Changes In Key Areas Research Articles

Progress of nations in the organisation of, and structures for, kidney care delivery between 2019 and 2023: cross sectional survey in 148 countries

ObjectiveTo assess changes in key measures of kidney care using data reported in 2019 and 2023.DesignCross sectional survey in 148 countries.SettingSurveys from International Society of Nephrology Global Kidney Health Atlas...

The experience of mood change over time for people diagnosed with bipolar disorder: a longitudinal interpretative phenomenological analysis

ABSTRACT Living with episodes of mania and depression is recognised to instil profound instability in people diagnosed with bipolar disorder, but little is known about how these mood changes arise through a person’s trajectory over time. This longitudinal study aimed to investigate the experience of mood change within and between bipolar disorder episodes. Semi-structured interviews were conducted with three women at two time points and were analysed using longitudinal interpretative phenomenological analysis to form idiographic trajectories. Three longitudinal themes illustrated the changing experiences of participants during periods of depression, euthymia (stability) and mania: (i) Extreme changes in activity and agency, (ii) Changes in feelings and connectivity, (iii) Shifting sense of the future disrupts momentum. The findings highlighted trajectories of change in key areas of the participants’ lives including activity levels, routine and agency, intensity of feelings and connectivity, and their sense of the future and progression. Changes experienced during episodes were cumulative, impacting participants’ ability to reconnect, take control and move forward during euthymia. The clinical value of mapping a client’s sense of change across BD phases is indicated, along with the need to build agency, progression and connectivity during euthymic periods. Suggestions for research and practice are discussed.

Dementia Knowledge in Chinese Newspapers (2005-2020): A Topic Modeling Analysis

ABSTRACT How public policies convey dementia is an important source of the public’s understanding of dementia, and newspapers are critical to depicting and disseminating this information to the public. The present study used topic modeling strategies to analyze Chinese newspaper portrayals of dementia from 2005 to 2020 to trace changes in key areas of dementia knowledge in relevant policies. Using WiseNews, the largest Chinese media database, we chose 45 newspapers from mainland China and identified 12,719 articles related to dementia. Using latent Dirichlet allocation (LDA), we performed a topic modeling analysis and identified the six most prevalent topics on dementia across articles: lifestyle recommendations, neighborhood life, foundational scientific research, celebrity and media portrayals, dementia caregiving, and pharmaceutical innovations – all related to the dementia knowledge scale’s four dimensions. Findings suggest a steady increase in the number of articles on dementia caregiving and a decline in lifestyle recommendations from 2005 to 2020. However, newspapers continued to stigmatize aging by regularly co-depicting dementia and old age and by using biased terminology. Among the first to investigate dementia’s portrayals in mainland Chinese newspapers, this study illuminates the need for expanding mass media campaigns to raise the country’s dementia knowledge to foster a dementia-inclusive society.

УПРАВЛЕНИЕ СТРАТЕГИЧЕСКИМ РАЗВИТИЕМ НА ОСНОВЕ КОНЦЕПЦИИ ВЕРЫ В НЕОБХОДИМОСТЬ ИЗМЕНЕНИЙ И ПРЕАКТИВНОГО ВИДЕНИЯ БУДУЩЕГО

T he article is devoted to the basics of the concept of strategic development management based on the belief in the necessity and effectiveness of changes, as well as a preactive vision of the future. The object of the research is the economic system of the state. The subject of the research is organizational-economic and managerial relations in the process of strategic development during the crisis. The purpose of the research is to develop approaches to the implementation of the concept of managed development based on the belief in the necessity and effectiveness of change, as well as a preactive vision of the future. Research objectives are the following; to analyze the directions of strategic changes in the economy and features of the current crisis; to reveal trends and features of the industrial, environmental and energy revolution as key areas of strategic change; to identify the main innovative problems and political risks of targeted development management. The directions of strategic changes in key areas of life are considered. It is shown that these changes are increasingly leading to crises that take on a systemic character. The nature and consequences of today's crisis are determined. The basics of the methodology of proactive management and preactive planning are considered. As examples of managed development based on the belief in the necessity and effectiveness of changes, the trends and features of the industrial, environmental and energy revolution are shown. On the example of the energy sector, the main innovative problems and political risks of targeted development management based on the belief in the need and effectiveness of changes, as well as a preactive vision of the future, are identified. The necessity of using the creative potential, innovative competencies, entrepreneurial and innovative activity of people in the management of strategic transformations is shown. The need for Russia to build a new economic system, to some extent less dependent on external influence, aimed at ensuring economic security, is revealed. It is shown that there is a need for consolidation of interests, a willingness to compromise for the sake of implementing managed development based on the belief in the need and effectiveness of changes, as well as a preactive vision of the future

