94 research outputs found
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Texas Catholic Missions Travel Guide
This presentation describes the use of The Portal to Texas History in the classroom through a lesson plan creating a journey through Spanish Missions in Texas
School leadership mentoring characteristics in an era of significant educational reform.
The state of Indiana is undergoing substantial educational reform,as is the nation.Educational leaders are in great need of support as they address reform initiatives.The support that educational leaders receive from mentors/coaches may be a determining factor in how they embrace the latest reform and work with their school communities.The primary purpose of this study was to understand the role of experienced superintendents/district leaders as mentors and coaches to new superintendents/district leaders in times of stressful educational reform.Four experienced district leaders were interviewed using the research method of qualitative inquiry.Based on the perceptions of four experienced district leaders in response to interview questions involving leadership skills outlined by the National Association of Secondary School Principals:Mentoring and Coaching-Developing Educational Leaders,the following conclusions were made:1)The mentor's leadership style is significant in the mentoring of new district leaders.Each participant described his or her leadership styles differently,yet there is a connection of high involvement in their organizations and the need to adapt their leadership to each unique situation. 2)Legislative agendas are directly impacting district leadership.Both Indiana Senate Bill No 575(Collective Bargaining Act,2011a)and Indiana Senate Bill No 1(Teaching Evaluation and Licensing Act,2011b)clearly focus on district leaders.3)Stress defines educational leadership and is a persistent topic between mentors and mentees. 4)Stress is a positive factor in leading.However,the stress from current educational reform is viewed as a positive factor in leading amidst the negative stressors. 5)Successful mentoring practices in education among participants are more informal than formal.6)The reasons for mentoring in an educational setting are grounded in feeling of moral accountability regarding mentoring and giving back to the craft of leading.Bobbie Jo MonahanBalch, BradleyGambaiani, LarryGruenert, SteveDoctor of PhilosophyDepartment of Educational Leadership, Administration, and FoundationsCunningham Memorial library, Terre Haute,Indiana State UniversityILL-ETD-066DoctoralTitle from document title page. Document formatted into pages: contains 140 p.: ill. Includes abstract and appendi
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Academic Library Innovations and Developments in Support of Student Learning
Presentation for the 2015 Emerging Technologies for Online Learning International Symposium. This presentation discusses academic library innovations and developments in support of student learning
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Teaming up with Your Graduate School for Academic and Career Success
As libraries continue to reinvent themselves to remain relevant, spaces, services, and instruction targeted specifically for the needs of the graduate student community are essential. This chapter describes how the Library Research Support Services Department (LRSS) of the University of North Texas (UNT) Libraries has collaborated with The Toulouse Graduate School (TGS) to support graduate students through the process of achieving the following three milestones: (1) writing the dissertation or thesis proposal, (2) completing the writing of the dissertation or thesis, and (3) developing an elevator speech for potential employers
In-training assessment using direct observation of single-patient encounters: a literature review
We reviewed the literature on instruments for work-based assessment in single clinical encounters, such as the mini-clinical evaluation exercise (mini-CEX), and examined differences between these instruments in characteristics and feasibility, reliability, validity and educational effect. A PubMed search of the literature published before 8 January 2009 yielded 39 articles dealing with 18 different assessment instruments. One researcher extracted data on the characteristics of the instruments and two researchers extracted data on feasibility, reliability, validity and educational effect. Instruments are predominantly formative. Feasibility is generally deemed good and assessor training occurs sparsely but is considered crucial for successful implementation. Acceptable reliability can be achieved with 10 encounters. The validity of many instruments is not investigated, but the validity of the mini-CEX and the ‘clinical evaluation exercise’ is supported by strong and significant correlations with other valid assessment instruments. The evidence from the few studies on educational effects is not very convincing. The reports on clinical assessment instruments for single work-based encounters are generally positive, but supporting evidence is sparse. Feasibility of instruments seems to be good and reliability requires a minimum of 10 encounters, but no clear conclusions emerge on other aspects. Studies on assessor and learner training and studies examining effects beyond ‘happiness data’ are badly needed
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Investigating the impact of CO2 on low-frequency variability of the AMOC in HadCM3
This study investigates the impact of CO2 on the amplitude, frequency, and mechanisms of Atlantic meridional
overturning circulation (AMOC) variability in millennial simulations of the HadCM3 coupled climate
model. Multichannel singular spectrum analysis (MSSA) and empirical orthogonal functions (EOFs)
are applied to the AMOC at four quasi-equilibrium CO2 forcings. The amount of variance explained by the
first and second eigenmodes appears to be small (i.e., 11.19%); however, the results indicate that both AMOC
strength and variability weaken at higher CO2 concentrations. This accompanies an apparent shift from a
predominant 100–125-yr cycle at 350 ppm to 160 yr at 1400 ppm. Changes in amplitude are shown to feed back
onto the atmosphere. Variability may be linked to salinity-driven density changes in the Greenland–Iceland–
Norwegian Seas, fueled by advection of anomalies predominantly from the Arctic and Caribbean regions. A
positive density anomaly accompanies a decrease in stratification and an increase in convection and Ekman
pumping, generating a strong phase of the AMOC (and vice versa). Arctic anomalies may be generated via an
internal ocean mode that may be key in driving variability and are shown to weaken at higher CO2, possibly
driving the overall reduction in amplitude. Tropical anomalies may play a secondary role in modulating
variability and are thought to be more influential at higher CO2, possibly due to an increased residence time in
the subtropical gyre and/or increased surface runoff driven by simulated dieback of the Amazon rain forest.
These results indicate that CO2 may not only weaken AMOC strength but also alter the mechanisms that
drive variability, both of which have implications for climate change on multicentury time scales
Identification of a Novel Gene Product That Promotes Survival of Mycobacterium smegmatis in Macrophages
BACKGROUND: Bacteria of the suborder Corynebacterineae include significant human pathogens such as Mycobacterium tuberculosis and M. leprae. Drug resistance in mycobacteria is increasingly common making identification of new antimicrobials a priority. Mycobacteria replicate intracellularly, most commonly within the phagosomes of macrophages, and bacterial proteins essential for intracellular survival and persistence are particularly attractive targets for intervention with new generations of anti-mycobacterial drugs. METHODOLOGY/PRINCIPAL FINDINGS: We have identified a novel gene that, when inactivated, leads to accelerated death of M. smegmatis within a macrophage cell line in the first eight hours following infection. Complementation of the mutant with an intact copy of the gene restored survival to near wild type levels. Gene disruption did not affect growth compared to wild type M. smegmatis in axenic culture or in the presence of low pH or reactive oxygen intermediates, suggesting the growth defect is not related to increased susceptibility to these stresses. The disrupted gene, MSMEG_5817, is conserved in all mycobacteria for which genome sequence information is available, and designated Rv0807 in M. tuberculosis. Although homology searches suggest that MSMEG_5817 is similar to the serine:pyruvate aminotransferase of Brevibacterium linens suggesting a possible role in glyoxylate metabolism, enzymatic assays comparing activity in wild type and mutant strains demonstrated no differences in the capacity to metabolize glyoxylate. CONCLUSIONS/SIGNIFICANCE: MSMEG_5817 is a previously uncharacterized gene that facilitates intracellular survival of mycobacteria. Interference with the function of MSMEG_5817 may provide a novel therapeutic approach for control of mycobacterial pathogens by assisting the host immune system in clearance of persistent intracellular bacteria
A Novel Approach to Determining Violence Risk in Schizophrenia: Developing a Stepped Strategy in 13,806 Discharged Patients
Clinical guidelines recommend that violence risk be assessed in schizophrenia. Current approaches are resource-intensive as they employ detailed clinical assessments of dangerousness for most patients. An alternative approach would be to first screen out patients at very low risk of future violence prior to more costly and time-consuming assessments. In order to implement such a stepped strategy, we developed a simple tool to screen out individuals with schizophrenia at very low risk of violent offending. We merged high quality Swedish national registers containing information on psychiatric diagnoses, socio-demographic factors, and violent crime. A cohort of 13,806 individuals with hospital discharge diagnoses of schizophrenia was identified and followed for up to 33 years for violent crime. Cox regression was used to determine risk factors for violent crime and construct the screening tool, the predictive validity of which was measured using four outcome statistics. The instrument was calibrated on 6,903 participants and cross-validated using three independent replication samples of 2,301 participants each. Regression analyses resulted in a tool composed of five items: male sex, previous criminal conviction, young age at assessment, comorbid alcohol abuse, and comorbid drug abuse. At 5 years after discharge, the instrument had a negative predictive value of 0.99 (95% CI = 0.98–0.99), meaning that very few individuals who the tool screened out (n = 2,359 out of original sample of 6,903) were subsequently convicted of a violent offence. Screening out patients who are at very low risk of violence prior to more detailed clinical assessment may assist the risk assessment process in schizophrenia
Syndromics: A Bioinformatics Approach for Neurotrauma Research
Substantial scientific progress has been made in the past 50 years in delineating many of the biological mechanisms involved in the primary and secondary injuries following trauma to the spinal cord and brain. These advances have highlighted numerous potential therapeutic approaches that may help restore function after injury. Despite these advances, bench-to-bedside translation has remained elusive. Translational testing of novel therapies requires standardized measures of function for comparison across different laboratories, paradigms, and species. Although numerous functional assessments have been developed in animal models, it remains unclear how to best integrate this information to describe the complete translational “syndrome” produced by neurotrauma. The present paper describes a multivariate statistical framework for integrating diverse neurotrauma data and reviews the few papers to date that have taken an information-intensive approach for basic neurotrauma research. We argue that these papers can be described as the seminal works of a new field that we call “syndromics”, which aim to apply informatics tools to disease models to characterize the full set of mechanistic inter-relationships from multi-scale data. In the future, centralized databases of raw neurotrauma data will enable better syndromic approaches and aid future translational research, leading to more efficient testing regimens and more clinically relevant findings
Mechanisms and management of loss of response to anti-TNF therapy for patients with Crohn's disease: 3-year data from the prospective, multicentre PANTS cohort study
This is the final version. Available from Elsevier via the DOI in this record. Background We sought to report the effectiveness of infliximab and adalimumab over the first 3 years of treatment
and to define the factors that predict anti-TNF treatment failure and the strategies that prevent or mitigate loss of
response.
Methods Personalised Anti-TNF therapy in Crohn’s disease (PANTS) is a UK-wide, multicentre, prospective
observational cohort study reporting the rates of effectiveness of infliximab and adalimumab in anti-TNF-naive patients
with active luminal Crohn’s disease aged 6 years and older. At the end of the first year, sites were invited to enrol
participants still receiving study drug into the 2-year PANTS-extension study. We estimated rates of remission across
the whole cohort at the end of years 1, 2, and 3 of the study using a modified survival technique with permutation
testing. Multivariable regression and survival analyses were used to identify factors associated with loss of response
in patients who had initially responded to anti-TNF therapy and with immunogenicity. Loss of response was defined
in patients who initially responded to anti-TNF therapy at the end of induction and who subsequently developed
symptomatic activity that warranted an escalation of steroid, immunomodulatory, or anti-TNF therapy, resectional
surgery, or exit from study due to treatment failure. This study was registered with ClinicalTrials.gov, NCT03088449,
and is now complete.
Findings Between March 19, 2014, and Sept 21, 2017, 389 (41%) of 955 patients treated with infliximab and
209 (32%) of 655 treated with adalimumab in the PANTS study entered the PANTS-extension study (median age
32·5 years [IQR 22·1–46·8], 307 [51%] of 598 were female, and 291 [49%] were male). The estimated proportion of
patients in remission at the end of years 1, 2, and 3 were, for infliximab 40·2% (95% CI 36·7–43·7),
34·4% (29·9–39·0), and 34·7% (29·8–39·5), and for adalimumab 35·9% (95% CI 31·2–40·5), 32·9% (26·8–39·2),
and 28·9% (21·9–36·3), respectively. Optimal drug concentrations at week 14 to predict remission at any later
timepoints were 6·1–10·0 mg/L for infliximab and 10·1–12·0 mg/L for adalimumab. After excluding patients who
had primary non-response, the estimated proportions of patients who had loss of response by years 1, 2, and 3
were, for infliximab 34·4% (95% CI 30·4–38·2), 54·5% (49·4–59·0), and 60·0% (54·1–65·2), and for adalimumab
32·1% (26·7–37·1), 47·2% (40·2–53·4), and 68·4% (50·9–79·7), respectively. In multivariable analysis, loss of
response at year 2 and 3 for patients treated with infliximab and adalimumab was predicted by low anti-TNF drug
concentrations at week 14 (infliximab: hazard ratio [HR] for each ten-fold increase in drug concentration 0·45
[95% CI 0·30–0·67], adalimumab: 0·39 [0·22–0·70]). For patients treated with infliximab, loss of response was
also associated with female sex (vs male sex; HR 1·47 [95% CI 1·11–1·95]), obesity (vs not obese 1·62 [1·08–2·42]),
baseline white cell count (1·06 [1·02–1·11) per 1 × 10⁹ increase in cells per L), and thiopurine dose quartile. Among
patients treated with adalimumab, carriage of the HLA-DQA1*05 risk variant was associated with loss of response
(HR 1·95 [95% CI 1·17–3·25]). By the end of year 3, the estimated proportion of patients who developed anti-drug
antibodies associated with undetectable drug concentrations was 44·0% (95% CI 38·1–49·4) among patients
treated with infliximab and 20·3% (13·8–26·2) among those treated with adalimumab. The development of antidrug antibodies associated with undetectable drug concentrations was significantly associated with treatment
without concomitant immunomodulator use for both groups (HR for immunomodulator use: infliximab 0·40
[95% CI 0·31–0·52], adalimumab 0·42 [95% CI 0·24–0·75]), and with carriage of HLA-DQA1*05 risk variant for
infliximab (HR for carriage of risk variant: infliximab 1·46 [1·13–1·88]) but not for adalimumab (HR 1·60
[0·92–2·77]). Concomitant use of an immunomodulator before or on the day of starting infliximab was associated
with increased time without the development of anti-drug antibodies associated with undetectable drug
concentrations compared with use of infliximab alone (HR 2·87 [95% CI 2·20–3·74]) or introduction of an
immunomodulator after anti-TNF initiation (1·70 [1·11–2·59]). In years 2 and 3, 16 (4%) of 389 patients treated
with infliximab and 11 (5%) of 209 treated with adalimumab had adverse events leading to treatment withdrawal.
Nine (2%) patients treated with infliximab and two (1%) of those treated with adalimumab had serious infections
in years 2 and 3.
Interpretation Only around a third of patients with active luminal Crohn’s disease treated with an anti-TNF drug were
in remission at the end of 3 years of treatment. Low drug concentrations at the end of the induction period predict
loss of response by year 3 of treatment, suggesting higher drug concentrations during the first year of treatment,
particularly during induction, might lead to better long-term outcomes. Anti-drug antibodies associated with
undetectable drug concentrations of infliximab, but not adalimumab, can be predicted by carriage of HLA-DQA1*05
and mitigated by concomitant immunomodulator use for both drugs.Guts UKCrohn’s and Colitis UKCure Crohn’s ColitisAbbVieMerck Sharp and DohmeNapp PharmaceuticalsPfizerCelltrion Healthcar
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