Students, community and belonging: an investigation of student experience across six European countries.

Despite existing empirical work that explores the multiple ways in which students develop a sense of belonging in higher education, there is a dearth of comparative research about the extent to which the concepts of community and belonging are central to what it means to be a student and how students in different national contexts (beyond Anglophone countries) construct community and belonging. Drawing on qualitative data from students from six European countries, we provide an account of conceptualisations of community and belonging. Specifically, this paper extends discussions around community and belonging in higher education through comparative inquiry. Notwithstanding the individualised and consumerist framing of students accompanied by market reforms in higher education across Europe, it shows that the notion of community and/or belonging features prominently in students' narratives. We also demonstrate how a sense of community and belonging is experienced on different levels. Crucially, the emphasis placed on community in students' sense of belonging varies by the country, pointing towards the continued influence of distinctive national traditions, structures and norms of higher education. Our analysis contributes to wider debates about the development of a European Higher Education Area and its impact on European homogenisation.

Cephalosporin resistance, tolerance, and approaches to improve their activities.

Cephalosporins comprise a ß-lactam antibiotic class whose first members were discovered in 1945 from the fungus Cephalosporium acremonium. Their clinical use for Gram-negative bacterial infections is widespread due to their ability to traverse outer membranes through porins to gain access to the periplasm and disrupt peptidoglycan synthesis. More recent members of the cephalosporin class are administered as last resort treatments for complicated urinary tract infections, MRSA, and other multi-drug resistant pathogens, such as Neisseria gonorrhoeae. Unfortunately, there has been a global increase in cephalosporin-resistant strains, heteroresistance to this drug class has been a topic of increasing concern, and tolerance and persistence are recognized as potential causes of cephalosporin treatment failure. In this review, we summarize the cephalosporin antibiotic class from discovery to their mechanisms of action, and discuss the causes of cephalosporin treatment failure, which include resistance, tolerance, and phenomena when those qualities are exhibited by only small subpopulations of bacterial cultures (heteroresistance and persistence). Further, we discuss how recent efforts with cephalosporin conjugates and combination treatments aim to reinvigorate this antibiotic class.

Higher education students' aspirations for their post-university lives: evidence from six European nations.

While there is now a relatively large literature on young people's aspirations with respect to their transitions from compulsory schooling, the body of work on the aspirations of those within higher education is rather less well-developed. This article draws on data from undergraduate students in six European countries to explore their hopes for their post-university lives. It demonstrates that although aspirations for employment were discussed most frequently, non-economic plans and desires were also important. Moreover, despite significant commonalities across the six nations, aspirations were also differentiated, to some extent at least, by national context, institutional setting and subject of study.

The PRESIDE (PhaRmacogEnomicS In DEpression) Trial: a double-blind randomised controlled trial of pharmacogenomic-informed prescribing of antidepressants on depression outcomes in patients with major depressive disorder in primary care.

BACKGROUND: The evidence for the clinical utility of pharmacogenomic (PGx) testing is growing, and guidelines exist for the use of PGx testing to inform prescribing of 13 antidepressants. Although previous randomised controlled trials of PGx testing for antidepressant prescribing have shown an association with remission of depression in clinical psychiatric settings, few trials have focused on the primary care setting, where most antidepressant prescribing occurs. METHODS: The PRESIDE Trial is a stratified double-blinded randomised controlled superiority trial that aims to evaluate the impact of a PGx-informed antidepressant prescribing report (compared with standard prescribing using the Australian Therapeutic Guidelines) on depressive symptoms after 12 weeks, when delivered in primary care. Six hundred seventy-two patients aged 18-65 years of general practitioners (GPs) in Victoria with moderate to severe depressive symptoms, measured using the Patient Health Questionnaire-9 (PHQ-9), will be randomly allocated 1:1 to each arm using a computer-generated sequence. Participants and GPs will be blinded to the study arm. The primary outcome is a difference between arms in the change of depressive symptoms, measured using the PHQ-9 after 12 weeks. Secondary outcomes include a difference between the arms in change in PHQ-9 score at 4, 8 and 26 weeks, proportion in remission at 12 weeks, a change in side effect profile of antidepressant medications, adherence to antidepressant medications, change in quality of life and cost-effectiveness of the intervention. DISCUSSION: This trial will provide evidence as to whether PGx-informed antidepressant prescribing is clinically efficacious and cost-effective. It will inform national and international policy and guidelines about the use of PGx to select antidepressants for people with moderate to severe depressive symptoms presenting in primary care. TRIAL REGISTRATION: Australian and New Zealand Clinical Trial Registry ACTRN12621000181808. Registered on 22 February 2021.

