44 research outputs found
Inside the Mentors’ Experience: Using Poetic Representation to Examine the Tensions of Mentoring Pre-Service Teachers.
The supervision and mentoring of pre-service teachers during professional experience is complex work that requires a range of skills and capacities. Professional development for this work has traditionally been limited, however, and mentor teachers report experiencing tensions in their work stemming from their roles as both supporter and assessor of pre-service teachers. Despite the central role that mentors play in professional experience, their voices are underrepresented in the literature. In this paper, I draw on interview data to examine teachers’ experiences as mentors and the tensions they experience. I use poetic representation to illuminate the tensions and emotions of mentoring and present seven poems that provide insight into these tensions. I argue that poetic representation of interview data provides an opportunity to connect with the experience of being a mentor and offer suggestions for teacher educators to work collaboratively with mentor teachers to explore the dimensions of their role
A comparative study investigating the enablers and barriers facing teacher educators in a regional university: Snapshots from 2013 and 2020.
Although the provision of initial teacher education has been the subject of more than 100 inquiries and multiple reforms, the work of those in teacher education remains under-researched. This comparative research provides two snapshots of teacher educator surveys conducted seven years apart (2013 and 2020) in a regional university in Australia. The primary aim of the research was to examine how teacher educators describe their work and goals and to identify the barriers and enablers that are present in their practice. The data were thematically coded and categorised. The outcomes highlight that personal and professional experiences do shape the goals and motivations of teacher educators; that knowledge and skills impact the ways that they enact their work, and that professional development is essential. Issues pertaining to the discipline of teacher education and an increasingly casualised workforce need to be addressed by those within and external to the profession
Walking for our health: couple-focused interventions to promote physical activity in older adults
More than 50% of U.S. adults do not engage in sufficient physical activity to meet current recommendations, making physical activity change and maintenance a priority for health promotion throughout adulthood. Among married partners, change in physical activity of one partner often is concordant with change of activity of the other. The primary purpose of this study was to examine two couple-focused interventions that capitalize on the co-occurrence of health behavior change within couples to promote physical activity in older adults. In this study, partners (N = 31 couples) participated together in assessment and intervention activities, and were randomized together into one of two couple-focused conditions. In one condition (concurrent), standard goal-setting techniques were extended to a couple-focused design with each partner setting daily step goals and monitoring her or his own progress. In the other condition (combined), partners collaborated to set and monitor shared daily step goals. Physical activity was assessed with accelerometers pre- and post-intervention. Post-intervention, average weekly physical activity increased by 58 min (p \u3c 0.001), and average body mass index (BMI) decreased by 0.50 kg/m2 (p = 0.001), from pre-intervention measures. Similar levels of change in weekly physical activity and in BMI were detected in both intervention groups. Furthermore, participants demonstrated high adherence to the intervention protocol. Results suggest that couple-focused physical activity interventions can be effective in eliciting increases in physical activity among older adults. Further research is needed to uncover interpersonal mechanisms that maximize physical activity promotion and maintenance within couples over time
Whole Genome Sequence analysis of apparent Treatment Resistant Hypertension Status in Participants From the Trans-Omics For Precision Medicine Program
Effect of a vitamin/mineral supplement on children and adults with autism
<p>Abstract</p> <p>Background</p> <p>Vitamin/mineral supplements are among the most commonly used treatments for autism, but the research on their use for treating autism has been limited.</p> <p>Method</p> <p>This study is a randomized, double-blind, placebo-controlled three month vitamin/mineral treatment study. The study involved 141 children and adults with autism, and pre and post symptoms of autism were assessed. None of the participants had taken a vitamin/mineral supplement in the two months prior to the start of the study. For a subset of the participants (53 children ages 5-16) pre and post measurements of nutritional and metabolic status were also conducted.</p> <p>Results</p> <p>The vitamin/mineral supplement was generally well-tolerated, and individually titrated to optimum benefit. Levels of many vitamins, minerals, and biomarkers improved/increased showing good compliance and absorption. Statistically significant improvements in metabolic status were many including: total sulfate (+17%, p = 0.001), S-adenosylmethionine (SAM; +6%, p = 0.003), reduced glutathione (+17%, p = 0.0008), ratio of oxidized glutathione to reduced glutathione (GSSG:GSH; -27%, p = 0.002), nitrotyrosine (-29%, p = 0.004), ATP (+25%, p = 0.000001), NADH (+28%, p = 0.0002), and NADPH (+30%, p = 0.001). Most of these metabolic biomarkers improved to normal or near-normal levels.