Slavery and the University is the first edited collection of scholarly essays devoted solely to the histories and legacies of this subject on North American campuses and in their Atlantic contexts. ...Gathering together contributions from scholars, activists, and administrators, the volume combines two broad bodies of work: (1) historically based interdisciplinary research on the presence of slavery at higher education institutions in terms of the development of proslavery and antislavery thought and the use of slave labor; and (2) analysis on the ways in which the legacies of slavery in institutions of higher education continued in the post–Civil War era to the present day. The collection features broadly themed essays on issues of religion, economy, and the regional slave trade of the Caribbean. It also includes case studies of slavery's influence on specific institutions, such as Princeton University, Harvard University, Oberlin College, Emory University, and the University of Alabama. Though the roots of Slavery and the University stem from a 2011 conference at Emory University, the collection extends outward to incorporate recent findings. As such, it offers a roadmap to one of the most exciting developments in the field of U.S. slavery studies and to ways of thinking about racial diversity in the history and current practices of higher education.
Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in ...this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness.
We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months.
Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was -3.2 kg (-7.0 lb, P=0.002); 37.8% of the participants in the intervention group lost 5% or more of their initial weight, as compared with 22.7% of those in the control group (P=0.009). There were no significant between-group differences in adverse events.
A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. Given the epidemic of obesity and weight-related disease among persons with serious mental illness, our findings support implementation of targeted behavioral weight-loss interventions in this high-risk population. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694.).
Extended periods of bed rest and mechanical ventilation (MV) have devastating effects on the body.
Early mobility (EM) for patients in respiratory failure is safe and feasible, and an ...interprofessional team is recommended. Using simulation to train EM skills improves student confidence. The purpose of this study was to enable health care student collaboration as an interprofessional team in providing safe management and monitoring during an EM simulation for a patient requiring MV.
Nursing (n = 33), respiratory (n = 7), occupational (n = 24), and physical therapist students (n = 55) participated in an EM interprofessional education (IPE) simulation experience. A mixed-methods analytic approach was used with pre/post quantitative analysis of the Student Perceptions of Interprofessional Clinical Education-Revised, Version 2 instrument and qualitative analysis of students' guided reflection papers.
Pre/post surveys completion rate was 39.5% (n = 47). The Student Perceptions of Interprofessional Clinical Education-Revised, Version 2 instrument indicated a significant improvement (P = .037) in students' perceptions of interprofessional collaborative practice. Qualitative data showed a positive response to the EM simulation IPE. Themes reflected all 4 Interprofessional Education Collaborative competencies.
This study demonstrated improved perception of interprofessional collaborative practice and better understanding of the Interprofessional Education Collaborative competencies.
Students collaborated in the simulation-based IPE to provide EM for a patient requiring MV and reported perceived benefits of the experience.
Therapeutics based on short interfering RNAs (siRNAs), which act by inhibiting the expression of target transcripts, represent a novel class of potent and highly specific next-generation treatments ...for human skin diseases. Unfortunately, the intrinsic barrier properties of the skin combined with the large size and negative charge of siRNAs make epidermal delivery of these macromolecules quite challenging. To help evaluate the in vivo activity of these therapeutics and refine delivery strategies we generated an innovative reporter mouse model that predominantly expresses firefly luciferase (luc2p) in the paw epidermis — the region of murine epidermis that most closely models the tissue architecture of human skin. Combining this animal model with state-of-the-art live animal imaging techniques, we have developed a real-time in vivo analysis work-flow that has allowed us to compare and contrast the efficacies of a wide range nucleic acid-based gene silencing reagents in the skin of live animals. While inhibition was achieved with all of the reagents tested, only the commercially available “self-delivery” modified Accell-siRNAs (Dharmacon) produced potent and sustained in vivo gene silencing. Together, these findings highlight just how informative reliable reporter mouse models can be when assessing novel therapeutics in vivo. Using this work-flow, we developed a novel clinically-relevant topical formulation that facilitates non-invasive epidermal delivery of unmodified and “self-delivery” siRNAs. Remarkably, a sustained >40% luc2p inhibition was observed after two 1-hour treatments with Accell-siRNAs in our topical formulation. Importantly, our ability to successfully deliver siRNA molecules topically brings these novel RNAi-based therapeutics one-step closer to clinical use.
