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Field experiences provide opportunities for early childhood and early childhood special education (EC/ECSE) educators to implement effective practices in learning settings, and are, therefore, a vital part of EC/ECSE teacher preparation. In this article, we describe field placement models from four universities in the United States: The Bridge Project, Getting Started Early, Peer Coaching to Increase Naturalistic Developmental Behavioral Interventions, and University Supervisors Coaching Teacher Candidates: Supporting Young Bi/Multilingual Children with Disabilities. Although there is variety in the settings and effective practices supported through these field placements, performance feedback and collaboration are clear themes across models.

Politics and science are inextricably connected, particularly in relation to the climate emergency and other environmental crises, yet science education is an often overlooked site for engaging with the political dimensions of environmental issues. This study examines how science teachers in England experience politics--specifically political participation--in relation to the environment in school science, against a background of increased obstruction in civic space. The study draws on an analysis of theoretically informed in-depth interviews with eleven science teachers about their experiences of political participation in relation to environmental issues. We find that politics enters the science classroom primarily through informal conversations initiated by students rather than planned by teachers. When planned for, the emphasis is on individual, latent-political (civic) engagement rather than manifest political participation. We argue that this is a symptom of the post-political condition and call for a more enabling environment for discussing the strengths and limitations of different forms of political participation in school science.

Natural killer (NK) cells are innate lymphoid cells (ILCs) contributing to immune responses to microbes and tumors. Historically, their classification hinged on a limited array of surface protein markers. Here, we used single-cell RNA sequencing (scRNA-seq) and cellular indexing of transcriptomes and epitopes by sequencing (CITE-seq) to dissect the heterogeneity of NK cells. We identified three prominent NK cell subsets in healthy human blood: NK1, NK2 and NK3, further differentiated into six distinct subgroups. Our findings delineate the molecular characteristics, key transcription factors, biological functions, metabolic traits and cytokine responses of each subgroup. These data also suggest two separate ontogenetic origins for NK cells, leading to divergent transcriptional trajectories. Furthermore, we analyzed the distribution of NK cell subsets in the lung, tonsils and intraepithelial lymphocytes isolated from healthy individuals and in 22 tumor types. This standardized terminology aims at fostering clarity and consistency in future research, thereby improving cross-study comparisons.

As chronic wasting disease (CWD) continues to spread across North America, the relationship between CWD and host genetics has become of interest. In Rocky Mountain elk (Cervus elaphus nelsoni), one or two copies of a leucine allele at codon 132 of the prion protein gene (132L*) has been shown to prolong the incubation period of CWD. Our study examined the relationship between CWD epidemiology and codon 132 evolution in elk from Wyoming, USA, from 2011 to 2018. Using PCR and Sanger sequencing, we genotyped 997 elk and assessed the relationship between genotype and CWD prevalence estimated from surveillance data. Using logistic regression, we showed that each 1% increase in CWD prevalence is associated with a 9.6% increase in the odds that an elk would have at least one copy of leucine at codon 132. In some regions, however, 132L* variants were found in the absence of CWD, indicating that evolutionary and epidemiologic patterns can be heterogeneous across space and time. We also provide evidence that naturally occurring CWD is not rare in 132L* elk, which merits the study of shedding kinetics in 132L* elk and the influence of genotype on CWD strain diversity. The management implications of cervid adaptations to CWD are difficult to predict. Studies that investigate the degree to which evolutionary outcomes are shaped by host spatial structure can provide useful epidemiologic insight, which can in turn aid management by informing scale and extent of mitigation actions.

Students' mathematics self-efficacy (MSE) is strongly associated with learning behaviours and performance, and students' future career choices. In our scoping review, we screened what "substantive foci" (conceptualization, directionality and role of MSE, change in MSE, and situational specificity of MSE) have been posed and which "methodological approaches" (participants, analytical methods, data sources, and congruence of measures) have been used in recent (2018-2022) studies of MSE. Studies of MSE were clearly in the mathematics domain with 21 of 49 included studies exploring specific mathematics areas. The key focus was on strength of MSE. International databases (i.e., PISA) have enabled broad generalization, while in-depth qualitative studies enable minute situation-specificity. Cross-sectional and longitudinal studies using hierarchically nested designs (i.e., students in classrooms) enable us to draw conclusions at both individual, classroom, and school levels. The current state-of-the-art indicates methodological advancement is rapid and we are likely to see further methodological-substantive synergies in the field of MSE in future studies. We see the potential and need for future mixed-methods studies that continue the focus on MSE as a multidimensional and dynamic concept. Careful consideration of the theoretical background of the construct of MSE continues to be important to bring the field forward.

