This study aims to explore the experiences of family caregivers during the COVID-19 pandemic-imposed visitation restrictions at formal care settings (FCS) such as assisted living centers and ...traditional nursing homes. Participants (N = 512) were recruited from an international caregiving social media site that was developed at the beginning of the COVID-19 pandemic. Descriptive data was collected on the family caregivers, the care recipient and facility. Respondents also provided a single feeling word describing their experience and an open-ended question allowed for further exploration. Caregivers were predominantly daughters (n = 375). The most common reported feeling words were sadness (n = 200), trauma (n = 108), anger (n = 65), frustration (n = 56), helplessness (n = 50), and anxiety (n = 36). Thematic analysis revealed four overarching themes: 1) isolation 2) rapid decline 3) inhumane care and 4) lack of oversight. This study highlights the importance of addressing the mental, emotional and physical needs of both care recipient and family caregiver during this challenging time. Caregiver visitation policy reform that includes the care recipient and family caregiver is also discussed.
Abstract
Recognizing the importance of timely guidance regarding the rapidly evolving field of hepatitis C management, the American Association for the Study of Liver Diseases (AASLD) and the ...Infectious Diseases Society of America (IDSA) developed a web-based process for the expeditious formulation and dissemination of evidence-based recommendations. Launched in 2014, the hepatitis C virus (HCV) guidance website undergoes periodic updates as necessitated by availability of new therapeutic agents and/or research data. A major update was released electronically in September 2017, prompted primarily by approval of new direct-acting antiviral agents and expansion of the guidance's scope. This update summarizes the latest release of the HCV guidance and focuses on new or amended recommendations since the previous September 2015 print publication. The recommendations herein were developed by volunteer hepatology and infectious disease experts representing AASLD and IDSA and have been peer reviewed and approved by each society's governing board.
Volitional exploration and learning are key to adaptive behavior, yet their characterization remains a complex problem for cognitive science. Exploration has been posited as a mechanism by which ...motivation promotes memory, but this relationship is not well-understood, in part because novel stimuli that motivate exploration also reliably elicit changes in neuromodulatory brain systems that directly alter memory formation, via effects on neural plasticity. To deconfound interrelationships between motivation, exploration, and memory formation we manipulated motivational state prior to entering a spatial context, measured exploratory responses to the context and novel stimuli within it, and then examined motivation and exploration as predictors of memory outcomes. To elicit spontaneous exploration, we used the physical space of an art exhibit with affectively rich content; we expected motivated exploration and memory to reflect multiple factors, including not only motivational valence, but also individual differences. Motivation was manipulated via an introductory statement framing exhibit themes in terms of Promotion- or Prevention-oriented goals. Participants explored the exhibit while being tracked by video. They returned 24 hours later for recall and spatial memory tests, followed by measures of motivation, personality, and relevant attitude variables. Promotion and Prevention condition participants did not differ in terms of group-level exploration time or memory metrics, suggesting similar motivation to explore under both framing contexts. However, exploratory behavior and memory outcomes were significantly more closely related under Promotion than Prevention, indicating that Prevention framing disrupted expected depth-of-encoding effects. Additionally, while trait measures predicted exploration similarly across framing conditions, traits interacted with motivational framing context and facial affect to predict memory outcomes. This novel characterization of motivated learning implies that dissociable behavioral and biological mechanisms, here varying as a function of valence, contribute to memory outcomes in complex, real-life environments.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The practice of removing "following" responses from speech perturbation analyses is increasingly common, despite no clear evidence as to whether these responses represent a unique response type. This ...study aimed to determine if the distribution of responses to auditory perturbation paradigms represents a bimodal distribution, consisting of two distinct response types, or a unimodal distribution.
This mega-analysis pooled data from 22 previous studies to examine the distribution and magnitude of responses to auditory perturbations across four tasks: adaptive pitch, adaptive formant, reflexive pitch, and reflexive formant. Data included at least 150 unique participants for each task, with studies comprising younger adult, older adult, and Parkinson's disease populations. A Silverman's unimodality test followed by a smoothed bootstrap resampling technique was performed for each task to evaluate the number of modes in each distribution. Wilcoxon signed-ranks tests were also performed for each distribution to confirm significant compensation in response to the perturbation.
