1,274 research outputs found

    From Abstraction to Documentary: Ernst Toller’s Plays as War Dramas

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    This article considers what the plays of Ernst Toller add to our conception of German literature about World War I. It interrogates the relevant themes that emerge in his plays: how the body at war is memorialized; the class divide as an instrument of militarism; and the responsibility to bear both sensory and documentary witness to war events. Though they are more frequently ascribed to Nachkriegsdrama or Heimkehrerdrama, Toller’s plays from 1919-1930 illustrate a broader development in Kriegsliteratur from Expressionist abstraction to a more realistic treatment of historical particulars. Tracing this gradual development helps to further dispel the myth that the war experience was an unwelcome subject for German writers until the explosion onto the scene of Erich Maria Remarque and others and counters our previous overreliance on novels in studies of German war literature. It adds complexity and diversity to our understanding of German war literature, not only chronologically and in terms of genre, but thematically and stylistically as well

    Giving credit when credit is due : improvement initiatives in three diverse school districts to increase on-time graduation

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    One of the most important measures of success of a high school is its graduation rate. There are many factors that influence whether or not students graduate in the traditional four-year schedule. Student motivation and achievement certainly are primary reasons students may meet this expectation, but oftentimes there are other issues that contribute to the delay of on-time graduation. Sometimes these factors are actually beyond the control of the student. Frequent student mobility, socio-economic disadvantages, and behavioral issues are reasons that often impede on-time graduation for students. Students affected by these issues desperately need schools to be flexible and find options to keep them in school and on course to graduate with their cohort. Of the students who eventually drop out, one-third are behind in their coursework in the 9th grade (Alliance for Excellent Education, 2010)The purpose of this initiative was to examine the impact of student mobility, socio-economic distress, and chronic negative behavior on on-time graduation, as well, evaluate and develop programs and protocols that provide options to help students retain and regain credits needed to graduate with their cohort. This work studied students and personnel in three demographically different high schools in North Carolina: a large, urban school in Cary, NC drawing from an affluent area; a large school located near a military base in Fayetteville, NC; and a small, mountain school serving many students who are socio-economically disadvantaged in Murphy, NC.Data were gathered through the spring, summer, and fall semesters of 2015. The research practitioners investigated data drawn from a variety of credit recovery and retention options, including, a personalized registration program and several on-line programs, such as GradPoint, Study Island, and Edgenuity. One research practitioner also identified effective strategies to create a training program for school counselors to assist students in retaining and regaining credits toward graduation. This qualitative data gives voice to the students who often have no voice when it comes to making decisions when they fall behind their cohort, and provides counselors with the tools to assist these students. Qualitative data were gathered through a variety of research methods, including surveys, interviews, case studies, and focus groups. These methods were selected because of their ability to solicit the thoughts, feelings, and experiences of those participating in the improvement change (Creswell, 2012). The intent of this work was to increase options for students at risk of not graduating on time, thereby improving their chance of staying in school and graduating with their cohort

    Deep Brain Stimulation Targeting the Fornix for Mild Alzheimer Dementia: Design of the ADvance Randomized Controlled Trial

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    Background: There are currently few available treatments and no cure for Alzheimer disease (AD), a growing public health burden. Animal models and an open-label human trial have indicated that deep brain stimulation (DBS) of memory circuits may improve symptoms and possibly slow disease progression. The ADvance trial was designed to examine DBS of the fornix as a treatment for mild AD. Methods: ADvance is a randomized, double-blind, placebo-controlled, delayed-start, multicenter clinical trial conducted at six sites in the US and one site in Canada. Eighty-five subjects initially consented to be screened for the trial. Of these, 42 subjects who met inclusion and exclusion criteria were implanted with DBS leads anterior to the columns of the fornix bilaterally. They were randomized 1:1 to DBS off or DBS on groups for the initial 12 months of follow-up. After 1 year, all subjects will have their devices turned on for the remainder of the study. Postimplantation, subjects will return for 13 follow-up visits over 48 months for cognitive and psychiatric assessments, brain imaging (up to 12 months), and safety monitoring. The primary outcome measures include Alzheimer\u27s Disease Assessment Scale -- cognitive component (ADAS-cog-13), Clinical Dementia Rating sum of boxes (CDR-SB), and cerebral glucose metabolism measured with positron emission tomography. This report details the study methods, baseline subject characteristics of screened and implanted participants, and screen-to-baseline test€“retest reliability of the cognitive outcomes. Results: Implanted subjects had a mean age of 68.2 years, were mostly male (55%), and had baseline mean ADAS-cog-13 and CDR-SB scores of 28.9 (SD, 5.2) and 3.9 (SD, 1.6), respectively. There were no significant differences between screened and implanted or nonimplanted subjects on most demographic or clinical assessments. Implanted subjects had significantly lower (better) ADAS-cog-11 (17.5 vs 21.1) scores, but did not differ on CDR-SB. Scores on the major outcome measures for the trial were consistent at screening and baseline. Conclusion: ADvance was successful in enrolling a substantial group of patients for this novel application of DBS, and the study design is strengthened by rigorous subject selection from seven sites, a double-blind placebo-controlled design, and extensive open-label follow-up

    Equipping Health Professions Educators to Better Address Medical Misinformation

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    As part of a cooperative agreement with the US Centers for Disease Control and Prevention (Federal Award Identification Number [FAIN]: NU50CK000586), the Association of American Medical Colleges (AAMC) began a strategic initiative in 2022 both to increase confidence in COVID-19 vaccines and to address medical misinformation and mistrust through education in health professions contexts. Specifically, the AAMC solicited proposals for integrating competency-based, interprofessional strategies to mitigate health misinformation into new or existing curricula. Five Health Professions Education Curricular Innovations subgrantees received support from the AAMC in 2022 and reflected on the implementation of their ideas in a series of meetings over several months. Subgrantees included the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Florida International University Herbert Wertheim College of Medicine, the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, the Maine Medical Center/Tufts University School of Medicine, and the University of Chicago Pritzker School of Medicine. This paper comprises insights from each of the teams and overarching observations regarding the challenges and opportunities involved with leveraging health professions education to address medical misinformation and improve patient health

