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Self-concept is recognised as useful in facilitating understanding of the development of resilience, academic achievement and social and emotional maturity in children. This framework is valuable for studying minorities such as Indigenous children, for who a positive self-concept is a means of bolstering resilience and mitigating the inherited structural disadvantages of colonisation. This paper aims to understand the academic self-concept of Indigenous children in Australia through analysis of univariate, bivariate and multivariate data of Indigenous children aged 9.5–11 years from the Longitudinal Study of Indigenous Children Wave's 7 K Cohort. Results show overall positive levels of Indigenous children's self-perception at school. Further, factors such as level of relative isolation, teacher perception, peer relationships, feedback from mother and contact with community leaders and Elders is positively associated with Indigenous children's schooling mathematic and reading self-concepts. Ensuring that Indigenous students are supported by community, peers and parents, immersed in their culture and are recognised and supported by their teachers can alleviate the undesirable effects that structural inequalities may have on their academic self-concept.
The Empire of Aksum was one of Africa's most influential ancient civilisations. Traditionally, most archaeological fieldwork has focused on the capital city of Aksum, but recent research at the site of Beta Samati has investigated a contemporaneous trade and religious centre located between Aksum and the Red Sea. The authors outline the discovery of the site and present important finds from the initial excavations, including an early basilica, inscriptions and a gold intaglio ring. From daily life and ritual praxis to international trade, this work illuminates the role of Beta Samati as an administrative centre and its significance within the wider Aksumite world.
The Single Ventricle Reconstruction Trial randomised neonates with hypoplastic left heart syndrome to a shunt strategy but otherwise retained standard of care. We aimed to describe centre-level practice variation at Fontan completion.
Centre-level data are reported as median or median frequency across all centres and range of medians or frequencies across centres. Classification and regression tree analysis assessed the association of centre-level factors with length of stay and percentage of patients with prolonged pleural effusion (>7 days).
The median Fontan age (14 centres, 320 patients) was 3.1 years (range from 1.7 to 3.9), and the weight-for-age z-score was −0.56 (−1.35 + 0.44). Extra-cardiac Fontans were performed in 79% (4–100%) of patients at the 13 centres performing this procedure; lateral tunnels were performed in 32% (3–100%) at the 11 centres performing it. Deep hypothermic circulatory arrest (nine centres) ranged from 6 to 100%. Major complications occurred in 17% (7–33%). The length of stay was 9.5 days (9–12); 15% (6–33%) had prolonged pleural effusion. Centres with fewer patients (<6%) with prolonged pleural effusion and fewer (<41%) complications had a shorter length of stay (<10 days; sensitivity 1.0; specificity 0.71; area under the curve 0.96). Avoiding deep hypothermic circulatory arrest and higher weight-for-age z-score were associated with a lower percentage of patients with prolonged effusions (<9.5%; sensitivity 1.0; specificity = 0.86; area under the curve 0.98).
Fontan perioperative practices varied widely among study centres. Strategies to decrease the duration of pleural effusion and minimise complications may decrease the length of stay. Further research regarding deep hypothermic circulatory arrest is needed to understand its association with prolonged pleural effusion.
The science of studying diamond inclusions for understanding Earth history has developed significantly over the past decades, with new instrumentation and techniques applied to diamond sample archives revealing the stories contained within diamond inclusions. This chapter reviews what diamonds can tell us about the deep carbon cycle over the course of Earth’s history. It reviews how the geochemistry of diamonds and their inclusions inform us about the deep carbon cycle, the origin of the diamonds in Earth’s mantle, and the evolution of diamonds through time.
Antipseudomonal carbapenems are an important target for antimicrobial stewardship programs. We evaluated the impact of formulary restriction and preauthorization on relative carbapenem use for medical and surgical intensive care units at a large, urban academic medical center using interrupted time-series analysis.
