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Studies document difficulties undergraduate pre-nursing and allied health students face when learning human anatomy and physiology (A&P) course content. A comprehensive synthesis exploring the teaching practices within the course and how those practices are evaluated is warranted. This scoping literature review identified 78 journal articles investigating teaching practices, and we charted their research methods, student outcomes, and institutional contexts. Content analysis found the teaching practices described most frequently in A&P education research literature involved multiple aligned changes across the curriculum, including student activities, course delivery, and assessments. Critical appraisal of study methodologies revealed that most studies in undergraduate A&P were longitudinal, included comparison groups, and used simple inferential statistics. In contrast, few studies listed limitations of their research, collected data from multiple institutions, or reported student demographic data. We believe these factors pose notable limitations to the interpretation of A&P education studies across institutional contexts. The results of this review identify future lines of inquiry to enrich existing evidence about pedagogical interventions in A&P courses.

The investigation of triggers causing the onset and intensification of Northern Hemisphere Glaciation (NHG) during the late Pliocene is essential for understanding the global climate system, with important implications for projecting future climate changes. Despite their critical roles in the global climate system, influences of land-ocean interactions on high-latitude ice sheets remain largely unexplored. Here, we present a high-resolution Asian dust record from Ocean Drilling Program Site 1208 in the North Pacific, which lies along the main route of the westerlies. Our data indicate that atmosphere-land-ocean interactions affected aeolian dust emissions through modulating moisture and vegetation in dust source regions, highlighting a critical role of terrestrial systems in initiating the NHG as early as 3.6 Myr ago. Combined with additional multi-proxy and model results, we further show that westerly wind strength was enhanced, mainly at low-to-middle tropospheric levels, during major glacial events at about 3.3 and 2.7 Myr ago. We suggest that coupled responses of Earths surface dynamics and atmospheric circulation in the Plio-Pleistocene likely involved feedbacks related to changes in paleogeography, ocean circulation, and global climate.

With projections from the Australian federal government indicating an impending exacerbation of the teacher shortage by 2025, it is timely to explore potential approaches that could help mitigate this imminent national crisis. In teaching, there is an historical tendency for the teaching profession to attract more women than men and this study therefore aims to analyse trends in female completion rates of Initial Teacher Education (ITE) degrees. The study objective was to identify the specific teaching degree levels (undergraduate and postgraduate) and modes of attendance that are most likely to continue attracting women to pursue careers in teaching. This research relies on non-identifiable open access data obtained from Australian ITE providers between 2001 and 2021, which have been collected by the Australian Government Department of Education, Skills and Employment. The study findings reveal an upward trend in female completions of ITE programs offered through external and multimodal study modes, while the internal mode of attendance show a decline. These findings hold significant implications for policy and practice, suggesting the need to enhance the accessibility of external and multimodal ITE degrees for women.

Abstract The investigation of triggers causing the onset and intensification of Northern Hemisphere Glaciation (NHG) during the late Pliocene is essential for understanding the global climate system, with important implications for projecting future climate changes. Despite their critical roles in the global climate system, influences of land-ocean interactions on high-latitude ice sheets remain largely unexplored. Here, we present a high-resolution Asian dust record from Ocean Drilling Program Site 1208 in the North Pacific, which lies along the main route of the westerlies. Our data indicate that atmosphere-land-ocean interactions affected aeolian dust emissions through modulating moisture and vegetation in dust source regions, highlighting a critical role of terrestrial systems in initiating the NHG as early as 3.6 Myr ago. Combined with additional multi-proxy and model results, we further show that westerly wind strength was enhanced, mainly at low-to-middle tropospheric levels, during major glacial events at about 3.3 and 2.7 Myr ago. We suggest that coupled responses of Earth’s surface dynamics and atmospheric circulation in the Plio-Pleistocene likely involved feedbacks related to changes in paleogeography, ocean circulation, and global climate.

