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Lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) students in undergraduate science, technology, engineering, and math (STEM) majors are more likely to drop out than their cisgender, heterosexual peers despite having equivalent grades and research exposure. It has been demonstrated that a sense of belonging, a very strong predictor of student retention, is low in LGBTQ+-identified STEM undergraduates. It has further been posited that faculty openness and authenticity can enhance a sense of belonging for LGBTQ+ students through the creation of an inclusive classroom culture. The authors of this article, three LGBTQ+-identified faculty in the health sciences department at Boston University, surveyed students enrolled in their courses to elicit student thoughts, feelings, and behaviors regarding the effect of faculty 1) sharing their identity openly in the classroom, and 2) actively working to create open, inclusive dialogue and space in their classrooms. Of 86 student participants across multiple classes, the large majority of students, both LGBTQ+-identified and non-LGBTQ+-identified, described feeling safe, included, and welcomed in the classroom. They described engaging more in peer-to-peer education and felt that instructor authenticity created a safe and inclusive classroom. A minority of LGBTQ+-identified students and non-LGBTQ+-identified students reported feeling unsure of voicing their opinions, for the former related to insecurity about being LGBTQ+ and the latter feeling a liberal bias existed in the classroom. Altogether, these results suggest a positive effect on student sense of belonging when faculty authenticity and intentionality create inclusive classroom environments in the health sciences.

BACKGROUND: Financial barriers in substance use disorder service systems have limited the widespread adoption-i.e., provider-level reach-of evidence-based practices (EBPs) for youth substance use disorders. Reach is essential to maximizing the population-level impact of EBPs. One promising, but rarely studied, type of implementation strategy for overcoming barriers to EBP reach is financing strategies, which direct financial resources in various ways to support implementation. We evaluated financing strategies for the Adolescent Community Reinforcement Approach (A-CRA) EBP by comparing two US federal grant mechanisms, organization-focused and state-focused grants, on organization-level A-CRA reach outcomes. METHOD: A-CRA implementation took place through organization-focused and state-focused grantee cohorts from 2006 to 2021. We used a quasi-experimental, mixed-method design to compare reach between treatment organizations funded by organization-focused versus state-focused grants (164 organizations, 35 states). Using administrative training records, we calculated reach as the per-organization proportion of trained individuals who received certification in A-CRA clinical delivery and/or supervision by the end of grant funding. We tested differences in certification rate by grant type using multivariable linear regression models that controlled for key covariates (e.g., time), and tested threats to internal validity from our quasi-experimental design through a series of sensitivity analyses. We also drew on interviews and surveys collected from the treatment organizations and (when relevant) interviews with state administrators to identify factors that influenced reach. RESULTS: The overall certification rates were 27 percentage points lower in state-focused versus organization-focused grants (p = .01). Sensitivity analyses suggested these findings were not explained by confounding temporal trends nor by organizational or state characteristics. We did not identify significant quantitative moderators of reach outcomes, but qualitative findings suggested certain facilitating factors were more influential for organization-focused grants (e.g., strategic planning) and certain barrier factors were more impactful for state-focused grants (e.g., states finding it difficult to execute grant activities). DISCUSSION: As the first published comparison of EBP reach outcomes between financing strategies, our findings can help guide state and federal policy related to financing strategies for implementing EBPs that reduce youth substance use. Future work should explore contextual conditions under which different financing strategies can support the widespread implementation of EBPs for substance use disorder treatment.

