A Comparison of Sinaitic Language In Support Of Jewish Claims Concerning The Presence Of God In The Second Temple

The Temple stood as the center of cultic Jewish life. It was their location for worship and where God had placed His name. It was a space where sacrifices were offered, and prayers heard. This sacred place was a permanent reminder that God had chosen to dwell among the people of Israel. As long as His presence remained among them, the people knew there was somewhere they could go to find and approach Him. Yet with the devastation of Solomon’s Temple and Ezekiel’s vision of the glory departing prior to its destruction the question remains how did the Jewish people justify their return to worship at this desecrated Temple-less spot? Did the Jews during this time believe the presence of God to again dwell in the Jerusalem Temple? Did they have historically recorded miraculous or theophanic type events that gave them confidence in their ability to worship there? If the Jews perceived the presence of God to be at the Second Temple what evidence did, they point to and did the literature of the Second Temple support this belief

The Impact of Incarceration on Food Insecurity among Households with Children

This study seeks to determine the role that parental incarceration plays on the probability of food insecurity among families with children and very low food security of children using micro-level data from the Fragile Families and Child Well Being Study (FFCWS). The data set contains the 18-question food security module which allows us to explore the link between incarceration and food insecurity and very low food security among children, families, and adults. The incidence of very low food security in our data is somewhat higher than the national average, but the incidence of other levels of food security is similar to national aggregates. Since there is likely reverse causality in the relationship between parental incarceration and food insecurity, we employ a variety of program evaluation techniques to identify the causal relationship between food insecurity and parental incarceration. We employ imputation techniques to account for non-response among the food security variables and independent variables. Our ordinary least squares results suggest that having at least one parent that has ever been incarcerated has a small positive effect (1 to 4 percentage points) on the probability of very low food security among children, adults and households with children, but the results are not significant in various specification. Food insecurity for adults and households with children (a less dire level of food insecurity than very low food security) is affected by parental incarceration under most specifications with magnitudes of impact from 4 to 15 percentage points. This research provides some evidence that incarceration adversely affects children and families in terms of food insecurity. Policies to mitigate the impact could be addressed through the court system whereby children are provided with court-sanctioned support to address food needs

Aspects of early arthritis. Biological therapy in early arthritis – overtreatment or the way to go?

The availability of newer, and more expensive, therapies for patients with rheumatoid arthritis has changed treatment beyond recognition. Disease remission is the goal for all new patients. Studies have shown that a combination of tumour necrosis factor (TNF)-blocking drugs and methotrexate produces superior outcomes over monotherapy alone; however, use is limited by cost and potential side-effects. Currently, anti-TNF therapy is normally reserved for patients who have failed traditional disease-modifying anti-rheumatic drugs. The question that remains is whether TNF-blocking drugs are better used if given early; the high direct costs are countered by both direct and indirect savings in healthcare costs from optimal control of disease, and the benefits of early control outweigh the increased risk of infection and malignancy

Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit?

BACKGROUND: Many young people with major depression fail first-line treatments. Treatment-resistant depression has various definitions in the literature but typically assumes nonresponse to medication. In young people, cognitive behavioral therapy (CBT) is the recommended first-line intervention, thus the definition of treatment resistance should be expanded. Therefore, our aim was to synthesize the existing evidence of any interventions for treatment-resistant depression, broadly defined, in children and adolescents and to investigate the effectiveness of CBT in this context. METHODS: We used Cochrane Collaboration methodology, with electronic searches of Medline, PsycINFO, Embase, and the Cochrane Depression Anxiety and Neurosis Group trials registers. Only randomized controlled trials were included, and were assessed for risk of bias. Meta- analysis was undertaken where possible and appropriate. RESULTS: Of 953 articles retrieved, four trials were eligible for inclusion. For one study, only the trial registration document was available, because the study was never completed. All other studies were well conducted with a low risk of bias, although one study had a high dropout rate. Two studies assessed the effect of adding CBT to medication. While an assertive trial of antidepressants does appear to lead to benefit, when compared with placebo, there was no significant advantage, in either study, or in a meta-analysis of data from these trials, that clearly demonstrated an additional benefit of CBT. The third trial showed little advantage of a tricyclic antidepressant over placebo in the context of an inpatient admission. CONCLUSION: Few randomized controlled trials have investigated interventions for treatment-resistant depression in young people, and results from these show modest benefit from antidepressants with no additional benefit over medication from CBT. Overall, there is a lack of evidence about effective interventions to treat young people who have failed to respond to evidence-based interventions for depression. Research in this area is urgently required

Unmet care needs in people living with advanced cancer: a systematic review

Purpose: The support needs of cancer patients vary according to the phase of their cancer journey. Recent developments in healthcare are such that the advanced cancer phase is increasingly experienced as a chronic illness phase, with consequent changes in patient support needs. Understanding these needs, and identifying areas of unmet need, can enable us to develop services that are more adequate to the task of supporting this population. Methods: We conducted a systematic search of four electronic databases to identify studies examining the unmet needs of people living with advanced cancer. Relevant data were extracted and synthesised; meta-analyses were conducted to obtain pooled estimates for prevalence of needs. Results: We identified 23 studies (4 qualitative) for inclusion. Unmet needs were identified across a broad range of domains, with greatest prevalence in informational (30–55 %), psychological (18–42 %), physical (17–48 %), and functional (17–37 %) domains. There was considerable heterogeneity amongst studies in terms of methods of assessment, coding and reporting of needs, respondent characteristics, and appraised study quality. Conclusions: Heterogeneity made it difficult to compare across studies and inflated confidence intervals for pooled estimates of prevalence—we need standardised and comprehensive approaches to assessment and reporting of unmet needs to further our understanding. Nonetheless, the review identified prominent needs across a range of (interacting) experiential domains. Moreover, by focussing on unmet needs for support, we were able to extrapolate potential implications for service development

A measure to evaluate parenting interventions: Using inclusive research to modify a tool to measure change in parenting self‐efficacy during the antenatal period

Background: With the right support, people with learning disabilities can be ‘good enough’ parents (Coren et al., 2011; Murphy & Feldman, 2002). Parenting programmes exist to support parents and are made accessible for people with learning disabilities who are expecting a baby, but evaluation of the benefit of these interventions is poor due to a lack of accessible outcome measures (May & Harris, 2020; Wade et al., 2008). The Tool to Measure Parenting Self‐Efficacy in the antenatal period (TOPSE‐ ante‐natal) measures the impact of parenting interventions on an individual's self‐efficacy during the antenatal period. This study aimed to modify the TOPSE ante‐natal tool through a process of inclusive research, to support a consistent approach to evaluating parenting interventions from the perspective of parents‐to‐be with learning disabilities. Methods: A two‐phase study using interviews and discussion groups was conducted in a process of inclusive research to modify the TOPSE ante‐natal tool. Phase one involved conducting eight cognitive interviews (interviews to understand how individuals process and recall information) with parents with learning disabilities. These were conducted remotely via Microsoft Teams, transcribed verbatim and analysed using content analysis (Krippendorff, 2013). Participants were recruited using snowballing techniques through the advisory groups' networks. Phase two included three discussion groups with study collaborators and advisors (n = 14) to assess the accessibility and acceptability of adaptations of the tool, each making further refinements for consideration. Findings: Interviews and discussion groups highlighted how parents‐to‐be with learning disabilities experienced some of the original TOPSE‐ante‐natal negative statements, including negative points on a Likert scale, difficult to comprehend. Figurative statements and unfamiliar words also caused confusion, and statements focussed on the pressures of parenting were experienced as confrontational by people with learning disabilities. Statements were removed or replaced and agreed upon in discussion groups to ensure that the tool was accessible and meaningful to people with learning disabilities. Conclusions: We have used a process of inclusive research to modify a self‐efficacy tool for parents‐to‐be with learning disabilities that is freely available on the TOPSE website (https://www.topse.org.uk/site/). The next steps are for this tool to be used and validated in future studies evaluating parenting interventions for people with learning disabilities. This will inform a knowledge base of what interventions should be used by practitioners who are supporting people with learning disabilities to prepare for parenthood

Computational Component Build-Up for the X-57 Distributed Electric Propulsion Aircraft

A computational study of the wing for the distributed electric propulsion X-57 Maxwell airplane configuration at cruise and takeoff/landing conditions was completed. Three unstructured-mesh, Navier-Stokes computational fluid dynamics methods, FUN3D, USM3D and Kestrel, were used to predict the performance buildup of components to the full X-57 configuration. The goal of the X-57 wing and distributed electric propulsion system design was to meet or exceed the required lift coefficient of 3.95 for a stall speed of 58 knots. The X-57 Maxwell airplane was designed with a small, high aspect ratio cruise wing that was designed for a high cruise lift coefficient of 0.75 at a cruise speed of 150 knots and altitude of 8,000 ft, with an angle of attack of approximately 0deg. The computational data indicates that the X-57 full aircraft drag would meet the cruise drag goal with a 25 count drag margin. The cruise configuration maximum lift coefficient is 2.07 and without including the stabilator is 1.86 at an angle of attack of 14 deg, predicted with the USM3D flow solver using the Spalart-Allmaras turbulence model. The maximum lift coefficient for the high-lift wing (with the 30deg flap deflection) without the stabilator contribution is 2.60 at an angle of attack of 13 deg. For high-lift blowing conditions with 13.7 hp/prop, the maximum lift coefficient excluding the stabilator is 4.426 at (alpha) = 13 deg. Therefore, the lift augmentation from the high-lift propellers is 1.7 and the total lift augmentation from the high-lift system (30 deg flap deflection and the high-lift blowing) is 2.38. The drag for the high-lift wing with 30 deg flap deflection is much higher than the cruise wing configuration, but the high-lift system is used only during a small portion of the flight envelope. The pitching moment is relatively constant for both blown and unblown conditions when the stabilator is excluded. Modeling the full geometry has indicated some adverse effects from the fuselage on the wing and stabilator. At high angles of attack, the solutions with the USM3D flow solver using the Spalart-Allmaras turbulence model indicates large flow separation on the wing upper surface between the two high-lift nacelles near the fuselage, and also a reduction in sectional lift on the stabilator in the first 50 percent of the stabilator semispan. However, the large flow separation near the fuselage is mostly eliminated in the solutions predicted with two codes, USM3D and Kestrel, using Hybrid Reynolds-averaged Navier Stokes/Large Eddy Simulation turbulence models