Independent Coding Research Articles

Design of Credit Bond Default Risk Measurement Model Based on Spatio-Temporal Attention Network and Genetic Algorithm Driven by Digital Economy

With the rapid advancement of the digital economy, the financial market confronts unprecedented complexity and interconnectivity, rendering the precise prediction of credit bond default risk particularly crucial. This paper introduces a novel credit bond default risk measurement model (GST-GRU) predicated on a spatio-temporal attention network and genetic algorithm, designed to enhance the accuracy and robustness of risk prediction. Initially, data preprocessing is undertaken, encompassing time series data cleaning, completion of missing values for historical financial information and bond default statuses, and extraction of spatial discrete information through independent vector coding. Subsequently, a spatio-temporal attention mechanism is employed to amplify feature information in both domains, while the GRU network captures the long-term dependencies within the time series data. Thereafter, model parameters are refined using a genetic algorithm to ensure global optimality. Experimental results demonstrate that the GST–GRU model markedly improves prediction accuracy across multiple public and self-constructed datasets, surpassing traditional models. This research furnishes robust technical support for risk management in the financial market, fosters the evolution of credit bond default risk prediction technology, and lays the groundwork for the intelligence and automation of future financial systems.

“I feel like I'm always on edge”: Perceptions of parole supervision by parolees with substance use disorders

IntroductionWhile extant research has looked at parole and its various actors as an institution, few studies recount the parole experience from the perspective of parolees. Additionally, despite the prevalence of substance use disorders (SUDs) within the criminal justice system, research that assesses the additional challenges this population faces throughout parole supervision is even scarcer. MethodsTo address this gap, we analyze in-depth qualitative interviews (n = 51) conducted with reentering men with SUDs as they navigate parole in Pennsylvania. Three independent coders identified all narratives relating to a broad theme of “parole and probation experiences.” The authors then completed iterative rounds of more fine-grained independent coding within that theme. ResultsOur results emphasize that SUDs present a significant barrier to reentry success, and the tension of surveillance and revocation is amplified for those enduring simultaneous reentry and recovery. Importantly, our respondents regard parole officers more positively than they view parole as an institution, yet this perception of officers does not equate to provision of reintegration and recovery support. Respondents perceive that parole presents unnecessary additional hurdles to their reentry success, and their perceived risk level impacts their surveillance intensity. ConclusionsThe information gleaned through inclusion of perspectives from those enduring parole supervision calls for a critical assessment of current parole practices. Further, the current approach to SUDs within community supervision criminalizes relapse without provision of treatment resources or support.

Resolving trauma: The unique contribution of trauma-specific mentalization to maternal insightfulness.

Resolving trauma may contribute to mental health and parenting in mother with histories of childhood maltreatment. The concept of trauma-specific reflective functioning (T-RF) was developed to assess the complexity of thought processes regarding trauma. The study aimed to validate the T-RF scale applied to the Trauma Meaning-Making Interview by examining its psychometric properties, associations with measures of trauma-processing strategies, maternal reflective functioning and mental health (depression and post-traumatic stress disorder [PTSD]), as well as evaluating whether T-RF offered a unique contribution to maternal insightfulness. Good construct validity of the T-RF scale was confirmed in a sample of 112 mothers with histories of childhood maltreatment using an independent coding system of trauma-processing. Better mentalization of trauma was prospectively associated with higher parental reflective functioning and mothers with high T-RF were much more likely to be insightful regarding the child's mental states than non-reflective mothers and mothers with limited T-RF. The association between T-RF and insightfulness was observed even when controlling for maternal reflective functioning, trauma-processing strategies, maternal education and sociodemographic risk. T-RF was associated neither with depression, PTSD nor the characteristics of trauma. Findings suggest that mentalizing trauma would be an important protective factor in the intergenerational trajectories of trauma.

