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•1. Long-term data are beneficial for monitoring the conservation status of species. Assessments of population change over recent periods of fixed duration will, however, be subject to ‘shifting baselines’, where the accepted norm for the population at the start of the period already represents a reduction from historical levels. International Union for Conservation of Nature Red List criteria for categorizing conservation threat rely on assessing declines against quantitative thresholds, generally measured over 10 years, as indications of the likelihood of extinction in the near future. By contrast, legal frameworks such as the European Habitats Directive require states to achieve and sustain ‘Favourable Conservation Status’ for protected species, while domestic conservation legislation can have more diverse objectives and mechanisms, based on local contexts that extend beyond biological or quantitative criteria. •2. We explore the challenges associated with assessing the risk of extinction and the conservation status that arise from the availability of long-term monitoring data for hazel dormice Muscardinus avellanarius in the United Kingdom. •3. Numbers of adult dormice counted in the National Dormouse Monitoring Programme are in ongoing decline, amounting to an overall decline of 78% (95% confidence interval = 72%–84%) over 27 years, 1994–2020. If the observed annual rate of decline of 5.7% (95% CI = 4.7%–6.8%) were to continue unabated, dormouse counts would decline by >90% from 1994 to 2034. Despite this, the species would never be categorized as Endangered, under IUCN criteria, which specify a reduction of >50% within 10 years. •4. While such chronic decline may not indicate imminent risk of extinction, justifying a higher Red List category, it is a demonstration of unfavourable conservation status at a national scale. Prioritization based on demonstration of such chronic declines might direct more effective action towards species conservation at a point when

Copyright © 2020 The Authors, Alzheimer’s disease (AD) is a neurodegenerative disorder that causes cognitive decline, memory loss, and inability to perform everyday functions. Hallmark features of AD—including generation of amyloid plaques, neurofibrillary tangles, gliosis, and inflammation in the brain—are well defined; however, the cause of the disease remains elusive. Growing evidence implicates pathogens in AD development, with herpes simplex virus type I (HSV-1) gaining increasing attention as a potential causative agent. Here, we describe a multidisciplinary approach to produce physiologically relevant human tissues to study AD using human-induced neural stem cells (hiNSCs) and HSV-1 infection in a 3D bioengineered brain model. We report a herpes-induced tissue model of AD that mimics human disease with multicellular amyloid plaque–like formations, gliosis, neuroinflammation, and decreased functionality, completely in the absence of any exogenous mediators of AD. This model will allow for future studies to identify potential downstream drug targets for treating this devastating disease.

BackgroundIn the rapidly changing landscape of undergraduate medical education (UME), the roles and responsibilities of clerkship directors (CDs) are not clear.ObjectiveTo describe the current roles and responsibilities of Internal Medicine CDs.DesignNational annual Clerkship Directors in Internal Medicine (CDIM) cross-sectional survey.ParticipantsOne hundred twenty-nine clerkship directors at all Liaison Committee on Medical Education accredited US medical schools with CDIM membership as of September 1, 2017.Main measuresResponsibilities of core CDs, including oversight of other faculty, and resources available to CDs including financial support and dedicated time.Key resultThe survey response rate was 83% (107/129). Ninety-four percent of the respondents oversaw the core clerkship inpatient experience, while 47.7% (n = 51) and 5.6% (n = 6) oversaw the outpatient and longitudinal integrated clerkships respectively. In addition to oversight, CDs were responsible for curriculum development, evaluation and grades, remediation, scheduling, student mentoring, and faculty development. Less than one-third of CDs (n = 33) received the recommended 0.5 full-time equivalent (FTE) support for their roles, and 15% (n = 16) had less than 20% FTE support. An average 0.41 FTE (SD .2) was spent in clinical work and 0.20 FTE (SD .21) in administrative duties. Eighty-three percent worked with other faculty who assisted in the oversight of departmental UME experiences, with FTE support varying by role and institution. Thirty-five percent of CDs (n = 38) had a dedicated budget for managing their clerkship.ConclusionsThe responsibilities of CDs have increased in both number and complexity since the dissemination of previous guidelines for expectations of and for CDs in 2003. However, resources available to them have not substantially changed.

