We didn\u27t miss a day : a history in narratives of schooling efforts for Jewish children and youths in German-occupied Europe

This is a study of adult and youth narratives about creating and participating in schooling during what has become known as the Holocaust. Jewish narrators created works that described and analyzed their experiences and educational efforts while in hiding, in ghettos, and in concentration camps. The narratives are in the form of diaries, journals, autobiographies, testimonies, and interviews. The narratives were analyzed in order to discover personal and shared themes and are interpreted and presented in ways meant to retain their particular natures and styles. Short pieces from other sources are included to enhance understanding of the roles of education and schooling in the experiences of Jews trapped in the Final Solution . Narrators are introduced through short biographies. Each narrative is offered in segments interlaced with discussion of the contexts and interpretations that enhance understanding of the narrators and their schooling efforts. Following the narratives are discussions of individual and shared themes and of views critical of schooling efforts on behalf of Jewish children. Relationships between social, political, cultural and ideological positions and schooling form a subtext of the analysis of the narratives. Educational efforts, often under fearsome bans on education for Jewish children, ranged from the autodidactic efforts of isolated children to complex, yet often clandestine, school systems. Schooling was an opportunity for resistance to German plans to destroy Judaism—when intellectual resistance was often the only possibility to fight back. Schooling connected youths and adults to each other and to their pasts, while creating possibilities for a future that many did not live to experience. It sent survivors into that future with a sense of having prepared for a new life. Many emerged from hiding places and sites of imprisonment and torture with little else. Their families and communities destroyed, their material resources stolen, no longer welcome in their own lands—only the intellectual growth and the sense of camaraderie. fostered in the educational enterprise, accompanied them into an often hostile and strange post-war world

Accessibility in Primary Care: Organizational Characteristics Associated with Better First-Contact Accessibility

Contexte : L'accessibilité de premier contact est un problème important au Canada, cet indicateur demeurant le pire de tous les pays de l'OCDE. Au Québec, bon nombre d'organisations de soins de première ligne (OSPL) ont adopté des mesures pour améliorer l'accès (par exemple : un horaire en accès adapté, des infirmières offrant des soins de façon autonome, le dossier médical électronique et certains incitatifs financiers). L'impact de ces changements est inconnu. Le but de cette étude est d'évaluer les caractéristiques des OSPL associées à un meilleur accès de premier contact. Méthodes : Une analyse secondaire a été effectuée à partir des données de l'enquête québécoise sur la performance des soins primaires QUALICO-PC menée en 2013-2014, soit une étude transversale visant à évaluer la qualité, les coûts et l'équité des soins de santé primaires dans 35 pays et juridictions. Les caractéristiques organisationnelles ont été mesurées à partir d’un questionnaire aux médecins de famille québécois. L'accessibilité de premier contact a été mesurée à partir du questionnaire à leurs patients. La régression logistique multi-niveaux (ORa et IC à 95 %) a été utilisée pour déterminer l’association entre les caractéristiques organisationnelles et l'accessibilité rapportée par les patients. Résultats : Un total de 218 médecins de famille ont participé à l'étude avec 1798 de leurs patients. Les caractéristiques des OSPL associées à un accès accru de premier contact comprenaient la possibilité d'avoir un rendez-vous le jour même ou de se rendre à la clinique sans rendez-vous (ORa : 2,94; 1,15-7,51), un nombre plus élevé de médecins par clinique (ORa : 1,13; 1,03-1,24) et un plus grand nombre d'heures travaillées par le médecin de famille (ORa : 1,03; 1,00-1,06). Le dossier de santé électronique et la présence d’infirmières prodiguant des soins de façon autonome n'étaient pas associés significativement à un accès accru. Conclusions : Un accès le jour même et un plus grand nombre d’heures travaillées par les médecins de famille sont associés à un meilleur accès rapporté par les patients. Cependant, d'autres caractéristiques des réformes récentes dans les OSPL n'ont pas été associées à un meilleur accès, peut-être en raison de leur introduction récente et de l'amélioration des autres dimensions de la performance des soins de première ligne.Background: First-contact accessibility remains an important problem in Canada, with this indicator staying the worst of all OECD countries. In the province of Quebec, a number of primary healthcare (PHC) organizations have adopted measures to improve access (e.g. advance access scheduling, expanded nursing role, electronic medical record, financial incentives). The impact of those changes is unknown. The goal of this study is to assess which PHC organizations’ characteristics are associated with improved first-contact accessibility. Methods: We conducted a secondary data analysis of the Quebec survey, conducted as part of the QUALICO-PC study on primary care performance. QUALICO-PC is a cross-sectional study to assess quality, costs and equity in PHC across 35 countries and jurisdictions. We used two types of surveys. Organizational characteristics were measured from the family practitioners’ questionnaire. First-contact accessibility was measured from the patient questionnaire. The patients received care in the participating PHC organizations. Multi-level logistic regression (aOR and 95% CI) was used to assess the association of organizational characteristics as predictors of patient-reported access. Results: A total of 218 family practitioners participated in the study with 1798 of their patients. PHC organizations’ characteristics associated with increased first-contact access included the possibility to have a same-day appointment or to walk in the clinic without an appointment (aOR: 2.94; 1.15-7.51), a higher number of physicians per clinic (aOR: 1.13; 1.03-1.24) and a higher number of hours worked by the family physician (aOR: 1.03; 1.00-1.06). Electronic medical record and expanded nursing role were not associated significantly with increased access. Conclusions: Same-day access and higher family physician working hours are associated with improved access. However, other characteristics of recent reforms in PHC organizations were not associated significantly with improved access, possibly because of their recent introduction and the improvement of other dimensions of PHC performance

