Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. ...Direct-to-consumer marketing offers a different approach to address the unmet need for youth receiving effective treatments. Involving a local caregiver key opinion leader in direct-to-consumer initiatives may be an effective strategy to increase caregiver demand for CBT. Research indicates that key opinion leaders improve health promotion campaigns, but key opinion leaders have not been studied in the context of increasing caregiver demand for evidence-based treatments.
Project CHAT (Caregivers Hearing about Anxiety Treatments) will test the role of key opinion leader participation in conducting outreach presentations to increase caregiver desire to seek CBT for their youth's anxiety. Caregiver attendees (N = 180) will be cluster randomized by school to receive one of two different approaches for presentations on CBT for youth anxiety. Both approaches will involve community outreach presentations providing information on recognizing youth anxiety, strategies caregivers can use to decrease youth anxiety, and how to seek CBT for youth anxiety. The researcher-only condition will be co-facilitated by two researchers. In the key opinion leader condition, a caregiver key opinion leader from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. In line with the theory of planned behavior, caregiver attendees will complete measures assessing their knowledge of, attitudes towards, perceived subjective norms about, and intention to seek CBT pre- and post-presentation; they will indicate whether they sought CBT for their youth at 3-month follow-up. Results will be analyzed using a mixed method approach to assess the effectiveness of a key opinion leader to increase caregiver demand for CBT.
This study will be the first to examine the potential of key opinion leaders to increase caregiver demand for CBT. If proven effective, the use of key opinion leaders could serve as a scalable dissemination strategy to increase the reach of evidence-based treatments.
This trial was registered on clinicaltrials.gov ( NCT04929262 ) on June 18, 2021. At the time of trial registration, pre/post-presentation data had been collected from 17 participants; thus, it was retrospectively registered.
Abstract The aim of this retrospective observational cohort study was to analyse and report the 5–10-year survival rates of endosseous zygomatic implants used in the rehabilitation of the atrophic ...maxilla. Forty-three consecutive zygomatic implant placements in 25 patients were evaluated over a 5–10-year period. All zygomatic implant surgery was carried out under general anaesthesia. Nobel Biocare zygomatic machined-surface implants were used, and placement was undertaken using the modified sinus slot method. The main outcome measures and determinants for success were survival of the restored implants and the proportion of originally planned prostheses delivered to patients. Of the 25 patients treated, 12 were male and 13 were female; 19 were non-smokers, and the mean age at time of surgery was 64 years. Patients were treatment-planned for implant-retained bridgework, a removable prosthesis retained by fixed cast gold or milled titanium beams, or magnet-retained removable prostheses. A combination of zygomatic and conventional implants was used in all but one patient. In this study it was shown that the overall success rate for zygomatic implants was 86%, with six of the implants either failing to integrate or requiring removal due to persistent infection associated with the maxillary sinus. All patients received their planned prosthesis, although in six cases the method of retention required modification. This study illustrates that zygomatic implants are a successful and important treatment option when trying to restore the atrophic maxilla, with the potential to avoid additional augmentation/grafting procedures and resulting in a high long-term success rate.
Although urban teachers are at-risk of experiencing significant work-related stress, urban teacher stress has been neglected in the research literature to date. Through semi-structured interviews ...conducted with a sample of K-4 urban teachers (
N
= 14) from three high-poverty schools in a large, Midwestern city, we examined teachers’ perceptions regarding sources and impact of stress and the resources needed to address identified stressors. Results from consensual qualitative research (CQR; Hill et al. in Couns Psychol, 25:517–572,
1997
; Hill et al. in Consensual qualitative research: an update,
2005
) suggest that at least one-half of the cases identified lack of resources, excessive workload, school-level disorganization, managing behavior problems, and accountability policies as significant sources of stress. The majority of teachers reported that occupational stress significantly impacted their personal relationships and physical health, and teachers identified human and material resources as most important to reducing work-related stress. Implications for organizationally based interventions and school policies to address urban teacher stress are discussed.
To explore the association between early computer experience (both accessibility and frequency of use) and cognitive and psychomotor development among young children.
The participants were 122 ...preschool children enrolled in a rural county Head Start program in the United States during 2001-2002. The following tests were administered to the children: the Bender Visual Motor Gestalt Test; the Boehm Test of Basic Concepts, Third Edition Preschool; the Test of Gross Motor Development, Second Edition; and a short form of the Wechsler Preschool and Primary Scales of Intelligence-Revised. Information pertaining to family characteristics and children's early computer experience was collected from parents. Both bivariate and multivariate analyses were used to assess the association between early computer experience and cognitive and motor development.
Of the participating children, 53% had a computer at home. Among families who had a computer, 83% had children's software on the computer. According to parents' reports, 29% of these children played on the home computer on a daily basis, and an additional 44% of the children played on the computer at least weekly. Of those families who did not have a home computer, 49% reported that their children had access to a computer somewhere outside home. Among these children, 10% had daily access to the computer and 33% had weekly access. The presence of a computer in the home was significantly associated with the family's income and the educational attainment of the parents. There was no gender difference in computer accessibility and frequency use among the participating children. Children who had access to a computer performed better on measures of school readiness and cognitive development, controlling for children's developmental stage and family socioeconomic status. The data in the current study did not suggest a relationship between computer experience and visual motor or gross motor skills among the participating children.
The findings in the present study suggest that early computer exposure before or during the preschool years is associated with development of preschool concepts and cognition among young children. However, frequency of use did not reveal such a relationship; neither did the ownership of other child electronic or video games in the household.
Increasing resistance of bacteria to antibiotics is a serious global challenge and there is a need to unlock the potential of novel antibacterial targets. One such target is the essential prokaryotic ...endoribonuclease RNase E. Using a combination of in silico high-throughput screening and in vitro validation we have identified three novel small molecule inhibitors of RNase E that are active against RNase E from Escherichia coli, Francisella tularensis and Acinetobacter baumannii. Two of the inhibitors are non-natural small molecules that could be suitable as lead compounds for the development of broad-spectrum antibiotics targeting RNase E. The third small molecule inhibitor is glucosamine-6-phosphate, a precursor of bacterial cell envelope peptidoglycans and lipopolysaccharides, hinting at a novel metabolite-mediated mechanism of regulation of RNase E.
•RNase E, an essential bacterial endoribonuclease, is a potential antibacterial target.•Three novel small molecule inhibitors of RNase E are identified.•Each inhibitor is active against RNase E from E. coli, F. tularensis and A. baumannii.•Two, as non-natural compounds, are suitable lead compounds for antibiotic development.•One, a metabolite, is a potential novel regulator of RNase E.
Melioidosis is an emerging disease of humans in Southeast Asia and tropical Australia. The bacterium causing this disease, Burkholderia pseudomallei, is also considered a bioterrorism agent, and as ...yet there is no licensed vaccine for preventing B. pseudomallei infection. In this study, we evaluated selected proteins (LolC, PotF, and OppA) of the ATP-binding cassette systems of B. pseudomallei as candidate vaccine antigens. Nonmembrane regions of the B. pseudomallei proteins were expressed and purified from Escherichia coli and then evaluated as vaccine candidates in an established mouse model of B. pseudomallei infection. When delivered with the monophosphoryl lipid A-trehalose dicorynomycolate adjuvant, the proteins stimulated antigen-specific humoral and cellular immune responses. Immunization with LolC or PotF protein domains afforded significant protection against a subsequent challenge with B. pseudomallei. The most promising vaccine candidate, LolC, provided a greater level of protection when it was administered with immune-stimulating complexes complexed with CpG oligodeoxynucleotide 10103. Immunization with LolC also protected against a subsequent challenge with a heterologous strain of B. pseudomallei, demonstrating the potential utility of this protein as a vaccine antigen for melioidosis.
Liposome-encapsulation has been suggested as method to improve the efficacy of ciprofloxacin against the intracellular pathogen, Francisella tularensis. Early work with a prototype formulation, ...evaluated for use against the F. tularensis live vaccine strain, showed that a single dose of liposomal ciprofloxacin given by the intranasal or inhalational route could provide protection in a mouse model of pneumonic tularemia. Liposomal ciprofloxacin offered better protection than ciprofloxacin given by the same routes. Liposomal ciprofloxacin has been further developed by Aradigm Corporation for Pseudomonas aeruginosa infections in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis. This advanced development formulation is safe, effective and well tolerated in human clinical trials. Further evaluation of the advanced liposomal ciprofloxacin formulation against the highly virulent F. tularensis Schu S4 strain has shown that aerosolized CFI (Ciprofloxacin encapsulated in liposomes for inhalation) provides significantly better protection than oral ciprofloxacin. Thus, liposomal ciprofloxacin is a promising treatment for tularemia and further research with the aim of enabling licensure under the animal rule is warranted.
The Toll/interleukin-1 receptor (TIR) domain plays a crucial role in the mammalian innate immune response. Recently, proteins containing TIR domains have been described in bacteria and it has been ...suggested that these bacterial proteins are involved in subversion of the vertebrate immune system. Here we describe the distribution of TIR-domain proteins among bacteria, fungi, archaea and viruses and evaluate the subversion hypothesis in the light of our findings. We suggest that most TIR domains in bacteria have nothing to do with subverting eukaryotic cells; instead, TIR domains function simply as general purpose protein-protein interaction domains put to diverse uses.
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