Objective: To describe the use of medications that interact with alcohol or for which alcohol reduces the medication's efficacy in older adults consuming alcohol at hazardous levels. Method: Retrospective file audit of patients discharged from Australia's only older adult-specific alcohol and other drug treatment service. Results: Seventy-two patients aged between 58 years and 87 years (M = 65.88; SD = 5.67) drinking alcohol at hazardous or harmful levels were taking between 1 and 12 pharmaceutical drugs (M = 4.03; SD = 2.42). The majority (92%) of patients were taking at least one medication that placed them at high risk of serious adverse side effects when consumed with alcohol. The efficacy of most patients’ (97%) medication was deemed to be significantly reduced when consumed with alcohol. Conclusions: Among older adults who consume alcohol at hazardous levels, many take prescribed medications that adversely interact with alcohol or have reduced efficacy when consumed alongside alcohol. Targeted education is required for patients and health-care workers to mitigate these risks.

Objective: To describe the use of medications that interact with alcohol or for which alcohol reduces the medication's efficacy in older adults consuming alcohol at hazardous levels. Method: Retrospective file audit of patients discharged from Australia's only older adult-specific alcohol and other drug treatment service. Results: Seventy-two patients aged between 58 years and 87 years (M = 65.88; SD = 5.67) drinking alcohol at hazardous or harmful levels were taking between 1 and 12 pharmaceutical drugs (M = 4.03; SD = 2.42). The majority (92%) of patients were taking at least one medication that placed them at high risk of serious adverse side effects when consumed with alcohol. The efficacy of most patients’ (97%) medication was deemed to be significantly reduced when consumed with alcohol. Conclusions: Among older adults who consume alcohol at hazardous levels, many take prescribed medications that adversely interact with alcohol or have reduced efficacy when consumed alongside alcohol. Targeted education is required for patients and health-care workers to mitigate these risks.

PURPOSE: To explore faculty perspectives on which characteristics of high-performing clerkship students are most important when determining an honors or top grade designation for clinical performance. METHOD: In 2016-2017, the authors surveyed faculty (teaching ward attendings) for internal medicine clerkships and 1 pediatrics clerkship in inpatient settings at 5 U.S. academic medical centers. Survey items were framed around competencies, 24 student characteristics, and attitudes toward evaluation. Factor analysis examined constructs defining high-performing students. RESULTS: Of 516 faculty invited, 319 (62%) responded. The top 5 characteristics as rated by respondents were taking ownership, clinical reasoning, curiosity, dependability, and high ethical standards (in descending order). Twenty-one characteristics fit into 3 factors (Cronbach alpha, 0.81-0.87). Clinical reasoning did not fit into a factor. Factor 1 was the most important (mean rating, 8.7/10 [95% confidence interval (CI), 8.6-8.8]). It included professionalism components (ownership, curiosity, dependability, high ethical standards), presentation and interviewing skills, seeking feedback, and documentation. Factor 2 (mean, 7.9 [95% CI, 7.7-8.0]) included aspects of teamwork and communication, such as positive attitude and comments from others. Factor 3 (mean, 7.6 [95% CI, 7.4-7.7]) addressed systems-based thinking, including patient safety and care transitions. CONCLUSIONS: Professionalism components, clinical reasoning, and curiosity were among the most important characteristics distinguishing high-performing clerkship students. These may represent behaviors that are highly valued, observable, and relevant to training stage. Improved definition of the characteristics associated with clinical honors would assist students, faculty, and residency program directors when interpreting clinical performance within core clerkships.

Objective: There are good data regarding the prevalence and patterns of dual diagnosis among the general population; however, data regarding the older adult cohort are limited. We aimed to extend the knowledge of the point prevalence and patterns of dual diagnosis among older adults and the impact of dual diagnosis on the utilization of alcohol and other drug treatment services. Method: A 12-month medical chart audit of clients discharged from an Australian older adult–specific alcohol and other drug treatment service was performed. Measures included the Alcohol Use Disorders Identification Test–Consumption, the Drug Use Disorders Identification Test–Consumption, the Kessler 10, and the Modified MINI Screen. Additional data collected included mental health diagnoses, number of session types, and treatment outcomes. Results: There were 79 (n = 45, 57% male) medical charts audited, with a mean age of 65.9 years (SD = 5.8). There were 68 (89%) clients having at least one comorbid mental illness. Clients with a dual diagnosis were younger (p = .011) than those without. Some comorbid mental health conditions were associated with additional service utilization (p < .05). Clients with personality disorders required more telephone calls and outreach services (p < .05). The number of mental health diagnoses was associated with additional treatment sessions (p < .05). Conclusions: Further research with a larger sample size of older adults seeking age-specific alcohol and other drug treatment services is required. Older adult–specific alcohol and other drug treatment services need to allow for longer episodes of care for clients with certain dual diagnoses and a focus on reducing anxiety to increase treatment retention.