China–Pakistan Conventional Arms Trade: An Appraisal of Supplier's and Recipient's Motives

This paper posits that the conventional arms trade between China and Pakistan is the most durable aspect of their relationship since the mid‐1960s. It carries out a succinct review of the relations to identify changes in key areas compared to continuity in the arms trade. The paper then looks into China's key motives as a supplier and Pakistan's as a recipient while focusing on political, economic, and technological factors; conversely, it excluded geopolitical reasons. This paper found that a mutuality of interests supports this arms trade. In return for its arms exports to Pakistan, China gained access to Western defense technology, earned revenue, and gained entry into the Islamic world. In addition, Pakistan proved itself as a marketer and testing ground of Chinese weapons. Islamabad initially approached Beijing to make up for the disruption caused by abrupt US sanctions but soon found China the trustiest supplier that also transferred technology, granted licenses for local production, trained engineers, and assisted in building defense industries to gain autarky. Both countries have become irreplaceable allies. The trajectory, marked by joint productions, joint military exercises, and advancement in China's weapon systems, coupled with congruence on regional security issues, indicates further strengthening of this arms trade.

SU17 - ALTERED BRAIN CONNECTIVITY IN PATIENTS WITH 16P11.2

Background Copy Number Variants (CNVs) at the 16p11.2 BP4-BP5 locus are among the most common genetic risk factors associated with neurodevelopmental disorders [1]. Deletion (DEL) have been associated with Autism Spectrum Disorder (ASD) and Duplication (DUP) with Schizophrenia and ASD. Voxel-based morphometry studies have revealed a robust association between the number of 16p11.2 genomic copies and global brain volume, as well as regional structural changes in key areas of the reward system, language circuitry and social cognition [2]. Our goal is to examine the effect of 16p11.2 CNVs on functional brain organization and its relationship with alterations in brain structure. Methods This study was conducted in a cohort of 20 16p11.2 DEL carriers, 19 DUP carriers and 74 controls (CON) [3]. Mean age was 23.8 yrs±14.9. Resting-state fMRI and structural scans were acquired at two sites on Siemens 3 T TIM Trio scanners using the same sequences (EPI: TR=3000; TE=30; scan time=06:12, flip angle=90). fMRI data were corrected for slice timing and subject motion and registered to MNI space [4] using the NIAK pipeline [5]. Timepoints with excessive head-motion (> 0.5mm) were removed [6]. Subjects with low time points ( Pairwise functional connectivity was estimated as the correlation between the average time series of 64 brain regions [7]. We then fitted a linear model to each connection with the CNV status, subject motion, sex and recording site as explanatory factors. Differences between CNV status groups were then tested by post-hoc contrasts. Each contrast was controlled for false discovery rate (FDR) across all connections at q Results Connectivity of regions in the basal ganglia, medial temporal gyrus and precuneus showed significant differences for the DEL vs CON, and DEL vs DUP contrasts. Specifically, connections among basal ganglia regions (caudate, thalamus, putamen) and between basal ganglia regions and superior and inferior temporal gyri showed significant overconnectivity in DEL group compared to both CON and DUP. Finally, connections between the caudate, superior frontal gyrus and inferior parietal lobule were found to be stronger in DEL than DUP. No significant differences of functional connectivity were found for the DUP vs CON contrast. We examined in a larger normative dataset whether changes in global brain volumes may mediate these changes but found no relationship between brain volume and connections altered in deletion carriers. Discussion Our results are concordant with previous findings of structural brain alterations in 16p11.2 DEL carriers. Striato-striatal and striato-cortical over-connectivity in the DEL carriers is consistent with previous reports of aberrant functional connectivity in ASD [10]. As previously observed the effect size of the duplication on brain structure and cognitive traits is smaller than the effects of the deletion. A larger sample size is likely required to observe the changes in connectivity associated with the duplication. 1. 10.1038/nature13908 2. 10.1038/mp.2014.145 3. 10.1016/j.neuron.2012.02.014 4. 10.1016/j.neuroimage.2010.07.033 5. niak.simexp-lab.org 6. 10.1016/j.neuroimage.2011.10.018 7. 10.6084/m9.figshare.1285615 8. www.jstor.org/stable/2346101 9. 10.1016/j.neuroimage.2015.07.071 10. 10.1016/j.biopsych.2010.10.029

