943 research outputs found

    Working Together to Stop Domestic Violence: State-Community Partnerships and the Changing Meaning of Public and Private

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    The increasing reliance in the United States on state-community partner- ships to address social problems represents both new opportunities and new dangers. This article presents examples of both possibilities through a consideration of contemporary collaborations between state and nonstate actors in the development of a public response to domestic violence. This discussion provides the basis for an elaboration of a conceptual approach to public/private relationships that replaces the traditional dichotomy with a triangular relationship, of state, family and community. By improving on our ability to think through the complex relationships between these three spheres, it is argued that this model that can assist those who are committed to pursuing the positive potential of community-state partnerships while avoiding their dangers. John Braithwaite\u27s theory of responsive regulation, and the regulatory pyramid that structures its operation, is discussed in terms of its ability to provide additional insights into the relationship between formal and informal responses to social problems

    Mobile Technology Use and mHealth Text Message Preferences: An Examination of Gender, Racial, and Ethnic Differences Among Emerging Adult College Students

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    Background: Mobile health (mHealth) interventions are a potentially feasible way of targeting emerging adult college students\u27 physical and mental health concerns, decreasing health-risk, and augmenting health promoting behaviors. However, there is limited evidence attesting to advantageous ways of designing mHealth treatments in a manner that is apt to be well-received by emerging adult college students at large, and gender, racial, and ethnic subgroups in particular. To address these research gaps, this exploratory study examined general trends, and gender (male, female), racial (White, Black), and ethnic (Latino, non-Latino) differences, in emerging adult college students\u27 mobile technology ownership and phone plan characteristics, technology use behaviors, and mHealth text message preferences. Methods: Participants included 1,371 college students aged 18 to 25 (20.54±1.80) years. Between July 2015 and April 2016, students from three universities in the Mid-Atlantic United States completed an online survey assessing technology use. Descriptive statistics and chi-square tests were run to answer primary study questions. Results: Results suggest that students frequently engage with mobile devices and inherent features. Overall, nearly all (99.5%) students owned smartphones, 89.5% had long-term phone contracts, 94.6% had unlimited texting, and 38.6% reported having unlimited data plans. Further, 96.8% reported texting, 92.0% accessing email, 97.3% accessing the internet, and 97.2% using apps on their mobile devices at least once per day. When asked about the types of text messages they would prefer to receive in the context of mHealth interventions, most students preferred messages that did not contain textese, were longer vs. shorter, contained a single vs. multiple exclamation marks, had a smiley face emoticon, used capitalization for emphatic purposes, contained a statement vs. a question, were polite in tone, and were non-directive. There was also multiple gender, racial, and ethnic group differences in mobile device ownership and plan attributes, usage patterns, and text message preferences. Conclusions: The present research provides evidence that smartphones are commonly used by college students and may be a feasible platform for health intervention delivery among diverse student groups. mHealth interventions could use the present results to inform the design of future mHealth interventions and, in turn, increase the acceptability, usability, and efficacy of such treatments for college students at large and diverse student groups in particular

    Teachers’ perspectives on communication in the context of supervising learners during telehealth encounters

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    Background: The COVID-19 pandemic has led to increased use of telehealth for healthcare visits. Telehealth visits have created new communication challenges for clinician-patient encounters and for interactions between health professional learners and clinical teachers, known as preceptors. Little research has explored how teachers can effectively supervise and explicitly emphasize communication skills during telehealth visits. Aim: This study’s purpose was to explore clinical preceptors’ perspectives on effective approaches in precepting telehealth visits with medical residents and students. Methods: An online survey elicited comments from clinical preceptors from two United States medical schools on effective telehealth teaching practices. Thematic analysis identified salient perspectives and overall guidance on precepting telehealth encounters. Results: Survey participants reported varying levels of experience with precepting telehealth visits. Main areas identified as important for effectively supervising telehealth encounters and facilitating effective communication included explicit preparation for preceptors, learners and patients and using educational opportunities, especially observation, during the telehealth encounter. Discussion: This study identifies strategies for maximizing effective communication between preceptors, learners, and patients during supervised telehealth visits. Participants identified potential educational advantages of supervising telehealth visits. Conclusions: Clinical teachers can reinforce effective telehealth communication skills with learner led telehealth patient encounters

    Cellular-level versus receptor-level response threshold hierarchies in T-Cell activation

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    Peptide-MHC (pMHC) ligand engagement by T-cell receptors (TCRs) elicits a variety of cellular responses, some of which require substantially more TCR-mediated stimulation than others. This threshold hierarchy could reside at the receptor level, where different response pathways branch off at different stages of the TCR/CD3 triggering cascade, or at the cellular level, where the cumulative TCR signal registered by the T-cell is compared to different threshold values. Alternatively, dual-level thresholds could exist. In this study, we show that the cellular hypothesis provides the most parsimonious explanation consistent with data obtained from an in-depth analysis of distinct functional responses elicited in a clonal T-cell system by a spectrum of biophysically defined altered peptide ligands across a range of concentrations. Further, we derive a mathematical model that describes how ligand density, affinity, and off-rate all affect signaling in distinct ways. However, under the kinetic regime prevailing in the experiments reported here, the TCR/pMHC class I (pMHCI) dissociation rate was found to be the main governing factor. The CD8 coreceptor modulated the TCR/pMHCI interaction and altered peptide ligand potency. Collectively, these findings elucidate the relationship between TCR/pMHCI kinetics and cellular function, thereby providing an integrated mechanistic understanding of T-cell response profiles

    Influence of cognitive reserve on neuropsychological functioning in bipolar disorder: Findings from a 5‐year longitudinal study

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136365/1/bdi12470_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136365/2/bdi12470.pd

    Equivalent linear change in cognition between individuals with bipolar disorder and healthy controls over 5 years

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    ObjectivesCognitive dysfunction is a key feature of bipolar disorder (BD). However, not much is known about its temporal stability, as some studies have demonstrated a neurodegenerative model in BD while others have shown no change in cognitive functioning over time. Building upon our prior work, which examined the natural course of executive functioning, the current study aimed to investigate the natural course of memory, emotion processing, and fine motor dexterity over a 5‐year period in BD and healthy control (HC) samples.MethodsUsing a 5‐year longitudinal cohort, 90 individuals with BD and 17 HCs were administered a battery of neuropsychological tests at study baseline and at 1 and 5 years after study entry that captured four areas of cognitive performance: visual memory, auditory memory, emotion processing, and fine motor dexterity.ResultsLatent growth curve modeling showed no group differences in the slopes of any of the cognitive factors between the BD and HC groups. Age at baseline was negatively associated with visual memory, emotion processing, and fine motor dexterity. Education level was positively associated with auditory and visual memory and fine motor. Female gender was negatively associated with emotion processing.ConclusionsExtending our prior work on longitudinal evaluation of executive functioning, individuals with BD show similar linear change in other areas of cognitive functioning including memory, emotion processing, and fine motor dexterity as compared to unaffected HCs. Age, education, and gender may have some differential effects on cognitive changes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142144/1/bdi12532.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142144/2/bdi12532_am.pd

    The pentameric complex drives immunologically covert cell -cell transmission of wild-type human cytomegalovirus

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    Human cytomegalovirus (HCMV) strains that have been passaged in vitro rapidly acquire mutations that impact viral growth. These laboratory-adapted strains of HCMV generally exhibit restricted tropism, produce high levels of cell-free virus, and develop susceptibility to natural killer cells. To permit experimentation with a virus that retained a clinically relevant phenotype, we reconstructed a wild-type (WT) HCMV genome using bacterial artificial chromosome technology. Like clinical virus, this genome proved to be unstable in cell culture; however, propagation of intact virus was achieved by placing the RL13 and UL128 genes under conditional expression. In this study, we show that WT-HCMV produces extremely low titers of cell-free virus but can efficiently infect fibroblasts, epithelial, monocyte-derived dendritic, and Langerhans cells via direct cell–cell transmission. This process of cell–cell transfer required the UL128 locus, but not the RL13 gene, and was significantly less vulnerable to the disruptive effects of IFN, cellular restriction factors, and neutralizing antibodies compared with cell-free entry. Resistance to neutralizing antibodies was dependent on high-level expression of the pentameric gH/gL/gpUL128–131A complex, a feature of WT but not passaged strains of HCMV

    Exposure and potential effects of pesticides and pharmaceuticals in protected streams of the US National park Service southeast region

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    Globally, protected areas offer refugia for a broad range of taxa including threatened and endangered species. In the United States (US), the National Park Service (NPS) manages public lands to preserve biodiversity, but increasing park visitation and development of surrounding landscapes increase exposure to and effects from bioactive contaminants. The risk (exposure and hazard) to NPS protected-stream ecosystems within the highly urbanized southeast region (SER) from bioactive contaminants was assessed in five systems based on 334 pesticide and pharmaceutical analytes in water and 119 pesticides in sediment. Contaminant mixtures were common across all sampled systems, with approximately 24% of the unique analytes (80/334) detected at least once and 15% (49/334) detected in half of the surface-water samples. Pharmaceuticals were observed more frequently than pesticides, consistent with riparian buffers and concomitant spatial separation from non-point pesticide sources in four of the systems. To extrapolate exposure data to biological effects space, site-specific cumulative exposure-activity ratios (REAR) were calculated for detected surface-water contaminants with available ToxCast data; common exceedances of a 0.001 REAR effects-screening threshold raise concerns for molecular toxicity and possible, sub-lethal effects to non-target, aquatic vertebrates. The results illustrate the need for continued management of protected resources to reduce contaminant exposure and preserve habitat quality, including prioritization of conservation practices (riparian buffers) near stream corridors and increased engagement with upstream/up-gradient property owners and municipal wastewater facilities

    Identifying Prevalent Mathematical Pathways to Engineering in South Carolina

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    National data indicate that initial mathematics course placement in college is a strong predictor of persistence to degree in engineering, with students placed in calculus persisting at nearly twice the rate of those placed below calculus. Within the state of South Carolina, approximately 95% of engineering-intending students who initially place below calculus are from in-state. In order to make systemic change, we are first analyzing system-wide data to identify prevalent educational pathways within the state, and the mathematical milestones along those pathways taken by students in engineering and engineering-related fields. This paper reports preliminary analysis of that data to understand trends in major selection and mathematics preparation within the state
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