Differentiation as a Consequence of Choice and Decentralization Reforms—Conditions for Teachers’ Competence Development

This paper examines the conditions for teacher competence development as they relate to the current restructured governance of the education sector in Sweden. In reviewing the literature, contextual factors in the workplace are often pointed out as central to conditions for competence development. However, we argue that a sector-level approach is useful in examining and explaining competence development conditions, especially in times of governance change. We describe how a workplace’s geographical location and budgetary situation, along with its size and age, relate to how teachers experience their working conditions. The findings indicate that the organization of work at a local workplace level impacts the conditions for competence development. Moreover, various regional and local characteristics seem to affect the conditions for competence development in that the organization and governance of the education sector create different conditions for competence development

Amygdala-ventral striatum circuit activation decreases long-term fear

In humans, activation of the ventral striatum, a region associated with reward processing, is associated with the extinction of fear, a goal in the treatment of fear-related disorders. This evidence suggests that extinction of aversive memories engages reward-related circuits, but a causal relationship between activity in a reward circuit and fear extinction has not been demonstrated. Here, we identify a basolateral amygdala (BLA)-ventral striatum (NAc) pathway that is activated by extinction training. Enhanced recruitment of this circuit during extinction learning, either by pairing reward with fear extinction training or by optogenetic stimulation of this circuit during fear extinction, reduces the return of fear that normally follows extinction training. Our findings thus identify a specific BLA-NAc reward circuit that can regulate the persistence of fear extinction and point toward a potential therapeutic target for disorders in which the return of fear following extinction therapy is an obstacle to treatment.National Institute of Mental Health (U.S.) (R01 MH084966)United States. Army Research OfficeUnited States. Defense Advanced Research Projects Agency (grant W911NF-10-1-0059

Peripheral Innate Immune Activation Correlates With Disease Severity in GRN Haploinsufficiency.

Objective: To investigate associations between peripheral innate immune activation and frontotemporal lobar degeneration (FTLD) in progranulin gene (GRN) haploinsufficiency. Methods: In this cross-sectional study, ELISA was used to measure six markers of innate immunity (sCD163, CCL18, LBP, sCD14, IL-18, and CRP) in plasma from 30 GRN mutation carriers (17 asymptomatic, 13 symptomatic) and 29 controls. Voxel based morphometry was used to model associations between marker levels and brain atrophy in mutation carriers relative to controls. Linear regression was used to model relationships between plasma marker levels with mean frontal white matter integrity [fractional anisotropy (FA)] and the FTLD modified Clinical Dementia Rating Scale sum of boxes score (FTLD-CDR SB). Results: Plasma sCD163 was higher in symptomatic GRN carriers [mean 321 ng/ml (SD 125)] compared to controls [mean 248 ng/ml (SD 58); p < 0.05]. Plasma CCL18 was higher in symptomatic GRN carriers [mean 56.9 pg/ml (SD 19)] compared to controls [mean 40.5 pg/ml (SD 14); p < 0.05]. Elevation of plasma LBP was associated with white matter atrophy in the right frontal pole and left inferior frontal gyrus (p FWE corrected <0.05) in all mutation carriers relative to controls. Plasma LBP levels inversely correlated with bilateral frontal white matter FA (R2 = 0.59, p = 0.009) in mutation carriers. Elevation in plasma was positively correlated with CDR-FTLD SB (b = 2.27 CDR units/μg LBP/ml plasma, R2 = 0.76, p = 0.003) in symptomatic carriers. Conclusion: FTLD-GRN is associated with elevations in peripheral biomarkers of macrophage-mediated innate immunity, including sCD163 and CCL18. Clinical disease severity and white matter integrity are correlated with blood LBP, suggesting a role for peripheral immune activation in FTLD-GRN

Syrian Refugees’ Participation in Language Classes: Motivators and Barriers

Resettlement country language literacy facilitates integration and counteracts social and economic marginalization. Thus, access to language learning is a social justice issue. Resettled refugees in Canada are eligible for free English/French language training. Between 2015-2017, Canada resettled 47,735 Syrian refugees. We explored predictors of language class participation for Syrian refugees, examining data from 1915 adult Syrian refugees in government-funded language classes in British Columbia, Ontario, and Quebec. Findings suggest access to language programs are shaped by provincial policies. Factors hindering participation varied by province and included gender, physical/mental health, education, English/French literacy, and employment. Practice and policy recommendations are discussed.L'alphabétisation dans la langue du pays d’accueil facilite l'intégration et réduit la marginalisation sociale et économique. Ainsi, l'accès à l'apprentissage de la langue est une question de justice sociale. Les réfugiés réinstallés au Canada sont admissibles à une formation gratuite en anglais/français. Entre 2015 et 2017, le Canada a réinstallé 47 735 réfugiés syriens. Nous avons exploré les prédicteurs de la participation aux cours de langue pour les réfugiés syriens, en examinant les données de 1 915 réfugiés syriens adultes dans des cours de langue financés par le gouvernement en Colombie-Britannique, en Ontario et au Québec. Les facteurs entravant la participation variaient selon la province et comprenaient le sexe, la santé physique/mentale, l'éducation, l'alphabétisation en anglais/français et l'emploi. Des recommandations pratiques et politiques sont discutées

What Role Does Type of Sponsorship Play in Early Integration Outcomes? Syrian Refugees Resettled in Six Canadian Cities

AbstractThere is little longitudinal research that directly compares the effectiveness of Canada’s Government-Assisted Refugee (GAR) and Privately Sponsored Refugee (PSR) Programs that takes into account possible socio-demographic differences between them. This article reports findings from 1,921 newly arrived adult Syrian refugees in British Columbia, Ontario, and Quebec. GARs and PSRs differed widely on several demographic characteristics, including length of time displaced. Furthermore, PSRs sponsored by Groups of 5 resembled GARs more than other PSR sponsorship types on many of these characteristics. PSRs also had broader social networks than GARs. Sociodemographic differences and city of residence influenced integration outcomes, emphasizing the importance of considering differences between refugee groups when comparing the impact of these programs.RésuméIl existe peu de recherches longitudinales comparant directement l’efficacité des programmes gouvernemental (RPG) et privé (PPR) de parrainage des réfugiés au Canada qui tiennent compte de possibles différences socio-démographique entre eux. Cet article rend compte des résultats de 1921 nouveaux arrivants syriens adultes en Colombie-Britannique, en Ontario et au Québec. Les RPG et PPR diffèrent largement sur plusieurs caractéristiques démographiques, dont le temps du déplacement. De plus, les PPR parrainés par groupes de cinq ressemblaient davantage aux RPG que les autres types de parrainage PPR sur plusieurs de ces caractéristiques. Les PPR avaient aussi des réseaux sociaux plus larges que les RPG. Les différences sociodémographiques et la ville de résidence influent sur l’intégration, ce qui fait ressortir l’importance de tenir compte des différences entre les groupes de réfugiés dans la comparaison de l’impact de ces programmes

Costs of UK community care for individuals with recessive dystrophic epidermolysis bullosa:Findings of the Prospective Epidermolysis Bullosa Longitudinal Evaluation Study

Background Recessive dystrophic epidermolysis bullosa (RDEB) is a rare inherited skin fragility disorder requiring multidisciplinary management. Information regarding costs of current standard treatment is scant. Objectives As part of a longitudinal natural history study, we explored the community care costs of UK patients with different forms of RDEB. Methods Fifty-nine individuals with RDEB provided detailed information on multiple facets of RDEB including disease severity scores (iscorEB, BEBS) and patient reported outcomes (quality of life evaluation in epidermolysis bullosa, iscorEB patient questionnaire). Costs data included time spent doing dressings, frequency of dressing changes, details of materials used, and paid and unpaid care. Results Overall costs of dressing materials and associated care were high in RDEB. Median annual costs across all subtypes for those using dressings (n = 51) were over £26 000. For severe RDEB (RDEB-S), median costs were almost £90 000 per annum, with a median of 18 h per week spent on dressing changes. Half of working-age adults with RDEB were unemployed and 39time or part-time paid employment, adding to indirect costs and the financial burden from RDEB on families and society. Conclusions The findings demonstrate the high costs of care of RDEB, particularly for RDEB-S. The current expense supports the drive to develop new therapies which accelerate wound healing and diminish total wound burden, thereby reducing costs of dressings and care. While costly to bring to market, these might ultimately reduce the overall cost of treatment and also the impact on individuals living with this rare disease. The data also highlight the need for adequate reimbursement for EB care which can place significant financial strain on families.<br/

A systematic review and meta-analysis on the efficacy of Internet-delivered behavioral activation

Behavioral activation (BA) is an evidence-based treatment for depression which has attracted interest and started to accumulate evidence for other conditions when delivered face-to-face. Due to its parsimoniousness, it is suitable to be delivered via the Internet. The goal of this systematic review and meta-analysis was to examine evidence from randomized controlled trials (RCTs) to determine the efficacy of Internet-based BA and assess the quality of this evidence.Studies were identified from electronic databases (EMBASE, ISI Web of Knowledge, Medline, CINHAL, PsychINFO, Cochrane) and reference lists of included studies. Two reviewers independently screened articles for inclusion and extracted data. They assessed the quality of evidence for each outcome using The Grading of Recommendations Assessment, Development and Evaluation framework.Nine RCTs on different forms of depression were included with 2157 adult participants. Random effects meta-analyses showed that in non-clinical settings, guided Internet-based BA was non-inferior to other forms of behavioral therapy and mindfulness (mainly very low to low quality evidence) and superior to physical activity (very low quality evidence), psychoeducation/treatment as usual (moderate quality evidence) and waitlist (low quality evidence) at reducing depression and anxiety outcomes at post-treatment and short follow-up.The poor quality of some of the findings means that results should be cautiously interpreted.Evidence for the efficacy of Internet-based BA as a treatment for depression is promising. However, high quality studies with longer follow-ups are needed to increase confidence in findings and determine its efficacy in clinical settings and other conditions

Profile: the Karonga Health and Demographic Surveillance System

The Karonga Health and Demographic Surveillance System (Karonga HDSS) in northern Malawi currently has a population of more than 35 000 individuals under continuous demographic surveillance since completion of a baseline census (2002–2004). The surveillance system collects data on vital events and migration for individuals and for households. It also provides data on cause-specific mortality obtained by verbal autopsy for all age groups, and estimates rates of disease for specific presentations via linkage to clinical facility data. The Karonga HDSS provides a structure for surveys of socio-economic status, HIV sero-prevalence and incidence, sexual behaviour, fertility intentions and a sampling frame for other studies, as well as evaluating the impact of interventions, such as antiretroviral therapy and vaccination programmes. Uniquely, it relies on a network of village informants to report vital events and household moves, and furthermore is linked to an archive of biological samples and data from population surveys and other studies dating back three decades