Client-reported challenges and opportunities for improved antiretroviral therapy services uptake at a secondary health facility in Ghana

Antiretroviral therapy (ART) regimens in African countries, including Ghana, are often faced with the challenge of treatment default. To maximize ART utilization and efficiency among people living with HIV (PLHIV), it is pertinent to ensure that ART-related challenges that clients encounter are identified and addressed holistically. A phenomenological qualitative study of thirty participants recruited through the purposive sampling technique was conducted using in-depth interviews from June to July 2021. Independent coding was done using Atlas ti. Sub-themes were developed from the codes, using the most expressive phrases, and grouped under two broad themes, challenges, and opportunities to maximise ART uptake. Ten different challenges, grouped into the health system and individual constraints were reported. Health system constraints included stigmatisation and discrimination by healthcare workers, queuing outside while waiting to be served, long waiting periods, non-communication of laboratory test results to clients, lack of proper education on side effects associated with ART, and language barrier. Individual constraints included financial constraints, perceived non-improvement in health outcomes, food insecurity, and forgetfulness. Opportunities identified for improved ART uptake were assuring ART clients of improved health outcomes, leveraging the good rapport between ART clients and healthcare providers, leveraging the better counselling services offered to PLHIV at the ART clinic, provision of varied ART treatment regimens to clients, routine communication of laboratory test results to clients, and leveraging clients’ satisfaction with ART services at ART clinic. We recommend health system reforms targeting healthcare service delivery to PLHIV to encourage linkage, continuity, and retention in care and augmenting ART regimes with financial and nutritional support while encouraging status disclosure to a trusted family member.

Measuring narrative identity: rater coding versus questionnaire-based approaches

ABSTRACT Narrative identity – how individuals narrate their lived and remembered past – is usually assessed via independent rater coding, but new methods relying on self-report have been introduced. To test the assumption that different methods assess aspects of the same underlying construct, studies measuring similar components of narrative identity with different methods are needed. However, such studies are surprisingly rare. To begin to fill this gap, the present study compared the narrative variables, temporal coherence, causal coherence, and thematic coherence, measured via rater coding of participants’ self-generated narratives of the remembered past and via subscales of the self-report measure Awareness of Narrative Identity Questionnaire (ANIQ). The results showed that the ANIQ subscales did not correlate significantly with their corresponding rater-coded dimension, and that the ANIQ subscales were generally unrelated to the other rater-coded dimensions. Furthermore, an exploratory factor analysis demonstrated that the ANIQ subscales loaded together on a factor that did not include any rater-coded variables. The findings suggest that the narrative variables share little empirical overlap when assessed via the ANIQ and rater coding of self-generated narratives.

When and how do peers stimulate engaging in desirable difficulties: Student perspectives on the effectiveness of supplemental instruction

Supplemental instruction, also known as Peer Assisted Study Sessions (SI-PASS), is a well-established form of peer learning that has been implemented in higher education institutions across the globe and that coincides with learning gains for participants. While the effects on learning gains have been extensively studied with quasi-experiments, the underlying mechanisms that make SI-PASS effective are less well understood. This study explored what benefits students thought SI-PASS offered and through which mechanisms. We studied this by interviewing 14 students who participated in SI-PASS during a field experiment that reliably found a significant impact of SI-PASS on performance. The students were asked to expand on if and why they thought SI-PASS was effective. Thematic analysis and independent coding indicated an interplay of three main drivers. SI-PASS was experienced as effective because it stimulated the use of effective study techniques and social learning. These drivers were facilitated and enhanced by a pedagogical climate that lowered the threshold to engage in collaborative learning and effective study techniques. These findings could help pinpoint what elements should be highlighted during the preparation of SI-leaders and what aspects should be monitored and tested when implementing or studying SI-PASS.

Creation of a Shared Medical Decision Support Tool for the Management of Abdominal Aortic Aneurysms

