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Reward Deficiency Syndrome (RDS) is an umbrella term for all drug and nondrug addictive behaviors, due to a dopamine deficiency, “hypodopaminergia.” There is an opioid-overdose epidemic in the USA, which may result in or worsen RDS. A paradigm shift is needed to combat a system that is not working. This shift involves the recognition of dopamine homeostasis as the ultimate treatment of RDS via precision, genetically guided KB220 variants, called Precision Behavioral Management (PBM). Recognition of RDS as an endophenotype and an umbrella term in the future DSM 6, following the Research Domain Criteria (RDoC), would assist in shifting this paradigm.
In a study conducted in the database of a large commercial healthcare insurer, we previously demonstrated that use of a commercial pharmacogenetic assay for individuals with mood disorders was associated with decreased resource utilization and cost in the 6 month period following use compared to propensity-score matched controls. We conducted a post hoc analysis to understand variables associated with high cost savings.
The results and methods of the initial study have previously been described. Cases were individuals with mood and anxiety disorders who received a commercial pharmacogenetic assay (Genomind, King of Prussia PA) to inform pharmacotherapy. 817 tested individuals (cases) with mood and/or anxiety disorders were matched to 2745 controls. Overall costs were estimated to be $1,948 lower in the tested group. The differences were largely the result of lesser emergency room and inpatient utilization for cases. In the present analysis, cost difference for cases compared to their matched controls was rank ordered by decile. High cost savers were arbitrarily defined a priori as the top 20% of savers. Using multivariable modeling techniques, an ordinal logistic regression model was generated in which baseline or follow-up variables were statistically tested for independent associations with high, low, and no cost savings.
606 (74%) of cases were net cost savers compared to their controls (cost difference <0). High cost savers (n=121) saved on average $10,690 compared to their matched controls. They were statistically more likely to have been diagnosed with bipolar disorder (n=33/121) than low cost savers (n=57/485) or non-savers (n=31/211), and had a lower Charlson Comorbidity index. High cost savers had fewer mean number of antidepressants in the baseline period (mean=3.16) compared to non-savers (3.73) but more than low cost savers (2.72) (p<0.05 across groups). In a multivariable model, bipolar, count of antidepressants, outpatient visits, and inpatient visits were statistically associated with being a high cost saver; antidepressant count and all-cause inpatient and outpatient visits in the baseline period were inversely associated with cost savings.
Use of a pharmacogenetic assay was associated with cost-savings in the database of a large commercial insurer. Patients with bipolar disorder were more likely to be high cost savers than individuals with other mood and anxiety disorders.
We present a detailed overview of the cosmological surveys that we aim to carry out with Phase 1 of the Square Kilometre Array (SKA1) and the science that they will enable. We highlight three main surveys: a medium-deep continuum weak lensing and low-redshift spectroscopic HI galaxy survey over 5 000 deg2; a wide and deep continuum galaxy and HI intensity mapping (IM) survey over 20 000 deg2 from
$z = 0.35$
to 3; and a deep, high-redshift HI IM survey over 100 deg2 from
$z = 3$
to 6. Taken together, these surveys will achieve an array of important scientific goals: measuring the equation of state of dark energy out to
$z \sim 3$
with percent-level precision measurements of the cosmic expansion rate; constraining possible deviations from General Relativity on cosmological scales by measuring the growth rate of structure through multiple independent methods; mapping the structure of the Universe on the largest accessible scales, thus constraining fundamental properties such as isotropy, homogeneity, and non-Gaussianity; and measuring the HI density and bias out to
$z = 6$
. These surveys will also provide highly complementary clustering and weak lensing measurements that have independent systematic uncertainties to those of optical and near-infrared (NIR) surveys like Euclid, LSST, and WFIRST leading to a multitude of synergies that can improve constraints significantly beyond what optical or radio surveys can achieve on their own. This document, the 2018 Red Book, provides reference technical specifications, cosmological parameter forecasts, and an overview of relevant systematic effects for the three key surveys and will be regularly updated by the Cosmology Science Working Group in the run up to start of operations and the Key Science Programme of SKA1.
We propose the nasal administration of calcium-enriched physiological salts as a new hygienic intervention with possible therapeutic application as a response to the rapid and tenacious spread of COVID-19. We test the effectiveness of these salts against viral and bacterial pathogens in animals and humans. We find that aerosol administration of these salts to the airways diminishes the exhalation of the small particles that face masks fail to filter and, in the case of an influenza swine model, completely block airborne transmission of disease. In a study of 10 human volunteers (5 less than 65 years and 5 older than 65 years), we show that delivery of a nasal saline comprising calcium and sodium salts quickly (within 15 min) and durably (up to at least 6 h) diminishes exhaled particles from the human airways. Being predominantly smaller than 1 μm, these particles are below the size effectively filtered by conventional masks. The suppression of exhaled droplets by the nasal delivery of calcium-rich saline with aerosol droplet size of around 10 μm suggests the upper airways as a primary source of bioaerosol generation. The suppression effect is especially pronounced (99%) among those who exhale large numbers of particles. In our study, we found this high-particle exhalation group to correlate with advanced age. We argue for a new hygienic practice of nasal cleansing by a calcium-rich saline aerosol, to complement the washing of hands with ordinary soap, use of a face mask, and social distancing.
