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Anuja Roy,1 Andrew Peterson,2 Nick Marchant,1 Jose Alvir,3 Rahul Bhambri,4 Jason Lynn,4 Darrin Benjumea,5 Sapna Prasad,6 Alex O’Brien,6 Yong Chen,7 Jason Kemner,8 Bhash Parasuraman8 1Global HEOR, Patient & Health Impact, Rare Diseases BU, Pfizer Inc, New York, NY, USA; 2Department of Pharmacy Practice/Pharmacy Administration, University of the Sciences, Philadelphia, PA, USA; 3Statistical Research and Data Science Center Global Product Development, Pfizer Inc, New York, NY, USA; 4Medical Affairs, Pfizer Inc, New York, NY, USA; 5Evidence Strategy, Genesis Research, Hoboken, NJ, USA; 6Clarify Insights Services, Clarify Health Solutions, New York, NY, USA; 7Rare Disease, Pfizer Inc, Collegeville, PA, USA; 8Patient & Health Impact, Pfizer Inc, Collegeville, PA, USACorrespondence: Anuja Roy, Global HEOR, Patient & Health Impact, Rare Diseases BU, Pfizer Inc, New York, NY, USA, Email Anuja.Roy@pfizer.comIntroduction: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a serious, underrecognized condition, which leads to heart failure and early mortality if left untreated. Until recently, heart transplantation was the only treatment for ATTR-CM. Regulatory approval of tafamidis transformed treatment for patients. In the phase 3 Transthyretin Amyloidosis Cardiomyopathy Clinical Trial (ATTR-ACT), which established the safety and efficacy of tafamidis, medication adherence was high with 97.2% of patients taking ≥ 80% of scheduled doses. Evidence of real-world adherence to cardiology drugs demonstrates low adherence and suboptimal outcomes; however, real-world adherence to tafamidis has not been investigated. The main objective of this study was to describe adherence patterns of patients filling tafamidis in the Symphony Health database.Methods: This retrospective analysis of the Symphony Health Solutions claims database used secondary adherence measures, including modified medication possession ratio (MPRm), days between fills adherence rate, and compliance rate, to assess adherence patterns of 2020 patients filling tafamidis free acid 61-mg capsules or tafamidis meglumine 4x20-mg capsules from June 1, 2019 to August 31, 2020.Results: Patients receiving a tafamidis formulation had characteristics consistent with the expected patient population; 71.6% were aged 75– 84 years, 83.2% were male, and the highest proportion resided in the Northeast region (30.5%) of the United States. Adherence for tafamidis was high, as 75% to 100% of the patients across subgroups met or exceeded the commonly defined adherence threshold of 80%. Median number of refills ordered and received was six refills per patient. Most patients received refills with no gap (n=1633) or a gap < 30 days (n=1267/1317 patients). Adherence was high across follow-up time, sex, and age subgroups. Adherence varied by geographic region, with the Northeast being significantly higher than the Midwest (mean MPRm 94.41% vs 88.21%, p=0.0007).Conclusion: These results provide evidence that real-world adherence to tafamidis in patients with ATTR-CM is high.Keywords: claims analysis, amyloidosis, cardiomyopathy, transthyretin amyloid, adherence

This mixed-methods observational pilot study compared clinician-supervisor and student satisfaction (surveys and semi-structured interviews), and final placement scores for two different physiotherapy clinical placement models: hybrid (half-onsite, half-remote) and traditional (onsite). All supervisors and students involved were invited to participate; ten supervisors and seven students completed the survey, and nine supervisors and one student participated in interviews. Qualitative data were analyzed using reflexive thematic analysis. Students and supervisors reported similar levels of satisfaction for either model. Supervisors reported some reservations and higher workloads with the hybrid model. The interviews identified three themes for satisfying placements: it is structure, not location that matters; managing competing demands on clinician-supervisors; and learning requires psychologically safe relationships. Final scores for both placement models were comparable. This pilot study with a small sample found the hybrid model was acceptable and achieved comparable outcomes to the traditional model. Remote structured learning has potential to innovate and support sustainable clinical placements.

We, four teachers in Ojibwe or majority-Ojibwe schools and three teachers in teacher preparation at a small ecologically focused liberal arts college, tell stories to reorient ourselves, centering place in ways accessible to our emerging practice. In these narratives, anchored in the seasons, we describe our challenges and successes in adapting education programs to better evoke the lifeways that predominate in our shared part of rural northern Wisconsin immersed in the lands of the Ojibwe. We relied on experiences, both ours and of Ojibwe learners, to illuminate the rhythms of our place and the seasons of learning defined by boreal forest, an inland sea, the sugar bush, and the wild rice harvest, in the hope of better outcomes for Indigenous and non-Indigenous teacher candidates (and their future students) in our evolving program. This narrative work cobbles a frame enabling connection to create rural, fugitive, decolonized teacher preparation that centers respect, reciprocity, and agency.

This study examined the within- and cross-language relationships between intrinsic language learning motivation, home literacy environment (shared book reading, parental literacy involvement, and parent perceived child literacy interest), and receptive vocabulary in 185 bilingual preschoolers and 233 primary school children in Singapore. Age differences were also examined. Unlike the motivation decline commonly observed in middle childhood, the primary school children demonstrated higher levels of intrinsic motivation than the preschoolers in both English and the second language (L2). Results showed a motivation gap between English and children's L2 in primary school children but not in preschoolers. The hierarchical regression results revealed that intrinsic motivation and the three facets of home literacy environment (HLE) were differentially involved in receptive vocabulary across languages and age groups. Within-language relations showed that intrinsic motivation only predicted receptive vocabulary in English among primary school children, but not among preschoolers. Among primary school children, parent perceived child literacy interest in L2 was the only significant predictor of L2 receptive vocabulary; among preschoolers, shared book reading was the only significant predictor. Cross-language relations revealed that parental literacy involvement in English negatively predicted L2 receptive vocabulary in primary school children, and there were no L2 effects on English receptive vocabulary.

Background: Documented inequalities in access to eye care for people with learning disabilities and/or autism are caused by poor uptake of primary eye care services, poor identification of eye problems, lack of signposting and reasonable adjustments of existing services, concerns about costs of care and the low priority historically given to these issues in eye care policy at a regional and national level. In 2019, the charity SeeAbility employed four eye care champions (ECCs) with lived experience of learning disability and/or autism to work in local communities in London and the Northwest of England. They provided peer-to-peer support on understanding the need for good eye health and engaged with policy makers, and learning disability, autism and eye care professionals at the local, regional and national levels to influence both the clinical practice of individual practitioners (within existing service/pathway models) and more widely to influence the commissioning of the Easy Eye Care pathway. This study explores the experiences of these ECCs. Methods: The study was conducted in April and May 2023. A case study approach was used to describe the experiences of the ECCs from March 2019 to March 2023. Data from structured interviews with the four ECCs and workload analysis were triangulated to provide a multifaceted understanding of this novel health promotion project. Findings: The ECCs found the role useful and reported that confidence in their practice and impact grew with time but they required ongoing support in the role. A good understanding of the promotional messages was reported. Developing a good network of contacts at an early stage, both people with learning disabilities and healthcare professionals, was key. Relationships with professionals were supportive and positive and a positive emotive response to their lived experience was reported in these interactions. Conclusions: From the perspective of the ECCs, the role is useful and beneficial. The work suggests some key recommendations for future development which include planning to build networks, support in presentation and communications skills and defining key messages and knowledge. Confidence of the ECCs builds with time in the role but also needs support the emotive impact of their lived experiences on audiences is highlighted. There is a need to evaluate how the programme is perceived by those who interact with it and how it changes behaviours which leads to better health outcomes.

The purpose of this systematic literature review was to understand trends in field experiences that were part of early childhood special education (ECSE) teacher preparation activities in the United States. Thirteen studies that included an analysis of ECSE teacher candidates (TCs) completing at least one field experience, including coursework-based practicums or student teaching internships, were published between 2013 and 2022 and reviewed. Specifically, we examined the demographics of TCs and student participants to understand who was included in this research. Field experience parameters including setting, duration, instructional approach, and instructional focus were reviewed to draw comparisons between the various approaches to structuring TCs' early teaching opportunities. Finally, specific learning activities and feedback opportunities within field experiences, as well as TC and student outcomes of the studies, were explored to determine current trends and findings. Implications for research and practice are discussed.

