THE COMPONENTS NECESSARY IN A CLINICAL DAY PROGRAM FOR A SUCCESSFUL TRANSITION TO TRADITIONAL SCHOOL

The purpose of this research was to determine what components of academic and therapeutic clinical day programs ensure success for students with mental health diagnoses as they transition back to conventional educational settings. This study focused on the importance of developing students\u27 capabilities to fulfill their own needs within Maslow’s Hierarchy of Needs through coping skills, academic skills, and ensuring those skills transition to their traditional home school setting. The research questions guiding this study were: 1. How is “successful reintegration” defined for students with mental health concerns by the students, families, teachers, and other school staff? 2. What program components are present in effective clinical day programs? The methodology for this research was an evaluative case study approach, with interviews serving as the primary form of data collection. Three staff members at two clinical day programs that serve middle and high school students provided valuable insight into what components of the programs help students prepare for the transition back to traditional schools. The study findings indicated that enhancing students\u27 capacity to independently use therapeutic and academic skills significantly improved the likelihood of a successful transition to their home school. The most important themes that came from the research included skills to help students meet their needs within the Hierarchy of Needs, individualization of the clinical day program, and the various possible outcomes. This study provides the foundation for further development of clinical day programs that focus on the therapeutic skills and academic skills necessary for students to successfully transition from a more restrictive environment to a less restrictive setting. It also leads to continuing research in methods to ensure students’ ability to continue utilizing the skills learned across various settings

Strategies to Increase Early Discharges to Reduce Avoidable Patient Days and Improve Patient Flow

CREATING ALGORITHMS TO INCREASE THE NUMBERS OF HOSPITAL MORNING DISCHARGES RESULTING IN IMPROVED PATIENT FLOW Discharging a percentage of patients early in the day helps to improve patient flow. This results in a reduction of Emergency Department congestion as well as peaks in patient numbers in the early to late afternoon on patient care units. A cardiac unit in an academic tertiary medical center created a goal to increase the number of their discharges by 11 AM and to streamline key discharge planning activities. A root cause analysis was initiated and after identifying several barriers, two KPIs were developed using improvement measures of operational excellence. Post KPI inception, metric goals were exceeded within the established timeline. Next steps include reviewing DRG specific readmission rates to make sure there are no negative impacts as a result of the established countermeasures. In addition, the unit will provide coaches for other care units interested in adopting these strategies

Comprehensive characterization of PTEN mutational profile in a series of 34,129 colorectal cancers

Loss of expression or activity of the tumor suppressor PTEN acts similarly to an activating mutation in the oncogene PIK3CA in elevating intracellular levels of phosphatidylinositol (3,4,5)-trisphosphate (PIP3), inducing signaling by AKT and other pro-tumorigenic signaling proteins. Here, we analyze sequence data for 34,129 colorectal cancer (CRC) patients, capturing 3,434 PTEN mutations. We identify specific patterns of PTEN mutation associated with microsatellite stability/instability (MSS/MSI), tumor mutational burden (TMB), patient age, and tumor location. Within groups separated by MSS/MSI status, this identifies distinct profiles of nucleotide hotspots, and suggests differing profiles of protein-damaging effects of mutations. Moreover, discrete categories of PTEN mutations display non-identical patterns of co-occurrence with mutations in other genes important in CRC pathogenesis, including KRAS, APC, TP53, and PIK3CA. These data provide context for clinical targeting of proteins upstream and downstream of PTEN in distinct CRC cohorts.Loss of the tumour suppressor gene PTEN leads to the activation of pro-tumourigenic signalling pathways. Here, the authors analyse sequencing data from a large cohort of colorectal cancer patients harbouring PTEN mutations and identify distinct patterns of associations with genomic and clinical features

Daily to decadal modulation of jet variability

The variance of a jet’s position in latitude is found to be related to its average speed: when a jet becomes stronger its variability in latitude decreases. This relationship is shown to hold for observed midlatitude jets around the world and also across a hierarchy of numerical models. North Atlantic jet variability is shown to be modulated on decadal timescales, with decades of a strong, steady jet being interspersed with decades of a weak, variable jet. These modulations are also related to variations in the basin-wide occurrence of high-impact blocking events. A picture emerges of complex multidecadal jet variability in which recent decades do not appear unusual. We propose an underlying barotropic mechanism to explain this behaviour, related to the change in refractive properties of a jet as it strengthens, and the subsequent effect on the distribution of Rossby wave breaking

A Longitudinal Analysis Reveals Early Activation and Late Alterations in B Cells During Primary HIV Infection in Mozambican Adults

Altres ajuts: Melinda Gates Foundation (OPP1068252)Primary HIV infection (PHI) and subsequent chronic infection alter B-cell compartment. However, longitudinal analysis defining the dynamics of B-cell alterations are still limited. We longitudinally studied B-cell subsets in individuals followed for 1 year after PHI (n = 40). Treated and untreated chronic HIV infected (n = 56) and HIV-uninfected individuals (n = 58) were recruited as reference groups at the Manhiça District in Mozambique. B cells were analyzed by multicolor flow-cytometry. Anti-HIV humoral response and plasma cytokines were assessed by ELISA or Luminex-based technology. A generalized activation of B cells induced by HIV occurs early after infection and is characterized by increases in Activated and Tissue-like memory cells, decreases in IgM-IgD- (switched) and IgM-only B cells. These alterations remain mostly stable until chronic infection and are reverted in part by ART. In contrast, other parameters followed particular dynamics: PD-1 expression in memory cells decreases progressively during the first year of infection, Transitional B cells expand at month 3-4 after infection, and Marginal zone-like B cells show a late depletion. Plasmablasts expand 2 months after infection linked to plasma viral load and anti-p24 IgG3 responses. Most of well-defined changes induced by HIV in B-cell activation and memory subsets are readily observed after PHI, lasting until ART initiation. However, subsequent changes occur after sustained viral infection. These data indicate that HIV infection impacts B cells in several waves over time, and highlight that early treatment would result in beneficial effects on the B-cell compartment

Doctor of Education Newsletter 2020

WSU Doctor of Education Cohort 2020 This newsletter was created by the second Education Doctorate graduate student cohort 2020.https://openriver.winona.edu/educationeddnewsletters/1001/thumbnail.jp

The powers in PowerPoint: Embedded authorities, documentary tastes, and institutional (second) orders in corporate Korea

Microsoft PowerPoint is both the bane and banality of contemporary South Korean office work. Corporate workers spend countless hours refining and crafting plans, proposals, and reports in PowerPoint that often lead to conflicts with coworkers and overtime work. This article theorizes the excessive attention to documents in modern office contexts. Where scholars have been under the impression that institutional documents align with institutional purposes, I describe a context in which making documents for individual purposes and making them for work exist under a basic tension. Based on fieldwork in corporate Korea between 2013 and 2015, I describe how Korean office workers calibrate documents to the tastes of superiors who populate the managerial chain. These practices leave little trace of real "work" on paper, but they are productive for navigating complex internal labor markets and demonstrating a higher order value of attention toward others. These findings suggest that institutional and individual authorities are not competing projects inside organizations but become entangled in increasingly complex participatory encounters, even as they are channeled through a seemingly simple software like PowerPoint. [documents, expertise, authority, technology, South Korea