Marine protected areas, marine heatwaves, and the resilience of nearshore fish communities.

Anthropogenic stressors from climate change can affect individual species, community structure, and ecosystem function. Marine heatwaves (MHWs) are intense thermal anomalies where water temperature is significantly elevated for five or more days. Climate projections suggest an increase in the frequency and severity of MHWs in the coming decades. While there is evidence that marine protected areas (MPAs) may be able to buffer individual species from climate impacts, there is not sufficient evidence to support the idea that MPAs can mitigate large-scale changes in marine communities in response to MHWs. California experienced an intense MHW and subsequent El Niño Southern Oscillation event from 2014 to 2016. We sought to examine changes in rocky reef fish communities at four MPAs and associated reference sites in relation to the MHW. We observed a decline in taxonomic diversity and a profound shift in trophic diversity inside and outside MPAs following the MHW. However, MPAs seemed to dampen the loss of trophic diversity and in the four years following the MHW, taxonomic diversity recovered 75% faster in the MPAs compared to reference sites. Our results suggest that MPAs may contribute to long-term resilience of nearshore fish communities through both resistance to change and recovery from warming events.

Caregiving fathers and the negotiation of crossroads: Journeys of continuity and change.

This article addresses the sustainability of extensive paternal involvement in caregiving by applying a temporal approach to understandings of the journeys of primary- and equal-carer fathers and their families. Drawing on a second phase of interviews with UK fathers first spoken to 5 years earlier, we explore continuities and changes in their roles, identities and outlooks as their caregiving journeys progressed and their children became older. Specifically, we explore how fathers and their families negotiated significant moments of change that had the potential to prompt reflection or reorientation, moments that we term caregiving crossroads. Through doing so, we highlight how, in spite of shifts in their arrangements and understandings, the embeddedness of fathers' caregiving routines, bonds and identities had apparently enabled their commitment to counter-normative roles to endure through such crossroads. We also outline, however, how gendered limitations to some aspects of the scope of their caregiving seemed also to persist as their journeys as fathers progressed.

A systematic review: what factors predict Post-Traumatic Stress Symptoms in ambulance personnel?

BACKGROUND: Ambulance personnel are frequently exposed to traumatic accidents, which makes them a high risk for poor mental health. High rates of Post-Traumatic Stress Symptoms (PTSS) have been found within ambulance personnel samples but no review has been completed to examine the factors that may be implicated in the development of these symptoms. This literature review provides an overview of the factors that predict PTSS in ambulance personnel. METHODS: A systematic search strategy was conducted in April 2020 across the following four databases: PsycINFO, PsycARTICLES, MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL). RESULTS: Eighteen papers were included in this review, and the predictive factors examined were grouped into four categories: coping style, personal factors, environmental factors and organisational factors. CONCLUSIONS: An array of factors across the four categories were implicated in the development of PTSS, but these tended to be indicated in only one or two papers. Evidence was found to suggest that dysfunctional coping styles, reduced levels of some personality traits, proximity and nature of the critical incident and high levels of organisation stress can all lead to PTSS. Further research is needed to support the reliability of findings.

Quantifying interfacial substrate interactions via surface energy analyses.

Determination of a substrate's surface energy profile is a facile and inexpensive method to indicate the substrate's interfacial thermodynamics with another substance (e.g., microorganisms, biomacromolecules, medical devices, etc). The following protocol details a goniometric method to calculate a substrate's surface energy profile which (1) directly correlates to a substrate's interfacial Gibbs energy (ΔG) and (2) predicts the interfacial interactions with other substances. We also provide a calculation template using advanced mathematics to expedite surface energy profile determination. For complete details on the use and execution of this protocol, please refer to Cavitt et al. (2020).

Cone beam computed tomography for dose calculation quality assurance for magnetic resonance-only radiotherapy.

BACKGROUND AND PURPOSE: Magnetic Resonance (MR)-only prostate radiotherapy using synthetic Computed Tomography (sCT) algorithms with high dose accuracy has been clinically implemented. MR images can suffer from geometric distortions so Quality Assurance (QA) using an independent, geometrically accurate, image could be required. The first-fraction Cone Beam CT (CBCT) has demonstrated potential but has not been evaluated in a clinical MR-only pathway. This study evaluated the clinical use of CBCT for dose accuracy QA of MR-only radiotherapy. MATERIALS AND METHODS: A total of 49 patients treated with MR-only prostate radiotherapy were divided into two cohorts. Cohort 1 (20 patients) received a back-up CT, whilst Cohort 2 (29 patients) did not. All patients were planned using the sCT and received daily CBCT imaging with MR-CBCT soft-tissue matching. Each CBCT was calibrated using a patient-specific stepwise Hounsfield Units-to-mass density curve. The treatment plan was recalculated on the first-fraction CBCT using the clinically applied soft-tissue match and the doses compared. For Cohort 1 the sCT was rigidly registered to the back-up CT, the plan recalculated and doses compared. RESULTS: Mean sCT-CBCT dose difference across both cohorts was - 0.6 ± 0.1 % (standard error of the mean, range - 2.3 % , 2.3 % ), with 47/49 patients within [ - 2 % , 1 % ]. The sCT-CBCT dose difference was systematically lower than the sCT-CT by - 0.7 ± 0.6 % ( ± 95 % limits of agreement). The mean sCT-CBCT gamma pass rate ( 2 % / 2 mm ) was 96.1 ± 0.4 % ( 85.4 % , 99.7 % ). CONCLUSIONS: CBCT-based dose accuracy QA for MR-only radiotherapy appears clinically feasible. There was a small systematic sCT-CBCT dose difference implying asymmetric tolerances of [ - 2 % , 1 % ] would be appropriate.

Are cone beam CT image matching skills transferrable from planning CT to planning MRI for MR-only prostate radiotherapy?

OBJECTIVES: Treatment verification for MR-only planning has focused on fiducial marker matching, however, these are difficult to identify on MR. An alternative is using the MRI for soft-tissue matching with cone beam computed tomography images (MR-CBCT). However, therapeutic radiographers have limited experience of MRI. This study aimed to assess transferability of therapeutic radiographers CT-CBCT prostate image matching skills to MR-CBCT image matching. METHODS: 23 therapeutic radiographers with 3 months-5 years' experience of online daily CT-CBCT soft-tissue matching prostate cancer patients participated. Each observer completed a baseline assessment of 10 CT-CBCT prostate soft-tissue image matches, followed by 10 MR-CBCT prostate soft-tissue image match assessment. A MRI anatomy training intervention was delivered and the 10 MR-CBCT prostate soft-tissue image match assessment was repeated. Limits of agreement were calculated as the disagreement of the observers with mean of all observers. RESULTS: Limits of agreement at CT-CBCT baseline were 2.8 mm, 2.8 mm, 0.7 mm (vertical, longitudinal, lateral). MR-CBCT matches prior to training were 3.3 mm, 3.1 mm, 0.9 mm, and after training 2.6 mm, 2.4 mm, 1.1 mm (vertical, longitudinal, lateral). Results show similar limits of agreement across the assessments, and variation reduced following the training intervention. CONCLUSION: This suggests therapeutic radiographers' prostate CBCT image matching skills are transferrable to a MRI planning scan, since MR-CBCT matching has comparable observer variation to CT-CBCT matching. ADVANCES IN KNOWLEDGE: This is the first publication assessing interobserver MR-CBCT prostate soft tissue matching in an MR-only pathway.

Historic Assessment and Analysis of the Mass Production of Laricobius spp. (Coleoptera: Derodontidae), Biological Control Agents for the Hemlock Woolly Adelgid, at Virginia Tech.

Laricobius nigrinus (Coleoptera: Derodontidae) Fender and Laricobius osakensis (Coleoptera: Derodontidae) Montgomery and Shiyake have been mass produced by Virginia Tech as biological control agents for the hemlock woolly adelgid (HWA), Adelges tsugae (Hemiptera: Adelgidae) Annand, for the past 15 and 9 yr, respectively. Herein, we describe modifications of our rearing procedures, trends and analyses in the overall production of these agents, and the redistribution of these agents for release to local and federal land managers. Based on these data, we have highlighted three major challenges to the rearing program: 1) high mortality during the subterranean portion of its life cycle (averaging 37% annually) reducing beetle production, 2) asynchrony in estivation emergence relative to the availability of their host HWA minimizing food availability, and 3) unintended field collections of Laricobius spp. larvae on HWA provided to lab-reared larvae complicating rearing procedures. We further highlight corresponding avenues of research aimed at addressing each of these challenges to further improve Laricobius spp. production.

Prevalence of gastrointestinal, cardiovascular, autonomic and allergic manifestations in hospitalized patients with Ehlers-Danlos syndrome: a case-control study.

OBJECTIVE: Previous observations suggest an association between Ehlers-Danlos syndrome (EDS) and gastrointestinal (GI), cardiovascular, immune, and autonomic nervous system dysfunction. We sought to determine whether a hospital diagnosis of EDS is associated with a higher prevalence of these manifestations vs hospitalized patients without EDS. We also evaluated hospital outcomes. METHODS: A total of 6,021 cases and matched controls were acquired from the 2016 National Inpatient Sample. In total, 2,007 EDS patients were identified via ICD-10 code. After bivariate analyses, multivariate logistic regression models were used to adjust for potential confounders. RESULTS: GI conditions were found in 44% of EDS patients vs 18% of controls [odds ratio (OR) = 3.57, 95% CI: 3.17, 4.02, P < 0.0001], with irritable bowel syndrome, gastroparesis and coeliac disease strongly associated with EDS. Autonomic dysfunction, including postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope and orthostatic hypotension was found in 20% of EDS patients vs 6% of controls (OR = 4.45, 95% CI: 3.71, 5.32, P < 0.0001). EDS patients were more likely to have food allergy (OR = 3.88, 95% CI: 2.65, 5.66, P < 0.0001) and cardiovascular complications such as mitral valve disorders, aortic aneurysm and dysrhythmias (OR = 6.16, 95% CI: 4.60, 8.23, P < 0.0001). These conditions remained highly associated with EDS after considering confounders. EDS patients were 76% more likely to have longer than average hospitalizations (OR = 1.76, 95% CI: 1.54, 2.02, P < 0.0001). CONCLUSION: GI, cardiovascular, autonomic and allergic manifestations are significantly more prevalent in EDS patients compared with hospitalized patients without EDS. Physicians should consider EDS in patients with unexplained GI, cardiovascular, autonomic and allergic conditions and exercise precautions when treating EDS patients in a hospital setting.

The Inability of Spotted Lanternfly (Lycorma delicatula) to Vector a Plant Pathogen between its Preferred Host, Ailanthus altissima, in a Laboratory Setting.

