December

I\u27m walking in the snowpast a house with Barbie\u27s headin the window. She is hairlessand forgotten behind a shade,she\u27s got a neck and shoulders like the doll I used to have

The Influence of Mental Models on Decision-Making Around Social and Environmental Aspects: Insights from Ontario SMEs

This study explores the influence of mental models on decision-­‐making around social and environmental aspects within Ontario SMEs. The research covers areas of design, foresight and innovation as well as sustainability and strongly sustainable business models. Through exploring how business leaders consider and prepare for the future, this project engages foresight and innovation. Business leaders use mental-­‐models to reach decisions by trying to imagine the possibilities compatible with what they know or believe (Johnson-­‐Laird, 2012). Ontario SMEs are a significant employment and economic contributor in Canada (Industry Canada, 2012). Progress towards greater sustainability by Ontario SME leaders would have a significant impact on the resiliency of our communities and the sustainability of our economy. While business leaders have access to information on social and environmental implications of their work, these items compete with others for priority and businesses continue to face a number of barriers to transitioning towards greater sustainability. The Design Probe method has been used to collect primary data from thirteen decision-­‐makers within Ontario SMEs. The insights collected will serve managers who are interested in transitioning their businesses towards more sustainable behaviours by understanding common biases and errors as well as potential blindspots in their decisions. These insights are also useful for policy makers, NGOs and social entrepreneurs looking at accelerating the sustainability and resiliency of SMEs in Ontario and beyond. In addition, this research will inform the design brief of a range of tools such as those being developed by the Strongly Sustainable Business Model group (SSBMG) with insights into the most appropriate designs to support a shift towards strong sustainability. Further research can then identify how it may be possible to bring more SMEs to the level of sustainability leaders

Dark Matter Disc Enhanced Neutrino Fluxes from the Sun and Earth

As disc galaxies form in a hierarchical cosmology, massive merging satellites are preferentially dragged towards the disc plane. The material accreted from these satellites forms a dark matter disc that contributes 0.25 - 1.5 times the non-rotating halo density at the solar position. Here, we show the importance of the dark disc for indirect dark matter detection in neutrino telescopes. Previous predictions of the neutrino flux from WIMP annihilation in the Earth and the Sun have assumed that Galactic dark matter is spherically distributed with a Gaussian velocity distribution, the standard halo model. Although the dark disc has a local density comparable to the dark halo, its higher phase space density at low velocities greatly enhances capture rates in the Sun and Earth. For typical dark disc properties, the resulting muon flux from the Earth is increased by three orders of magnitude over the SHM, while for the Sun the increase is an order of magnitude. This significantly increases the sensitivity of neutrino telescopes to fix or constrain parameters in WIMP models. The flux from the Earth is extremely sensitive to the detailed properties of the dark disc, while the flux from the Sun is more robust. The enhancement of the muon flux from the dark disc puts the search for WIMP annihilation in the Earth on the same level as the Sun for WIMP masses < 100 GeV.Comment: 7 pages, 4 figures, added a short paragraph to the discussion section, conclusions unchanged, published versio

Weaving a clinical academic career: illuminating the method and pattern to follow

The benefits of developing occupational therapists as clinical academics are well recognised. They include improved healthcare outcomes and experiences for service users, efficiencies for organisations and increased prominence of occupational therapy within healthcare. Yet occupational therapists describe uncertainty about how best to navigate clinical academic career pathways. We suggest that occupational therapists can increase their research aspirations, confidence and capacity by following a four-step method, weaving together clinical, academic and personal development. We outline our view of clinical academic development as a process with flexibility to incorporate occupational therapists’ diversity of interests and circumstances. By demystifying and illuminating the process of clinical academic development, we believe that occupational therapists may be able to weave more clinical academic development opportunities into their careers and increase the profession’s research capacity

Utilization of Never-Medicated Bipolar Disorder Patients towards Development and Validation of a Peripheral Biomarker Profile

There are currently no biological tests that differentiate patients with bipolar disorder (BPD) from healthy controls. While there is evidence that peripheral gene expression differences between patients and controls can be utilized as biomarkers for psychiatric illness, it is unclear whether current use or residual effects of antipsychotic and mood stabilizer medication drives much of the differential transcription. We therefore tested whether expression changes in first-episode, never-medicated BPD patients, can contribute to a biological classifier that is less influenced by medication and could potentially form a practicable biomarker assay for BPD. We employed microarray technology to measure global leukocyte gene expression in first-episode (n=3) and currently medicated BPD patients (n=26), and matched healthy controls (n=25). Following an initial feature selection of the microarray data, we developed a cross-validated 10-gene model that was able to correctly predict the diagnostic group of the training sample (26 medicated patients and 12 controls), with 89% sensitivity and 75% specificity (p<0.001). The 10-gene predictor was further explored via testing on an independent cohort consisting of three pairs of monozygotic twins discordant for BPD, plus the original enrichment sample cohort (the three never-medicated BPD patients and 13 matched control subjects), and a sample of experimental replicates (n=34). 83% of the independent test sample was correctly predicted, with a sensitivity of 67% and specificity of 100% (although this result did not reach statistical significance). Additionally, 88% of sample diagnostic classes were classified correctly for both the enrichment (p=0.015) and the replicate samples (p<0.001). We have developed a peripheral gene expression biomarker profile, that can classify healthy controls from patients with BPD receiving antipsychotic or mood stabilizing medication, which has both high sensitivity and specificity. Moreover, assay of three first-episode patients who had never received such medications, to first enrich the expression dataset for disease-related genes independent of medication effects, and then to test the 10-gene predictor, validates the peripheral biomarker approach for BPD

Depressive symptoms, ruminative thinking, marijuana use motives, and marijuana outcomes: A multiple mediation model among college students in five countries

Treball Final de Grau en Medicina. Codi: MD1158. Curs acadèmic: 2018/2019.Background: Previous studies have evidenced that rumination and drinking motives may mediate the association between depressive symptoms and alcohol outcomes. The present study cross-culturally examined whether a similar mediation model may extend to marijuana. Specifically, we tested distinct rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and marijuana use motives (social, coping, expansion, conformity, enhancement) as double-mediators of the paths from depressive symptoms to marijuana outcomes (use and consequences). Method: A comprehensive mediation path model was tested in a cross-sectional sample of college student marijuana users (n = 1,175) from five countries (U.S., Argentina, Uruguay, Spain, Netherlands). Multi-group models were tested to determine if the proposed mediational model was invariant across sex and different cultures/countries. Results: Depressive symptoms and marijuana outcomes were indirectly associated through ruminative thinking and marijuana motives. Specifically, higher depressive symptoms were associated with higher problem-focused thoughts; which in turn were associated with: a) higher endorsement of coping motives which in turn was associated with higher marijuana use and related consequences and b) lower endorsement of enhancement motives which in turn was associated with lower marijuana use and related consequences. The multi-group analyses showed that the model was invariant across sex and the five countries. Conclusions: The present research supports the existence of a universal (i.e., cross-national invariant) negative affect regulation pathway to marijuana use/misuse similar to those previously found with alcohol. Additional research is needed to confirm the role of enhancement motives in the associations of depression, rumination and marijuana outcomes

Botulinum neurotoxin C initiates two different programs for neurite degeneration and neuronal apoptosis

Clostridial neurotoxins are bacterial endopeptidases that cleave the major SNARE proteins in peripheral motorneurons. Here, we show that disruption of synaptic architecture by botulinum neurotoxin C1 (BoNT/C) in central nervous system neurons activates distinct neurodegenerative programs in the axo-dendritic network and in the cell bodies. Neurites degenerate at an early stage by an active caspase-independent fragmentation characterized by segregation of energy competent mitochondria. Later, the cell body mitochondria release cytochrome c, which is followed by caspase activation, apoptotic nuclear condensation, loss of membrane potential, and, finally, cell swelling and lysis. Recognition and scavenging of dying processes by glia also precede the removal of apoptotic cell bodies, in line with a temporal and spatial segregation of different degenerative processes. Our results suggest that, in response to widespread synaptic damage, neurons first dismantle their connections and finally undergo apoptosis, when their spatial relationships are lost

Seven steps for improving influenza vaccination rates in risk-groups: findings from a national cross sectional survey in UK general practice

The problem: Seasonal influenza vaccination rates in at-risk population in the UK are below the national and international target of 75%. Of people aged over 65 years in England 72.8% received influenza (flu) vaccine in 2010/11, just below the target of 75%. However, flu vaccination rates during 2010/11 in the under 65 year old at-risk groups was just 50.4%, which fell far short of 75%; in pregnant women who were not otherwise at risk the vaccination rate was only 36.6%, despite increasing evidence showing the beneficial effects of protection against flu for both mothers and babies. Evidence-based guidance, to advise practices how to optimise all aspects of their flu vaccination campaigns and maximise their likelihood of protecting at-risk patients against flu and its serious sequelae is greatly needed. This study sought to identify which strategies and procedures were associated with higher rates of flu vaccine uptake. The approach: An online questionnaire survey was administered to general practitioners (GPs), nursing staff and practice managers in 795 practices across England. We used logistic regression to analyse data for factors independently associated with higher practice flu vaccination rates in at-risk groups. Findings: The survey was completed by 569 practice managers, 335 nursing staff and 107 GPs. We identified seven independent factors associated with higher flu vaccination rates. Having a lead staff member for planning the flu campaign and producing a written report of practice performance predicted an 8% higher vaccination rate for at-risk patients aged <65 years (OR 1.37; 95% CI 1.10 to 1.71). These strategies, plus sending a personal invitation to all eligible patients and only stopping vaccination when Quality and Outcomes framework (QOF) targets were reached, predicted a 7% higher vaccination rate (OR 1.45; 95% CI 1.10 to 1.92) in patients aged 65 years and over. Using a lead member of staff for identifying eligible patients, with either a modified manufacturer’s or in-house search program for interrogating the practice computer system, independently predicted a 4% higher vaccination rate in patients aged 65 years and over (OR 1.22; 95% CI 1.06 to 1.41 / OR 1.20; 95% CI 1.03 to 1.40). The provision of flu vaccine by midwives was associated with a 4% higher vaccination rate in pregnant women (OR 1.19; 1.02 to 1.40). Consequences: Clear leadership, effective communication with patients, and methods used to identify and contact eligible patients were independently associated with significantly higher rates of flu vaccination. Financial targets appear to incentivise practices to work harder to maximise seasonal influenza vaccine uptake. The strategies identified here could help primary care providers to substantially increase their seasonal flu vaccination rates to meet or even exceed national targets

The experience of trial participation, treatment approaches and perceptions of change among participants with dissociative seizures within the CODES randomized controlled trial: A qualitative study

Background Nested within a large, multicenter randomized controlled trial (RCT) for people with dissociative seizures (DS), the study used purposive sampling to explore participants' experience of participating in an RCT, their experience of DS-specific cognitive behavioral therapy (CBT) and another component of the RCT, Standardized Medical Care (SMC) and their perceptions of and reflections on seizure management and change. Methods A qualitative study using semistructured interviews was conducted with 30 participants in an RCT (the COgnitive behavioral therapy vs standardized medical care for adults with Dissociative non-Epileptic Seizures (CODES) Trial) investigating the effectiveness of two treatments for DS. Key themes and subthemes were identified using thematic framework analysis (TFA). Results Analysis yielded three overarching themes: taking part in a treatment trial — “the only thing out there”, the experience of treatment techniques that were perceived to help with seizure management, and reflections on an “unpredictable recovery”. Conclusions People with DS are amenable to participating in a psychotherapy RCT and described a largely positive experience. They also described the applicability of aspects of DS-specific CBT and SMC in the management of their DS, received within the confines of the CODES trial. Factors that appeared to account for the variability in response to treatment delivery included individual preferences for the nature of sessions, the nature of therapeutic relationships, readiness to discuss trauma, other aspects of emotional avoidance, and whether therapy provided something new

The pH-responsive PacC transcription factor of Aspergillus fumigatus governs epithelial entry and tissue invasion during pulmonary aspergillosis

Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. Raw data have been deposited in the Gene Expression Omnibus (GEO) (http://www.ncbi.nlm.nih.gov/geo/) under accession number GSE54810. Funding: This work was supported in part by grants to EMB from the MRC (G0501164) and BBSRC (BB/G009619/1), to EMB and NDR from the Wellcome Trust (WT093596MA), to MB from Imperial College London (Division of Investigative Sciences PhD Studentship), to HH from the ERA-NET PathoGenoMics project TRANSPAT, Austrian Science Foundation (FWF I282-B09), to SGF from the National Institutes of Health, USA (R01AI073829). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD