Supporting people with cognitive disabilities in decision making – processes and dilemmas

The exploratory study found that participants, including those with cognitive disability, mostly supported the broad concept of supported decision making. However supporters saw this as a complex, dynamic and frequently chaotic process. Fundamental to the process were relationships and tailoring support to the individual. The skills and knowledge required included communication skills, self-awareness, the capacity for reflective discussion, conflict resolution skills, and knowledge of strategies for tailoring the decision making process to the individual. The study revealed multiple dilemmas and tensions associated with supporting someone with cognitive disability to make a decision but most commonly mentioned were remaining neutral, managing conflicting perspectives amongst differing supporters, balancing rights with risk and best interests, and resource constraints. The study provides some key insights into the practice of supporting people with cognitive disability to make decisions and knowledge that can be incorporated into training programs for people in this role. The findings also highlight the need for further research in this area, particularly in relation to ‘what works’ in support for decision making for people with cognitive disabilit

Inclusion in political and public life: the experiences of people with intellectual disability on government disability advisory bodies in Australia

BACKGROUND: Civil and political participation lies at the core of citizenship. Increasingly, people with intellectual disability are members of disability advisory bodies. This study investigated the political orientations of advisory body members with intellectual disability, their participatory experiences, and the types of support they received. METHOD: The 9 people with intellectual disability who in 2005 were members of disability advisory bodies at a state, national, and Victorian local government level were interviewed, together with 12 other members or secretariat staff of these bodies. Observations were also conducted of advisory body meetings. RESULTS: The political perspective of members with intellectual disability varied, but all had a background in self-advocacy. They found the work hard but rewarding and encountered both practical and intangible obstacles to participation. Members received varying types of practical support, but a supportive collegial milieu was characteristic among members who felt most confident about their participation. CONCLUSIONS: The milieu, structures, and processes of advisory bodies must all be adjusted to accommodate people with intellectual disability if they are to participate meaningfully

TGA2 dual activity: N-terminus regulation of reversible DNA binding influenced by NPRI and CK2

TGA2 is a dual-function Systemic Acquired Resistance (SAR) transcription factor involved in the activation and repression of pathogenesis-related (PR) genes. Recent studies have shown that TGA2 is able to switch from a basal repressor to activator, likely, through regulatory control from its N-terminus. The N-terminus has also been shown to affect DNA binding of the TGA2 bZIP domain when phosphorylated by Casein Kinase II (CK2). The mechanisms involved for directing a switch from basal repressor to activator, and the role of kinase activity, have not previously been looked at in detail. This study provides evidence for the involvement of a CK2-like kinase in the switch of TGA2 activity from repressor to activator, by regulating the DNA-binding activity of TGA2 by phosphorylating residues in the N terminus of the protein

Death, dying and informatics: misrepresenting religion on MedLine

BACKGROUND: The globalization of medical science carries for doctors worldwide a correlative duty to deepen their understanding of patients' cultural contexts and religious backgrounds, in order to satisfy each as a unique individual. To become better informed, practitioners may turn to MedLine, but it is unclear whether the information found there is an accurate representation of culture and religion. To test MedLine's representation of this field, we chose the topic of death and dying in the three major monotheistic religions. METHODS: We searched MedLine using PubMed in order to retrieve and thematically analyze full-length scholarly journal papers or case reports dealing with religious traditions and end-of-life care. Our search consisted of a string of words that included the most common denominations of the three religions, the standard heading terms used by the National Reference Center for Bioethics Literature (NRCBL), and the Medical Subject Headings (MeSH) used by the National Library of Medicine. Eligible articles were limited to English-language papers with an abstract. RESULTS: We found that while a bibliographic search in MedLine on this topic produced instant results and some valuable literature, the aggregate reflected a selection bias. American writers were over-represented given the global prevalence of these religious traditions. Denominationally affiliated authors predominated in representing the Christian traditions. The Islamic tradition was under-represented. CONCLUSION: MedLine's capability to identify the most current, reliable and accurate information about purely scientific topics should not be assumed to be the same case when considering the interface of religion, culture and end-of-life care

Advocating for Sustainability at The City of Beaverton, Oregon: An Advocacy Initiative and Sustainability Strategy using the STAR Communities (Sustainability Tools for Assessing and Rating Communities) Framework and Rating System

This paper analyzes the policy and advocacy dimensions of an effort that secured approval from the mayor and city council of Beaverton, Oregon for an ambitious addition to its sustainability initiatives. As a result, Beaverton has now applied for STAR (Sustainability Tools for Assessing and Rating Communities) certification – a national program that uses the STAR Rating System, that includes hundreds of measurable indicators to assess a community’s environmental, economic and social sustainability. In addition, the paper analyzes the process by which STAR indicator data were collected and are being incorporated into a comprehensive planning document – the Sustainable Beaverton Community Strategy (SBCS). The author was a member of the city’s Sustainability Program that developed and carried out an internal advocacy strategy to secure approval for the STAR initiative, has been the lead staff member for collecting and compiling the data for each STAR indicator included in the city’s report, and wrote the draft of the SBCS document. Drawing on those experiences and concepts from the field of policy advocacy, the paper evaluates the outcomes of these efforts and identifies key lessons