Educational psychologists face challenging decisions around ethical dilemmas to uphold the rights of all children. Due to finite government resources for supporting all learners, one of the roles of educational psychologists is to apply for this funding on behalf of schools and children. Tensions can emerge when unintended ethical dilemmas arise through decisions that compromise their professional judgement. This paper presents the findings from an exploratory study around educational psychologists' understandings and concerns around ethical dilemmas they faced within New Zealand over the past 5 years. The study set out to explore how educational psychologists manage the ethical conflicts and inner contradictions within their work. The findings suggest that such pressures could influence evidence-based practice in subtle ways when in the course of decision making, practitioners experienced some form of ethical drift. There is seldom one correct solution across similar situations. Although these practitioners experienced discomfort in their actions they rationalised their decisions based on external forces such as organisational demands or funding formulas. This illustrates the relational, contextual, organisational and personal influences on how and when 'ethical drift' occurs.

BACKGROUND: Post-COVID-19 condition (also known as long COVID) is an emerging chronic illness potentially affecting millions of people. We aimed to evaluate whether outpatient COVID-19 treatment with metformin, ivermectin, or fluvoxamine soon after SARS-CoV-2 infection could reduce the risk of long COVID. METHODS: We conducted a decentralised, randomised, quadruple-blind, parallel-group, phase 3 trial (COVID-OUT) at six sites in the USA. We included adults aged 30-85 years with overweight or obesity who had COVID-19 symptoms for fewer than 7 days and a documented SARS-CoV-2 positive PCR or antigen test within 3 days before enrolment. Participants were randomly assigned via 2 × 3 parallel factorial randomisation (1:1:1:1:1:1) to receive metformin plus ivermectin, metformin plus fluvoxamine, metformin plus placebo, ivermectin plus placebo, fluvoxamine plus placebo, or placebo plus placebo. Participants, investigators, care providers, and outcomes assessors were masked to study group assignment. The primary outcome was severe COVID-19 by day 14, and those data have been published previously. Because the trial was delivered remotely nationwide, the a priori primary sample was a modified intention-to-treat sample, meaning that participants who did not receive any dose of study treatment were excluded. Long COVID diagnosis by a medical provider was a prespecified, long-term secondary outcome. This trial is complete and is registered with ClinicalTrials.gov, NCT04510194. FINDINGS: Between Dec 30, 2020, and Jan 28, 2022, 6602 people were assessed for eligibility and 1431 were enrolled and randomly assigned. Of 1323 participants who received a dose of study treatment and were included in the modified intention-to-treat population, 1126 consented for long-term follow-up and completed at least one survey after the assessment for long COVID at day 180 (564 received metformin and 562 received matched placebo; a subset of participants in the metformin vs placebo trial were also randomly assigned to receive ivermectin or fluvoxamine). 1074 (95%) of 1126 participants completed at least 9 months of follow-up. 632 (56·1%) of 1126 participants were female and 494 (43·9%) were male; 44 (7·0%) of 632 women were pregnant. The median age was 45 years (IQR 37-54) and median BMI was 29·8 kg/m2 (IQR 27·0-34·2). Overall, 93 (8·3%) of 1126 participants reported receipt of a long COVID diagnosis by day 300. The cumulative incidence of long COVID by day 300 was 6·3% (95% CI 4·2-8·2) in participants who received metformin and 10·4% (7·8-12·9) in those who received identical metformin placebo (hazard ratio [HR] 0·59, 95% CI 0·39-0·89; p=0·012). The metformin beneficial effect was consistent across prespecified subgroups. When metformin was started within 3 days of symptom onset, the HR was 0·37 (95% CI 0·15-0·95). There was no effect on cumulative incidence of long COVID with ivermectin (HR 0·99, 95% CI 0·59-1·64) or fluvoxamine (1·36, 0·78-2·34) compared with placebo. INTERPRETATION: Outpatient treatment with metformin reduced long COVID incidence by about 41%, with an absolute reduction of 4·1%, compared with placebo. Metformin has clinical benefits when used as outpatient treatment for COVID-19 and is globally available, low-cost, and safe. FUNDING: Parsemus Foundation; Rainwater Charitable Foundation; Fast Grants; UnitedHealth Group Foundation; National Institute of Diabetes, Digestive and Kidney Diseases; National Institutes of Health; and National Center for Advancing Translational Sciences.