ObjectivePatients with an unruptured abdominal aortic aneurysm (AAA) at the surgical threshold may benefit from aneurysmal exclusion either by open surgery or endovascular repair. A patient decision aid (PtDA) could be useful to help patients and their surgeons choose between the two techniques. The aim of this study was to develop a shared medical decision support tool, in french language, for the surgical treatment of AAA. MethodsFollowing the steps recommended by the International Patient Decision Aids Standards, we carried out a qualitative study using semi-structured interviews with patients and vascular surgeons and focus group with patients to identify their main points of interest. After analyzing the interviews using grounded theory with independent double coding, the verbatims were discussed at a steering committee, at the end of which a prototype of the tool was created. Results4 surgeons and 14 patients were interviewed. No new codes emerged from the last two interviews. At the end of the steering committee meeting, the informations selected for inclusion in the PtDA tool were the definition of an AAA, a description of the two surgical techniques (approach, duration of operation), the main complications, the peri-operative mortality rate, and post operative follow-up (length of hospital stay, monitoring frequency, risk of re-intervention). It had to be produced on a synthetic paper format, with six illustrations and a simple vocabulary. ConclusionWe developed a PtDA tool for use in a sharing decision making process with the patient during the consultation with the vascular surgeon and the general practitioner. Further studies are needed to validate the tool and to test it in clinical practice.

Assessment of food availability in New Zealand primary schools

Childhood obesity and overweight rates in New Zealand are considerably higher than that globally with one in three children aged between 2-14 years being overweight or obese(1). Children’s dietary knowledge and food preferences are influenced by various factors including the food environment. Schools are an excellent setting to influence children’s dietary behaviours since they have the potential to reach almost all children during the first two decades of their lives. However, previous analyses indicate many school canteens and food providers do not supply foods that promote healthy eating and nutrition behaviours (2,3). The Ministry of Health (MoH) recently implemented a ‘Food and Drink Guidance for Schools’ which utilises a traffic-light framework dividing foods into three categories: ‘green’, ‘amber’, and ‘red’(4). The aim of this study was to assess primary school canteen food menus against the newly implemented MoH Guidance. A convenience sample of 133 primary school canteen menus were collected in 2020 as part of the baseline evaluation of the Healthy Active Learning initiative across New Zealand. Four researchers (three nutritionists and one dietitian) developed a menu analysis toolkit to undertake the analysis of all menus collected. The toolkit provided a breakdown of commonly packaged foods and meals/menu items available to purchase within schools based on Health Star Ratings, ingredients, and/or standard recipes. Assumptions were created for menu items requiring additional detail to be categorised according to the guidance through consensus by all four researchers. Primary school menus were coded by two researchers, and intercoder reliability was ensured by independent coding and cross-checking of 10% of menus. Descriptive and inferential analyses were conducted using IBM SPSS and P<0.05 denoted significance. Analyses of canteen menus revealed that most menu items belonged to the less healthy amber (41.0%) and red (40%) food categories. Low decile schools had a lower percentage of green food items (8.6%) and a higher percentage of red food items (48.3%) compared to high decile schools (p = 0.028). Similarly, schools in low deprivation areas had a significantly higher percentage of green food items (14.2%) compared to high deprivation areas (8.6%) (p = 0.031). Sandwiches, filled rolls, and wraps were the most commonly available items (86%) followed by baked foods and foods with pastry (71%). Sugar-sweetened beverages were just as prevalent as water on school food menus (54% each). Over half of in-house catered canteen menu items were classified as 'red’ foods (55.3%). This study highlights that most school canteens were not meeting the guidelines for healthy food and drink provision outlined by the MoH. Improving school food availability for children in socioeconomically deprived areas needs to be prioritised to reduce inequities. Findings suggest the need for more robust national policies and mandated school guidance to improve the food environments in New Zealand schools.

How patients experience respect in healthcare: findings from a qualitative study among multicultural women living with HIV