Understanding population connectivity is paramount for effective conservation. While genetic tools have elucidated sea turtle migration patterns, notable data gaps limit our understanding of ocean-wide connectivity, especially regarding east Atlantic green turtles. We characterized the genetic composition of a globally important green turtle foraging aggregation at the Banc d’Arguin, Mauritania, incorporating data from 323 individuals captured between 2018 and 2021. Using extended mitochondrial DNA D-loop (738 base pairs [bp]) and mitochondrial short tandem repeat (mtSTR; ~200 bp) markers, we assessed the genetic structure of Atlantic green turtle foraging aggregations and estimated the most likely origin of immature green turtles from the Banc d’Arguin using mixed stock analyses (MSAs). We identified 6 D-loop haplotypes, with a clear dominance of CM-A8.1 (91.8%) followed by CM-A5.1 (6.3%) and 4 rare haplotypes: CM-A1.4, CMA6.1, CM24.1 and CM36.1. We found 13 mtSTR haplotypes, with ‘7-12-4-4’ being dominant (89.0%). The genetic composition at the Banc d’Arguin differed significantly from the only foraging aggregation studied in West Africa to date—in the archipelago of Cabo Verde (located ca. 750 km from the Banc d’Arguin)—dominated by haplotype CM-A5. The MSA combining both genetic markers indicated that 87.6% of immature green turtles at the Banc d’Arguin originate from the major East Atlantic rookery at Poilão (Guinea-Bissau), but 11.6% come from more distant rookeries in South America (8.1%) and potentially Ascension Island (3.4%). We suggest that green turtle transatlantic movements may be more common than previously thought and highlight the importance of the Banc d’Arguin as a regional foraging hub for this species.

Marine vertebrates, particularly green sea turtles, are especially vulnerable to plastic pollution through ingestion or entanglement. This study investigated wild juvenile green sea turtles (Chelonia mydas) from two Ecuadorian national parks (Galápagos and Machallilla) to assess the prevalence of plastic pollution in their feces and its potential impact on various health metrics. We analyzed fecal samples from 46 juvenile green sea turtles using Fourier transform infrared spectroscopy (FT-IR) to quantify microplastics (MPs). A complementary methodology using pressurized liquid extraction with double-shot pyrolysis-mass spectrometry gas chromatography (Pyr-GC/MS) was also employed to quantify synthetic polymer mass concentrations. The results from these analyses were compared with blood analytes. FT-IR analysis revealed a mean of 4.4±5.2 MPs/g in fecal samples, with the highest quantities found in the Galápagos Marine Reserve (GMR). The most common MPs shape identified were fibers (x̄= 3.8±4.5 MPs/g), and the predominant synthetic polymers were polyvinyl alcohol (PVOH) and polyacrylates (PMMA). The daily intake of MPs by the sampled turtles ranged from a minimum of 312±409 MPs/day to a maximum of 430±563 MPs/day. Pyr-GC/MS analysis detected polyethylene (PE) with a mean of 367±1158 µg/g and polypropylene (PP) with a mean of 155±434 µg/g in fecal samples, with the highest pollution levels observed in the GMR. Both FT-IR and Pyr-GC/MS techniques detected plastic pollution in 98% of the sampled population. Although both FT-IR and Pyr-GC/MS are reliable methods, they produced slightly different results due to methodological variations. However, both supported the finding that turtles in the GMR were exposed to higher rates of plastic ingestion. Despite the turtles appearing clinically healthy based on blood analysis, significant differences in eleven health metrics were observed between turtles classified as less at risk and those most at risk for plastic pollution. Further research is necessary to understand the potential health implications of these findings.

Purpose: This study draws on genre theory to analyze the linguistic and discursive presentation of the self in successful US college application essays. Research Methods: We used qualitative discourse analysis informed by the systemic functional linguistic concepts of field, tenor, and mode to analyze 20 sample application essays identified as exemplary by college admissions staff from 4 US colleges, along with essay-writing advice obtained from websites of 12 US universities. Our analysis aimed to specify (1) the characteristics of the self that are represented in successful essays and (2) how the writers linguistically and discursively construct these characteristics. Findings: Successful essays portrayed a unique and authentic self through distinctive, patterned features that spanned the three categories of field, tenor, and mode. Features related to "field" included extended metaphors representing insights gained from learning and experience, language representing niche interests, verbs suggesting learning or change, and appraisal language positioning the writer as charitable and optimistic; features related to "tenor" did not include direct address or questions but rather implicit persuasion through descriptive representation of the writer's character; and features related to "mode" included micronarratives, extended metaphors that supported cohesion, and syntactic structures that facilitated contrast of the writer's self before and after a significant moment of learning. Implications: As colleges move away from requiring standardized tests for admission, the importance of college application essays has increased. Our findings contribute to efforts to make successful performance of this high-stakes genre more attainable, particularly for first-generation and underrepresented students applying to college.