The impact of smoking on antimüllerian hormone levels in women aged 38 to 50 years

Smoking is associated with increased follicle-stimulating hormone levels and early menopause. Smoking may directly accelerate ovarian follicular depletion or may act indirectly by increasing the pituitary production of follicle-stimulating hormone. Antimüllerian hormone (AMH), produced by ovarian follicles, is a more direct measure of ovarian reserve. The objective of our study was to determine the extent to which smoking influences ovarian reserve, as measured by AMH levels

Allelic Variation in the Toll-Like Receptor Adaptor Protein

Host genetic variation is known to contribute to differential pathogenesis following infection. Mouse models allow direct assessment of host genetic factors responsible for susceptibility to Severe Acute Respiratory Syndrome coronavirus (SARS-CoV). Based on an assessment of early stage lines from the Collaborative Cross mouse multi-parent population, we identified two lines showing highly divergent susceptibilities to SARS-CoV: the resistant CC003/Unc and the susceptible CC053/Unc. We generated 264 F2 mice between these strains, and infected them with SARS-CoV. Weight loss, pulmonary hemorrhage, and viral load were all highly correlated disease phenotypes. We identified a quantitative trait locus of major effect on chromosome 18 (27.1-58.6 Mb) which affected weight loss, viral titer and hemorrhage. Additionally, each of these three phenotypes had distinct quantitative trait loci [Chr 9 (weight loss), Chrs 7 and 12 (virus titer), and Chr 15 (hemorrhage)]. We identified Ticam2 , an adaptor protein in the TLR signaling pathways, as a candidate driving differential disease at the Chr 18 locus. Ticam2 -/- mice were highly susceptible to SARS-CoV infection, exhibiting increased weight loss and more pulmonary hemorrhage than control mice. These results indicate a critical role for Ticam2 in SARS-CoV disease, and highlight the importance of host genetic variation in disease responses

A call for policy guidance on psychometric testing in doping control in sport.

One of the fundamental challenges in anti-doping is identifying athletes who use, or are at risk of using, prohibited performance enhancing substances. The growing trend to employ a forensic approach to doping control aims to integrate information from social sciences (e.g., psychology of doping) into organised intelligence to accelerate the pursuit of clean sport. Beyond the foreseeable consequences of a positive identification as a doping user, this task is further complicated by the discrepancy between what constitutes a doping offence in the World Anti-Doping Code and operationalized in doping research. Whilst psychology plays an important role in developing our understanding of doping behaviour in order to inform intervention and prevention, its contribution to the array of doping diagnostic tools is still in its infancy. At the same time, we must acknowledge that socially desirable responding confounds self-reported psychometric test results. Further, the cognitive complexity surrounding test performance means that the response-time based measures and the lie detector tests for revealing concealed life-events (e.g., doping use) are prone to produce false or non-interpretable outcomes in field settings. Differences in social-cognitive characteristics of doping behaviour that are tested at group level (doping users vs. non-users) cannot be extrapolated to individuals; nor these psychometric measures used for individual diagnostics. In this paper, we present a position statement calling for policy guidance on appropriate use of psychometric assessments in the pursuit of clean sport. We argue that both self-reported and response-time based psychometric tests for doping have been designed, tested and validated to explore how athletes feel and think about doping in order to develop a better understanding of doping behaviour, not to establish evidence for doping. A false 'positive' psychological profile for doping (or even failing to produce a definite negative profile) affects not only the individual ‘clean’ athlete but also their entourage, their organisation and sport itself. The proposed policy guidance aims to protect the global athletic community against social, ethical and legal consequences from potential misuse of psychological tests, including applications as forensic diagnostic tools in both practice and research

Promoting healthy eating in early pregnancy in individuals at risk of gestational diabetes mellitus: does it improve glucose homeostasis? A study protocol for a randomized control trial