Unique epidermal mice were combined with IVIS live animal imaging to define nucleic acid-based therapeutic afficacies in vivo and develop a novel clinic-ready siRNA topical delivery formulation. Display omitted
Recent evidence has shown that state health officials typically have relatively short tenures as leaders of state public health agencies, with a median of three years. Rapid turnover of state health ...officials underscores the critical roles that senior managers in state public health agencies play in maintaining agency stability and leadership during tumultuous periods of uncertainty. Frequent departures of agency heads mean that the deputy health officers and other senior managers are often the keepers of institutional memory, expertise, and experience-and find themselves inserted into policymaking positions when leadership has been vacated. They also play a critical role in training and onboarding newly appointed state health officials who often come from outside of public health practice to lead state public health agencies and need substantial support given the steep learning curve ofthe transition to their new responsibilities.Previous studies of the public health workforce have indicated that as much as 42% of the overall workforce plans to retire or leave their organizations by 2020. Because of this uncertainty and the importance ofseniormanagers and executives to state public health agencies, it is worth exploring retirement plans specifically among established senior leaders and the institutional consequences of a mass exodus. In this editorial, we propose several recommendations to mitigate the untoward ill effects that high levels of abrupt departure may precipitate. This information can be used proactively as an actionable framework to address these pending gaps strategically.
For workplaces which cannot operate as telework or remotely, there is a critical need for routine occupational SARS-CoV-2 diagnostic testing. Although diagnostic tests including the CDC 2019-Novel ...Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel (CDC Diagnostic Panel) (EUA200001) were made available early in the pandemic, resource scarcity and high demand for reagents and equipment necessitated priority of symptomatic patients. There is a clearly defined need for flexible testing methodologies and strategies with rapid turnaround of results for (1) symptomatic, (2) asymptomatic with high-risk exposures and (3) asymptomatic populations without preexisting conditions for routine screening to address the needs of an on-site work force. We developed a distinct SARS-CoV-2 diagnostic assay based on the original CDC Diagnostic Panel (EUA200001), yet, with minimum overlap for currently employed reagents to eliminate direct competition for limited resources. As the pandemic progressed with testing loads increasing, we modified the assay to include 5-sample pooling and amplicon target multiplexing. Analytical sensitivity of the pooled and multiplexed assays was rigorously tested with contrived positive samples in realistic patient backgrounds. Assay performance was determined with clinical samples previously assessed with an FDA authorized assay. Throughout the pandemic we successfully tested symptomatic, known contact and travelers within our occupational population with a ~ 24-48-h turnaround time to limit the spread of COVID-19 in the workplace. Our singleplex assay had a detection limit of 31.25 copies per reaction. The three-color multiplexed assay maintained similar sensitivity to the singleplex assay, while tripling the throughput. The pooling assay further increased the throughput to five-fold the singleplex assay, albeit with a subtle loss of sensitivity. We subsequently developed a hybrid 'multiplex-pooled' strategy to testing to address the need for both rapid analysis of samples from personnel at high risk of COVID infection and routine screening. Herein, our SARS-CoV-2 assays specifically address the needs of occupational healthcare for both rapid analysis of personnel at high-risk of infection and routine screening that is essential for controlling COVID-19 disease transmission. In addition to SARS-CoV-2 and COVID-19, this work demonstrates successful flexible assays developments and deployments with implications for emerging highly transmissible diseases and future pandemics.