Maternal educational attainment (MEA) shapes offspring health through multiple potential pathways. Differential DNA methylation may provide a mechanistic understanding of these long-term associations. We aimed to quantify the associations of MEA with offspring DNA methylation levels at birth, in childhood and in adolescence. Using 37 studies from high-income countries, we performed meta-analysis of epigenome-wide association studies (EWAS) to quantify the associations of completed years of MEA at the time of pregnancy with offspring DNA methylation levels at birth (n = 9 881), in childhood (n = 2 017), and adolescence (n = 2 740), adjusting for relevant covariates. MEA was found to be associated with DNA methylation at 473 cytosine-phosphate-guanine sites at birth, one in childhood, and four in adolescence. We observed enrichment for findings from previous EWAS on maternal folate, vitamin-B12 concentrations, maternal smoking, and pre-pregnancy BMI. The associations were directionally consistent with MEA being inversely associated with behaviours including smoking and BMI. Our findings form a bridge between socio-economic factors and biology and highlight potential pathways underlying effects of maternal education. The results broaden our understanding of bio-social associations linked to differential DNA methylation in multiple early stages of life. The data generated also offers an important resource to help a more precise understanding of the social determinants of health.

Background: Transcatheter aortic valve implantation (TAVI) has shown similar or improved clinical outcomes compared with surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic stenosis at low risk for surgical mortality. This cost-utility analysis compared TAVI with SAPIEN 3 versus SAVR in symptomatic severe aortic stenosis patients at low risk of surgical mortality from the perspective of the Swedish healthcare system. Methods: A published, two-stage, Markov-based cost-utility model that captured clinical outcomes from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated according to Recommended Therapies (SWEDEHEART) registry (2018–2020) was adapted from the perspective of the Swedish healthcare system using local general population mortality, utility and costs data. The model had a lifetime horizon. Model outputs included changes in direct healthcare costs and health-related quality of life from using TAVI as compared with SAVR. Results: TAVI with SAPIEN 3 resulted in lifetime costs per patient of 940,541 Swedish krona (SEK) and lifetime quality-adjusted life years (QALYs) per patient of 7.16, whilst SAVR resulted in lifetime costs and QALYs per patient of 821,380 SEK and 6.81 QALYs, respectively. Compared with SAVR, TAVI offered an incremental improvement of +0.35 QALY per patient at an increased cost of +119,161 SEK per patient over a lifetime horizon, resulting in an incremental cost-effectiveness ratio of 343,918 SEK per QALY gained. Conclusion: TAVI with SAPIEN 3 is a cost-effective option versus SAVR for patients with symptomatic severe aortic stenosis at low risk for surgical mortality treated in the Swedish healthcare setting. These findings may inform policy decisions in Sweden for the management of this patient group.

Abstract Background Recent studies have underscored the potential of innovative administration methods to mitigate the capacity burden on healthcare systems, without compromising the quality of care. This study assessed and compared the resource utilization and associated costs of two distinct administration modes of immune checkpoint inhibitors: the innovative elastomeric pump and conventional intravenous infusion. This comparison can inform sustainable healthcare practices and healthcare decision-making to optimize treatment efficiency in an era of escalating healthcare demands. Methods In this micro-costing study, data on resource use and time allocation for drug preparation and administration were collected using an observational, non-interventional study design. Data were registered at the oncology daycare unit and hospital pharmacy. Cost categories included drug acquisition, disposable materials, healthcare professional time for drug administration, drug preparation, and patient time spent at the oncology day care unit. Results Drug administration through the elastomeric pump resulted in substantially lower healthcare costs when compared to conventional infusion, particularly due to reduced labor and chair time. The elastomeric pump reduced the total chair time by 78% and nurse time by 55%. Total average costs (excluding drug costs) were €103,47 and €77.99 for conventional infusion and the elastomeric pump, respectively, showcasing potential savings of €25.48 (P

