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Describes the archaeological discovery of thousands of life-sized terracotta warrior statues in northern China in 1974, and discusses the emperor who had them created and placed near his tomb.

This article addresses the methodological challenge of capturing and comparing children’s experiences of everyday life by using a novel rhythmanalysis approach to explore the experiences of a small sample (N = 16) of home based children aged 7–10 in England and Greece during the 2020 global lockdown. The children kept a 1 day diary in which they recorded their activities and feelings at regular intervals during their waking hours. The data collected indicates that the children’s lives were both disrupted and synchronised during this period, and highlights how their individual experiences were interconnected in time and space by shared rhythms which underpinned the patterns of their day. The paper highlights the utility of the specially designed rhythmanalysis data collection tool and analytical approach for future comparative international studies of children’s everyday lives.

Preparing for picture day at school by choosing just the right outfit, Nancy wonders how she should style her hair and considers pigtails, a bun, and long ringlets before formulating a plan that has her reaching for the scissors.

Background/IntroductionAcute decompensated heart failure (ADHF) leads to hospitalisations, frequent re-hospitalisations and mortality. The safety and efficacy of telehealth-guided outpatient ADHF management (virtual ward-VW) as an alternative to hospitalisation has not been assessed previously.AimThe aim of this study was to assess the safety and outcomes of our acute heart failure virtual ward (HFVW) pathway (figure 1) when compared to hospitalised ADHF patients.MethodsThis cohort study (May 2022-October 2023) assessed the outcomes of telehealth-guided outpatient ADHF management using bolus intravenous furosemide in a HF-specialist VW. We compared baseline patient characteristics, NTproBNP, ejection fraction, NYHA Class, clinical risk score (Get With the Guidelines-Heart Failure-GWTG-HF), comorbidities (Charlson Co-morbidity Index-CCI), frailty (Rockwood Clinical Frailty Score-CFS), HF therapies and measured clinical outcomes at 1, 3, 6 and 12 months (re-hospitalisations, mortality) in the HFVW cohort versus standard care (ADHF patients managed without telehealth in 2021).Results554 HFVW ADHF patients (age 73.1±10.9 years; 46% female) were compared with 402 ADHF patients (74.2±11.8; p=0.15 and 49% female) in the standard care cohort (SC). Despite similar baseline patient characteristics, GWTG-HF score, CCI and CFS, re-hospitalisations were significantly lower in the HFVW compared to standard care (1 month - 11.6% vs. 21%, p=0.002; 3 months - 20.4% vs. 30%, p=0.001; 6 months -29.3% vs 41%, p=0.02 and 12 months-48% vs. 57%,p=0.03) whereas mortality was lower at 1 month (6% vs. 14%; p<0.001), 3 months (10.5% vs. 15%; p=0.02) and 6 months (15.5% vs. 21%; p=0.04) (figure 2). Multivariate logistic regression analysis showed that an increased daily step count whilst on HFVW independently predicted reduced odds of re-hospitalisations at 1 month (OR 0.85; 95% CI 0.7–0.9; p=0.005), 3 months [OR 0.95 (0.93–0.98); p=0.003] and 1 month mortality [OR 0.85 (0.7–0.95), p=0.01]. Whereas CCI predicted adverse 12-month outcomes [OR 1.2 (1.1–1.4), p=0.03]. Higher GWTG-HF score independently predicted increased odds of re-hospitalisation [1-month OR 1.2 (1.1–1.3), p=0.01; 12-month OR 1.1, 1.05–1.2, p=0.03) as well as mortality [1-month OR 1.2 (1.1–1.4), p=0.01; 12-month OR 1.3 (1.1–1.7), p=0.02]. Similarly higher CFS also independently predicted increased odds of re-hospitalisations [1-month OR 1.5 (1.1–2.2), p=0.03; 12-month OR 1.9 (1.2–3, p=0.01] and mortality [1-month OR 2 (1.1–3.5), p=0.02; 12-month OR 2.6 (1.6–10); p=0.02] throughout the follow-up period.ConclusionsA telehealth-guided specialist HFVW management strategy for ADHF may offer a safe and efficacious alternative to hospitalisation in suitable patients. Daily step count, GWTG, CCI and CFS can play a vital role in assessing suitability for VW and in predicting risk of adverse clinical outcomes.Abstract 139 Figure 1This graph outlines the observed re-hospitalisation rates in the two cohorts (SC - Standard care and HFVW - Heart Failure Virtual Ward) at 1, 3, 6 and 12 months follow up. Significance is shown with p-values and an asterisk (*) where appropriateAbstract 139 Figure 2This graph outlines the observed mortality rates in the two cohorts (SC - Standard care and HFVW - Heart Failure Virtual Ward) at 1, 3, 6 and 12 months follow up. Significance is shown with p-values and an asterisk (*) where appropriateConflict of InterestNone

When Frenchy gets in trouble one too many times, the Clancy's decide it's time for puppy school.

