Le Community Resources Consultants de Toronto : deux programmes de case management

Cet article décrit deux programmes bien établis de case management qui ont été développés en réponse aux lacunes identifiées au sein du système de soins de santé mentale à Toronto. Le case management y est défini ainsi que la place qu'il occupe au sein du système de soins en santé mentale. On y décrit aussi la philosophie des programmes, comment elle est appliquée au niveau organisationnel et dans la dispensation des services. Des vignettes illustrent ensuite le travail quotidien des case managers et soulignent l'importance de la relation de partenariat avec l'usager.This article describes two well established case management services which were developed in response to clearly identified gaps in the mental health system in Toronto. The significance of case management and its place in the mental health system are addressed. CRCT's service philosophy and how that philosophy is put into operation at an organizational level and in the delivery of case management service is described. Client vignettes illustrate the day-to-day work of the case managers and the importance of a strong working alliance.Este articulo describe dos programas de case management bien establecidos, que han sido desarrolados como respuesta a las lagunas identificadas al interior des sistema de asisencia de salud mental en Toronto. Una definiciôn des case management asî que el lugar que este ocupa al interior del sistema de asistencia en salud mental, son abordados. También se describe la filosoffa de los programas, el como son aplicados de manera organizacional en el dispensario de servicios. En seguida, las vinuelas ilustran el trabajo diario de los case manager y subrayan la importancia de la relation de partenariado con el usuario

Religious diversity, empathy, and God images : perspectives from the psychology of religion shaping a study among adolescents in the UK

Major religious traditions agree in advocating and promoting love of neighbour as well as love of God. Love of neighbour is reflected in altruistic behaviour and empathy stands as a key motivational factor underpinning altruism. This study employs the empathy scale from the Junior Eysenck Impulsiveness Questionnaire to assess the association between empathy and God images among a sample of 5993 religiously diverse adolescents (13–15 years old) attending state maintained schools in England, Northern Ireland, Scotland, Wales, and London. The key psychological theory being tested by these data concerns the linkage between God images and individual differences in empathy. The data demonstrate that religious identity (e.g. Christian, Muslim) and religious attendance are less important than the God images which young people hold. The image of God as a God of mercy is associated with higher empathy scores, while the image of God as a God of justice is associated with lower empathy scores

Young people's attitudes to religious diversity : quantitative approaches from social psychology and empirical theology

This essay discusses the design of the quantitative component of the ‘Young People’s Attitudes to Religious Diversity’ project, conceived by Professor Robert Jackson within the Warwick Religions and Education Research Unit, and presents some preliminary findings from the data. The quantitative component followed and built on the qualitative component within a mixed method design. The argument is advanced in seven steps: introducing the major sources of theory on which the quantitative approach builds from the psychology of religion and from empirical theology; locating the empirical traditions of research among young people that have shaped the study; clarifying the notions and levels of measurement employed in the study anticipating the potential for various forms of data analysis; discussing some of the established measures incorporated in the survey; defining the ways in which the sample was structured to reflect the four nations of the UK, and London; illustrating the potential within largely descriptive cross-tabulation forms of analysis; and illustrating the potential within more sophisticated multivariate analytic models

How to spot a statistical problem: advice for a non-statistical reviewer

Statistical analyses presented in general medical journals are becoming increasingly sophisticated. BMC Medicine relies on subject reviewers to indicate when a statistical review is required. We consider this policy and provide guidance on when to recommend a manuscript for statistical evaluation. Indicators for statistical review include insufficient detail in methods or results, some common statistical issues and interpretation not based on the presented evidence. Reviewers are required to ensure that the manuscript is methodologically sound and clearly written. Within that context, they are expected to provide constructive feedback and opinion on the statistical design, analysis, presentation and interpretation. If reviewers lack the appropriate background to positively confirm the appropriateness of any of the manuscript’s statistical aspects, they are encouraged to recommend it for expert statistical review

