Between God and markets : class, race, and state in the underdevelopment of the American South

This study examines the shifts that have occurred in the world-economy over the past 500 years and how they have transformed the American South\u27s role in the world- economy and its relationships with the U.S. North and Europe. This work is premised on the argument that, in spite of the various transformations, the region\u27s relative economic role within the world-economy has remained largely unchanged between 1620 and 1918. I have periodized the period between 1492 and 1918 CE as pertains to the South into four distinct phases, each of which was marked by a major historical event or disjuncture that had the potential of changing the trajectory of social change, and thus the region\u27s development. The purpose of the study is to examine the impact those changes had on the region\u27s development. The current study is defined by three major and closely related goals. First, it seeks to critically examine how the South, in the midst of one of the world\u27s great core economies, has been systematically underdeveloped and how particular historical processes have contributed to that phenomenon. Then, the research aims to specify the linkages between the world-economy and Southern economic and political activities that existed during each of four historical phases, particularly their relationship to the previous periods and the processes of underdevelopment. Finally, the work attempts to enhance our understanding of the world-system concept of reincorporation and why, at major historical disjunctures, policies regarding the South acted to deepen rather than weaken existing structural and institutional barriers to radical changes. Evidence accumulated in this study suggests that the systematic underdevelopment of the US. South began with the region\u27s first incorporation into the world-economy beginning with European \u27discovery’ and conquest. Furthermore, even when the structures of accumulation were weakened at various points in the region\u27s history particularly with American independence and post-Civil War reunification incorporation was subsequently intensified. Consequently, rather than opportunities being extended to most of the region\u27s population at key junctures, structures of accumulation were increasingly controlled by a small elite group and the processes of underdevelopment were strengthened and intensified

Change Capacity as a Determinant of Sustainable ROI Implementation in Human Resource Development Practice

The demand for accountability through measurement continues to heighten application and use of the ROI (return-on-investment) Methodology™ as an essential part of human resource development (HRD) and program evaluation in both private and public sector organizations. Although progress has been made towards identifying best practices in ROI process implementation, sustainability of the process is an aspect of implementation that is often overlooked and under-estimated. This research identifies characteristics of sustainable ROI process implementation in HRD practice and offers a framework for ROI process maturity, along with practical guidelines to enhance evaluation process and practice maturity. The target population was drawn from public and private sector organizations in the U.S. that have offered ROI Methodology™ training to its employees and included HRD professionals who have had experience implementing the ROI Methodology™ and who have achieved, or who are in the process of achieving, ROI certification. A sequential, mixed methods research design was used to test and address four research objectives. Statistical analysis conducted during phase one showed a highly significant positive relationship between the degree of sustainable ROI process implementation and the degree in which a planned change process is applied to ROI process implementation. Statistical analysis also supports existing research that describes change capacity as a determinant of a sustainable, results-based evaluation system. Qualitative findings identified key themes related to enablers and barriers to implementation success and confirmed existing research about characteristics of a sustainable measurement and evaluation system, including: committed leadership; dedicated resources; internal support; contextualized implementation planning; business alignment; and individual and organizational change capacity and change readiness. Quantitative and qualitative research findings were linked during data collection and analysis and qualitative findings were used to expand upon interpretations and conclusions drawn from quantitative results to present a more comprehensive picture of sustainability issues. There was consistent agreement among groups about themes, factors, and characteristics of sustainability, including implementation success factors and implementation barriers. However, some differences emerged around the degree to which participating organizations have been able to sustain success factors and counter implementation barriers. Findings unique to this research show that the business context in which the ROI process is embedded is typically volatile and that organizational change patterns can impede successful implementation if not properly addressed. Other unique findings suggest that a multiplier effect takes place as the ROI Methodology™ becomes more embedded in an organization. In other words, the greater the operational maturity of the ROI Methodology™, the greater the multiplier effect of value creation as an outcome of sustainable ROI implementation. Implications for evaluation practice are provided, along with recommendations for future research

Teacher Induction: Exploring Beginning Teacher Mentorship

Induction programs, including mentorship, serve to bridge the transition from pre‐ service to in‐service teaching. This study explored the mentorship experiences of Saskatchewan beginning teachers. Analysis of interviews identified three themes: assigned/unassigned mentors, engaged/disengaged mentors, and single/multiple mentors. One moderating theme also emerged: the compatibility of the mentor and beginning teacher. The combination of themes provides preliminary support for an alternative model of mentoring based on learning communities and founded on the concepts of strong and weak ties and the constructivist model of knowledge. Key Words: theoretical model, mentor relationship, multiple mentors, learning com‐ munities Les programmes d’insertion professionnelle, dont les programmes de mentorat, ser‐ vent à faciliter la transition entre la formation initiale à l’enseignement et la prati‐ qued’enseignement. Cette recherche porte sur les expériences de nouveaux ensei‐ gnants en Saskatchewan. L’analyse des entrevues effectuées a permis d’identifier trois thèmes : mentors attitrés/non attitrés, mentors actifs/peu impliqués et mentor unique/mentors multiples. Un autre thème entre également en ligne de compte : la compatibilité entre le mentor et le nouvel enseignant. La combinaison de ces thèmes fournit un cadre préliminaire pour un nouveau modèle de mentorat axé sur des communautés d’apprentissage et fondé sur les concepts de liens étroits et faibles et le modèle constructiviste du savoir. Mots clés : modèle théorique, relation au mentor, mentors multiples, communautés d’apprentissage

Plenary Session I – Medical Track: Identifying Medically At-Risk Drivers

This session will focus on assessing and identifying medical conditions that may impact one’s ability to safely operate a motor vehicle. The session will include information on Alzheimer’s disease, dementia, changes in vision, reaction time, and cognition

Dynamic Attention as a Predictor of Driving Performance in Clinical Populations: Preliminary Results

Existing tests (e.g., useful field of view; UFOV) that are commonly used to evaluate visual attention when predicting at-risk drivers do not have a dynamic component. In this project, we developed a brief computerized test of dynamic visual attention (multiple object tracking; MOT). Estimates of threshold tracking speed from the brief MOT test showed good agreement with those determined by a full psychometric function (n = 41, r = 0.876, p \u3c 0.001). The brief MOT test was then implemented in a clinical driving assessment program; participants with poorer MOT scores had higher error scores on the road test (n = 15, r = -0.670, p = 0.006)

Response to anti-IL17 therapy in inflammatory disease is not strongly impacted by genetic background

Response to the anti-IL17 monoclonal antibody secukinumab is heterogeneous, and not all participants respond to treatment. Understanding whether this heterogeneity is driven by genetic variation is a key aim of pharmacogenetics and could influence precision medicine approaches in inflammatory diseases. Using changes in disease activity scores across 5,218 genotyped individuals from 19 clinical trials across four indications (psoriatic arthritis, psoriasis, ankylosing spondylitis, and rheumatoid arthritis), we tested whether genetics predicted response to secukinumab. We did not find any evidence of association between treatment response and common variants, imputed HLA alleles, polygenic risk scores of disease susceptibility, or cross-disease components of shared genetic risk. This suggests that anti-IL17 therapy is equally effective regardless of an individual’s genetic background, a finding that has important implications for future genetic studies of biological therapy response in inflammatory diseases

Outcomes and Cost-Effectiveness of Two Nicotine Replacement Treatment Delivery Models for a Tobacco Quitline

Many tobacco cessation quitlines provide nicotine replacement therapy (NRT) in the U.S. but consensus is lacking regarding the best shipping protocol or NRT amounts. We evaluated the impact of the Minnesota QUITPLAN® Helpline’s shift from distributing NRT using a single eight-week shipment to a two-shipment protocol. For this observational study, the eight week single-shipment cohort (n = 247) received eight weeks of NRT (patches or gum) at once, while the split-shipment cohort (n = 160) received five weeks of NRT (n = 94), followed by an additional three weeks of NRT if callers continued with counseling (n = 66). Patient satisfaction, retention, quit rates, and cost associated with the three groups were compared. A higher proportion of those receiving eight weeks of NRT, whether in one or two shipments, reported that the helpline was “very helpful” (77.2% of the single-shipment group; 81.1% of the two-shipment group) than those receiving five weeks of NRT (57.8% of the one-shipment group) (p = 0.004). Callers in the eight week two-shipment group completed significantly more calls (3.0) than callers in the five week one-shipment group (2.4) or eight week single-shipment group (1.7) (p < 0.001). Using both responder and intent-to-treat calculations, there were no significant differences in 30-day point prevalence abstinence at seven months among the three protocol groups even when controlling for demographic and tobacco use characteristics, and treatment group protocol. The mean cost per caller was greater for the single-shipment phase than the split-shipment phase ($350 vs.$326) due to the savings associated with not sending a second shipment to some participants. Assuming no difference in abstinence rates resulting from the protocol change, cost-per-quit was lowest for the five week one-shipment group ($1,155), and lower for the combined split-shipment cohort ($1,242) than for the single-shipment cohort ($1,350). Results of this evaluation indicate that while satisfaction rates increase among those receiving more counseling and NRT, quit rates do not, even when controlling for demographic and tobacco use characteristics

Antipsychotic medication versus psychological intervention versus a combination of both in adolescents with first-episode psychosis (MAPS): a multicentre, three-arm, randomised controlled pilot and feasibility study

Background Evidence for the effectiveness of treatments in early-onset psychosis is sparse. Current guidance for the treatment of early-onset psychosis is mostly extrapolated from trials in adult populations. The UK National Institute for Health and Care Excellence has recommended evaluation of the clinical effectiveness and cost-effectiveness of antipsychotic drugs versus psychological intervention (cognitive behavioural therapy [CBT] and family intervention) versus the combination of these treatments for early-onset psychosis. The aim of this study was to establish the feasibility of a randomised controlled trial of antipsychotic monotherapy, psychological intervention monotherapy, and antipsychotics plus psychological intervention in adolescents with first-episode psychosis. Methods We did a multicentre pilot and feasibility trial according to a randomised, single-blind, three-arm, controlled design. We recruited participants from seven UK National Health Service Trust sites. Participants were aged 14–18 years; help-seeking; had presented with first-episode psychosis in the past year; were under the care of a psychiatrist; were showing current psychotic symptoms; and met ICD-10 criteria for schizophrenia, schizoaffective disorder, or delusional disorder, or met the entry criteria for an early intervention for psychosis service. Participants were assigned (1:1:1) to antipsychotics, psychological intervention (CBT with optional family intervention), or antipsychotics plus psychological intervention. Randomisation was via a web-based randomisation system, with permuted blocks of random size, stratified by centre and family contact. CBT incorporated up to 26 sessions over 6 months plus up to four booster sessions, and family intervention incorporated up to six sessions over 6 months. Choice and dose of antipsychotic were at the discretion of the treating consultant psychiatrist. Participants were followed up for a maximum of 12 months. The primary outcome was feasibility (ie, data on trial referral and recruitment, session attendance or medication adherence, retention, and treatment acceptability) and the proposed primary efficacy outcome was total score on the Positive and Negative Syndrome Scale (PANSS) at 6 months. Primary outcomes were analysed by intention to treat. Safety outcomes were reported according to as-treated status, for all patients who had received at least one session of CBT or family intervention, or at least one dose of antipsychotics. The study was prospectively registered with ISRCTN, ISRCTN80567433. Findings Of 101 patients referred to the study, 61 patients (mean age 16·3 years [SD 1·3]) were recruited from April 10, 2017, to Oct 31, 2018, 18 of whom were randomly assigned to psychological intervention, 22 to antipsychotics, and 21 to antipsychotics plus psychological intervention. The trial recruitment rate was 68% of our target sample size of 90 participants. The study had a low referral to recruitment ratio (around 2:1), a high rate of retention (51 [84%] participants retained at the 6-month primary endpoint), a high rate of adherence to psychological intervention (defined as six or more sessions of CBT; in 32 [82%] of 39 participants in the monotherapy and combined groups), and a moderate rate of adherence to antipsychotic medication (defined as at least 6 consecutive weeks of exposure to antipsychotics; in 28 [65%] of 43 participants in the monotherapy and combined groups). Mean scores for PANSS total at the 6-month primary endpoint were 68·6 (SD 17·3) for antipsychotic monotherapy (6·2 points lower than at randomisation), 59·8 (13·7) for psychological intervention (13·1 points lower than at randomisation), and 62·0 (15·9) for antipsychotics plus psychological intervention (13·9 points lower than at randomisation). A good clinical response at 6 months (defined as ≥50% improvement in PANSS total score) was achieved in four (22%) of 18 patients receiving antipsychotic monotherapy, five (31%) of 16 receiving psychological intervention, and five (29%) of 17 receiving antipsychotics plus psychological intervention. In as-treated groups, serious adverse events occurred in eight [35%] of 23 patients in the combined group, two [13%] of 15 in the antipsychotics group, four [24%] of 17 in the psychological intervention group, and four [80%] of five who did not receive any treatment. No serious adverse events were considered to be related to participation in the trial. Interpretation This trial is the first to show that a head-to-head clinical trial comparing psychological intervention, antipsychotics, and their combination is safe in young people with first-episode psychosis. However, the feasibility of a larger trial is unclear because of site-specific recruitment challenges, and amendments to trial design would be needed for an adequately powered clinical and cost-effectiveness trial that provides robust evidence

SMART trial: A randomized clinical trial of self-monitoring in behavioral weight management-design and baseline findings.

BACKGROUND: The primary form of treatment for obesity today is behavioral therapy. Self-monitoring diet and physical activity plays an important role in interventions targeting behavior and weight change. The SMART weight loss trial examined the impact of replacing the standard paper record used for self-monitoring with a personal digital assistant (PDA). This paper describes the design, methods, intervention, and baseline sample characteristics of the SMART trial. METHODS: The SMART trial used a 3-group design to determine the effects of different modes of self-monitoring on short- and long-term weight loss and on adherence to self-monitoring in a 24-month intervention. Participants were randomized to one of three conditions (1) use of a standard paper record (PR); (2) use of a PDA with dietary and physical activity software (PDA); or (3), use of a PDA with the same software plus a customized feedback program (PDA + FB). RESULTS: We screened 704 individuals and randomized 210. There were statistically but not clinically significant differences among the three cohorts in age, education, HDL cholesterol, blood glucose and systolic blood pressure. At 24 months, retention rate for the first of three cohorts was 90%. CONCLUSIONS: To the best of our knowledge, the SMART trial is the first large study to compare different methods of self-monitoring in a behavioral weight loss intervention and to compare the use of PDAs to conventional paper records. This study has the potential to reveal significant details about self-monitoring patterns and whether technology can improve adherence to this vital intervention component