Recently, there has been an emphasis on keeping the study of anatomy using donor material confined to the domain of medical and allied healthcare professionals. Given the abundance of both accurate and inaccurate information online, coupled with a heightened focus on health following the COVID-19 pandemic, one may question whether it is time to review who can access learning anatomy using donors. In 2019, Brighton and Sussex Medical School (BSMS) obtained a Human Tissue Authority Public Display license with the aim of broadening the reach of who could be taught using donor material. In 2020, BSMS received its first full-body donor with consent for public display. Twelve workshops were delivered to student groups who do not normally have the opportunity to learn in the anatomy laboratory. Survey responses (10.9% response rate) highlighted that despite being anxious about seeing inside a deceased body, 95% felt more informed about the body. A documentary "My Dead Body" was filmed, focusing on the rare cancer of the donor Toni Crews. Viewing figures of 1.5 million, and a considerable number of social media comments highlighted the public's interest in the documentary. Thematic analysis of digital and social media content highlighted admiration and gratitude for Toni, the value of education, and that while the documentary was uncomfortable to watch, it had value in reminding viewers of life, their bodies, and their purpose. Fully consented public display can create opportunities to promote health-conscious life choices and improve understanding of the human body.

Background: People with a learning disability experience challenges accessing primary health care services, including eye care services. Methods: Eye care needs of people with a learning disability, and how well they are met by existing services in England, were explored. Barriers and enablers to accessing these services were investigated. This was informed by a scoping review of the literature and a historic literature library. Findings: Adults with a learning disability are 10 times more likely than other adults to have a serious sight problem and children with learning disabilities are 28 times more likely. There is good evidence of high levels of unmet eye care need special schools in England with over 4 in 10 children attending having no history of any eye care. Conclusion: The authors discuss possible systemic changes to address these inequalities in England. These include automatic entitlement to an NHS sight test annually, specialist pathways in community opticians, eye care services in special schools, and peer to peer and peer to professional promotion of services by people with lived experience. Dedicated care pathways have improved uptake of services in other areas of primary care. Research into the effectiveness of lived experience eye health advocacy is needed.

Success for 4-year universities is often measured by graduation and retention rates; however, gaps exist in understanding nonreturning students at private institutions. Recent research is helping to build the lexicon of drop-outs, stop-outs, opt-outs, and transfer-outs to inform strategic retention initiatives. Using an action research method, we characterized 1,091 students into designated subclasses and utilized exit interviews, advising notes, and university surveys to theme their departure intentions. Findings reveal transfer-outs to be the largest subclass, with departure reasons being summarized within themes of university experience and fit, health, academic, and financial. Recommendations are made for university administrators and retention offices related to exit survey questions, broadening success metrics, and to focus on specific student characteristic groups.

The generally low usage of artificial insemination and single-sire mating in sheep, compounded by mob lambing (and lambing outdoors), implies that parentage assignment in sheep is challenging. The objective here was to develop a low-density panel of single nucleotide polymorphisms (SNPs) for accurate parentage verification and discovery in sheep. Of particular interest was where SNP selection was limited to only a subset of chromosomes, thereby eliminating the ability to accurately impute genome-wide denser marker panels. Data used consisted of 10,933 candidate SNPs on 9,390 purebred sheep. These data consisted of 1,876 validated genotyped sire–offspring pairs and 2,784 validated genotyped dam–offspring pairs. The SNP panels developed consisted of 87 SNPs to 500 SNPs. Parentage verification and discovery were undertaken using 1) exclusion, based on the sharing of at least one allele between candidate parent–offspring pairs, and 2) a likelihood-based approach. Based on exclusion, allowing for one discordant offspring–parent genotype, a minimum of 350 SNPs was required when the goal was to unambiguously identify the true sire or dam from all possible candidates. Results suggest that, if selecting SNPs across the entire genome, a minimum of 250 carefully selected SNPs are required to ensure that the most likely selected parent (based on the likelihood approach) was, in fact, the true parent. If restricting the SNPs to just a subset of chromosomes, the recommendation is to use at least a 300-SNP panel from at least six chromosomes, with approximately an equal number of SNPs per chromosome.