Abstract Introduction Guidelines recommend that patients with acute venous thromboembolism (VTE) represented by low-risk deep vein thrombosis (DVT) and pulmonary embolism (PE) receive initial treatment at home versus at the hospital, but a large percentage of these patients are not managed at home. This study assessed the effectiveness of a quality intervention on provider knowledge and confidence in evaluating outpatient treatment for patients with VTE in the emergency department (ED). Methods A pilot program to overcome obstacles to outpatient VTE treatment in appropriate patients was initiated at Baylor Scott & White Health Temple ED. Subsequently, a formalized quality intervention with a targeted educational program was developed and delivered to ED providers. Provider surveys were administered pre- and post-quality intervention in order to assess clinical knowledge, confidence levels, and perceived barriers. Patient discharge information was extracted from electronic health records. Results Twenty-five ED providers completed the pre- and post-surveys; 690 and 356 patients with VTE were included in the pre- and post-pilot and pre- and post-quality intervention periods, respectively. Many ED providers reported that a major barrier to discharging patients to outpatient care was the lack of available and adequate patient follow-up appointments. Notably, after the quality intervention, an increase in provider clinical knowledge and confidence scores was observed. Discharge rates for patients with VTE increased from 25.6% to 27.5% after the pilot intervention and increased from 28.5% to 29.9% after the quality intervention, but these differences were not statistically significant. Despite instantaneous uptick in discharge rates after the interventions, there was not a long-lasting effect. Conclusion Although the quality intervention led to improvements in provider clinical knowledge and confidence and identified barriers to discharging patients with VTE, discharge rates remained stable, underscoring the need for additional endeavors.

For the Western Indian Ocean region, there is a significant knowledge gap regarding marine turtle nesting on the continental coast of East Africa. Here we present results from a long-term (2000–2020) community-based monitoring programme in and around Watamu Marine National Park, Kenya, covering 30 km of coastline (c. 6% of the national total). Conservation actions effectively protected nesting turtles and resulted in a near-total cessation of illegal egg harvesting in Watamu Marine National Park. Collected data indicate this is an important marine turtle nesting index site in Kenya and the wider region. Green turtle Chelonia mydas nests were most common (95%), followed by olive ridley turtles Lepidochelys olivacea (4%), with occasional nests of hawksbill Eretmochelys imbricata and leatherback turtles Dermochelys coriacea. Clutches per season increased significantly over the 20-year monitoring period for green turtles (50%) and showed a positive trend for olive ridley turtles. Watamu remains an area at risk from human pressures such as coastal development. Clutch distribution along the Watamu Marine National Park beach has shifted over time, probably because of coastal development and disturbance. Illegal take of adults and eggs continues in areas north and south of the Watamu Marine National Park, possibly slowing rates of recovery. Clutches deemed at risk were moved to a safe location within the National Park, and hatching success was high. Continued conservation efforts, including wider engagement with stakeholders to reduce human pressures, are needed to ensure the perpetuation of this nesting site.

The Arts and Science Honours Academy (ASHA) is a unique interdisciplinary undergraduate honours programme at a large research-intensive university in Canada. Data were collected in early 2020 from 108 past and present students, representing the first eleven cohorts of the programme. Triangulating results from quantitative and qualitative analyses, we describe the ASHA students’ educational and social experience during their time at university and, for those who have graduated, their post-graduate activities. Situating our investigation within previous literature examining interdisciplinary undergraduate learning communities and high impact practices, we assess whether students from arts and science disciplines experienced the programme differently, and which aspects of the programme were most impactful. We find that academically, students reported benefiting from the exposure to interdisciplinary thought, the opportunity to do research, and the study abroad requirement. Socially, students reported benefiting from the connections they formed with a small cohort of high achieving peers from a variety of disciplinary backgrounds. While science students reported benefitting the most from ASHA socially, arts students were more likely to indicate that the programme influenced their careers following graduation. These findings provide evidence to support the creation and design of future interdisciplinary undergraduate programmes.

Sea turtles are an iconic group of marine megafauna that have been exposed to multiple anthropogenic threats across their different life stages, especially in the past decades. This has resulted in population declines, and consequently many sea turtle populations are now classified as threatened or endangered globally. Although some populations of sea turtles worldwide are showing early signs of recovery, many still face fundamental threats. This is problematic since sea turtles have important ecological roles. To encourage informed conservation planning and direct future research, we surveyed experts to identify the key contemporary threats (climate change, direct take, fisheries, pollution, disease, predation, and coastal and marine development) faced by sea turtles. Using the survey results and current literature, we also outline knowledge gaps in our understanding of the impact of these threats and how targeted future research, often involving emerging technologies, could close those gaps.

It is widely recognized that the examination of haplotypes among sea turtles inhabiting nesting beaches holds significant importance. Yet, an effective conservation effort of a population also requires an investigation of the origin of sea turtles that strand on the shore, especially as many of these result from interactions with fisheries. In consideration of this, we analyzed the haplotypes of 542 stranded individuals from the Eastern Mediterranean and identified a total of 9 different haplotypes. Two of these were new haplotypes, one individual was found in Marmaris, Türkiye, and the other in a stranded species in northern Cyprus. Mixed-stock analysis demonstrated that the majority of the individuals stranded in western Türkiye originated from nesting beaches in the same area (33%), followed by Dalyan, Türkiye (25%), and Cyprus (21%). The partial mixed-stock analysis of individuals stranded in the Dalyan–Dalaman region of Türkiye revealed that most originated from Dalaman (45%) and Dalyan (21%), followed by western Greece (11%). The partial mixed-stock analysis for the Eastern Mediterranean showed that the majority of individuals originated from western Türkiye (69%), followed by Cyprus (11%) and Dalyan (7%). These findings, by quantifying the relative contributions of each region, provide valuable insights for guiding conservation efforts regarding Caretta caretta in the Mediterranean marine environment.

Introduction Social networks can affect health beliefs, behaviours and outcomes through various mechanisms, including social support, social influence and information diffusion. Social network analysis (SNA), an approach which emerged from the relational perspective in social theory, has been increasingly used in health research. This paper outlines the protocol for a scoping review of literature that uses social network analytical tools to examine the effects of social connections on individual non-communicable disease and health outcomes.Methods and analysis This scoping review will be guided by Arksey and O’Malley’s framework for conducting scoping reviews. A search of the electronic databases, Ovid Medline, PsycINFO, EMBASE and CINAHL, will be conducted in April 2024 using terms related to SNA. Two reviewers will independently assess the titles and abstracts, then the full text, of identified studies to determine whether they meet inclusion criteria. Studies that use SNA as a tool to examine the effects of social networks on individual physical health, mental health, well-being, health behaviours, healthcare utilisation, or health-related engagement, knowledge, or trust will be included. Studies examining communicable disease prevention, transmission or outcomes will be excluded. Two reviewers will extract data from the included studies. Data will be presented in tables and figures, along with a narrative synthesis.Ethics and dissemination This scoping review will synthesise data from articles published in peer-reviewed journals. The results of this review will map the ways in which SNA has been used in non-communicable disease health research. It will identify areas of health research where SNA has been heavily used and where future systematic reviews may be needed, as well as areas of opportunity where SNA remains a lesser-used method in exploring the relationship between social connections and health outcomes.

