Common Practice for Behavioral Health Screening in Pediatric Primary Care Settings

Mental health disorders in the United States are highly prevalent, affecting 14-20% of children yearly. Only 25-35% receive treatment after on average a six-plus year delay from symptom onset. Current recommendations suggest primary care physicians/providers (PCP) manage mental health conditions, however, PCPs are wary, citing lack of time, training and resources.This study evaluated pediatric/adolescent PCPs using a self-report questionnaire assessing knowledge/skill, clinical practice (e.g. screening tool) and perceived barriers when managing attention deficit hyperactivity disorder (ADHD), anxiety and depression (N = 11). Self-reported knowledge/skill diagnosing, treating and referring each disorder were recorded on a 5-point Likert scale and evaluated using repeated-measures ANOVA with post-hoc Bonferroni tests. Percentages of providers screening for each disorder were calculated (91% for depression, 55% for ADHD and 9% for anxiety). Results showed significant differences in self-reported skill diagnosing the conditions assessed, and in self-reported skill treating the conditions assessed, F (2, 20) = 13.671, p F (2, 20) = 14.933, p p = 0.01), and the significant differences in skill treating were between ADHD (M=3.45, SD=0.688) and anxiety (M=2.36, SD=0.5, p \u3c 0.001), and between ADHD and depression (M=2.73, SD=0.9, p = 0.036). Providers were unlikely to screen for anxiety indicating an area where PCPs could improve their management of mental health disorders. Further study may reveal differences in clinical practice and perceived barriers to increased PCP screening and management

Should Central Banks Use Distributed Ledger Technology and Digital Currencies to Advance Financial Inclusion?

This paper examines how central banks might use distributed ledger technology (“DLT”) to improve access to safe and affordable financial products and services. We consider how central banks might use DLT to advance objectives such as Anti-Money Laundering (“AML”) compliance and discuss both central bank digital currencies (“CBDC”) and private digital currencies. We consider implementation challenges for these new approaches relating to interoperability, privacy, and efficiency. We conclude that financial inclusion is far from an assured outcome: central banks must work to ensure that any new technologies they adopt or foster do not exclude marginalized groups and instead focus with intentionality on low-income households. Moreover, difficult issues with respect to financial disintermediation, credit availability, and financial stability would need to be addressed

Homogeneous Cu-Fe super saturated solid solutions prepared by severe plastic deformation

A Cu-Fe nanocomposite containing 50 nm thick iron filaments dispersed in a copper matrix was processed by torsion under high pressure at various strain rates and temperatures. The resulting nanostructures were characterized by transmission electron microscopy, atom probe tomography and M\"ossbauer spectrometry. It is shown that alpha-Fe filaments are dissolved during severe plastic deformation leading to the formation of a homogeneous supersaturated solid solution of about 12 at.% Fe in fcc Cu. The dissolution rate is proportional to the total plastic strain but is not very sensitive to the strain rate. Similar results were found for samples processed at liquid nitrogen temperature. APT data revealed asymmetric composition gradients resulting from the deformation induced intermixing. On the basis of these experimental data, the formation of the supersaturated solid solutions is discusse

Academic freedom in Europe: time for a Magna Charta?

This paper is a preliminary attempt to establish a working definition of academic freedom for the European Union states. The paper details why such a definition is required for the European Union and then examines some of the difficulties of defining academic freedom. By drawing upon experience of the legal difficulties beset by the concept in the USA and building on previous analyses of constitutional and legislative protection for academic freedom, and of legal regulations concerning institutional governance and academic tenure, a working definition of academic freedom is then derived. The resultant definition which, it is suggested, could form the basis for a European Magna Charta Libertatis Academicae, goes beyond traditional discussions of academic freedom by specifying not only the rights inherent in the concept but also its accompanying duties, necessary limitations and safeguards. The paper concludes with proposals for how the definition might be tested and carried forward