Crucial to health and social care practice, the Mental Capacity Act (MCA) 2005 safeguards decision-making within a legal framework. This book provides theoretical, practical and up-to-date guidance on mental capacity legislation. It focuses on the theory underpinning the principles of the MCA 2005, including historical background, and the practical challenges in applying legal statute in varied clinical settings, from hospitals to social care in community settings. Recent case law is detailed, and examples of ethical dilemmas and medico-legal challenges feature, along with guidance to navigate these in clinical practice. Applying mental capacity principles in end-of-life decision-making is an area of discussion, as well as the future of legislative changes in the field. To be read alongside the MCA 2005 Code of Practice, this guide will support mental health and social care professionals in clinical settings.
Background: Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord impairment. In a public healthcare system, wait times to see spine specialists and eventually access surgical treatment for CSM can be substantial. The goals of this study were to determine consultation wait times (CWT) and surgical wait times (SWT), and identify predictors of wait time length. Methods: Consecutive patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) prospective and observational CSM study from March 2015 to July 2017 were included. A data-splitting technique was used to develop and internally validate multivariable models of potential predictors. Results: A CSORN query returned 264 CSM patients for CWT. The median was 46 days. There were 31% mild, 35% moderate, and 33% severe CSM. There was a statistically significant difference in median CWT between moderate and severe groups; 207 patients underwent surgical treatment. Median SWT was 42 days. There was a statistically significant difference in SWT between mild/moderate and severe groups. Short symptom duration, less pain, lower BMI, and lower physical component score of SF-12 were predictive of shorter CWT. Only baseline pain and medication duration were predictive of SWT. Both CWT and SWT were shorter compared to a concurrent cohort of lumbar stenosis patients (p <0.001). Conclusions: Patients with shorter duration (either symptoms or medication) and less neck pain waited less to see a spine specialist in Canada and to undergo surgical treatment. This study highlights some of the obstacles to overcome in expedited care for this patient population.
We generalize the Cohen–Lenstra heuristics over function fields to étale group schemes
(with the classical case of abelian groups corresponding to constant group schemes). By using the results of Ellenberg–Venkatesh–Westerland, we make progress towards the proof of these heuristics. Moreover, by keeping track of the image of the Weil-pairing as an element of
, we formulate more refined heuristics which nicely explain the deviation from the usual Cohen–Lenstra heuristics for abelian
-groups in cases where
$\ell \mid q-1$
; the nature of this failure was suggested already in the works of Malle, Garton, Ellenberg–Venkatesh–Westerland, and others. On the purely large random matrix side, we provide a natural model which has the correct moments, and we conjecture that these moments uniquely determine a limiting probability measure.
Horseweed is a problematic weed to control, especially in no-tillage production. Increasing cases of herbicide resistance have exacerbated the problem, necessitating alternative control options and an integrated weed management approach. Field experiments were conducted to evaluate horseweed suppression from fall-planted cover crop monocultures and mixtures as well as two fall-applied residual herbicide treatments. Prior to cover crop termination, horseweed density was reduced by 88% to 96% from cover crops. At cover crop termination in late spring, cereal rye biomass was 7,671 kg ha–1, which was similar to cereal rye–containing mixtures (7,720 kg ha–1) but greater than legumes in monoculture (3,335 kg ha–1). After cover crops were terminated in late spring using a roller crimper, corn and soybeans were planted and horseweed was evaluated using density counts, visible ratings, and biomass collection until harvest. Forage radish winterkilled, offering no competition in late winter or biomass to contribute to horseweed suppression after termination. Excluding forage radish in monoculture, no difference in horseweed suppression was detected between cereal rye–containing cover crops and legumes (crimson clover and hairy vetch) in monoculture. Likewise, horseweed suppression was similar between monocultures and mixtures, with the exception of one site-year in which mixtures provided better suppression. In this experiment, the cover crop treatments performed as well as or better than the fall-applied residual herbicides, flumioxazin+paraquat and metribuzin+chlorimuron-ethyl. These results indicate that fall-planted cover crops are a viable option to suppress horseweed and can be an effective part of an integrated weed management program. Furthermore, cover crop mixtures can be used to gain the benefits of legume or brassica cover crop species without sacrificing horseweed suppression.
