Physical optics simulations for beamlines and experiments allow users to test experiment feasibility and optimize beamline settings ahead of beam time in order to optimize valuable beam time at synchrotron light sources like NSLS-II. Further, such simulations also help to develop and test experimental data processing methods and software in advance. The Synchrotron Radiation Workshop (SRW) software package supports such complex simulations. We demonstrate how recent developments in SRW significantly improve the efficiency of physical optics simulations, such as end-to-end simulations of time-dependent X-ray photon correlation spectroscopy experiments with partially coherent undulator radiation (UR). The molecular dynamics simulation code LAMMPS was chosen to model the sample: a solution of silica nanoparticles in water at room temperature. Real-space distributions of nanoparticles produced by LAMMPS were imported into SRW and used to simulate scattering patterns of partially coherent hard X-ray UR from such a sample at the detector. The partially coherent UR illuminating the sample can be represented by a set of orthogonal coherent modes obtained by simulation of emission and propagation of this radiation through the coherent hard X-ray (CHX) scattering beamline followed by a coherent-mode decomposition. GPU acceleration is added for several key functions of SRW used in propagation from sample to detector, further improving the speed of the calculations. The accuracy of this simulation is benchmarked by comparison with experimental data.

Coherent X-ray imaging is an active field at synchrotron sources. The images rely on the available coherent flux over a limited field of view. At many synchrotron beamlines a double-crystal monochromator (DCM) is employed in a standard nondispersive arrangement. For coherent diffraction imaging it is advantageous to increase the available field of view by increasing the spatial coherence length (SCL) of a beam exiting such a DCM. Here, Talbot interferometry data together with ray-tracing simulations for a (+ − − +) four-reflection experimental arrangement are presented, wherein the first two reflections are in the DCM and the final fourth reflection is asymmetric at grazing exit. Analyses of the interferometry data combined with the simulations show that compared with the beam exiting the DCM a gain of 76% in the SCL was achieved, albeit with a factor of 20 reduction in flux density, which may not be a severe penalty at a synchrotron beamline. Previous efforts reported in the literature to increase the SCL that employed asymmetric crystal diffraction at grazing incidence are also discussed. A much reduced SCL is found presently in simulations wherein the same asymmetric crystal is set for grazing incidence instead of grazing exit. In addition, the present study is compared and contrasted with two other means of increasing the SCL. These are (i) focusing the beam onto an aperture to act as a secondary source, and (ii) allowing the beam to propagate in vacuum an additional distance along the beamline.

Bragg coherent X-ray diffraction imaging (BCDI) has emerged as a powerful technique for strain imaging and morphology reconstruction of nanometre-scale crystals. However, BCDI often suffers from angular distortions that appear during data acquisition, caused by radiation pressure, heating or imperfect scanning stages. This limits the applicability of BCDI, in particular for small crystals and high-flux X-ray beams. Here, we present a pre-processing algorithm that recovers the 3D datasets from the BCDI dataset measured under the impact of large angular distortions. We systematically investigate the performance of this method for different levels of distortion and find that the algorithm recovers the correct angles for distortions up to 16.4× (1640%) the angular step size dθ = 0.004°. We also show that the angles in a continuous scan can be recovered with high accuracy. As expected, the correction provides marked improvements in the subsequent phase retrieval.

The inherent ambiguity in reconstructed images from coherent diffraction imaging (CDI) poses an intrinsic challenge, as images derived from the same dataset under varying initial conditions often display inconsistencies. This study introduces a method that employs the Noise2Noise approach combined with neural networks to effectively mitigate these ambiguities. We applied this methodology to hundreds of ambiguous reconstructed images retrieved from a single diffraction pattern using a conventional retrieval algorithm. Our results demonstrate that ambiguous features in these reconstructions are effectively treated as inter-reconstruction noise and are significantly reduced. The post-Noise2Noise treated images closely approximate the average and singular value decomposition analysis of various reconstructions, providing consistent and reliable reconstructions.

Evidence that the electronic structure of atoms persists in molecules to a much greater extent than has been usually admitted is presented. This is achieved by resorting to N-electron real-space descriptors instead of one- or at most two-particle projections like the electron or exchange-correlation densities. Here, the 3N-dimensional maxima of the square of the wavefunction, the so-called Born maxima, are used. Since this technique is relatively unknown to the crystallographic community, a case-based approach is taken, revisiting first the Born maxima of atoms in their ground state and then some of their excited states. It is shown how they survive in molecules and that, beyond any doubt, the distribution of electrons around an atom in a molecule can be recognized as that of its isolated, in many cases excited, counterpart, relating this fact with the concept of energetic promotion. Several other cases that exemplify the applicability of the technique to solve chemical bonding conflicts and to introduce predictability in real-space analyses are also examined.