BackgroundRespect is essential to providing high quality healthcare, particularly for groups that are historically marginalized and stigmatized. While ethical principles taught to health professionals focus on patient autonomy as the object of respect for persons, limited studies explore patients’ views of respect. The purpose of this study was to explore the perspectives of a multiculturally diverse group of low-income women living with HIV (WLH) regarding their experience of respect from their medical physicians.MethodsWe analyzed 57 semi-structured interviews conducted at HIV case management sites in South Florida as part of a larger qualitative study that explored practices facilitating retention and adherence in care. Women were eligible to participate if they identified as African American (n = 28), Hispanic/Latina (n = 22), or Haitian (n = 7). They were asked to describe instances when they were treated with respect by their medical physicians. Interviews were conducted by a fluent research interviewer in either English, Spanish, or Haitian Creole, depending on participant’s language preference. Transcripts were translated, back-translated and reviewed in entirety for any statements or comments about “respect.” After independent coding by 3 investigators, we used a consensual thematic analysis approach to determine themes.ResultsResults from this study grouped into two overarching classifications: respect manifested in physicians’ orientation towards the patient (i.e., interpersonal behaviors in interactions) and respect in medical professionalism (i.e., clinic procedures and practices). Four main themes emerged regarding respect in provider’s orientation towards the patient: being treated as a person, treated as an equal, treated without blame or prejudice, and treated with concern/emotional support. Two main themes emerged regarding respect as evidenced in medical professionalism: physician availability and considerations of privacy.ConclusionsFindings suggest a more robust conception of what ‘respect for persons’ entails in medical ethics for a diverse group of low-income women living with HIV. Findings have implications for broadening areas of focus of future bioethics education, training, and research to include components of interpersonal relationship development, communication, and clinic procedures. We suggest these areas of training may increase respectful medical care experiences and potentially serve to influence persistent and known social and structural determinants of health through provider interactions and health care delivery.

Dialogues with AI: Comparing ChatGPT, Bard, and Human Participants’ Responses in In-Depth Interviews on Adolescent Health Care

This study explores the feasibility of large language models (LLMs) like ChatGPT and Bard as virtual participants in health-related research interviews. The goal is to assess whether these models can function as a “collective knowledge platform” by processing extensive datasets. Framed as a “proof of concept”, the research involved 20 interviews with both ChatGPT and Bard, portraying personas based on parents of adolescents. The interviews focused on physician–patient–parent confidentiality issues across fictional cases covering alcohol intoxication, STDs, ultrasound without parental knowledge, and mental health. Conducted in Dutch, the interviews underwent independent coding and comparison with human responses. The analysis identified four primary themes—privacy, trust, responsibility, and etiology—from both AI models and human-based interviews. While the main concepts aligned, nuanced differences in emphasis and interpretation were observed. Bard exhibited less interpersonal variation compared to ChatGPT and human respondents. Notably, AI personas prioritized privacy and age more than human parents. Recognizing disparities between AI and human interviews, researchers must adapt methodologies and refine AI models for improved accuracy and consistency. This research initiates discussions on the evolving role of generative AI in research, opening avenues for further exploration.

Self-perceptions of masculinities and testicular cancer: Qualitative explorations.

Masculinities have been explored in men with testicular cancer (TC), though limited contemporary research is available on traditional masculine norms important to masculine self-perception. The purpose of this research was to explore the discourse of TC experience in relation to masculine self-perception. A qualitative descriptive study was conducted consisting of semi-structured interviews with 21 men. Men were aged between 31 and 47 (Mage=35.7). Most men were diagnosed with Stage 1 cancer (66.6%), all men had finished active treatment and time since diagnosis ranged from 17.3 to 71.8months (M=47.2). Independent coding was conducted by two researchers and was refined in coding meetings with authors. Themes were developed in a predominantly deductive manner, and analysis of themes was undertaken using a reflexive analysis approach. Traditional masculine norms showed differing relationships to masculine self-perception. Two main themes were identified [1] Maintained or enhanced masculine self-perception and [2] threats to masculine self-perception. Subthemes demonstrated that maintaining emotional control, strength and 'winning' was important to men, and reduced physical competencies (i.e., strength, sexual dysfunction, virility) challenged self-perception. Strict adherence to traditional norms in response to threatened self-perception related to psychological distress. Leveraging traditionally masculine norms such as physical strength and control and developing flexible adaptations of masculinities should be encouraged with men with TC to retain self-perception and potentially enable better coping. Masculine self-perception of gay/bisexual men may centre around sexual functioning, though further research is required.