Modality analyses were not significant (
> .05) for any group or task, indicating unimodal distributions. Our analyses also confirmed compensatory reflexive responses to pitch and formant perturbations across all groups, as well as adaptive responses to sustained formant perturbations. However, analyses of sustained pitch perturbations only revealed evidence of adaptation in studies with younger adults.
The demonstration of a clear unimodal distribution across all tasks suggests that following responses do not represent a distinct response pattern, but rather the tail of a unimodal distribution.
https://doi.org/10.23641/asha.24282676.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Improved treatment for major depressive disorder (MDD) remains elusive because of the limited understanding of its underlying biological mechanisms. It is likely that stress-induced maladaptive ...transcriptional regulation in limbic neural circuits contributes to the development of MDD, possibly through epigenetic factors that regulate chromatin structure. We establish that persistent upregulation of the ACF (ATP-utilizing chromatin assembly and remodeling factor) ATP-dependent chromatin-remodeling complex, occurring in the nucleus accumbens of stress-susceptible mice and depressed humans, is necessary for stress-induced depressive-like behaviors. We found that altered ACF binding after chronic stress was correlated with altered nucleosome positioning, particularly around the transcription start sites of affected genes. These alterations in ACF binding and nucleosome positioning were associated with repressed expression of genes implicated in susceptibility to stress. Together, our findings identify the ACF chromatin-remodeling complex as a critical component in the development of susceptibility to depression and in regulating stress-related behaviors.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SBMB, UILJ, UKNU, UL, UM, UPUK
Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare primary immunodeficiency disorder typically caused by homozygous
mutations. It classically presents with chronic ...mucocutaneous candidiasis and autoimmunity that primarily targets endocrine tissues; hypoparathyroidism and adrenal insufficiency are most common. Developing any two of these classic triad manifestations establishes the diagnosis. Although widely recognized in Europe, where nonendocrine autoimmune manifestations are uncommon, APECED is less defined in patients from the Western Hemisphere. We enrolled 35 consecutive American APECED patients (33 from the US) in a prospective observational natural history study and systematically examined their genetic, clinical, autoantibody, and immunological characteristics. Most patients were compound heterozygous; the most common
mutation was c.967_979del13. All but one patient had anti-IFN-ω autoantibodies, including 4 of 5 patients without biallelic
mutations. Urticarial eruption, hepatitis, gastritis, intestinal dysfunction, pneumonitis, and Sjögren's-like syndrome, uncommon entities in European APECED cohorts, affected 40%-80% of American cases. Development of a classic diagnostic dyad was delayed at mean 7.38 years. Eighty percent of patients developed a median of 3 non-triad manifestations before a diagnostic dyad. Only 20% of patients had their first two manifestations among the classic triad. Urticarial eruption, intestinal dysfunction, and enamel hypoplasia were prominent among early manifestations. Patients exhibited expanded peripheral CD4
T cells and CD21
CD38
B lymphocytes. In summary, American APECED patients develop a diverse syndrome, with dramatic enrichment in organ-specific nonendocrine manifestations starting early in life, compared with European patients. Incorporation of these new manifestations into American diagnostic criteria would accelerate diagnosis by approximately 4 years and potentially prevent life-threatening endocrine complications.
Over the last two decades, there has been a significant change in the financing of higher education in the United States. A decrease in student and institutional support in real terms, tuition ...increases at all types of institutions, along with the view that students are the primary beneficiaries of higher education has resulted in policies that reduce the proportion of higher education costs borne by the federal and state governments. This paper will describe this financing shift in the United States, and analyse its impact on college participation with a particular focus on equity and opportunity. It will also provide an analysis of some questions that European countries should address as they implement their own policies that shift the burden of paying for college from the government to individuals, and as they consider various forms of financial assistance to help students pay for college.
Over the last two decades, there has been a significant change in the financing of higher education in the United States. A decrease in student and institutional support in real terms, tuition ...increases at all types of institutions, along with the view that students are the primary beneficiaries of higher education has resulted in policies that reduce the proportion of higher education costs borne by the federal and state governments. This paper will describe this financing shift in the United States, and analyse its impact on college participation with a particular focus on equity and opportunity. It will also provide an analysis of some questions that European countries should address as they implement their own policies that shift the burden of paying for college from the government to individuals, and as they consider various forms of financial assistance to help students pay for college.
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