Formation of a low barrier back contact plays a critical role in improving the photoconversion efficiency of the CdTe solar cells. Incorporating a buffer layer to minimize the band bending at the back of the CdTe device can significantly lower the barrier for the hole current, improving open circuit voltage (VOC) and the fill factor. Over the past years, researchers have incorporated the both ZnTe and Te as buffer layers to improve CdTe device performance. Here we compare device performance using these two materials as buffer layers at the back of CdTe devices. We show that using Te in contact to CdTe results in higher performance than using ZnTe in contact to the CdTe. Low temperature current density-voltage measurements show that Te results is a lower barrier with CdTe than ZnTe, indicating that Te has better band alignment, resulting in less downward bending in the CdTe at the back interface, than ZnTe does.
Optimising short- and long-term outcomes for children and patients with CHD depends on continued scientific discovery and translation to clinical improvements in a coordinated effort by multiple stakeholders. Several challenges remain for clinicians, researchers, administrators, patients, and families seeking continuous scientific and clinical advancements in the field. We describe a new integrated research and improvement network – Cardiac Networks United – that seeks to build upon the experience and success achieved to-date to create a new infrastructure for research and quality improvement that will serve the needs of the paediatric and congenital heart community in the future. Existing gaps in data integration and barriers to improvement are described, along with the mission and vision, organisational structure, and early objectives of Cardiac Networks United. Finally, representatives of key stakeholder groups – heart centre executives, research leaders, learning health system experts, and parent advocates – offer their perspectives on the need for this new collaborative effort.
Funding for mental health services in England faces many challenges, including operating under financial constraints where it is not easy to demonstrate the link between activity and funding. Mental health services need to operate alongside and collaborate with acute physical hospital services, where there is a well-established system for paying for activity. The funding landscape is shifting at a rapid pace and we outline the distinctions between the three main options – block contracts, episodic payment and capitation. Classification of treatment episodes via clustering presents an opportunity to demonstrate activity and reward it within these payment approaches. We discuss the results of our research into how well the clustering system is performing against a number of fundamental criteria. We find that, according to these criteria, clusters are falling short of providing a sound basis for measuring and financing services. Nevertheless, we argue that clustering is the best available option and is essential for a more transparent funding approach for mental healthcare to demonstrate its claim on resources, and that clusters should therefore be a starting point for evolving a better funding system.
•Understand the different payment models currently being used and proposed in mental health services in England
•Understand the role of clustering in measuring mental health activity and providing a basis for funding
•Understand how a robust model of clustering can benefit the provision of mental health services
In this study, we report on the mechanical cleavage of conductive metal-based aluminum diboride (AlB2) flakes. The cleavage resulted in a highly single crystalline 2D material and had an atomically flat and smooth surface as shown by atomic force microscopy (AFM) and secondary ion mass spectrometry. Nanoindentation and AFM imaging of freshly cleaved specimens revealed sub-nm roughness and 30% improvement in the nanomechanical properties as compared to the as-grown AlB2 flakes. Once exposed to ambient air, the cleaved AlB2 flakes formed a superficial oxidation layer of less than 1 nm thickness within 5 min. Owing to the smooth surface, ultra-thin and stable oxide layer, and the excellent mechanical and electrical characteristics of AlB2, the cleaved flakes present an ideal 2D material for emerging applications in microfabrication such as the growth of epitaxial thin films. To prove the sub-nm surface characteristics of cleaved AlB2, a 10-nm thick TiO2 film was deposited on a freshly cleaved AlB2 using atomic layer deposition. Surface roughness and compositional consistency of this film were compared with a control sample deposited on Si. The TiO2 film on AlB2 showed a distinct thin interface layer with fewer defects than TiO2 on Si and superior flatness.