    Effect of Algorithm-Based Therapy vs Usual Care on Clinical Success and Serious Adverse Events in Patients with Staphylococcal Bacteremia: A Randomized Clinical Trial

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    Importance: The appropriate duration of antibiotics for staphylococcal bacteremia is unknown. Objective: To test whether an algorithm that defines treatment duration for staphylococcal bacteremia vs standard of care provides noninferior efficacy without increasing severe adverse events. Design, Setting, and Participants: A randomized trial involving adults with staphylococcal bacteremia was conducted at 16 academic medical centers in the United States (n = 15) and Spain (n = 1) from April 2011 to March 2017. Patients were followed up for 42 days beyond end of therapy for those with Staphylococcus aureus and 28 days for those with coagulase-negative staphylococcal bacteremia. Eligible patients were 18 years or older and had 1 or more blood cultures positive for S aureus or coagulase-negative staphylococci. Patients were excluded if they had known or suspected complicated infection at the time of randomization. Interventions: Patients were randomized to algorithm-based therapy (n = 255) or usual practice (n = 254). Diagnostic evaluation, antibiotic selection, and duration of therapy were predefined for the algorithm group, whereas clinicians caring for patients in the usual practice group had unrestricted choice of antibiotics, duration, and other aspects of clinical care. Main Outcomes and Measures: Coprimary outcomes were (1) clinical success, as determined by a blinded adjudication committee and tested for noninferiority within a 15% margin; and (2) serious adverse event rates in the intention-to-treat population, tested for superiority. The prespecified secondary outcome measure, tested for superiority, was antibiotic days among per-protocol patients with simple or uncomplicated bacteremia. Results: Among the 509 patients randomized (mean age, 56.6 [SD, 16.8] years; 226 [44.4%] women), 480 (94.3%) completed the trial. Clinical success was documented in 209 of 255 patients assigned to algorithm-based therapy and 207 of 254 randomized to usual practice (82.0% vs 81.5%; difference, 0.5% [1-sided 97.5% CI, -6.2% to ∞]). Serious adverse events were reported in 32.5% of algorithm-based therapy patients and 28.3% of usual practice patients (difference, 4.2% [95% CI, -3.8% to 12.2%]). Among per-protocol patients with simple or uncomplicated bacteremia, mean duration of therapy was 4.4 days for algorithm-based therapy vs 6.2 days for usual practice (difference, -1.8 days [95% CI, -3.1 to -0.6]). Conclusions and Relevance: Among patients with staphylococcal bacteremia, the use of an algorithm to guide testing and treatment compared with usual care resulted in a noninferior rate of clinical success. Rates of serious adverse events were not significantly different, but interpretation is limited by wide confidence intervals. Further research is needed to assess the utility of the algorithm. Trial Registration: ClinicalTrials.gov Identifier: NCT01191840

    Pion-Xi correlations in Au-Au collisions at STAR

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    We present pion-Xi correlation analysis in Au-Au collisions at sqrt(s_NN)= 200 GeV and sqrt(s_NN) = 62.4 GeV, performed using the STAR detector at RHIC. A Xi*(1530) resonance signal is observed for the first time in Au-Au collisions. Experimental data are compared with theoretical predictions. The strength of the Xi* peak is reproduced in the correlation function assuming that pions and Xis emerge from a system in collective expansion.Comment: To appear in the proceedings of 18th Nuclear Physics Division Conference of the EPS (NPDC18),Prague, 23.8.-29.8. 200

    Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

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    Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

    Using narratives to inform the development of a digital health intervention related to COVID-19 vaccination in Black young adults in Georgia, North Carolina and Alabama

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    Interactive stories are a relatively newer form of storytelling with great potential to correct misinformation while increasing self-efficacy, which is crucial to vaccine acceptance. To address COVID-19 vaccine hesitancy and medical mistrust in young Black adults (BYA), we sought to adapt a pre-existing application (“app”; Tough Talks) designed to address HIV disclosure decision-making through choose-your-own adventure (CYOA) narratives and other activities. The adapted app (Tough Talks – COVID) uses a similar approach to situate COVID-19 vaccination decision-making within social contexts and to encourage greater deliberation about decisions. To inform content for the CYOA narratives, we conducted an online survey that was used to elicit the behavioral, cognitive, and environmental determinants influencing COVID-19 vaccine hesitancy among 150 BYA (ages 18–29) in Georgia, Alabama, and North Carolina. The survey included scenario questions that were developed with input from a youth advisory board to understand responses to peer and family influences. In two scenarios that involved discussions with family and friends about vaccination status, most respondents chose to be honest about their vaccination status. However, vaccinated individuals perceived more social pressure and stigma about not being vaccinated than unvaccinated respondents who were not as motivated by social pressure. Personal choice/agency in the face of perceived vaccine risks was a more common theme for unvaccinated respondents. Results suggest that relying on changing social norms alone may not impact barriers to vaccination in unvaccinated young adults without also addressing other barriers to vaccination such as concerns about autonomy and vaccine safety. Based on these findings, CYOA narratives in the app were adapted to include discussions with family and friends but also to touch on themes of personal choice as well as other topics that influence behaviors besides norms such as safety, side effects, and risk of COVID-19 in an evolving pandemic
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