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Highly efficacious direct acting antiviral (DAA) therapy for treatment of Hepatitis C Virus (HCV) infection is largely inaccessible to communities facing a shortage of available specialist providers. Though less demanding than previous interferon regimens, DAA therapy requires patients to adhere to 8–12 weeks of daily treatment, which can be challenging for some patient populations. Duffy Health Center, located on Cape Cod, Massachusetts, provides integrated medical, mental health and case management services to people who are homeless or at risk for homelessness. The goal of this manuscript is to evaluate the outcomes of treatment of HCV infection with a shared medical appointment (SMA) model. The primary outcome was sustained virologic response (SVR-12), or HCV RNA ≤ 15 IU/mL at 12 weeks post-treatment. There were 102 patients recruited, with a total of 104 treatments administered. Over three-fourths of patients who attended one SMA visit (78 of 102) continued in SMA for the duration of treatment. Of these patients opting for SMA, 99% (77 of 78) completed the full treatment course, and 91% (71 of 78) of SMA patients achieved SVR-12. DAA therapy provided by non-specialist providers using the SMA model yielded comparable response rates to those achieved by specialist providers, and has the potential to substantially increase access to HCV treatment for patient populations within high-risk communities.

The problem addressed in this study was that many students in DE have a decrease in academic success and, as a result, never make it to college-level courses nor complete a program and earn a degree, leading to a decrease in academic success. The purpose of this qualitative multiple case study was to provide insight on historically black colleges and universities (HBCUs) DE placement systems and to find instructional practices and institutional policies that may be hindering students' academic progress within developmental education at HBCU’s designed to prepare underperforming students to complete college. The study included two groups: one comprised 20 first-year and second-year students taking developmental or remedial courses, and the other comprised three faculty members. Questionnaires were used for data collection. Through the analysis of questionnaire data, several themes appeared. Key themes identified by students included issues related to course enrollment and credits, time management challenges, resource availability, and financial concerns. Major themes that appeared from faculty were (a) service, (b) instruction, (c) academic advising and mentoring, (d) skills, and (e) resources. One implication of this study is that teaching methods should align with students' comprehension levels to effectively engage them. Enhancing the range of activities and services in developmental education could potentially enhance students' academic performance. These services include life skills and career counseling, academic tutoring, and effective study sessions to improve academic performance. Future research should explore student support initiatives and collaborations in developmental education, encompassing diverse activities, services, and programs aimed at enhancing students' academic success.

Discusses three projects she has worked on over the last six years that can be seen as functioning as archives : 'LA botanical', a personal response to the collapse of New Orleans in the aftermath of Hurricane Katrina; 'Crown Coach botanical', a survey of the poisoned, Crown Coach industrial brownfield site in downtown Los Angeles; and 'Te taniwha', a depiction of the rural East Coast settlement of Te Reinga. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

This research attempts to establish an empirical link between highly skilled human capital availability and the strength of traded regional clusters using regression analysis and time series data from existing sources. A new construct is suggested to explain the strength of certain clusters as a function of regionally awarded bachelor and master’s degrees in fields related to those clusters. Such a link does not exist in the literature today and would potentially accelerate the transition of cluster theory to practical application for economic development. One potential application is a creative and innovative industry cluster design tool that provides investors and economic developers a low cost, qualitative method for identifying latent industry clusters. This, and other potential cluster development tools, assume a theoretical link between cluster success and identifiable factors of production. However, none of the cluster research to date has quantified the relationship between the factors of production, including highly skilled human capital availability, and cluster strength. Empirical evidence of a link between regionally awarded bachelor and master’s degrees, an indication of highly skilled human capital availability, and the strength of related clusters in those regions would provide a powerful justification for systematic coordination between educational program design and regional economic development policies and funding. This work may encourage researchers to quantify links between other factors of production such as infrastructure development and financial capital availability and regional cluster strength to further inform public and private economic development decisions. The collective efforts of researchers to establish these links would contribute to a comprehensive quantitative model of the factors driving traded cluster strength.

In 2013, the alignment of the geographic boundaries of the regional Local Health District, Family and Community Services and the Medicare Local/Primary Health Network presented a strategic opportunity to form a high-level strategic partnership and planning group. This group provided an ideal platform for collaboration.The Local Health District had already identified the need for a five-year child health plan and proposed that this was completed collaboratively and that it covered both health and broader wellbeing. The emergence of integrated care as a focus area for the New South Wales (NSW) Ministry of Health was an additional driver for developing a shared plan. Membership of the Senior Partnership and Planning Group was expanded to include representatives from the child and family non-government sector and the Department of Education.Whilst each organisation involved are working towards child health and wellbeing in many ways every day, the Plan focuses on the ‘additionality’ that comes from cross-agency collaboration and integration.A stakeholder consultation workshop with over one hundred service providers informed the determination of strategic priorities and related actions for inclusion in the Plan. The Plan provides a framework for shared governance, collaboration and a common vision for child health and wellbeing outcomes over a five year period.The mission for the Child Health and Wellbeing Plan is for the children of Inner West Sydney region to be healthy, safe, respected, valued and happy, living in supportive families, and nurtured in strong inclusive communities.The Plan is based on the important idea that agencies working together, in collaboration with communities, can do more and can achieve meaningful change, particularly when vulnerable children and families are involved. Vulnerable children include those living in poverty, at risk of violence, abuse and neglect, newly arrived refugees and migrants, living with parents or carers who have mental health and/or substance abuse issues, and whose chances of reaching their potential are reduced or at risk.The ‘Inner-West Child Health and Wellbeing Plan: Doing Better Together’ was launched by the NSW Minister for Health in November 2015.'Healthy Homes and Neighbourhoods' is a three-year integrated care initiative funded through a NSW Ministry of Health Integrated Care Planning and Innovation Fund. 'Healthy Homes and Neighbourhoods' is a demonstration project of the Child Health and Wellbeing Plan and provided an immediate and significant opportunity to extend and test the collaborative partnership.The program addresses the complex health and social needs of the most vulnerable families in our community who may be disconnected from key services and who require multi-agency assistance. Approximately 170 individuals have enrolled for care coordination since program implementation in June 2015. All the needs of identified families are in scope for the intervention, including housing, employment, income support and legal advice. Geospatial mapping identified clusters of extreme family disadvantage, where additional community projects are being implemented.Scoping papers have been completed for the Child Health and Wellbeing Plan high priority initiatives with oversight, support and quality assurance from an Implementation Sub-Committee with cross-agency representation.