Objective: There are good data regarding the prevalence and patterns of dual diagnosis among the general population; however, data regarding the older adult cohort are limited. We aimed to extend the knowledge of the point prevalence and patterns of dual diagnosis among older adults and the impact of dual diagnosis on the utilization of alcohol and other drug treatment services. Method: A 12-month medical chart audit of clients discharged from an Australian older adult–specific alcohol and other drug treatment service was performed. Measures included the Alcohol Use Disorders Identification Test–Consumption, the Drug Use Disorders Identification Test–Consumption, the Kessler 10, and the Modified MINI Screen. Additional data collected included mental health diagnoses, number of session types, and treatment outcomes. Results: There were 79 (n = 45, 57% male) medical charts audited, with a mean age of 65.9 years (SD = 5.8). There were 68 (89%) clients having at least one comorbid mental illness. Clients with a dual diagnosis were younger (p = .011) than those without. Some comorbid mental health conditions were associated with additional service utilization (p < .05). Clients with personality disorders required more telephone calls and outreach services (p < .05). The number of mental health diagnoses was associated with additional treatment sessions (p < .05). Conclusions: Further research with a larger sample size of older adults seeking age-specific alcohol and other drug treatment services is required. Older adult–specific alcohol and other drug treatment services need to allow for longer episodes of care for clients with certain dual diagnoses and a focus on reducing anxiety to increase treatment retention.

Objective: There are good data regarding the prevalence and patterns of dual diagnosis among the general population; however, data regarding the older adult cohort are limited. We aimed to extend the knowledge of the point prevalence and patterns of dual diagnosis among older adults and the impact of dual diagnosis on the utilization of alcohol and other drug treatment services. Method: A 12-month medical chart audit of clients discharged from an Australian older adult–specific alcohol and other drug treatment service was performed. Measures included the Alcohol Use Disorders Identification Test–Consumption, the Drug Use Disorders Identification Test–Consumption, the Kessler 10, and the Modified MINI Screen. Additional data collected included mental health diagnoses, number of session types, and treatment outcomes. Results: There were 79 (n = 45, 57% male) medical charts audited, with a mean age of 65.9 years (SD = 5.8). There were 68 (89%) clients having at least one comorbid mental illness. Clients with a dual diagnosis were younger (p = .011) than those without. Some comorbid mental health conditions were associated with additional service utilization (p < .05). Clients with personality disorders required more telephone calls and outreach services (p < .05). The number of mental health diagnoses was associated with additional treatment sessions (p < .05). Conclusions: Further research with a larger sample size of older adults seeking age-specific alcohol and other drug treatment services is required. Older adult–specific alcohol and other drug treatment services need to allow for longer episodes of care for clients with certain dual diagnoses and a focus on reducing anxiety to increase treatment retention.

The colored Jones polynomial assigns to each knot a sequence of Laurent polynomials. This dissertation will focus on the patterns in the coefficients of these polynomials. We will discuss a new formula for calculating the colored Jones polynomial of certain pretzel knots and the stabilization and higher-order stabilization of the coefficients, specifically discussing what the second N coefficients of the N colored Jones polynomial of certain knots stabilize to. We will also look at patterns in the middle coefficients and explore a new way of looking at the colored Jones polynomials of amphichiral knots

The colored Jones polynomial assigns to each knot a sequence of Laurent polynomials. This dissertation will focus on the patterns in the coefficients of these polynomials. We will discuss a new formula for calculating the colored Jones polynomial of certain pretzel knots and the stabilization and higher-order stabilization of the coefficients, specifically discussing what the second N coefficients of the N colored Jones polynomial of certain knots stabilize to. We will also look at patterns in the middle coefficients and explore a new way of looking at the colored Jones polynomials of amphichiral knots

Sea Enterprise is the resource-enabling component of the Navy's Sea Power 21 initiative. In recognition of a future resource-constrained environment, Sea Enterprise seeks to reform the culture and business practices of the Navy so as to generate resources internally that can be applied to reinvestment and recapitalization. Sea Enterprise contracted the Center for Defense Management Reform to research transformation and benchmarking best practices in the private sector. The aim of this research is to help Sea Enterprise understand, design and implement its agenda for organizational change. This report presents a brief recent history of management reform within the Department of Defense and a summary review of current business management transformation initiatives in the DoD and in the services. Then, a survey of the scholarly and practitioner literature on organizational change explores the questions of first-order and second-order change, and looks at models of incremental, episodic and continuous change. Next, this report examines various types of benchmarking and identifies benchmarking candidates from both private- and public-sector organizations categorized by distinctive best practices that may be applicable to Sea Enterprise. The report concludes that further in-depth benchmarking by matching Sea Enterprise with specific organizations could contribute to the success of Sea Enterprise. Modeling and benchmarking can help the leaders and managers of Sea Enterprise understand, promote, and advance the success of this important change initiative.-- p. iv.

