260 underwent cranial surgery, comprising 65% decompressive craniectomy, 23% craniotomy, 12% other surgery. Subjects with surgery (vs. without surgery) presented with worse neurological injury (median Glasgow Coma Scale = 6 vs. 15; midline shift ≥5 mm: 48% vs. 2%; cisternal effacement: 61% vs. 4%; p

Objectives An estimated 14–23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.Methods Data from hospitalized subjects with Glasgow Coma Scale score of 3–12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014–2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1–3 (vs. 4–8)) at 3, 6, and 12 months after injury.Results Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01–4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months.Conclusions After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed.Level of evidence IV.Trial registration number NCT02119182.

As part of developing and researching a virtual reality (VR) game intended to increase access to and broaden participation in STEM learning, designers and researchers from EdGE at TERC and interns from Landmark College, a post-secondary institute for learners with ADHD, autism, dyslexia, and other learning differences, have been immersed in an intensive co-design process. Co-design embraces the ‘nothing about us without us’ movement by ensuring stakeholder voices, in this case neurodiverse learners, have a prominent role throughout the design process. We present our co-design process, key lessons learned, important game-design decisions, and the experiences and perspectives of individual co-design participants. And recommendations are provided to help guide others who are interested in implementing a co-design process of their own.

Abstract Background Scots pine (Pinus sylvestris L.) underwent significant population declines across much of northwest Europe during the mid-to-late Holocene and was thought to have become extirpated in Ireland from about 400 AD. However, most extant populations are plantations reintroduced from Scotland. Others are naturalised therefrom and one in Western Ireland is a putative relict. In this paper, Scots pine in Ireland are genetically described for the first time. Results Using two mitochondrial (mtDNA) loci, eight chloroplast (cpSSR) and 18 nuclear (nSSR) loci, the genetic composition and diversity of 19 Irish Scots pine populations is described and compared to other European populations. All trees sampled in Ireland were fixed for mitotype a, which is the most common across northwest Europe. By contrast, cpSSR (H CP = 0.967) and nSSR (H e = 0.540) variation was high, and comparable with estimates for other regions across the species range. Differentiation at both sets of loci were similarly low (cpSSR F ST = 0.019; nSSR F ST = 0.018), but populations from continental Europe were significantly differentiated from all Irish populations based on nSSR variation. Conclusions All Irish Scots pine are likely part of a common Irish-Scottish gene pool which diverged from continental Scots pine following post-glacial recolonisation. A high genetic diversity and an absence of evidence of inbreeding suggests the regional decline of Scots pine did not critically reduce allelic variation. The post-glacial relationship between Irish and Scottish pine is discussed, and a suggestion from recent palaeoecological work that reintroduced Scots pine be managed as a native species is now further supported by genetic data.

Background: The Ireland North and South Report Card on Physical Activity (PA) for Children and Adolescents aims to monitor progress in PA participation across a range of internationally established indicators. Methods: Data were collated for 11 indicators and graded following the harmonised Active Healthy Kids Global Alliance report card process. Six representative studies (sample size range n = 898 to n = 15,557) were primarily used in the grading, with many indicators supplemented with additional studies and reports. Data collected since the implementation of COVID-19 public health measures in March 2020 were excluded. Results: Grades were awarded as follows: ‘Overall physical activity’, C-; ‘Organised Sport and Physical Activity’, C; ‘Active Play’, INC; ‘Sedentary Behaviours’, C-; ‘Physical Fitness’, INC; ‘Family and Peers’, D+; ‘School’, C-; ‘Physical Education’, D; ‘Community and Environment’, B+ and ‘Government’, B. Separate grades were awarded for disability as follows; ‘Overall physical activity’, F; ‘Organised Sport and Physical Activity’, D; ‘Sedentary Behaviours’, C-; ‘Family and Peers’, C; ‘School’, C- and ‘Government’, B. ‘Active Play’, ‘Physical Fitness’, ‘Physical Education’ and ‘Community and Environment’ were all graded INC for disability. Since the last report card in 2016, four grades remained the same, three increased (‘Overall physical activity’, ‘School’ and ‘Physical Education’) and two (‘Family and Peers,’ and ‘Government’) were awarded grades for the first time. Conclusion: Grades specific to children and adolescents with disability were generally lower for each indicator. While small improvements have been shown across a few indicators, PA levels remain low across many indicators for children and adolescents.