The COVID-19 pandemic and children’s engagement with learning in rural Sierra Leone

The COVID-19 pandemic caused worldwide educational disruption. This paper addresses a gap in the literature relating to the impact of the pandemic on learning experiences of children in rural communities in the Global South, particularly in earlier years of schooling. Children in these communities are at considerable disadvantage in comparison to their urban peers due to poor school infrastructure and challenges in recruitment and retention of teachers. Drawing on a mixed-methods study of primary school children, their teachers and families in rural Sierra Leone, both during and immediately after school closures, the paper highlights how primary schools and their communities responded to the pandemic and how this influenced children’s engagement with their learning. While national planning focused on pandemic control measures and provision of some remote learning support, findings highlight challenges for poor rural communities in accessing basic learning supports and the consequent disruption to children’s education

The Influence of Enhanced Post-Glacial Coastal Margin Productivity on the Emergence of Complex Societies

Abstract We analyze the dynamics of post-glacial coastal margin (CM) productivity and explore how it affected the emergence of six complex CM societies. Following deglaciation, global relative sea level stabilized after ~7000 BP and CM productivity significantly increased in many areas. Primary and secondary productivity (fish) likely increased by an order of magnitude or more. Aquatic animals were readily available in the CM providing sources of polyunsaturated omega-3 fatty acids, high quality protein, and nutrients, especially essential to human nutrition. In all six case studies, mature CMs appear to have been occupied by Neolithic agricultural and fishing villages within ~500 years of sea-level stabilization. Within a few hundred years population densities increased and roughly a millennium later social ranking and monumental architecture appeared. Sea-level stabilization and increased CM productivity in conjunction with agricultural intensification in lower alluvial floodplains were major contributors to the origins of many complex CM societies. Keyword

A systematic review and meta-analysis of outcomes after elective surgery for ulcerative colitis.

AIM: Approximately 20%-30% of patients with ulcerative colitis (UC) will undergo surgery during their disease course, the vast majority being elective due to chronic refractory disease. The risks of elective surgery are reported variably. The aim of this systematic review and meta-analysis is to summarize the outcomes after elective surgery for UC. METHODS: A systematic review was conducted that analysed studies reporting outcomes for elective surgery in the modern era (>2002). It was prospectively registered on the PROSPERO database (ref: CRD42018115513). Searches were performed of Embase and MEDLINE on 15 January 2019. Outcomes were split by operation performed. Primary outcome was quality of life; secondary outcomes were early, late and functional outcomes after surgery. Outcomes reported in five or more studies underwent a meta-analysis of incidence using random effects. Heterogeneity is reported with I2 , and publication bias was assessed using Doi plots and the Luis Furuya-Kanamori index. RESULTS: A total of 34 studies were included (11 774 patients). Quality of life was reported in 12 studies, with variable and contrasting results. Thirteen outcomes (eight early surgical complications, five functional outcomes) were included in the formal meta-analysis, all of which were outcomes for ileal pouch-anal anastomosis (IPAA). A further 71 outcomes were reported (50 IPAA, 21 end ileostomy). Only 14 of 84 outcomes received formal definitions, with high inter-study variation of definitions. CONCLUSION: Outcomes after elective surgery for UC are variably defined. This systematic review and meta-analysis highlights the range of reported incidences and provides practical information that facilitates shared decision making in clinical practice

A survey of patient informational preferences when choosing between medical and surgical therapy for ulcerative colitis:a sub‐study from the DISCUSS project

Aim: People living with ulcerative colitis (UC) have two broad treatment avenues, namely medical or surgical therapy. The choice between these can depend on patient preference as well as the receipt of relevant information. The aim of this study was to define the informational needs of patients with UC.Method: A postal survey was designed to capture respondent demographics, treatment experienced within the previous 12 months and informational preferences by rating a long list of items. It was delivered through two hospitals that provide tertiary inflammatory bowel disease services. Descriptive analyses were performed to describe demographics and experiences. Principal component analysis was carried out using a varimax rotation to investigate informational needs.Results: A total of 101 responses were returned (20.1% response rate). The median age of respondents was 45 years and the median time since diagnosis was 10 years. Control preferences skewed towards shared (42.6%) or patient-led but clinician-informed (35.6%). Decision regret was low for the population (median 12.5/100, range 0–100). Key informational needs related to medical therapy were benefits and risks of long-term therapy, burden of hospital attendance, reproductive health, need for steroid treatment and impact on personal life. For surgery, these were stoma information, effect on daily life, effect on sexual and reproductive health, risks and benefits and disruption of life due to surgery.Conclusion: This study has identified key areas for discussion when counselling patients about treatment decisions around medical therapy and surgery for UC

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV