687 research outputs found

    Identifying Transdiagnostic Mechanisms in Mental Health Using Computational Factor Modeling

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    Most psychiatric disorders do not occur in isolation, and most psychiatric symptom dimensions are not uniquely expressed within a single diagnostic category. Current treatments fail to work for around 25% to 40% of individuals, perhaps due at least in part to an overreliance on diagnostic categories in treatment development and allocation. In this review, we describe ongoing efforts in the field to surmount these challenges and precisely characterize psychiatric symptom dimensions using large-scale studies of unselected samples via remote, online, and "citizen science" efforts that take a dimensional, mechanistic approach. We discuss the importance that efforts to identify meaningful psychiatric dimensions be coupled with careful computational modeling to formally specify, test, and potentially falsify candidate mechanisms that underlie transdiagnostic symptom dimensions. We refer to this approach, i.e., where symptom dimensions are identified and validated against computationally well-defined neurocognitive processes, as computational factor modeling. We describe in detail some recent applications of this method to understand transdiagnostic cognitive processes that include model-based planning, metacognition, appetitive processing, and uncertainty estimation. In this context, we highlight how computational factor modeling has been used to identify specific associations between cognition and symptom dimensions and reveal previously obscured relationships, how findings generalize to smaller in-person clinical and nonclinical samples, and how the method is being adapted and optimized beyond its original instantiation. Crucially, we discuss next steps for this area of research, highlighting the value of more direct investigations of treatment response that bridge the gap between basic research and the clinic

    The impact of leadership on student outcomes: An analysis of the differential effects of leadership types

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    El prop贸sito de este estudio fue examinar el impacto relativo de los diferentes tipos de liderazgo en los resultados acad茅micos y no acad茅micos de los estudiantes. La metodolog铆a consisti贸 en el an谩lisis de los resultados de 27 estudios publicados sobre la relaci贸n entre liderazgo y resultados de los estudiantes. El primer meta-an谩lisis, que incluy贸 22 de los 27 estudios, implic贸 una comparaci贸n de los efectos de la transformaci贸n y liderazgo instructivo en los resultados de los estudiantes. Con el segundo meta-an谩lisis se realiz贸 una comparaci贸n de los efectos de cinco conjuntos derivados inductivamente de pr谩cticas de liderazgo en los resultados de los estudiantes. Doce de los estudios contribuyeron a este segundo an谩lisis. El primer meta-an谩lisis indic贸 que el efecto promedio de liderazgo instructivo en los resultados de los estudiantes fue de tres a cuatro veces la de liderazgo transformacional. La inspecci贸n de los elementos de la encuesta que se utilizaron para medir el liderazgo escolar revel贸 cinco conjuntos de pr谩cticas de liderazgo o dimensiones: el establecimiento de metas y expectativas; dotaci贸n de recursos estrat茅gicos, la planificaci贸n, coordinaci贸n y evaluaci贸n de la ense帽anza y el curr铆culo; promoci贸n y participan en el aprendizaje y desarrollo de los profesores, y la garant铆a de un ambiente ordenado y de apoyo. El segundo meta- an谩lisis revel贸 fuertes efectos promedio para la dimensi贸n de liderazgo que implica promover y participar en el aprendizaje docente, el desarrollo y efectos moderados de las dimensiones relacionadas con la fijaci贸n de objetivos y la planificaci贸n, coordinaci贸n y evaluaci贸n de la ense帽anza y el curr铆culo. Las comparaciones entre el liderazgo transformacional y el instructivo y entre las cinco dimensiones de liderazgo sugirieron que los l铆deres que focalizan sus relaciones, su trabajo y su aprendizaje en el asunto clave de la ense帽anza y el aprendizaje, tendr谩n una mayor influencia en los resultados de los estudiantiles. El art铆culo concluye con una discusi贸n sobre la necesidad de que liderazgo, investigaci贸n y pr谩ctica est茅n m谩s estrechamente vinculados a la evidencia sobre la ense帽anza eficaz y el aprendizaje efectivo del profesorado. Dicha alineaci贸n podr铆a aumentar a煤n m谩s el impacto del liderazgo escolar en los resultados de los estudiantesThe purpose of this study was to examine the relative impact of different types of leadership on students鈥 academic and nonacademic outcomes. The methodology involved an analysis of findings from 27 published studies of the relationship between leadership and student outcomes. The first meta-analysis, including 22 of the 7 studies, involved a comparison of the effects of transformational and instructional leadership on student outcomes. The second meta-analysis involved a comparison of the effects of five inductively derived sets of leadership practices on student outcomes. Twelve of the studies contributed to this second analysis. The first meta-analysis indicated that the average effect of instructional leadership on student outcomes was three to four times that of transformational leadership. Inspection of the survey items used to measure school leadership revealed five sets of leadership practices or dimensions: establishing goals and expectations; resourcing strategically; planning, coordinating, and evaluating teaching and the curriculum; promoting and participating in teacher learning and development, and ensuring an orderly and supportive environment. The second meta-analysis revealed strong average effects for the leadership dimension involving promoting and participating in teacher learning and development and moderate effects for the dimensions concerned with goal setting and planning, coordinating, and evaluating teaching and the curriculum. The comparisons between transformational and instructional leadership and between the five leadership dimensions suggested that the more leaders focus their relationships, their work, and their learning on the core business of teaching and learning, the greater their influence on student outcomes. The article concludes with a discussion of the need for leadership research and practice to be more closely linked to the evidence on effective teaching and effective teacher learning. Such alignment could increase the impact of school leadership on student outcomes even furthe

    ER exit in physiology and disease

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    The biosynthetic secretory pathway is comprised of multiple steps, modifications and interactions that form a highly precise pathway of protein trafficking and secretion, that is essential for eukaryotic life. The general outline of this pathway is understood, however the specific mechanisms are still unclear. In the last 15 years there have been vast advancements in technology that enable us to advance our understanding of this complex and subtle pathway. Therefore, based on the strong foundation of work performed over the last 40聽years, we can now build another level of understanding, using the new technologies available. The biosynthetic secretory pathway is a high precision process, that involves a number of tightly regulated steps: Protein folding and quality control, cargo selection for Endoplasmic Reticulum (ER) exit, Golgi trafficking, sorting and secretion. When deregulated it causes severe diseases that here we categorise into three main groups of aberrant secretion: decreased, excess and altered secretion. Each of these categories disrupts organ homeostasis differently, effecting extracellular matrix composition, changing signalling events, or damaging the secretory cells due to aberrant intracellular accumulation of secretory proteins. Diseases of aberrant secretion are very common, but despite this, there are few effective therapies. Here we describe ER exit sites (ERES) as key hubs for regulation of the secretory pathway, protein quality control and an integratory hub for signalling within the cell. This review also describes the challenges that will be faced in developing effective therapies, due to the specificity required of potential drug candidates and the crucial need to respect the fine equilibrium of the pathway. The development of novel tools is moving forward, and we can also use these tools to build our understanding of the acute regulation of ERES and protein trafficking. Here we review ERES regulation in context as a therapeutic strategy

    Commissioning care for people with dementia at the end of life: a mixed methods study.

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    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ The version of record, Zoe M Gotts, Nicole Baur, Emma McLellan, Claire Goodman, Louise Robinson and Richard P Lee, 鈥楥ommissioning care for people with dementia at the end of life: a mixed methods study鈥, BMJ Open, 2016,; 6: e013554, is available online at doi: 10.1136/ bmjopen-2016-013554Objectives To understand how end of life care for people with dementia is currently commissioned (.e contracted)and organised, with a view to informing the development of commissioning guidance for good quality community-based end of life care in dementia. Design Mixed-methods study; narrative review and qualitative interviews. Setting 8 NHS clinical commissioning groups and 5 Adult Services across England. Methods Narrative review of evidence; 20 semi structured interviews (telephone and face-to-face) with professionals involved in commissioning end of life care for people with dementia. Main outcome measures Summary of the existing evidence base for commissioning, commissioners鈥 approaches to the commissioning process for end of life care for people with dementia in England. Results In the context of commissioning end of life care for people with dementia, the literature review generated three key themes; (1) importance of joint commissioning; (2) lack of clarity for the process; and (3) factors influencing commissioning. In exploring health professionals鈥 perceptions of the commissioning process, 鈥榰ncertainty鈥 was elicited as an overarching theme across the CCGs interviewed. Organisation of the process, lack of expertise, issues surrounding integration and the art of specification were considered important factors that contribute to the uncertainty surrounding the commissioning process. Conclusions The current evidence base for commissioning end of life care is limited with considerable uncertainty as how clinical commissioners in England undertake the process to ensure future services are evidence-based. Strengths and limitations of this study 鈥 The use of a multimethod approach (narrative review, qualitative interviews) allowed for triangulation of our findings. 鈥 The evidence indentified in the review may be limited given that 鈥榗ommissioning鈥 is a relatively new term in England. 鈥 The review presented is a narrative review; the manuscripts were not subject to a quality assessment process. 鈥 Generalisability of findings might be affected by the small number of published studies, their heterogeneity in methodologies, and small sample sizes. 鈥 The study highlights that information on commissioning specifically for health and social care in England is limited; this is mirrored in commissioners鈥 accounts.Peer reviewe

    Risk Behaviors and Reasons for not Getting Tested for HIV among Men Who Have Sex with Men: An Online Survey in Peru

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    Men who have sex with men (MSM) account for the greatest burden of the HIV epidemic in Peru. Given that MSM are frequent users of the Internet, understanding the risk behaviors and the reasons for not getting tested among MSM who surf the Internet may improve the tailoring of future online behavioral interventions.From October 2007 to April 2008, we conducted an online survey among users of seven Peruvian gay websites.We received 1,481 surveys, 1,301 of which were included in the analysis. The median age of the participants was 22.5 years (range 12-71), 67% were homosexual, and the remainder was bisexual. Of survey respondents, 49.4% had never been tested for HIV and only 11.3% were contacted in-person during the last year by peer health educators from the Peruvian Ministry of Health and NGOs. Additionally, 50.8% had unprotected anal or vaginal sex at last intercourse, and a significant percentage reported a condom broken (22.1%), slipped (16.4%) or sexual intercourse initiated without wearing a condom (39.1%). The most common reasons for not getting tested for HIV among high-risk MSM were "I fear the consequences of a positive test result" (n鈥=鈥55, 34.4%), and "I don't know where I can get tested" (n鈥=鈥50, 31.3%).A small percentage of Peruvian MSM who answered our online survey, were reached by traditional peer-based education programs. Given that among high-risk MSM, fear of a positive test result and lack of awareness of places where to get tested are the most important reasons for not taking an HIV test, Internet interventions aimed at motivating HIV testing should work to reduce fear of testing and increase awareness of places that offer free HIV testing services to MSM

    Choral Ensembles Spring Concert

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    This Kennesaw State University School of Music performance features Chamber Singers, Men\u27s Ensemble, and University Chorale directed by Dr. Leslie Blackwell, Director of Choral Activities and Professor of Music and Music Education.https://digitalcommons.kennesaw.edu/musicprograms/2054/thumbnail.jp

    Food Resilience Toolkit

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    This toolkit is intended to help community leaders and technical support professionals assess and build food system resilience in their regions. The toolkit is available in English and Spanish and in written and video format. In the introduction, we explore the concept of resilience and the Community Capitals framework and suggest possible indicators of food system resilience. In Chapter 2, we outline four tools for assessing community advantages and challenges and developing plans to address them. These tools are: asset mapping, focus groups, nominal groups, and strategic planning. While many research techniques can be deployed for resilience building, we have found these four to be especially useful in building purpose-driven, directed initiatives that are responsive to community needs and assets. Chapter 3 explores the role of policy in building (or obstructing) resilience, and in responding to shocks. We take a birds-eye view of disaster experiences in both Vermont and Puerto Rico and review how political actors responded differently in each region. We use the Multiple Streams Approach as a lens for understanding how policy decisions happen and where there are opportunities to advocate for change. In the final chapter, we offer lessons from our own resilience research efforts in Puerto Rico and Vermont. We connect our findings with food system resilience indicators and community capitals to offer real-world examples of strengths and vulnerabilities in the face of crisis

    c-Fms-Mediated Differentiation and Priming of Monocyte Lineage Cells Play a Central Role in Autoimmune Arthritis

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    Introduction: Tyrosine kinases are key mediators of multiple signaling pathways implicated in rheumatoid arthritis (RA). We previously demonstrated that imatinib mesylate--a Food and Drug Administration (FDA)-approved, antineoplastic drug that potently inhibits the tyrosine kinases Abl, c-Kit, platelet-derived growth factor receptor (PDGFR), and c-Fms--ameliorates murine autoimmune arthritis. However, which of the imatinib-targeted kinases is the principal culprit in disease pathogenesis remains unknown. Here we examine the role of c-Fms in autoimmune arthritis. Methods: We tested the therapeutic efficacy of orally administered imatinib or GW2580, a small molecule that specifically inhibits c-Fms, in three mouse models of RA: collagen-induced arthritis (CIA), anti-collagen antibody-induced arthritis (CAIA), and K/BxN serum transfer-induced arthritis (K/BxN). Efficacy was evaluated by visual scoring of arthritis severity, paw thickness measurements, and histological analysis. We assessed the in vivo effects of imatinib and GW2580 on macrophage infiltration of synovial joints in CIA, and their in vitro effects on macrophage and osteoclast differentiation, and on osteoclast-mediated bone resorption. Further, we determined the effects of imatinib and GW2580 on the ability of macrophage colony-stimulating factor (M-CSF; the ligand for c-Fms) to prime bone marrow-derived macrophages to produce tumor necrosis factor (TNF) upon subsequent Fc receptor ligation. Finally, we measured M-CSF levels in synovial fluid from patients with RA, osteoarthritis (OA), or psoriatic arthritis (PsA), and levels of total and phosphorylated c-Fms in synovial tissue from patients with RA. Results: GW2580 was as efficacious as imatinib in reducing arthritis severity in CIA, CAIA, and K/BxN models of RA. Specific inhibition of c-Fms abrogated (i) infiltration of macrophages into synovial joints of arthritic mice; (ii) differentiation of monocytes into macrophages and osteoclasts; (iii) osteoclast-mediated bone resorption; and (iv) priming of macrophages to produce TNF upon Fc receptor stimulation, an important trigger of synovitis in RA. Expression and activation of c-Fms in RA synovium were high, and levels of M-CSF were higher in RA synovial fluid than in OA or PsA synovial fluid. Conclusions: These results suggest that c-Fms plays a central role in the pathogenesis of RA by mediating the differentiation and priming of monocyte lineage cells. Therapeutic targeting of c-Fms could provide benefit in RA

    Food Resilience Toolkit

    Get PDF
    This toolkit is intended to help community leaders and technical support professionals assess and build food system resilience in their regions. The toolkit is available in English and Spanish and in written and video format. In the introduction, we explore the concept of resilience and the Community Capitals framework and suggest possible indicators of food system resilience. In Chapter 2, we outline four tools for assessing community advantages and challenges and developing plans to address them. These tools are: asset mapping, focus groups, nominal groups, and strategic planning. While many research techniques can be deployed for resilience building, we have found these four to be especially useful in building purpose-driven, directed initiatives that are responsive to community needs and assets. Chapter 3 explores the role of policy in building (or obstructing) resilience, and in responding to shocks. We take a birds-eye view of disaster experiences in both Vermont and Puerto Rico and review how political actors responded differently in each region. We use the Multiple Streams Approach as a lens for understanding how policy decisions happen and where there are opportunities to advocate for change. In the final chapter, we offer lessons from our own resilience research efforts in Puerto Rico and Vermont. We connect our findings with food system resilience indicators and community capitals to offer real-world examples of strengths and vulnerabilities in the face of crisis
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