This study investigates the relationship between students' self-efficacy beliefs, goal-setting, and learning tactics in an online business course. Using sequence analysis and process mining techniques, we analyzed log data from 209 students to identify distinct learning tactics and their association with self-efficacy beliefs, inferred from initial goal-setting and final grades. Four learning tactics were identified, with significant differences observed between students with high and low self-efficacy beliefs. High self-efficacy students demonstrated more varied and adaptive tactics, including greater use of quizzes and project-focused activities. In contrast, low self-efficacy students and those who didn't set goals showed less engagement and fewer monitoring activities. The project-focused tactic had the strongest correlation with final grades and goal achievement. Goal-setting at the course's start was linked to more effective learning behaviors and better outcomes. The study reveals how students' online learning behavior changes based on initial goal-setting and subsequent reflection. These findings contribute to research on self-regulated learning in online environments and offer practical implications for designing online courses and learning analytics interventions. Understanding these differences enables the development of targeted interventions to improve learning tactics and self-efficacy beliefs among students, ultimately enhancing their ability to achieve learning goals in online educational settings.

Whether intended by education policy (e.g., via school entrance examinations) or unintended (e.g., via social stratification), selection effects in education (who goes where, gets what, and how much) shape educational opportunities -- influencing the life chances of individuals and groups, and the structure of societies. However, within the quantitative approach to educational research, current statistical methods can struggle to simultaneously evaluate both the presence and impacts of these effects. In turn, this methodological limitation impedes efforts to facilitate equality of educational opportunity. This paper responds with a critical overview of types of selection effects in education, their consequences for educational opportunity, and the statistical methods used for their identification. Two empirical illustrations show how a new statistical method ("airbag moderation") can enable better detection and evaluation of selection effects in education and help direct future research into selection effects in education with a focus on opportunities for equality of educational opportunity.

Abstract Background Persistent pain is a frequent cause of sick leave and work disability in Norway. A return-to-work intervention featuring supported work placements, developed in the UK, demonstrated feasibility, and a return-to-work rate of 20% within 6 months was observed in the sample. We sought to adapt the intervention for delivery in Norway and to confirm feasibility prior to a full-scale trial. Methods In this internal pilot, we used a pragmatic cohort randomised controlled approach with national recruitment in Norway. We recruited people who were unemployed (for at least 1 month), having persistent pain (for at least 3 months), aged between 18 and 64, and wanting to return to work. We initially recruited people to an observational cohort study of the impact of being unemployed with persistent pain. After baseline measurement, we randomly sub-sampled participants to whom we offered the intervention, which featured individual case management and support, work-familiarisation sessions, and the offer of a 6-week part-time unpaid work placement. We assessed recruitment rates (aiming to recruit 66, and sub-sample 17 within 6 months); optimal recruitment pathways; intervention acceptance rates; the feasibility of data collection; using video links for work-familiarisation sessions and remote case manager support. Results The pilot ran from June to November 2022. Of 168 people expressing interest, 94 consented. Recruitment posts on Facebook yielded the most ‘expressions of interest’ (66%, n = 111). After screening for eligibility, we included 55 participants. Of these, 19 were randomised to be offered the intervention. Of these, less than half (n = 8) consented to intervention participation. Remote case manager and work-familiarisation sessions appeared feasible. Following a delay in identifying placements, three participants received offers of work placements, with one starting and completing during the pilot period. Data collection methods were feasible, and no adverse events were reported. Conclusions Recruitment and logistical processes, such as remote management by video link, are feasible. However, delivery of the intervention is challenging. In particular, sourcing placements and the time required for identifying appropriate placements was more challenging than anticipated. A full-scale trial is feasible but will require improvements to the placement identification processes. Trial registration ISRCTN85437524 (Referring to the ReISE trial, of which this internal pilot was a part), Registered 31 of May 2022 https://doi.org/10.1186/ISRCTN85437524 Trial funding Norwegian Research Council.