With the recent introduction of the non-native spotted lanternfly (Lycorma delicatula) to the USA, research and concern regarding this insect is increasing. Though L. delicatula is able to feed on many different plant species, its preference for the invasive tree-of-heaven (Ailanthus altissima) is apparent, especially during its later life stage. Therefore, management focused on A. altissima control to help limit L. delicatula establishment and population growth has become popular. Unfortunately, the control of A. altissima is difficult. Verticillium nonalfalfae, a naturally occurring vascular-wilt pathogen, has recently received attention as a potential biological control agent. Therefore, we studied if L. delicatula fourth instars or adults could vector V. nonalfalfae from infected A. altissima material to healthy A. altissima seedlings in a laboratory setting. We were unable to re-isolate V. nonalfalfae from the 45 A. altissima seedlings or from the 225 L. delicatula utilized in this experiment. We therefore, found no support that L. delicatula could effectively vector this pathogen between A. altissima in laboratory conditions. Since L.delicatula's ability to vector V. nonalfalfae has implications for the dissemination of both this beneficial biological control and other similar unwanted plant pathogens, future research is needed to confirm these findings in a field setting.

Invasive plants negatively impact native, but not exotic, animals.

Despite our growing understanding of the impacts of invasive plants on ecosystem structure and function, important gaps remain, including whether native and exotic species respond differently to plant invasion. This would elucidate basic ecological interactions and inform management. We performed a meta-analytic review of the effects of invasive plants on native and exotic resident animals. We found that invasive plants reduced the abundance of native, but not exotic, animals. This varied by animal phyla, with invasive plants reducing the abundance of native annelids and chordates, but not mollusks or arthropods. We found dissimilar impacts among "wet" and "dry" ecosystems, but not among animal trophic levels. Additionally, the impact of invasive plants increased over time, but this did not vary with animal nativity. Our review found that no studies considered resident nativity differences, and most did not identify animals to species. We call for more rigorous studies of invaded community impacts across taxa, and most importantly, explicit consideration of resident biogeographic origin. We provide an important first insight into how native and exotic species respond differently to invasion, the consequences of which may facilitate cascading trophic disruptions further exacerbating global change consequences to ecosystem structure and function.

The accuracy of Magnetic Resonance - Cone Beam Computed Tomography soft-tissue matching for prostate radiotherapy.

BACKGROUND AND PURPOSE: Magnetic Resonance (MR)-Only radiotherapy requires a method for matching image with on-treatment Cone Beam Computed Tomography (CBCT). This study aimed to investigate the accuracy of MR-CBCT soft-tissue matching for prostate MR-only radiotherapy. MATERIALS AND METHODS: Three patient cohorts were used, with all patients receiving MR and CT scans. For the first cohort (10 patients) the first fraction CBCT was automatically rigidly registered to the CT and MR scans and the MR-CT registration predicted using the MR-CBCT and CT-CBCT registrations. This was compared to the automatic MR-CT registration. For the second and third cohorts (five patients each) the first fraction CBCT was independently matched to the CT and MR by four radiographers, the MR-CBCT and CT-CBCT matches compared and the inter-observer variability assessed. The second cohort used a CT-based structure set and the third a MR-based structure set with the MR relabelled as a 'CT'. RESULTS: The mean difference between predicted and actual MR-CT registrations was Δ R All = - 0.1 ± 0.2 mm (s.e.m.). Radiographer MR-CBCT registrations were not significantly different to CT-CBCT, with mean differences in soft-tissue match ⩽ 0.2 mm and all except one difference ⩽ 3.3 mm . This was less than the MR-CBCT inter-observer limits of agreement [ 3.5 , 2.4 , 0.9 ] mm (vertical, longitudinal, lateral), which were similar ( ⩽ 0.5 mm ) to CT-CBCT. CONCLUSIONS: MR-CBCT soft-tissue matching is not significantly different to CT-CBCT. Relabelling the MR as a 'CT' does not appear to change the automatic registration. This suggests that MR-CBCT soft-tissue matching is feasible and accurate.

Environmental proteomics reveals taxonomic and functional changes in an enriched aquatic ecosystem.