A deep-learning algorithm is proposed for the inpainting of Bragg coherent diffraction imaging (BCDI) patterns affected by detector gaps. These regions of missing intensity can compromise the accuracy of reconstruction algorithms, inducing artefacts in the final result. It is thus desirable to restore the intensity in these regions in order to ensure more reliable reconstructions. The key aspect of the method lies in the choice of training the neural network with cropped sections of diffraction data and subsequently patching the predictions generated by the model along the gap, thus completing the full diffraction peak. This approach enables access to a greater amount of experimental data for training and offers the ability to average overlapping sections during patching. As a result, it produces robust and dependable predictions for experimental data arrays of any size. It is shown that the method is able to remove gap-induced artefacts on the reconstructed objects for both simulated and experimental data, which becomes essential in the case of high-resolution BCDI experiments.

Coherent diffractive imaging with X-ray free-electron lasers could enable structural studies of macromolecules at room temperature. This type of experiment could provide a means to study structural dynamics on the femtosecond timescale. However, the diffraction from a single protein is weak compared with the incoherent scattering from background sources, which negatively affects the reconstruction analysis. This work evaluates the effects of the presence of background on the analysis pipeline. Background measurements from the European X-ray Free-Electron Laser were combined with simulated diffraction patterns and treated by a standard reconstruction procedure, including orientation recovery with the expand, maximize and compress algorithm and 3D phase retrieval. Background scattering did have an adverse effect on the estimated resolution of the reconstructed density maps. Still, the reconstructions generally worked when the signal-to-background ratio was 0.6 or better, in the momentum transfer shell of the highest reconstructed resolution. The results also suggest that the signal-to-background requirement increases at higher resolution. This study gives an indication of what is possible at current setups at X-ray free-electron lasers with regards to expected background strength and establishes a target for experimental optimization of the background.

Jason Statham's character H in the film "Wrath of Man"; Credit: Metro Goldwyn Mayer Pictures

This content is from Southern California Public Radio. View the original story at SCPR.org.

File: Queen's Freddie Mercury has his mustache groomed.
; Credit: Steve Wood/Express/Getty Images

The new Queen compilation "Queen Forever" includes three previously unreleased tracks, but the one that has people talking is a collaboration between two legends: Freddie Mercury and Michael Jackson.

The new song, "There Must Be More to Life Than This," was an unfinished track recorded during studio sessions for the 1981 Queen album "Hot Space," according to a press release on the new compilation. Queen also looked at the song for 1984's "The Works," but still don't go with it — the song finally landed, sans Jackson, on 1985's Mercury solo album "Mr. Bad Guy."

Listen to the new version of the song here:

Michael Jackson/Queen Soundcloud

Listen to the originally recorded version of the Queen/Jackson collaboration below:

Michael Jackson/Queen collabo

The new version was produced by William Orbit, who also did a remix of the song.

"Hearing Michael Jackson's vocals was stirring. So vivid, so cool, and poignant, it was like he was in the studio singing live. With Freddie's vocal solo on the mixing desk, my appreciation for his gift was taken to an even higher level," Orbit said in a press release.

The song is a call for peace, talking human rights in a general way. It almost didn't end up on the album — Queen's Brian May said that working with the Jackson family and Jackson's estate was like "wading through glue," according to Philly.com, but the track ended up making the cut.

The album also includes unreleased song "Let Me In Your Heart Again" and a new version of a song Mercury released solo, an acoustic take on "Love Kills." "Let Me In Your Heart Again" was previously recorded and released by May's wife Anita Dobson.

"Freddie sounds as fresh as yesterday," May said at a press conference while the new compilation was in the works.

Listen to Mercury's solo version of "There Must Be More to Life Than This" below:

There Must Be More To Life Than This, solo

Listen to Anita Dobson's version of "Let Me In (Your Heart Again)" below:

Anita Dobson track

Many hospitals around the country, including Medstar Washington Hospital in Washington DC., have started sharing their prices online in compliance with a recent federal rule.; Credit: DANIEL SLIM/AFP via Getty Images

A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use.

Long hidden, such price variations are supposed to be available in stark black and white under a Trump administration price transparency rule that took effect at the start of this year. It requires hospitals to post a range of actual prices — everything from the rates they offer cash-paying customers to costs negotiated with insurers.

Many have complied.

But some hospitals bury the data deep on their websites or have not included all the categories of prices required, according to industry analysts. A sizable minority of hospitals have not disclosed the information at all.

While imperfect and potentially of limited use right now to the average consumer, the disclosures that are available illustrate the huge differences in prices — nationally, regionally and within the same hospital. But they're challenging for consumers and employers to use, giving a boost to a cottage industry that analyzes the data.

