Toward a More Functional Analysis of Aggression

Given the substantial and oftentimes irreversible human loss resulting from aggressive acts, the need for systematic, treatment-linked assessment of aggression in school-aged children and youth cannot be overstated. Based upon recent research, the authors provide a broadly framed model for the functional analysis of aggression in school-age children and youth. Our model incorporates multi-modal data collection and data triangulation to generate credible hypotheses regarding the function(s) of aggression. Three primary data sources—record review and interviews, naturalistic observation, and analogue assessment—form the cornerstone of the model. Key features of our approach to the assessment of aggression include operational definition(s) of target behavior(s), examination of the environmental context(s) of aggression, and discovery of the function(s) of aggressive behaviors for the individual. Samples of several specific, ready-to-use data collection instruments and a basic description of the assessment procedure are presented. The assessment process assumes that a team of individuals participates in data collection, data analysis, and hypothesis generation

Improving Election Administration with Vote Centers: Toward a National Model

Paper prepared for delivery at the Western Political Science Association annual meeting, Vancouver, BC, Canada, March 19, 2009This paper was produced as a product of the Making Voting Work: Assessment and Evaluation of Indiana Voting Centers project. This project was funded by the Make Voting Work Project of the Pew Charitable Trusts in Washington, D.C. The Indiana project was directed by Dr. Ray Scheele and focused on the three Indiana counties (Cass, Tippecanoe and Wayne) that initiated Vote Centers in 2007 and 2008 to replace traditional precinct polling places. The final report was submitted to Pew Charitable Trusts in December 2009 and the data are being analyzed for academic conference papers

Medical student wellbeing - a consensus statement from Australia and New Zealand

Abstract Background Medical student wellbeing – a consensus statement from Australia and New Zealand outlines recommendations for optimising medical student wellbeing within medical schools in our region. Worldwide, medical schools have responsibilities to respond to concerns about student psychological, social and physical wellbeing, but guidance for medical schools is limited. To address this gap, this statement clarifies key concepts and issues related to wellbeing and provides recommendations for educational program design to promote both learning and student wellbeing. The recommendations focus on student selection; learning, teaching and assessment; learning environment; and staff development. Examples of educational initiatives from the evidence-base are provided, emphasising proactive and preventive approaches to student wellbeing. Main recommendations The consensus statement provides specific recommendations for medical schools to consider at all stages of program design and implementation. These are:Design curricula that promote peer support and progressive levels of challenge to students.Employ strategies to promote positive outcomes from stress and to help others in need.Design assessment tasks to foster wellbeing as well as learning.Provide mental health promotion and suicide prevention initiatives.Provide physical health promotion initiatives.Ensure safe and health-promoting cultures for learning in on-campus and clinical settings.Train staff on student wellbeing and how to manage wellbeing concerns. Conclusion A broad integrated approach to improving student wellbeing within medical school programs is recommended. Medical schools should work cooperatively with student and trainee groups, and partner with clinical services and other training bodies to foster safe practices and cultures. Initiatives should aim to assist students to develop adaptive responses to stressful situations so that graduates are prepared for the realities of the workplace. Multi-institutional, longitudinal collaborative research in Australia and New Zealand is needed to close critical gaps in the evidence needed by medical schools in our region

Acute cough: a diagnostic and therapeutic challenge

Abstract Background Acute cough is one of the most common complaints prompting patient visits to healthcare professionals. Despite the broad repercussions of acute cough on patient quality of life, school and work productivity, and public health resources, research on this condition is minimal, as are the available treatment options. Many patients use over-the-counter medicines, which are often ineffective for symptom relief. Some therapies may achieve antitussive activity, but at the expense of unpleasant or intolerable side effects. Unmet needs When considering the treatments currently available for the management of acute cough, the multiple limitations of such treatments are quite apparent. Most of these treatments lack clinically proven efficacy and reliability to support their use. This reinforces the need for the generation of quality scientific data from well-performed clinical trials. Hopefully, the result will be the development of safer, more effective and more reliable therapeutic options in the management of acute cough. Cough assessment and management Acute cough can be due to a variety of causes, and it is worthwhile to consider these pathogenic factors in some detail. It is also important to be familiar with the effects that acute cough has on patients' quality of life, work productivity, and the healthcare system; proper awareness of these effects may contribute to better understanding of the social impact of cough. In reference to the available treatments for the management of acute cough, adequate knowledge of the type of over-the-counter and prescription products in the market, as well as their mode of action and advantages/disadvantages, may provide expanded pharmacotherapeutic opportunities and facilitate better clinical decisions. However, due to the drawbacks of current treatment options, ideas for future cough management and newer products need to be considered and tested. Conclusion In view of the socio-economic impact of acute cough and the limitations of available treatments, a renewed interest in the management of acute cough needs to be encouraged. The current strategies for acute cough management need to be reassessed, with a focus on developing new, reliable products and formulations with proven efficacy and safety