Abstract We demonstrate aluminum-on-silicon planar transmon qubits with time-averaged T 1 energy relaxation times of up to 270 μs, corresponding to Q = 5 million, and a highest observed value of 501 μs. Through materials analysis techniques and numerical simulations we investigate the dominant source of energy loss, and devise and demonstrate a strategy toward its mitigation. Growing aluminum films thicker than 300 nm reduces the presence of oxide, a known host of defects, near the substrate-metal interface, as confirmed by time-of-flight secondary ion mass spectrometry. A loss analysis of coplanar waveguide resonators shows that this results in a reduction of dielectric loss due to two-level system defects. The correlation between the enhanced performance of our devices and the film thickness is due to the aluminum growth in columnar structures of parallel grain boundaries: transmission electron microscopy shows larger grains in the thicker film, and consequently fewer grain boundaries containing oxide near the substrate-metal interface.

The current study uses a within-person temporal and sequential analysis to understand individual learning processes as part of collaborative learning. Contemporary perspectives of self-regulated learning acknowledge monitoring as a crucial mechanism for each phase of the regulated learning cycle, but little is known about the function of the monitoring of these phases by individual students in groups and the role of motivation in this process. This study addresses this gap by investigating how monitoring coexists temporally and progresses sequentially during collaborative learning. Twelve high school students participated in an advanced physics course and collaborated in groups of three for twenty 90-minute learning sessions. Each student's monitoring events were first identified from the videotaped sessions and then associated with the regulation phase. In addition, the ways in which students acknowledged each monitoring event were coded. The results showed that cyclical phases of regulation do not coexist. However, when we examined temporal and sequential aspects of monitoring, the results showed that the monitoring of motivation predicts the monitoring of task definition, leading to task enactment. The results suggest that motivation is embedded in regulation phases. The current study sheds light on idiographic methods that have implications for individual learning analytics.

That predators ‘cull the sick and the weak’ is an adage in ecological texts, but the mechanisms by which disease is curtailed within ecosystems has puzzled ecologists for many years. Advances in our understanding of host-pathogen interactions have revealed defense mechanisms implemented by hosts that minimize infectious diseases in wild populations. Defense mechanisms for hosts include adaptations that ameliorate fitness loss or preemptively limit pathogen exposure, and these mechanisms underlie fundamental questions about how scavenging or predation influence pathogen transmission. A key lens for our understanding of predator-prey and scavenging dynamics include behaviorally-mediated trade-offs weighed by consumers between nutritional gains and pathogen exposure risks. Consequently, the degree to which pathogens and associated diseases perpetuate through food webs can be partly attributed to behavioral responses of predators and scavengers, particularly their selection or avoidance of diseased prey and infected carcasses. Even so, examinations of avoidance or preference by predators and scavengers to diseased carrion are underrepresented. Here we identify areas for future research focused on behavioral immunity that could illuminate where, when, and how pathogen transmission reverberates through ecological communities. While directly attributing behavioral responses to pathogen exposure may be challenging, particularly for organisms with low susceptibility to spillover, identifying these responses though experimentation or observation help describe complex systems regarding infectious disease.

Sarracenia provide an optimal system for deciphering the host-microbiome interactions at various levels. We analyzed the pitcher microbiomes and metatranscriptomes of the parental species, and F1 and F2 generations from the mapping population (Sarracenia purpurea X Sarracenia psittacina) utilizing high-throughput sequencing methods. This study aimed to examine the host influences on the microbiome structure and function and to identify the key microbiome traits. Our quality datasets included 8,892,553 full-length bacterial 16s rRNA gene sequences and 65,578 assembled metatranscripts with microbial protein annotations. The correlation network of the bacterial microbiome revealed the presence of 3-7 distinct community clusters, with 8 hub and 19 connector genera. The entire microbiome consisted of viruses, bacterial, archaea, and fungi. The richness and diversity of the microbiome varied among the parental species and offspring genotypes despite being under the same greenhouse environmental conditions. We have discovered certain microbial taxa that are genotype-enriched, including the community hub and connector genera. Nevertheless, there were no significant differences observed in the functional enrichment analysis of the metatranscriptomes across the different genotypes, suggesting a functional convergence of the microbiome. We found that the pitcher microcosm harbors both rhizosphere and phyllosphere microbiomes within its boundaries, resulting in a structurally diverse and functionally complex microbiome community. A total of 50,424 microbial metatranscripts were linked to plant growth-promoting microbial proteins. We show that this complex pitcher microbiome possesses various functions that contribute to plant growth promotion, such as biofertilization, bioremediation, phytohormone signaling, stress regulation, and immune response stimulation. Additionally, the pitcher microbiome exhibits traits related to microbe-microbe interactions, such as colonization of plant systems, biofilm formation, and microbial competitive exclusion. In summary, the demonstrated taxonomical divergence and functionally convergence of the pitcher microbiome are impacted by the host genetics, making it an excellent system for discovering novel beneficial microbiome traits.

