What is the economic and social return on investment for telephone cancer information and support services in Australia? An evaluative social return on investment study protocol.

INTRODUCTION: Over 50% of people affected by cancer report unmet support needs. To address unmet information and psychological needs, non-government organisations such as Cancer Councils (Australia) have developed state-based telephone cancer information and support services. Due to competing demands, evidence of the value of these services is needed to ensure that future investment makes the best use of scarce resources. This research aims to determine the costs and broader economic and social value of a telephone support service, to inform future funding and service provision. METHODS AND ANALYSIS: A codesigned, evaluative social return on investment analysis (SROI) will be conducted to estimate and compare the costs and monetised benefits of Cancer Council Victoria's (CCV) telephone support line, 13 11 20, over 1-year and 3-year benefit periods. Nine studies will empirically estimate the parameters to inform the SROI and calculate the ratio (economic and social value to value invested): step 1 mapping outcomes (in-depth analysis of CCV's 13 11 20 recorded call data; focus groups and interviews); step 2 providing evidence of outcomes (comparative survey of people affected by cancer who do and do not call CCV's 13 11 20; general public survey); step 3 valuing the outcomes (financial proxies, value games); step 4 establishing the impact (Delphi); step 5 calculating the net benefit and step 6 service improvement (discrete choice experiment (DCE), 'what if' analysis). Qualitative (focus groups, interviews) and quantitative studies (natural language processing, cross-sectional studies, Delphi) and economic techniques (willingness-to-pay, financial proxies, value games, DCE) will be applied. ETHICS AND DISSEMINATION: Ethics approval for each of the studies will be sought independently as the project progresses. So far, ethics approval has been granted for the first two studies. As each study analysis is completed, results will be disseminated through presentation, conferences, publications and reports to the partner organisations.

The Reentry Health Care Hub: Creating a California-Based Referral System to Link Chronically Ill People Leaving Prison to Primary Care.

People released from prison experience high health needs and face barriers to health care in the community. During the COVID-19 pandemic, people released early from California state prisons to under-resourced communities. Historically, there has been minimal care coordination between prisons and community primary care. The Transitions Clinic Network (TCN), a community-based non-profit organization, supports a network of California primary care clinics in adopting an evidence-based model of care for returning community members. In 2020, TCN linked the California Department of Corrections and Rehabilitation (CDCR) and 21 TCN-affiliated clinics to create the Reentry Health Care Hub, supporting patient linkages to care post-release. From April 2020-August 2022, the Hub received 8420 referrals from CDCR to facilitate linkages to clinics offering medical, behavioral health, and substance use disorder services, as well as community health workers with histories of incarceration. This program description identifies care continuity components critical for reentry, including data sharing between carceral and community health systems, time and patient access for pre-release care planning, and investments in primary care resources. This collaboration is a model for other states, especially after the Medicaid Reentry Act and amid initiatives to improve care continuity for returning community members, like California's Medicaid waiver (CalAIM).

A-B-3-Associations and dissociations of reading and arithmetic: Is domain-specific prediction outdated?

Reading and arithmetic are core domains of academic achievement with marked impact on career opportunities and socioeconomic status. While associations between reading and arithmetic are well established, evidence on underlying mechanisms is inconclusive. The main goal of this study was to reevaluate the domain-specificity of established predictors and to enhance our understanding of the (co-)development of reading and arithmetic. In a sample of 885 German-speaking children, standard domain-specific predictors of reading and arithmetic were assessed before and/or at the onset of formal schooling. Reading and arithmetic skills were measured at the beginning and end of second grade. Latent variables were extracted for all relevant constructs: Grapheme-phoneme processing (phonological awareness, letter identification), RAN (RAN-objects, RAN-digits), number system knowledge (number identification, successor knowledge), and magnitude processing (non-symbolic and symbolic magnitude comparison), as well as the criterion measures reading and arithmetic. Four structural equation models tested distinct research questions. Grapheme-phoneme processing was a specific predictor of reading, and magnitude processing explained variance specific to arithmetic. RAN explained variance in both domains, and it explained variance in reading even after controlling for arithmetic. RAN and number system knowledge further explained variance in skills shared between reading and arithmetic. Reading and arithmetic entail domain-specific cognitive components, and they both require tight networks of visual, verbal, and semantic information, as reflected by RAN. This perspective provides a useful background to explain associations and dissociations between reading and arithmetic performance.

Transcoding counts: Longitudinal contribution of number writing to arithmetic in different languages.