Successful attainment of SDG17 is essential for implementing the other 16 SDGs, all of which depend upon secure means of implementation and durable partnerships. Funding for forests from ODA and other sources has trended upwards since 2000, providing reason for cautious optimism. However, REDD+ finance is declining. Private sector investment remains important. The idea of impact investment, which aims to solve pressing environmental and social problems while providing a return for investors, could make a significant contribution to the SDGs. However, not all sustainable development finance promotes forest conservation. Increasing funding for agricultural production often incentivises the conversion of forests to agricultural land while generating deforestation. The policy of zero net deforestation (ZND) is leading to the creation of partnerships to promote deforestation-free commodity supply chains for four forest risk commodities (palm oil, soy, beef and timber). Some innovative partnerships have been created to promote sustainable development involving intergovernmental organisations, the private sector, research institutes, NGOs and grass roots organisations. However, such partnerships exist within a neoliberal global economic order in which there are net financial flows from the Global South to the Global North that negate financial flows for sustainable development.
Bog bodies are among the best-known archaeological finds worldwide. Much of the work on these often extremely well-preserved human remains has focused on forensics, whereas the environmental setting of the finds has been largely overlooked. This applies to both the ‘physical’ and ‘cultural’ landscape and constitutes a significant problem since the vast spatial and temporal scales over which the practice appeared demonstrate that contextual assessments are of the utmost importance for our explanatory frameworks. In this article we develop best practice guidelines for the contextual analysis of bog bodies, after assessing the current state of research and presenting the results of three recent case studies including the well-known finds of Lindow Man in the United Kingdom, Bjældskovdal (Tollund Man and Elling Woman) in Denmark, and Yde Girl in the Netherlands. Three spatial and chronological scales are distinguished and linked to specific research questions and methods. This provides a basis for further discussion and a starting point for developing approaches to bog body finds and future discoveries, while facilitating and optimizing the re-analysis of previous studies, making it possible to compare deposition sites across time and space.
In this chapter we introduce and explain the key principles of integrated learning and outline ways in which it can be put into practice to provide quality Arts experiences, as well as quality learning in other areas. We suggest ways to achieve integrated learning that you can adapt to construct your own successful program.
We also move beyond the concept of curriculum integration to look at child integration as it should be applied in the classroom. Schools do exclude, both intentionally and otherwise. We explore the justifications offered for, and ways to remove, these barriers to engagement in the Arts by all. We argue in this chapter for the need for everyone to experience the Arts equally, no matter what their background or what form of diverse learning is brought to the classroom. For some children, this is the only pathway to success. In the Arts anyone can engage; everyone gets to live them.
This chapter will provide a foundation for the provision of quality visual arts educational experiences in early childhood and primary years. Practical suggestions for planning a high-quality visual arts program are linked to recent theory in a way that helps you construct your own visual arts program. Visual arts concepts, language, elements and principles will be defined and explained, with examples of the progression in visual arts education from early childhood through the primary years. Practicalities such as classroom management, safety and materials are addressed and additional interactive material can be found through the icons.
If we approach Arts education as we might approach literacy, we would aim to develop Arts literacy in students. We would teach students the tools of language, ways of constructing meaning, vocabulary, structures, forms, genres and shaping cultural and social contexts. In literacy we allow children freedom to gain confidence and experiment with creative writing, but we also intervene when necessary to correct, guide and teach them explicit skills and knowledge. If we apply this approach to the Arts, then, rather than stand back and ‘let the child be free’, we focus on developing proficiency in knowledge and skills as well as fostering creativity and imagination right from the start. As with any other Learning Area, child engagement and achievement in the Arts are determined by exposure to ongoing, sequential learning experiences. This chapter suggests ways in which teachers can achieve this in a way that is respectful of the needs and interests of the child.
The previous chapters have explored the teaching methodologies and concepts related to different forms of the Arts, as well as methodologies for integration and organisation. However, in addition to being able to teach the Arts, we need to have in place a system for evaluating the teaching process to ensure that the outcomes and goals we wish to achieve are met for the learners. There has been a great deal of research to identify specific teaching practices that can improve children’s outcomes. This chapter does not intend to analyse the validity or otherwise of these outcomes, as these are mandated by the various examination and education boards. In part, this is because it is difficult to isolate any specific technique or learning skill that works for individuals because all children have unique and individual learning styles. For these reasons, the focus of recent research has been to isolate general characteristics.
Teaching the Arts: Early Childhood and Primary Education foregrounds the importance of arts education to children's development and learning while connecting each arts area to the Australian Curriculum. The third edition provides comprehensive coverage and an exciting introduction to arts education in Australia, with updated content and new, interactive features. The book covers the key areas of dance, drama, media arts, music and visual arts, full of teacher tips, spotlights on arts education, and downloadable lesson plans. This new edition includes interactive eBook content such as interactive questions and answers throughout each chapter, example videos of arts activities accompanying lesson plans and teacher tips, and weblinks to further content to support students in their learning This book is a vital resource for all pre-service early childhood and primary teachers, emphasising the fundamental nature of the arts in schools.
In this chapter we will discuss the important role of the Arts in addressing the cross-curriculum priorities of the Australian Curriculum. The cross-curriculum priorities serve a number of functions, including fostering intercultural understanding. We will also explore ways the Arts can be used to respond to issues of sustainability. The chapter includes innovative and practical suggestions for developing continuous and sequential cross-curriculum learning in the Arts.