P093 Innovating in IBD care: what do patients and informal caregivers value? Preliminary results of a narrative inquiry

Abstract Background Given the increasing incidence, evolving treatment goals, and the need for tight and holistic monitoring, transformation in delivery of Inflammatory Bowel Disease (IBD) care is warranted. To innovate successfully, it is crucial to consider the values of healthcare professionals (HCP) and healthcare services, as well as the patient’s and informal caregiver’s perspective. This study aims to explore what patients with IBD and their informal caregivers value in Dutch IBD care. Methods In total, approximately 16 patients and 8 informal caregivers from an academic and a general hospital will be included. Respondents are recruited purposefully. Data collection will take place until data saturation is reached. The interviews are focused on real-life experiences and stories of respondents with regard to IBD. Interviews are conducted face-to-face or digitally, audio recorded and transcribed verbatim. Independent coding was executed by three researchers. A deductive thematic analysis approach was used, guided by the Picker Principles of Person Centred Care. Results Semi-structured narrative interviews were conducted with 8 IBD patients and 4 informal caregivers, i.e. family members, between June-September 2023. All Picker principles came across in the narratives. Respondents said that it is important to receive an effective treatment, minimizing intestinal symptoms and to function as good as possible with IBD. Involving patients in their treatment plan and paying attention to non-medical aspects, e.g. impact on work and social relationships, was relevant to respondents. Patients and caregivers valued easy and accessible communication with their HCP, the feeling to be heard, and immediate action of the HCP when required. A trustful relationship, fostered through e.g. regular face-to-face contact, was highlighted as important. Some respondents appreciated the use of eHealth tools, as these facilitate remote care if desired. Moreover, providing informal caregivers with information about the disease, treatment and impact on daily life was suggested as beneficial in supporting patients with IBD. Conclusion IBD patients and their informal caregivers value shared decision making, fast access to reliable healthcare advice, immediate action when needed, the feeling to be heard and a trustful relationship with their HCP when receiving IBD care in the Netherlands. These values and insight in the (shared)-values of all relevant stakeholders within the Dutch context will facilitate the development of valuable innovation and successful implementation. The perspectives of other stakeholders, such as HCPs, policymakers, health insurers, pharmaceutical companies, and eHealth providers, will be explored in an extensive qualitative study.

Parliamentary reaction to the announcement and implementation of the UK Soft Drinks Industry Levy: applied thematic analysis of 2016-2020 parliamentary debates.

The UK Soft Drinks Industry Levy (SDIL) (announced in March 2016; implemented in April 2018) aims to incentivise reformulation of soft drinks to reduce added sugar levels. The SDIL has been applauded as a policy success, and it has survived calls from parliamentarians for it to be repealed. We aimed to explore parliamentary reaction to the SDIL following its announcement until two years post-implementation in order to understand how health policy can become established and resilient to opposition. Searches of Hansard for parliamentary debate transcripts that discussed the SDIL retrieved 186 transcripts, with 160 included after screening. Five stages of Applied Thematic Analysis were conducted: familiarisation and creation of initial codebooks; independent second coding; codebook finalisation through team consensus; final coding of the dataset to the complete codebook; and theme finalisation through team consensus. The United Kingdom Parliament. N/A. Between the announcement (16/03/2016) - royal assent (26/04/2017), two themes were identified 1: SDIL welcomed cross-party 2: SDIL a good start but not enough. Between royal assent - implementation (5/04/2018), one theme was identified 3: The SDIL worked - what next? The final theme identified from implementation until 16/03/2020 was 4: Moving on from the SDIL. After the announcement, the SDIL had cross-party support and was recognised to have encouraged reformulation prior to implementation. Lessons for governments indicate that the combination of cross-party support and a policy's documented success in achieving its aim can help cement the resilience of it to opposition and threats of repeal.

Developing a framework of concerns from people living with frailty, for the Measure Yourself Concerns and Wellbeing (MYCaW) person-centred outcome measure

IntroductionMeasure Yourself Concerns and Wellbeing is a validated person-centred outcome measure, piloted as a core monitoring tool to understand what matters to people living with frailty in Gloucestershire. This paper...

HOW DO OLDER ADULTS COPE WITH INTERSECTIONAL EXPERIENCES OF AGEISM AND RACISM?

