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To increase knowledge of National Library of Medicine resources by using a train-the-trainer approach.
Workshops were held in spring 2016 to increase knowledge of 4 National Library of Medicine tools. Data were collected before the workshop and immediately, 3 months, and 1 year after the workshop. Knowledge questions were scored as 1 point per question; an aggregated knowledge score could range from 0 to 16 points. A paired t test assessed the change in knowledge from before to after the workshop.
Four workshops were hosted, with a total of 74 attendees. The response rate for the surveys ranged from 50% to 100%. Knowledge scores changed significantly from 7.2 to 11.9 (t = 15, P < .001). One year after the workshop, more of the participants reported having informally trained others (56.8%) than reported providing 1 or more formal training session (8.1%)(P < .001).
Objective measures of knowledge and information dissemination showed that the National Library of Medicine workshop was successful and resulted in both short- and long-term gains. This workshop could be repeated with other populations to further disseminate information regarding the National Library of Medicine tools, which could help improve disaster response.
Schizophrenia is associated with robust hippocampal volume deficits but subregion volume deficits, their associations with cognition, and contributing genes remain to be determined.
Hippocampal formation (HF) subregion volumes were obtained using FreeSurfer 6.0 from individuals with schizophrenia (n = 176, mean age ± s.d. = 39.0 ± 11.5, 132 males) and healthy volunteers (n = 173, mean age ± s.d. = 37.6 ± 11.3, 123 males) with similar mean age, gender, handedness, and race distributions. Relationships between the HF subregion volume with the largest between group difference, neuropsychological performance, and single-nucleotide polymorphisms were assessed.
This study found a significant group by region interaction on hippocampal subregion volumes. Compared to healthy volunteers, individuals with schizophrenia had significantly smaller dentate gyrus (DG) (Cohen's d = −0.57), Cornu Ammonis (CA) 4, molecular layer of the hippocampus, hippocampal tail, and CA 1 volumes, when statistically controlling for intracranial volume; DG (d = −0.43) and CA 4 volumes remained significantly smaller when statistically controlling for mean hippocampal volume. DG volume showed the largest between group difference and significant positive associations with visual memory and speed of processing in the overall sample. Genome-wide association analysis with DG volume as the quantitative phenotype identified rs56055643 (β = 10.8, p < 5 × 10−8, 95% CI 7.0–14.5) on chromosome 3 in high linkage disequilibrium with MOBP. Gene-based analyses identified associations between SLC25A38 and RPSA and DG volume.
This study suggests that DG dysfunction is fundamentally involved in schizophrenia pathophysiology, that it may contribute to cognitive abnormalities in schizophrenia, and that underlying biological mechanisms may involve contributions from MOBP, SLC25A38, and RPSA.
Environmental rights, also known as the human rights or constitutional rights that are used for the protection of the environment, have proliferated over the last forty-five years. However, the precise levels of protection that they represent has since been a major question associated with this phenomenon. Environmental Rights: The Development of Standards systematically investigates this question by analyzing the emerging standards of environmental protection that are associated with such rights and the way that those associations are becoming formalized. It covers all of the relevant human rights treaties to illustrate how environmental rights standards are emerging in this dynamic area. Bringing together an elite group of scholars, this book discusses significant new insights into the way that environmental rights are developing, the standards of protection that they confer, and the way that standards in the field of environmental rights can potentially be further developed in the future.
Many in the Christian tradition affirm two things: (1) that Jesus Christ descended to Hades/Limbus Patrum on Holy Saturday and (2) that the human nature of Jesus is a hylemorphic compound, the unity of a human soul and prime matter. I argue that (1) and (2) are incompatible; for the name ‘Jesus’, ‘Christ’, and ‘Jesus Christ’ rigidly designates a human being. But, given a certain view of hylemorphism, the human being, Jesus, ceased to exist in the time between his death and resurrection. So, Jesus did not descend to Hades/Limbus Patrum, even if God the Son did.
Telephone cognitive–behaviour therapy (TCBT) may be a cost-effective method for improving access to evidence-based treatment for obsessive–compulsive disorder (OCD) in young people.
Economic evaluation of TCBT compared with face-to-face CBT for OCD in young people.