Green Line Calgary: Integrating Pedestrian LRT Crossings into Our Communities ( breakout presentation )

Calgary’s Green Line Light Rail Transit (LRT) program is more than a transit project; it will improve the way Calgarians live, work, and move around the city by creating sustainable, liveable, and vibrant communities. The Green Line will integrate Low Floor LRT (LFLRT) into Calgary communities to provide enhanced transit service and support dramatic mode split changes in key areas of the city. This unique project focuses on fostering pedestrian and cycling connectivity, improving existing urban realm, and potential for future Transit Oriented Developments (TOD) integration. As the Green Line progresses through existing communities and future TOD areas, a strong focus on pedestrian connectivity to/from stations and across the LRT is essential. In creating connections, emphasis was placed on creating safe, convenient, and effective crossings for all transit users, and minimizing physical impacts/disruption to adjacent communities. This paper provides an overview of collaborative design processes used in enhancing the walking and cycling environment at key intersections along the Green Line, deviating from the City’s traditional approach. This includes both a description of the consensus building process, the extensive research completed and the preferred design treatments that were developed. Challenges encountered in creating pedestrian connections included working within limited road right-of-way, avoiding the LRT’s dynamic envelope, and maintaining cross-street access for large vehicles utilizing the corridor. Following extensive research, collaboration, and constructive workshop discussions with city staff from multiple disciplines, architects, and engineering consultants, pedestrian crossing treatments for each intersection type were narrowed. Each intersection type received stakeholder consensus on best possible LRT crossing treatments. This paper presents crossing treatments developed including M-crossings, Z-Crossings, smart right medians, raised crosswalks, and truck aprons. As transportation authorities worldwide invest in LFLRT systems, understanding challenges in facilitating safe, comfortable, and equitable pedestrian crossings is critical. This paper entails lessons learned, best practices, and suggested design treatments to achieve enhanced pedestrian accommodation with new LRT construction.

One Step Forward, One Step Back: Changes in News Coverage of Medical Interventions

ABSTRACTDuring 2005–2013, the award-winning website HealthNewsReview.org offered reviews of major media outlets’ news stories related to health interventions, including tests, treatments, dietary changes, and prescription drugs. The reviews offered a measure by which the public and journalists themselves could assess the completeness and usefulness of health coverage across 10 criteria for quality reporting. This study produced an analysis of those reviews from 2005 to 2013, indicating significant changes in key areas. Analysis of 1,889 health news story reviews published by HealthNewsReview.org (HNR) between 2005 and 2013 showed that, on average, the stories reviewed during 2005–2010 successfully met just less than half of the criteria, but by 2010–2013, that average had improved to almost 70%. There were significant improvements over time in news organizations’ success in meeting six of HNR’s 10 criteria for a successful health news story related to drugs, devices, surgery and other medical procedures, and diet; however, when data for television stories were excluded, only the improvement in avoiding disease-mongering remained significant. In addition, there was a statistically significant decline in the percentage of stories rated satisfactory on establishing the true novelty of the intervention discussed in the story. There was no improvement in quantification of possible harms from medical interventions. Changes over time in meeting the criteria were related to outlet type and story topic.

Effects of Online Instructional Design Training on TA’s Perceptions of Efficacy, Competence, and Knowledge Satisfaction

<p class="2M-body">Teaching assistants (TAs) in higher education are expected to teach courses in their major subject area with little to no formal instruction in the principles of effective teaching methods. The demands on TAs time are high and there is a need for easy to access, flexible, high quality instruction to provide them with the tools necessary to be effective instructors at the college level. One method of meeting this need is to provide TAs with a “toolbox” of instructional theory and methods based on instructional design principles. In order to be effective, it is important for TAs to understand the interconnected nature of effective educational principles including: instructional design, motivation, learning environments, instructional technologies and assessment. The current study looks at the effects of a self-paced online instruction designed for TAs on their teaching efficacy, perceived teaching competence and satisfaction with knowledge of the delivered instructional concepts using a pre-post, self-report design. Thirteen TAs at a southwestern research university completed both pre and post measures of knowledge and perceptions. Findings indicate that self-paced online training in instructional design concepts significantly increased TAs’ satisfaction with their knowledge of instructional theory and principles, design of learning environments and instructional technology. It further increased the significance and magnitude of their understanding of the interconnected nature of instructional principles and elements of the learning dynamic and led to appreciable knowledge change in key areas. These findings provide evidence of the benefits and utility of flexible, easily accessible training in instructional principles for TAs.</p>

Negotiating the future under the shadow of the past: the eleventh session of the United Nations Forum on Forests and the 2015 renewal of the international arrangement on forests

SUMMARY Prior to the eleventh session of the United Nations Forum on Forests (UNFF) in 2015 a series of interlinked initiatives took place intended to generate new options for strengthening the international arrangement on forests. The paper analyses these initiatives and identifies the main proposals to emerge from them. It is shown that almost all these proposals were lost or weakened during the negotiation process. One reason for this, it is argued, is the consensual decision making procedures of the UNFF whereby it takes all states to say yes, and only one to say no. This empowers veto states, namely powerful and intransigent states that wish to resist change in key areas. It is also argued that international forest negotiations do not start from a blank page, with ‘textual shadows’, namely precedents from inside and outside the UNFF, delimiting the possibilities available for delegates and, for some issues, leading to the perpetuation of the status quo. The result is that during the formal intergover...

Functional connectivity changes related to cognitive and motor performance in spinocerebellar ataxia type 2.

Several neuropathological studies in spinocerebellar ataxia type 2 (SCA2) have revealed significant atrophy of the cerebellum, brainstem, sensorimotor cortex, and several regions in the frontal lobe. However, the impact of the neurodegeneration on the functional integration of the remaining tissue is unknown. To analyze the clinical impact of these functional changes, we correlated the abnormal functional connectivity found in SCA2 patients with their scores in clinical scales. To obtain the functional connectivity changes, we followed two approaches. In one we used areas with significant cerebellar gray matter atrophy as anchor seeds, and in the other we performed a whole-brain data-driven analysis. Fourteen genetically confirmed SCA2 patients and aged-matched healthy controls participated in the study. Voxel-based morphometry and resting-state functional magnetic resonance imaging (fMRI) were done to analyze structural and functional brain changes. Independent component analysis and dual regression were used for intrinsic network comparison. Significant functional connectivity differences were correlated with the behavioral scores. Seed-based analysis found reduced functional connectivity within the cerebellum and between the cerebellum and frontal/parietal cortices. Cerebellar functional connectivity increases were found with parietal, frontal, and temporal areas. Intrinsic network analysis found a functional decrease in the cerebellar network, and increase in the default-mode and fronto-parietal networks. Further analysis showed significant correlations between clinical scores and the abnormal functional connectivity strength. Our findings show significant correlations between functional connectivity changes in key areas affected in SCA2 and these patients' motor and neuropsychological impairments, adding an important insight to our understanding of the pathophysiology of SCA2.

The Effects of Low-Cost, Adapted Ride-on-Toys: A Case Series With Toddlers With Neuromuscular Disorders

Abstract Date Presented 4/17/2015 This study investigated early power mobility using adapted ride-on-toys in toddlers with disabilities. Improvements were seen in cognitive, social, and self-care domains on standardized measures. Early power mobility using adapted ride-on-toys may yield positive changes in key areas of development.

Paediatric nephrology: the last 50 years.

