Enrollment of adolescents and young adults onto SWOG cancer research network clinical trials: A comparative analysis by treatment site and era.

BackgroundFew adolescents and young adults (AYAs, 15-39 years old) enroll onto cancer clinical trials, which hinders research otherwise having the potential to improve outcomes in this unique population. Prior studies have reported that AYAs are more likely to receive cancer care in community settings. The National Cancer Institute (NCI) has led efforts to increase trial enrollment through its network of NCI-designated cancer centers (NCICC) combined with community outreach through its Community Clinical Oncology Program (CCOP; replaced by the NCI Community Oncology Research Program in 2014).MethodsUsing AYA proportional enrollment (the proportion of total enrollments who were AYAs) as the primary outcome, we examined enrollment of AYAs onto SWOG therapeutic trials at NCICC, CCOP, and non-NCICC/non-CCOP sites from 2004 to 2013 by type of site, study period (2004-08 vs 2009-13), and patient demographics.ResultsOverall, AYA proportional enrollment was 10.1%. AYA proportional enrollment decreased between 2004-2008 and 2009-2013 (13.1% vs 8.5%, P < .001), and was higher at NCICCs than at CCOPs and non-NCICC/non-CCOPs (14.1% vs 8.3% and 9.2%, respectively; P < .001). AYA proportional enrollment declined significantly at all three site types. Proportional enrollment of AYAs who were Black or Hispanic was significantly higher at NCICCs compared with CCOPs or non-NCICC/non-CCOPs (11.5% vs 8.8, P = .048 and 11.5% vs 8.6%, P = .03, respectively).ConclusionNot only did community sites enroll a lower proportion of AYAs onto cancer clinical trials, but AYA enrollment decreased in all study settings. Initiatives aimed at increasing AYA enrollment, particularly in the community setting with attention to minority status, are needed

Sexual function in 16- to 21-year-olds in Britain

Purpose: Concern about young people's sexuality is focused on the need to prevent harmful outcomes such as sexually transmitted infections and unplanned pregnancy. Although the benefit of a broader perspective is recognized, data on other aspects of sexuality, particularly sexual function, are scant. We sought to address this gap by measuring the population prevalence of sexual function problems, help seeking, and avoidance of sex in young people. Methods: A cross-sectional stratified probability sample survey (Natsal-3) of 15,162 women and men in Britain (response rate: 57.7%), using computer-assisted self-interviews. Data come from 1875 (71.9%) sexually active, and 517 sexually inactive (18.7%), participants aged 16–21 years. Measures were single items from a validated measure of sexual function (the Natsal-SF). Results: Among sexually active 16- to 21-year-old participants, 9.1% of men and 13.4% of women reported a distressing sexual problem lasting 3 months or more in the last year. Most common among men was reaching a climax too quickly (4.5%), and among women was difficulty in reaching climax (6.3%). Just over a third (35.5%) of men and 42.3% of women reporting a problem had sought help, but rarely from professional sources. Among those who had not had sex in the last year, just >10% of young men and women said they had avoided sex because of sexual difficulties. Conclusions: Distressing sexual function problems are reported by a sizeable minority of sexually active young people. Education is required, and counseling should be available, to prevent lack of knowledge, anxiety, and shame progressing into lifelong sexual difficulties

An Organizational Quality Improvement Project Exploring Diversity, Equity, and Inclusion Opportunities

Aims: The purpose of this participatory action quality improvement project was to identify challenges and member-driven solutions to enhance diversity, equity, and inclusion (DEI) in a regional nursing research society (RNRS). Methods: This project adhered to a quality improvement (QI) framework and drew on strategies used in participatory action research to collect data on member-identified organizational practices that support and/or limit DEI within the RNRS, and member-generated solutions to enhance DEI within the society. The QI team consisted of RNRS members serving on a DEI Task Force and members with qualitative methods expertise. The team conducted focus groups during the society’s annual meeting and collected quantitative and qualitative data using a cross-sectional survey sent to all society members following the annual meeting. Results: Preliminary findings of this project in progress (PIP) indicate membership willingness to identify DEI issues and potential organizational solutions. Preliminary focus group data demonstrated members’ desires to encourage and support underrepresented members of the society. Potential solutions suggested by membership included creating mechanisms for financial support of underrepresented current/prospective members, increasing transparency in executive board decision-making, and creating more robust mechanisms for new member orientation and existing member professional development through a formal mentorship program. Conclusions: This PIP provides an exemplar of nursing research societies’ potential capacity to engage members in efforts to enhance organizational DEI. Efforts to create regional nursing research societies that are more inclusive and more accurately reflect the broader population is an important first step in supporting research on social and structural determinants of health

A Collaborative Approach: Assessing the Impact of Multi-Grade Classrooms

Catholic schools in the United States are faced with the looming challenge of declining enrollments. One possible strategy for dealing with this problem is to institute multi-grade classrooms where students from two or more grades are combined in one classroom with one instructor. In this article, the authors examined one urban Catholic school’s successful transition to multi-grade classrooms when student enrollment dropped dramatically. The transition to multi-grade classrooms did not have a significant impact on student outcomes as measured by absences, tardiness, or academic performance though other social-emotional and developmental benefits were perceived. For example, the students were more likely to nurture other students and be nurtured by them; assume shared responsibility and leadership in the classroom and at home; were involved in fewer disciplinary incidents; and were more respectful of their classmates. The researchers offer lessons learned about the transition for other Catholic school leaders who may be considering such a change

Interaction takes two: typical adults exhibit mind-blindness towards those with Autism Spectrum Disorder

Recent work suggests that we are better at interpreting the movements of others who move like us, and that individuals with Autism Spectrum Disorder (ASD) move in a quantifiably different way from typical individuals. Therefore, ‘social impairments’ exhibited by individuals with ASD may, at least in part, represent a failure by typical individuals to infer the correct mental states from the movements of those with ASD. To examine this possibility, individuals with ASD and typical adults manually directed two triangles to generate animations depicting mental state interactions. Kinematic analysis of the generated animations demonstrated that the participants with ASD moved atypically, specifically with increased jerk compared to the typical participants. In confirmation of our primary hypothesis, typical individuals were better able to identify the mental state portrayed in the animations produced by typical, relative to autistic individuals. The participants with ASD did not show this ‘same group’ advantage, demonstrating comparable performance for the two sets of animations. These findings have significant implications for clinical assessment and intervention in ASD, and potentially other populations with atypical movement

Where do women and men in Britain obtain contraception? Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

INTRODUCTION: To estimate the prevalence of use of different sources of contraceptive supplies in Britain and its variation by key demographic and behavioural characteristics. METHODS: Cross-sectional probability sample survey of women and men aged 16-74 years, resident in Britain, interviewed between 2010 and 2012. Analyses reported here were of 4571 women and 3142 men aged 16-44 years who reported having vaginal sex in the past year. Those relying exclusively on sterilisation (including hysterectomy) were excluded. Sources of contraceptive supplies were categorised as: general practice, community clinic, retail and other. Prevalence of use of these sources was estimated, and associated factors examined. RESULTS: Some 87.0% of women and 73.8% of men accessed at least one source of contraceptive supplies in the previous year. Most women (59.1%) used general practice and most men (54.6%) used retail outlets. Community clinics were less commonly used, by 23.0% of women and 21.3% of men, but these users were younger and at greater sexual health risk. These associations were also observed among the 27.3% of women and 30.6% of men who used more than one source category (general practice, community clinic or retail) for contraceptive supplies. CONCLUSIONS: People in Britain use a variety of sources to obtain contraceptive supplies and some sources are more commonly used by those more vulnerable to poorer sexual health. Our findings suggest that national policy changes to increase access to contraceptive methods have had an effect on the diversity of services used

Where do women and men in Britain obtain contraception? Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