Sea Enterprise is the resource-enabling component of the Navy's Sea Power 21 initiative. In recognition of a future resource-constrained environment, Sea Enterprise seeks to reform the culture and business practices of the Navy so as to generate resources internally that can be applied to reinvestment and recapitalization. Sea Enterprise contracted the Center for Defense Management Reform to research transformation and benchmarking best practices in the private sector. The aim of this research is to help Sea Enterprise understand, design and implement its agenda for organizational change. This report presents a brief recent history of management reform within the Department of Defense and a summary review of current business management transformation initiatives in the DoD and in the services. Then, a survey of the scholarly and practitioner literature on organizational change explores the questions of first-order and second-order change, and looks at models of incremental, episodic and continuous change. Next, this report examines various types of benchmarking and identifies benchmarking candidates from both private- and public-sector organizations categorized by distinctive best practices that may be applicable to Sea Enterprise. The report concludes that further in-depth benchmarking by matching Sea Enterprise with specific organizations could contribute to the success of Sea Enterprise. Modeling and benchmarking can help the leaders and managers of Sea Enterprise understand, promote, and advance the success of this important change initiative.-- p. iv.

Sea Enterprise is the resource-enabling component of the Navy's Sea Power 21 initiative. In recognition of a future resource-constrained environment, Sea Enterprise seeks to reform the culture and business practices of the Navy so as to generate resources internally that can be applied to reinvestment and recapitalization. Sea Enterprise contracted the Center for Defense Management Reform to research transformation and benchmarking best practices in the private sector. The aim of this research is to help Sea Enterprise understand, design and implement its agenda for organizational change. This report presents a brief recent history of management reform within the Department of Defense and a summary review of current business management transformation initiatives in the DoD and in the services. Then, a survey of the scholarly and practitioner literature on organizational change explores the questions of first-order and second-order change, and looks at models of incremental, episodic and continuous change. Next, this report examines various types of benchmarking and identifies benchmarking candidates from both private- and public-sector organizations categorized by distinctive best practices that may be applicable to Sea Enterprise. The report concludes that further in-depth benchmarking by matching Sea Enterprise with specific organizations could contribute to the success of Sea Enterprise. Modeling and benchmarking can help the leaders and managers of Sea Enterprise understand, promote, and advance the success of this important change initiative.-- p. iv., Approved for public release; distribution is unlimited.

Sea Enterprise is the resource-enabling component of the Navy's Sea Power 21 initiative. In recognition of a future resource-constrained environment, Sea Enterprise seeks to reform the culture and business practices of the Navy so as to generate resources internally that can be applied to reinvestment and recapitalization. Sea Enterprise contracted the Center for Defense Management Reform to research transformation and benchmarking best practices in the private sector. The aim of this research is to help Sea Enterprise understand, design and implement its agenda for organizational change. This report presents a brief recent history of management reform within the Department of Defense and a summary review of current business management transformation initiatives in the DoD and in the services. Then, a survey of the scholarly and practitioner literature on organizational change explores the questions of first-order and second-order change, and looks at models of incremental, episodic and continuous change. Next, this report examines various types of benchmarking and identifies benchmarking candidates from both private- and public-sector organizations categorized by distinctive best practices that may be applicable to Sea Enterprise. The report concludes that further in-depth benchmarking by matching Sea Enterprise with specific organizations could contribute to the success of Sea Enterprise. Modeling and benchmarking can help the leaders and managers of Sea Enterprise understand, promote, and advance the success of this important change initiative.-- p. iv.

This is the peer reviewed version of the following article: Bright, S., Milroy, J., Walsh, K., & Blatchford, E. (2020). Medication use among older Australians seeking alcohol and other drug treatment. Australasian Journal on Ageing, 39(3), 287-291, which has been published in final form at https://doi.org/10.1111/ajag.12756

Bright, S., Walsh, K., & Williams, C. (2018). Point prevalence and patterns of mental health comorbidity among people accessing Australia's first older adult–specific alcohol and other drug treatment service. Journal of Dual Diagnosis, 14(1), 70-75. doi:here.