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Aims: Auditory Verbal Hallucinations (AVH) are a hallmark of psychosis, but affect many other clinical populations. Patients’ understanding and self-management of AVH may differ between diagnostic groups, change over time, and influence clinical outcomes. We aimed to explore patients’ understanding and self-management of AVH in a young adult clinical population. Method: 35 participants reporting frequent AVH were purposively sampled from a youth mental health service, to capture experiences across psychosis and non-psychosis diagnoses. Diary and photo-elicitation methodologies were used – participants were asked to complete diaries documenting experiences of AVH, and to take photographs representing these experiences. In-depth, unstructured interviews were held, using participant-produced materials as a topic guide. Conventional content analysis was conducted, deriving results from the data in the form of themes. Result: Three themes emerged:(1)Searching for answers, forming identities – voice-hearers sought to explain their experiences, resulting in the construction of identities for voices, and descriptions of relationships with them. These identities were drawn from participants’ life-stories (e.g., reflecting trauma), and belief-systems (e.g., reflecting supernatural beliefs, or mental illness). Some described this process as active / volitional. Participants described re-defining their own identities in relation to those constructed for AVH (e.g. as diseased, 'chosen', or persecuted), others considered AVH explicitly as aspects of, or changes in, their personality. (2)Coping strategies and goals – patients’ self-management strategies were diverse, reflecting the diverse negative experiences of AVH. Strategies were related to a smaller number of goals, e.g. distraction, soothing overwhelming emotions, 'reality-checking', and retaining agency. (3)Outlook – participants formed an overall outlook reflecting their self-efficacy in managing AVH. Resignation and hopelessness in connection with disabling AVH are contrasted with outlooks of “acceptance” or integration, which were described as positive, ideal, or mature. Conclusion: Trans-diagnostic commonalities in understanding and self-management of AVH are highlighted - answer-seeking and identity-formation processes; a diversity of coping strategies and goals; and striving to accept the symptom. Descriptions of “voices-as-self”, and dysfunctional relationships with AVH, could represent specific features of voice-hearing in personality disorder, whereas certain supernatural/paranormal identities and explanations were clearly delusional. However, no aspect of identity-formation was completely unique to psychosis or non-psychosis diagnostic groups. The identity-formation process, coping strategies, and outlooks can be seen as a framework both for individual therapies and further research.

This study explored secondary Georgia school-based agricultural education (SBAE) teachers' perceptions of instructing students with learning difficulties in Supervised Agricultural Experiences (SAEs) programs. The perceived importance and competence levels of SBAE teachers utilizing individualized education programs (IEPs), implementing inclusive classroom practices, and adapting instruction for diverse learners were addressed using Bandura's self-efficacy theory. We used a postpositivist, descriptive correlational design to gather and analyze collected data. The instrument contained 65 questions and statements separated into six sections: 1) Individualized Education Programs (IEPs); 2) best management practices for the agriculture classroom and SAE; 3) implementing teaching strategies based on learning challenges; 4) changes in the IEP population; 5) current IEP population; and 6) personal characteristics. The questions were categorized into sections to determine the educator's perception of Individualized Education Programs alone before introducing IEPs in the various components of the agriculture classroom. A Borich Model was used to determine the educator's perceived level of importance as well as the level of competence. Participants (n = 43) acknowledged the high importance of including students with learning difficulties, needing additional training to utilize student IEPs to tailor instruction effectively, and equipping new teachers with the skills needed for selecting appropriate instructional strategies to improve student learning. These discrepancies suggest a need for targeted professional development to enhance teachers' confidence and skills. The findings highlight areas for improvement, such as effectively using IEPs, implementing best practices for inclusive learning environments in classrooms and SAEs, and selecting appropriate teaching strategies for students with varying needs. [ABSTRACT FROM AUTHOR]

Objectives: Maternal mortality and morbidity disproportionately affect birthing people from racialized populations. Unfortunately, researchers can often compound these poor outcomes through a lack of authentic community engagement in research beyond the role of the research subject, leading to ineffective strategies for improving care and increasing equity. This article details the real-life strategies utilized to develop a community-engaged research project of a phased federally funded grant employing community engagement principles of co-leadership and co-creation. It also includes reflections from the researchers and advisory board on promising practices and lessons learned for equitably engaging patients and community partners in research. Methods: This article details the application of principles of community-engaged research in a federally funded phased research project focused on understanding disparities in maternal sepsis to develop better clinical and community interventions. Specifically, it discusses early steps in the research partnership to create a sustainable partnership with a Community Leadership Board guided by the principles of transparency, respect, compensation, and increasing research justice. Results: Based on the authors' experience, recommendations are provided for funders, researchers, and institutions to improve the quality and outcomes of communityengaged research. This work adds to community-based participatory and community-engaged research literature by providing concrete and practical steps for equitably engaging in research partnerships with a variety of collaborators. Conclusions: In conclusion, integrated patient and community co-leadership enhances research by providing insight, access to communities for education and dissemination of information, and identifying critical areas needing change. This report may help others address fundamental principles in this journey. Significance: Community-engaged research can be an equitable approach to research that involves communities most affected by empowering them to guide the research as equal partners. This article serves as a guide for researchers to form these critical partnerships, sustain relationships, and recommend solutions to common challenges based on the reflections of the researchers and advisory board. [ABSTRACT FROM AUTHOR]

Cave ice can contain a wealth of paleo-climatic and geochemical information that is rapidly being lost with the melting of the temperate zone cryosphere. The karst areas of Slovenia host over 260 ice caves. We collected samples for stable water isotope, major ion, and nutrient analyses from two Slovenian ice caves. Samples included two shallow ice cores in Snežna Cave, collected »5 m apart, and an ice face profile in Ivačičeva Cave. All ice isotopic ratios reflected modern precipitation that could be described by high-elevation meteoric water lines. An offset suggested that fractionation and mixing processes of melted ice affected the isotopic signals. Cation concentrations of ice in both caves showed Ca » Mg>Na>K. The high Ca2+ and Mg2+ contents and elevated HCO3- concentrations indicate that CaCO3 dissolution within the local karst landscape is a primary control on ice chemistry. Low concentrations and inconsistent profile patterns of other major ions and nutrients suggest atmospheric deposition and vadose zone leaching were also primary sources of ions to the ice. Differences in Cl- and SO4 2- profile concentrations at similar depths in Snežna Cave imply that ice melting, water mixing, and re-freezing processes can affect the primary climatic signal stored in the ice. While temperate ice caves can be repositories of climatic information, secondary diagenetic processes that affect ice chemical composition alter the original signal. In addition to chemical analysis, physical processes within the caves must be studied at a small spatial scale to understand and interpret ice chemistry. [ABSTRACT FROM AUTHOR]