Related Changes Research Articles

168. “We Followed Their Lead”: Exploring Relational Change and Support Among Caregivers of Transgender and Gender Diverse Youth

168. “We Followed Their Lead”: Exploring Relational Change and Support Among Caregivers of Transgender and Gender Diverse Youth

Phytoplankton community changes in relation to nutrient fluxes along a quasi-stationary front

The main strait (Great Belt) connecting the North Sea and the Baltic Sea constitutes a quasi-stationary front and exposes phytoplankton to various degrees of water column mixing. Here, we examine phytoplankton community distributions (using the cell abundance of 4 readily identifiable diatoms) and estimate new production along the strait during early spring. Vertical turbulent mixing was ~10 times greater at stations in the strait compared to stations outside the strait. New production in the strait was on average ~50 mg C m-2 d-1, i.e. 8% of the average total primary production, and could explain the increase in chlorophyll observed along the strait. A non-metric multidimensional scaling analysis of phytoplankton community composition showed significant spatial groupings. However, variation of species abundances could not be explained by the general transport, where the abundance of the largest species decreased during the passage of the strait. A relatively small species (Guinardia delicatula) showed an increasing dominance in and above the subsurface chlorophyll maximum along the strait, and the bottom layer was also correspondingly dominated by a relatively small species (Skeletonema marinoi). This phytoplankton composition could be explained by photosynthetic traits associated with more efficient light usage of small cells together with increased nutrient supply in the strait.

Responsiveness of Isokinetic Dynamometry in Patients with Osteoarthritis after Knee and Hip Arthroplasty: A Prospective Repeated-Measures Cohort Study

Functional assessments are crucial for the evaluation of rehabilitation after total knee (TKA) and hip (THA) arthroplasty. Muscle strength, a key determinant of physical function (PF), is often measured with isokinetic dynamometry (ID), which is considered the gold standard. However, studies lack evaluations of responsiveness—the ability to detect changes over time. This study aims to determine the responsiveness of ID in measuring PF in TKA and THA rehabilitation—is muscle strength a valid indicator for assessing improvement in rehabilitation processes? The pre- and post-surgery PF of 20 osteoarthritis patients (age 55–82) was assessed, using ID, performance-based and self-reported measures. Responsiveness was evaluated by comparing the observed relationship of changes in ID and PF scores with the a priori defined expected relationship of change scores. While the performance-based and self-reported measures showed significant improvements post-surgery (Cohen’s d [0.42, 1.05] p < 0.05), ID showed no significant differences. Moderate correlations were found between changes in some ID parameters and selected functional tests (r ≈|0.5|, p < 0.05). Responsiveness was solely found for the peak torque of knee extension at 180°/s on the operated side. Responsiveness is an often-overlooked psychometric property of outcome measurements. The findings suggest that ID may not be fully responsive to the construct of PF after TKA and THA, raising questions about its role and usefulness in this context and the need for more appropriate assessment methods.

Closing circles: Family-of-origin reconciliations following the transition to parenthood in lesbian and gay parents through assisted reproduction

Introduction Research on lesbian and gay parent families has mostly focused on parenting quality and child development, yet little attention has been given to the transformations in families of origin’s dynamics following the transition to parenthood. Aims and Methods In this qualitative study, we explored the experiences of 35 lesbian parents and 35 gay parents, regarding family-of-origin ruptures following coming out (CO) and the reconciliations that occur with the arrival of children. Results The study utilized a thematic analysis identifying three core themes: (a) parental rejection at CO, encompassing descriptions of heteronormativity shaping parental prejudices regarding homosexuality; (b) consequences of CO rejection, focused on internalized homophobia, silence in communication with parents, relocations to move away from the parents; and, finally (c) grandparenthood as an opportunity for relational changes, focused on the changes which occurred when lesbian and gay parents’ own parents became grandparents: reconciliations after detachment, reconsiderations of past experiences, and COs done following the arrival of grandchildren. Conclusion Overall, the findings revealed that the transition to parenthood facilitated the repair of long-standing relational ruptures and the strengthening of bonds with parents’ families of origin. This study contributes to a deeper understanding of the challenges faced by people with minoritized sexual identities who come out and years later transition to parenthood.

