Cancer Awareness in Alternative Settings: Lessons Learned and Evaluation of the Barbershop Men’s Health Project

Prostate and colorectal cancer are two of the leading causes of cancer deaths among African American men. This study describes lessons learned from the development, implementation and evaluation of a culturally appropriate, barbershop-based intervention to improve prostate and colorectal cancer screening awareness among African American men. Working with an Advisory Panel of shop owners, barbers, and cancer survivors, local barbers were recruited and trained as Community Health Advisors to educate, motivate, and assist their clients in becoming more knowledgeable about prostate and colorectal cancer. Survey results reveal increases in prostate and colorectal cancer knowledge and self-reported screening among participants. Lessons learned include the need for adequate project staffing and the appropriate role of the barber as a Community Health Advisor. Findings from this study suggest that barbershops are a promising setting for reaching African American men and could be used to target additional conditions that disproportionately impact this community

Decreasing the threat to learning: the impact of gender ratio in clinical skills small groups

Background & Objective: Small-group learning is a popular fundamental teaching strategy in undergraduate medical education (UME). Evidence of women acting as “social vaccines” for their women peers in small groups has been described in engineering, but not in UME. We seek to better understand the impact of smallgroup gender composition on medical student learning. Methods: Preclinical medical students were surveyed throughout their clinical skills (CS) course. Likert-scale questions measured students’ perception of their simulation encounters as challenging or threatening, and data were used to calculate a challenge-to-threat ratio (CTR). Scores \u3e1 indicated a situation more challenging than threatening, whilesurvey. Results: Survey response rates ranged from 62.6-78.8%. Average CTRs of firstyear students were higher for men (1.52-1.64, n=62) than women (1.23-1.46, n=71). All CTRs decreased at the start of the second year (0.80-1.40, n=108), but rebounded as student training progressed (1.29-2.36, n=118). Early second-year CS group gender composition did not impact men (similar CTRs ranging 0.83-1.09). However, women reported a disparate CTR across groups with one, two, and three women (0.80, 1.40, and 1.38 , respectively). Late second-year students reported the highest CTRs in groups with gender parity and lowest CTRs in groups with only one female student. Sentiment analysis of open comments shows a gender effect, with more negative sentiments from women. Conclusions: Women were less confident than their male peers in the early CS small-group learning environment. Less confidence for all students was reported as CS cases progressed in the second-year to an internal medicine focus; however, confidence recovered in the late second year. A significant threat was perceived by the sole woman in a small group, but the presence of 1-2 other women appeared to be protective against this effect on confidence.https://jdc.jefferson.edu/sexandgenderhealth/1024/thumbnail.jp

Tumor Growth Enhances Cross-Presentation Leading to Limited T Cell Activation without Tolerance

Using a tumor model of spontaneously arising insulinomas expressing a defined tumor-associated antigen, we investigated whether tumor growth promotes cross-presentation and tolerance of tumor-specific T cells. We found that an advanced tumor burden enhanced cross-presentation of tumor-associated antigens to high avidity tumor-specific T cells, inducing T cell proliferation and limited effector function in vivo. However, contrary to other models, tumor-specific T cells were not tolerized despite a high tumor burden. In fact, in tumor-bearing mice, persistence and responsiveness of adoptively transferred tumor-specific T cells were enhanced. Accordingly, a potent T cell–mediated antitumor response could be elicited by intravenous administration of tumor-derived peptide and agonistic anti-CD40 antibody or viral immunization and reimmunization. Thus, in this model, tumor growth promotes activation of high avidity tumor-specific T cells instead of tolerance. Therefore, the host remains responsive to T cell immunotherapy

Big Data and AI – A transformational shift for government: So, what next for research?

Big Data and artificial intelligence will have a profound transformational impact on governments around the world. Thus, it is important for scholars to provide a useful analysis on the topic to public managers and policymakers. This study offers an in-depth review of the Policy and Administration literature on the role of Big Data and advanced analytics in the public sector. It provides an overview of the key themes in the research field, namely the application and benefits of Big Data throughout the policy process, and challenges to its adoption and the resulting implications for the public sector. It is argued that research on the subject is still nascent and more should be done to ensure that the theory adds real value to practitioners. A critical assessment of the strengths and limitations of the existing literature is developed, and a future research agenda to address these gaps and enrich our understanding of the topic is proposed

A Threshold Model for T-Cell Activation in the Era of Checkpoint Blockade Immunotherapy

Continued discoveries of negative regulators of inflammatory signaling provide detailed molecular insights into peripheral tolerance and anti-tumor immunity. Accumulating evidence indicates that peripheral tolerance is maintained at multiple levels of immune responses by negative regulators of proinflammatory signaling, soluble anti-inflammatory factors, inhibitory surface receptors & ligands, and regulatory cell subsets. This review provides a global overview of these regulatory machineries that work in concert to maintain peripheral tolerance at cellular and host levels, focusing on the direct and indirect regulation of T cells. The recent success of checkpoint blockade immunotherapy (CBI) has initiated a dramatic shift in the paradigm of cancer treatment. Unprecedented responses to CBI have highlighted the central role of T cells in both anti-tumor immunity and peripheral tolerance and underscored the importance of T cell exhaustion in cancer. We discuss the therapeutic implications of modulating the negative regulators of T cell function for tumor immunotherapy with an emphasis on inhibitory surface receptors & ligands—central players in T cell exhaustion and targets of checkpoint blockade immunotherapies. We then introduce a Threshold Model for Immune Activation—the concept that these regulatory mechanisms contribute to defining a set threshold of immunogenic (proinflammatory) signaling required to elicit an anti-tumor or autoimmune response. We demonstrate the value of the Threshold Model in understanding clinical responses and immune related adverse events in the context of peripheral tolerance, tumor immunity, and the era of Checkpoint Blockade Immunotherapy

Reading Disability as a Condition of Family Stability

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72295/1/j.1545-5300.1964.00066.x.pd