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This paper describes a collaborative approach to professional learning that has provided an opportunity for refreshed practices and growth in capacity in schools supporting students with various learning needs in several schools that are part of the Association of Independent Schools in the Australian Capital Territory. An action research approach to professional learning for school staff was facilitated with the participating schools in 2018/2019, centred on the Nationally Consistent Collection of Data on School Students with Disability.
Secession was supposed to express solidarity rooted in a shared dream of Southern independence, but something was amiss. When Georgia legislators gathered in November 1860 to consider calling a state secession convention, debate in the quiet capital of Milledgeville turned cacophonous. At issue was whether Abraham Lincoln’s election was, as Thomas R. R. Cobb put it, “sufficient ground for the dissolution of the Union.” Cobb, an ardent secessionist later killed in action at Fredericksburg, answered emphatically in the affirmative. For years, he said, Northerners had attacked slavery by opposing its westward expansion, refusing to enforce the Fugitive Slave Law, admiring John Brown, and allowing abolitionists to preach their heresies. Things would only get worse under a Republican president. Lincoln could appoint antislavery zealots to federal offices in the South. He could withhold military aid during a slave revolt. He could plant abolitionists in the Supreme Court. Given these past crimes and future threats, who could counsel delay? Cobb conceded that if the issues were fleeting or superficial, like tariff rates, he would wait for Lincoln to make an overtly aggressive move. But safeguarding slavery was too important. “My friends,” exhorted Cobb, “there is danger in delay.” He urged “immediate, unconditional secession.”
Depression is one of the most common mental disorders in people with advanced cancer. Although cognitive–behavioural therapy (CBT) has been shown to be effective for depression in people with cancer, it is unclear whether this is the case for people with advanced cancer and depression.
We sought to determine whether CBT is more clinically effective than treatment as usual (TAU) for treating depression in people with advanced cancer (trial registration number ISRCTN07622709).
A multi-centre, parallel-group single-blind randomised controlled trial comparing TAU with CBT (plus TAU). Participants (n = 230) with advanced cancer and depression were randomly allocated to (a) up to 12 sessions of individual CBT or (b) TAU. The primary outcome measure was the Beck Depression Inventory-II (BDI-II). Secondary outcome measures included the Patient Health Questionnaire-9, the Eastern Cooperative Oncology Group Performance Status, and Satisfaction with Care.
Multilevel modelling, including complier-average intention-to-treat analysis, found no benefit of CBT. CBT delivery was proficient, but there was no treatment effect (−0.84, 95% CI −2.76 to 1.08) or effects for secondary measures. Exploratory subgroup analysis suggested an effect of CBT on the BDI-II in those widowed, divorced or separated (−7.21, 95% CI −11.15 to −3.28).
UK National Institute for Health and Care Excellence (NICE) guidelines recommend CBT for treating depression. Delivery of CBT through the Improving Access to Psychological Therapies (IAPT) programme has been advocated for long-term conditions such as cancer. Although it is feasible to deliver CBT through IAPT proficiently to people with advanced cancer, this is not clinically effective. CBT for people widowed, divorced or separated needs further exploration. Alternate models of CBT delivery may yield different results.
Timely access to care services is crucial to support people with dementia and their family carers to live well. Carers of people with dementia (N = 390), recruited from eight countries, completed semi-structured interviews about their experiences of either accessing or not using formal care services over a 12-month period in the Access to Timely Formal Care (Actifcare) study. Participant responses were summarised using content analysis, categorised into clusters and frequencies were calculated. Less than half of the participants (42.3%) reported service use. Of those using services, 72.8 per cent reported timely access and of those not using services 67.2 per cent were satisfied with this situation. However, substantial minorities either reported access at the wrong time (27.2%), or feeling dissatisfied or mixed feelings about not accessing services (32.8%). Reasons for not using services included use not necessary yet, the carer provided support or refusal. Reasons given for using services included changes in the condition of the person with dementia, the service's ability to meet individual needs, not coping or the opportunity to access services arose. Facilitators and barriers to service use included whether participants experienced supportive professionals, the speed of the process, whether the general practitioner was helpful, participant's own proactive attitude and the quality of information received. To achieve timely support, simplified pathways to use of formal care services are needed.