Number writing involves transcoding from number words (e.g., "thirty-two") to written digit strings (32) and is an important unique predictor of arithmetic. The existing longitudinal evidence about the relation between transcoding and arithmetic is mostly language specific. In languages with number word inversion (e.g., German), the order of tens and units is transposed in spoken number words compared with Arabic numbers. This makes transcoding more challenging than in languages without number word inversion (e.g., English). In the current study, we aimed to understand whether the contribution of number writing to the development of arithmetic is similar in languages with and without number word inversion. German-speaking children (n = 166) and English-speaking children (n = 201) were followed over the first 3 years of primary school. In a series of multiple linear regressions, we tested whether number writing of multi-digit numbers was a significant unique predictor of arithmetic after controlling for well-known non-numerical predictors (nonverbal reasoning and working memory) and numerical predictors (symbolic and nonsymbolic magnitude comparison). Number writing in Grade 1 predicted arithmetic in Grades 1, 2, and 3 over and above the other predictors. Crucially, number writing performance was of comparable importance for arithmetic development in German- and English-speaking children. Our findings extend previous evidence by showing that transcoding predicts the development of arithmetic skills during the first 3 years of primary school in languages with and without number word inversion.

Cross-Format Integration of Auditory Number Words and Visual-Arabic Digits: An ERP Study.

Converting visual-Arabic digits to auditory number words and vice versa is seemingly effortless for adults. However, it is still unclear whether this process takes place automatically and whether accessing the underlying magnitude representation is necessary during this process. In two event-related potential (ERP) experiments, adults were presented with identical (e.g., "one" and 1) or non-identical (e.g., "one" and 9) number pairs, either unimodally (two visual-Arabic digits) or cross-format (an auditory number word and a visual-Arabic digit). In Experiment 1 (N=17), active task demands required numerical judgments, whereas this was not the case in Experiment 2 (N=19). We found pronounced early ERP markers of numerical identity unimodally in both experiments. In the cross-format conditions, however, we only observed late neural correlates of identity and only if the task required semantic number processing (Experiment 1). These findings suggest that unimodal pairs of digits are automatically integrated, whereas cross-format integration of numerical information occurs more slowly and involves semantic access.

Common and distinct predictors of non-symbolic and symbolic ordinal number processing across the early primary school years.

What are the cognitive mechanisms supporting non-symbolic and symbolic order processing? Preliminary evidence suggests that non-symbolic and symbolic order processing are partly distinct constructs. The precise mechanisms supporting these skills, however, are still unclear. Moreover, predictive patterns may undergo dynamic developmental changes during the first years of formal schooling. This study investigates the contribution of theoretically relevant constructs (non-symbolic and symbolic magnitude comparison, counting and storage and manipulation components of verbal and visuo-spatial working memory) to performance and developmental change in non-symbolic and symbolic numerical order processing. We followed 157 children longitudinally from Grade 1 to 3. In the order judgement tasks, children decided whether or not triplets of dots or digits were arranged in numerically ascending order. Non-symbolic magnitude comparison and visuo-spatial manipulation were significant predictors of initial performance in both non-symbolic and symbolic ordering. In line with our expectations, counting skills contributed additional variance to the prediction of symbolic, but not of non-symbolic ordering. Developmental change in ordering performance from Grade 1 to 2 was predicted by symbolic comparison skills and visuo-spatial manipulation. None of the predictors explained variance in developmental change from Grade 2 to 3. Taken together, the present results provide robust evidence for a general involvement of pair-wise magnitude comparison and visuo-spatial manipulation in numerical ordering, irrespective of the number format. Importantly, counting-based mechanisms appear to be a unique predictor of symbolic ordering. We thus conclude that there is only a partial overlap of the cognitive mechanisms underlying non-symbolic and symbolic order processing.

Formerly Incarcerated Community Health Workers Engaging Individuals Returning From Incarceration Into Primary Care: Results From the Transition Clinic Network.

Over half a million individuals return from United States prisons and millions more from jails every year, many of whom with complex health and social needs. Community health workers (CHWs) perform diverse roles to improve health outcomes in disadvantaged communities, but no studies have assessed their role as integrated members of a primary care team serving individuals returning from incarceration. Using data from participants who received primary care through the Transitions Clinic Network, a model of care that integrates CHWs with a lived experienced of incarceration into primary care teams, we characterized how CHWs address participant health and social needs during interactions outside of clinic visits for 6 months after participants established primary care. Among the 751 participants, 79% had one or more CHW interactions outside of the clinic documented. Participants with more comorbid conditions, longer stays during their most recent incarceration, and released with a prescription had more interactions with CHWs compared to those with fewer comorbidities, shorter stays, and no prescription at release. Median number of interactions was 4 (interquartile range, IQR 2-8) and 56% were in person. The most common issues addressed (34%) were social determinants of health, with the most common being housing (35%). CHWs working in interdisciplinary primary care teams caring for people with histories of incarceration perform a variety of functions for clients outside of scheduled primary care visits. To improve health outcomes among disadvantaged populations, CHWs should be able to work across multiple systems, with supervision and support for CHW activities both in the primary care clinic and within the community.

