Research has indicated that reading aloud to young students can enhance their foundational reading skills and their reading motivation, but such research has been lacking in African contexts. In this ...study, we assessed the efficacy of story read-aloud lessons in improving students' foundational reading skills in Nigeria. The experiment took place in a cluster randomized trial of 199 schools in Northern Nigeria. In treatment schools, second-grade teachers conducted weekly read-aloud lessons as an addition to the core learning curriculum. In control schools, second-grade teachers implemented only the core curriculum, without weekly read-aloud lessons. We found that story read-alouds led to positive effects on listening comprehension, letter sound recognition, nonword decoding, and reading fluency, with effect sizes between 0.17 and 0.33 standard deviations. These outcomes suggest that enhanced student motivation from read-alouds may enhance text-based skills. To identify the effects of increased teacher experience on read-aloud effectiveness, we employed a two-period difference-in-differences approach. We found that increased teacher experience explained between 26% and 51% of the overall read-aloud effect, depending on the literacy subskill. We also found that the read-aloud effects coupled with increased teacher experience had an equalizing effect on the reading outcomes of students from divergent home literacy environments.
The athletic trainer's (AT's) emergency management skillset requires competency in the delivery of basic lifesaving medications. Some lifesaving medications have been a part of athletic training ...practice for decades, but that list has grown as ATs' practice settings have expanded, increasing the types of emergent conditions that the AT may have to treat. The 2020 Commission on Accreditation of Athletic Training Education (CAATE) curricular standards require that athletic training students be trained to administer the following: supplemental oxygen, nitroglycerine, low-dose aspirin, bronchodilators, epinephrine using an automated injection device, glucagon, and naloxone. Clinically, the conditions treated by these medications can be categorized as cardiac, respiratory, hypoglycemia, and anaphylaxis. All ATs should know the indications, contraindications, administration methods, and details of patient monitoring for each medication. Generally, these medications are safe and have clear indications for use and few contraindications. Although ATs are trained to administer these medications, they must consider state laws and local policies governing administration.
People with schizophrenia experience unique barriers to routine HIV testing, despite increased risk of HIV compared with the general US population. Little is known about how health care delivery ...system factors affect testing rates or whether there are testing differences for people with schizophrenia.
Nationally representative sample of Medicaid enrollees with and without schizophrenia.
Using retrospective longitudinal data, we examined whether state-level factors were associated with differences in HIV testing among Medicaid enrollees with schizophrenia compared with frequency-matched controls during 2002-2012. Multivariable logistic regression estimated testing rate differences between and within cohorts.
Higher HIV testing rates for enrollees with schizophrenia were associated with higher state-level Medicaid spending per enrollee, efforts to reduce Medicaid fragmentation, and higher federal prevention funding. State-level AIDS epidemiology predicted more frequent HIV testing for enrollees with schizophrenia versus controls. Living in rural settings predicted lower HIV testing, especially for people with schizophrenia.
Overall, state-level predictors of HIV testing rates varied among Medicaid enrollees, although rates were generally higher for those with schizophrenia than controls. Increased HIV testing for people with schizophrenia was associated with coverage of HIV testing when medically necessary, higher Centers for Disease Control and Prevention prevention funding, and higher AIDS incidence, prevalence, and mortality when compared with controls. This analysis suggests that state policymaking has an important role to play in advancing that effort. Overcoming fragmented care systems, sustaining robust prevention funding, and consolidating funding streams in innovative and flexible ways to support more comprehensive systems of care delivery deserve attention.
Increasing access to human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) is a high priority for the Ending the HIV Epidemic Initiative. Expanding ...access to PrEP and PEP through a variety of health care settings, including community pharmacies, may increase access in communities most in need. California is the first state to allow community pharmacists to furnish PrEP and PEP directly to consumers. Our objective was to assess attitudes among key stakeholders about a California policy to allow community pharmacists to furnish HIV PrEP and PEP.
We conducted a qualitative case study with key pharmacy stakeholders. Semistructured phone interviews were audio-recorded and transcribed verbatim. We generated analytical memos for each interview and working with these analytical memos, we conducted a constant comparison across cases to identify commonalities and differences.
We launched the study in October 2018 and interviewed pharmacists (n = 7) working in a variety of settings, including retail-, clinic-, and community-based pharmacies. We also interviewed medical providers (n = 2) working in high-volume PrEP clinics and sought input from representatives of large retail chain pharmacies (n = 2). Overall, pharmacists and medical provider informants shared similar opinions about the central benefits as well as the key challenges related to pharmacist-delivered PrEP and PEP services. Benefits included: community pharmacists are widely accessible, PrEP and PEP protocols are similar to other preventative medications, policy may lead to efficiencies in the health care workforce, and community pharmacists are authorities on medication adherence. Challenges included: implementation issues may limit pharmacist involvement, and missed opportunities to diagnose and treat other health conditions.
This study characterizes the types of benefits and challenges that can be expected when PrEP and PEP prescribing privileges are extended to community pharmacists. This information may be useful to policymakers and other stakeholders considering legislation to permit direct prescription of PrEP and PEP by pharmacists.