Levetiracetam modulates brain metabolic networks and transcriptomic signatures in the 5XFAD mouse model of Alzheimer's disease.

Subcritical epileptiform activity is associated with impaired cognitive function and is commonly seen in patients with Alzheimer's disease (AD). The anti-convulsant, levetiracetam (LEV), is currently being evaluated in clinical trials for its ability to reduce epileptiform activity and improve cognitive function in AD. The purpose of the current study was to apply pharmacokinetics (PK), network analysis of medical imaging, gene transcriptomics, and PK/PD modeling to a cohort of amyloidogenic mice to establish how LEV restores or drives alterations in the brain networks of mice in a dose-dependent basis using the rigorous preclinical pipeline of the MODEL-AD Preclinical Testing Core. Chronic LEV was administered to 5XFAD mice of both sexes for 3 months based on allometrically scaled clinical dose levels from PK models. Data collection and analysis consisted of a multi-modal approach utilizing 18F-FDG PET/MRI imaging and analysis, transcriptomic analyses, and PK/PD modeling. Pharmacokinetics of LEV showed a sex and dose dependence in Cmax, CL/F, and AUC0-∞, with simulations used to estimate dose regimens. Chronic dosing at 10, 30, and 56 mg/kg, showed 18F-FDG specific regional differences in brain uptake, and in whole brain covariance measures such as clustering coefficient, degree, network density, and connection strength (i.e., positive and negative). In addition, transcriptomic analysis via nanoString showed dose-dependent changes in gene expression in pathways consistent 18F-FDG uptake and network changes, and PK/PD modeling showed a concentration dependence for key genes, but not for network covariance modeling. This study represents the first report detailing the relationships of metabolic covariance and transcriptomic network changes resulting from LEV administration in 5XFAD mice. Overall, our results highlight non-linear kinetics based on dose and sex, where gene expression analysis demonstrated LEV dose- and concentration-dependent changes, along with cerebral metabolism, and/or cerebral homeostatic mechanisms relevant to human AD, which aligned closely with network covariance analysis of 18F-FDG images. Collectively, this study show cases the value of a multimodal connectomic, transcriptomic, and pharmacokinetic approach to further investigate dose dependent relationships in preclinical studies, with translational value toward informing clinical study design.

Aukštaičių vaizdeliai, or On the Search for the Autobiography of Juozas Tumas-Vaižgantas

Juozas Tumas-Vaižgantas has the reputation of an autobiographical author who overshadows his texts. At the same time, he is an author without autobiography, whose epistolary works form the basis of his egodocumentary research. Keeping in mind the characteristic of this reception, I examine Vaižgantas’s autobiographical texts: compile a corpus of his autobiographical texts, and conduct a research of Tumas’ autobiographical narrative, with a focus on the speaker’s relationship to the autobiographical discourse. I began the search for author’s autobiography with the first text that has the status of an autobiographical narrative, Aukštaičių vaizdeliai (Scenes of Aukštaičiai). The research has revealed certain features of Tumas’ treatment of autobiographical texts that have not been studied in detail. The article presents the history of the formation, attempted publication and disassembling of Aukštaičių vaizdeliai. It describes Tumas’ attitude towards his autobiographical texts and raises the question of the boundaries between literary and autobiographical texts, revealing the author’s changing and individual relationship to autobiographical narrative. The research also points to a secondary effect of the research—the highly problematic identity of Aukštaičių vaizdeliai.

Fiscal policy and dimensions of inequality in South Africa: A time‐varying coefficient approach

AbstractSouth Africa continues to face high inequality levels despite its progressive tax and extensive social protection systems. We compare the dynamic impact of fiscal policy on the distribution of incomes, wages and wealth in South Africa from 1993 to 2019. For this purpose, we use a time‐varying parameter vector autoregression to estimate the impact of direct tax revenue and total transfer spending on three distinct inequality datasets. The analysis of various dimensions of inequality is the main contribution of the paper as the literature typically focuses on income inequality. A second contribution lies in the incorporation of time‐varying effects, which enables the analysis of the changing relationship between fiscal policy and inequality. The results suggest that this relationship is indeed time‐varying and that the impact of direct taxes and transfers differs markedly across the inequality dimensions, both in terms of magnitude and sign. Overall, we find that both transfers and direct taxes have not significantly reduced income, wage or wealth inequality in South Africa.

