Constitutional Law - First Amendment - Free Exercise of Religion

The United States Supreme Court held that when a law that is neither neutral nor generally applicable burdens religious practices that law must be justified by a compelling state interest. Church of Lukumi Babalu Aye, Inc. v. City of Hialeah, 113 S. Ct. 2217 (1993)

Conditional analysis of the major histocompatibility complex in rheumatoid arthritis

We performed a whole-genome association study of rheumatoid arthritis susceptibility using Illumina 550k single-nucleotide polymorphism (SNP) genotypes of 868 cases and 1194 controls from the North American Rheumatoid Arthritis Consortium (NARAC). Structured association analysis with adjustment for potential population stratification yielded 200 SNPs with p < 1 × 10-8 for association with RA, all of which were on chromosome 6 in a 2.7-Mb region of the major histocompatibility complex (MHC). Given the extensive linkage equilibrium in the region and known risk of HLA-DRB1 alleles, we then applied conditional analyses to ascertain independent signals for RA susceptibility among these 200 candidate SNPs. Conditional analyses incorporating risk categories of the HLA-DRB1 "shared epitope" revealed three SNPs having independent associations with RA (conditional p < 0.001). This supports the presence of significant effects on RA susceptibility in the MHC in addition to the shared epitope

Barriers and Facilitators to Enhance Interprofessional Education for Rehabilitation Science Graduate Students

Interprofessional education (IPE) aims to develop healthcare practitioners who work effectively in teams, demonstrate strong communication skills, respect others, and have a working knowledge of the roles and responsibilities of other professionals. Of identified research to date, it is unclear what students perceive as important for effective IPE delivery and learning. The purpose of this study was to identify graduate students\u27 perceptions of facilitators and barriers to learning interprofessional practice using phenomenology. Three semi-structured focus groups were conducted including athletic training, occupational therapy, or speech-language pathology students and the transcripts were analyzed using thematic analysis. Four themes emerged about IPE teaching methods and delivery: (1) addressing roles and responsibilities (2) student collaboration and communication (3) engaging with faculty and (4) enhancing realism and diversity of experiences. The themes suggested that IPE can either facilitate or create barriers for students when learning roles and responsibilities, collaborating, and communicating with fellow students, and engaging with faculty. Enhancing the realism and diversity of represented professionals were perceived as potential facilitators for future IPE sessions

Scribes Impact On Patient And Provider Experience In The Outpatient Setting

The purpose of this project was to evaluate the effectiveness of using scribes in the outpatient setting on patient and provider experience. A mixed methods approach with a convenience sample of voluntary patient participants scheduled for an outpatient appointment was utilized. Two primary care physicians volunteered to receive scribes. Four hospital corpsmen were selected and trained to serve in the scribe role. This quality improvement project evaluated two aspects of experience during the implementation of the scribes. These included: 1) patient experience as indicated via a pre and post implementation questionnaire; and 2) provider experience as indicated via a pre and post implementation questionnaire. SPSS was used to analyze quantitative data. Results revealed a slight decrease of 0.18 mean patient satisfaction and overall patient experience. The providers’ experience improved with an average 50% decrease in time spent after hours documenting in the electronic health record, enhanced engagement with patients, and improved work life balance. Clinic efficiencies improved with a savings of 13.88 minutes per appointment, and enhanced clinical and war time readiness for hospital corpsmen were identified. Although a small-scale project, the provider experience was strengthened when using scribes while patient experience decreased slightly. Future exploration, centered on the patient and provider experience could be beneficial to organizations. The consideration of scribes could foster work life balance, retention, and wellness in this setting for providers. Further study of the scribe’s experience, especially considering the positive comments from the hospital corpsmen that participated as scribes during the project, could provide beneficial outcomes

Mexican-Origin Parents’ Latent Occupational Profiles: Associations with Parent-Youth Relationships and Youth Aspirations

This study utilized an ecological, person-centered approach to identify subgroups of families who had similar profiles across multiple dimensions of Mexican-origin mothers’ and fathers’ occupational characteristics (i.e., self-direction, hazardous conditions, physical activity) and to relate these subgroups to families’ sociocultural characteristics and youth adjustment. The study included 160 dual-earner Mexican-origin families from the urban Southwest. Mothers’ and fathers’ objective work characteristics and families’ sociocultural characteristics were assessed when youth were in early to middle adolescence; adjustment was assessed during late adolescence and early adulthood for two offspring in each family. A latent profile analysis identified 3 profiles that evidenced distinct patterns of occupational characteristics: a differentiated high physical activity profile characterized by high levels of physical activity and low levels of self-direction; an incongruent profile characterized by large differences between parents on self-direction, hazards, and physical activity; and a congruent highly self-directed profile characterized by congruence across parents on occupational characteristics. These profiles were linked to sociocultural characteristics (i.e., family income, educational attainment, and acculturation) and to relational adjustment (i.e., mother- and father-youth conflict, father warmth) and educational aspirations. Results are discussed with respect to implications of parents’ work for youth’s future family relationships and attainment

Mexican-Origin Parents’ Latent Occupational Profiles: Associations with Parent-Youth Relationships and Youth Aspirations

This study utilized an ecological, person-centered approach to identify subgroups of families who had similar profiles across multiple dimensions of Mexican-origin mothers’ and fathers’ occupational characteristics (i.e., self-direction, hazardous conditions, physical activity) and to relate these subgroups to families’ sociocultural characteristics and youth adjustment. The study included 160 dual-earner Mexican-origin families from the urban Southwest. Mothers’ and fathers’ objective work characteristics and families’ sociocultural characteristics were assessed when youth were in early to middle adolescence; adjustment was assessed during late adolescence and early adulthood for two offspring in each family. A latent profile analysis identified 3 profiles that evidenced distinct patterns of occupational characteristics: a differentiated high physical activity profile characterized by high levels of physical activity and low levels of self-direction; an incongruent profile characterized by large differences between parents on self-direction, hazards, and physical activity; and a congruent highly self-directed profile characterized by congruence across parents on occupational characteristics. These profiles were linked to sociocultural characteristics (i.e., family income, educational attainment, and acculturation) and to relational adjustment (i.e., mother- and father-youth conflict, father warmth) and educational aspirations. Results are discussed with respect to implications of parents’ work for youth’s future family relationships and attainment

Functional network changes and cognitive control in schizophrenia

Cognitive control is a cognitive and neural mechanism that contributes to managing the complex demands of day-to-day life. Studies have suggested that functional impairments in cognitive control associated brain circuitry contribute to a broad range of higher cognitive deficits in schizophrenia. To examine this issue, we assessed functional connectivity networks in healthy adults and individuals with schizophrenia performing tasks from two distinct cognitive domains that varied in demands for cognitive control, the RiSE episodic memory task and DPX goal maintenance task. We characterized general and cognitive control-specific effects of schizophrenia on functional connectivity within an expanded frontal parietal network (FPN) and quantified network topology properties using graph analysis. Using the network based statistic (NBS), we observed greater network functional connectivity in cognitive control demanding conditions during both tasks in both groups in the FPN, and demonstrated cognitive control FPN specificity against a task independent auditory network. NBS analyses also revealed widespread connectivity deficits in schizophrenia patients across all tasks. Furthermore, quantitative changes in network topology associated with diagnostic status and task demand were observed. The present findings, in an analysis that was limited to correct trials only, ensuring that subjects are on task, provide critical insights into network connections crucial for cognitive control and the manner in which brain networks reorganize to support such control. Impairments in this mechanism are present in schizophrenia and these results highlight how cognitive control deficits contribute to the pathophysiology of this illness