Abstract Background To meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents – coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent–child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group). Methods We describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with 252 families randomly allocated to SPARCK or UC. Assessment of key variables will be conducted at pre-, post-, and six-month follow-up. Discussion The current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology. Trial registration ClinicalTrials.gov ID: NTCT05800522

Background: Group affective states for learning are constantly formed through socio-emotional interactions. However, it remains unclear how the affective states vary during collaboration and how they occur with regulation of learning. Appropriate methods are needed to track both group affective states and these interaction processes. Aims: The present study identifies different socio-emotional interaction episodes during groups' collaborative learning and examines how group affective states fluctuate with regulation of learning during these episodes. Sample: The participants were 54 secondary school students working in groups across four science learning sessions. Methods: Multichannel process data (video, electrodermal activity [EDA]) were collected in an authentic classroom. Groups' affective states were measured with emotional valence captured from video data, and activation captured as sympathetic arousal from EDA data. Regulation of learning was observed from the videotaped interactions. Results: The study disclosed four clusters of socio-emotional interaction episodes (positive, negative, occasional regulation, frequent regulation), which differed in terms of fluctuation of affective states and activated regulation of learning. These clustered episodes confirm how affective states are constantly reset by socio-emotional interactions and regulation of learning. The results also show that states requiring regulation do not automatically lead to its activation. Conclusions: By advancing existing understanding of how group level socio-emotional processes contribute to regulation of learning, the study has implications for educational design and psychological practice. Methodologically, it contributes to collaborative learning research by employing multiple data channels (including biophysiological measures) to explore the various dimensions of socio-emotional processes in groups.

Aim: We investigated the dose--response relationship between acute physical activity (PA) intensity during physical education (PE) lessons (dose), and task behaviour and learning experiences in the classroom after PE (response), and mediation effects of acute PA on-task behaviour via learning experiences. Method: A total of 78 children (M[subscript age] = 9.30 years; 43 females) took part. Participants reported learning experiences (tiredness, positive and negative affect) during one afternoon per week for 6 weeks. Their task behaviour was observed (on-task, active off-task and passive off-task) during two classroom lessons. Between the classroom lessons, they took part in a PE lesson, with experimentally induced PA intensity (low, medium and high). Accelerometers were worn for 24 h leading up to and during every intervention afternoon. Participants completed self-reports three times per classroom lesson, both before and after PE. Intra- and interindividual differences in PA, task behaviour and learning experiences were analysed with multilevel structural equation models. Results: Moderate PA directly increased on-task behaviour and reduced passive off-task behaviour, whereas light PA increased active off-task behaviour and reduced on-task behaviour. We found no direct effects of vigorous PA or mediated effects of any PA intensity on-task-related behaviour. However, a greater positive affect during PE indirectly led to more on-task and less passive off-task behaviour. Regularly active children reported less tiredness in the classroom. Conclusion: PE lessons can increase on-task behaviour and reduce both passive and active off-task behaviours. Positive affect and tiredness are indirectly involved in the impact of PA on task-related behaviour. The greatest benefits were found for moderate PA and for PE lessons, which left children feeling positive. Moreover, regular participation in moderate-to-vigorous PA leads children to feel less tired during school lessons.

