Building an effective one-on-one working relationship between middle school teachers and parents: What are the steps of learning for teachers?

The topic of parental involvement has been widely studied but within the topic, the area of training teachers to work with parents has not. The training and preparation for teachers to work with parents are scarce and at times, non-existent. The primary purpose of this study is to examine effective middle school teachers about the steps on their path of learning to work effectively with parents. The study also included middle student teachers that shared their needs in learning how to work with parents. The study focused on interviewing highly successful middle school teachers in the area of working with parents. The first part of the study involved 18 semi-structured interviews with teachers who were recommended by their building administrators because the administrators have first hand information about the expert teachers in the area of working with parents. The second part of the study involved focus group interviews with middle school student teachers that shared their experiences, training and materials to learn to work with parents effectively in a university setting. Several homogeneous focus groups were established based on the SES (socio-economic status) level of schools where the student teachers were assigned. Data were analyzed and the results included eight categories that impacted the steps of learning for middle school teachers to work with parents: amount of training, methods of learning, personal experiences, communication tools, approaches to communication, teachers’ beliefs, support for teachers and suggestions for future training. The steps on the path of learning for teachers to work with parents were clearly established. Almost all teachers start with little to no training in the university as an undergraduate student. Often, teachers begin their first teaching position unprepared to work with parents. Therefore, they are left with a few methods of learning by being mentored, being observant and, unfortunately, trial and error as well. Moreover, teachers drew from their personal experiences ranging from being parents to doing other types of jobs. On the other hand, teachers learn to utilize the variety of communication tools that are widely available at most schools but the effectiveness of teachers comes from the wisdom in the usage of the communication tools for specific purposes. These steps of learning are supported by teacher’s own beliefs and approaches to communication. Furthermore, regardless of a teacher’s specific path of learning, he/she requires support and resources including administrators, counselors, teachers, other support staff and time. Finally, the participants gave suggestions for the purpose of improving training for future teachers

Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents

Objective: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries.Design: Population-based prospective observational study.Setting: Urban and rural communities in 20 high income, middle income and low income.Participants: 119 894 community-dwelling middle-aged adults.Main outcome measures: Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases.Results: Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and the unemployed. It was more frequent among smokers and those with a poorer diet. Social isolation was associated with greater risk of mortality (HR of 1.26, 95% CI: 1.17 to 1.36), incident stroke (HR: 1.23, 95% CI: 1.07 to 1.40), cardiovascular disease (HR: 1.15, 95% CI: 1.05 to 1.25) and pneumonia (HR: 1.22, 95% CI: 1.09 to 1.37), but not cancer. The associations between social isolation and mortality were observed in populations in high-income, middle-income and low-income countries (HR (95% CI): 1.69 (1.32 to 2.17), 1.27 (1.15 to 1.40) and 1.47 (1.25 to 1.73), respectively, interaction p=0.02). The HR associated with social isolation was greater in men than women and in younger than older individuals. Mediation analyses for the association between social isolation and mortality showed that unhealthy behaviours and comorbidities may account for about one-fifth of the association.Conclusion: Social isolation is associated with increased risk of mortality in countries at different economic levels. The increasing share of older people in populations in many countries argues for targeted strategies to mitigate its adverse effects

Try, try again: Lessons learned from success and failure in participatory modeling

Participatory Modeling (PM) is becoming increasingly common in environmental planning and conservation, due in part to advances in cyberinfrastructure as well as to greater recognition of the importance of engaging a diverse array of stakeholders in decision making. We provide lessons learned, based on over 200 years of the authors' cumulative and diverse experience, about PM processes. These include successful and, perhaps more importantly, not-so-successful trials. Our collective interdisciplinary background has supported the development, testing, and evaluation of a rich range of collaborative modeling approaches. We share here what we have learned as a community of participatory modelers, within three categories of reflection: a) lessons learned about participatory modelers; b) lessons learned about the context of collaboration; and c) lessons learned about the PM process. First, successful PM teams encompass a variety of skills beyond modeling expertise. Skills include: effective relationship-building, openness to learn from local experts, awareness of personal motivations and biases, and ability to translate discussions into models and to assess success. Second, the context for collaboration necessitates a culturally appropriate process for knowledge generation and use, for involvement of community co-leads, and for understanding group power dynamics that might influence how people from different backgrounds interact. Finally, knowing when to use PM and when not to, managing expectations, and effectively and equitably addressing conflicts is essential. Managing the participation process in PM is as important as managing the model building process. We recommend that PM teams consider what skills are present within a team, while ensuring inclusive creative space for collaborative exploration and learning supported by simple yet relevant models. With a realistic view of what it entails, PM can be a powerful approach that builds collective knowledge and social capital, thus helping communities to take charge of their future and address complex social and environmental problems