Aquatic ecosystem enrichment can lead to distinct and irreversible changes to undesirable states. Understanding changes in active microbial community function and composition following organic-matter loading in enriched ecosystems can help identify biomarkers of such state changes. In a field experiment, we enriched replicate aquatic ecosystems in the pitchers of the northern pitcher plant, Sarracenia purpurea. Shotgun metaproteomics using a custom metagenomic database identified proteins, molecular pathways, and contributing microbial taxa that differentiated control ecosystems from those that were enriched. The number of microbial taxa contributing to protein expression was comparable between treatments; however, taxonomic evenness was higher in controls. Functionally active bacterial composition differed significantly among treatments and was more divergent in control pitchers than enriched pitchers. Aerobic and facultative anaerobic bacteria contributed most to identified proteins in control and enriched ecosystems, respectively. The molecular pathways and contributing taxa in enriched pitcher ecosystems were similar to those found in larger enriched aquatic ecosystems and are consistent with microbial processes occurring at the base of detrital food webs. Detectable differences between protein profiles of enriched and control ecosystems suggest that a time series of environmental proteomics data may identify protein biomarkers of impending state changes to enriched states.

Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why.

AIM: Autism spectrum disorder (ASD) is a neurodevelopmental disorder impairing social skills and communication. Adolescents with ASD have sexual needs, but may not understand their physical and emotional development resulting in inappropriate sexual behaviour. The aim of this review is to describe the type of inappropriate behaviour that presents in these adolescents, explain why such behaviours occur, suggest what education is suitable and identify current gaps in research. METHOD: The databases EMBASE, OVID MEDLINE and PSYCINFO were searched for relevant articles. In total, 5241 articles were found, with an additional 15 sources found via soft searches, of which 42 met inclusion criteria and were subsequently reviewed. RESULTS: Sexual behaviours that occur in these adolescents with ASD include hypermasturbation, public masturbation, inappropriate romantic gestures, inappropriate arousal and exhibitionism. Such behaviours are thought to be caused via a lack of understanding of normal puberty, the absence of appropriate sex education, the severity of their ASD and other associated problems. It is suggested that individualized, repetitive education should be started from an early age in an accessible form. Social skills development is also important before more technical aspects of sex education are taught. CONCLUSION: Despite being such a common problem for schools, institutions and families to manage, it is surprising how sparse literature is particularly regarding why inappropriate behaviour occurs and what education is effective.

Teaching pediatric communication skills to medical students.

BACKGROUND: Delivering effective clinical pediatric communication skills training to undergraduate medical students is a distinct and important challenge. Pediatric-specific communication skills teaching is complex and under-researched. We report on the development of a scenario-based pediatric clinical communication skills program as well as students' assessment of this module. METHODS: We designed a pediatric clinical communication skills program and delivered it five times during one academic year via small-group teaching. Students were asked to score the workshop in eight domains (learning objectives, complexity, interest, competencies, confidence, tutors, feedback, and discussion) using 5-point Likert scales, along with free text comments that were grouped and analyzed thematically, identifying both the strengths of the workshop and changes suggested to improve future delivery. RESULTS: Two hundred and twenty-one of 275 (80%) student feedback forms were returned. Ninety-six percent of students' comments were positive or very positive, highlighting themes such as the timing of teaching, relevance, group sizes, and the use of actors, tutors, and clinical scenarios. CONCLUSION: Scenario-based teaching of clinical communication skills is positively received by students. Studies need to demonstrate an impact on practice, performance, development, and sustainability of communications training.

Ring-opening copolymerization (ROCOP): synthesis and properties of polyesters and polycarbonates.

Controlled routes to prepare polyesters and polycarbonates are of interest due to the widespread application of these materials and the opportunities provided to prepare new copolymers. Furthermore, ring-opening copolymerization may enable new poly(ester-carbonate) materials to be prepared which are inaccessible using alternative polymerizations. This review highlights recent advances in the ring-opening copolymerization catalysis, using epoxides coupled with anhydrides or CO2, to produce polyesters and polycarbonates. In particular, the structures and performances of various homogeneous catalysts are presented for the epoxide-anhydride copolymerization. The properties of the resultant polyesters and polycarbonates are presented and future opportunities highlighted for developments of both the materials and catalysts.