Global Natural Product Social Molecular Networking (GNPS) is an interactive online small molecule-focused tandem mass spectrometry (MS
) data curation and analysis infrastructure. It is intended to ...provide as much chemical insight as possible into an untargeted MS
dataset and to connect this chemical insight to the user's underlying biological questions. This can be performed within one liquid chromatography (LC)-MS
experiment or at the repository scale. GNPS-MassIVE is a public data repository for untargeted MS
data with sample information (metadata) and annotated MS
spectra. These publicly accessible data can be annotated and updated with the GNPS infrastructure keeping a continuous record of all changes. This knowledge is disseminated across all public data; it is a living dataset. Molecular networking-one of the main analysis tools used within the GNPS platform-creates a structured data table that reflects the molecular diversity captured in tandem mass spectrometry experiments by computing the relationships of the MS
spectra as spectral similarity. This protocol provides step-by-step instructions for creating reproducible, high-quality molecular networks. For training purposes, the reader is led through a 90- to 120-min procedure that starts by recalling an example public dataset and its sample information and proceeds to creating and interpreting a molecular network. Each data analysis job can be shared or cloned to disseminate the knowledge gained, thus propagating information that can lead to the discovery of molecules, metabolic pathways, and ecosystem/community interactions.
The degree to which COVID-19 has disrupted the advances in reducing new HIV infections and preventing AIDS-related deaths is unknown. We present findings related to the effect COVID-19 had on HIV, ...sexual health and harm reduction service delivery in the state of California. We conducted a qualitative rapid assessment with health care providers, as well as representatives from non-medical support service agencies serving clients living with HIV in a range of counties in California. Some organizations adapted fairly easily while others struggled or were unable to adapt at all. Clinics were better positioned than community-based organizations to accommodate COVID restrictions and to quickly reestablish services. Influential forces that softened or calcified the hardships created by COVID-19 included influx of funding, flexibility in managing funds, networking and relationships, and workforce vulnerabilities. These data clearly suggest that an enhanced level of flexibility within funding streams and reporting requirements should be continued.
Surprisingly few details have been reported in the literature that help the experimentalist to determine the conditions necessary for the preparation of self-assembled monolayers on graphene with a ...high surface coverage. With a view to graphene-based sensing arrays and devices and, in particular, in view of graphene-based varactors for gas sensing, graphene was modified in this work by the π–π interaction-driven self-assembly of 10 pyrene and cyclodextrin derivatives from solution. The receptor compounds were pyrene, pyrene derivatives with hydroxyl, carboxyl, ester, ammonium, amino, diethylamino, and boronic acid groups, and perbenzylated α-, β-, and γ-cyclodextrins. Adsorption of these compounds onto graphene was quantified by contact-angle measurements and X-ray photoelectron spectroscopy. Data thus obtained were fitted with the Langmuir adsorption model to determine the equilibrium constants for surface adsorption and the concentrations of self-assembly solutions needed to form dense monolayers on graphene. The equilibrium constants of all pyrene derivatives fell into the range from 103.4 to 104.6 M–1. For the perbenzylated α-, β-, and γ-cyclodextrins, the equilibrium constants are 103.24, 102.97, and 102.95 M–1, respectively. Monolayers of 1-pyrenemethylammonium chloride on graphene were confirmed to be stable under heating to 100 °C in a high vacuum (2 × 10–5 Torr).
The Ediacaran–Cambrian transition marks one of the most important geobiological revolutions in Earth History, including multiple waves of evolutionary radiation and successive episodes of apparent ...mass extinction. Among the proposed drivers of these events (in particular the extinction of the latest Neoproterozoic ‘Ediacara biota’) is the emergence of complex metazoans and their associated behaviors. Many metazoans are thought to have crucial geobiological impacts on both resource availability and the character of the physical environment – ‘ecosystem engineering’ – biological processes best preserved in the geological record as trace fossils. Here, we review this model using the trace fossil record of the Ediacaran to Cambrian Nama Group of southern Namibia, combining previous published accounts with the results of our own field investigations. We produce a revised ichnostratigraphy for the Nama Group that catalogues new forms, eliminates others, and brings the trace fossil record of the Nama into much closer alignment with what is known from other Ediacaran sections worldwide. We provide evidence for a link between sequence stratigraphy, oxygen, and the emergence of more complex bilaterian behaviors. Lastly, we show that observed patterns of extinction and survival over pulses of Ediacaran extinction are hard to ally with any one specific source of ecological stress associated with bioturbation, and thus a biologically-driven extinction of the Ediacara biota, if it occurred, was more likely to have been driven by some combination of these factors, rather than any single one.
Early evidence suggests long-acting injectable cabotegravir and rilpivirine (LA-CAB/RPV) may be beneficial for people with HIV (PWH) who are unable to attain viral suppression (VS) on oral therapy. ...Limited guidance exists on implementation strategies for this population.
Ward 86, a clinic serving publicly insured PWH in San Francisco.
We describe multi-level determinants of and strategies for LA-CAB/RPV implementation for PWH without VS, using the Consolidated Framework for Implementation Research. To assess patient and provider-level determinants, we drew on pre-implementation qualitative data. To assess inner and outer context determinants, we undertook a structured mapping process.
Key patient-level determinants included perceived ability to adhere to injections despite oral adherence difficulties and care engagement challenges posed by unmet subsistence needs; strategies to address these determinants included a direct-to-inject approach, small financial incentives, and designated drop-in days. Provider-level determinants included lack of time to obtain LA-CAB/RPV, assess injection response, and follow-up late injections; strategies included centralizing eligibility review with the clinic pharmacist, a pharmacy technician to handle procurement and monitoring, regular multidisciplinary review of patients, and development of a clinic protocol. Ward 86 did not experience many outer context barriers due to rapid and unconstrained inclusion of LA-CAB/RPV on local formularies and ability of its affiliated hospital pharmacy to stock the medication.
Multi-level strategies to support LA-CAB/RPV implementation for PWH without VS are required, which may necessitate additional resources in some settings to implement safely and effectively. Advocacy to eliminate outer-context barriers, including prior authorizations and specialty pharmacy restrictions, is needed.
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