Background Because of the potential gravity of finding a person incompetent, assessment of mental capacity is challenging for clinicians. We aimed to test validity of a new structured professional judgement tool designed to assess functional mental capacity in three domains – finances, welfare and healthcare. Methods Fifty-five male forensic psychiatric patients with Schizophrenia were interviewed using the Dundrum Capacity Ladders – a new semi-structured interview, and scores were assigned on a stratified scoring system, measuring ability to understand, reason, appreciate the personal importance of the decision at hand and communicate a decision. Data were also gathered pertaining to level of therapeutic security at the time of interview, diagnosis, neurocognitive function and a validated measure of real world function. Results The results show that internal consistency and inter-rater reliability were high for all items. There were correlations between higher scores of functional mental capacity, neurocognitive function and measures of real world function in this population. Correlations were in the range 0.358 to 0.693, effect sizes that were moderate to high. Conclusions The DUNDRUM Capacity Ladders appear to be a valid measure of functional mental capacity in this population. Further prospective studies of functional mental capacity as a measure of recovery are now required.

Nancy makes the best of not dancing the lead in her ballet school's Deep Sea Dances show, but becomes jealous when her best friend gets a bettr role than hers.

Children and young people (CYP) with skin and hair conditions are at an increased risk of mental health problems and vice versa. Current child and adolescent mental health services are already stretched and in our experience, this unique combination of symptoms and signs requires a multi‐disciplinary approach. We report our experience of establishing a paediatric psychodermatology clinic where, at each appointment, CYP are seen by a consultant dermatologist and a clinical psychologist initially jointly and then individually to ensure all viewpoints are heard and a collaborative treatment plan can be agreed. The clinic was established one month prior to the national lockdown during the COVID‐19 pandemic and the face‐to‐face model was converted to a virtual format. CYP are now seen either face to face or virtually according to CYP/parent/carer preference and this hybrid model increases accessibility and has reduced DNA rates. Referrals were received from primary, secondary and tertiary care settings. Thirty –six new patients were seen and followed‐up over a 2 year period, age range 3–17 years old. The majority of patients presented with compulsive hair pulling (trichotillomania) and medically unexplained signs (dermatitis artefacta); other problems seen were eczema, skin picking and acne. Half of the patients required additional psychology sessions. Seventy‐six percent of patients have been discharged, almost half back to the care of their general practitioner. We use pre‐ and post‐clinic questionnaires and share these and feedback from CYP/families who have found this clinic model helpful and effective. Establishing and developing a paediatric psychodermatology service and our experience of a new paediatric psychodermatology clinic during the Covid 19 pandemic

Fancy Nancy and her class learn about poetry and write their own poems to read on Family Day at school.

Researchers and society in general seem to be conflicted regarding the use of digital technology in early childhood education (ECE). Some are focusing on the positive aspects of using digital technology, while others are critical and position it as an enemy of early childhood practice. It has been argued that digital technology is not appropriate for young children’s cognitive, physical, social and emotional development. Nevertheless, supporting and developing young children’s beginning digital competence is implemented in curricula and teacher education globally. The need for teachers’ professional digital competence (PDC) is increasing according to the development and increased use of digital technology in society as a whole, including in the field of education. The field of research has, to a large extent, been focused on primary and secondary education, and there is a lack of research on PDC in ECE. To gain insight into the dynamics of PDC in ECE, we investigated a range of ECE contexts by including different international perspectives in a comparative study of pre-service early childhood (EC) teachers transitioning to being in-service teachers. The survey was conducted in eight different nations (Norway, Slovenia, Portugal, Poland, Turkey, Ukraine, England and Jordan) and resulted in 772 responses from pre-service teachers in the last year of their education. The paper discusses these international perspectives, considering the differences found between nations. It also investigates the dynamics of PDC, understood in this article as comprising attitudes, skills and knowledge. Following this, it also investigates how these dynamics are affecting the pre-service teachers’ expectations related to their future application of digital tools as teachers to be. The results indicate large differences between nations for both single items and multi-item scales. At the same time, the dynamics of digital practices across nations reveal that attitudes, digital skills and knowledge are statistically strong predictors of pre-service teachers’ future use of educational digital technology (EDT). This indicates both similarities and differences across nations and could serve as insight regarding the development of teacher programmes and the importance of including all aspects when developing pre-service teachers’ PDC. This article, due to its limitation, will not elaborate in depth on contextual differences, and further qualitative research is needed to understand the complexity related to educational culture and practice.