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Non-traditional doctoral students encounter numerous challenges seeking a doctoral degree in an online learning environment. Non-traditional online doctoral students tend to be working adults who are integrating their online doctoral studies with the existing challenges of work and family. Effective online accountability partners must work within a framework of virtual mentoring competencies for online doctoral students to successfully collaborate, communicate, and learn together. The qualitative exploratory study explored the experiences of successful online doctoral students at working with accountability partners during their doctoral journey. The research question guiding the study was: How can accountability partner relationships be effective for online doctoral students when almost no face-to-face and in-person interaction takes place? The three themes emerging from the study addressed the online doctoral student's need for (1) collaboration, (2) socialization, and (3) support from their accountability partners. Study participants emphasized the many characteristics of a successful accountability partner relationship, including bidirectional support, feedback, communication, encouragement, cooperation, and collaboration. The study findings aligned with existing literature and illustrated the many challenges faced by online doctoral students that their more traditional student counterparts studying in a more traditional brick-and mortar university environment do not encounter. Numerous practical implications and recommendations resulted from this study. The researchers created the Collaboration, Socialization, and Support (CSS) framework using the thematic analysis of the coded interview results. The CSS framework is a practical model for creating and maintaining successful accountability partner relationship between online doctoral students.

Abstract Background Financial barriers in substance use disorder service systems have limited the widespread adoption—i.e., provider-level reach—of evidence-based practices (EBPs) for youth substance use disorders. Reach is essential to maximizing the population-level impact of EBPs. One promising, but rarely studied, type of implementation strategy for overcoming barriers to EBP reach is financing strategies, which direct financial resources in various ways to support implementation. We evaluated financing strategies for the Adolescent Community Reinforcement Approach (A-CRA) EBP by comparing two US federal grant mechanisms, organization-focused and state-focused grants, on organization-level A-CRA reach outcomes. Method A-CRA implementation took place through organization-focused and state-focused grantee cohorts from 2006 to 2021. We used a quasi-experimental, mixed-method design to compare reach between treatment organizations funded by organization-focused versus state-focused grants (164 organizations, 35 states). Using administrative training records, we calculated reach as the per-organization proportion of trained individuals who received certification in A-CRA clinical delivery and/or supervision by the end of grant funding. We tested differences in certification rate by grant type using multivariable linear regression models that controlled for key covariates (e.g., time), and tested threats to internal validity from our quasi-experimental design through a series of sensitivity analyses. We also drew on interviews and surveys collected from the treatment organizations and (when relevant) interviews with state administrators to identify factors that influenced reach. Results The overall certification rates were 27 percentage points lower in state-focused versus organization-focused grants (p = .01). Sensitivity analyses suggested these findings were not explained by confounding temporal trends nor by organizational or state characteristics. We did not identify significant quantitative moderators of reach outcomes, but qualitative findings suggested certain facilitating factors were more influential for organization-focused grants (e.g., strategic planning) and certain barrier factors were more impactful for state-focused grants (e.g., states finding it difficult to execute grant activities). Discussion As the first published comparison of EBP reach outcomes between financing strategies, our findings can help guide state and federal policy related to financing strategies for implementing EBPs that reduce youth substance use. Future work should explore contextual conditions under which different financing strategies can support the widespread implementation of EBPs for substance use disorder treatment.

Vestibular migraine (VM) is an increasingly recognized pathology yet remains as an underdiagnosed cause of vestibular disorders. While current diagnostic criteria are codified in the 2012 Barany Society document and included in the third edition of the international classification of headache disorders, the pathophysiology of this disorder is still elusive. The Association for Migraine Disorders hosted a multidisciplinary, international expert workshop in October 2020 and identified seven current care gaps that the scientific community needs to resolve, including a better understanding of the range of symptoms and phenotypes of VM, the lack of a diagnostic marker, a better understanding of pathophysiologic mechanisms, as well as the lack of clear recommendations for interventions (nonpharmacologic and pharmacologic) and finally, the need for specific outcome measures that will guide clinicians as well as research into the efficacy of interventions. The expert group issued several recommendations to address those areas including establishing a global VM registry, creating an improved diagnostic algorithm using available vestibular tests as well as others that are in development, conducting appropriate trials of high quality to validate current clinically available treatment and fostering collaborative efforts to elucidate the pathophysiologic mechanisms underlying VM, specifically the role of the trigemino-vascular pathways.