A summary framework for effective engagement of IPLCs and rangers

In this paper we focus on the pressing need to effectively engage with Indigenous Peoples and Local Communities (IPLCs) and the need to strengthen the capacity of rangers originating from these communities. Opportunities for full participation and leadership by IPLCs are improved by enhancing the role of Indigenous and local rangers in fostering relationships while integrating cultural knowledge into the work on the ground. This also strengthens local benefits. We emphasize the invaluable contribution of IPLCs to conservation, often honed over generations, and explore current models of partnership and engagement. Particularly, we spotlight the vital role of IPLC rangers, who leverage unique skills, local knowledge, and cultural practices in their conservation work. The roles of both IPLCs and local Indigenous rangers are essential if we are to meet our goals for conserving 30% of the earth’s lands and waters by 2030 as promoted at the COP15 meeting of the Convention on Biological Diversity (CBD), achieve the objectives for development of IPLC rangers as stated of Chitwan Declaration of 2019 (CD), or meet the related targets set by the Universal Ranger Support Alliance (URSA). We advocate for a partnership model with IPLCs that applies the principles of Collective Impact to improve outcomes and secure enduring benefits at all levels. To aid stakeholders in conservation projects involving IPLCs (including governments, businesses, and non-governmental organizations), we propose a straightforward summary framework that outlines stages for the development of relationships and projects. It integrates the work of others, including foundation principles, management systems for partnerships, and good practices, and stresses the need for pre-project training, learning and other forms of preparation. Altogether, these principles and accompanying recommendations help lay the groundwork for effective intergenerational projects involving IPLCs with long-term benefits

Comparative analysis of RNA expression in a single institution cohort of pediatric cancer patients.

With the low incidence of mutations in pediatric cancers, alternate genomic approaches are needed to identify therapeutic targets. Our study, the Comparative Analysis of RNA Expression to Improve Pediatric and Young Adult Cancer Treatment, was conducted by the UC Santa Cruz Treehouse Childhood Cancer Initiative and Stanford University School of Medicine. RNA sequencing data from 33 children and young adults with a relapsed, refractory or rare cancer underwent CARE analysis to reveal activated cancer driver pathways and nominate treatments. We compare our pipeline to other gene expression outlier detection approaches and discuss challenges for clinical implementation. Of our 33 patients, 31 (94%) had findings of potential clinical significance. Findings were implemented in 5 patients, 3 of which had defined clinical benefit. We demonstrate that comparator cohort composition determines which outliers are detected. This study highlights the clinical utility and challenges of implementing comparative RNA sequencing analysis in the clinic

Independent repeated mutations within the alphaviruses Ross River virus and Barmah Forest virus indicates convergent evolution and past positive selection in ancestral populations despite ongoing purifying selection

Ross River virus (RRV) and Barmah Forest virus (BFV) are arthritogenic arthropod-borne viruses (arboviruses) that exhibit generalist host associations and share distributions in Australia and Papua New Guinea (PNG). Using stochastic mapping and discrete-trait phylogenetic analyses, we profiled the independent evolution of RRV and BFV signature mutations. Analysis of 186 RRV and 88 BFV genomes demonstrated their viral evolution trajectories have involved repeated selection of mutations, particularly in the nonstructural protein 1 (nsP1) and envelope 3 (E3) genes suggesting convergent evolution. Convergent mutations in the nsP1 genes of RRV (residues 248 and 441) and BFV (residues 297 and 447) may be involved with catalytic enzyme mechanisms and host membrane interactions during viral RNA replication and capping. Convergent E3 mutations (RRV site 59 and BFV site 57) may be associated with enzymatic furin activity and cleavage of E3 from protein precursors assisting viral maturation and infectivity. Given their requirement to replicate in disparate insect and vertebrate hosts, convergent evolution in RRV and BFV may represent a dynamic link between their requirement to selectively ‘fine-tune’ intracellular host interactions and viral replicative enzymatic processes. Despite evidence of evolutionary convergence, selection pressure analyses did not reveal any RRV or BFV amino acid sites under strong positive selection and only weak positive selection for nonstructural protein sites. These findings may indicate that their alphavirus ancestors were subject to positive selection events which predisposed ongoing pervasive convergent evolution, and this largely supports continued purifying selection in RRV and BFV populations during their replication in mosquito and vertebrate hosts

Recombination and positive selection identified in complete genome sequences of Japanese encephalitis virus

The mosquito-borne Japanese encephalitis virus (JEV) causes encephalitis in man but not in pigs. Complete genomes of a human, mosquito and pig isolate from outbreaks in 1982 and 1985 in Thailand were sequenced with the aim of identifying determinants of virulence that may explain the differences in outcomes of JEV infection between pigs and man. Phylogenetic analysis revealed that five of these isolates belonged to genotype I, but the 1982 mosquito isolate belonged to genotype III. There was no evidence of recombination among the Thai isolates, but there were phylogenetic signals suggestive of recombination in a 1994 Korean isolate (K94P05). Two sites of the genome under positive selection were identified: codons 996 and 2296 (amino acids 175 of the non-structural protein NS1 and 24 of NS4B, respectively). A structurally significant substitution was seen at NS4B position 24 of the human isolate compared with the mosquito and pig isolates from the 1985 outbreak in Thailand. The potential importance of the two sites in the evolution and ecology of JEV merits further investigation