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School discipline has been a site of contention and reform. In this study, we draw from 17 interviews with traditional and charter school principals in one mid-sized urban school district to examine how principals use discipline as a tool to both maintain control and demonstrate care. Our study calls attention to different strategies principals use to establish this balance, including reducing suspensions, moderating "no-excuses" systems, and building positive student--teacher relationships. We also make a theoretical contribution by showing how schools and school leaders respond to competing institutional logics in developing practices and policies.

Concealed campus carry is the subject of both popular discussion and academic scholarship. For almost a decade, the University of Texas at Austin (UT) has been the site of the debate over campus carry during a prolonged legislative battle and an implementation marked by pro- and anti-gun protests, various Texas attorney general's opinions, and lawsuits. Using self-determination theory (Deci & Ryan, 2000), this article presents the results from in-depth interviews with 32 women professionals in academic and student services at UT about how campus carry affects their personal and professional lives. Because of their daily interactions with students, these professionals have been at the forefront of implementing state and campus gun policies. Their experiences can inform the development of campus carry law, policy, and implementation at other universities

As online education becomes a more popular and permanent option for obtaining an education after high school, it also raises questions as to the academic rigor of such classes and the academic integrity of the students taking the classes. The purpose of the current study is to explore the integrity issue and to investigate student performance on online examinations. Utilizing a sample of about 1,700 students who took online psychology classes of varying difficulty at Washington State University from spring 2015 to spring 2016, we found that students performed 10-20% better and took about twice as long on non-proctored versus proctored exams. The effect held when we compared our in-house proctoring service used during this time against ProctorU, used for one semester in fall 2012. To ensure the most robust design possible, we also rotated the proctored exam in each class at least once and then compared performance on an exam when it was proctored versus when the same exam was non-proctored. Results showed better performance when the exam was non-proctored than when it was proctored. Finally, since instructors changed over the four semesters our study ran, we wanted to ensure that the results were not due to differences in teaching style. This potential confounding variable was eliminated. We discuss possible reasons for the difference in performance, to include student academic misconduct, and offer suggestions for ensuring we have both academic rigor and integrity in online courses.

From the inception of the integration of predominantly White institutions in higher education marked by "Sweatt v. Painter" in 1950, The University of Texas at Austin (UT Austin) has been a battleground for educational equity. The university continues to find itself at ground zero in the battle for race and equity in higher education and embroiled in the debate over affirmative action, first in "Hopwood v. Texas" (1996) and then in "Fisher v. University of Texas at Austin" (2013; 2016). For these reasons, UT Austin serves as a bellwether institution for public, predominantly White institutions (PWIs) when it comes to integration. The legal challenges, coupled with evidence of a challenging campus climate for students of color, reflect the kind of hostility recently reported at Michigan, UCLA, and other public flagship institutions such as Texas A&M, where a group of visiting students from Dallas's Uplift Hampton Preparatory School were racially harassed and taunted by a group of White men and women who told them to "go home" (Heinz). As UT Austin continues to confront challenges in recruiting Black students and maintaining a supportive campus climate for students of color (Jaramillo & Cannizzo), it is important to consider the ways in which the institution has and has not changed in the past sixty years. In addition, it is worth noting that although Black undergraduates began attending UT Austin in 1956 (albeit in small numbers), Black students did not graduate from the prestigious Plan II Honors Program until twenty years later.

BackgroundProgressive supranuclear palsy is a neurodegenerative tauopathy manifesting clinically as a progressive akinetic-rigid syndrome. In this study, we sought to identify genetic variants influencing PSP susceptibility through a genome-wide association analysis of a cohort of well-characterized patients who had participated in the Neuroprotection and Natural History in Parkinson Plus Syndromes and Blood Brain Barrier in Parkinson Plus Syndromes studies.MethodsWe genotyped single-nucleotide polymorphisms in 283 PSP cases from the United Kingdom, Germany, and France and compared these with genotypes from 4472 controls. Copy number variants were identified from genotyping data.ResultsWe observed associations on chromosome 17 within or close to the MAPT gene and explored the genetic architecture at this locus. We confirmed the previously reported association of rs1768208 in the MOBP gene (P = 3.29 × 10-13 ) and rs1411478 in STX6 (P = 3.45 × 10-10 ). The population-attributable risk from the MAPT, MOBP, and STX6 single-nucleotide polymorphisms was found to be 0.37, 0.26, and 0.08, respectively. In addition, we found 2 instances of copy number variants spanning the MAPT gene in patients with PSP. These copy number variants include tau but few other genes within the chromosome 17 haplotype region, providing additional support for the direct pathogenicity of MAPT in PSP.ConclusionsClinicians should also be aware of MAPT duplication as a possible genetic cause of PSP, especially in patients presenting with young age at onset. © 2019 International Parkinson and Movement Disorder Society.