While it's still an unanswered question whether price transparency will lead to overall lower prices, KHN took a dive into the initial trove of data to see what it reveals. Here are five takeaways from the newly public data and tips for how you might be able to use it to your benefit

1) As expected, prices are all over the map

The idea behind the requirement to release prices is that the transparency may prompt consumers to shop around, weighing cost and quality. Perhaps they could save a few hundred dollars by getting their surgery or imaging test across town instead of at the nearby clinic or hospital.

Under the Trump-era rule, hospitals must post what they accept from all insurers for thousands of line items, including each drug, procedure or treatment they provide. In addition, hospitals must present this in a format easily readable by computers and include a consumer-friendly separate listing of 300 "shoppable" services, bundling the full price a hospital accepts for a given treatment, such as having a baby or getting a hip replacement.

The negotiated rates now being posted publicly often show an individual hospital accepting a wide range of prices for the same service, depending on the insurer, often based on how much negotiating power each has in a market.

In some cases, the cash-only price is less than what insurers pay. And prices may vary widely within the same city or region.

In Virginia, for example, the average price of a diagnostic colonoscopy is $2,763, but the range across the state is from $208 to $10,563, according to a database aggregated by San Diego-based Turquoise Health, one of the new firms looking to market the data to businesses, while offering some information free of charge to patients.

2) Patients can look up the information, but it's incomplete

Patients can try to find the price information themselves by searching hospital websites, but even locating the correct tab on a hospital's website is tricky.

Typically, consumers don't comparison-shop, preferring to choose convenience or the provider their doctor recommends. A recent Peterson-KFF Health System Tracker brief, for instance, found that 85% of adults said they had not researched online the price of a hospital treatment.

And hospitals say the transparency push alone won't help consumers much, because each patient's situation is different and may vary from the average— and individual deductibles and insurance plans complicate matters.

But if you do want to try, here's one tip: "You can Google the hospital name and the words 'price transparency' and see where that takes you," says Caitlin Sheetz, director and head of analytics at the consulting firm ADVI Health in the Washington, D.C., metro area.

Typing in "MedStar Health hospital transparency," for example, likely points to the MedStar Washington Hospital Center's "price transparency disclosure" page, with a link to its full list of prices, as well as its separate list of 300 shoppable services.

By clicking on the list of shoppable services, consumers can download an Excel file. Searching it for "colonoscopy" pulls up several variations of the procedure, along with prices for different insurers, such as Aetna and Cigna, but a "not available" designation for the cash-only price. The file explains that MedStar does not have a standard cash price but makes determinations case by case.

Performing the same Google search for the nearby Inova health system results in less useful information.

Inova's website links to a long list of thousands of charges, which are not the discounts negotiated by insurers, and the list is not easily searchable. The website advises those who are not Inova patients or who would like to create their own estimate to log into the hospitals' "My Chart" system, but a search on that for "colonoscopy" failed to produce any data.

3) Third-party firms are trying to make searching prices simpler – and cash in

Because of the difficulty of navigating these websites — or locating the negotiated prices once there — some consumers may turn to sites like Turquoise. Another such firm is Health Cost Labs, which will have pricing information for 2,300 hospitals in its database when it goes live July 1.

Doing a similar search for "colonoscopy" on Turquoise shows the prices at MedStar by insurer, but the process is still complicated. First, a consumer must select the "health system" button from the website's menu of options, click on "surgical procedures," then click again on "digestive" to get to it.

There is no similar information for Inova because the hospital has not yet made its data accessible in a computer-friendly format, said Chris Severn, CEO of Turquoise.

Inova spokesperson Tracy Connell said in a written statement that the health system will create personalized estimates for patients and is "currently working to post information on negotiated prices and discounts on services."

Firms like Turquoise and Health Cost Labs aim to sell the data gathered from hospitals nationally to insurers, employers and others. In turn, those groups may use it in negotiations with hospitals over future prices. While that may drive down prices in areas with a lot of competition, it might do the opposite where there are few hospitals to choose from, or in situations where a hospital raises its prices to match competitors.

4) Consumers could use this data to negotiate, especially if they're paying cash

For consumers who go the distance and can find price data from their hospitals, it may prove helpful in certain situations:

• Patients who are paying cash or who have unmet deductibles may want to compare prices among hospitals to see if driving farther could save them money.
• Uninsured patients could ask the hospital for the cash price or attempt to negotiate for the lowest amount the facility accepts from insurers.
• Insured patients who get a bill for out-of-network care may find the information helpful because it could empower them to negotiate a discount off the hospitals' gross charges for that care.

While there's no guarantee of success, "if you are uninsured or out of network, you could point to some of those prices and say, 'That's what I want,'" says Barak Richman, a contract law expert and professor of law at Duke University School of Law.