</p> <p>The supplement group had significantly greater improvements than the placebo group on the Parental Global Impressions-Revised (PGI-R, Average Change, p = 0.008), and on the subscores for Hyperactivity (p = 0.003), Tantrumming (p = 0.009), Overall (p = 0.02), and Receptive Language (p = 0.03). For the other three assessment tools the difference between treatment group and placebo group was not statistically significant.</p> <p>Regression analysis revealed that the degree of improvement on the Average Change of the PGI-R was strongly associated with several biomarkers (adj. R<sup>2 </sup>= 0.61, p < 0.0005) with the initial levels of biotin and vitamin K being the most significant (p < 0.05); both biotin and vitamin K are made by beneficial intestinal flora.</p> <p>Conclusions</p> <p>Oral vitamin/mineral supplementation is beneficial in improving the nutritional and metabolic status of children with autism, including improvements in methylation, glutathione, oxidative stress, sulfation, ATP, NADH, and NADPH. The supplement group had significantly greater improvements than did the placebo group on the PGI-R Average Change. This suggests that a vitamin/mineral supplement is a reasonable adjunct therapy to consider for most children and adults with autism.</p> <p>Trial Registration</p> <p><b>Clinical Trial Registration Number: </b><a href="http://www.clinicaltrials.gov/ct2/show/NCT01225198">NCT01225198</a></p
Contribution of Common Genetic Variants to Risk of Early-Onset Ischemic Stroke
Background and Objectives Current genome-wide association studies of ischemic stroke have focused primarily on late-onset disease. As a complement to these studies, we sought to identify the contribution of common genetic variants to risk of early-onset ischemic stroke. Methods We performed a meta-analysis of genome-wide association studies of early-onset stroke (EOS), ages 18-59 years, using individual-level data or summary statistics in 16,730 cases and 599,237 nonstroke controls obtained across 48 different studies. We further compared effect sizes at associated loci between EOS and late-onset stroke (LOS) and compared polygenic risk scores (PRS) for venous thromboembolism (VTE) between EOS and LOS. Results We observed genome-wide significant associations of EOS with 2 variants in ABO, a known stroke locus. These variants tag blood subgroups O1 and A1, and the effect sizes of both variants were significantly larger in EOS compared with LOS. The odds ratio (OR) for rs529565, tagging O1, was 0.88 (95% confidence interval [CI]: 0.85-0.91) in EOS vs 0.96 (95% CI: 0.92-1.00) in LOS, and the OR for rs635634, tagging A1, was 1.16 (1.11-1.21) for EOS vs 1.05 (0.99-1.11) in LOS; p-values for interaction = 0.001 and 0.005, respectively. Using PRSs, we observed that greater genetic risk for VTE, another prothrombotic condition, was more strongly associated with EOS compared with LOS (p = 0.008). Discussion The ABO locus, genetically predicted blood group A, and higher genetic propensity for venous thrombosis are more strongly associated with EOS than with LOS, supporting a stronger role of prothrombotic factors in EOS.Peer reviewe
Loci influencing blood pressure identified using a cardiovascular gene-centric array
Blood pressure (BP) is a heritable determinant of risk for cardiovascular disease (CVD). To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP), we genotyped 50 000 single-nucleotide polymorphisms (SNPs) that capture variation in 2100 candidate genes for cardiovascular phenotypes in 61 619 individuals of European ancestry from cohort studies in the USA and Europe. We identified novel associations between rs347591 and SBP (chromosome 3p25.3, in an intron of HRH1) and between rs2169137 and DBP (chromosome1q32.1 in an intron of MDM4) and between rs2014408 and SBP (chromosome 11p15 in an intron of SOX6), previously reported to be associated with MAP. We also confirmed 10 previously known loci associated with SBP, DBP, MAP or PP (ADRB1, ATP2B1, SH2B3/ATXN2, CSK, CYP17A1, FURIN, HFE, LSP1, MTHFR, SOX6) at array-wide significance (P 2.4 10(6)). We then replicated these associations in an independent set of 65 886 individuals of European ancestry. The findings from expression QTL (eQTL) analysis showed associations of SNPs in the MDM4 region with MDM4 expression. We did not find any evidence of association of the two novel SNPs in MDM4 and HRH1 with sequelae of high BP including coronary artery disease (CAD), left ventricular hypertrophy (LVH) or stroke. In summary, we identified two novel loci associated with BP and confirmed multiple previously reported associations. Our findings extend our understanding of genes involved in BP regulation, some of which may eventually provide new targets for therapeutic intervention.</p
Socioeconomic position and incident mobility impairment in the Cardiovascular Health Study
Background
We investigated if personal socioeconomic position (SEP) factors and neighborhood characteristics were associated with incident mobility impairment in the elderly.