BackgroundProgressive supranuclear palsy (PSP) is a rare neurodegenerative disease for which the genetic contribution is incompletely understood.MethodsWe conducted a joint analysis of 5,523,934 imputed SNPs in two newly-genotyped progressive supranuclear palsy cohorts, primarily derived from two clinical trials (Allon davunetide and NNIPPS riluzole trials in PSP) and a previously published genome-wide association study (GWAS), in total comprising 1646 cases and 10,662 controls of European ancestry.ResultsWe identified 5 associated loci at a genome-wide significance threshold P

PURPOSE:Early intervention for adolescent substance use and mental health problems may mitigate potential harm. We examined patient outcomes from a pragmatic trial of two modalities of delivering screening, brief intervention, and referral to treatment (SBIRT) and usual care (UC) in pediatric primary care. METHODS:All clinic pediatricians (n = 52) were randomized to three arms: (1) pediatrician-only, in which pediatricians were trained to deliver SBIRT; (2) embedded behavioral clinician (BC), in which pediatricians were trained to refer eligible adolescents to a BC who administered SBIRT; and (3) UC. Using electronic health record data, changes in past year substance use and depression symptoms between the index visit and next screening visit were examined across treatment arms. RESULTS:Among patients who endorsed substance use and/or depression symptoms or were eligible for further assessments, brief interventions, and referrals based on clinician assessment at the index visit, 648 patients (mean age = 15.2 [standard deviation = 1.2]) were rescreened at a follow-up visit between 6 months and 2 years later. Among all patients, self-reported substance use rates did not differ over time or across arms, and depression symptoms increased over time. The embedded BC arm had lower odds of having depression symptoms at follow-up than the physician-only arm, and lower odds than the UC arm although not significant; we found no differences between the pediatrician-only and UC arms. CONCLUSIONS:The increase in depression symptoms over time highlights this population's vulnerability and the importance of developing appropriate interventions. An embedded BC in pediatric primary care trained in SBIRT may benefit patients with depression symptoms.

ObjectiveMany adolescents needing specialty addiction or psychiatry treatment never access care. We examined initiation and engagement with addiction and/or psychiatry treatment among adolescents referred to treatment from a trial comparing two different modalities of delivering Screening, Brief Intervention and Referral to Treatment (SBIRT) to Usual Care in pediatric primary care. We hypothesized that both intervention arms would have higher initiation and engagement rates than usual care.MethodsWe randomized all pediatricians (n=52) in a pediatric primary care clinic to three arms: 1) pediatrician-only arm, in which pediatricians were trained to deliver SBIRT for substance use and/or mental health problems; 2) embedded-behavioral health clinician (embedded-BHC arm), in which pediatricians referred adolescents who endorsed substance use and/or mental health problems to a BHC; and 3) Usual Care (UC). We used electronic health record (EHR) data to examine specialty addiction and psychiatry treatment initiation and engagement rates after referral.ResultsAmong patients who screened positive for substance use and/or mental health problems and were referred to specialty addiction and/or psychiatry (n=333), those in the embedded-BHC arm had almost four times higher odds of initiating treatment than those in the pediatrician-only arm, OR=3.99, 95% CI=[1.99-8.00]. Compared to UC, those in the pediatrician-only arm had lower odds of treatment initiation (OR=0.53, 95% CI=[0.28-0.99]), while patients in the embedded-BHC arm had marginally higher odds (OR=1.83, 95% CI=[0.99-3.38]). Black patients and those with other/unknown race/ethnicity had lower odds of treatment initiation compared with white adolescents; there were no gender or age differences. We found no differences in treatment engagement across the three arms.ConclusionsEmbedded BHCs can have a significant positive impact on facilitating treatment initiation for pediatric primary care adolescents referred to addiction and/or psychiatry services.Clinical trials registrationClinicalTrials.gov #NCT02408952.