Mind Over Matter or Matter Over Mind: How Potential Role Conflict Affects the Psychological Well-Being of College Student-Athletes

Student-athletes have two priorities during their time in college. As a student receiving an education and an athlete that competes for the institution. The demands of the two roles have the potential for the student-athlete to experience role conflict. According to Hurley (1993), role conflict develops when two or more roles produce differing demands on a person to the extent that the individual is unable to effectively fulfill one or all roles. Role conflict can cause many problems for the individual that experiences it. One of the negative outcomes of a person perceiving role conflict in two or more of their roles is to their mental health (Brookins 2018). The objective for conducting this research study is to definitively parse out whether NCAA Division I college student-athletes experience role conflict and whether role conflict negatively impacts the psychological well-being of student-athletes

Social Integration of Learning-Disabled Students in Mainstream Programs Where the Method of Instruction is Divergent Questioning

This paper concentrates on an approach to enhance the social integration of learning- disabled students in regular classrooms. The chief problem is to design learning experiences which stimulate the development of social integration in mainstream programs. What effect does method of instruction have on positive affective states of learning- disabled students when mainstreamed? After defining terms, the literature review includes studies on l)divergent questioning and its relationship to the thinking processes, 2)methods of instruction, 3)actual and perceived peer status of learning- disabled students in regular classrooms. The research design will be experimental, using the classroom situation and primary students. The Peer Acceptance Scale (Bruininks 1972) will be used to assess peer status. Divergent questioning will be the method of instruction. The investigation will be aimed at the relationship between the level of the learning- disabled student \u27 s peer status in mainstream programs before and after the method of instruction of divergent questioning . In addition, a design of divergent questioning techniques for teachers preparing to mainstream will be included

The pathogenesis of oral lichen planus

Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8(+) cytotoxic T-cells. Non-specific mechanisms include mast cell degranulation and matrix metalloproteinase (MMP) activation in OLP lesions. These mechanisms may combine to cause T-cell accumulation in the superficial lamina propria, basement membrane disruption, intra-epithelial T-cell migration, and keratinocyte apoptosis in OLP. OLP chronicity may be due, in part, to deficient antigen-specific TGF-beta1-mediated immunosuppression. The normal oral mucosa may be an immune privileged site (similar to the eye, testis, and placenta), and breakdown of immune privilege could result in OLP and possibly other autoimmune oral mucosal diseases. Recent findings in mucocutaneous graft-versus-host disease, a clinical and histological correlate of lichen planus, suggest the involvement of TNF-alpha, CD40, Fas, MMPs, and mast cell degranulation in disease pathogenesis. Potential roles for oral Langerhans cells and the regional lymphatics in OLP lesion formation and chronicity are discussed. Carcinogenesis in OLP may be regulated by the integrated signal from various tumor inhibitors (TGF-beta1, TNF-alpha, IFN-gamma, IL-12) and promoters (MIF, MMP-9). We present our recent data implicating antigen-specific and non-specific mechanisms in the pathogenesis of OLP and propose a unifying hypothesis suggesting that both may be involved in lesion development. The initial event in OLP lesion formation and the factors that determine OLP susceptibility are unknown

‘Toxic Tourism on Indigenous Country’

In the far northeastern corner of the state of Oklahoma lie lands and waterways promised to a diverse set of Tribal Nations forcibly removed to this area throughout the 19th century. Today, these lands are home to both tribal members and non-Indigenous peoples alike, but the landscape and waterways have been irrevocably assaulted and transformed as a result of 20th century lead and zinc mining and the waste left behind (Manders and Aber 2014). Long known with the unfortunate designation of the “worst EPA Superfund Site in the United States” (Meadows 2019), the Tar Creek Superfund area remains to this day an ecosystem that is striving to recover from toxic chat piles, polluted creeks and overmined lands caving in on themselves. Just as important, the community members of the Tar Creek region and surrounding areas—including notably the Quapaw Nation—continue forward in an ongoing journey of healing and recovery from the severe impacts of this pollution on their health, wellbeing, sense of community and futures. At the forefront of efforts to keep the clean-up of the Tar Creek Superfund Site and the support for its communities going is the Local Environmental Action Demanded (LEAD) agency, founded by Rebecca Jim (Cherokee Nation), a long-time educator, counselor and environmental activist in the region. As part of her work in supporting local communities and educating visitors to the area, Rebecca has been leading Tar Creek Toxic Tours that allow participants to witness and experience first-hand the devastating impacts of the mining industry on the land and her people. This presentation highlights these Tar Creek Toxic Tours as a powerful mechanism for educating and advocating on themes of environmental justice, community development, local agency and the sovereignty of Tribal Nations