INTRODUCTION: To estimate the prevalence of use of different sources of contraceptive supplies in Britain and its variation by key demographic and behavioural characteristics. METHODS: Cross-sectional probability sample survey of women and men aged 16-74 years, resident in Britain, interviewed between 2010 and 2012. Analyses reported here were of 4571 women and 3142 men aged 16-44 years who reported having vaginal sex in the past year. Those relying exclusively on sterilisation (including hysterectomy) were excluded. Sources of contraceptive supplies were categorised as: general practice, community clinic, retail and other. Prevalence of use of these sources was estimated, and associated factors examined. RESULTS: Some 87.0% of women and 73.8% of men accessed at least one source of contraceptive supplies in the previous year. Most women (59.1%) used general practice and most men (54.6%) used retail outlets. Community clinics were less commonly used, by 23.0% of women and 21.3% of men, but these users were younger and at greater sexual health risk. These associations were also observed among the 27.3% of women and 30.6% of men who used more than one source category (general practice, community clinic or retail) for contraceptive supplies. CONCLUSIONS: People in Britain use a variety of sources to obtain contraceptive supplies and some sources are more commonly used by those more vulnerable to poorer sexual health. Our findings suggest that national policy changes to increase access to contraceptive methods have had an effect on the diversity of services used

Actual and preferred contraceptive sources among young people: findings from the British National Survey of Sexual Attitudes and Lifestyles

OBJECTIVE: To describe actual and preferred contraceptive sources among young people in Britain and whether discordance between these is associated with markers of sexual risk behaviour or poor sexual health. DESIGN: Cross-sectional probability sample survey. SETTING: British general population. PARTICIPANTS: 3869 men and women aged 16-24 years interviewed for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) between 2010 and 2012. MAIN OUTCOME MEASURES: Reported source of contraceptive method(s) and preferred source if all were available and easily accessible. RESULTS: Of the 75% of young people (aged 16-24) who were heterosexually active (1619 women, 1233 men), >86% reported obtaining contraceptives in the past year. Most common sources were general practice (women, 63%) and retail (men, 60%): using multiple sources was common (women 40%, men 45%). Healthcare sources were preferred by 81% of women and 57% of men. Overall, 32% of women and 39% of men had not used their preferred source. This discordance was most common among men who preferred general practice (69%) and women who preferred retail (52%). Likelihood of discordance was higher among women who usually used a less effective contraceptive method or had an abortion. It was less likely among men who usually used a less effective method of contraception and men who were not in a steady relationship. CONCLUSIONS: Most young people in Britain obtained contraception in the past year but one-third had not used their preferred source. Healthcare sources were preferred. Discordance was associated with using less effective contraception and abortion among young women. Meeting young people's preference for obtaining contraception from healthcare sources could improve uptake of effective contraception to reduce unwanted pregnancies

A Model for the Two-Phase Behavior of Fluids in Dilute Porous Media

Experiments show that the coexistence region of a vapor-liquid system or binary liquid mixture is dramatically narrowed when the fluid is confined in a dilute porous medium such as a silica aerogel. We propose a simple model of the gel as a periodic array of cylindrical strands, and study the phase behavior of an Ising system confined in this geometry. Our results suggest that the coexistence region should widen out at lower temperatures, and that the narrowness observed near the critical point may be a fluctuation-induced effect

Masked Bobwhite Recovery: The Need for a Multifaceted Approach

Masked bobwhite (Colinus virginianus ridgwayi) is a critically endangered quail historically found in the Sonoran grasslands of southern Arizona, USA and Sonora, Mexico. Native populations of masked bobwhite may already be extinct in the wild, but captive populations exist in the United States at G. M. Sutton Avian Research Center (Oklahoma, USA), Buenos Aires National Wildlife Refuge (Arizona, USA), and various zoos. The 47,000-hectare Buenos Aires National Wildlife Refuge, located in south-central Arizona, was established primarily for reintroduction of this bird. Recovery efforts within the refuge boundary in the 1980s and 1990s were initially successful but suffered debilitating setbacks that ultimately resulted in failure. Substantial releases were suspended in 2005. Improved habitat restoration efforts and promising conditioning and release techniques led to the belief that reintroductions could again be attempted and successful. In 2016–2017 plans were developed to increase captive propagation and reinitiate release efforts. Releases began in 2018. Over-winter survival of birds released in 2018–2019 was encouraging, and reproduction of wild birds was documented in 2019. An existing base of wild birds established from these releases could help masked bobwhite populations recover in the state. Habitat restoration, better methods of rearing, release, and conditioning, and improved production from captive facilities also inspire hope that a full recovery of the species in Arizona is possible