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161 results

Page 1 of 9

  • Increased hippocampal blood flow in people at clinical high risk for psychosis and effects of cannabidiol

  • Cathy Davies, Matthijs G Bossong, Daniel Martins, Robin Wilson, Elizabeth Appiah-Kusi, Grace Blest-Hopley, Fernando Zelaya, Paul Allen, Michael Brammer, Jesus Perez, Philip McGuire, Sagnik Bhattacharyya
  • Journal:
    Psychological Medicine , First View
    Published online by Cambridge University Press:
    17 October 2023, pp. 1-11
    • Article
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      • Open access
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  • Background

    Hippocampal hyperperfusion has been observed in people at Clinical High Risk for Psychosis (CHR), is associated with adverse longitudinal outcomes and represents a potential treatment target for novel pharmacotherapies. Whether cannabidiol (CBD) has ameliorative effects on hippocampal blood flow (rCBF) in CHR patients remains unknown.

    Methods

    Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single oral 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug. Hippocampal rCBF was measured using Arterial Spin Labeling. We examined differences relating to CHR status (controls v. placebo), effects of CBD in CHR (placebo v. CBD) and linear between-group relationships, such that placebo > CBD > controls or controls > CBD > placebo, using a combination of hypothesis-driven and exploratory wholebrain analyses.

    Results

    Placebo-treated patients had significantly higher hippocampal rCBF bilaterally (all pFWE<0.01) compared to healthy controls. There were no suprathreshold effects in the CBD v. placebo contrast. However, we found a significant linear relationship in the right hippocampus (pFWE = 0.035) such that rCBF was highest in the placebo group, lowest in controls and intermediate in the CBD group. Exploratory wholebrain results replicated previous findings of hyperperfusion in the hippocampus, striatum and midbrain in CHR patients, and provided novel evidence of increased rCBF in inferior-temporal and lateral-occipital regions in patients under CBD compared to placebo.

    Conclusions

    These findings suggest that hippocampal blood flow is elevated in the CHR state and may be partially normalized by a single dose of CBD. CBD therefore merits further investigation as a potential novel treatment for this population.

  • 362 Group Model Building to characterize the experiences of older adults with type 1 diabetes (T1D) with continuous glucose monitoring (CGM) therapy and uncover suboptimal response patterns

  • Anna R Kahkoska, John A. Batsis, Michael R. Kosorok, Elizabeth J. Mayer-Davis, Richard Pratley, Ruth Weinstock, Laura A. Young, Kristen Hassmiller Lich
  • Journal:
    Journal of Clinical and Translational Science / Volume 6 / Issue s1 / April 2022
    Published online by Cambridge University Press:
    19 April 2022, p. 67
    • Article
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      • Open access
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  • OBJECTIVES/GOALS: As the number of older adults (≥65 years) with T1D grows, there are limited data to guide care. In a six-month trial, CGM reduced hypoglycemia in older adults, yet there are challenges for widespread uptake. Our objective is to characterize older adults experiences with using CGM and define suboptimal responses signaling a need for resources or support. METHODS/STUDY POPULATION: The study will engage key stakeholders (i.e., older adults with T1D, caregivers [recruited as patient-caregiver dyads], and providers [endocrinologists, geriatricians, diabetes educators]) for a Group Model Building (GMB). GMB is a participatory approach to system dynamics in which participants share perceptions and experiences with a problem and collaboratively explore the system structure that shapes those trends. A series of 8 GMB workshops will be held with 3-8 participants. The final study n will be determined by thematic saturation. Workshops comprise 1) a questionnaire, 2) a GMB session, and 3) a focus group discussion. GMB will follow a replicable process to generate a model of the complex web of causal determinants affecting CGM-related experiences, including optimal and suboptimal CGM responses. RESULTS/ANTICIPATED RESULTS: To date, the study has enrolled 33 participants, including 28 older adults living with T1D and 5 caregivers (mean age = 74 years, range 67-83 years). Twenty-four patient participants will be active CGM users and 4 will be CGM non-users. The study will report on patient data capture from the questionnaire and EMR, including demographics, experiences, familiarity, and confidence surrounding CGM use; diabetes duration; insulin pump use; history of severe hypoglycemia. Analysis of aggregated data will generate causal loop diagrams that integrate pertinent theoretical frameworks, lived experiences, and CGM outcomes. Maps will be used to identify a set of suboptimal CGM responses (i.e., key outcome trajectories) that signal a need for action, with a diagram of factors that interact to produce each response. DISCUSSION/SIGNIFICANCE: Delivering CGM to older adults with T1D demands new approaches. This study will yield critical evidence to tailor support and resources for effective CGM use in older adults. Findings may be translated into suite of pragmatic interventions to bolster CGM use and matched to individual patients expected to benefit using a precision medicine framework.