Twenty-four or four-and-twenty: Language modulates cross-modal matching for multidigit numbers in children and adults.

Does number-word structure have a long-lasting impact on transcoding? Contrary to English, German number words comprise decade-unit inversion (e.g., vierundzwanzig is literally translated as four-and-twenty). To investigate the mental representation of numbers, we tested the effect of visual and linguistic-morphological characteristics on the development of verbal-visual transcoding. In a longitudinal cross-linguistic design, response times (RTs) in a number-matching experiment were analyzed in Grade 2 (119 German-speaking and 179 English-speaking children) and in Grade 3 (131 German-speaking and 160 English-speaking children). To test for long-term effects, the same experiment was given to 38 German-speaking and 42 English-speaking adults. Participants needed to decide whether a spoken number matched a subsequent visual Arabic number. Systematic variation of digits in the nonmatching distractors allowed comparison of three different transcoding accounts (lexicalization, visual, and linguistic-morphological). German speakers were generally slower in rejecting inverted number distractors than English speakers. Across age groups, German speakers were more distracted by Arabic numbers that included the correct unit digit, whereas English speakers showed stronger distraction when the correct decade digit was included. These RT patterns reflect differences in number-word morphology. The individual cost of rejecting an inverted distractor (inversion effect) predicted arithmetic skills in German-speaking second-graders only. The moderate relationship between the efficiency to identify a matching number and arithmetic performance could be observed cross-linguistically in all age groups but was not significant in German-speaking adults. Thus, findings provide consistent evidence of a persistent impact of number-word structure on number processing, whereas the relationship with arithmetic performance was particularly pronounced in young children.

Molecular identification and characterization of rhodaneses from the insect herbivore Pieris rapae.

The association of cabbage white butterflies (Pieris spec., Lepidoptera: Pieridae) with their glucosinolate-containing host plants represents a well-investigated example of the sequential evolution of plant defenses and insect herbivore counteradaptations. The defensive potential of glucosinolates, a group of amino acid-derived thioglucosides present in plants of the Brassicales order, arises mainly from their rapid breakdown upon tissue disruption resulting in formation of toxic isothiocyanates. Larvae of P. rapae are able to feed exclusively on glucosinolate-containing plants due to expression of a nitrile-specifier protein in their gut which redirects glucosinolate breakdown to the formation of nitriles. The release of equimolar amounts of cyanide upon further metabolism of the benzylglucosinolate-derived nitrile suggests that the larvae are also equipped with efficient means of cyanide detoxification such as ß-cyanoalanine synthases or rhodaneses. While insect ß-cyanoalanine synthases have recently been identified at the molecular level, no sequence information was available of characterized insect rhodaneses. Here, we identify and characterize two single-domain rhodaneses from P. rapae, PrTST1 and PrTST2. The enzymes differ in their kinetic properties, predicted subcellular localization and expression in P. rapae indicating different physiological roles. Phylogenetic analysis together with putative lepidopteran rhodanese sequences indicates an expansion of the rhodanese family in Pieridae.

Trends in Chlamydia Screening, Test Positivity, and Treatment Among Females in California Juvenile Detention Facilities, 2003-2014.

BACKGROUND: Juvenile detention facilities house adolescents at high risk for sexually transmitted diseases. Collaboration between health departments and juvenile detention authorities can provide routine, cost-efficient chlamydia screening and treatment to females with limited access to care. We describe trends in screening, positivity, treatment, and associated costs in a well-established juvenile detention chlamydia screening program. METHODS: In the California Chlamydia Screening Project, juvenile detention facilities in 12 counties collected quarterly aggregate data on female census and line-listed chlamydia test results and treatment data from fiscal year (FY) 2003-2004 to FY 2013-2014. Trends in the proportion of females screened, positivity, and treatment by age, race/ethnicity, and facility volume were evaluated by Cochran-Armitage test. The median cost of the program per chlamydia positive identified was compared by facility in FY 2013-2014. RESULTS: Data from 59,518 test records among juvenile females indicated high screening rates (75.1%-79.4%). Chlamydia positivity, although consistently high, decreased from 14.8% in 2003-2004 to 11.5% in 2013-2014 (P < 0.001). Documented treatment decreased (88.8% in 2005-2006 to 79.0% in 2013-2014, P < 0.001); of those treated, treatment within 7 days increased (80.1% in 2005-2006 to 88.8% in 2013-2014, P < 0.001). The median cost per chlamydia positive identified was $708 (interquartile range, $669-$894) and was lowest for facilities with high chlamydia positivity. CONCLUSIONS: The California Chlamydia Screening Project demonstrated consistently high rates of chlamydia screening and positivity among adolescent females while keeping costs low for high-volume facilities. Further improvement in timely treatment rates remains a challenge for extending the impact of screening in this high-risk population.