Background: The combination of an inhaled corticosteroid (ICS) and long-acting β-agonist (LABA) (ICS/LABA) has shown superiority in improving lung function (FEV1) compared with an ICS alone. The clinical effect of a ICS/LABA combination depends on the fine-particle fraction and the pulmonary deposition. Objective: We sought to compare the efficacy of 2 combinations of an ICS and LABA, namely, fluticasone propionate (FP) and formoterol (FORM) (FP/FORM) and fluticasone furoate (FF) and vilanterol (VI) (FF/VI), in asthmatic adolescents with chronic bronchial obstruction. Methods: FP/FORM (125 μg/5 μg, 2 doses twice daily via the k-haler [Mundipharma, Cambridge, UK]) and FF/VI (92 μg/22 μg, once daily via the Ellipta inhaler [GlaxoSmithKline]) were administered to adolescents aged 12 to 17 years who required regular antiasthmatic medication and had a ratio of FEV1 to forced vital capacity (FEV1/FVC) less than –1.65 SD in a 2-sequence, 16-week crossover trial. The primary efficacy end point was change in FEV1 compared with baseline. Secondary end points were FEV1/FVC ratio, maximal expiratory flow at 50% of the FVC, impulse oscillometry indices respiratory resistance at 5 Hz (R5), difference between R5 and respiratory resistance at 20 Hz (R20), area of reactance, and Asthma Control Test score. Results: Both ICS/LABA combinations resulted in a significant improvement in FEV1 and maximal expiratory flow at 50% of the FVC z scores without any significant difference between FP/FORM and FF/VI, with 40% of patients with either treatment achieving a normal prebronchodilator FEV1/FVC z score. Neither area of reactance nor difference between R5 and R20 improved significantly with either treatment. Conclusion: Both ICS/LABA combinations demonstrated significant improvements in FEV1 z score. More than one-third of the asthmatic adolescents with prolonged bronchial obstruction achieved a normal prebronchodilator FEV1/FVC ratio.

Asthma is a common chronic disease in children. It is a dynamic condition—symptoms change over time, and the outcome of diagnostic tests can vary. Consequently, evaluating the onset of asthma at a single point in time, perhaps when patients are asymptomatic with limited impairment of the lung function, may result in false diagnostic conclusions. The absence of consistent gold-standard diagnostic criteria in children challenges the ability of any study to ascertain an effect of treatment on asthma prevention. A comprehensive review of the diagnostic criteria used for new-onset asthma in school-age children was conducted based on existing recommendations from published clinical guidance, alongside evidence from paediatric asthma prevention trials. Findings from the review were used to propose suggestions for diagnosing new-onset asthma in future asthma prevention trials. Despite an overall lack of consensus in the published clinical guidance, there are similarities between the various recommendations for diagnosing asthma in children, which typically involve assessing the variable symptoms and supplementing the medical history with objective measures of lung function. For future paediatric asthma prevention trials, we suggest that paediatric clinical trials should use a new-onset asthma definition that incorporates the concepts of “possible”, “probable” and “confirmed” asthma. “Possible” asthma would capture self-reported features of chronic symptoms and symptom relief with β2-agonist bronchodilator (suggesting reversibility). “Probable” asthma would include symptom chronicity, self-reported symptom relief with β2-agonist bronchodilator, and objective features of asthma (reversibility or bronchial hyper-responsiveness). A “confirmed” diagnosis would be made only if there is a positive response to controller therapy. These suggestions aim to improve the diagnosis of new-onset childhood asthma in clinical trials, which will be useful in the design and conduct of future paediatric asthma prevention trials.

NAVs jobbklubb har vært en sentral del av arbeidsmarkedstiltakene i Norge i flere tiår, men vi vet lite om hvorvidt jobbklubb fører til økt arbeidsdeltakelse. I denne artikkelen undersøker vi arbeidsdeltakelsen blant deltakerne etter endt jobbklubb, sammenlignet med året før de deltok, og om mønsteret varierer mellom ulike demografiske grupper. Dataene omfatter 2856 personer som deltok i jobbklubb, organisert av Nav Hordaland, i én til to måneder i perioden mellom januar 2016 og november 2019. Arbeidsdeltakelsen økte med omtrent 10 prosentpoeng i året etter deltakelse i jobbklubb sammenlignet med året før. Økningen er størst for kvinner, norskfødte og yngre deltakere.

Abstract Background The COVID-19 control policies might negatively impact older adults’ participation in volunteer work, instrumental support provision, and the likelihood of receiving instrumental support. Studies that quantify changes in these activities and the related factors are limited. The current study aimed to examine the level of volunteering, instrumental support provision and receipt before and during the first phase of the COVID-19 pandemic in Europe and to determine whether older adults’ volunteering, instrumental support provision and receipt were associated with individual exposure to COVID-19 and the stringency of country’s COVID-19 control policy during the first phase of the COVID-19 pandemic. Methods A cross-sectional survey using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) Corona Survey 1 was designed to focus on community-dwelling Europeans aged ≥50 years. History of participation in volunteering work and instrumental support provision or receipt was assessed from the previous SHARE Wave data. The country’s COVID-19 control policy stringency index (S-Index) was from the Oxford COVID-19 Government Response Tracker database. A total of 45,669 respondents from 26 European countries were included in the volunteering analysis. Seventeen European countries were included in the analyses of instrumental support provision (N = 36,518) and receipt (N = 36,526). The multilevel logistic regression model was fitted separately to analyse each activity. Results The level of volunteering and instrumental support provision was lower during the pandemic, but instrumental support receipt was higher. The country S-Index was positively associated with support provision (OR:1.13;95%CI:1.02–1.26) and negatively associated with support receipt (OR:0.69;95%CI:0.54–0.88). Exposure to COVID-19 was positively associated with support receipt (OR:1.64;95%CI:1.38–1.95). COVID-19 exposure on close ones positively associated with volunteering (OR:1.47;95%CI:1.32–1.65), support provision (OR:1.28;95%CI:1.19–1.39), and support receipt (OR:1.25;95%CI:1.15–1.35). Conclusions The COVID-19 pandemic impacted older Europeans’ volunteering, instrumental support provision, and instrumental support receipt from outside their household. When someone close to them was exposed to COVID-19, older Europeans were likely to receive instrumental support and to volunteer and provide instrumental support. A stricter country’s COVID-19 control policy might motivate older adults to provide instrumental support, but it prevents them from receiving instrumental support from outside their households.

Abstract Background Combining multimodal lifestyle interventions and disease-modifying drugs (novel or repurposed) could provide novel precision approaches to prevent cognitive impairment. Metformin is a promising candidate in view of the well-established link between type 2 diabetes (T2D) and Alzheimer’s Disease and emerging evidence of its potential neuro-protective effects (e.g. vascular, metabolic, anti-senescence). MET-FINGER aims to test a FINGER 2.0 multimodal intervention, combining an updated FINGER multidomain lifestyle intervention with metformin, where appropriate, in an APOE ε4-enriched population of older adults (60–79 years) at increased risk of dementia. Methods MET-FINGER is an international randomised, controlled, parallel-group, phase-IIb proof-of-concept clinical trial, where metformin is included through a trial-within-trial design. 600 participants will be recruited at three sites (UK, Finland, Sweden). Participants at increased risk of dementia based on vascular risk factors and cognitive screening, will be first randomised to the FINGER 2.0 intervention (lifestyle + metformin if eligible; active arm) or to receive regular health advice (control arm). Participants allocated to the FINGER 2.0 intervention group at risk indicators of T2D will be additionally randomised to receive metformin (2000 mg/day or 1000 mg/day) or placebo. The study duration is 2 years. The changes in global cognition (primary outcome, using a Neuropsychological Test Battery), memory, executive function, and processing speed cognitive domains; functional status; lifestyle, vascular, metabolic, and other dementia-related risk factors (secondary outcomes), will be compared between the FINGER 2.0 intervention and the control arm. The feasibility, potential interaction (between-groups differences in healthy lifestyle changes), and disease-modifying effects of the lifestyle-metformin combination will be exploratory outcomes. The lifestyle intervention is adapted from the original FINGER trial (diet, physical activity, cognitive training, monitoring of cardiovascular/metabolic risk factors, social interaction) to be consistently delivered in three countries. Metformin is administered as Glucophage®XR/SR 500, (500 mg oral tablets). The metformin/placebo treatment will be double blinded. Conclusion MET-FINGER is the first trial combining a multimodal lifestyle intervention with a putative repurposed disease-modifying drug for cognitive impairment prevention. Although preliminary, its findings will provide crucial information for innovative precision prevention strategies and form the basis for a larger phase-III trial design and future research in this field. Trial registration ClinicalTrials.gov (NCT05109169).