Abstract The World Health Organization recently launched a global campaign to end ageism due to its widespread, insidious negative health impacts on older adults. Similarly, racism is a key driver of health disparities and has been declared a public health crisis by jurisdictions around the United States. While a strong literature summarizes coping theory in general as well as beneficial and maladaptive coping mechanisms among older adults, limited research describes how older adults cope with experiences of ageism and racism, particularly through an intersectional lens. The aim of this qualitative, phenomenological study was to understand how older adults cope with intersectional experiences of ageism and racism. Twenty adults 60+ residing in the U.S. Mountain West who identified as Black, Hispanic/Latino(a), Asian-American/Pacific Islander, Indigenous, or White participated in a one-hour, semi-structured interview. A team of five coders engaged in an inductive coding process through independent coding followed by critical discussion. Peer debriefing, member checking, and an audit trail enhanced credibility. Nine themes were identified: 1) resistance, 2) exhaustion, 3) acceptance/‘let it go,’ 4) avoidance, 5) increased awareness through aging, 6) help others, 7) educate others, 8) self-determination/defy stereotypes, and 9) healthy lifestyle. These themes exemplify problem-focused and emotion-focused, as well as individual and collective coping strategies. Novel findings include how older adults may cope with ageism and racism through helping peer older adults and via increased awareness through aging. Practitioners should recommend coping strategies which combine collective and problem-focused responses to ageism and racism such as resistance, helping others, and educating others.

Gill Structure Linked to Ecological and Species Diversification in a Clade of Caddisflies

Streams represent a special case of directional environmental gradients where ecological opportunity for diversification may be associated with upstream and downstream dispersal into habitats that differ in selective pressures. Temperature, current velocity and variability, sediment erosion dynamics and oxygen saturation are key environmental parameters that change in predictable ways from springs to river mouth. Many aquatic insects occupy specific longitudinal regions along these gradients, indicating a high degree of adaptation to these specific environmental conditions. In caddisflies, the evolution of tracheal gills in larval and pupal stages may be a major driver in oxygen uptake efficiency and ecological diversification. Here we study the evolution of larval gill structure in the Rhyacophila vulgaris species group using phylogenomic methods. Based on anchored hybrid enrichment, we sequenced 97 kbp of data representing 159 independent nuclear protein coding gene regions to infer the phylogeny of the R. vulgaris species group, whose species exhibit both high diversity of gill types and varied longitudinal preferences. We find that the different gill types evolved independently as derived characters in the genus and that gill structure is linked to the longitudinal habitat preference, thereby serving as a possible ecological key innovation in the R. vulgaris group.

Supervised on-site dosing in injectable opioid agonist treatment-considering the patient perspective. Findings from a cross-sectional interview study in two German cities.

Injectable opioid agonist treatment (iOAT) is an effective option to support people living with opioid use disorder (OUD) who have not sufficiently benefitted from oral OAT. However, iOAT has been criticised based on theoretical and practical grounds for its dosing policies: Current regulations demand supervised, on-site application and require patients to frequently visit their treatment facility. The current study aims to investigate how patients experience on-site application and derive strategies to enhance the acceptability and effectiveness of iOAT-delivery. This article is based on semi-structured interviews with 27 individuals currently or previously in iOAT in two German outpatient iOAT-clinics. We undertook an inductive qualitative content analysis, which included blinded, independent coding and the analysis of individual cases. Comments regarding on-site application and daily visits to the clinic were grouped into positive and negative aspects, iOAT as the best alternative option, facilitators of daily visits, and suggestions for improvement. Positive aspects took the factors stability and social support in regard. Negative aspects ranged from general inconveniences to major impediments to individuals' daily lives and towards achieving psychosocial goals. Participants reported rigorous adherence to iOAT's treatment regime, often due to a perceived lack of alternative options. Meeting iOAT's demands was eased by the patients' coping-strategies and through facilitating measures implemented by iOAT-clinics. Despite acknowledgement of the potential detriments from easing regulations, take-home arrangements were frequently suggested by participants to improve iOAT. Being required to attend the clinic for supervised iOAT-application is not experienced uniformly. While clinics can support their patients to cope with strict regulations, alternative approaches to iOAT-application should be considered to accommodate patients' individual needs. Examples from other treatment modalities (e.g., remote supervision and delivery services) might aid to reconcile individualisation while providing adequate safety measures and improve iOAT in the long term.

The Genetic Code Assembles via Division and Fusion, Basic Cellular Events.