MRI Treatment Response Assessment Maps (TRAMs) for differentiating recurrent glioblastoma from radiation necrosis.

MRI treatment response assessment maps (TRAMs) were introduced to distinguish recurrent malignant glioma from therapy related changes. TRAMs are calculated with two contrast-enhanced T1-weighted sequences and reflect the "late" wash-out (or contrast clearance) and wash-in of gadolinium. Vital tumor cells are assumed to produce a wash-out because of their high turnover rate and the associated hypervascularization, whereas contrast medium slowly accumulates in scar tissue. To examine the real value of this method, we compared TRAMs with the pathology findings obtained after a second biopsy or surgery when recurrence was suspected. We retrospectively evaluated TRAMs in adult patients with histologically demonstrated glioblastoma, contrast-enhancing tissue and a pre-operative MRI between January 1, 2017, and December 31, 2022. Only patients with a second biopsy or surgery were evaluated. Volumes of the residual tumor, contrast clearance and contrast accumulation before the second surgery were analyzed. Among 339 patients with mGBM who underwent MRI, we identified 29 repeated surgeries/biopsies in 27 patients 59 ± 12 (mean ± standard deviation) years of age. Twenty-eight biopsies were from patients with recurrent glioblastoma histology, and only one was from a patient with radiation necrosis. We volumetrically evaluated the 29 pre-surgery TRAMs. In recurrent glioblastoma, the ratio of wash-out volume to tumor volume was 36 ± 17% (range 1-73%), and the ratio of the wash-out volume to the sum of wash-out and wash-in volumes was 48 ± 21% (range 22-92%). For the one biopsy with radiation necrosis, the ratios were 42% and 54%, respectively. Typical recurrent glioblastoma shows a > 20%ratio of the wash-out volume to the sum of wash-out and wash-in volumes. The one biopsy with radiation necrosis indicated that such necrosis can also produce high wash-out in individual cases. Nevertheless, the additional information provided by TRAMs increases the reliability of diagnosis.

Disturbance-diversity relationships of microbial communities change based on growth substrate.

Disturbance events can impact ecological community dynamics. Understanding how communities respond to disturbances and how those responses can vary is a challenge in microbial ecology. In this study, we grew a previously enriched specialized microbial community on either cellulose or glucose as a sole carbon source and subjected them to one of five different disturbance regimes of varying frequencies ranging from low to high. Using 16S rRNA gene amplicon sequencing, we show that the community structure is largely driven by substrate, but disturbance frequency affects community composition and successional dynamics. When grown on cellulose, bacteria in the genera Cellvibrio, Lacunisphaera, and Asticcacaulis are the most abundant microbes. However, Lacunisphaera is only abundant in the lower disturbance frequency treatments, while Asticcacaulis is more abundant in the highest disturbance frequency treatment. When grown on glucose, the most abundant microbes are two Pseudomonas sequence variants and a Cohnella sequence variant that is only abundant in the highest disturbance frequency treatment. Communities grown on cellulose exhibited a greater range of diversity (1.95-7.33 Hill 1 diversity) that peaks at the intermediate disturbance frequency treatment or one disturbance every 3 days. Communities grown on glucose, however, ranged from 1.63 to 5.19 Hill 1 diversity with peak diversity at the greatest disturbance frequency treatment. These results demonstrate that the dynamics of a microbial community can vary depending on substrate and the disturbance frequency and may potentially explain the variety of diversity-disturbance relationships observed in microbial systems.IMPORTANCEA generalizable diversity-disturbance relationship (DDR) of microbial communities remains a contentious topic. Various microbial systems have different DDRs. Rather than finding support or refuting specific DDRs, we investigated the underlying factors that lead to different DDRs. In this study, we measured a cellulose-enriched microbial community's response to a range of disturbance frequencies from high to low, across two different substrates: cellulose and glucose. We demonstrate that the community displays a unimodal DDR when grown on cellulose and a monotonically increasing DDR when grown on glucose. Our findings suggest that the same community can display different DDRs. These results suggest that the range of DDRs we observe across different microbial systems may be due to the nutritional resources microbial communities can access and the interactions between bacteria and their environment.