But the data may not help insured patients who notice their prices are higher than those negotiated by other insurers.

In those cases, legal experts say the insured patients are unlikely to get a bill changed because they have a contract with that insurer, which has negotiated the price with their contracted hospitals.

"Legally, a contract is a contract," says Mark Hall, a health law professor at Wake Forest University.

Richman agrees.

"You can't say, 'Well, you charged that person less,'" he notes, but neither can they say they'll charge you more.

Getting the data, however, relies on the hospital having posted it.

5) Hospitals still aren't really on board

When it comes to compliance, "we're seeing the range of the spectrum," says Jeffrey Leibach, a partner at the consulting firm Guidehouse, which found earlier this year that about 60% of 1,000 hospitals surveyed had posted at least some data, but 30% had reported nothing at all.

Many in the hospital industry have long fought transparency efforts, even filing a lawsuit seeking to block the new rule. The suit was dismissed by a federal judge last year.

They argue the rule is unclear and overly burdensome. Additionally, hospitals haven't wanted their prices exposed, knowing that competitors might then adjust theirs, or health plans could demand lower rates. Conversely, lower-cost hospitals might decide to raise prices to match competitors.

The rule stems from requirements in the Affordable Care Act. The Obama administration required hospitals to post their chargemaster rates, which are less useful because they are generally inflated, hospital-set amounts that are almost never what is actually paid.

Insurers and hospitals are also bracing for next year when even more data is set to come online. Insurers will be required to post negotiated prices for medical care across a broader range of facilities, including clinics and doctors' offices.

In May, the Centers for Medicare & Medicaid Services sent letters to some of the hospitals that have not complied, giving them 90 days to do so or potentially face penalties, including a $300-a-day fine.

"A lot of members say until hospitals are fully compliant, our ability to use the data is limited," says Shawn Gremminger, director of health policy at the Purchaser Business Group on Health, a coalition of large employers.

His group and others have called for increasing the penalty for noncomplying hospitals from $300 a day to $300 a bed per day, so "the fine would be bigger as the hospital gets bigger," Gremminger says. "That's the kind of thing they take seriously."

Already, though, employers or insurers are eyeing the hospital data as leverage in negotiations, says Severn, Turquoise's CEO. Conversely, some employers may use it to fire their insurers if the rates they're paying are substantially more than those agreed to by other carriers.

"It will piss off anyone who is overpaying for health care, which happens for various reasons," he says.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation).

This content is from Southern California Public Radio. View the original story at SCPR.org.

#FreeBritney activists protest outside the Los Angeles Superior Court during one of Britney Spears' hearings this April.; Credit: Matt Winkelmeyer/Getty Images

Pop star Britney Spears hasn't been in charge of her personal life or her finances for 13 years — that's how long she has been in a court-dictated legal arrangement called a conservatorship.

But on Wednesday, the artist will be speaking directly, albeit from a remote location, to a Los Angeles Superior Court judge about her situation. What exactly she intends to say in her appearance and what her goals might be are anyone's guess.

Before then, here's a quick look at what conservatorships are and why they exist, the specifics of Spears' arrangements, the #FreeBritney movement and what Spears and others have said publicly — and privately — about her conservatorship.

What is a conservatorship, and why does one get put in place?

Typically, legal and financial conservatorships are arranged for people who are unable to make their own decisions in their own best self-interest, such as in the case of an elderly person or someone with some kind of cognitive impairment.

Why does Britney Spears have one?

The exact reasons that the 39-year-old Spears is under a conservatorship have not been publicly disclosed. She lost her autonomy 13 years ago, in 2008, after apparently suffering a mental health crisis.

During the time that Spears has lived under this arrangement, though, she has released four albums (two of which, 2008's Circus and 2011's Femme Fatale, achieved platinum sales); appeared as a judge on both The X Factor and American Idol; and had a four-year residency in Las Vegas that reportedly grossed close to $138 million. Those accomplishments don't exactly line up with the typical profile of someone unable to look after themselves.

What does Spears' conservatorship cover?

Essentially, it controls all the major aspects of Spears' life, including decisions regarding her financial, medical and personal well-being. The conservators also oversee visitation arrangements with her two teenage sons, who are under the full custody of her ex-husband, Kevin Federline.

According to Forbes, Spears' current net worth is around $60 million.

Who controls Spears' conservatorship?

Up until recently, both the financial and personal arms of the conservatorship were controlled by Spears' father, Jamie Spears.

In 2020, her lawyer, Samuel D. Ingham III, stated in a filing that Spears "strongly opposed" her father as conservator and that she refused to perform if he remained in charge of her career. Spears asked the court for her father to be suspended from his role as conservator. (He had temporarily stepped away in 2019 for health reasons.)

In February, Los Angeles Superior Court Judge Brenda Penny overruled an objection from Jamie Spears to having a third party help look after his daughter's financial affairs. A wealth-management company, Bessemer Trust, is now a co-conservator for the financial side of Spears' situation. But Jamie Spears is still the main conservator for all other aspects of Spears' arrangement.

Why is Spears planning to talk to the court now?

Back in April, Spears' legal team asked Penny to allow her to speak to the court directly about the conservatorship, and they agreed that June 23 would be the date for this to happen. At the time, Ingham did not disclose why Spears wants to speak or what she intends to say.

Has Spears ever asked for the conservatorship to end?

Up until now, Spears has never voiced a desire for the conservatorship to be removed completely — at least not publicly. In a court filing, she has stated that the conservatorship "rescued her from a collapse, exploitation by predatory individuals and financial ruin" and allowed her to "regain her position as a world class entertainer."

But on Tuesday afternoon, The New York Times reported that it had obtained confidential court records that purport to show that Spears has opposed the conservatorship privately for years. The Times quoted a 2016 report from a court investigator assigned to Spears' case, in which the investigator wrote that Spears told her that the conservatorship had "become an oppressive and controlling tool against her" and that she wanted the arrangement to end quickly.

According to the Times, Spears told the court in 2019 that the conservatorship had forced her into a stay at a mental health facility, as well as into making public performances against her will. The article further reported that the conservatorship had dictated Spears' friendships, her dating life and her spending habits, even preventing her from refinishing kitchen cabinets according to her taste.

As early as 2014, the article states, Spears wanted to consider removing her father from his prime role in the conservatorship, citing his reportedly heavy drinking.

Does Spears herself support the #FreeBritney movement?

Certain Spears fans have organized themselves into a grassroots movement — #FreeBritney — to help Spears regain autonomy over her life. The dynamics between Spears and her dedicated #FreeBritney fans are murky, as are her various declarations on social media.

In a court filing last September, her lawyer, Ingham, wrote: "At this point in her life when she is trying to regain some measure of personal autonomy, Britney welcomes and appreciates the informed support of her many fans."

On the other hand, Spears to date has never publicly asked to be released from the conservatorship and regain her autonomy — which is the main goal of #FreeBritney.

A very sympathetic New York Times television documentary, Framing Britney Spears, debuted on FX in February. The project reckons with the way the media, comedians and the music industry itself characterized Spears during her ascent to global fame and during her later, very public struggles — and it also profiles some #FreeBritney activists.

After it aired, Spears wrote on Instagram: "My life has always been very speculated [sic] ... watched ... and judged really my whole life !!! ... I didn't watch the documentary but from what I did see of it I was embarrassed by the light they put me in ... I cried for two weeks and well .... I still cry sometimes !!!!"

Some #FreeBritney supporters don't believe Spears writes her own Instagram messages, leaving them to speculate about the pop star's true feelings. But Spears reportedly told TMZ in April that she writes her own captions.

What's next for Britney Spears?

Unclear. In an Instagram video posted last week, a visibly jittery Spears professed to be answering fans' most burning questions, including her shoe size and her favorite business trip (answer: "a trip to Italy [to] Donatella Versace. ... She fined [sic] and dined us").

The last question Spears put forward to herself was a crucial one: Would she ever return to the stage again?

"I have no idea," she said. "I'm having fun right now. I'm in transition in my life, and I'm enjoying myself."

This content is from Southern California Public Radio. View the original story at SCPR.org.

As search and rescue efforts at the site of the Surfside, Fla., condo collapse stretch into day nine, officials have said that the number of confirmed fatalities has risen to 20, while the number of people unaccounted for has dropped from 145 to 128.

Miami-Dade County Mayor Daniella Levine Cava told reporters Friday that one of the two fatalities recovered overnight was the 7-year-old daughter of a firefighter for the city of Miami.

"It goes without saying that every night since this last Wednesday has been immensely difficult for everybody, particularly the families that have been impacted," Levine Cava said. "But last night was truly different and more difficult for our first responders. These men and women are paying an enormous human toll each every day, and I ask that all of you please keep all of them in your thoughts and prayers."

"They truly represent the very best in all of us, and we need to be there for them as they are here for us," she said.

The number of people who have been accounted for has grown to 188, officials also confirmed Friday. In many cases, detectives followed leads regarding individuals who were unaccounted for but then reached them and discovered they were safe.

They even discovered additional family members who were safe and who could have been in the building, and added them to the tally of accounted for individuals.

Officials have not yet released the names of all of the dead and missing people, and asked Friday that the privacy of the families be respected.

This content is from Southern California Public Radio. View the original story at SCPR.org.

To help keep weak swimmers safe, stay "touch-close" and don't rely on a busy lifeguard to be the only eyes on a crowded pool or beach. It's best, say experts working to prevent drownings, to designate a nondrinking adult to scan the water at any pool party or beach outing, and to rotate that "watching" shift every 30 minutes to keep fresh eyes on the kids.; Credit: Imgorthand/Getty Images

I'm going to let you in on one of the most important lessons I learned early on, in my years of training to become a doctor: Absolutely anyone can drown, or lose a loved one to a drowning.

The Centers for Disease Control and Prevention estimates that more than 3,900 people die from unintentional drowning in the US each year — with one in five under 14-years-old. And for each pediatric fatality, another five children require emergency care for nonfatal drownings that can cause irreversible organ damage.

Every patient or family I've cared for after a drowning accident has said they didn't think it could happen to them. And yet, it happens, along with the cruel "if onlys" that haunt cautious and well-intentioned people in the aftermath: "If only I'd done something different, or known what to look for." I hear this again and again, especially from those who've lost a child.

Unfortunately, research shows that in the majority of drowning cases, the child was being supervised by an adult when the accident happened. So, as our summer of post-vaccination reunions and vacations heats up, remember just how vulnerable kids are in water. The rate of admissions for nonfatal drownings at the Arnold Palmer Children's Hospital in Orlando, for example, was already double in May what it was in the last three years at that same time.

Among basic water supervision precautions, a few potentially life-saving details are often overlooked. Here are some essentials to help keep our young swimmers safe this summer:

Follow the 'arm's length' rule

It may sound commonsensical to stay close by when kids are in or near a pool or other body of water, but it's important to know what safety experts consider close enough supervision to avoid a drowning event.

The American Academy of Pediatrics recommends that adults who are supervising a child of any age who isn't a strong swimmer should be within one arm's length at all times when kids are in the water, offering "touch supervision" this way.

Dr. Andrew Schmidt, a lifeguard-turned-ER doctor at University of Florida Health-Jacksonville and an expert in water safety, notes the definition of a "strong swimmer" is subjective — and overestimating a child's independence in the water has led to tragic accidents.

Schmidt falls back on the way the American Red Cross, a longtime leader in teaching water safety, defines a "water competent" swimmer. According to the Red Cross guidelines , someone is water-competent if they find themselves in water over their head and are able to:

• Swim to the surface after being submerged, then float or tread water for at least one minute.
• Swim in a full circle and find an exit, then swim about 25 yards to that exit.
• Get out of the water on their own, which means exiting the water without a ladder if they're in a pool.

That's a good starting point for judging kids' vulnerability in the water, but adults still need to stay vigilant. "Even a strong swimmer can get into trouble," warns Dr. Terri McFadden, a professor in the department of pediatrics at Emory University's School of Medicine and medical director of the Injury Free Coalition for Kids in Atlanta.

Treat water safety supervision like a job

Calling appropriate water supervision an "intense job," McFadden is quick to remind the parents of her patients to stay alert even if the child is a proficient swimmer.

Having older kids or young teens — or adults that are weak swimmers — acting as chaperones isn't safe, she says. And if you're the adult in charge, doing anything that draws your eyes away from the water for just a moment is risky. Reading, using your phone in any capacity, socializing, fiddling with the bluetooth speaker or doing household chores – all such lapses are dangerous when children are swimming or playing in water. Drowning accidents have happened in the time it takes for a caretaker to run inside just long enough to put wet clothes in the dryer, or while they were looking on from a kitchen window and doing dishes. No distraction is quick enough to be safe when it comes to kids in or around water – not seconds, not minutes.

Mcfadden is among many leaders in child safety who recommend assigning an adult "watcher" at the pool or waterfront who can agree to be totally attentive for a brief period of time (15 to 30 minutes or so), then switching to another watcher in intervals; short spurts of duty making it easier to stay focused. It doesn't matter at a pool party that there are a dozen responsible adults nearby; if there isn't one pair of mature eyes devoted to watching the young swimmers 100% of the time, the risk of a deadly accident goes up.

Similarly, it's never safe to simply rely on lifeguards. Though trained to scan for emergencies and quickly respond, they can also get distracted, especially when there are lots of people bobbing along or jumping in and out of the water.

Stay sober when you're the adult in charge

There's also been a well-documented spike in alcohol use during the pandemic, and coupling that increase with an uptick in warm weather and waterside celebrations with friends and family can be a drowning accident waiting to happen.

Not only does alcohol lower our level of alertness and slow the reflexes needed to act quickly when we spot danger, it will also make swimming and helping someone to safety slower and more difficult as well.

And I'm not just talking about avoiding being drunk; cognitive processes and reflexes can slow after just a drink or two. Should something bad happen, it's not worth the heartbreak of wondering if the outcome could have been different without alcohol — something I've witnessed first-hand among some families of drowning victims.

The safest bet is to designate one fully sober adult as the watcher for 15 to 30 minutes at a time when kids are in or near the water. "Sober" means those adults agree to not use any mind-altering substances in that time — not alcohol, marijuana or even some allergy medicines or other prescription drugs that can cause drowsiness.

Use the safest life jacket, but don't rely on it alone

Life jackets do provide an added layer of protection against drowning, and most states require kids to wear them at all times when on a boat — regardless of their swimming strength.

Water safety and drowning experts recommend kids only wear life vests or jackets that are US Coast Guard-approved, which includes many different brands and will be noted clearly on the tag or printed onto the life jacket itself, along with a number that tells you what federal regulation it's approved under.

Pay close attention to what's printed there; the labels will tell you if it's not meant for weak or non-swimmers. You'll also find the weight range the vest is designed to fit. It should be nice and snug; wearing a loose life vest is like not wearing one at all.

Schmidt also cautions parents against relying on any unregulated flotation devices — including arm floaties, swimsuits with built-in floats or blow up neck rings. They may be cute, but can provide a false sense of safety that supports distracted supervision, he says.

Don't let shallow water deceive you

The risk to kids isn't equal to the depth of the water when we're talking about drowning. Small children can drown in baby pools, bathtubs or even household water buckets or tide pools — anything with enough water in it to cover their mouth and nose if they can't lift themselves out easily. They need adult supervision in these places, too.

And be forewarned — though child gates, locks and other safety measures are additional safety layers, if you've ever seen a kid use an iPhone you know that they're smart, and craftier than we realize. Most can still problem-solve their way around those barriers and into the water no matter the physical precautions.

Be ready to recognize what drowning or distress looks like

Parents and caretakers are often surprised to hear that drowning can look like nothing you'd notice, hear, or even expect — which is why it takes 100% visual and/or touch supervision to pick up the signs. The splashing, yelling and commotion you've seen in movies could certainly be a signal a child is in trouble, but it doesn't always happen that way.

Instead, be on the lookout for subtle and quick: a child motionless or face down in water or swimming upright but not making any progress forward; a lowered head, or a head tilted way back or with hair covering the eyes or face; a look of fear or doom in a child's eyes; or perhaps just a constant gaze toward shore or an exit/ladder. And a child that jumps or dives into the water but doesn't come up quickly could be missed without sharp visual supervision.

A swimmer of any skill level might need your help, and it can often take all of our senses on full-alert to identify a drowning in progress.

Swim classes are available for even very young kids. Enroll your child ASAP

Many 1-year-old babies can benefit from swim classes taught by a skilled instructor, according to the AAP. Children develop along different timelines, so check with your doctor to see if your child's ready to start.

And swim classes aren't just for beginners or kids — people of any age or ability can benefit. Even if you already know the fundamentals, swim instruction will help you expand your skills and be even safer in the water. Many instructors nowadays teach safety tactics like safer ways to jump into the water, how to safely escape an ocean's riptide or undertow, and how to save others from drowning without putting yourself in danger.

You can find classes through community pools, health departments or regional chapters of the American Red Cross or YMCA; some local nonprofits offer scholarships, so cost shouldn't be a barrier. Plus, the same groups can help you find CPR classes, which is a must for all chaperones and other adults — whether or not water is involved.

It's impossible to fully control environments where water and kids mix, but what we know about drowning is this: Sharp-eyed, adult supervision is key to prevention. And parents can't do it alone — if we all share the responsibility whenever we're near the water, we can save lives.

Dr. Kristen Kendrick is a board-certified family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Students work on a classroom exercise at a school in Kibera, a poor neighborhood in Nairobi, Kenya.; Credit: Tony Karumba/AFP via Getty Images

You'd think the best way to get girls to succeed in school would to be design programs specifically for them — offer them mental health support or free menstrual pads.

But a new study, published in May in the journal World Bank Economic Review, begs to differ. Researchers David Evans and Fei Yuan reviewed 267 studies of education programs from 54 low- and middle-income countries to find the most effective ways to get more girls in school and improve their learning. Globally, more than 130 million girls remain out of school, according to the World Bank, due to poverty, child marriage and violence.

Instead of only examining girls' education programs, they looked at all kinds of programs. To measure access, they analyzed enrollment rates, attendance, drop-out, graduation and completion rates, and to measure performance, they looked at test scores.

Their biggest finding is that gender-neutral programs — such as handing out cash aid to families of school-aged children — can be just as effective at improving girls' education as programs designed just for girls.