Despite its necessity, integration of natural and social sciences to inform conservation efforts has been difficult. We examined the views of 63 scientists and practitioners involved in marine ...management in Mexico's Gulf of California, the central California coast, and the western Pacific on the challenges associated with integrating social science into research efforts that support ecosystem-based management (EBM) in marine systems. We used a semistructured interview format. Questions focused on how EBM was developed for these sites and how contextual factors affected its development and outcomes. Many of the traditional challenges linked with interdisciplinary research were present in the EBM projects we studied. However, a number of contextual elements affected how mandates to include social science were interpreted and implemented as well as how easily challenges could be addressed. For example, a common challenge is that conservation organizations are often dominated by natural scientists, but for some projects it was easier to address this imbalance than for others. We also found that the management and institutional histories that came before EBM in specific cases were important features of local context. Because challenges differed among cases, we believe resolving challenges to interdisciplinary research should be context specific. A pesar de que es necesaria, la integración de las ciencias naturales y sociales para informar esfuerzos de conservación ha sido difícil. Examinamos los puntos de vista de 63 científicos y practicantes involucrados en el manejo marino en el Golfo de California en México, la costa central de California y el Pacífico occidental sobre los retos asociados con la integración de la ciencia social en los esfuerzos de investigación que sostienen el manejo basado en ecosistemas (MBE) en sistemas marinos. Utilizamos un formato de encuesta semiestructurada. Las preguntas se centraron en como se desarrolló el MBE en esos sitios y como afectaron su desarrollo y resultados los factores contextúales. Muchos de los retos tradicionales relacionados con la investigación interdisciplinaria se presentaron en los proyectos MBE que estudiamos. Sin embargo, un número de elementos contextúales afectó la manera en que se interpretaron e implementaron los mandatos para incluir la ciencia social y la facilidad con que se abordaron los retos. Por ejemplo, un reto común es que las organizaciones de conservación a menudo están dominadas por científicos naturales, pero para algunos proyectos fue más fácil abordar este desbalance que para otros. También encontramos que las historias de manejo e institucionales previas al MBE en casos específicos fueron aspectos importantes del contexto local. Debido a que los retos fueron diferentes en todos los casos, consideramos que la resolución de retos para la investigación interdisciplinaria debe ser específica para cada contexto.
Abstract Background Serious mental illness (SMI) and minority race are each associated with elevated cardiovascular disease (CVD) mortality. However, little is known about racial variation in CVD ...risk factors in individuals with SMI. This study aimed to determine racial patterns of CVD risk factors in individuals with SMI and to compare these patterns to those of the general population. Methods Overweight/obese adults with SMI (163 whites; 111 African Americans) examined from 2008 to 2011 during a weight loss trial were compared at study baseline to overweight/obese adults (1103 whites; 550 African Americans) of similar age, sex, and race in the 2007 to 2010 National Health and Nutrition Examination Survey. Results All CVD risk factors except cholesterol were higher in SMI than the overall U.S. population. After adjusting for age and sex, both racial groups with SMI had similarly high risks of smoking, obesity, diabetes, and hypertension, while African Americans with SMI had lower risks of high cholesterol (RR 0.73; 95% CI 0.57–0.94) and metabolic syndrome (RR 0.75; 95% CI 0.63–0.91) than whites with SMI. In the U.S. population sample, African Americans compared to whites had higher risks of obesity (RR 1.23; 95% CI 1.14–1.34), diabetes (RR 1.68; 95% CI 1.21–2.34), and hypertension (RR 1.44; 95% CI 1.31–1.60) but no significant difference in smoking, high cholesterol, and metabolic syndrome. Conclusions Compared to the general population, the greater burden and dissimilar racial pattern of CVD risk factors in SMI underscore the need for CVD prevention programs targeting the SMI population.
Abstract Background Right ventricular (RV) dysfunction is associated with adverse outcomes in heart failure (HF). Mechanical unloading should be more effective than pharmacologic therapy to reduce RV ...afterload and improve RV function. We compared RV size and function after aggressive medical unloading therapy to that achieved in the same patients after 3 months of left ventricular assist device (LVAD) support. Methods and Results We studied 20 patients who underwent isolated LVAD placement (9 pulsatile and 11 axial flow). Echocardiograms were performed after inpatient optimization with diuretic and inotropic therapy and compared with studies done after 3 months of LVAD support. After medical optimization right atrial pressure was 11 ± 5 mm Hg, mean pulmonary artery pressure 36 ± 11 mm Hg, pulmonary capillary wedge pressure 23 ± 9 mm Hg, and cardiac index 2.0 ± 0.6 L·min·m2 . Preoperatively, RV dysfunction was moderate (2.6 ± 0.9 on a 0 to 4 scale), RV diameter at the base was 3.1 ± 0.6 cm, and mid-RV was 3.5 ± 0.6 cm. After median LVAD support of 123 days (92 to 170), RV size and global RV dysfunction (2.6 ± 0.9) failed to improve, despite reduced RV afterload. Conclusions RV dysfunction seen on intensive medical therapy persisted after 3 months of LVAD unloading therapy. Selection of candidates for isolated LV support should anticipate persistence of RV dysfunction observed on inotropic therapy.
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