Iron is an essential metal in biology, requiring strong cellular regulatory mechanisms. In prokaryotes, the Ferric Uptake Regulation (Fur) pathway helps control Iron-Sulfur (Fe-S) cluster biosynthesis. Fe-S clusters are ubiquitous in nature and they are conserved biological cofactors that are found in almost all life forms. There are however multiple pathways that control iron-sulfur cluster biosynthesis, including the Iron-Sulfur Cluster Assembly Pathway, a pathway found in both prokaryotic and eukaryotic organisms. The ISC multiprotein complex that accomplishes Fe-S cluster assembly consists of six proteins, complexed as a dimer of hexomers that includes the scaffold and frataxin proteins, which are the topic of my work, as well as 4 additional proteins. The scaffold is the protein upon which Fe-S clusters are assembled, and the interaction between the scaffold and frataxin is important for Fe-S cluster assembly and cell (and organism) viability, as illustrated in the human diseases Friedreich’s ataxia and ISCU Myopathy. Here we study the role of the bacterial protein YlaN as it relates to the Fur pathway in S. aureus, and we determined that YlaN acts as an iron-binding protein that relieves Fur-repression of gene expression. We study the C-terminus of the scaffold protein as part of the ISC pathway, and we found that the protein’s C-terminus is required for cluster assembly but not for iron-binding. Finally, we studied the effect of Fe and multiprotein complex formation on the biophysical characteristics of Isu1, followed by studying the same biophysical characteristics at a variety of pH levels. Understanding the dynamic characteristics of YlaN and Isu1 helps advance our understanding of the different iron-sulfur cluster biosynthesis pathways.

Previous research has indicated that mental health professionals working closely with traumatized victims are more likely to experience a harmful stress response and are vulnerable to compassion fatigue. There is a gap in the literature, however, regarding when and how often mental health professionals are vulnerable to compassion fatigue. The purpose of this research was to identify the prevalence and relationships of compassion fatigue as measured by the combined variables of professional burnout and secondary traumatic stress in mental health care professionals. The primary theories used in this study were social cognitive theory and the role of self-efficacy in compassion fatigue. The relationships of compassion fatigue and compassion satisfaction were compared to years of experience, education level, professional licensure, age, gender, job position or title, work setting, stress level, and access to supervision. A total of 362 mental health care professionals were solicited from the professional membership organization database of the American Mental Health Counselors Association. The Professional Quality of Life Scale and a demographic survey were completed online. Descriptive statistics and correlational, chi square, regression, and ANOVA analyses were used, indicating statistically significant findings of a high level of professional burnout and a medium level of secondary traumatic stress as well as a significant high level of compassion satisfaction related to age, stress, and working setting. This study's findings have social change implications for mental health care professionals by recognizing how stress develops in fatigue and burnout, which also effects satisfaction. These findings also have implications for organizations by demonstrating that supervision would add to work setting changes and retention of competent mental health care professionals.

This thesis describes the significance of seabirds to Diomede village Inupiat. Anthropologists have understudied birds in Inupiaq culture despite their recognized importance to Yupiit. A major seabird colony, Little Diomede Island was initially occupied by humans over 2,000 years ago. Thesis research included a pilot survey about the cultural ecology of seabirds. Inupiat consume the flesh and eggs, utilize skins and beaks for apparel and ornamentation, and incorporate seabird themes in rich ceremonial and intellectual life. People gather auklet eggs once and murre eggs up to three times, after which the Inupiat Diomede say the murre will lay a live chick. Individuals harvest seabirds in association with numerous stone walls on Diomede Island that served in the past as bird blinds and fortifications, documented by a reconnaissance archaeological survey. Bird blinds are also reportedly on Greenland, Saint Lawrence Island, and East Cape, Siberia. A communal autumn auklet harvest is described.

Published guidelines adopted in many countries recommend that women whose family history of breast cancer places them at a risk ≥1.7 times that of the age-matched general population, should be considered for inclusion in special surveillance programmes. However validation of risk assessment models has been called for as a matter of urgency. The databases of the four Scottish Familial Breast Cancer clinics and the Scottish Cancer Registry have been searched to identify breast cancers occurring among 1,125 women aged 40–56, with family histories placing them below the “moderate” level of genetic risk. The observed incidence over 6 years was compared with age-specific data for the Scottish population. Our findings confirm that when there are two affected relatives (one first degree) the relative risk (RR) exceeds 1.7 regardless of their ages at diagnosis. When only one (first degree) relative was affected at any age from 40 to 55, the RR does not reach 1.7 if that relative was a mother but exceeds it if the relative was a sister. The probable explanation is that sisters are more likely than mother/daughter pairs to share homozygosity for a risk allele. Surveillance programmes might therefore accommodate sisters of women affected before age 55. Evidence that “low penetrance” alleles contributing to breast cancer risk may be recessive should be taken into account in strategies for identifying them.