Academic freedom: in justification of a universal ideal

This paper examines the justification for, and benefits of, academic freedom to academics, students, universities and the world at large. The paper surveys the development of the concept of academic freedom within Europe, more especially the impact of the reforms at the University of Berlin instigated by Wilhelm von Humboldt. Following from this, the paper examines the reasons why the various facets of academic freedom are important and why the principle should continue to be supported

Rise and Fall of a Multi-sheet Intrusive Complex, Elba Island, Italy

Elba Island intrusive complex: multisheet laccoliths, sheeted pluton, mafic dyke swarm. Laccolith magma fed from dykes and emplaced in crustal discontinuities (traps). Pluton growth by downward stacking of three magma pulses. Laccoliths and plutons: different outcomes of similar processes in different conditions. Emplacement of excess magma in a short time led to massive gravity slide

Explosive volcanism in complex impact craters on Mercury and the Moon: influence of tectonic regime on depth of magmatic intrusion

Vents and deposits attributed to explosive volcanism occur within numerous impact craters on both the Moon and Mercury. Given the similarities between the two bodies it is probable that similar processes control this spatial association on both. However, the precise morphology and localization of the activity differs on the two bodies, indicating that the nature of structures beneath impact craters and/or volcanic activity may also be different. To explore this, we analyze sites of explosive volcanism within complex impact craters on the Moon and Mercury, comparing the scale and localization of volcanic activity and evidence for post-formation modification of the host crater. We show that the scale of vents and deposits is consistently greater on Mercury than on the Moon, indicating greater eruption energy, powered by a higher concentration of volatiles. Additionally, while the floors of lunar craters hosting explosive volcanism are commonly fractured, those on Mercury are not. The most probable explanation for these differences is that the state of regional compression acting on Mercury's crust through most of the planet's history results in deeper magma storage beneath craters on Mercury than on the Moon. The probable role of the regional stress regime in dictating the depth of intrusion on Mercury suggests that it may also play a role in the depth of sub-crater intrusion on the Moon and on other planetary bodies. Examples on the Moon (and also on Mars) commonly occur at locations where flexural extension may facilitate shallower intrusion than would be driven by the buoyancy of the magma alone

PRAS40 and PRR5-Like Protein Are New mTOR Interactors that Regulate Apoptosis

TOR (Target of Rapamycin) is a highly conserved protein kinase and a central controller of cell growth. TOR is found in two functionally and structurally distinct multiprotein complexes termed TOR complex 1 (TORC1) and TOR complex 2 (TORC2). In the present study, we developed a two-dimensional liquid chromatography tandem mass spectrometry (2D LC-MS/MS) based proteomic strategy to identify new mammalian TOR (mTOR) binding proteins. We report the identification of Proline-rich Akt substrate (PRAS40) and the hypothetical protein Q6MZQ0/FLJ14213/CAE45978 as new mTOR binding proteins. PRAS40 binds mTORC1 via Raptor, and is an mTOR phosphorylation substrate. PRAS40 inhibits mTORC1 autophosphorylation and mTORC1 kinase activity toward eIF-4E binding protein (4E-BP) and PRAS40 itself. HeLa cells in which PRAS40 was knocked down were protected against induction of apoptosis by TNFα and cycloheximide. Rapamycin failed to mimic the pro-apoptotic effect of PRAS40, suggesting that PRAS40 mediates apoptosis independently of its inhibitory effect on mTORC1. Q6MZQ0 is structurally similar to proline rich protein 5 (PRR5) and was therefore named PRR5-Like (PRR5L). PRR5L binds specifically to mTORC2, via Rictor and/or SIN1. Unlike other mTORC2 members, PRR5L is not required for mTORC2 integrity or kinase activity, but dissociates from mTORC2 upon knock down of tuberous sclerosis complex 1 (TSC1) and TSC2. Hyperactivation of mTOR by TSC1/2 knock down enhanced apoptosis whereas PRR5L knock down reduced apoptosis. PRR5L knock down reduced apoptosis also in mTORC2 deficient cells. The above suggests that mTORC2-dissociated PRR5L may promote apoptosis when mTOR is hyperactive. Thus, PRAS40 and PRR5L are novel mTOR-associated proteins that control the balance between cell growth and cell death