  • Introduction

  • Edited by Amanda Hiner, Elizabeth Tasker Davis
  • Book:
    British Women Satirists in the Long Eighteenth Century
    Published online:
    31 March 2022
    Print publication:
    07 April 2022, pp 1-24

  • Summary

    Lady Mary Wortley Montagu’s bold attack on Pope’s satire in “Verses Addressed to the Imitator of the First Satire of the Second Book of Horace” (1733) positions her in a place of literary and cultural authority. Montagu critiques Pope’s satire – “an Oyster-Knife, that hacks and hews” – on the grounds that his indiscriminate personal attacks violate the benevolent spirit of Horatian satire and fail to produce sufficient moral effects. Satire should aim judiciously at targets, she explains, and the satirist must always wield the pen with precision and self-restraint. Like a surgeon’s knife, satire will cut and wound, but it is ultimately meant to heal and should never be used to bludgeon literary, political, or personal opponents.

  • 31 - Advances in Teacher Learning Research in the Learning Sciences

  • from Part VI - Moving Learning Sciences Research into the Classroom
  • Edited by R. Keith Sawyer, University of North Carolina, Chapel Hill
  • Book:
    The Cambridge Handbook of the Learning Sciences
    Published online:
    14 March 2022
    Print publication:
    07 April 2022, pp 619-637

  • Summary

    This chapter reviews the contribution of the learning sciences to teacher learning research, with particular consideration of how cognitive, sociocognitive, sociocultural, and improvement-focused perspectives extend teacher learning research. Learning scientists study all phases of teacher learning, including preservice education (before becoming a teacher), the first few years of teaching, and ongoing mastery throughout the career. Research often focuses on teaching practices – what teachers do in the classroom and how they move from novice to expert performance. Teacher learning can be supported through collaboration with other teachers in a professional learning community (PLC); through coaching and mentoring; through videos of expert teaching practice; and through educative curriculum materials.

British Women Satirists in the Long Eighteenth Century
  • Edited by Amanda Hiner, Elizabeth Tasker Davis
  • Published online:
    31 March 2022
    Print publication:
    07 April 2022
  • This collection of innovative essays by leading scholars on eighteenth-century British women satirists showcases women's contributions to the satiric tradition and challenges the assumption that women were largely targets, rather than practitioners, of satire during the long eighteenth century. The essays examine women's satires across diverse genres, from the fable to the periodical, and attend to women writers' appropriation of a literary style and form often viewed as exclusively masculine. The introduction features a new theory of women's satire and proposes a framework for analyzing satiric techniques employed by women writers. Organized chronologically, the contributors' essays address a wide range of authors and explore the ways in which satiric writings by women engaged in contemporary cultural conversations, influencing assumptions about gender, sociability, politics, and literary practices. This inclusive yet tightly-focused collection formulates an innovative and provocative new feminist theory of satire.

  • The Acknowledge–Normalize–Partner (ANP) Framework: A novel empathic communication tool for oncology nurses

  • Dana Kramer, Kimberly Chow, Mary Elizabeth Davis, Judith E. Nelson, Kelley Anderson, Molly Okpako, Camila Bernal, Catherine E. Malisse, Jessica I. Goldberg
  • Journal:
    Palliative & Supportive Care / Volume 21 / Issue 1 / February 2023
    Published online by Cambridge University Press:
    03 March 2022, pp. 12-19
  • Objective

    To describe the development and implementation of a novel tool designed to enhance nurse–patient communication in a major academic cancer center, which nurses can learn quickly, incorporate into their primary palliative care practice, and broadly disseminate in order to improve the patient experience.

    Method

    An evidence-based empathic communication tool and educational program were designed to provide essential skills to oncology nurses in having discussions with patients about their personal values. Evaluation included nurse focus groups, pre- and post-course evaluations and interviews, and patient questionnaires.

    Results

    Nurses were satisfied with the educational program and found the communication tool effective in a variety of clinical situations including discussions about personal values. Patients reported increased occurrences of these discussions when nurses utilized the framework (97% vs. 58%, p < 0.0001) and a higher quality of clinician communication (mean [SD] from 0 = very worst to 10 = very best: 7.18 [2.3] vs. 5.04 [2.9], p = 0.001).

    Significance of results

    Skilled, empathic communication is an essential component of high-quality primary palliative care. Oncology nurses are well suited to lead communication and provide this care as part of an interprofessional team. The training and tool described here are targeted and efficient, and prepare nurses to respond skillfully to emotion while facilitating important discussions about patient values.

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