In 1965, the specialty of paediatric nephrology was in its infancy. Following the development of a landmark collaborative research study, the International Study of Kidney Disease in Childhood in the mid-1960s, the first specialist societies were formed: the European Society of Pediatric Nephrology in 1967 and the American Society of Pediatric Nephrology in 1969. The extraordinary improvements in care delivered to children with kidney disease over the past 50 years are too broad to cover in any one paper. They traverse the spectrum of diagnosis, classification, therapeutics, social well-being and transition to adult care. We have selected four case scenarios to highlight these changes in key areas of paediatric nephrology: post-streptococcal glomerulonephritis, nephrotic syndrome, haemolytic uraemic syndrome and neonatal dialysis and childhood transplantation.

The Gwent County History. Volume 3: The Making of Monmouthshire, 1536–1780, ed. Madeleine Gray and Prys Morgan

This handsome volume constitutes the third in a series of five studies covering the history of Gwent/Monmouthshire from prehistory to the modern day. Sandwiched between the Age of the Marcher Lordships and Industrial Monmouthshire, it tackles a host of social, political and cultural themes to trace the area’s varied responses to its new status as an English county after the Union of 1536. With no less than sixteen contributors, ranging from senior academics to independent historians, the book makes a substantive contribution to the history of the region, and highlights important avenues for future research. Although the book is not formally divided into two parts, the first eight chapters take the reader through the religious and political history of the county, leaving the other eleven chapters to cover social, economic and cultural themes. This structure is generally well-advised, although those unfamiliar with the county might have wished for a stronger overall introduction to acclimatise themselves to the county’s geography and historical development before the Act of Union. The early chapters on Tudor Monmouthshire do indeed highlight the artificiality of the new county unit, and the essential continuities of its early history are recognised by most of the contributors. Even at élite level, the dominant aristocratic families would retain a strong Welsh character into the Stuart period, although after the civil wars they would migrate to a more national orbit. For those lower down the social ladder, the pace of change was even less dramatic, for the county remained largely rural in character until the onset of industrial development in the later eighteenth century. Even in 1801, its largest borough, the county town of Monmouth, could boast a population of only 3,345, out of a county total of some 45,000. The contributors demonstrate that this sluggish growth did not preclude significant change in key areas of county life, although neighbouring Glamorgan and Gloucestershire appear more dynamic across the period.

Towards Social Inclusion Through Lifelong Learning in Mental Health: Analysis of Change in the Lives of the Emilia Project Service Users

The application of formal lifelong learning to enhance social inclusion in mental health is rarely investigated in terms of change in the lives of service users on a cross-country comparative scale. This study was aimed at examining changes in key areas of the lives of mental health service users across eight European mental health sites. A before and after case study design was applied. Users of mental health services who participated in the lifelong leaning interventions reviewed the changes in key areas of their lives at baseline and 10 months later, through the thematic analysis of qualitative data collected in semi-structured interviews (27 and 21, respectively) and self-reports (138 and 99, respectively). In-depth examples from one site are provided. Most users reported positive changes in the areas of training and social networks, with a sizeable minority moving onto unpaid and paid employment. In addition most users reported active planning for job search and other goals. Obstacles that were highlighted included the negative effects of having a mental illness, difficulties in close relationships and economic disadvantages. The lifelong learning intervention offered within an EU Framework 6 project to mental health service users in eight demonstration sites had a largely positive impact on key areas of their lives at 10 months, though obstacles remained which may be less amenable to change by social interventions.

An evaluation of the Enhanced Thinking Skills (ETS) programme with mentally disordered offenders in a high security hospital