To elucidate the genetic architecture of amyotrophic lateral sclerosis (ALS) and find associated loci, we assembled a custom imputation reference panel from whole-genome-sequenced patients with ALS and matched controls (n = 1,861). Through imputation and mixed-model association analysis in 12,577 cases and 23,475 controls, combined with 2,579 cases and 2,767 controls in an independent replication cohort, we fine-mapped a new risk locus on chromosome 21 and identified C21orf2 as a gene associated with ALS risk. In addition, we identified MOBP and SCFD1 as new associated risk loci. We established evidence of ALS being a complex genetic trait with a polygenic architecture. Furthermore, we estimated the SNP-based heritability at 8.5%, with a distinct and important role for low-frequency variants (frequency 1-10%). This study motivates the interrogation of larger samples with full genome coverage to identify rare causal variants that underpin ALS risk.

Farca, Gerald. Playing Dystopia: Nightmarish Worlds in Video Games and the Player's Aesthetic Response. Bielefeld, Germany: Transcript Verlag Publishers, 2018. 433 pp. Cloth. ISBN 978-3-8376-4597-2. $60.00. In Playing Dystopia, Gerald [...]

ImportanceEarly intervention for substance use is critical to improving adolescent outcomes. Studies have found promising results for Screening, Brief Intervention, and Referral to Treatment (SBIRT), but little research has examined implementation.ObjectiveTo compare SBIRT implementation in pediatric primary care among trained pediatricians, pediatricians working in coordination with embedded behavioral health care practitioners (BHCPs), and usual care (UC).Design, setting, and participantsThe study is a 2-year (November 1, 2011, through October 31, 2013), nonblinded, cluster randomized, hybrid implementation and effectiveness trial examining SBIRT implementation outcomes across 2 modalities of implementation and UC. Fifty-two pediatricians from a large general pediatrics clinic in an integrated health care system were randomized to 1 of 3 SBIRT implementation arms; patients aged 12 to 18 years were eligible.InterventionsTwo modes of SBIRT implementation, (1) pediatrician only (pediatricians trained to provide SBIRT) and (2) embedded BHCP (BHCP trained to provide SBIRT), and (3) UC.Main outcomes and measuresImplementation of SBIRT (primary outcome), which included assessments, brief interventions, and referrals to specialty substance use and mental health treatment.ResultsThe final sample included 1871 eligible patients among 47 pediatricians; health care professional characteristics did not differ across study arms. Patients in the pediatrician-only (adjusted odds ratio [AOR], 10.37; 95% CI, 5.45-19.74; P < .001) and the embedded BHCP (AOR, 18.09; 95% CI, 9.69-33.77; P < .001) arms had higher odds of receiving brief interventions compared with patients in the UC arm. Patients in the embedded BHCP arm were more likely to receive brief interventions compared with those in the pediatrician-only arm (AOR, 1.74; 95% CI, 1.31-2.31; P < .001). The embedded BHCP arm had lower odds of receiving a referral compared with the pediatrician-only (AOR, 0.58; 95% CI, 0.43-0.78; P < .001) and UC (AOR, 0.65; 95% CI, 0.48-0.89; P = .006) arms; odds of referrals did not differ between the pediatrician-only and UC arms.Conclusions and relevanceThe intervention arms had better screening, assessment, and brief intervention rates than the UC arm. Patients in the pediatrician-only and UC arms had higher odds of being referred to specialty treatment than those in the embedded BHCP arm, suggesting lingering barriers to having pediatricians fully address substance use in primary care. Findings also highlight age and ethnic groups less likely to receive these important services.Trial registrationClinicaltrials.gov Identifier: NCT02408952.

