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Culturally relevant pedagogy (CRP) seeks to improve equity in instruction and leverage students' experiences by promoting academic success, cultural competence, and sociopolitical consciousness. We examine instructors' perceptions of student identity to understand the ways undergraduate mathematics instructors are enacting or experiencing barriers to enacting CRP. Interviews with ten mathematics faculty at Hispanic-serving institutions identified two potential barriers to enacting CRP: first, instructors' hesitance to communicate about student identity, especially with respect to race and gender; and second, instructors holding epistemologies that mathematics is culture-free. Despite these barriers, almost all interviewees implemented the academic success tenet of CRP. These barriers may prevent instruction around cultural competence and sociopolitical consciousness, which are the two tenets that most capitalize on students' informal knowledge, identities, and cultural experiences. Changing discourse by taking more risks in conversation and inviting a more diverse range of people to the undergraduate mathematics community are potential ways to address these barriers.

Abstract Serious infection is common in patients with multiple myeloma due to immune deficiency from the underlying disease and/or its treatment. Immunoglobulin replacement is one approach to reduce infection risk in these patients. However, few real‐world data exist on its use in patients with myeloma. We investigated immunoglobulin use in Australia, New Zealand and Asia‐Pacific using registry data and explored its association with survival outcomes. A total of 2374 patients with a median follow‐up time of 29.5 months (interquartile range 13.3–54.3 months) were included in the analysis – 1673 from Australia, 313 Korea, 281 New Zealand and 107 Singapore. Overall, 7.1% of participants received immunoglobulin replacement within 24 months of diagnosis. Patients who received immunoglobulin replacement were likely to be younger, had lower baseline IgG levels (excluding paraprotein), were more likely to have baseline hypogammaglobulinaemia, baseline severe hypogammaglobulinaemia and abnormal baseline fluorescent in‐situ hybridisation status, receive first‐line myeloma treatment with immunomodulatory drugs or anti‐CD38 therapy and undergo upfront autologous stem cell transplant. In our patient cohort, the use of immunoglobulin was not associated with overall survival benefit at the time of last follow‐up (adjusted hazard ratio 0.72, 95% CI 0.46–1.14, p = 0.16). Understanding treatment approaches in clinical practice can help support future planning and provision of immunoglobulin resources.

Purpose: Analysis of narrative language samples is a recommended clinical practice in the assessment of children's language skills, but we know little about how results from such analyses relate to overall oral language ability across the early school years. We examined the relations between language sample metrics from a short narrative retell, collected in kindergarten, and an oral language factor in grades kindergarten through 3. Our specific questions were to determine the extent to which metrics from narrative language sample analysis are concurrently related to language in kindergarten and predict language through Grade 3. Method: Participants were a sample of 284 children who were administered a narrative retell task in kindergarten and a battery of vocabulary and grammar measures in kindergarten through Grade 3. Language samples were analyzed for number of different words, mean length of utterance, and a relatively new metric, percent grammatical utterances (PGUs). Structural equation models were used to estimate the concurrent and longitudinal relationships. Results: The narrative language sample metrics were consistently correlated with the individual vocabulary and grammar measures as well as the language factor in each grade, and also consistently and uniquely predicted the language factor in each grade. Standardized path estimates in the structural equation models ranged from 0.20 to 0.39. Conclusions: This study found narrative language sample metrics to be predictive, concurrently and longitudinally, of a latent factor of language from kindergarten through Grade 3. These results further validate the importance of collecting and analyzing narrative language samples, to include PGU along with more traditional metrics, and point to directions for future research. [The article is written with the Language and Reading Research Consortium (LARRC).]

Abstract Background The extraordinary growth in women’s incarceration over the past several decades has resulted in calls for expansion of research into their unique needs and experiences, including those related to pregnancy and perinatal care. However, while research into the health outcomes of women who are incarcerated while pregnant has grown, research on women’s custodial and perinatal care patterns has remained nearly non-existent. Here, we sought to describe (1) the characteristics of the population of women who came to be incarcerated in a state prison system during pregnancy and (2) the characteristics of women’s custodial and perinatal care patterns during and after incarceration. Methods We conducted a retrospective chart review of the population of women who received perinatal care while incarcerated in the Arkansas state prison system over a 5-year period from June 2014 to May 2019. Electronic medical records and state prison records were merged to form our study population. Data were from 212 women (Mage = 28.4 years; 75.0% non-Latina White) with a singleton pregnancy who received at least one obstetric care visit while incarcerated. Results Drug-related convictions were the most common crimes leading to women’s incarceration while pregnant, and violent crime convictions were rare. Nearly half (43.4%) of women who gave birth in custody did so within 90 days of admission and the great majority (80.4%) released within 1-year of giving birth, including 13.3% who released within 30 days. Discussion The frequency with which women who became incarcerated while pregnant released from prison either prior to or shortly after giving birth was a striking, novel finding of this study given the implications for perinatal care disruption among a high-risk population and the harms of forced separation from infants within hours of birth. Conclusions Diversionary programs for pregnant women convicted of crimes, particularly in states without current access, are urgently needed and should be a priority for future policy work.

IntroductionAcinetobacter baumannii strain 17978 is an opportunistic pathogen possessing a DNA damage response (DDR) in which multiple error-prone polymerase genes are co-repressed by a UmuD homolog, UmuDAb, and the small Acinetobacter-specific protein DdrR. Additionally, these regulators coactivate nine other genes. We identified the DNA damage-inducible transcriptome for wildtype, umuDAb, and recA strains, and later established the ddrR DDR transcriptome. However, the ATCC 17978 reference genome had several assembly errors and lacked the 44 kb virulence locus, AbaAL44, that is present in the strain 17978 UN.MethodsFor this project, we combined our earlier single-end read RNAseq data with the ddrR paired-end reads and aligned these data to the improved 17978 UN genome assembly that resembled our laboratory strain, 17978 JH.ResultsNew DESeq2 analyses verified previous differentially expressed genes (DEGs) but also found 339 genes in 17978 JH that were not annotated or physically present in the older genome assembly. Sixty-three were differentially expressed after DNA damage, and 182 had differential basal expression when comparing umuDAb, ddrR, or recA strains to wildtype, with 94 genes’ expression unchanged. This work identified and characterized the 55 gene DNA damage-repressible transcriptome, 98% of which required either umuDAb or ddrR for repression. Two-thirds of these DEGs required both regulators. We also identified 110 genes repressed only in the ddrR strain, ~50% of which were due to increased basal expression levels. Basal gene expression in the ddrR mutant was further dysregulated independent of the DDR. Over 800 genes were upregulated, and over 1200 genes were downregulated compared to wildtype expression. Half of A. baumannii’s essential genes were upregulated in the ddrR strain, including cell division genes, and two-thirds of these were downregulated in the umuDAb strain.DiscussionThe ddrR mutant upregulated genes enriched in translation, RNA metabolism, protein metabolism, AA/FA/cell-structure synthesis, and transport, while downregulating genes enriched in quorum sensing, biofilm production, secretion systems, pilus production, cell adhesion, and aromatics and chlorine degradation. Our data underscore the need for accurate and appropriately matched genome assemblies and indicate that ddrR affects approximately 60% of the genome, rendering it a potential target for Acinetobacter baumannii infection treatment.

This multicentre, phase II study of the Australian Lymphoma and Leukaemia Group (ALLG) and the Asian Myeloma Network (AMN) investigated fixed-duration (18-month) treatment with carfilzomib (K), thalidomide (T), and dexamethasone (d; KTd) in patients with relapsed and/or refractory multiple myeloma and 1-3 prior lines of therapy. Patients received induction with up to twelve 28-day cycles of K [20mg/m2 IV cycle 1 day 1 and 2, 56mg/m2 (36mg/m2 for patients ≥75 years) from day 8 onwards), T 100mg PO nocte and weekly dexamethasone 40mg (20mg for patients ≥75 years). During maintenance T was omitted, while K continued on days 1,2,15,16 with fortnightly dexamethasone. The primary endpoint was progression free survival (PFS). Secondary endpoints were overall response rate, overall survival (OS), duration of response, safety, and tolerability. Ninety-three patients (median age 66.3 years (41.9 – 84.5)) were enrolled with a median follow-up of 26.4 (1.6 – 54.6) months. The median PFS was 22.3 months (95% CI 15.7 – 25.6) with a 46.3% (95% CI 35.1 – 52.8) 2-year PFS. Median OS was not reached and was 73.8% (95% CI 62.9 – 81.9) at 2 years. The overall response rate was 88% (≥ VGPR 73%). There was no difference in the depth of response, PFS or OS comparing Asian and Non-Asian cohorts (p=0.61). The safety profile for KTd was consistent with each individual drug. KTd is well tolerated and effective in patients with RRMM irrespective of Asian or non-Asian ethnicity and provides an alternative option particularly where use of KRd is limited by access, cost, or renal impairment.

This article addresses why instructors choose to not use inquiry-oriented instructional practices (IO-IPs) even if they believe the practices are beneficial. A national sample of undergraduate mathematics instructors (N = 269) responded to questionnaires on their use of IO-IPs, beliefs on student learning, and recognition of professional obligations--their responsibilities toward various stakeholders including the individual student, mathematics as a discipline, the institution, and society. Structural equation modeling indicates that learner-focused beliefs often predict the use of IO-IPs, but that recognition of some professional obligations can work in opposition to those beliefs. Future work advocating for instructional change could use this framework to provide instructors with resources that leverage their existing priorities.

The investigation at scale of the tensions that teachers need to manage when deciding to follow recommendations for practice has been hampered by the problem of occurrence: The conditions in which those decisions could be made need to occur during an observation in order for observers to document how teachers handle them. Simulations have been recommended as a way to immerse teachers in instructional contexts in which they have the opportunity to follow such recommendations and observe what teachers choose to do in response. In this article, we show an example of how a teaching simulation may be used to support such investigation, in the context of policy recommendations to open up classroom discussion and consider multiple solutions and in the instructional situation of doing proofs in geometry. A contrast between the decisions made by expert and novice teachers (n = 59) in the simulation, analyzed using multiple regression, adds empirical evidence to earlier conjectures based on qualitative analysis of classroom teaching experiments that revealed teachers to be particularly attentive to epistemological and temporal constraints. We found that expert and novice teachers differed in how likely they were to prefer practices recommended by policymakers. Specifically, expert teachers were significantly more likely than novice teachers to open up classroom discussions when they had the knowledge resources to correct a student error. Similarly, expert teachers were significantly more likely than novice teachers to explore multiple solutions when there were no time constraints.

PURPOSE: To evaluate the effects of daratumumab, lenalidomide, and dexamethasone (D-Rd) versus lenalidomide and dexamethasone (Rd) on patient-reported outcomes (PROs) in the phase III MAIA study. PATIENTS AND METHODS: PROs were assessed on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item and the EuroQol 5-dimensional descriptive system at baseline and every 3 months during treatment. By mixed-effects model, changes from baseline are presented as least squares means with 95% CIs. RESULTS: A total of 737 transplant-ineligible (TIE) patients with newly diagnosed multiple myeloma were randomly assigned to D-Rd (n = 368) or Rd (n = 369). Compliance with PRO assessments was high at baseline (> 90%) through month 12 (> 78%) for both groups. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item global health status scores improved from baseline in both groups and were consistently greater with D-Rd at all time points. A global health status benefit was achieved with D-Rd, regardless of age (< 75 and ≥ 75 years), baseline Eastern Cooperative Oncology Group (ECOG) performance status score, or depth of response. D-Rd treatment resulted in significantly greater reduction in pain scores as early as cycle 3 (P = .0007 v Rd); the magnitude of change was sustained through cycle 12. Reductions in pain with D-Rd were clinically meaningful in patients regardless of age, ECOG status, or depth of response. Similarly, PRO improvements were observed with D-Rd and Rd on the EuroQol 5-dimensional descriptive system visual analog scale score. CONCLUSION: D-Rd compared with Rd was associated with faster and sustained clinically meaningful improvements in PROs, including pain, in transplant-ineligible patients with newly diagnosed multiple myeloma regardless of age, baseline ECOG status, or depth of treatment response.