BackgroundHealthy eating during pregnancy has favorable effects on glycemic control and is associated with a lower risk of gestational diabetes mellitus (GDM). According to Diabetes Canada, there is a need for an effective and acceptable intervention that could improve glucose homeostasis and support pregnant individuals at risk for GDM.AimsThis unicentric randomized controlled trial (RCT) aims to evaluate the effects of a nutritional intervention initiated early in pregnancy, on glucose homeostasis in 150 pregnant individuals at risk for GDM, compared to usual care.MethodsPopulation: 150 pregnant individuals ≥18 years old, at ≤14 weeks of pregnancy, and presenting ≥1 risk factor for GDM according to Diabetes Canada guidelines. Intervention: The nutritional intervention initiated in the first trimester is based on the health behavior change theory during pregnancy and on Canada’s Food Guide recommendations. It includes (1) four individual counseling sessions with a registered dietitian using motivational interviewing (12, 18, 24, and 30 weeks), with post-interview phone call follow-ups, aiming to develop and achieve S.M.A.R.T. nutritional objectives (specific, measurable, attainable, relevant, and time-bound); (2) 10 informative video clips on healthy eating during pregnancy developed by our team and based on national guidelines, and (3) a virtual support community via a Facebook group. Control: Usual prenatal care. Protocol: This RCT includes three on-site visits (10–14, 24–26, and 34–36 weeks) during which a 2-h oral glucose tolerance test is done and blood samples are taken. At each trimester and 3 months postpartum, participants complete web-based questionnaires, including three validated 24-h dietary recalls to assess their diet quality using the Healthy Eating Food Index 2019. Primary outcome: Difference in the change in fasting blood glucose (from the first to the third trimester) between groups. This study has been approved by the Ethics Committee of the Centre de recherche du CHU de Québec-Université Laval.DiscussionThis RCT will determine whether a nutritional intervention initiated early in pregnancy can improve glucose homeostasis in individuals at risk for GDM and inform Canadian stakeholders on improving care trajectories and policies for pregnant individuals at risk for GDM.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT05299502, NCT0529950

Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial

Background: Rucaparib, a poly(ADP-ribose) polymerase inhibitor, has anticancer activity in recurrent ovarian carcinoma harbouring a BRCA mutation or high percentage of genome-wide loss of heterozygosity. In this trial we assessed rucaparib versus placebo after response to second-line or later platinum-based chemotherapy in patients with high-grade, recurrent, platinum-sensitive ovarian carcinoma. Methods: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients from 87 hospitals and cancer centres across 11 countries. Eligible patients were aged 18 years or older, had a platinum-sensitive, high-grade serous or endometrioid ovarian, primary peritoneal, or fallopian tube carcinoma, had received at least two previous platinum-based chemotherapy regimens, had achieved complete or partial response to their last platinum-based regimen, had a cancer antigen 125 concentration of less than the upper limit of normal, had a performance status of 0–1, and had adequate organ function. Patients were ineligible if they had symptomatic or untreated central nervous system metastases, had received anticancer therapy 14 days or fewer before starting the study, or had received previous treatment with a poly(ADP-ribose) polymerase inhibitor. We randomly allocated patients 2:1 to receive oral rucaparib 600 mg twice daily or placebo in 28 day cycles using a computer-generated sequence (block size of six, stratified by homologous recombination repair gene mutation status, progression-free interval after the penultimate platinum-based regimen, and best response to the most recent platinum-based regimen). Patients, investigators, site staff, assessors, and the funder were masked to assignments. The primary outcome was investigator-assessed progression-free survival evaluated with use of an ordered step-down procedure for three nested cohorts: patients with BRCA mutations (carcinoma associated with deleterious germline or somatic BRCA mutations), patients with homologous recombination deficiencies (BRCA mutant or BRCA wild-type and high loss of heterozygosity), and the intention-to-treat population, assessed at screening and every 12 weeks thereafter. This trial is registered with ClinicalTrials.gov, number NCT01968213; enrolment is complete. Findings: Between April 7, 2014, and July 19, 2016, we randomly allocated 564 patients: 375 (66%) to rucaparib and 189 (34%) to placebo. Median progression-free survival in patients with a BRCA-mutant carcinoma was 16·6 months (95% CI 13·4–22·9; 130 [35%] patients) in the rucaparib group versus 5·4 months (3·4–6·7; 66 [35%] patients) in the placebo group (hazard ratio 0·23 [95% CI 0·16–0·34]; p<0·0001). In patients with a homologous recombination deficient carcinoma (236 [63%] vs 118 [62%]), it was 13·6 months (10·9–16·2) versus 5·4 months (5·1–5·6; 0·32 [0·24–0·42]; p<0·0001). In the intention-to-treat population, it was 10·8 months (8·3–11·4) versus 5·4 months (5·3–5·5; 0·36 [0·30–0·45]; p<0·0001). Treatment-emergent adverse events of grade 3 or higher in the safety population (372 [99%] patients in the rucaparib group vs 189 [100%] in the placebo group) were reported in 209 (56%) patients in the rucaparib group versus 28 (15%) in the placebo group, the most common of which were anaemia or decreased haemoglobin concentration (70 [19%] vs one [1%]) and increased alanine or aspartate aminotransferase concentration (39 [10%] vs none). Interpretation: Across all primary analysis groups, rucaparib significantly improved progression-free survival in patients with platinum-sensitive ovarian cancer who had achieved a response to platinum-based chemotherapy. ARIEL3 provides further evidence that use of a poly(ADP-ribose) polymerase inhibitor in the maintenance treatment setting versus placebo could be considered a new standard of care for women with platinum-sensitive ovarian cancer following a complete or partial response to second-line or later platinum-based chemotherapy. Funding: Clovis Oncology