Infant Hearing Screening 1984 to 1989: The Henry Ford Hospital Experience

From 1984 to 1989 the Infant Hearing Screening (IHS) program at Henry Ford Hospital identified 1,300 infants as being at risk for hearing loss. The prevalence of significant sensorineural hearing loss in this sample was 1.4%. Additionally, 80 infants who passed the IHS program and reached 3 years of age were found to have normal hearing sensitivity by conventional audiometric techniques (ie, no false-negative predictions). There were three false-positive predictions. It was discovered that infants of low birthweight (ie, \u3c 1,500 g) were three times more likely to fail IHS than those whose weight exceeded 1,500 g. A higher return rate was found for infants failing an initial hearing screening conducted in the neonatal intensive care unit in comparison to those screened as outpatients one week postdischarge. The sensitivity and specificity of behavioral observation audiometry were 43% and 92%, respectively, when brainstem auditory-evoked potentials was used as the criterion validity measure

Interviews with Dorothy Jane Nuckolls, Joseph, Vodraska, Connie Congdon and Kay Finley

Interviews with Dorothy Jane Nuckolls, Joseph, Vodraska, Connie Congdon and Kay Finley 00:00:00 - Recording begins in-progress. Song, I Will Never Marry vocal with guitar 00:02:27 - Song, Engine 143 vocal with guitar 00:05:19 - Song, Squirty, Squirty vocal duet with guitar 00:06:25 - Song, Old Paint vocal with guitar 00:08:01 - Introduction, Joseph H. Vodraska of Wilson, KS by Mona Mae Brubaker on November 1, 1963 in Blackwolf, KS. 00:08:27 - Song, Austrian-Hungarian Cavalry Song played on accordion 00:09:01 - Song, Austrian-Hungarian Cavalry Song vocal, in Czech 00:10:55 - Song, May I Sleep In Your Barn Tonight, Mister? vocal group and accordion, to the tune of Red River Valley 00:13:41 - Introduction, Connie Congdon and Kay Finley of Garden City, KS by Gary Freeman on November 23, 1963 00:14:00 - Song, Mandy vocal duet with guitar. This portion of the tape suffers from distortion. 00:18:04 - Song, In the Pines vocal duet with guitar. 00:20:12 - Song, How Sad Flows The Stream vocal with guitar 00:21:52 - Song, Darlin\u27 Corey vocal with guitar 00:26:50 - Song, O\u27 Freedom vocal with guitar 00:30:32 - Song, Handsome, Winsome Johnny vocal with guitar 00:34:20 - Song, Good Ol\u27 Mountain Dew vocal with guitar 00:37:06 - Song, Pretty Saro vocal with guitar 00:40:23 - Song, Goodnight Irene vocal with guitar 00:43:05 - Song, Jamaica Goodbye vocal with guitar 00:45:06 - Concluding remarks 00:45:37 - Tape concludes with a faint musical recording and conversationhttps://scholars.fhsu.edu/sackett/1090/thumbnail.jp

General Practice Management of Type 2 Diabetes: 2016–18

[Extract] Diabetes is a national health priority. The Australian National Diabetes Strategy 2016–2020was released by the Australian Government in November 2013. The number of people with type 2 diabetes is growing, most likely the result of rising overweight and obesity rates, lifestyle and dietary changes, and an ageing population. Within 20 years, the number of people in Australia with type 2 diabetes may increase from an estimated 870,000 in 2014, to more than 2.5 million.1The most socially disadvantaged Australians are twice as likely to develop diabetes. If left undiagnosed or poorly managed, type 2 diabetes can lead to coronary artery disease (CAD), stroke, kidney failure, limb amputations and blindness. The early identification and optimal management of people with type 2 diabetes is therefore critical. General practice has the central role in type 2 diabetes management across the spectrum, from identifying those at risk right through to caring for patients at the end of life. These guidelines give up-to-date, evidence-based information tailored for general practice to support general practitioners (GPs) and their teams in providing high-quality management.1In the development of the 2016–18 edition of General practice management of type 2 diabetes, The Royal Australian College of General Practitioners (RACGP) has focused on factors relevant to current Australian clinical practice. The RACGP has used the skills and knowledge of your general practice peers who have an interest in diabetes management and are members of the RACGP Specific Interests Diabetes Network. This publication has been produced in accordance with the rules and processes outlined in the RACGP’s conflict of interest (COI) policy. The RACGP’s COI policy is available at www.racgp.org.au/support/policies/organisationalThis edition represents 19 years of a successful relationship between the RACGP and Diabetes Australia. We acknowledge the support of the RACGP Expert Committee – Quality Care, the Medical Education and Scientific Committee of Diabetes Australia, and RACGP staff in the development of these guideline

Is bureaucracy being busted in research ethics and governance for health services research in the UK?:Experiences and perspectives reported by stakeholders through an online survey

Acknowledgements: We would like to thank the Board of Trustees of HSRUK for support and advice throughout study. Thank you to all respondents to the survey for contributing their data and views. The HRA and NIHR are also warmly acknowledged for their continued support throughout the study.Peer reviewedPublisher PD

Cholinergic neurons in the dorsomedial hypothalamus regulate mouse brown adipose tissue metabolism.

OBJECTIVE: Brown adipose tissue (BAT) thermogenesis is critical in maintaining body temperature. The dorsomedial hypothalamus (DMH) integrates cutaneous thermosensory signals and regulates adaptive thermogenesis. Here, we study the function and synaptic connectivity of input from DMH cholinergic neurons to sympathetic premotor neurons in the raphe pallidus (Rpa). METHODS: In order to selectively manipulate DMH cholinergic neuron activity, we generated transgenic mice expressing channelrhodopsin fused to yellow fluorescent protein (YFP) in cholinergic neurons (choline acetyltransferase (ChAT)-Cre::ChR2-YFP) with the Cre-LoxP technique. In addition, we used an adeno-associated virus carrying the Cre recombinase gene to delete the floxed Chat gene in the DMH. Physiological studies in response to optogenetic stimulation of DMH cholinergic neurons were combined with gene expression and immunocytochemical analyses. RESULTS: A subset of DMH neurons are ChAT-immunopositive neurons. The activity of these neurons is elevated by warm ambient temperature. A phenotype-specific neuronal tracing shows that DMH cholinergic neurons directly project to serotonergic neurons in the Rpa. Optical stimulation of DMH cholinergic neurons decreases BAT activity, which is associated with reduced body core temperature. Furthermore, elevated DMH cholinergic neuron activity decreases the expression of BAT uncoupling protein 1 (Ucp1) and peroxisome proliferator-activated receptor γ coactivator 1 α (Pgc1α) mRNAs, markers of BAT activity. Injection of M2-selective muscarinic receptor antagonists into the 4th ventricle abolishes the effect of optical stimulation. Single cell qRT-PCR analysis of retrogradely identified BAT-projecting neurons in the Rpa shows that all M2 receptor-expressing neurons contain tryptophan hydroxylase 2. In animals lacking the Chat gene in the DMH, exposure to warm temperature reduces neither BAT Ucp1 nor Pgc1α mRNA expression. CONCLUSION: DMH cholinergic neurons directly send efferent signals to sympathetic premotor neurons in the Rpa. Elevated cholinergic input to this area reduces BAT activity through activation of M2 mAChRs on serotonergic neurons. Therefore, the direct DMH(ACh)-Rpa(5-HT) pathway may mediate physiological heat-defense responses to elevated environmental temperature.We thank Althea Cavanaugh and Licheng Wu for technical supports. This work was supported by NIDDK (RO1DK092246) to Y.-H.J. and New York obesity nutrition research center to J.H.J.This is the final published version. It first appeared at http://www.sciencedirect.com/science/article/pii/S2212877815000617