Petőfi Sándor és a hiteles kép

ThŠe history of Sándor Petőfi’s visual representations can be examined with the concept of the true image of Hans Belting which makes a connection between faith and picture: the existence of Christ is confirmed by portraits for Christian worshipers and pictures have their devotional function for Christian communities. ŠThere are many portraits and genre paintings made during Petőfi’s life, but thanks to his cult there were many pictures painted of him even after his death. It is known to posterity that his portrait was recorded in a daguerreotype in the 1840s, but its status in his cult is still uncertain, because it was only found in 1868 in the legacy of her wife Júlia Szendrey, meaning that his depictions right after his death were based above all on the painting tradition and the personal practice of remembrance. In the 1870’s, after the presentation of the daguerreotype to the larger public, there was a debate in the press about the true image of Petőfi, which shows a rivalry between artistic and technical portraits. In my paper, I review the changing relationship between Petőfi’s pictorial representations and the concept of the true image in the 19th and early 20th centuries.

Steering the Intangible Wheel: Chief Executive Officer Effect on Corporate Cultural Change

We provide large-scale empirical evidence of how much chief executive officers (CEOs) change corporate culture. To do this, we use employee reviews to measure corporate cultural change in S&P 1500 firms. In a variance decomposition analysis, we find a modest effect of CEOs on corporate cultural change. The effect of CEOs on cultural change is larger than industry effect but smaller than firm effect. Regression analysis in the context of CEO succession further shows consistent evidence of a modest effect of CEO succession on corporate cultural change. In addition, the relationship between CEOs and cultural change is not likely to be fully explained by time trend, reverse causality, sample selection bias, and omitted variable bias. An investigation into the contextual contingencies of the CEO-cultural change relationship suggests that succession characteristics, such as predecessor influence and turnaround situation, weaken postsuccession cultural change, but industry task environment has a weak moderation effect. Overall, our study contributes to the literature on strategic leadership and corporate culture. Funding: X. Li acknowledges financial support from the Ian Potter (‘93D) PhD Award. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2022.17210 .

Accelerating Elevation Gain Indicates Land Loss Associated with Erosion in Mississippi River Deltaic Plain Tidal Wetlands

AbstractIn recent years, the Mississippi River Deltaic Plain (MRDP) has experienced the highest rates of wetland loss in the USA. Although the process of vertical drowning has been heavily studied in coastal wetlands, less is known about the relationship between elevation change and land loss in wetlands that are experiencing lateral erosion and the contribution of erosion to land loss in the MRDP. We quantified relationships of elevation change and land change in ten submerging tidal wetlands and found that, despite significant land loss, elevation trajectories in seven of the land loss study sites were positive. Furthermore, we observed an acceleration in elevation gain preceding the conversion from vegetated marsh to open water.To identify regional contributions of lateral erosion to land loss, we quantified the relationship of elevation change and land change in 159 tidal marsh sites in the MRDP. Approximately half the sites were persistently losing land, and 82% of these sites were vulnerable to erosion, identifying erosion as a dominant mechanism of coastal wetland loss in this region. Notably, the sites that were vulnerable to erosion were experiencing land loss while also gaining elevation, and sites with the highest land loss exhibited accelerating elevation gain. Together, these data illustrate that (1) erosion is a dominant mechanism of wetland loss in the MRDP, (2) accelerated elevation gain is an indicator of erosion, and (3) consideration of elevation change trajectories within the context of land change is critical for providing accurate coastal wetland vulnerability assessments.

Preventing Machines From Lying: Why Interdisciplinary Collaboration is Essential for Understanding Artefactual or Artefactually Dependent Expert Evidence

This article demonstrates a significantly different approach to managing probative risks arising from the complex and fast changing relationship between law and computer science. Law's historical problem in adapting to scientific and technologically dependent evidence production is seen less as a socio-techno issue than an ethical failure within criminal justice. This often arises because of an acceptance of epistemological incomprehension between lawyers and scientists. Something compounded by the political economy of criminal justice and safeguard evasion within state institutions. What is required is an exceptionally broad interdisciplinary collaboration to enable criminal justice decision-makers to understand and manage the risk of further ethical failure. If academic studies of law and technology are to address practitioner concerns, it is often necessary, however, to step down the doctrinal analysis to a specific jurisdictional level.

Depositional and circulation changes at the Chukchi margin, Arctic Ocean, during the last two glacial cycles

The shallow Chukchi-East Siberian margin of the Arctic Ocean was repeatedly impacted by Pleistocene glaciations and related changes in sea level and circulation. The depositional history across the last two Arctic glacial cycles is investigated in sediment core ARC6-C15 from the foot of the Chukchi Rise, an extension of the Chukchi Sea shelf that was impacted by the East Siberian Ice Sheet (ESIS). Our proxy data indicate a large extent of the ESIS, likely blocking the westward sediment transport from the Laurentide Ice Sheet (LIS) during the penultimate glaciation estimated to have occurred within an age span from Marine Isotope Stage (MIS) 4 to 6. The deglacial environments are characterized by enhanced sediment inputs from the East Siberian and Chukchi shelves, while overlying interstadial/interglacial sediments have a signature of the Chukchi Sea and the Beaufort Gyre. During the last glaciation, the ESIS had a smaller impact on the Chukchi margin, and the deglaciation was dominated by the LIS sediment sources. Glacial discharge from the Mackenzie area is identified in the Bølling/Allerød interval, while later deglacial pulses can be tracked to the Canadian Arctic Archipelago. In addition to glacigenic sediment inputs, both deglacial intervals contain FeMn micronodules, possibly formed under the influence of meltwater pulses during sea level rise. An increase in the chlorite content that likely marks the flooding of the Bering Strait is identified at the start of the Holocene. A pronounced oxygen and carbon isotope excursion in the early Holocene may indicate hydrographic changes in the Arctic Ocean related to the 8.2 ka meltwater discharge event.

Dopamine Signaling in Substantia Nigra and Its Impact on Locomotor Function-Not a New Concept, but Neglected Reality.

The mechanistic influences of dopamine (DA) signaling and impact on motor function are nearly always interpreted from changes in nigrostriatal neuron terminals in striatum. This is a standard practice in studies of human Parkinson's disease (PD) and aging and related animal models of PD and aging-related parkinsonism. However, despite dozens of studies indicating an ambiguous relationship between changes in striatal DA signaling and motor phenotype, this perseverating focus on striatum continues. Although DA release in substantia nigra (SN) was first reported almost 50 years ago, assessment of nigral DA signaling changes in relation to motor function is rarely considered. Whereas DA signaling has been well-characterized in striatum at all five steps of neurotransmission (biosynthesis and turnover, storage, release, reuptake, and post-synaptic binding) in the nigrostriatal pathway, the depth of such interrogations in the SN, outside of cell counts, is sparse. However, there is sufficient evidence that these steps in DA neurotransmission in the SN are operational and regulated autonomously from striatum and are present in human PD and aging and related animal models. To complete our understanding of how nigrostriatal DA signaling affects motor function, it is past time to include interrogation of nigral DA signaling. This brief review highlights evidence that changes in nigral DA signaling at each step in DA neurotransmission are autonomous from those in striatum and changes in the SN alone can influence locomotor function. Accordingly, for full characterization of how nigrostriatal DA signaling affects locomotor activity, interrogation of DA signaling in SN is essential.

Bank Deposits as Money Quanta

According to the Accounting View of Money (AVM), the money issued by commercial banks in the form of demand deposits features a hybrid nature, since deposits can be shown to consist of a share of deposits bearing the characteristics of debt (debt-deposits) and a share of deposits bearing the characteristics of equity (equity-deposits), in a mix that depends on factors that relate to the issuing banks and the environment where they operate and interact, which may change over time. Following this important finding of the AVM, it is only consequential to associate the hybrid nature of bank deposits with the dual nature of the objects which is typical in quantum physics, and to investigate whether and how the application of quantum analytical methods and ideas to a form of money showing dualistic features could be used to extract valuable economic information. This article studies demand deposits (which represents the prevailing form of money in all contemporary economies) as a possible form of “money quanta”, that is, quantities reflecting some aspects tipical of quantum physics, and analyzes it using a quantum model to describe some relevant aspects of it, including for instance how banks’ power to create money (i.e., issue deposits typically via the credit channel) is affected by the interactions taking place between the banks and between the banks and their environments, and how system efficiency and stability change in relation to changes in bank behaviors. This article lays the foundations of money quanta and is the first step towards a better understanding of the relevance of quantum mechanical tools and ideas in connection with the study of economics and finance.

Modified motor unit properties in residual muscle following transtibial amputation

Objective. Neural signals in residual muscles of amputated limbs are frequently decoded to control powered prostheses. Yet myoelectric controllers assume muscle activities of residual muscles are similar to that of intact muscles. This study sought to understand potential changes to motor unit (MU) properties after limb amputation. Approach. Six people with unilateral transtibial amputation were recruited. Surface electromyogram (EMG) of residual and intact tibialis anterior (TA) and gastrocnemius (GA) muscles were recorded while subjects traced profiles targeting up to 20% and 35% of maximum activation for each muscle (isometric for intact limbs). EMG was decomposed into groups of MU spike trains. MU recruitment thresholds, action potential amplitudes (MU size), and firing rates were correlated to model Henneman’s size principle, the onion-skin phenomenon, and rate-size associations. Organization (correlation) and modulation (rates of change) of relations were compared between intact and residual muscles. Main results. The residual TA exhibited significantly lower correlation and flatter slopes in the size principle and onion-skin, and each outcome covaried between the MU relations. The residual GA was unaffected for most subjects. Subjects trained prior with myoelectric prostheses had minimally affected slopes in the TA. Rate-size association correlations were preserved, but both residual muscles exhibited flatter decay rates. Significance. We showed peripheral neuromuscular damage also leads to spinal-level functional reorganizations. Our findings suggest models of MU recruitment and discharge patterns for residual muscle EMG generation need reparameterization to account for disturbances observed. In the future, tracking MU pool adaptations may also provide a biomarker of neuromuscular control to aid training with myoelectric prostheses.

Abstract C087: Window-of-opportunity trial of metastatic pancreatic cancer reveals mechanisms of response to targeting RAS signaling

Abstract KRAS is mutated in ~85% of pancreatic ductal adenocarcinoma (PDAC) patients' tumors, suggesting that it is a key node of PDAC targeted therapy. RAF/MEK/ERK signaling is downstream of KRAS signaling. Preclinical studies targeting MEK showed promises but clinical trials failed to show the benefit compared to Standard-of-Care treatment chemotherapy. To elucidate the mechanism of action and resistance to several targeted therapies including MEK inhibition in human PDAC, we conducted a Window-Of-Opportunity trial for Metastatic pancreatic cancer (WOOM trial). In this trial, metastatic PDAC patients received 10 days of Cobimetinib, a FDA approved MEK inhibitor, therapy and specimens of pre- and post- treatment were obtained by biopsy to evaluate the response to targeted treatment using deep multi-omic analytics including DNA-seq, RNA-seq, multiplex IHC, cyclic IF and Digital Spatial Profiling (DSP). The clinical grade KI67 staining positivity was used as a readout of tumor response. We found three of 15 patients’ tumors had significantly decreased KI67 staining after MEKi treatment. Genomic sequence showed that two of three KI67-decreased patient’s tumors had KrasG12R mutations, which is significantly higher penetration compared to none of twelve KI67-non-responsive patient’s tumors. RNA-seq analysis showed that these KI67-decreased tumors are more classical-like compared to Ki67-non-responsive tumors. DSP analysis confirmed the downregulation of ERK phosphorylation after treatment in all examined cases. Moreover, MYC protein expression change is significantly correlated with KI67 protein expression change, which suggests MYC downregulation is the mechanism of action of MEK-inhibitor. Interestingly, MEK phosphorylation was upregulated after treatment in all examined cases. This suggests paradoxical RAF activation as a potential resistance mechanism. Furthermore, we found that Cobimetinib treatment changed the tumor microenvironment. Here, we summarize the multi-omics data and discuss the mechanism of response and resistance to target RAS signaling and related microenvironmental changes. Citation Format: Motoyuki Tsuda, Colin J. Daniel, Carl Pelz, Sam Sivagnanam, Dove Keith, Christopher L. Corless, Koei Chin, Lisa M. Coussens, Jonathan R. Brody, Charles D. Lopez, Gordon B. Mills, Rosalie C. Sears. Window-of-opportunity trial of metastatic pancreatic cancer reveals mechanisms of response to targeting RAS signaling [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr C087.

2022 개정 교육과정 ‘학교자율시간’ 실행 경험 탐색

Objectives ‘School-designed autonomous time’, newly introduced in the 2022 revised curriculum, is a note-worthy change in relation to curriculum autonomy and decentralization as it grants schools the authority to develop subjects at a school-level. This study aimed at expanding the autonomy and authority of regions and schools, seeking concrete implementation strategies for school-designed autonomous time, which is newly introduced in the 2022 revised elementary and middle school curriculum.
 Methods This study was conducted using a qualitative case study method: in-depth interviews with teachers, participatory observations of open lessons and teacher meetings, and artifacts related to school autonomy (e.g., school curriculum documents, research paper, teacher meeting materials).
 Results This study explores the main points of school-designed autonomous time described in the 2021 draft and final version of the 2022 revised curriculum. School-autonomous time is valuable as it is an experimental attempt in a region accepted as a national policy, expansion of school-based curriculum development, and posibilities of teachers’ curriculum.
 Conclusions The specific plan and future tasks of school-designed autonomous time in the 2022 revised curricu-lum were explored.

Don’t be late! Postponing cognitive decline and preventing early unemployment in people with multiple sclerosis: a study protocol

BackgroundUp to 65% of people with multiple sclerosis (PwMS) develop cognitive deficits, which hampers their ability to work, participating in day-to-day life and ultimately reducing quality of life (QoL). Early cognitive symptoms are often less tangible to PwMS and their direct environment and are noticed only when symptoms and work functioning problems become more advanced, i.e., when (brain) damage is already advanced. Treatment of symptoms at a late stage can lead to cognitive impairment and unemployment, highlighting the need for preventative interventions in PwMS.AimsThis study aims to evaluate the (cost-) effectiveness of two innovative preventative interventions, aimed at postponing cognitive decline and work functioning problems, compared to enhanced usual care in improving health-related QoL (HRQoL).MethodsRandomised controlled trial including 270 PwMS with mild cognitive impairment, who have paid employment ≥ 12 h per week and are able to participate in physical exercise (Expanded Disability Status Scale < 6.0). Participants are randomised across three study arms: 1) ‘strengthening the brain’ – a lifestyle intervention combining personal fitness, mental coaching, dietary advice, and cognitive training; 2) ‘strengthening the mind’ – a work-focused intervention combining the capability approach and the participatory approach in one-on-one coaching by trained work coaches who have MS themselves; 3) Control group—receiving general information about cognitive impairment in MS and receiving care as usual. Intervention duration is four months, with short-term and long-term follow-up measurements at 10 and 16 months, respectively. The primary outcome measure of the Don’t be late! intervention study will be HRQoL as measured with the 36-item Short Form. Secondary outcomes include cognition, work related outcomes, physical functioning, structural and functional brain changes, psychological functioning, and societal costs. Semi-structured interviews and focus groups with stakeholders will be organised to qualitatively reflect on the process and outcome of the interventions.DiscussionThis study seeks to prevent (further) cognitive decline and job loss due to MS by introducing tailor-made interventions at an early stage of cognitive symptoms, thereby maintaining or improving HRQoL. Qualitative analyses will be performed to allow successful implementation into clinical practice.Trial registrationRetrospectively registered at ClinicalTrials.gov with reference number NCT06068582 on 10 October 2023.