Systemic gene therapy rescues retinal dysfunction and hearing loss in a model of Norrie disease

Deafness affects 5% of the world's population, yet there is a lack of treatments to prevent hearing loss due to genetic causes. Norrie disease is a recessive X‐linked disorder, caused by NDP gene mutation. It manifests as blindness at birth and progressive sensorineural hearing loss, leading to debilitating dual sensory deprivation. To develop a gene therapy, we used a Norrie disease mouse model (Ndp$^{tm1Wbrg}$), which recapitulates abnormal retinal vascularisation and progressive hearing loss. We delivered human NDP cDNA by intravenous injection of adeno‐associated viral vector (AAV)9 at neonatal, juvenile and young adult pathological stages and investigated its therapeutic effects on the retina and cochlea. Neonatal treatment prevented the death of the sensory cochlear hair cells and rescued cochlear disease biomarkers as demonstrated by RNAseq and physiological measurements of auditory function. Retinal vascularisation and electroretinograms were restored to normal by neonatal treatment. Delivery of NDP gene therapy after the onset of the degenerative inner ear disease also ameliorated the cochlear pathology, supporting the feasibility of a clinical treatment for progressive hearing loss in people with Norrie disease

Systemic gene therapy rescues retinal dysfunction and hearing loss in a model of Norrie disease

Deafness affects 5% of the world's population, yet there is a lack of treatments to prevent hearing loss due to genetic causes. Norrie disease is a recessive X-linked disorder, caused by NDP gene mutation. It manifests as blindness at birth and progressive sensorineural hearing loss, leading to debilitating dual sensory deprivation. To develop a gene therapy, we used a Norrie disease mouse model (Ndptm1Wbrg ), which recapitulates abnormal retinal vascularisation and progressive hearing loss. We delivered human NDP cDNA by intravenous injection of adeno-associated viral vector (AAV)9 at neonatal, juvenile and young adult pathological stages and investigated its therapeutic effects on the retina and cochlea. Neonatal treatment prevented the death of the sensory cochlear hair cells and rescued cochlear disease biomarkers as demonstrated by RNAseq and physiological measurements of auditory function. Retinal vascularisation and electroretinograms were restored to normal by neonatal treatment. Delivery of NDP gene therapy after the onset of the degenerative inner ear disease also ameliorated the cochlear pathology, supporting the feasibility of a clinical treatment for progressive hearing loss in people with Norrie disease

Preventing obesity in infants: the growing healthy feasibility trial protocol

INTRODUCTION: Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course. Early feeding choices, including breast and/or formula, timing of introduction of solids, physical activity and electronic media use among infants and young children are considered likely determinants of childhood obesity. Parents play a primary role in shaping these behaviours through parental modelling, feeding styles, and the food and physical activity environments provided. Children from low socio-economic backgrounds have higher rates of obesity, making early intervention particularly important. However, such families are often more difficult to reach and may be less likely to participate in traditional programs that support healthy behaviours. Parents across all socio-demographic groups frequently access primary health care (PHC) services, including nurses in community health services and general medical practices, providing unparalleled opportunity for engagement to influence family behaviours. One emerging and promising area that might maximise engagement at a low cost is the provision of support for healthy parenting through electronic media such as the Internet or smart phones. The Growing healthy study explores the feasibility of delivering such support via primary health care services. METHODS: This paper describes the Growing healthy study, a non-randomised quasi experimental study examining the feasibility of an intervention delivered via a smartphone app (or website) for parents living in socioeconomically disadvantaged areas, for promoting infant feeding and parenting behaviours that promote healthy rather than excessive weight gain. Participants will be recruited via their primary health care practitioner and followed until their infant is 9 months old. Data will be collected via web-based questionnaires and the data collected inherently by the app itself. ETHICS AND DISSEMINATION: This study received approval from the University of Technology Sydney Ethics committee and will be disseminated via peer-reviewed publications and conference presentations

Assessing user engagement of an mHealth intervention: development and implementation of the growing healthy app engagement index

Background: Childhood obesity is an ongoing problem in developed countries that needs targeted prevention in the youngest age groups. Children in socioeconomically disadvantaged families are most at risk. Mobile health (mHealth) interventions offer a potential route to target these families because of its relatively low cost and high reach. The Growing healthy program was developed to provide evidence-based information on infant feeding from birth to 9 months via app or website. Understanding user engagement with these media is vital to developing successful interventions. Engagement is a complex, multifactorial concept that needs to move beyond simple metrics.Objective: The aim of our study was to describe the development of an engagement index (EI) to monitor participant interaction with the Growing healthy app. The index included a number of subindices and cut-points to categorize engagement.Methods: The Growing program was a feasibility study in which 300 mother-infant dyads were provided with an app which included 3 push notifications that was sent each week. Growing healthy participants completed surveys at 3 time points: baseline (T1) (infant age ≤3 months), infant aged 6 months (T2), and infant aged 9 months (T3). In addition, app usage data were captured from the app. The EI was adapted from the Web Analytics Demystified visitor EI. Our EI included 5 subindices: (1) click depth, (2) loyalty, (3) interaction, (4) recency, and (5) feedback. The overall EI summarized the subindices from date of registration through to 39 weeks (9 months) from the infant’s date of birth.Basic descriptive data analysis was performed on the metrics and components of the EI as well as the final EI score. Group comparisons used t tests, analysis of variance (ANOVA), Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests as appropriate. Consideration of independent variables associated with the EI score were modeled using linear regression models.Results: The overall EI mean score was 30.0% (SD 11.5%) with a range of 1.8% - 57.6%. The cut-points used for high engagement were scores greater than 37.1% and for poor engagement were scores less than 21.1%. Significant explanatory variables of the EI score included: parity (P=.005), system type including “app only” users or “both” app and email users (P<.001), recruitment method (P=.02), and baby age at recruitment (P=.005).Conclusions: The EI provided a comprehensive understanding of participant behavior with the app over the 9-month period of the Growing healthy program. The use of the EI in this study demonstrates that rich and useful data can be collected and used to inform assessments of the strengths and weaknesses of the app and in turn inform future interventions

Effects of fecal microbiome transfer in adolescents with obesity: the gut bugs randomized controlled trial

Peer reviewe

Attaching-and-Effacing Pathogens Exploit Junction Regulatory Activities of N-WASP and SNX9 to Disrupt the Intestinal Barrier

Background & Aims Neural Wiskott-Aldrich Syndrome protein (N-WASP) is a key regulator of the actin cytoskeleton in epithelial tissues and is poised to mediate cytoskeletal-dependent aspects of apical junction complex (AJC) homeostasis. Attaching-and-effacing (AE) pathogens disrupt this homeostasis through translocation of the effector molecule early secreted antigenic target-6 (ESX)-1 secretion-associated protein F (EspF). Although the mechanisms underlying AJC disruption by EspF are unknown, EspF contains putative binding sites for N-WASP and the endocytic regulator sorting nexin 9 (SNX9). We hypothesized that N-WASP regulates AJC integrity and AE pathogens use EspF to induce junction disassembly through an N-WASP– and SNX9-dependent pathway. Methods: We analyzed mice with intestine-specific N-WASP deletion and generated cell lines with N-WASP and SNX9 depletion for dynamic functional assays. We generated EPEC and Citrobacter rodentium strains complemented with EspF bearing point mutations abolishing N-WASP and SNX9 binding to investigate the requirement for these interactions. Results: Mice lacking N-WASP in the intestinal epithelium showed spontaneously increased permeability, abnormal AJC morphology, and mislocalization of occludin. N-WASP depletion in epithelial cell lines led to impaired assembly and disassembly of tight junctions in response to changes in extracellular calcium. Cells lacking N-WASP or SNX9 supported actin pedestals and type III secretion, but were resistant to EPEC-induced AJC disassembly and loss of transepithelial resistance. We found that during in vivo infection with AE pathogens, EspF must bind both N-WASP and SNX9 to disrupt AJCs and induce intestinal barrier dysfunction. Conclusions: Overall, these studies show that N-WASP critically regulates AJC homeostasis, and the AE pathogen effector EspF specifically exploits both N-WASP and SNX9 to disrupt intestinal barrier integrity during infection

Improving bus service reliability: The Singapore experience

In February 2014, Singapore embarked on a 2-year trial of a Bus Service Reliability Framework (BSRF) to improve en-route bus regularity and reduce instances of bus bunching and prolonged waiting times. Based on London's Quality Incentive Contract, the Singapore model also imposes penalties or provides incentives to operators for increases/reductions of Excess Wait Time (EWT) beyond a certain route-specific baseline. Drawing on insights derived from research on performance-based contracts, this paper describes some key considerations surrounding this particular innovation in Singapore's overall bus regulatory framework. We also discuss an important advancement in our understanding of how bus users value reliability improvements through estimates obtained from stated preference data. At the same time, early indications from the trial have been encouraging