This study used a life-course perspective to identify and understand life events related to long-term alcohol and other drug (AOD) use trajectories across the life span. Using a purposive sample, we conducted semi-structured telephone interviews with 48 participants (n = 30 abstinent and 18 non-abstinent) from a longitudinal study of AOD outcomes 15 years following outpatient AOD treatment. A content analysis was conducted using ATLAS.ti software to identify events and salient themes. Caregiving for an ill or dependent family member was related to better AOD outcomes by reinforcing abstinence and reduced drinking, and contributing to alcohol cessation in most individuals who cited caregiving as a pivotal event. Grandparenting and parenting an adult child were motivational for sustaining abstinence and reduced drinking. Findings were mixed on death of a loved one, which was related to abstinence in some and relapse in others. Redemption and mutual fulfillment as caregivers, reconciliations with adult children, and legacy-building as grandparents were themes associated with maintaining abstinence and reduced drinking. AOD treatment has the opportunity to employ motivational interventions for relapse prevention that address the meaning and lifelong reach of intimate relationships for individuals and their AOD use across the life span.

Meerkats (Suricata suricatta) housed at two accredited zoological institutions in the United States were evaluated via echocardiography, thoracic radiography, and blood biomarkers—taurine and feline N-terminal pro-B-type natriuretic peptide—to determine the prevalence and severity of dilated cardiomyopathy (DCM) in both populations. In total, 24 meerkats were evaluated and 7 were diagnosed with DCM based on the following parameters: left ventricular internal diameter at end diastole > 1.30 cm, left ventricular internal diameter at end systole > 1.10 cm, and a fractional shortening of <18%. Echocardiographic parameters were identified and reported for normal and affected meerkats, whereas thoracic radiographs were not useful for screening for DCM. Meerkats with DCM were treated with pimobendan and/or benazepril and furosemide if indicated. Seven meerkats died during the study period, with the majority exhibiting myocardial fibrosis. Of the blood parameters tested, elevated taurine levels were associated with DCM. Further research is necessary to characterize the etiology of DCM in meerkats. [ABSTRACT FROM AUTHOR]

Exploring the roles of gender performance through the experience of digital gaming provides an arena for discussing the power of fear and anxiety as cultural tools for counterhegemonic forces. The power and function of gender performativity in its varied and multiplicitous forms is a newer branch of game studies research. In this article, fear and anxiety are explored as a game procedure and cultural tool used by the character Alice Angel in Kindly Beast's Bendy and the Ink Machine. By enacting Barbara Creed's uncanny gaze and the monstrous-feminine, Alice Angel calls attention and visibility to the function of the abject as a form of visibility for the oppressed. The monstrous-feminine as a theoretical concept for horror media texts provides a framework to explore the posing, behaviors, and actions of game characters and their relationships to the player and culture at large. [ABSTRACT FROM AUTHOR]

The TREAT trial compared the effects of ciclosporin (CyA) and methotrexate (MTX) on severe atopic dermatitis in children, finding that CyA initially showed greater improvement but MTX was more effective in the long term. Both drugs can affect kidney function, but monitoring with standard tests may not be sensitive enough. The study recommended less frequent monitoring to reduce costs and make treatment more acceptable to children. The trial was funded by the UK Medical Research Council/NIHR EME Programme and approved by the Cambridge Research Ethics Committee. [Extracted from the article]

COVID-19 rapidly spread worldwide starting in December 2019, reaching its peak during the first quarter of 2021. As of October 28, 2021, COVID-19 deaths have surpassed 5,000,000 globally, with the highest death tolls in the United States, Brazil, and India. Governments scrambled to combat the pandemic using various techniques, including social welfare and pandemic tracking applications. This scramble accelerated the progress of the digital revolution through the proliferation of numerous social welfare applications worldwide. These applications are used for tracking vaccination status, contact tracing, social distancing, symptoms, and positive cases, as well as for enforcing quarantine and lockdown policies and detecting violations. Artificial intelligence and other technology advances raise concerns about security, privacy, and equity since many of these applications work with personal information from one's health records, employment information, and location data. This paper examines such applications in the Kingdom of Saudi Arabia, the Kingdom of Bahrain, and the United States. Develop best practices that can be followed to enhance the security of and equitable access to social applications. [ABSTRACT FROM AUTHOR]