Culture

Amsterdam, July 14, 2021 - The Journal of Vocational Rehabilitation (JVR) announces publication of an openly available special issue that provides free access to key presentations from the 2020 Virtual Conference of the Association of People Supporting Employment First (APSE). These contributions advocate for and help facilitate the full inclusion of people with disabilities in the workplace and community.

APSE Conferences are the only national conferences focused solely on the advancement of Employment First, Employment for All. They bring together more than 1,000 key influencers and stakeholders representing individuals with disabilities, communities, agencies, and services to network and discuss state-of-the-art strategies to ensure equitable employment for all citizens with disabilities receiving assistance from publicly funded systems.

"This special issue highlights just a few of the incredible topics covered during the 45 sessions comprising the 2020 event," explains Guest Editor Julie J. Christensen, MSW, PhD, Executive Director, APSE, Rockville, MD, USA. "It represents the resilience of a community that remains dedicated to making a contribution in research, practice, and policy. All three are integral and necessary to create lasting change, perhaps more now than ever as we continue to work for Employment First, Employment for All. I'm just incredibly excited to be focusing more attention on the resource that JVR provides to the APSE Community."

Highlights from the conference include coverage of:

Importance of developing multicultural competency to ensure equity in rehabilitation services

Moving beyond "what gets measured, gets done" to leveraging data to scale up and track outcomes and quality improvement

Empowering coalitions of self-advocates to hold state laws accountable for Statewide Employment First efforts

Importance of family input and taking the socioeconomic and cultural context of the family unit into consideration

Need to update information tools to remain current with the times (such as using social media in talent recruitment)

Rehabilitation professionals are required to be competent in serving multiculturally diverse individuals in a manner that promotes empowerment and full engagement. Tammy Jorgensen Smith, PhD, CRC, University of South Florida, College of Behavioral and Community Sciences, Department of Rehabilitation and Mental Health Counseling, Tampa, Florida, USA, writes that "Multicultural competency is critical for accurate clinical assessment and diagnosis and for effectively serving a diverse population of clients." In her paper, Dr. Smith discusses diagnostic tools and ethical decision-making models that integrate multicultural considerations and recommendations for building multicultural competency.

Families bring their own set of values and assumptions based on their socioeconomic and cultural background. In the article "Good fences make good neighbors," Bethany Chase, DSW, Rutgers University, The Boggs Center on Developmental Disabilities, New Brunswick, NJ, USA, provides context for why parents/guardians may be distrustful of the employment process, as well as why employment specialists may struggle to build strong partnerships with them. She discusses how to implement practices that not only welcome the critical input of families, but also maintain healthy and well-defined boundaries that affirm the autonomy, professionalism, and competence of the worker.

"By setting proactive, positive, welcoming, and compassionate guidelines and boundaries, employment specialists can reap the benefits of an engaged family while continuing to affirm the professionalism, autonomy, and competence of the worker," Dr. Chase concludes.

The issue features a postschool follow-up study of the integrated vocational functioning of 50 workers with significant intellectual disabilities over a 35-year period - the longest follow-up of its kind - contributed by Lou Brown, PhD, Professor Emeritus, University of Wisconsin-Madison, and co-investigators.

Dr. Brown, widely regarded one of the most influential scholars and advocates for students with disabilities, passed away in May 2021. In a tribute honoring Dr. Brown JVR's Editor-in-Chief Paul Wehman writes, "Lou was a great man, an incredible pioneer, and an irreplaceable voice for persons with all disabilities, but especially those with the greatest challenges. When he wrote, he talked to the reader, he made the reader believe in what true inclusionary values were, and why all people with disabilities should be a normal part of our local communities."

The conference took place during the early months of the COVID-19 pandemic and takes into account the dramatic shift in the workplace. "We struggled to adapt to a virtual-only environment at the start of the pandemic," notes Dr. Christensen. "In many states, the flow of funding was temporarily interrupted and resulted in layoffs of the Disability Students Program (DSP) workforce. Some industries have disappeared. Others have grown exponentially. We're going to need to adjust accordingly.

"On the positive side, 'Work from Home' is now normalized. While we don't want this 'new normal' to be interpreted as letting the business community off the hook for complying with the ADA and ensuring that workplaces are fully accessible, 'Work from Home' has opened up new opportunities for employment for people with disabilities," she concludes.

AUSTIN, Texas -- Researchers at St. Edward's University have found that frugal individuals are more likely than their spendthrift counterparts to give in to the allure of deep discounts, whether it is Tax-free weekend, Amazon Prime Day, a Groupon Deal or some other offer.

In order to reconcile making unplanned purchases that may be at odds with their highly disciplined approach to spending, frugal shoppers will categorize the purchase as a necessity versus a luxury, according to the research published recently in the Journal of Business Research.

"Essentially, frugal consumers convince themselves they "really" need the product to justify getting the deep discount and call it a "win" in the smart shopper category. It seems that deep discounts truly are the folly of frugal shoppers," said Sarah Mittal, an assistant professor of Marketing at St. Edward's University.

Mittal and her co-authors Sommer Kapitan, Jill M. Sundie and Daniel J. Beal (of the Auckland University of Technology, Washington and Lee University and Virginia Tech, respectively) conducted a set of three studies to better understand the process by which frugal consumers justify these impulsive responses to deep discounts.

"Frugality is a trait that balances spending restraint and exuberant exploitation of bargain opportunities," Mittal said. "With our studies, we set out to offer insight into the manner in which this balance is kept and the conditions under which it can be tilted toward increased expenditures."

According to the researchers, the buying tendencies of frugal shoppers is one of the less studied aspects of consumer behavior. And yet in times of recession or economic downturns, such as the downturn brought on by the ongoing pandemic, consumers tend to turn into more price-conscious and conservation minded consumers.

In the first qualitative study, focused on interviews with self-identified frugal consumers, the researchers found that these shoppers make a "clear distinction between necessities and luxuries" and that it is a guiding principle that helps frugal consumers determine when to spend money.

In a second experimental study, the researchers offered frugal shoppers a deeply discounted and minimally discounted offering, and found that frugal consumers (but not less frugal consumers) reported a higher need for a desirable product when it was deeply discounted (60% off), compared to when it was only minimally discounted (10% off).

Lastly, in a third longitudinal study designed to look more closely at the process of updating a perceived need, the researchers looked at how shoppers viewed their need for a more practical service -- a car wash -- and a less practical good -- a selfie stick -- before and after a discount offer.

They found that frugal individuals -- but not those low in frugality -- increased their perceptions of need for the car wash in response to a good deal and correspondingly increased their purchase intentions as well. But frugal consumers did not change their perceived need for any product just because it was a good deal.

"If a moderate need for a good/service already exists, deep discounts and good deals, then, tend to push product need from a "maybe I need that" to an "I really need that" perception for frugal consumers. This positive change in need then enhances purchase intentions," Mittal said.

What could these insights mean for marketers?

"Marketers who partake in deep discounting should stick to moderate- to high-need items," Mittal said. "What we found is that frugal individuals justify the splurge by adjusting up their perceived "need" for a product. The effect did not hold for low need items (e.g. a selfie stick or a banana holder --- too frivolous to justify even for the frugal). Marketers can also emphasize the practical utility of a product to help nudge frugals to buy the deal."

In the future, research could delve further into the consequences for frugal consumers of making such impulse purchases, such as having feelings of guilt, shame or pride after getting the "good deal," which could provide additional insights into psychological mechanisms that may help facilitate their overall spending restraint.

Key Findings

When confronted with an unexpected deep discount on an (at least moderately needed) offering, the necessity vs. luxury distinction that keeps frugal people in check is flexibly adjusted to justify a purchase.

Frugal individuals -- like their less frugal counterparts -- can be triggered to make unplanned or impulse purchases.

Spendthrifts are not motivated by deals in the same way. It's like a switch that goes off in frugal individuals ---it allows them to let go of restraint and convince themselves they are meeting frugal goals by getting a "good" deal for an item they would have "needed" anyway.

Humans are no stranger to coronavirus (CoV) pandemics. Just like SARS-CoV-2 (the virus that causes COVID-19), another member of the coronavirus family--SARS-CoV--caused the severe acute respiratory syndrome (SARS) epidemic across parts of Asia in 2003. But, its spread was contained way faster than COVID-19. So, what makes SARS-CoV-2 so contagious?

Both SARS-CoV and SARS-CoV-2 viruses bear "spike proteins" which get inside our cells by binding to a protein called angiotensin-converting enzyme 2 (ACE2) that is found in our cells. However, the SARS-CoV-2 spike (S) protein has been found to have a higher binding affinity (10 to 20 times that of SARS-CoV) to ACE2, thus establishing a link between the pathogen and the protein.

Interestingly, recent studies have shown that patients with COVID-19 who have rhinosinusitis (i.e., inflammation of the nose) have a low risk of hospitalization. Moreover, the expression of ACE2 was reduced in patients with rhinosinusitis. Coincidentally, another study has shown that short-chain fatty acids (SCFAs), produced by bacteria in the gut have beneficial effects in allergy and viral infections. These separate findings prompted an investigation of the effect that SCFAs in the nasal cavity against SARS-CoV-2 infection by scientists from the University of Fukui, Japan, led by Dr. Tetsuji Takabayashi.

In a new study published in the American Journal of Rhinology & Allergy, the scientists attempted to understand the effect of SCFAs on ACE2 expression in the nasal passage, and the potential impact on COVID-19 infection. "This is the first report that short-chain fatty acids (SCFAs) effectively reduce the ACE2 levels in human airway epithelial cells," remarks Dr. Takabayashi.

To understand the status of ACE2 expression in patients with allergies, the researchers studied the levels of ACE2 in the inner lining of the nose in patients with seasonal allergic rhinitis induced by Japanese cedar pollen (SAR-JCP) and chronic rhinosinusitis (CRS). Using techniques like real time-PCR to quantify the expression of ACE2, the researchers found that there was no increase in ACE2 expression in in patients with SAR-JCP, whereas it was decreased in patients with CRS.

To better understand the effect of SCFAs on ACE2 expression, the researchers cultured nasal epithelial cells and exposed them to either SFCA and double-stranded RNA (similar to the nuclear material found in some viruses and known to enhance ACE2 expression). Upon examining the expression of ACE2, the researchers saw that the SFCAs had suppressed ACE2 expression in the presence of the RNA as well.

These results suggest that SFCAs has potential therapeutic applications against COVID-19. Dr. Takabayashi explains, "The nasal mucosa exhibits the highest ACE2 expression among human organs and hence is a prominent target of original infection. Therefore, the development of strategies to downregulate ACE2 expression in nasal epithelial cells could reduce SARS-CoV-2 transmission and be useful as a novel therapeutic approach."

The team's timely findings will certainly aid in our fight against COVID-19.

An international research team, including physics from Russia, has created new glasses for protection against X-ray and gamma radiation. Scientists could select new components that improved the characteristics of the samples and allowed to reduce the amount of lead in the glass composition. Physicists engineered several samples of glasses. One of the latest results - glasses based on barium fluoride - was described by the team in the Optic magazine. But the best results have bismuth borate glasses. Its radiation protection characteristics (mean-free-path, half-value layer) are better than commercial analogs. The features of these samples are described in the Scientific Reports.

"Gamma-ray is using in many fields like industrial (to detect defects in metal casting), medical (to treat malignant and cancerous tumors), agriculture (to control the degree of ripeness and extend the shelf life of fruits and vegetables) and space applications, etc," says Karem Abdelazim Gaber Mahmud, co-author of the research articles, research engineer at the Ural Federal University (Russia), an employee of the Nuclear Material Authority (Egypt). "Gamma radiation has significant penetrating depths, so we are faced with the task of creating a material that could provide maximum protection and the necessary safety for workers."

Commercial radiation shielded glasses contain predominantly lead and phosphate. Due to its high density, lead is one of the most effective protection against gamma-ra?. But this is a heavy toxic metal. Lead glass can weigh up to several hundred kilograms. Therefore, scientists worldwide try to find the optimal composition, components that would help lighten the weight of the glass, reduce the thickness, and lower cost price. Another problem is that after exceeding a certain percentage of additive materials, the glasses lose their clarity, just as after absorbing a certain dose of radiation. Therefore, on the one hand, it is necessary to minimize the amount of lead in the glass composition, while maintaining the protective properties, and on the other hand, it is necessary to extend the shelf life of the end-product, its clarity. Scientists from Jordan, Saudi Arabia, Turkey, Malaysia, China, Egypt are working most actively in this direction.

"Scientists began to create protective glasses in the late 1940s, in the early 1950s, during the formation of nuclear power," says Oleg Tashlykov, research co-author, associate professor at Ural Federal University. "That time in England, America, Russia they were solving the problem of monitoring radiation-hazardous work. They came up with several options for glasses with different additives, but everywhere the basic components are lead and phosphate. The current trend is to choose such a composition to minimize the volume of lead, or better to replace it with another metal."

Note that the protective properties of glass researchers have experimentally tested at the Institute of Reactor Materials of the Russian state corporation "Rosatom" (Sverdlovsk region, Russia). The next step is further research of parameters, improvement, and optimization of the composition, commercialization of technology.

HERSHEY, Pa. -- Electroconvulsive therapy, which may be effective at lowering long-term risks of suicide and death among patients with certain mood disorders, may result in longer hospital stays and increased health care costs, according to Penn State College of Medicine researchers. They said delivering the therapy in outpatient settings may make the treatment more cost-effective.

Electroconvulsive therapy (ECT) -- which involves passing small electric currents through the brain to trigger brief seizures while a patient is under anesthesia -- is seldom utilized in the U.S. due to high costs, low insurance coverage, lack of medical training and long-term side effects. The researchers conducted a study, which published June 5 in Administration and Policy in Mental Health and Mental Health Services Research, examining privately insured adults hospitalized for major depression or bipolar disorder. They found that those who received ECT were hospitalized twice as long and had more than double the total health care costs compared to patients receiving standard care.

"Although ECT is an effective therapy for treatment-resistant depression, its high cost is a deterrent," said author Edeanya Agbese, research project manager in the Department of Public Health Sciences and the Center for Applied Studies in Health Economics. "If this therapy were delivered in an outpatient setting, it's possible that the potential of reduced cost burdens to patients and insurers could increase utilization of ECT in the U.S."

The investigators used a private insurance database to evaluate the cost-effectiveness of ECT compared to standard care. They examined several factors including patient characteristics, length of hospitalization and treatments received. Analyzing the associated costs before, during and after hospitalization, the researchers were able to derive patients' total health care costs during the three periods.

The findings revealed that depending on the number of treatments, those receiving ECT were hospitalized four to 29 days longer and incurred an additional $5,700 to $52,700 more than patients who did not receive this treatment. Furthermore, patients who received ECT continued to have higher health care costs even after hospitalization.

According to the researchers, it may be beneficial and more cost-effective for patients if ECT treatments could be offered in outpatient settings when possible depending on illness severity. Because this study focused on privately insured individuals, it did not explore the financial implications and out-of-pocket expenses for ECT patients without health care insurance or those on Medicare and Medicaid.

Douglas Leslie and Djibril Ba both from the Center for Applied Studies in Health Economics and Penn State College of Medicine; Robert Rosenheck from the U.S. Department of Veterans Affairs and the Department of Psychiatry at Yale School of Medicine also contributed to this research. The researchers declare no conflicts of interest or specific funding for this research.

While several biology techniques have undergone significant technical advances that have allowed their high-throughput implementation, assessing the resistance levels of plant varieties to microbial pathogens remains an arduous and time-consuming task. In response to this, Pujara and collaborators took advantage of the naturally occurring luminescence of a deep-sea shrimp to engineer a light-producing bacterial reporter that allows the quantification of plant resistance levels through imaging.

The Nanoluc luciferase (NL) from Oplophorus gracilirostris is a small protein characterized by its high stability and strong brightness. The researchers exploited these features to produce a light emitting bacterial strain from the Pseudomonas syringae species, a plant pathogen. Because plant pathogens reproduce at a higher pace in susceptible than resistant hosts, susceptible plants were expected to produce more light when infected with a controlled amount of the luminescent pathogen. By integrating this setup with an automated table with a camera that moves within and images plants, the researchers were able to simultaneously phenotype over 30 Arabidopsis thaliana mutants. This novel quantification method was compared with conventional culture-based techniques, showing a high correlation between the outcomes of both approaches, indicating the robustness of the newly developed tool and the potential of this technology for other uses and applications.

"Our high throughput imaging-based resistance assay will provide plant pathologists and breeders a long-sought tool to screen an unprecedented number of plants to identify resistance traits that could fight a potential future pandemic," explained Hong-Gu Kang, the researcher leading this project. "In addition, we are currently working on developing an artificial intelligence (AI) algorithm that will further expedite resistance analysis processes. Ultimately, we would like to conduct a project to assess all the genes in Arabidopsis and other species for resistance," he added.

Read more about this technical advance in the fully open access MPMI journal. This article has been through peer-review but has not yet been edited and formatted.

When a hurricane threatens to make landfall, forecasters offer a barrage of informational tools to communicate the risk of it coming through coastal and inland communities, so residents can prepare for its impact. Chief among these tools is the "cone of uncertainty" - a visual depiction of the storm's potential path.

But is the cone doing its job? Studies show that people often misinterpret this popular weather graphic. They don't understand the information it's conveying: the likely path of a storm, and its likelihood to deviate from that path based on historical data. The graphic is cone-shaped because the farther we try to look into the future, the more uncertain the forecast. But because the cone draws a line around a specific area, many people assume that locations outside the cone will not be affected by the storm.

Researchers in Colorado State University's Department of Psychology are working on an easily understood, science-backed way to visually represent hurricane danger to the general public. They contend that the cone of uncertainty creates a false sense of security for people who live outside the boundary of the cone and that there are better ways to signal likely impacts.

The research team includes psychology professors Jessica Witt, who studies the human visual system, and Benjamin Clegg, who studies human factors in the design of new technologies. Together, they created experiments to test whether hurricane projections could be better understood by average viewers through dynamic graphics the researchers have christened "zoomies." Their results are detailed in Journal of Experimental Psychology: Applied.

Summarizing information

According to Witt, the human visual system excels at something called ensemble perception. When your eyes see a group of objects, your brain quickly extracts a summary of those objects. Looking at a patch of grass, your brain makes a snap judgement about its average greenness. When you look at a tree, your brain automatically estimates the average size of the leaves.

The cone of uncertainty is what researchers call a summary statistic. The average, projected track of the hurricane goes up the middle, and that track is surrounded by varying degrees of uncertainty.

When the cone gets bigger, people think that means the storm will be getting worse or increasing in severity. But the cone's size is only communicating increasing uncertainty around the forecast. The cone also lends itself to what researchers call a containment heuristic.

"People like categories, and to be able to put things in these binary buckets - [at] risk, not at risk," Witt said. "The cone basically encourages that. It has this well-defined boundary, and people treat things within a boundary as qualitatively different than what's outside the boundary."

Clegg points to Hurricane Katrina that devastated New Orleans and surrounding areas in 2005. "It's a good example of a storm that shifted its path just before landfall, heading outside the previously forecast cone of uncertainty," Clegg said. People who lived outside earlier forecast cone boundaries might have assumed they weren't at great risk, he said.

The researchers wondered if instead of the summary statistic of the cone, a better graphic would take advantage of what the visual system is already good at - synthesizing and summarizing. "Rather than visualize the summary, let's give them raw data, and let the visual system do the summary instead," Witt said.

'Zoomies'

Their new and improved graphic is more like a track ensemble, or a spaghetti plot. But track ensembles also have their issues. If a town is located on a track, then people perceive it to be at higher risk than one located off a track, even if the latter one is located closer to the storm's center.

So Witt and Clegg came up with the idea of "zoomies," which are sets of dots that each represent a different projected hurricane path and move accordingly. "The idea is that by getting rid of the defined boundary, we do not have this yes-or-no binary risk distinction, but rather a more gradual, more probabilistic understanding of risk," Witt said.

View an example gif of zoomies: https://col.st/TbdQ1

Lots of zoomies following paths close to the most likely path convey the higher risk there. But even a few zoomies showing more extreme deviations illustrate that there is still some risk for those areas, the researchers said.

Their hypothesis was borne out in a series of experiments with CSU students who, the researchers noted in their paper, are typically not very experienced with hurricanes. In the experiment, they tasked participants with deciding whether to evacuate a town on a map, based on seeing either a traditional cone of uncertainty or the experimental zoomies.

The cone of uncertainty had a distinct containment effect: Study participants chose to evacuate the town located within the cone at high rates, and the town beyond the cone at low rates. The cutoff was sharp and happened over a very short geographical distance - defined by the boundary of the forecast cone.

When the participants assessed hurricane risk using the zoomies, however, researchers saw a gradual decrease in evacuation rates. As the town got further from the center of the projected path, evacuation rates decreased gradually - more in line with what should be done in real life.

"This showed that the participants understood there is risk beyond where the cone ends," Witt said. "There is risk in these peripheral areas."

The researchers repeated the experiments with university students in Florida - who are notably more experienced with actual hurricanes - with collaborators Amelia Warden, a CSU graduate student, and Lisa Blalock, a psychology faculty member at University of West Florida. The results were strikingly similar to the study conducted in Fort Collins. This parity indicates that the visual impression from the cone of uncertainty is so strong that it overcomes even prior knowledge of how hurricane forecasts work.

"It's hard to resist that visual impression," Witt said.

The experimental results with the Florida students are accepted as a conference paper at the Human Factors and Ergonomics Society meeting in October, where Witt and Clegg will present their findings.

The researchers think their findings could not only help decisionmakers and the public better prepare for hurricane landfalls, but also help improve trust in forecasting.

Lessons from Primary Care and Behavioral Health Integration Should Inform Health Care Practices to Identify and Address Patients' Social, Economic Needs

Although interest is accelerating around addressing patients' social and economic needs, effective and sustainable strategies for integrating social care practices into health care delivery have not yet been identified. This paper synthesizes learnings from primary care and behavioral health care integration and translates them into organizing principles with the goal of advancing social care integration practices to improve the health of patients and communities.

Applying Lessons From Behavioral Health Integration to Social Care Integration in Primary Care
Theresa J. Hoeft, PhD, et al
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
https://www.annfammed.org/content/19/4/356

Heart attack, or myocardial infarction, is one of the leading causes of death worldwide. Although modern surgical techniques, diagnostics and medications have greatly improved early survival from these events, many patients struggle with the long-term effects of permanently damaged tissue, and the 5-year mortality rate remains high. Now, researchers reporting in ACS Nano have developed a minimally invasive exosome spray that helped repair rat hearts after myocardial infarction.

Scientists have explored using stem cell therapy as a way to regrow tissue after a heart attack. But introducing stem cells directly to the heart can be risky because they could trigger an immune response or grow uncontrollably, resulting in a tumor. Therefore, researchers have tried injecting exosomes -- membrane-bound sacs containing proteins, lipids and nucleic acids secreted by stem cells -- into the heart, but they often break down before they can have therapeutic effects. Others have developed cardiac patches, or scaffolds that help implanted exosomes last longer, but they usually must be placed on the heart during open-chest surgery. Yafeng Zhou and colleagues wanted to develop an exosome solution that could be sprayed onto the heart through a tiny incision, avoiding major surgery.

The researchers mixed exosomes from mesenchymal stem cells with fibrinogen, a protein involved in blood clotting. They added this solution to a tiny, double-barreled syringe that contained a separate solution of another clotting protein called thrombin. When the team sprayed the solutions out of the syringe onto a rat's heart through a small chest incision, the liquids mixed and formed an exosome-containing gel that stuck to the heart. A mini-endoscope, inserted through a second small incision, guided the spray needle. In rats that had recently had a heart attack, the exosome spray lasted longer, healed injuries better and boosted the expression of beneficial proteins more than heart-injected exosomes. In pigs, the spray caused less severe immune reactions and surgical stress than open-chest surgery. The spray is a promising strategy to deliver therapeutic exosomes for heart repair, the researchers say.

Given the aging world population, there is international interest in helping older people live longer and healthier lives. Avoiding unplanned hospital admissions is an important aspect of care for older people. Palapar et al focused on the way primary care practice characteristics influence outcomes such as unplanned hospitalizations, function and well-being. They investigated the variability in older people's outcomes by primary care physician and practice characteristics in New Zealand and the Netherlands. Findings revealed that none of the physician or practice characteristics were significantly associated with rates of unplanned admissions in the New Zealand sample. In contrast, in the Netherlands sample, researchers found higher rates of admissions in large practices and practices staffed with a practice nurse who typically works in the primary care setting with general practitioners. Practice nurses are common in primary care practices in New Zealand but are relatively new and only in a portion of practices in the Netherlands, the authors note. It is unclear if these associations are causal or if the increase in hospitalizations represent higher or lower quality care. Considering these findings, the authors conclude that the central focus of international health policies on reducing hospital overuse should approach primary health care structural reform carefully.

More than 40% of physicians in the United States reported at least one symptom of burnout, which is particularly high among family physicians. This study examined a nationally-representative sample of family physicians to determine whether physician race-ethnicity was associated with burnout among a nationally-representative sample of family physicians. Of the 3,0916 physicians studied, 450 (15%) were from racial-ethnic groups underrepresented in medicine (UIM), which include Blacks/African Americans, Hispanics/Latinos, American Indians and Pacific Islanders who together comprise 30-35% of the general population yet account for only 12.4% of family physicians. The study findings support the researchers' hypothesis that UIMs were significantly less likely than their non-UIM counterparts to report emotional exhaustion and depersonalization. This may be attributed to practicing in more racially-diverse counties and being less likely to practice obstetrics, both of which partially mediated the protective effect of UIM status on depersonalization. The mediating effect of working in more racially and ethnically diverse counties is consistent with evidence of the beneficial effect of cultural diversity on health outcomes for minorities and better overall self-rated health among adults. Understanding the attributes of UIMs that may prevent burnout may also provide insights for developing a more resilient physician workforce.

BIRMINGHAM, Ala. - Uveal melanoma, or UM, is a rare and deadly cancer of the eye, and the mortality rate has remained unimproved for 40 years. Half of the melanomas spread to other organs of the body, causing death in less than a year, so new treatments to preserve vision and prevent death are an urgent need.

Now a preclinical study by researchers at the University of Alabama at Birmingham and Emory University, Atlanta, offers hope -- a small molecule inhibitor has been identified that dampens the potent drivers of this tumor. In mouse models, the inhibitor, KCN1, strongly limited primary disease in the eye and metastatic tumor dissemination to the liver, and animals survived longer, without overt side effects.

Thus, this class of inhibitory compounds shows promise, though the co-leaders of the research -- Erwin Van Meir, Ph.D., professor of neurosurgery at UAB, and Hans Grossniklaus, M.D., MBA, professor of ophthalmic pathology at Emory -- say the drug needs further optimization before clinical use.

"Overall," they wrote in the paper published in the journal Oncogene, "our preclinical studies support the further translation of the KCN1 arylsulfonamide scaffold toward a novel treatment for patients with metastatic uveal melanoma." The uvea is the pigmented layer of the eye.

Prior to this study, it was known that: 1) a hypoxia gene signature, indicative of low oxygen levels in the tumor, is associated with poor prognosis and a high metastatic rate in uveal melanoma; 2) the hypoxia-inducible transcription factor, or HIF, turns on a large number of gene products with critical roles in cancer growth and metastasis; and 3) for UM specifically, HIF promotes tumor progression by regulating proliferation, migration, invasion and adhesion of tumor cells, as well as promoting blood vessel growth to feed the tumor.

Little was known of the role of HIF in directing pro-invasive extracellular matrix remodeling in UM. Changes in the extracellular matrix, including increased collagen deposition and reorganization of collagen fibers outside the cell, is known to aid cancer progression and tumor cell invasion. Extracellular matrix is the non-cellular component of all tissues that provides physical scaffolding for cells and has other biochemical roles.

Hypoxia promotes collagen deposition, in part, because HIF increases production of two gene products, P4HA1 and P4HA2, that are part of an enzyme complex that adds hydroxyl residues to prolines in procollagen. Procollagen is a precursor protein in the complex maturation process that collagen undergoes.

In their study, Van Meir, Grossniklaus and colleagues decided to evaluate the expression of the P4HA1/2 genes in relation to UM patient prognosis, and to determine whether inhibiting hypoxia-induced P4HA1/2 expression in a preclinical model of metastatic UM would yield therapeutic benefit.

They found that P4HA1 and P4HA2 were induced by hypoxia in human UM cell lines, and this induction was reduced by KCN1. Comparison of 46 patients with non-metastatic UM and 46 with metastatic UM showed that P4HA1/2 were significantly overexpressed in patients with metastatic disease. Also, P4HA1/2 expression correlated with poor overall survival in UM patients. This suggests that P4HA1 and P4HA2 can serve as prognostic markers in UM, and that they may be important for malignant progression of the disease and patient survival.

The researchers next turned to preclinical animal models of UM. They showed that KCN1 was abundantly taken up in the liver and the eyes after intraperitoneal injection, and it dampened tumor growth and disease burden at the primary site of the eye, as well as reduced distant metastases in the liver. KCN1 also increased survival in three different models that test the growth of human UM after injection in mice uvea. The inhibitor was most effective at reducing metastases when it was administered early.

At the molecular level, treatment with KCN1 to inhibit the hypoxic induction of P4HA1/2 decreased the hydroxylation of proline amino acids in the procollagen. It also caused cleavage of the collagen and disordered the structure of collagen VI, a mature structural component of the extracellular matrix. These collagen changes correlated with a reduction in tumor cell invasion.

"Our study," Van Meir and Grossniklaus concluded, "suggests that KCN1 has desirable properties as a suppressor of metastasis: It is well tolerated, has excellent distribution to the eye and the liver, and is thus ideally suited for treating metastatic UM."

Male seed beetles with genital structures that injure females may have greater reproductive success. As new research from Uppsala University shows, females that mate with such males benefit, in the sense that their offspring are healthier. This new piece of the puzzle will help scientists to understand how complex mating interactions between males and females have developedevolved. The study is published in Proceedings of the Royal Society B.

"This helps us understand is connected with the evolutionary dance between males and females of all animal species, and the resulting differences between them - sexual dimorphism - that we observe. It's important to understand this evolutionary dance that we're all caught up in. We can show that this intricate process is influenced and governed by several different processes at the same time," says Göran Arnqvist, Professor of Animal Ecology at Uppsala University's Department of Ecology and Genetics.

The evolved mechanisms behind successful mating interactions between the sexes are complicated, and have developed throughout evolution. In insects, for example, it is not uncommon for males to have developed spiny reproductive organs that confer greater success in reproduction but simultaneously inflict harm on the females' reproductive tract in the course of mating.

In their study, the researchers bred various strains of the seed beetle (Callosobruchus maculatus). In some strains the males had mating organs with large spines, while in others thhese spines were small. When the male beetles were then mated with females, it turned out that the males with the longest thorns spines also had the greatest success with the opposite sex, despite the females suffering severe injuries during the mating. Despite these injuries, however, the females also benefited from mating with these males since their offspring, male and female alike, apparently became more viable. The existence of a genetic link between big spines and good genes was demonstrated by the fact that the sisters of the males with the longest spines were in better health than other females .

The researchers also investigated what happened if the spines were peeled off the mating organs by means of a microlaser. The males' ability to mate then deteriorated, which indicates that the number of young a male beetle can produce is not solely dependent on his genes.

"Our experiments indicate that the females do pay a high price for mating with successful males -getting injured - but also that the females simultaneously obtain genetic advantages for their offspring. Our results provide support for a more nuanced view of mating interactions in the animal world, where behaviours can be shaped by several effects, and seemingly different evolutionary forces, at the same time," Arnqvist says.

A new study led by the U.S. Geological Survey outlines a means to better estimate COVID-19 occurrence and trends in populations.

Currently, COVID-19 testing is primarily limited to self-selected individuals, many of whom are symptomatic or have had contact with someone who is symptomatic. While these tests are useful for individual medical treatment and contact tracing, they do not provide health officials with a complete picture of the disease across the population.

"Coordinated sampling of COVID-19 is key to informing health officials as they continue their efforts to control the pandemic, permitting better predictions of disease dynamics and decisions that help limit transmission," said James Nichols, USGS scientist emeritus and lead author of the study. "The proposed sampling methods should also help officials determine the effectiveness of vaccines, social distancing, masks and other mitigation efforts."

By bringing its unique expertise in the design of data-gathering and monitoring systems, statistical analysis and mathematical modeling to human epidemiology, the USGS provides a means to fill the current information gap in testing data. This can benefit national and local governments and health officials as they develop interventions in response to new disease variants, plan for augmented vaccination efforts and prepare for future outbreaks.

With some countries experiencing surges in cases, Nichols points out, "the proposed testing strategies can be applied within the U.S. and internationally for COVID-19 and other diseases."

One proposal in the study is to select a random sample within a population and survey those individuals for symptoms, such as elevated temperature, in order to gather more representative data on asymptomatic cases. This would help researchers estimate the proportion of symptomatic and asymptomatic individuals in the population.

The asymptomatic individuals, or a random subset of those individuals, could be tested for COVID-19 to help estimate infection probability for asymptomatic individuals in the population.

"The strategies outlined in this new research would help strengthen current testing approaches and could be done with relatively few additional tests and non-invasive surveys," said Michael Runge, a USGS scientist and a co-author of the study. "Strategic testing, based on specific objectives, can provide information valuable for decisions about both individual healthcare and protecting communities."

"It is critically important to be clear about the goal of a surveillance program," said co-author Katriona Shea, a professor of biology and alumni professor in the biological sciences at Penn State. "Without knowing exactly what you want to achieve, how can you achieve it? A surveillance program for individual outcomes would be designed differently than a program aimed to understand population level public health objectives."

BUFFALO, N.Y. - Write down the benefits of obtaining a college degree and, more than likely, all the items on the completed list will relate to graduates: higher salaries, autonomous jobs and better access to health care, for instance. All of those factors, supported by extensive research, help draw a direct line connecting higher education and health. Similar research suggests how the education of parents affects their children.

Now, two University at Buffalo sociologists have used a new wave of data from a survey launched in 1994 to further extend the geometry linking educational attainment and health that demonstrates another dimension of the intergenerational effects of completing college. Their findings published recently in the Journal of Gerontology: Social Sciences suggest that adult children's educational attainment has an impact on their parents' mental and physical health.

"By analyzing these data we arrived at the conclusion that it was detrimental to parents' self-reported health and depressive symptoms if none of their children completed college," says Christopher Dennison, PhD, assistant professor of sociology in UB's College of Arts and Sciences, and a co-author of the paper with UB colleague Kristen Schultz Lee, PhD, an associate professor in the Department of Sociology. "The negative mental health outcome of the parents was in fact our strongest finding."

Dennison and Lee have both used the National Longitudinal Study of Adolescent to Adult Health (Add Health) in their previous research. Add Health is a nationally representative longitudinal study of over 20,000 adolescents. It is the largest such survey of its kind. There was an initial wave of data on the parents (ages 30-60) when the survey began and another wave of data from roughly 2,000 of those original participants (now ages 50-80) gathered from 2015-17.

It's this latter data set that provided the researchers an opportunity to look at the intergenerational relationship between parents and children over time, while statistically balancing factors that could influence an aging parent's health.

"These results are particularly important in light of growing educational inequalities in the U.S. in the last several decades," says Lee. "We know how our own education impacts our own health; we know how parents' education impacts their children in many different ways; now we're trying to add to that understanding by explaining how children's education can have an impact on their parents.

"One thing I thought particularly interesting about these findings is that those parents who are the least likely to have a child attain a college education (low socioeconomic status) seem to benefit the most from a child having a college degree."

Dennison and Lee speculate on a number of elements that might be driving this association, including anxiety, assistance and lifestyle.

"Parents whose children have lower levels of education might spend more time worrying about their children. That has negative implications for their mental health and their self-rated health," says Lee. "Kids without a degree might need more help from their parents and are also less able to provide help if needed in return.

"Another possibility is that educated children might be doing a better job of helping their parents live healthier lives by encouraging exercise and a sensible diet."

What's clear is the evidence pointing to how the benefits of a college degree show up in the parents' health later in life.

"In this era when a college degree is of ever-growing importance, we see how the long-term investment in education is advantageous to the adult child's health, but also has benefits down the road for their parents too," says Dennison.

And it's this idea of an investment that speaks to how educational attainment reaches across generations from a policy perspective.

"Historically, there has been a debate over whether or not different generations are at odds with one another, with one generation taking resources away from another older or younger generation," says Lee. "But our findings point to the fundamentally inter-related nature of the interests and needs of different generations.

"Investing in one generation, in this case, positively benefits another generation."