Randomised non-inferiority trial comparing TCBT with face-to-face CBT for 72 young people (aged 11 to 18) with a diagnosis of OCD. Cost-effectiveness at 12-month follow-up was explored in terms of the primary clinical outcome (Children's Yale-Brown Obsessive-Compulsive Scale, CY-BOCS) and quality-adjusted life-years (QALYs) (trial registration: ISRCTN27070832).
Total health and social care costs were higher for face-to-face CBT (mean total cost £2965, s.d. = £1548) than TCBT (mean total cost £2475, s.d. = £1024) but this difference was non-significant (P = 0.118). There were no significant between-group differences in QALYs or the CY-BOCS and there was strong evidence to support the clinical non-inferiority of TCBT. Cost-effectiveness analysis suggests a 74% probability that face-to-face CBT is cost-effective compared with TCBT in terms of QALYs, but the result was less clear in terms of CY-BOCS, with TCBT being the preferred option at low levels of willingness to pay and the probability of either intervention being cost-effective at higher levels of willingness to pay being around 50%.
Although cost-effectiveness of TCBT was sensitive to the outcome measure used, TCBT should be considered a clinically non-inferior alternative when access to standard clinic-based CBT is limited, or when patient preference is expressed.
Declaration of interest
D.M.-C. reports research grants from the Swedish Research Council (Vetenskapsrådet), the Swedish Research Council for Health, working life and welfare (Forte), the US National Institute of Mental Health (NIMH), the UK National Institute of Health Research (NIHR), as well as royalties from Wolters Kluwer Health and Elsevier, all unrelated to the submitted work.
We agree with the authors that putting forward specific models and examining their agreement with experimental data are the best approach for understanding the nature of decision making. Although the authors only consider the likelihood function, prior, cost function, and decision rule (LPCD) framework, other choices are available. Bayesian statistics can be used to estimate essential parameters and assess the degree of optimality.
Just war, international law, and world order are all historically conditioned realities that interrelate with one another in complex ways. This paper explores their historical development and current status while critically examining their interrelationship. It begins with exploring just war as a basic frame for analysis and interconnection with the other two realities. Just war is not an abstract body of moral thought but instead a practically informed morality of war rooted in Christian thought and law, Roman law, and the practice of statecraft. The essay notes the importance of the ideas of jus gentium and jus naturale in just war's fundamental formation, as well as the parallel between its three basic features—sovereign authority, just cause, and the end of peace—and the three goods or ends of politics as classically defined, namely, order, justice, and peace. The essay then moves out to explore the historical and thematic relations between just war tradition and international law, especially the law of war, arguing that these together define a moral and legal structure that is normative for world order. The final section of the paper considers the functioning of the institutions of world order in the context of challenges from rival cultural understandings of war, law, and world order and from the rise of nonstate actors in the international sphere, arguing for dialogical efforts aimed at strengthening both the moral and legal basis for world order against contemporary threats to that order.
In the latter half of the twentieth century, lasting memories of two world wars and astonishment over the power of nuclear weapons left both policymakers and scholars of war largely preoccupied with the possibility of a catastrophic World War III. Instead, however, the face of war since 1945 has been that of regionally limited small wars and insurgencies fought with conventional weapons. Many of these conflicts began as armed rebellions against colonial regimes, but often later evolved into armed conflicts between and among various subgroups seeking control of state government. Such conflicts have usually been asymmetrical, with the party holding the reins of state power using aircraft, artillery, and armored vehicles, while those fighting against the regime have been limited to weapons that individuals can carry, such as automatic rifles, mortars, rocket-propelled grenade launchers, and improvised weapons of various sorts. The asymmetries have also typically gone deeper, with the fighters on the former side wearing uniforms and those on the latter often not; those on the former side making use of fortified bases and those on the latter side protecting themselves by blending in with the civilian population. Further, there have frequently been asymmetries in how each side has fought, with the militarily weaker side relying on stealth tactics, deception, and attacks against nonmilitary targets of more general public value, including direct attacks on people protected as noncombatants under the laws of war. The particular range of tactics classified as terrorism begins at this point, with the specific, direct, and intentional targeting of noncombatants. Such attacks not only have been the means of choice for transnational nonstate actors, including al-Qaeda and the self-styled Islamic State, but have also been used to considerable effect in local civil wars.