Performance of a Brief Assessment Tool for Identifying Substance Use Disorders

Objective: Evaluation of the performance of a brief assessment tool for identifying substance use disorders. The Triage Assessment for Addictive Disorders (TAAD) is a triage instrument that provides professionals with a tool to evaluate indications of current substance use disorders in accordance with the DSM-IV diagnostic criteria. The TAAD is a 31-item structured interview that addresses both alcohol and other drug issues to discriminate among those with no clear indications of a diagnosis, those with definite, current indications of abuse or dependence, and those with inconclusive diagnostic indications. Methods: Employing a sample of 1325 women between the ages of 18 and 60, reliability estimates and problem profiles produced by the TAAD were evaluated. Results: The Cronbach alpha coefficients for internal consistency for both the alcohol and drug dependence scales were .92. The alpha coefficients for the alcohol and drug abuse scales were .83 and .84 respectively. The diagnostic profiles elicited from the TAAD indicate that alcohol and drug dependences are the more definitive and distinct syndromes compared with the abuse syndromes. Conclusions: The diagnostic profiles from this sample are consistent with previous research. The Cronbach alpha coefficients suggest that the TAAD provides an internally consistent index for alcohol and drug dependence and abuse. Implications for use in clinical practice and the need for further research regarding the psychometric properties of the TAAD are discussed

Ophthalmic manifestations of Cryptococcus gattii species complex: a case series and review of the literature

AIM: To report 4 cases of Cryptococcus gattii (C. gattii) species complex infection with diverse ophthalmic manifestations, and to review the literature to examine pathobiology of disease, classical ophthalmic presentations and outcomes, and treatment modalities for this emerging pathogen. METHODS: Cases of C. gattii meningoencephalitis with ophthalmic manifestations were identified via chart review at two institutions in Australia and one institution in the mid-west region of the United States and are reported as a case series. Additionally, a MEDLINE literature review was conducted to identify all reported cases of C. gattii with ophthalmic manifestations from 1990-2020. Cases were reviewed and tabulated, together with our series of patients, in this report. RESULTS: Four cases of C. gattii with ophthalmic manifestations are presented; three from Australia and one from the USA. A literature review identified a total of 331 cases of C. gattii with visual sequelae. The majority of cases occurred in immunocompetent individuals. Blurred vision and diplopia were the most common presenting symptoms, with papilloedema the most common sign, reported in 10%-50% of cases. Visual loss was reported in 10%-53% of cases, as compared to rates of visual loss of 1%-9% in C. neoformans infection. Elevated intracranial pressure, cerebrospinal fluid (CSF) fungal burden, and abnormal neurological exam at presentation correlated with poor visual outcomes. The mainstays of treatment are anti-fungal agents and aggressive management of intracranial hypertension with serial lumbar punctures. CSF diversion procedures should be considered for refractory cases. Acetazolamide and mannitol are associated with high complication rates, and adjuvant corticosteroids have demonstrated higher mortality rates; these treatments should be avoided. CONCLUSION: Permanent visual loss represents a devastating yet potentially preventable sequelae of C. gattii infection. Intracranial hypertension needs to be recognised early and aggressively managed. Referral to an ophthalmologist/neuro-ophthalmologist in all cases of cryptococcal infection independent of visual symptoms at time of diagnosis is recommended

Corn and Sorghum Herbicides and Water Quality: An Evaluation of Alternative Policy Options

The policies restricting the use of atrazine and other triazines to achieve desirable water quality standards are analyzed in a CEEPES framework. Five policies, including atrazine post restriction, restricting atrazine to meet MCL and HAL standards in runoff, a complete ban on atrazine, and also a ban on all triazines, were evaluated. The results suggest a $764 million total economic welfare loss with a triazine ban; with all other policies there was only one-third as much economic welfare loss. Although the triazine ban produced desirable water quality benefits, the economic costs are significantly higher. The overall goal of reducing water quality risk with the least economic welfare loss would not be achieved through an atrazine ban either, unless producers adopt practices that minimize risk from substitute herbicides. The runoff standards-based policy restrictions and atrazine post restriction offer best results for minimizing environmental risks with the least welfare reduction, but the current analysis assumes zero transaction costs, namely zero cost of monitoring and assessment

Restoring the Heart: A Community Vision for the Neighborhood of Aldenville

The goal of the Master of Regional Planning Studio is to develop a student’s techniques for collecting, analyzing, and synthesizing spatial and non-spatial data and then presenting that collective data in a manner (i.e., report, video, presentation, and charettes) that is understandable to academics, professionals, and the public. Planning Studio allows students to integrate knowledge from coursework and research, and apply such knowledge to resolving representative planning problems. At UMASS Amherst, these problems are found in neighborhood, rural, urban, and/or regional settings. For the Fall 2017 Planning Studio, Chicopee tasked the Masters of Regional Planning Studio to prepare a vision plan that focuses on improving Chicopee’s public engagement and land-use in Aldenville. The vision plan will contain a multi-question survey that will query Chicopee residents on their opinions of Chicopee, overall, and/or the neighborhood of Aldenville. In addition, the vision plan will also include two proposed land-use studies (zoning, land-use, pedestrian access, design, street improvements) for the neighborhood of Aldenville. This project has 6 goals: § Goal 1: Develop an outreach/engagement process that includes community survey materials (in hard-copy and digital formats) for distribution to Aldenville residents and stakeholders. The Planning Studio shall develop these materials understanding the City’s intended re-use of materials in a City-wide comprehensive visioning process. § Goal 2: Experiment with non-traditional modes of community engagement to maximize variety and volume of community response and data collection. § Goal 3: Analyze data collected from the outreach/engagement process to best inform the neighborhood visioning process and final Aldenville Vision Plan. § Goal 4: Develop a comprehensive understanding and graphic representation of major neighborhood destinations within Aldenville from which a more connected neighborhood concept can be developed. § Goal 5: Document, analyze, and discuss neighborhood opportunities and challenges (informed by the Community Outreach/Public Engagement Process) to advance visions for improving connectivity within the neighborhood and broadening the potential for Aldenville to function as a destination for all City residents as well as visitors from outside the City. § Goal 6: Document and prioritize destinations within Aldenville and propose urban design interventions to improve these destinations while using these destinations as anchors in a larger neighborhood network

Atrazine and Water Quality: An Evaluation of Restricting Atrazine Use on Corn and Sorghum to Postemergent Applications

Atrazine is the most widely used herbicide for corn and sorghum and the most commonly encountered in ground and surface water. In addition to water quality problems, atrazine poses hazards through atmospheric transport, food residues, and exposure of applications and wildlife. If atrazine use is restricted, substitute herbicides will come into wider use, increasing the likelihood of occurrence of their own sets of potentially undesirable side effects and imposing cost or efficacy penalties

An Examination of the Changes in Science Teaching Orientations and Technology-Enhanced Tools for Student Learning in the Context of Professional Development

This research examines how science teaching orientations and beliefs about technology-enhanced tools change over time in professional development (PD). The primary data sources for this study came from learning journals of 8 eighth grade science teachers at the beginning and conclusion of a year of PD. Based on the analysis completed, Information Transmission (IT) and Struggling with Standards-Based Reform (SSBR) profiles were found at the beginning of the PD, while SSBR and Standards-Based Reform (SBR) profiles were identified at the conclusion of PD. All profiles exhibited Vision I beliefs about the goals and purposes for science education, while only the SBR profile exhibited Vision II goals and purposes for science teaching. The IT profile demonstrated naïve or unrevealed beliefs about the nature of science, while the SSBR and SBR profiles had more sophisticated beliefs in this area. The IT profile was grounded in more teacher-centered beliefs about science teaching and learning as the other two profiles revealed more student-centered beliefs. While no beliefs about technology-enhanced tools were found for the IT profile, these were found for the other two profiles. Our findings suggest promising implications for (a) Roberts\u27 Vision II as a central support for reform efforts, (b) situating technology-enhanced tools within the beliefs about science teaching and learning dimension of science teaching orientations, and (c) revealing how teacher orientations develop as a result of PD

The institutional shaping of management: in the tracks of English individualism

Globalisation raises important questions about the shaping of economic action by cultural factors. This article explores the formation of what is seen by some as a prime influence on the formation of British management: individualism. Drawing on a range of historical sources, it argues for a comparative approach. In this case, the primary comparison drawn is between England and Scotland. The contention is that there is a systemic approach to authority in Scotland that can be contrasted to a personal approach in England. An examination of the careers of a number of Scottish pioneers of management suggests the roots of this systemic approach in practices of church governance. Ultimately this systemic approach was to take a secondary role to the personal approach engendered by institutions like the universities of Oxford and Cambridge, but it found more success in the different institutional context of the USA. The complexities of dealing with historical evidence are stressed, as is the value of taking a comparative approach. In this case this indicates a need to take religious practice as seriously as religious belief as a source of transferable practice. The article suggests that management should not be seen as a simple response to economic imperatives, but as shaped by the social and cultural context from which it emerges

Functional cardiac fibroblasts derived from human pluripotent stem cells via second heart field progenitors

Cardiac fibroblasts (CFs) play critical roles in heart development, homeostasis, and disease. The limited availability of human CFs from native heart impedes investigations of CF biology and their role in disease. Human pluripotent stem cells (hPSCs) provide a highly renewable and genetically defined cell source, but efficient methods to generate CFs from hPSCs have not been described. Here, we show differentiation of hPSCs using sequential modulation of Wnt and FGF signaling to generate second heart field progenitors that efficiently give rise to hPSC-CFs. The hPSC-CFs resemble native heart CFs in cell morphology, proliferation, gene expression, fibroblast marker expression, production of extracellular matrix and myofibroblast transformation induced by TGFβ1 and angiotensin II. Furthermore, hPSC-CFs exhibit a more embryonic phenotype when compared to fetal and adult primary human CFs. Co-culture of hPSC-CFs with hPSC-derived cardiomyocytes distinctly alters the electrophysiological properties of the cardiomyocytes compared to co-culture with dermal fibroblasts. The hPSC-CFs provide a powerful cell source for research, drug discovery, precision medicine, and therapeutic applications in cardiac regeneration.J.L.C. received funding from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and Fundação de Amparo à Pesquisa do Distrito Federal. The work was funded by NIH R01 HL129798 (T.J.K.); NIH U01 HL134764 (T.J.K.); S10RR025644 (T.J.K.); and the UW Institute for Clinical and Translational Research, grant UL1TR000427, from the Clinical and Translational Science Award of the NCATS/NIH.S