The Genomics Education Partnership (GEP) engages students in a course-based undergraduate research experience (CURE). To better understand the student attributes that support success in this CURE, we asked students about their attitudes using previously published scales that measure epistemic beliefs about work and science, interest in science, and grit. We found, in general, that the attitudes students bring with them into the classroom contribute to two outcome measures, namely, learning as assessed by a pre- and postquiz and perceived self-reported benefits. While the GEP CURE produces positive outcomes overall, the students with more positive attitudes toward science, particularly with respect to epistemic beliefs, showed greater gains. The findings indicate the importance of a student's epistemic beliefs to achieving positive learning outcomes.

In this essay, as a group of teacher educators, we discuss our experience of "walking the walk" of teacher education transformation at a time of urgent change. We reflect upon our process of integrating three key priorities in our preservice teacher education courses: education for sustainability; trauma-informed practice; and Indigenizing curriculum. Specifically, we reflect on how these processes were adapted according to the needs of individual courses and units, while at the same time making space for our strengths and our "unlearnings" as academics, and for the ethical considerations that troubled us. In this essay, we explore walking the walk of change and integrating social, environmental, and cultural justice principles in our work together toward equipping and enabling new teachers to be themselves agents of change.

Policy approaches to the global energy transition often focus on technology-based solutions while ignoring challenges of overall energy demand. A sufficiency-first approach aims to limit superfluous consumption while achieving wellbeing for all. This study focuses on US built environment mechanisms of sufficiency under urban land-use policy. The historical context of US exclusionary and car-oriented planning is reviewed with an order-of-magnitude assessment of the effects on greenhouse gas emissions (GHGE). Using national vehicle-miles traveled (VMT) data derived from mobile device locations (Replica) and validated here with federal data, a hypothetical scenario explores the potential for state urban land-use reforms to enable energy sufficiency. Tenth percentile-VMT (per capita) neighborhoods are defined by state: in 47 states, the typical such neighborhood has less than 33% of its housing units in structures larger than four units. Assuming each state redresses its housing shortage while matching this VMT, 31 Mt CO2e (direct GHGE) and about 38 Mt CO2e (indirect and life-cycle GHGE) would be avoided in 2033. Texas, California, and Florida have the largest absolute emissions reduction opportunity. Urban land-use reforms comprise a logical starting point for a US sufficiency agenda. Key priorities for research, data collection, and technology and policy innovation are proposed. Policy relevance International climate policy is increasingly focused on enabling people to consume less energy: not just technological ‘efficiency’ but ‘sufficiency’ is needed. However, sufficiency has seen little uptake in the US. It may be more relevant to US policymakers if related to the growing momentum for reforming land-use planning and housing policy to address the housing shortage and affordability crisis. This crisis stems in part from the US prevalence of single-family zoning and car-centric planning, rooted in a history of racial segregation; these same laws effectively mandate people to maintain more polluting lifestyles. This study estimates how much climate pollution could be avoided with state-led land-use reform. If states committed to solving the housing shortage while building new housing in neighborhoods where people can drive less, the savings could be comparable with expanding electric vehicle policies. Policymakers and practitioners can enable these reforms while supporting complementary policy goals.

As the number and proportion of older adults living in the U.S. increases, growing evidence shows that people are entering late life with more functional disability than in previous generations. Using data from the 2020 Behavioral Risk Factor Surveillance System survey, we sought to identify the contributions of demographic variables and health conditions to functional disability. Specifically, we tested the associations among age, sex, race, chronic physical health conditions, depression, and functional ability among 243,693 adults, ages 45 years and older. Model testing, implemented in AMOS 29.0.0, resulted in an acceptable fit of the model to the data, Χ 2 ( DF = 18, N = 243,693) = 19,512.64, p

ABSTRACT Studies document difficulties undergraduate pre-nursing and allied health students face when learning human anatomy and physiology (A&P) course content. A comprehensive synthesis exploring the teaching practices within the course and how those practices are evaluated is warranted. This scoping literature review identified 78 journal articles investigating teaching practices, and we charted their research methods, student outcomes, and institutional contexts. Content analysis found the teaching practices described most frequently in A&P education research literature involved multiple aligned changes across the curriculum, including student activities, course delivery, and assessments. Critical appraisal of study methodologies revealed that most studies in undergraduate A&P were longitudinal, included comparison groups, and used simple inferential statistics. In contrast, few studies listed limitations of their research, collected data from multiple institutions, or reported student demographic data. We believe these factors pose notable limitations to the interpretation of A&P education studies across institutional contexts. The results of this review identify future lines of inquiry to enrich existing evidence about pedagogical interventions in A&P courses.

Drinking water and sanitation services in high-income countries typically bring widespread health and other benefits to their populations. Yet gaps in this essential public health infrastructure persist, driven by structural inequalities, racism, poverty, housing instability, migration, climate change, insufficient continued investment, and poor planning. Although the burden of disease attributable to these gaps is mostly uncharacterised in high-income settings, case studies from marginalised communities and data from targeted studies of microbial and chemical contaminants underscore the need for continued investment to realise the human rights to water and sanitation. Delivering on these rights requires: applying a systems approach to the problems; accessible, disaggregated data; new approaches to service provision that centre communities and groups without consistent access; and actionable policies that recognise safe water and sanitation provision as an obligation of government, regardless of factors such as race, ethnicity, gender, ability to pay, citizenship status, disability, land tenure, or property rights.

To manage Earth in the Anthropocene, new tools, new institutions, and new forms of international cooperation will be required. Earth Virtualization Engines is proposed as an international federation of centers of excellence to empower all people to respond to the immense and urgent challenges posed by climate change.

Abstract With projections from the Australian federal government indicating an impending exacerbation of the teacher shortage by 2025, it is timely to explore potential approaches that could help mitigate this imminent national crisis. In teaching, there is an historical tendency for the teaching profession to attract more women than men and this study therefore aims to analyse trends in female completion rates of Initial Teacher Education (ITE) degrees. The study objective was to identify the specific teaching degree levels (undergraduate and postgraduate) and modes of attendance that are most likely to continue attracting women to pursue careers in teaching. This research relies on non-identifiable open access data obtained from Australian ITE providers between 2001 and 2021, which have been collected by the Australian Government Department of Education, Skills and Employment. The study findings reveal an upward trend in female completions of ITE programs offered through external and multimodal study modes, while the internal mode of attendance show a decline. These findings hold significant implications for policy and practice, suggesting the need to enhance the accessibility of external and multimodal ITE degrees for women.

The coming out process differs for everyone, and parents may experience difficulties such as external stress, ostracism and finding local services. Access to resources is, therefore, fundamental, and parents need support in accompanying their children. Methods: This research was carried out in two waves. Firstly, data collection began with parents of TNB children living in the Gaspésie, Bas-Saint-Laurent and Îles-de-la-Madeleine regions, who participated in five group meetings. Secondly, nine in-depth interviews were conducted with parents living in the province of Quebec, outside major urban centres. Results: This article presents the synergy between the two waves of data collection. The results show that parents report various experiences of vulnerability in the process of accepting their children’s gender identity. Despite this, the families we met provided their children with unconditional support to help them navigate various service structures. Conclusions: Although parents of TNB children living in regional areas face similar difficulties to their urban peers, the lack of resources and access to services limits their options, contributing to their isolation. As a result, these parents must employ strategies to initiate change and improve their conditions.

Abstract Oilseed rape (Brassica napus) is an important global oil crop, with spring and winter varieties grown commercially. To understand the transcriptomic differences between these varieties, we collected transcriptomes from apex and leaf tissue from a spring variety, Westar, and a winter variety, Tapidor, before, during, and after vernalisation treatment, until the plants flowered. Large transcriptomic differences were noted in both varieties during the vernalisation treatment because of temperature and day length changes. Transcriptomic alignment revealed that the apex transcriptome reflects developmental state, whereas the leaf transcriptome is more closely aligned to the age of the plant. Similar numbers of copies of genes were expressed in both varieties during the time series, although key flowering time genes exhibited expression pattern differences. BnaFLC copies on A2 and A10 are the best candidates for the increased vernalisation requirement of Tapidor. Other BnaFLC copies show tissue-dependent reactivation of expression post-cold, with these dynamics suggesting some copies have retained or acquired a perennial nature. BnaSOC1 genes, also related to the vernalisation pathway, have expression profiles which suggest tissue subfunctionalisation. This understanding may help to breed varieties with more consistent or robust vernalisation responses, of special importance due to the milder winters resulting from climate change.

Abstract Background To diagnose the full spectrum of hereditary and congenital diseases, genetic laboratories use many different workflows, ranging from karyotyping to exome sequencing. A single generic high-throughput workflow would greatly increase efficiency. We assessed whether genome sequencing (GS) can replace these existing workflows aimed at germline genetic diagnosis for rare disease. Methods We performed short-read GS (NovaSeq™6000; 150 bp paired-end reads, 37 × mean coverage) on 1000 cases with 1271 known clinically relevant variants, identified across different workflows, representative of our tertiary diagnostic centers. Variants were categorized into small variants (single nucleotide variants and indels

The COVID-19 pandemic has been associated with lifestyle changes, reduced access to care and potential impacts on medication self-management. Our main objectives are to evaluate the impact of the pandemic on patient adherence and access to care and long-term medications and determine its association with sociodemographic and clinical factors. This study is part of the Specchio-COVID-19 longitudinal cohort study in Geneva, Switzerland, conducted through an online questionnaire. Among the 982 participants (median age: 56; 61% female), 827 took long-term medications. There were 76 reported changes in medication dosages, of which 24 (31%) were without a physician’s recommendation, and 51 delays in initiation or premature medication interruptions, of which 24 (47%) were without a physician’s recommendation. Only 1% (9/827) of participants faced medication access issues. Participants taking a respiratory medication had a four-times greater odds of reporting more regular medication (OR = 4.27; CI 95%: 2.11–8.63) intake, whereas each year increase in age was significantly associated with 6% fewer relative risks of discontinuation (OR = 0.94; CI 95%: 0.91–0.97) and 3% fewer relative risks of changes in medication dosage (OR = 0.97; CI 95%: 0.95–1.00). Despite the limited impact of the pandemic on adherence and access to medications, our results emphasize the need for understanding patient challenges when self-managing their long-term medication, notably during public health crises.

In the wake of COVID-19, numerous research projects moved to online data collection to comply with public health guidelines. Since then, many qualitative projects have continued to use online methods to collect data. While online methods facilitated research continuity, they also introduced new opportunities for deceptive behaviors, particularly misrepresentation and multiple participation. Drawing from a recent project that conducted online interviews with young people who detransition after a gender transition, this article describes how fraudulent interviews were identified and dealt with. We present 12 indicators of potential scams in qualitative interviews, including similarities between participants, the type of information provided, participants’ behaviors, and inconsistencies in the narratives. We discuss our overall experience and, in light of recent literature, present strategies to prevent and deal with scams in qualitative research.