Supporting the Inclusion of Socially Vulnerable Early Adolescents: Theory and Illustrations of the BASE Model

We focus on the inclusion of socially vulnerable early adolescents including students with special education needs (SEN). Building from multiple intervention and randomized control trials of a professional development model aimed at supporting teachers\u27 management of the classroom social context, we provide an overview of the Behavioral, Academic, and Social Engagement (BASE) Model as a framework to foster social inclusion. We briefly review the conceptual foundations of this model and we present the delivery (i.e., directed consultation, the scouting report process) and content (i.e., Academic Engagement Enhancement, Competence Enhancement Behavior Management, Social Dynamics Management) components of BASE. We then briefly discuss the intervention support needs of subtypes of socially vulnerable youth and how these needs can be differentially addressed within the BASE framework. Many students are concerned about social difficulties during the late elementary and middle school years (Graham et al., 2006; Rice et al., 2011). This is particularly true for early adolescents with special education needs (SEN) who are at increased risk for peer rejection, social isolation, and involvement in peer victimization (Frederickson and Furnham, 2004; Estell et al., 2009a; Sullivan et al., 2015). The Behavioral, Academic, and Social Engagement (BASE) Model was developed as a holistic, ecological classroom management approach that teachers can use to support socially vulnerable youth during the transition to middle school. Our goal is to describe the application of the BASE model for supporting the inclusion of distinct subtypes of students with SEN during the late childhood and early adolescent school years. We address five aims. We begin with an overview of the social inclusion of students with SEN. Then, we build upon a person-in context dynamic systems perspective to describe the theoretical foundations of the BASE model. Next, we summarize the intervention components and practice elements of the BASE model and their linkages to key social development process variables typically experienced by early adolescents. Building on research using latent profile analysis of interpersonal competence, we discuss three distinct configurations or subtypes of socially vulnerable youth: popular aggressive; passive; and low-adaptive (i.e., multi-risk). Finally, using these configurations and associated adjustment factors as a guide, we illustrate how teachers can use the BASE model to adapt strategies and supports for each subtype. We focus on how teachers need to be attuned not only to the differential needs of sub-types of youth, but to also be aware that their management of the classroom experience of students characterized by different configurations may contribute to how subtypes of students are perceived by their classmates and their corresponding relationships and social roles in the peer ecology

Medical Cost Associated with Prediabetes

Abstract In this article, we estimate national health care resource use and medical costs in 2007 associated with prediabetes (PD), defined as either fasting plasma glucose between 100 and 125 or oral glucose tolerance test between 140 and 200. We use Poisson regression with medical claims for an adult population continuously insured between 2004 and 2006 to analyze patterns of health care resource use by PD status. Combining rate ratios that reflect health care use patterns with national PD prevalence rates from the National Health and Nutrition Examination Survey, we calculate etiological fractions to estimate the portion of national health resource use associated with PD. The findings suggest that PD is associated with statistically higher rates of ambulatory visits for hypertension; endocrine, metabolic, and renal complications; and general medical conditions. PD is associated with a slight increase in visit rates for neurological symptoms, peripheral vascular disease, and cardiovascular disease, but the increase is not statistically significant. There is no indication that PD is associated with an increase in emergency visits and inpatient days. Extrapolating these patterns to the 57 million adults with PD in 2007 suggests that national annual medical costs of PD exceed $25 billion, or an additional$443 for each adult with PD. PD is associated with excessive use of ambulatory services for comorbidities known to be related to diabetes. Our findings strengthen the business case for lifestyle interventions to prevent diabetes by adding additional economic benefits that potentially can be achieved by preventing or delaying PD. (Population Health Management

Structural Model Reveals Key Interactions in the Assembly of the Pregnane X Receptor/Corepressor Complex Running Title: Molecular Dynamics of PXR-SMRT Interactions

Abstract The human pregnane X receptor (PXR), also known as steroid and xenobiotic receptor (SXR), is a member of the orphan nuclear receptors and mediates the mammalian xenobiotic response with broad specificity and implications for drug clearance. The mouse pregnane X receptor is highly similar to the human ortholog in structure but with subtle species differentiation in the ligand binding domain (LBD). The C-terminal helix named α AF or AF-2 helix in other nuclear receptors is responsible for transcription activation by recruiting co-activators through conformational change. In the absence of ligands, PXR can also repress gene expression by interacting with transcriptional corepressors such as the silencing mediator for retinoid and thyroid hormone receptor (SMRT). We first constructed homology models of completed LBD with two SMRT nuclear receptor (NR)-interacting domains (ID1 and ID2) respectively. We then performed energy minimization and molecular dynamics simulations on these systems to study the specific interactions between the interacting domains and LBD. Further experimental results supported and validated the observed preference of SMRT toward ID2 over ID1. Our modeling results revealed the key interactions that account for the binding preference. Here, we propose structural models of the PXR-LBD/SMRT-ID1 and PXR-LBD/SMRT-ID2 complexes to understand their molecular interactions and potential inhibitory mechanism

Structural Model Reveals Key Interactions in the Assembly of the Pregnane X Receptor/Corepressor Complex Running Title: Molecular Dynamics of PXR-SMRT Interactions

Abstract The human pregnane X receptor (PXR), also known as steroid and xenobiotic receptor (SXR), is a member of the orphan nuclear receptors and mediates the mammalian xenobiotic response with broad specificity and implications for drug clearance. The mouse pregnane X receptor is highly similar to the human ortholog in structure but with subtle species differentiation in the ligand binding domain (LBD). The C-terminal helix named α AF or AF-2 helix in other nuclear receptors is responsible for transcription activation by recruiting co-activators through conformational change. In the absence of ligands, PXR can also repress gene expression by interacting with transcriptional corepressors such as the silencing mediator for retinoid and thyroid hormone receptor (SMRT). We first constructed homology models of completed LBD with two SMRT nuclear receptor (NR)-interacting domains (ID1 and ID2) respectively. We then performed energy minimization and molecular dynamics simulations on these systems to study the specific interactions between the interacting domains and LBD. Further experimental results supported and validated the observed preference of SMRT toward ID2 over ID1. Our modeling results revealed the key interactions that account for the binding preference. Here, we propose structural models of the PXR-LBD/SMRT-ID1 and PXR-LBD/SMRT-ID2 complexes to understand their molecular interactions and potential inhibitory mechanism