Intracranial aneurysm (IA) is an expansion of the weakened arterial wall that is often asymptomatic until rupture, resulting in subarachnoid hemorrhage. Here we describe the high prevalence of familial IA in a cohort of Newfoundland ancestry. We began to investigate the genetic etiology of IA in affected family members, as the inheritance of this disease is poorly understood.
Whole exome sequencing was completed for a cohort of 12 affected individuals from two multiplex families with a strong family history of IA. A filtering strategy was implemented to identify rare, shared variants. Filtered variants were prioritized based on validation by Sanger sequencing and segregation within the families.
In family R1352, six variants passed filtering; while in family R1256, 68 variants remained, so further filtering was pursued. Following validation by Sanger sequencing, top candidates were investigated in a set of population controls, namely, C4orf6 c.A1G (p.M1V) and SPDYE4c.C103T (p.P35S). Neither was detected in 100 Newfoundland control samples.
Rare and potentially deleterious variants were identified in both families, though incomplete segregation was identified for all filtered variants. Alternate methods of variant prioritization and broader considerations regarding the interplay of genetic and environmental factors are necessary in future studies of this disease.
Species distribution models (SDMs) are statistical tools used to develop continuous predictions of species occurrence. ‘Integrated SDMs’ (ISDMs) are an elaboration of this approach with potential advantages that allow for the dual use of opportunistically collected presence-only data and site-occupancy data from planned surveys. These models also account for survey bias and imperfect detection through the use of a hierarchical modelling framework that separately estimates the species–environment response and detection process. This is particularly helpful for conservation applications and predictions for rare species, where data are often limited and prediction errors may have significant management consequences. Despite this potential importance, ISDMs remain largely untested under a variety of scenarios. We performed an exploration of key modelling decisions and assumptions on an ISDM using the endangered Baird’s tapir (Tapirus bairdii) as a test species. We found that site area had the strongest effect on the magnitude of population estimates and underlying intensity surface and was driven by estimates of model intercepts. Selecting a site area that accounted for the individual movements of the species within an average home range led to population estimates that coincided with expert estimates. ISDMs that do not account for the individual movements of species will likely lead to less accurate estimates of species intensity (number of individuals per unit area) and thus overall population estimates. This bias could be severe and highly detrimental to conservation actions if uninformed ISDMs are used to estimate global populations of threatened and data-deficient species, particularly those that lack natural history and movement information. However, the ISDM was consistently the most accurate model compared to other approaches, which demonstrates the importance of this new modelling framework and the ability to combine opportunistic data with systematic survey data. Thus, we recommend researchers use ISDMs with conservative movement information when estimating population sizes of rare and data-deficient species. ISDMs could be improved by using a similar parameterization to spatial capture–recapture models that explicitly incorporate animal movement as a model parameter, which would further remove the need for spatial subsampling prior to implementation.
Elevated levels of pro-inflammatory cytokines are consistently reported in schizophrenia (SZ) and bipolar-I disorder (BD), as well as among individuals who have been exposed to childhood trauma. However, higher levels of inflammatory markers in these disorders are yet to be investigated with respect to levels of exposure to different types of childhood trauma.
Participants were 68 cases with a diagnosis of schizophrenia/schizoaffective disorder (SZ), 69 cases with a diagnosis of psychotic BD and 72 healthy controls (HC). Serum levels of interleukin 6 (IL-6), tumour necrosis factor-α (TNF-α) and C-reactive protein (CRP) were quantified, and childhood trauma exposure was assessed with the Childhood Trauma Questionnaire.
The SZ group had significantly higher levels of IL-6, TNF-α and CRP when compared with the HC group (all p < 0.05, d = 0.41–0.63), as well as higher levels of TNF-α when compared with the BD group (p = 0.014, d = 0.50); there were no differences between the BD and HC groups for any markers. Exposure to sexual abuse was positively associated (standardised β = 0.326, t = 2.459, p = 0.018) with levels of CRP in the SZ group, but there were no significant associations between any form of trauma exposure and cytokine levels in the HC or BD groups.
These results contribute to the evidence for a chronic state of inflammation in SZ but not BD cases. Differential associations between trauma exposure and levels of pro-inflammatory cytokines across the diagnostic categories suggest that trauma may impact biological (stress and immune) systems differently in these patient groups.
THE STUDY OF LITERARY HISTORY comes—as does the closer investigation of any history, be it cultural, economic, social, etc.—with an unavoidable challenge. Trying to understand a historic period undoubtedly demands more than just recounting every document of it that has survived. Often as a result of the enormity of such a task, making sense of a bygone age also requires separating the seemingly important from the apparently irrelevant, the symptomatic from the singular, the influential from the ignored, and the original from the conventional. Yet while they might offer heuristically indispensable starting points and lines of enquiry, the narratives that come about through such processes of selection and rejection risk being incorrect in detail or unjust with regard to the complexity of a period; indeed, in the end, interpretations of historical periods run the danger of ending up as reductive, anachronistic, and falsely generalizing depictions of how and why things were done by whom, for whom, and to whom in another time.
In 1917 Max Weber gave a radical definition of the scientific mode of operation, claiming that “wer also nicht die Fähigkeit besitzt, sich einmal sozusagen Scheuklappen anzuziehen und sich hineinzusteigern in die Vorstellung, daß das Schicksal seiner Seele davon abhängt: ob er diese, gerade diese Konjektur an dieser Stelle dieser Handschrift richtig macht, der bleibe der Wissenschaft nur ja fern” (anyone who lacks the ability to don blinkers for once and to convince himself that the destiny of his soul depends upon whether he is right to make precisely this conjecture and no other at this point in his manuscript should keep well away from science). On the other end of the spectrum, however, attention to detail might even stand in the way of formulating a historical narrative. In 1918, one year after Weber delivered his lecture on “Wissenschaft als Beruf” (Science as Profession) in Munich, Lytton Strachey remarked in the preface to his Eminent Victorians: “The history of the Victorian Age will never be written: we know too much about it. For ignorance is the first requisite of the historian—ignorance, which simplifies and clarifies, which selects and omits, with a placid perfection unattainable by the highest art…. It is not by the direct method of a scrupulous narration that the explorer of the past can hope to depict that singular epoch.”
IN MARCH 1798, TWO GIANTS of European letters devoted a few words of their ongoing correspondence to someone now almost entirely unknown to us. Writing to Goethe from Jena on March 13, Schiller comments on an “altes deutsches Ritterstück” (old German play of chivalry) that he has recently re-read. This play, he finds, clearly has its faults, but makes such an impression on him that it is worth mentioning to Goethe:
… Fust von Stromberg [ist] zwar überladen von historischen Zügen und oft gesuchten Anspielungen, und diese Gelehrsamkeit macht das Stück schwerfällig und oft kalt, aber der Eindruck ist höchst bestimmt und nachhaltig, und der Poet erzwingt wirklich die Stimmung die er geben will. Auch ist nicht zu leugnen, daß solche Kompositionen, sobald man ihnen die poetische Wirkung erläßt, eine andre allerdings sehr schätzbare leisten, denn keine noch so gut geschriebene Geschichte könnte so lebhaft und sinnlich in jene Zeit hinein führen, als dieses Stück es tut.
[Fust von Stromberg is indeed overladen with historical details and often contrived allusions, and this scholarliness makes the play labored and sometimes cold; but the impression left by it is most precise and durable and the poet really forces out the sensation that he wants to create. It also cannot be denied that, as soon as you waive any need for them to be effective as works of poetry, compositions like this have another certainly very valuable effect, for no history yet written so well could lead us into that time as vividly and as sensually as this play does.]
In calling Fust von Stromberg an old German Ritterstück, Schiller is referring to the age depicted within the play (the years immediately following the First Crusade, i.e., around 1100) as opposed to the age of the play itself, which was first performed at Mannheim's Nationaltheater on November 5, 1782 and published in Mannheim in the same year. Its author, the high-ranking statesman Jacob Maier of Mannheim, had only recently died, in 1784, at the age of 44 or 45. Notably, Schiller singles out this play as an example of one that uses historical sources to convey the spirit of the times and presents history in a lively manner.