Methods
We used data from the Cardiovascular Health Study, a longitudinal, population-based examination of coronary heart disease and stroke among persons aged 65 and older in the United States.
Results
Among 3,684 persons without baseline mobility impairment, lower baseline SEP was associated with increased risk of incident mobility disability during the 10-year follow-up period, although the strengths of these associations varied by socioeconomic indicator and race/sex group.
Conclusion
Among independent-living elderly, SEP affected development of mobility impairment into later life. Particular effort should be made to prevent or delay its onset among the elderlyhttp://deepblue.lib.umich.edu/bitstream/2027.42/57781/1/Socioeconomic Position and Incident Mobility Impairment in the Cardiovascular Health Study.pd
New Australian guidelines for the treatment of alcohol problems: an overview of recommendations
Summary of recommendations and levels of evidence
Chapter 2: Screening and assessment for unhealthy alcohol use
Screening
Screening for unhealthy alcohol use and appropriate interventions should be implemented in general practice (Level A), hospitals (Level B), emergency departments and community health and welfare settings (Level C).
Quantity–frequency measures can detect consumption that exceeds levels in the current Australian guidelines (Level B).
The Alcohol Use Disorders Identification Test (AUDIT) is the most effective screening tool and is recommended for use in primary care and hospital settings. For screening in the general community, the AUDIT-C is a suitable alternative (Level A).
Indirect biological markers should be used as an adjunct to screening (Level A), and direct measures of alcohol in breath and/or blood can be useful markers of recent use (Level B).
Assessment
Assessment should include evaluation of alcohol use and its effects, physical examination, clinical investigations and collateral history taking (Level C).
Assessment for alcohol-related physical problems, mental health problems and social support should be undertaken routinely (GPP).
Where there are concerns regarding the safety of the patient or others, specialist consultation is recommended (Level C).
Assessment should lead to a clear, mutually acceptable treatment plan which specifies interventions to meet the patient’s needs (Level D).
Sustained abstinence is the optimal outcome for most patients with alcohol dependence (Level C).
Chapter 3: Caring for and managing patients with alcohol problems: interventions, treatments, relapse prevention, aftercare, and long term follow-up
Brief interventions
Brief motivational interviewing interventions are more effective than no treatment for people who consume alcohol at risky levels (Level A).
Their effectiveness compared with standard care or alternative psychosocial interventions varies by treatment setting. They are most effective in primary care settings (Level A).
Psychosocial interventions
Cognitive behaviour therapy should be a first-line psychosocial intervention for alcohol dependence. Its clinical benefit is enhanced when it is combined with pharmacotherapy for alcohol dependence or an additional psychosocial intervention (eg, motivational interviewing) (Level A).
Motivational interviewing is effective in the short term and in patients with less severe alcohol dependence (Level A).
Residential rehabilitation may be of benefit to patients who have moderate-to-severe alcohol dependence and require a structured residential treatment setting (Level D).
Alcohol withdrawal management
Most cases of withdrawal can be managed in an ambulatory setting with appropriate support (Level B).
Tapering diazepam regimens (Level A) with daily staged supply from a pharmacy or clinic are recommended (GPP).
Pharmacotherapies for alcohol dependence
Acamprosate is recommended to help maintain abstinence from alcohol (Level A).
Naltrexone is recommended for prevention of relapse to heavy drinking (Level A).
Disulfiram is only recommended in close supervision settings where patients are motivated for abstinence (Level A).
Some evidence for off-label therapies baclofen and topiramate exists, but their side effect profiles are complex and neither should be a first-line medication (Level B).
Peer support programs
Peer-led support programs such as Alcoholics Anonymous and SMART Recovery are effective at maintaining abstinence or reductions in drinking (Level A).
Relapse prevention, aftercare and long-term follow-up
Return to problematic drinking is common and aftercare should focus on addressing factors that contribute to relapse (GPP).
A harm-minimisation approach should be considered for patients who are unable to reduce their drinking (GPP).
Chapter 4: Providing appropriate treatment and care to people with alcohol problems: a summary for key specific populations
Gender-specific issues
Screen women and men for domestic abuse (Level C).
Consider child protection assessments for caregivers with alcohol use disorder (GPP).
Explore contraceptive options with women of reproductive age who regularly consume alcohol (Level B).
Pregnant and breastfeeding women
Advise pregnant and breastfeeding women that there is no safe level of alcohol consumption (Level B).
Pregnant women who are alcohol dependent should be admitted to hospital for treatment in an appropriate maternity unit that has an addiction specialist (GPP).
Young people
Perform a comprehensive HEEADSSS assessment for young people with alcohol problems (Level B).
Treatment should focus on tangible benefits of reducing drinking through psychotherapy and engagement of family and peer networks (Level B).
Aboriginal and Torres Strait Islander peoples
Collaborate with Aboriginal or Torres Strait Islander health workers, organisations and communities, and seek guidance on patient engagement approaches (GPP).
Use validated screening tools and consider integrated mainstream and Aboriginal or Torres Strait Islander-specific approaches to care (Level B).
Culturally and linguistically diverse groups
Use an appropriate method, such as the “teach-back” technique, to assess the need for language and health literacy support (Level C).
Engage with culture-specific agencies as this can improve treatment access and success (Level C).
Sexually diverse and gender diverse populations
Be mindful that sexually diverse and gender diverse populations experience lower levels of satisfaction, connection and treatment completion (Level C).
Seek to incorporate LGBTQ-specific treatment and agencies (Level C).
Older people
All new patients aged over 50 years should be screened for harmful alcohol use (Level D).
Consider alcohol as a possible cause for older patients presenting with unexplained physical or psychological symptoms (Level D).
Consider shorter acting benzodiazepines for withdrawal management (Level D).
Cognitive impairment
Cognitive impairment may impair engagement with treatment (Level A).
Perform cognitive screening for patients who have alcohol problems and refer them for neuropsychological assessment if significant impairment is suspected (Level A).
Summary of key recommendations and levels of evidence
Chapter 5: Understanding and managing comorbidities for people with alcohol problems: polydrug use and dependence, co-occurring mental disorders, and physical comorbidities
Polydrug use and dependence
Active alcohol use disorder, including dependence, significantly increases the risk of overdose associated with the administration of opioid drugs. Specialist advice is recommended before treatment of people dependent on both alcohol and opioid drugs (GPP).
Older patients requiring management of alcohol withdrawal should have their use of pharmaceutical medications reviewed, given the prevalence of polypharmacy in this age group (GPP).
Smoking cessation can be undertaken in patients with alcohol dependence and/or polydrug use problems; some evidence suggests varenicline may help support reduction of both tobacco and alcohol consumption (Level C).
Co-occurring mental disorders
More intensive interventions are needed for people with comorbid conditions, as this population tends to have more severe problems and carries a worse prognosis than those with single pathology (GPP).
The Kessler Psychological Distress Scale (K10 or K6) is recommended for screening for comorbid mental disorders in people presenting for alcohol use disorders (Level A).
People with alcohol use disorder and comorbid mental disorders should be offered treatment for both disorders; care should be taken to coordinate intervention (Level C).
Physical comorbidities
Patients should be advised that alcohol use has no beneficial health effects. There is no clear risk-free threshold for alcohol intake. The safe dose for alcohol intake is dependent on many factors such as underlying liver disease, comorbidities, age and sex (Level A).
In patients with alcohol use disorder, early recognition of the risk for liver cirrhosis is critical. Patients with cirrhosis should abstain from alcohol and should be offered referral to a hepatologist for liver disease management and to an addiction physician for management of alcohol use disorder (Level A).
Alcohol abstinence reduces the risk of cancer and improves outcomes after a diagnosis of cancer (Level A)
Rewriting the Script of Mentoring Pre-Service Teachers in Third Space: Exploring Tensions of Loyalty, Obligation and Advocacy
Supporting pre-service teachers as they develop their understandings of teaching, learning and their identities as teachers is complex and multi-faceted work. I draw on self-study to explore my work in a new partnership model between a school in Victoria, Australia and a regional university. During 2013, I worked in both contexts and carried out the dual roles of teacher educator and secondary teacher. In this partnership, I set out to create a third space for mentoring and supporting pre-service teachers, making connections between their on-campus work and their developing practice in schools. Throughout the self-study, I kept field notes and a reflective journal. In analysing these, I identified the tensions and challenges of working in this space and in articulating my pedagogy as a university mentor. I experienced uncomfortable moments of learning, where I faced tensions related to issues of obligation, loyalty and advocacy. I argue that engaging in processes of translation and mediation enables university mentors to articulate a pedagogy of mentoring and, in so doing, to rewrite the script of mentoring for pre-service and supervising teachers.C