The American Chemical Society holds supporting diverse student populations engaging in chemistry as a core value. We analyzed chemical concept inventory scores from 4,612 students across 12 institutions to determine what inequities in content knowledge existed before and after introductory college chemistry courses. We interpreted our findings from a Quantitative Critical (QuantCrit) perspective that framed inequities as educational debts that society owed students due to racism, sexism, or both. Results showed that society owed women and Black men large educational debts before and after instruction. Society's educational debts before instruction were large enough that women and Black men's average scores were lower than White men's average pretest scores even after instruction. Society would have to provide opportunities equivalent to taking the course up to two and a half times to repay the largest educational debts. These findings show the scale of the inequities in the science education systems and highlight the need for reallocating resources and opportunities throughout the K-16 education system to mitigate, prevent, and repay society's educational debts from sexism and racism.

Background: The growing understanding of the oppressive inequities that exist in postsecondary education has led to an increasing need for culturally relevant pedagogy. Researchers have found evidence that beliefs about the nature of knowledge predict pedagogical practices. Culturally relevant pedagogy supports students in ways that leverage students' own cultures through three tenets: academic success, cultural competence, and sociopolitical consciousness. If STEM practitioners believe that their disciplines are culture-free, they may not enact culturally relevant pedagogy in their courses. We investigated how and in what forms 40 faculty from mathematics, physics, chemistry, and biology departments at Hispanic-Serving Institutions enacted culturally relevant pedagogy. We used the framework of practical rationality to understand how epistemological beliefs about the nature of their discipline combined with their institutional context impacted instructors' decision to enact practices aligning with the three tenets of culturally relevant pedagogy. Results: In total, 35 instructors reported using practices that aligned with the academic success tenet, nine instructors with the cultural competence tenet, and one instructor with the sociopolitical consciousness tenet. Instructors expressed and even lauded their disciplines' separation from culture while simultaneously expressing instructional decisions that aligned with culturally relevant pedagogy. Though never asked directly, six instructors made statements reflecting a "culture-free" belief about knowledge in their discipline such as "To me, mathematics has no color." Five of those instructors also described altering their teaching in ways that aligned with the academic success tenet. The framework of practical rationality helped explain how the instructors' individual obligation (to the needs of individual students) and interpersonal obligation (to the social environment of the classroom) played a role in those decisions. Conclusions: Instructors' ability to express two contradictory views may indicate that professional development does not have to change an instructor's epistemological beliefs about their discipline to convince them of the value of enacting culturally relevant pedagogy. We propose departmental changes that could enable instructors to decide to cultivate students' cultural competence and sociopolitical consciousness. Our findings highlight the need for future research investigating the impacts of culturally relevant pedagogical content knowledge on students' experiences.

Abstract Background Accurate staging and response assessment are essential for prognosis and to guide treatment in patients with lymphoma. The aim of this study was to compare the diagnostic performance of FDG PET/MRI versus FDG PET/CT in adult patients with newly diagnosed Hodgkin and Non- Hodgkin lymphoma. Methods In this single centre study, 50 patients were prospectively recruited. FDG PET/MRI was performed after staging FDG PET/CT using a single injection of 18F-FDG. Patients were invited to complete same-day FDG PET/MRI with FDG PET/CT at interim and end of treatment response assessments. Performance was assessed using PET/CT as the reference standard for disease site identification, staging, response assessment with Deauville score and concordance in metabolic activity. Results Staging assessment showed perfect agreement (κ = 1.0, P = 0) between PET/MRI and PET/CT using Ann Arbor staging. There was excellent intermodality correlation with disease site identification at staging (κ = 0.976, P

Abstract Background Trauma exposure and drug addiction go hand-in-hand for the 2.17 million people who are incarcerated in US prisons; prevalence of both exceed 80% among this population. This manuscript describes the rationale and methods for a participant-randomized effectiveness-implementation hybrid type II pilot trial designed to: 1) examine the effectiveness of Cognitive Processing Therapy group (CPT), an evidence-based psychotherapy for posttraumatic stress disorder (PTSD), for reducing post-release drug use and PTSD symptoms when adapted for and delivered in prisons; and 2) provide data on implementation outcomes associated with the use of implementation facilitation as a strategy for supporting uptake of CPT in prisons. Method Participants in the effectiveness portion of the trial (N = 120) will be incarcerated men and women who are randomly assigned to one of two group therapies: CPT or a control condition (PTSD coping skills group; PCS). Participants will complete assessment measures three times: pre-treatment, post-treatment, and 3 months following release from incarceration. CPT groups will be led by prison counselors who are receiving implementation facilitation to support their efforts. PCS groups will be led by trained clinicians on the research team. Implementation outcomes will include acceptability, appropriateness, adoption, feasibility, fidelity, and sustainability. After enrollment ends, the research team will monitor CPT sustainment and recidivism outcomes of study participants for one year. Discussion This study will lay the groundwork for a larger study of interventions for co-occurring PTSD and SUD in prisons and, critically, inform the development of strategies (such as implementation facilitation) for supporting their uptake in routine practice. Trial registration NCT04007666 , clinicaltrials.gov, 24 June 2019, 02 September 2021.