Purpose. Further to evidence of the successful application of cognitive skills programmes with offenders in HM prison service, the Enhanced Thinking Skills (ETS) training course is now delivered in various secure forensic hospitals, and its usefulness with an offender patient population merits examination. Our aim was to evaluate the impact of ETS using measures designed to capture change in key areas targeted by the course, and a more global measure of mental well‐being.Methods. Offender patients (N = 83) referred for ETS between 2001 and 2006 via a wider groupwork service within a high security hospital were administered questionnaires before and after the training course, which was minimally adjusted to meet the needs of the patient population. Attendance rates, including ‘drop‐out’ (completion of 10 or less sessions) were recorded. Demographics by subgroup (completers vs. non‐completers), and the clinical significance of any changes endorsed by participants post‐group were examined.Results. ETS completers were significantly more likely than non‐completers to endorse changes in thinking style (e.g. a reduction in post‐course scores). Significant differences were observed at both the group and individual level in the direction of less externalization of blame, a slight increase in tolerance of frustration, an increase in social conformity, and improvement in critical reasoning skills. Furthermore there was a reduction in the endorsement of aggressive solutions to social problems.Conclusions. These findings demonstrate a significant short‐term impact of the course for mentally disordered offenders with regards change in aspects of their thinking style and enhancement of their social problem solving skills. This profile lends some support to the provision of ETS within secure hospital settings.

Fatherhood in the Child Welfare System: Evaluation of a Pilot Project to Improve Father Involvement

Fathers provide emotional and physical, as well as financial support to their children. However, little is known about public child welfare policies and practices related to involving fathers and fathers' families in case planning and services to children involved in child welfare services. This article reports on the results of a pilot project designed to improve child welfare principles, policies, and practices related to the involvement of fathers in the lives of children served in one Northwest public child welfare agency. The pilot project provided training on father involvement in child welfare decision processes and evaluated changes in practice over time. The evaluation included an assessment of agency policy and practice, an assessment of social workers' perceptions regarding fathers' involvements in the lives of their children, and examination of actual social work practices related to father involvement over time. Changes in key areas of policy, beliefs regarding father involvement in child welfare case practice, and changes in actual involvement of fathers and fathers' families in practice were suggested.

Using T‐PODs to assess variations in the occurrence of coastal bottlenose dolphins and harbour porpoises

Abstract Assessments of anthropogenic impacts on cetaceans are often constrained by limited data on the extent to which these species use particular areas. Timing porpoise detectors (T‐PODs) are autonomous data recorders for detecting cetacean echolocation clicks, potentially providing cost‐effective opportunities for monitoring cetacean occurrence. The performance of T‐PODs was assessed in three areas off the Scottish east coast, where the relative occurrence of bottlenose dolphins and harbour porpoises was known to differ. Land‐based observations in one area compared visual and acoustic detections of dolphins, while direct hydrophone recordings of dolphin echolocation clicks were compared with T‐POD detections during boat surveys. Land‐based surveys recorded 89 groups of dolphins within 900 m of the T‐POD. All groups spending >30 min in the area were detected on the T‐POD, and the probability of detection declined in relation to distance from the recording site. The number of dolphin clicks recorded on the independent hydrophone system was significantly related to the number detected by a T‐POD. Between pairs of T‐PODs, there was also significant correlation with the numbers of clicks recorded in each hour, both for channels set to detect bottlenose dolphins and for channels set to detect harbour porpoises. Year‐round deployments of paired T‐PODs detected significant geographical variation in detections for both bottlenose dolphins and harbour porpoises. This pattern reflected published data from visual surveys, where dolphins occurred most regularly within the Moray Firth Special Area of Conservation, and porpoises were sighted more regularly in offshore waters. T‐PODs do not detect all cetaceans in the area, and care must be taken when interpreting data from mixed species communities. Nevertheless, these results confirm that T‐PODs provide an effective method for monitoring the occurrence of bottlenose dolphins and harbour porpoises, and provide excellent potential for collecting baseline data from poorly studied areas and monitoring long‐term temporal change in key areas of interest. Copyright © 2009 John Wiley & Sons, Ltd.

Treatment and treatment outcomes in children’s homes

A follow‐up study of 141 young people in 48 children’s homes examined changes in their moods, relationships with their family and adjustment. The average scores of the group on these variables changed little between first interview and follow‐up 6–9 months later. However, some individuals improved and others deteriorated. Improvements in family relationships were more likely in homes where the head of home could describe strategies for fostering family ties. Improvements in adjustment were also more likely in homes where the head of home could articulate ways of enabling change in key areas of the residents’ lives. Residents who spoke of attempts to bully them were more distressed at the time of the first interview and less adjusted at follow‐up. The study underlines the damaging effects of bullying and the key role of the head of home.