Story telling in bilingual Urdu-Cantonese ethnic minority children: Macrostructure and its relation to microstructural linguistic skills.

Introduction: The ability to produce a well-structured, coherent and informative narrative requires the integration of lexical and grammatical skills at different levels of complexity. Investigating how narrative macrostructure competence is predicted by microstructural linguistic skills is conceptually enlightening; yet there have been very few, if any, studies documenting the associations between macrostructure and microstructure in both languages of the same bilinguals. In this paper we attempt to address this research gap and report on the first empirical study of Urdu-Cantonese bilingual children's narrative abilities, bringing in data from a new language pair that is currently understudied. Methods: Twenty-four bilinguals (mean age = 9.17 years) acquiring Urdu as first, family and heritage minority language, and Cantonese as second, school and majority language were assessed via Multilingual Assessment Instrument for Narratives (MAIN). We examined these children's macrostructural competence and its relations to microstructural skills in both languages (Urdu and Cantonese). Three macrostructure components were scored as response variables: Story Structure (SS), Story Complexity (SC), Internal State Terms (IST). Four microstructural measures were scored as predictor variables: number of different words (NDW), mean length of Communication Units (MLCU), proportion of grammatical Communication Units (Gproportion), proportion of correct connectives linking the major episodic elements (Cproportion). Results: In regression analyses, NDW emerged consistently as a positive predictor of SS, SC and IST in both languages. MLCU and NDW were positive predictors of SS in the stronger L1, but NDW was the only positive predictor of SS in L2. By contrast, NDW and an index of syntactic competence (MLCU in L1, but Cproportion in L2) were significant or close-to-significant positive predictors of SC in both languages. NDW was the only positive predictor of IST in both languages. These findings suggested that the relationships between narrative macrostructure and specific microstructural abilities could manifest both similarly and differently between L1 and L2. Discussion: We discuss the findings by considering the unique nature of each macrostructure component and how each component might be related to specific microstructural linguistic skills. We suggest directions for further research and discuss how the current findings bring deeper implications for educators and clinicians in assessment, pedagogy, and intervention.

Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England.

Background: To minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of English general practice consultations was modified in March 2020 to enable separation of diagnosed or suspected COVID-19 patients from others. Remote triage and consultations became the default, with adapted face-to-face contact used only when clinically necessary. This study aimed to identify the modified face-to-face delivery models used nationwide in spring/summer 2020. Information was also sought concerning COVID-19 outbreaks linked to English general practice. Methods: In June 2020, a survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) in England to identify local organisation of face-to-face general practice consultations since March 2020. An email was  sent to Public Health England (PHE) requesting data on COVID-19 outbreaks linked to general practice. Results: All CCGs responded. Between March and July 2020, separation of COVID-19 patients from others was achieved using combinations of the following models: zoned surgeries (reported by 47% of CCGs), where COVID-19 and other patients were separated within their own practice;'hot' or 'cold' hubs (reported by 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices were seen;'hot' and 'cold' home visits (reported by 70% of CCGs). One of seven combinations of these models was used across each CCG, with some flexibility shown according to changing demand through hub availability. PHE data indicated 25 possible or confirmed COVID-19 outbreaks or clusters in English general practice to July 31st 2020. Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified.  Analysis of the modified delivery in terms of management of COVID-19 and other conditions, and impacts on staff and patients, together with learning from investigations into confirmed COVID-19 outbreaks, may both aid future pandemic management and identify beneficial elements for practice beyond this.

Public perception of NHS general practice during the first six months of the COVID-19 pandemic in England.

Background: In March 2020, the delivery of NHS general practice consultations was rapidly modified to mitigate the spread of COVID-19. Remote triage and consultations became the default, with adapted models for face-to-face contact if clinically required. This study aimed to gain insight into public perception of these adaptations. Methods: Two online surveys were developed, and conducted in August and September 2020. Survey A, open to adults (>18 years) receiving the link to it, considered respondents' perspectives on healthcare contacts since March 2020, and their understanding of the adapted delivery. Survey B, open to survey A respondents only, then considered how healthcare communication had been received and individual preferences for this. Survey participation was voluntary. Results: The perceptions of 150 members of the public were obtained. 105 had considered contacting general practice, although half avoided this or delayed doing so for longer than usual. While some patients did so 'to help the NHS', others experienced reduced access for reasons including concerns about telephone consultations and about COVID-19 safety. Some however reported benefitting from remote consultation availability and regular texts/emails from their practice. 68% (102/150) of respondents were unaware that patients with COVID-19 were seen separately from other patients during general practice appointments. 27% in survey B who had avoided or delayed contact said they would have felt more comfortable contacting general practice had they known this. Conclusions: Experience and use of the adapted general practice models varied. Some patients felt their access to healthcare was reduced, often due to technological requirements. For some who found attending face-to-face appointments difficult however, remote contact was advantageous. Most of those surveyed were unaware of the COVID-19 control measures in place during face-to-face general practice consultations. Assessment of adapted delivery model accessibility and clearer public messaging about the changes may help reduce inequalities.

CRAGE enables rapid activation of biosynthetic gene clusters in undomesticated bacteria.

It is generally believed that exchange of secondary metabolite biosynthetic gene clusters (BGCs) among closely related bacteria is an important driver of BGC evolution and diversification. Applying this idea may help researchers efficiently connect many BGCs to their products and characterize the products' roles in various environments. However, existing genetic tools support only a small fraction of these efforts. Here, we present the development of chassis-independent recombinase-assisted genome engineering (CRAGE), which enables single-step integration of large, complex BGC constructs directly into the chromosomes of diverse bacteria with high accuracy and efficiency. To demonstrate the efficacy of CRAGE, we expressed three known and six previously identified but experimentally elusive non-ribosomal peptide synthetase (NRPS) and NRPS-polyketide synthase (PKS) hybrid BGCs from Photorhabdus luminescens in 25 diverse γ-Proteobacteria species. Successful activation of six BGCs identified 22 products for which diversity and yield were greater when the BGCs were expressed in strains closely related to the native strain than when they were expressed in either native or more distantly related strains. Activation of these BGCs demonstrates the feasibility of exploiting their underlying catalytic activity and plasticity, and provides evidence that systematic approaches based on CRAGE will be useful for discovering and identifying previously uncharacterized metabolites.