Background: Incarcerated perinatal populations report high rates of substance use in the United States (US). Despite this, substance use disorder (SUD) treatment is not routinely available in carceral settings and state policies related to the provision of substance use screening and treatment are unknown. Methods: We conducted a systematic search in WestLaw through the end of the 2020 legislative session combining the terms “pregnant” and “postpartum” with terms for incarceration and related terms. The search returned 453 statutes from 43 states. A deductive codebook of various maternal health topics was developed. Legislative texts related to SUD screening and treatment were extracted for textual analysis. Results: Of the 43 states identified as having at least 1 state statute pertaining to pregnant or postpartum incarcerated people, 7 states had statutes relevant to SUD screening and treatment. Statutes related to substance use screening, education, treatment and diversion programs, program eligibility, aftercare and release planning, and funding appropriations. Conclusions: The majority of states across the U.S. lack legislation that address SUD screening and treatment among incarcerated perinatal populations. Given the known limited access to SUD treatment for perinatal populations in custody, increasing legislative statutes could increase access to essential care.

AimsDifferentiating phenotypes of cardiac “hypertrophy” characterised by increased wall thickness on echocardiography is essential for management and prognostication. Transthoracic echocardiography is the most commonly used screening test for this purpose. We sought to identify echocardiographic markers that distinguish infiltrative and storage disorders that present with increased left ventricular (LV) wall thickness, namely, cardiac amyloidosis (CA) and Anderson–Fabry disease (AFD), from hypertensive heart disease (HHT).MethodsPatients were retrospectively recruited from Westmead Hospital, Sydney, and Princess Alexandra Hospital, Brisbane. LV structural, systolic, and diastolic function parameters, as well as global (LVGLS) and segmental longitudinal strains, were assessed. Previously reported echocardiographic parameters including relative apical sparing ratio (RAS), LV ejection fraction-to-strain ratio (EFSR), mass-to-strain ratio (MSR) and amyloidosis index (AMYLI) score (relative wall thickness × E/e′) were evaluated.ResultsA total of 209 patients {120 CA [58 transthyretin amyloidosis (ATTR) and 62 light-chain (AL) amyloidosis], 31 AFD and 58 HHT patients; mean age 64.1 ± 13.7 years, 75% male} comprised the study cohort. Echocardiographic measurements differed across the three groups, The LV mass index was higher in both CA {median 126.6 [interquartile range (IQR) 106.4–157.9 g/m2]} and AFD [median 134 (IQR 108.8–152.2 g/m2)] vs. HHT [median 92.7 (IQR 79.6–102.3 g/m2), p

