Derailment in adolescence: Factor analytic structure and correlates.

Derailment is the sense of being "off-course" in life. But what could this mean for adolescents, who are often establishing identity and self-direction for the first time? We examined the structure and correlates of the Derailment Scale and its short form, the Derailment Scale-6 (DS-6), among middle-to-late adolescents (N = 452). Both scales exhibited unidimensionality, but the DS-6 demonstrated superior fit and correlated with cross-sectional distress markers (e.g., greater depression, lower life satisfaction, strained sense of purpose). Breaking from adult-based research, we failed to find evidence that derailment related to adolescent identity exploration and commitment. In extending assessment of derailment to adolescence, this study invites exploration of this experience during a time characterized by substantial transition and the emergence of stable self-views.

Effects of social and environmental contexts on multi-male mating and mixed paternity in socially monogamous female prairie voles.

With whom and how often to mate are fundamental questions that impact individual reproductive success and the mating system. Relatively few studies have investigated female mating tactics compared with males. Here, we asked how differential access to mates influences the occurrence of mixed paternity and overall reproductive success in socially monogamous female prairie voles (Microtus ochrogaster). We created male- and female-biased sex ratios of prairie voles living in semi-natural outdoor enclosures. We ran paternity analyses to determine the identity and number of mating partners females had and the number of offspring produced. We found that 57.1% of females had litters fathered by two or more males when males outnumbered females, and 87.5% of females had litters with more than one father when females outnumbered males. However, the percentage of mixed paternity and the total number of embryos were not statistically different between social contexts. We determined that female fecundity (i.e. number of embryos) correlated with the number of male fathers in each litter across social contexts. Although our study did not support the hypothesis that social context directly influences female mating decisions, it did suggest that female multi-male mating might lead to increased fertilization success under semi-natural conditions.

Using the EPAs to Evaluate the Clinical Experience of Medical Students.

Introduction: Although there are standardized assessments of medical students throughout medical school, the clinical experience of each student may vary widely. Currently, medical schools do not have a systematic method to ensure that students perform clinical skills during clinical clerkships. Our study used the Entrustable Professional Activities for Entering Residency (EPAs) framework to assess the ways in which medical students meaningfully participate in patient care at various clinical sites in each required clerkship and over time. Methods: Over the 2020-2021 academic year, 170 third-year medical students were asked to report the number of times they performed EPA-1 (gather history and perform physical examination), EPA-5 (document clinical encounter), and EPA-6 (provide oral presentation of clinical encounter) at the end of each required clinical rotation (emergency medicine, internal medicine, surgery, obstetrics/gynecology, pediatrics, neurology, psychiatry) at a single medical school. We used descriptive statistics and t tests to compare frequency of these EPAs by campus type, site type, clerkship, and time. Results: One thousand, two hundred sixty-one surveys met inclusion criteria. Students performed EPA-5 more often at an academic medical center, and EPA-1 more frequently in the outpatient setting. Students performed EPA-1 and EPA-6 most often during emergency medicine and EPA-5 most often during internal medicine. Performance of all three EPAs increased over time. Conclusion: This reporting system produced a robust data set that allowed for EPA performance comparisons by campus, site type, clerkship, and time. EPA performance varied by rotation, site type, clerkship, and time.

Implementation and outcomes of a standard dose dextrose gel protocol for management of transient neonatal hypoglycemia.

OBJECTIVE: The use of oral dextrose gel (DG) reduces IV dextrose use. Prior studies used weight-based dosing (WD), though barriers exist, and are mitigated using standard dosing (SD). Our outcomes include IV dextrose use, NICU admissions, breastfeeding, adverse events, and assessment of WD vs SD. STUDY DESIGN: Retrospective chart review comparing pre-DG, WD, and SD in 16490 newborns (1329 hypoglycemic) ≥ 35 weeks admitted to the nursery over 3 years. RESULTS: There was reduction in IV dextrose use 10.9% vs 6.5% (p = 0.004) and NICU admissions 27.9% vs 16.1% (p < 0.001) associated with DG use, and increased rate of breastfed infants 33.8% vs 43.5% (p = 0.001), with no difference between WD and SD. No difference noted in adverse events across the study period. CONCLUSIONS: DG utilization is associated with reduced IV dextrose use, NICU admissions, and improved breastfeeding rates without changes in adverse events. We offer SD as a safe alternative to WD.

Social context alters spatial memory performance in free-living male prairie voles.

Spatial memory is crucial for mating success because it enables males to locate potential mates and potential competitors in space. Intraspecific competition and its varying intensity under certain conditions are potentially important for shaping spatial memory. For example, spatial memory could enable males to know where competitors are (contest competition), it could help males find mating partners (scramble competition) or both. We manipulated the intensity of intraspecific competition in two distinct contexts by altering the operational sex ratio of prairie voles (Microtus ochrogaster) living in outdoor enclosures by creating male- and female-biased sex ratios. After living freely under these contexts for four weeks, we compared males' performance in a laboratory spatial memory test. Males in the male-biased context demonstrated better spatial memory performance than males in the female-biased context. Notably, these data show that in spite of experiencing equally complex spatial contexts (i.e. natural outdoor enclosures), it was the social context that influenced spatial cognition, and it did so in a manner consistent with the hypothesis that spatial memory is particularly relevant for male-male interactions.

When to Cheat: Modeling Dynamics of Paternity and Promiscuity in Socially Monogamous Prairie Voles (Microtus ochrogaster).

In many socially monogamous species, individuals form long-term pair bonds and males mate guard females. Such behavior is thought to help secure intra-pair fertilizations, the result of intra-pair copulations (IPCs), and ensure paternity. However, socially monogamous males are also often opportunistic and seek additional mating opportunities with other females, leaving their partner unguarded. The success associated with a male's decision to seek more mates over guarding his partner might be impacted by the activity of other males, specifically the proportion of other males leaving their territories to seek extra-pair copulations (EPCs). The amount of EPC-seeking males can impact the likelihood of a given male encountering an unguarded paired female, but also of being cuckolded (losing IPCs). It remains unclear under which conditions it is optimal to stay and guard or seek EPCs. Using field data from socially monogamous prairie voles (Microtus ochrogaster) to generate parameters, we used optimal performance modeling (Monte Carlo simulations) to ask when is it most reproductively advantageous for a bonded male to seek EPCs, despite the risk of losing IPCs. We defined three types of males: exclusive mating bonded males (true residents), non-exclusive mating bonded residents (roving residents), and unpaired males (wanderers). We first modeled the success of an individual male living in a context that incorporated only true and roving residents. We next added wandering males to this model. Finally, we considered the effects of including wandering males and unpaired females in our model. For all contexts, we found that as EPC-seeking in the population increases, the potential reproductive benefit for seeking EPCs increasingly outpaces the rate of cuckolding. In other words, we observe a shift in optimal strategy from true residents to rovers among paired males. Our models also demonstrate that reproductive fitness is likely to remain constant, despite the shift toward obtaining success via EPCs over IPCs. Our results show the dynamic nature of reproductive decision-making, and demonstrate that alternative reproductive decisions yield subtle but important differences despite appearing as balanced strategies.

Cryptic sexual dimorphism in spatial memory and hippocampal oxytocin receptors in prairie voles (Microtus ochrogaster).

Sex differences are well documented and are conventionally associated with intense sex-specific selection. For example, spatial memory is frequently better in males, presumably due to males' tendency to navigate large spaces to find mates. Alternatively, monogamy (in which sex-specific selection is relatively relaxed) should diminish or eliminate differences in spatial ability and the mechanisms associated with this behavior. Nevertheless, phenotypic differences between monogamous males and females persist, sometimes cryptically. We hypothesize that sex-specific cognitive demands are present in monogamous species that will influence neural and behavioral phenotypes. The effects of these demands should be observable in spatial learning performance and neural structures associated with spatial learning and memory. We analyzed spatial memory performance, hippocampal volume and cell density, and hippocampal oxytocin receptor (OTR) expression in the socially monogamous prairie vole. Compared to females, males performed better in a spatial memory and spatial learning test. Although we found no sex difference in hippocampal volume or cell density, male OTR density was significantly lower than females, suggesting that performance may be regulated by sub-cellular mechanisms within the hippocampus that are less obvious than classic neuroanatomical features. Our results suggest an expanded role for oxytocin beyond facilitating social interactions, which may function in part to integrate social and spatial information.