The study is among the first to look both at ways to boost girls' access to school as well as their classroom performance, says Markus Goldstein, lead economist at the World Bank's Africa Gender Innovation Lab, who did not work on the report.

We spoke with Evans, a senior fellow at the Center for Global Development, and Yuan, a doctoral candidate in education policy and program evaluation at Harvard University, to discuss the best ways to boost education for girls in low- and middle-income countries. This interview has been edited for length and clarity.

What inspired you to conduct this study?

Evans: A lot of the previous work that examined this issue have focused on programs targeted to needs that are unique to girls, such as menstrual health. Those are worthy interventions, but if we only focus on programs that target girls, we might miss programs that benefit girls a lot but happen to help boys as well.

That's why we decided to look at all of the interventions we know of to identify the ones that are most effective at improving outcomes for girls, regardless of whether they're specifically for girls or not.

You found that the most effective programs for getting more girls into school cut the cost of education for students, regardless of gender, and their families. What are some examples of programs that worked well?

Evans: A lot of the most effective programs are ones that either eliminate school fees, provide scholarships or provide families a cash transfer to cover the other costs of having their daughter in school.

For example, in Ghana, lots of girls and boys pass their secondary school entrance exam, but they don't have the money to pay school fees. So, a program there provided scholarships to students who had already passed the entrance exam. It dramatically increased the high-school graduation rate of girls by 66%.

But the most effective interventions are those that address costs related to specific obstacles that girls face in a particular setting. In Afghanistan, for example, a [non-gendered] program built schools in rural communities. It decreased [the cost of] travel to school for both girls and boys and led to a more than 50% increase in girls' participation in primary school. That's dramatic.

Which programs were the most helpful for improving a girl's school performance, as opposed to just getting them into the classroom?

Evans: The most effective interventions to increase learning were programs that improved the quality of teaching. But it's not just throwing teachers into a conference room and giving them some lecture. It's also not about throwing fancy technology, like laptops or tablets, at classrooms. Hardware doesn't work. It's distracting for teachers and students.

Instead, a literacy program – which included coaching teachers, providing them with detailed teachers' guides and providing students with books – had a big impact on girls' education [in terms of test scores] in Kenya. So did another program in Kenya that helped teachers to teach children in a language they spoke at home (rather than English).

Were there any other types of programs that helped girls learn better in the classroom?

Yuan: Another intervention worth mentioning is called Teaching at the Right Level, based in India. The idea is that students in the same classroom may have many different reading levels. But because of constraints like large class sizes, teachers may not be able to tailor their teaching to the right level for every student. This leaves some students behind.

Teaching at the Right Level facilitated summer camps in which children were grouped by reading level, instead of age or grade. This allowed teachers to target their teaching to the specific levels of these students. In one region, after 50 days of focused teaching in these camps, children at the lowest achievement levels in India were able to catch up to the learning level of the third-highest achieving state in the country.

Many of the high-impact interventions you're referencing don't target girls specifically. Are you saying that girls' programs aren't necessary?

Evans: Not at all! We particularly focused on how to increase access to education and improve quality of learning. Some [girl-focused] programs have other goals – such as reducing violence against girls, improving girls' psychological and emotional wellbeing, reducing adolescent pregnancy or helping girls to transition from school to the workforce.

But when teaching is of bad quality, we just need to help schools improve the teaching. That's not necessarily a gender-specific problem.

Wouldn't it be more cost-effective to just offer scholarships or cash transfers to girls only instead of both genders, especially if far fewer girls are attending school than boys?

Evans: Sure, if you don't have the budget to waive school fees for everyone, eliminating school fees for girls is an effective way to do a girl-targeted program. That's what The Gambia did. But sometimes general, non-targeted interventions are more politically palatable for governments, since constituents have both daughters and sons.

Were you concerned that some of the gender-neutral programs might benefit boys more than girls?

Evans: That was something we were worried about – increasing inequality. But we found that overall, the impact of gender-neutral programs tends to be slightly larger on girls than boys both in terms of access and learning. These differences, for the most part, were not statistically significant. They were small. But it does mean that these general, non-targeted interventions are not increasing inequality between boys and girls. If anything, they're likely to decrease it.

What changes do you hope to see in how we work on girls' education around the world?

Evans: We want to make sure that people who care about girls' education draw on the full toolbox of programs that can improve girls' education. That includes girl-targeted programs. It also includes general programs.

We don't anyone to walk away from this and say, 'Oh, we don't need to worry about girls.' Instead, it means that if we are worried about girls, we have a broader array of tools to help them.

Joanne Lu is a freelance journalist who covers global poverty and inequity. Her work has appeared in Humanosphere, The Guardian, Global Washington and War is Boring. Follow her on Twitter: @joannelu

This content is from Southern California Public Radio. View the original story at SCPR.org.

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