Though considered an agricultural country, the Philippines is the world’s largest importer of rice. The persistent problem of insufficient rice supply, however, has been exacerbated by economic crises and natural calamities. Yet, for the Higaonon tribe in Bukidnon Province, the Philippines, the rich agrobiodiversity and wild edible plants are vital for food security and resilience since the mountainous terrain in this province presents a challenge for rice cultivation. To gain insight from the indigenous edible plant knowledge of the Higaonon tribe, we conducted an ethnobotanical research to document the diversity, utilization, and biocultural refugia of both cultivated and wild edible plants. A total of 76 edible plant species belonging to 62 genera and 36 botanical families were documented. The most represented botanical families included the Fabaceae, Solanaceae, and Zingiberaceae. In terms of dietary usage, 3 species were categorized as cereals; 8 species were white roots, tubers, and plantains; 3 species were vitamin A-rich vegetables and tubers; 16 species were green leafy vegetables; 12 species were categorized as other vegetables; 2 species were vitamin A-rich fruits; 27 species were classified as other fruits; 7 species were legumes, nuts, and seeds; and 8 species were used as spices, condiments, and beverages. Using the statistical software R with ethnobotanyR package, we further calculated the ethnobotanical indices (use-report (UR), use-value (UV), number of use (NU), and fidelity level (FL)) from 1254 URs in all 9 food use-categories. The species with the highest UV and UR were from a variety of nutrient-rich edible plants such as Ipomoea batatas (L.) Lam., Musa species, Colocasia esculenta (L.) Schott, Zea mays L., and Manihot esculenta Crantz. The extensive utilization of root and tuber crops along with corn and plantain that contain a higher amount of energy and protein, carbohydrates, minerals, and vitamins were shown to be an important nutrient-rich alternatives to rice. Whilst males appeared to be more knowledgeable of edible plant species collected from the forests and communal areas, there were no significant differences between males and females in terms of knowledge of edible plants collected from homegardens, riverbanks, and farms. The various food collection sites of the Higaonon tribe may be considered as food biocultural refugia given their socio-ecological function in food security, biodiversity conservation, and preservation of indigenous knowledge.

Abstract Background The growing understanding of the oppressive inequities that exist in postsecondary education has led to an increasing need for culturally relevant pedagogy. Researchers have found evidence that beliefs about the nature of knowledge predict pedagogical practices. Culturally relevant pedagogy supports students in ways that leverage students’ own cultures through three tenets: academic success, cultural competence, and sociopolitical consciousness. If STEM practitioners believe that their disciplines are culture-free, they may not enact culturally relevant pedagogy in their courses. We investigated how and in what forms 40 faculty from mathematics, physics, chemistry, and biology departments at Hispanic-Serving Institutions enacted culturally relevant pedagogy. We used the framework of practical rationality to understand how epistemological beliefs about the nature of their discipline combined with their institutional context impacted instructors’ decision to enact practices aligning with the three tenets of culturally relevant pedagogy. Results In total, 35 instructors reported using practices that aligned with the academic success tenet, nine instructors with the cultural competence tenet, and one instructor with the sociopolitical consciousness tenet. Instructors expressed and even lauded their disciplines’ separation from culture while simultaneously expressing instructional decisions that aligned with culturally relevant pedagogy. Though never asked directly, six instructors made statements reflecting a “culture-free” belief about knowledge in their discipline such as “To me, mathematics has no color.” Five of those instructors also described altering their teaching in ways that aligned with the academic success tenet. The framework of practical rationality helped explain how the instructors’ individual obligation (to the needs of individual students) and interpersonal obligation (to the social environment of the classroom) played a role in those decisions. Conclusions Instructors’ ability to express two contradictory views may indicate that professional development does not have to change an instructor’s epistemological beliefs about their discipline to convince them of the value of enacting culturally relevant pedagogy. We propose departmental changes that could enable instructors to decide to cultivate students’ cultural competence and sociopolitical consciousness. Our findings highlight the need for future research investigating the impacts of culturally relevant pedagogical content knowledge on students’ experiences.

This study describes how nine university professors managed their teaching when a shift from lecturing to inquiry-based learning was mandated in a large enrollment course, linear algebra for math majors. We describe the tensions that emerged and how they were resolved, in part via the production of worksheets that were used in teaching. We describe the way in which professional obligations towards the discipline and towards the institution shaped the tensions and the ways in which they were resolved by this group of faculty. We offer a conceptualization of the enactment of instruction that was prompted by the study and implications for continued investigation of change strategies in undergraduate mathematics.

Purpose: Although language sample analysis is widely recommended for assessing children's expressive language, few school-based speech-language pathologists routinely use it, citing a lack of time, resources, and training (Pavelko, Owens, Ireland, & Hahs-Vaughn, 2016). The purpose of this clinical tutorial is (a) to describe options for language sample analysis using computer programs and (b) to demonstrate a process of using language sample analysis focused on the assessment of 2 preschool children as case studies. Method: We provide an overview of collecting and analyzing child language samples and describe 3 programs for language sample analysis: 2 dedicated software programs (Computerized Language Analysis [MacWhinney, 2000] and Systematic Analysis of Language Transcripts [Miller & Iglesias, 2015]) and 1 protocol for using word processing software to analyze language samples (Sampling Utterances and Grammatical Analysis Revised; Pavelko & Owens, 2017). We also present analysis results from each program for play-based language samples from 2 preschool children and detailed analysis of the samples with potential treatment goals. Results: Each program offers different analyses, comparison databases, and sampling contexts. We present options for additional analysis, clinical interpretations, and potential treatment goals based on the 2 preschool cases. Conclusion: Clinicians can use computer programs for language sample analysis as part of a process to make naturalistic language assessment more feasible.

People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (n = 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12–52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12–24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.

Pregnancy is a critical time to provide access to substance use treatment; this is especially true among incarcerated populations, who are known to be at particularly high risk of poor health outcomes. In this integrated literature review, we (1) report what is known about the prevalence of substance use among incarcerated pregnant and postpartum populations; (2) describe substance use treatment programs and current care practices of pregnant and postpartum populations in carceral settings; and (3) explore recommendations and strategies for increasing access to substance use treatment for incarcerated pregnant and postpartum populations. A comprehensive search of seven electronic databases yielded in the retrieval of 139 articles that were assessed for inclusion. Of the retrieved articles, 33 articles met criteria for inclusion in this review. A review of the literature revealed that the understanding of substance use prevalence among pregnant incarcerated women is limited. We also found that treatment of substance use disorders among pregnant and postpartum populations is not routinely available, enhanced perinatal services are sorely needed, and substance use treatment programs are feasible with the help of community partnerships. More research is required to understand current substance use treatment initiatives and outcomes for pregnant women in prison. In addition, strategies for integrating evidence-based, substance use treatment in carceral settings is also needed. Future directions are discussed.

Abstract Background Obesity is common in persons with a lower limb amputation, an amputation can also lead to further weight gain. Data regarding the prevalence of obesity in the Dutch population with a lower limb amputation are lacking. Furthermore, the impact of obesity on skin problems of the residual limb and the need of prosthetic repairs is unknown. The aim of this study was to determine the prevalence of obesity in Dutch persons with a lower limb amputation and to investigate the relationship between body weight, body mass index and skin problems of the residual limb and the frequency of prosthetic repairs. Methods A survey was performed among adults with a unilateral lower limb amputation due to any cause, and who are user of a prosthesis. The survey consisted of measurement of the subjects’ body height and weight, a questionnaire which assessed self-reported skin problems in the previous month and factors potentially associated with these skin problems, and assessment of the frequency of visits to the orthopedic workshop. Results In total, 413 persons were enrolled. Of them, 39% (95 % confidence interval 35;44) were overweight and 28% (95% confidence interval 24;33) were obese. A total of 77% (95% confidence interval 73;81) reported one or more skin problems in the past month. Body weight and body mass index were neither associated with the presence of skin problems in general nor with the number of prosthetic repairs. Persons with severe skin problems had a slightly lower body mass index (26.6 kg/m2 vs. 28.0 kg/m2, p = 0.012). Persons with skin problems were younger than those without (difference in means 6.0 years (95% confidence interval 3.0;8.9)). Conclusions Our findings show that obesity is common in the Dutch ambulant population with a lower limb amputation, with a prevalence being higher than in the general Dutch adult population. However, its negative impact on the presence of skin problems and the frequency of prosthetic repairs may be limited.

Purpose: The goal was to determine whether interactive book reading outcomes for children with developmental language disorder (DLD) were affected by manipulation of dose (i.e., the number of exposures to the target word during a book reading session) and dose frequency (i.e., the number of repeated book reading sessions) and whether pretreatment factors predicted treatment response variation. Method: Thirty-four kindergarten children with DLD (aged 5;0-6;2 [years;months]) were taught 1 set of words using the Dose 6 and Dose Frequency 6 format from a prior study (Storkel, Voelmle, et al., 2017) and taught a different set of words using an alternative format, either Dose 4 x Dose Frequency 9 or Dose 9 × Dose Frequency 4, determined through random assignment. Word learning was tracked for each treatment via a definition task prior to, during, and after treatment. Results: Results showed that children with DLD learned a significant number of words during treatment regardless of the dose and dose frequency format but that significant forgetting of newly learned words occurred in all formats once treatment was withdrawn. Individual differences in word learning were related to Clinical Evaluation of Language Fundamentals Core Language and Understanding Spoken Paragraphs scores. Conclusion: When administered at an adequate intensity, variation in the dose and dose frequency of interactive book reading does not appear to influence word learning by children with DLD. Although interactive book reading continues to show promise as an effective word learning intervention for children with DLD, further development is needed to enhance the effectiveness of this treatment approach.