Standard Genetic Code (SGC) evolution is quantitatively modeled in up to 2000 independent coding 'environments'. Environments host multiple codes that may fuse or divide, with division yielding identical descendants. Code division may be selected-sophisticated gene products could be required for an orderly separation that preserves the coding. Several unforeseen results emerge: more rapid evolution requires unselective code division rather than its selective form. Combining selective and unselective code division, with/without code fusion, with/without independent environmental coding tables, and with/without wobble defines 25 = 32 possible pathways for SGC evolution. These 32 possible histories are compared, specifically, for evolutionary speed and code accuracy. Pathways differ greatly, for example, by ≈300-fold in time to evolve SGC-like codes. Eight of thirty-two pathways employing code division evolve quickly. Four of these eight that combine fusion and division also unite speed and accuracy. The two most precise, swiftest paths; thus the most likely routes to the SGC are similar, differing only in fusion with independent environmental codes. Code division instead of fusion with unrelated codes implies that exterior codes can be dispensable. Instead, a single ancestral code that divides and fuses can initiate fully encoded peptide biosynthesis. Division and fusion create a 'crescendo of competent coding', facilitating the search for the SGC and also assisting the advent of otherwise uniformly disfavored wobble coding. Code fusion can unite multiple codon assignment mechanisms. However, via code division and fusion, an SGC can emerge from a single primary origin via familiar cellular events.

A phenomenological, intersectional understanding of coping with ageism and racism among older adults

The aim of this qualitative, phenomenological study was to understand how older adults cope with experiences of ageism and racism through an intersectional lens. Twenty adults 60+ residing in the U.S. Mountain West who identified as Black, Hispanic/Latino(a), Asian-American/Pacific Islander, Indigenous, or White participated individually in a one-hour, semi-structured interview. A team of five coders engaged in an inductive coding process through independent coding followed by critical discussion. Peer debriefing enhanced credibility. Nine themes were organized by three umbrella categories: Coping with ageism: 1) distancing via self-determination/defying stereotypes, 2) distancing by helping others; Coping with racism: 3) resistance, 4) exhaustion; Coping with both ageism and racism: 5) increased awareness through aging, 6) healthy lifestyle, 7) education, 8) acceptance/ ‘let it go’, and 9) avoidance. Novel findings include how older adults may cope with ageism and racism via increased awareness through aging and with ageism specifically by helping peer older adults, although instances of internalized ageism were noted and discussed. The themes exemplify problem-focused (e.g., helping others) and emotion-focused (acceptance), as well as individual (e.g., self-determination) and collective (e.g., resistance) coping strategies. This study can serve as a resource for practitioners in applying a more nuanced understanding of the ways older adults cope with ageism and racism in later life.

Assessing Parental Perceptions of Meaningful Outcomes for Children with Autism Spectrum Disorder.

Outcomes of children diagnosed with autism spectrum disorder (ASD) generally focus on cognition, language, behavioral, and adaptive functioning, yet it is unknown whether this reflects patient and caregiver priorities. Identify parental perceptions of ASD outcomes and identify whether health care providers are currently addressing these concerns. Participant were 60 parents of school-aged children previously diagnosed with ASD participating in a larger autism outcomes study. Parents answered the open-ended question, "What aspect of your child's functioning matters most for your child at this time?" They also ranked a list of outcome categories (thinking and reasoning skills, daily living skills, etc). Parents answered a second open-ended question, "What should healthcare providers be asking about how your child is doing, that they may not be currently asking?" Open-ended independent coding and thematic analysis were used to identify themes for the open-ended questions. The most common themes identified with "what aspect of your child's functioning matters most" were "Social," "Communication," "Emotional," and "Behavior." These were similar to the results of a ranking question in which parents ranked "Communicating with and understanding others," "Social skills," and "Behavior" as most important. "Emotional" was a unique theme, although there is potential overlap between this and the theme of "Behavior." The most common theme identified with the question about what health care providers should be asking was "Social," followed by "Nothing." This study demonstrates that parental concerns largely match previous outcome categories, with the exception of a theme identified as "Emotional" which may overlap with "Behavior."