Highly feminised sex ratio estimations for the world’s third largest nesting aggregation of loggerhead sea turtles

Despite being a fundamental life-history character, there is a paucity of populationwide, data-driven studies of primary sex ratios for any marine turtle species. The Republic of Cape Verde hosts the third-largest nesting population of loggerhead turtles Caretta caretta in the world (hosting up to 15% of global nesting by the species). Weighting for the spatial distribution of nests, we estimate that 84% of female hatchlings are currently likely produced across the population, with 85% of nests laid on Boa Vista, where incubation temperatures are coolest. In future climate change scenarios (by 2100), irrespective of beach, island or sand colour, sex ratios reach over 99% female, and 3 islands (Fogo, Sao Nicolau, Santiago) would cease to produce males, with &gt;90% of nests incubating at lethally high temperatures. Given that most of the population cannot move to nest on cooler islands, we highlight that temporal refugia are amongst the primary means available to this population to adapt. Under a low-emissions scenario, without phenological adaptation, there would only be an estimated 0.14% males produced across the whole population, while under mid- and high-emissions scenarios, male production may cease on most islands.</p

Highly feminised sex ratio estimations for the world’s third largest nesting aggregation of loggerhead sea turtles

Despite being a fundamental life-history character, there is a paucity of populationwide, data-driven studies of primary sex ratios for any marine turtle species. The Republic of Cape Verde hosts the third-largest nesting population of loggerhead turtles Caretta caretta in the world (hosting up to 15% of global nesting by the species). Weighting for the spatial distribution of nests, we estimate that 84% of female hatchlings are currently likely produced across the population, with 85% of nests laid on Boa Vista, where incubation temperatures are coolest. In future climate change scenarios (by 2100), irrespective of beach, island or sand colour, sex ratios reach over 99% female, and 3 islands (Fogo, Sao Nicolau, Santiago) would cease to produce males, with &gt;90% of nests incubating at lethally high temperatures. Given that most of the population cannot move to nest on cooler islands, we highlight that temporal refugia are amongst the primary means available to this population to adapt. Under a low-emissions scenario, without phenological adaptation, there would only be an estimated 0.14% males produced across the whole population, while under mid- and high-emissions scenarios, male production may cease on most islands.</p

Making waves in education

Making Waves in Education is a book of a collaborative nature, being a collection of chapters written by undergraduates studying B.A. Hons in Education at the Universities of Plymouth and York. Thirteen chapters, each from a different student, cover topics from learning theories to sex education, home education and autism. The chapters are well-organised and written, and they cover key topics in an accessible and thoughtful way. The chapters are generally well - referenced and present critical and balanced arguments. Many use hard statistics in an effective way to back up their points and all include bibliographies as indeed one expects from a serious publication. The collection therefore addresses itself to a wide readership of anyone interested in education, and students and teachers/trainers in HE in particula

Assessing the quality of ReSPECT documentation using an accountability for reasonableness framework.

BACKGROUND: The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form, which supports the ReSPECT process, is designed to prompt clinicians to discuss wider emergency treatment options with patients and to structure the documentation of decision-making for greater transparency. METHODS: Following an accountability for reasonableness framework (AFR), we analysed 141 completed ReSPECT forms (versions 1.0 and 2.0), collected from six National Health Service (NHS) hospitals in England during the early adoption of ReSPECT. Structured through an evaluation tool developed for this study, the analysis assessed the extent to which the records reflected consistency, transparency, and ethical justification of decision-making. RESULTS: Recommendations relating to CPR were consistently recorded on all forms and were contextualised within other treatment recommendations in most forms. The level of detail provided about treatment recommendations varied widely and reasons for treatment recommendations were rarely documented. Patient capacity, patient priorities and preferences, and the involvement of patients/relatives in ReSPECT conversations were recorded in some, but not all, forms. Clinicians almost never documented their weighing of potential burdens and benefits of treatments on the ReSPECT forms. CONCLUSION: In most ReSPECT forms, CPR recommendations were captured alongside other treatment recommendations. However, ReSPECT form design and associated training should be modified to address inconsistencies in form completion. These modifications should emphasise the recording of patient values and preferences, assessment of patient capacity, and clinical reasoning processes, thereby putting patient/family involvement at the core of good clinical practice. Version 3.0 of ReSPECT responds to these issues

Transforming citywide sanitation provision: Utility voices on pit emptying and transport services in Kenya and Zambia

This paper documents the key challenges faced by utilities in sub-Saharan Africa attempting to establish citywide safe manual and semi-mechanized latrine pit emptying, transport and disposal services. The research aims to take a snapshot of utilities at a pivotal point in service development, where initial services have been piloted and the utilities are looking to go to scale. We use the CWIS framework to guide analysis of perspectives of the implementing agencies in Livingstone, Zambia, and Malindi, Kenya, using a secondary data review and 34 key informant interviews. This paper confirms previous findings around the high cost of safe sanitation services in low-income areas, the barriers of emptiability, the engagement of manual pit emptiers and the requirement for investment in supporting systems. Areas for future research were identified, including approaches for service delivery to reduce the decision load on the household, structures of engagement and regulation of pit emptiers, and finally how regulation could support incremental improvements toward full coverage, including the lowest income households. The research documents, for the first time in the region, the challenges of dealing with disgust in establishing these new services and the conflicting role of public utilities as both commercial and social organizations. The current model for private sector delivery of the service is politically viable and reduces the risk and cost burden on the utilities. However, it is likely to leave the utilities unable to scale sanitation to low-income areas

Are DNA repair factors promising biomarkers for personalized therapy in gastric cancer?

Chronic inflammation is a driving force for gastric carcinogenesis. Reactive oxygen species (ROS) generated during the inflammatory process generates DNA damage that is processed through the DNA repair pathways. In this study, we profiled key DNA repair proteins (single-strand-selective monofunctional uracil-DNA glycosylase 1 [SMUG1], Flap endonuclease 1 [FEN1], X-ray repair cross-complementing gene 1 [XRCC1], and Ataxia telangiectasia mutated [ATM]) involved in ROS-induced oxidative DNA damage repair in gastric cancer and correlated to clinicopathological outcomes. High expression of SMUG1, FEN1, and XRCC1 correlated to high T-stage (T3/T4) (p-values: 0.001, 0.005, and 0.02, respectively). High expression of XRCC1 and FEN1 also correlated to lymph node-positive disease (p-values: 0.009 and 0.02, respectively). High expression of XRCC1, FEN1, and SMUG1 correlated with poor disease-specific survival (DSS) (p-values: 0.001, 0.006, and 0.05, respectively) and poor disease-free survival (DFS) (p-values: 0.001, 0.001, and 0.02, respectively). Low expression of ATM correlated to lymph node positivity (p=0.03), vascular invasion (p=0.05), and perineural invasion (p=0.005) and poor DFS (p=0.001) and poor DSS (p=0.003). In the multivariate Cox model, high XRCC1 and low ATM were independently associated with poor survival (p=0.008 and 0.011, respectively). Our observation supports the hypothesis that DNA repair factors are promising biomarkers for personalized therapy in gastric cancer. Antioxid. Redox Signal. 18, 2392–2398

Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups

Objectives To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture. Design Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams. Setting North Wales. Participants Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13). Results The realist review provided understanding of how rehabilitation interventions work in the realworld context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring. Conclusions A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III)