Land is both a source and a sink of carbon dioxide (CO2), the chief greenhouse gas. Through sustainable land management (SLM), it can capture extra CO2 and store it as carbon in vegetation and soil. SLM can also reduce CO2 emissions from the land. Thus, SLM is viewed as the key land-based solution for climate change mitigation. Yet, SLM also provides effective climate change (CC) adaptation practices—such as agroforestry, mulching and water harvesting—which confer resilience, and simultaneously help secure production. This is especially valuable for land users in sub-Saharan Africa (SSA) who depend on rainfed agriculture. They are amongst the poorest on Earth and the most vulnerable to CC impacts, despite their minimal carbon footprint. The World Overview of Conservation Approaches and Technologies (WOCAT) manages the Global SLM Database: this holds a rich and ever-growing collection of SLM practices. Analysis of the database for rainfed SSA sheds light on which SLM technologies are effective in CC adaptation, and how well they cope with changing rainfall and temperature. Both “mechanisms” and “attributes” are explored, yielding new insights. This perspective paper showcases current developments in the field, and summarizes future directions for SLM as a CC adaptation solution for land users in SSA.

Informal foraging for food and other natural materials in urban greenspaces is an activity undertaken by many across the world. For some, foraging is a necessary means of survival and livelihood, while for others, it provides cultural and recreational opportunities. In the socioeconomic crises induced by Covid-19, foraging can help communities, especially (but not exclusively) vulnerable people, cope with the impacts of lockdowns, and associated economic decline. In the long run, foraging can help improve social–ecological resilience in urban systems, particularly in response to climate, economic, and disease disruptions. First, we elaborate the ways in which urban foraging can provide immediate relief from the shocks to natural, human, social, physical, and financial capital. We then describe how over time, the livelihood, food, and income diversification brought about by foraging can contribute to preparedness for future uncertainties and gradual change. Cities are increasingly becoming home to the majority of humanity, and urban foraging can be one of the pathways that makes cities more liveable, for humans as well as other species we coexist with. Through the capitals framework, we explore the role foraging could play in addressing issues of biodiversity conservation, culture, and education, good governance and social justice, multifunctional greenspace, and sustainable nature-based livelihoods in urban areas.

There are limited data on post-transplant lymphoproliferative disorder (PTLD) in the era of positron emission tomography (PET) and rituximab (R). Furthermore, there is limited data on the risk of graft rejection with modern practices in reduction in immunosuppression (RIS). We studied 91 patients with monomorphic diffuse large B-cell lymphoma PTLD at 11 Australian centers: median age 52 years, diagnosed between 2004 and 2017, median follow-up 4.7 years (range, 0.5–14.5 y). RIS occurred in 88% of patients. For patients initially treated with R-monotherapy, 45% achieved complete remission, rising to 71% with the addition of rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone (R-CHOP) for those not in complete remission. For patients initially treated with R-CHOP, the complete remission rate was 76%. There was no difference in overall survival (OS) between R-monotherapy and R-chemotherapy patients. There was no difference in OS for patients with systemic lymphoma (n = 68) versus central nervous system (CNS) involvement (n = 23) (3-y OS 72% versus 73%; P = 0.78). Treatment-related mortality was 7%. End of treatment PET was prognostic for patients with systemic lymphoma with longer OS in the PET negative group (3-y OS 91% versus 57%; P = 0.01). Graft rejection occurred in 9% (n = 4 biopsy-proven; n = 4 suspected) during the entire follow-up period with no cases of graft loss. RIS and R-based treatments are safe and effective with a low likelihood of graft rejection and high cure rate for patients achieving complete remission with CNS or systemic PTLD.