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ما المقصود بـ \"رعاية المعلمين ماذا تقول الأبحاث عن أهمية رعاية المعلمين ما هي عناصر التعليم الفعال الواحد والأربعون كيف يستطيع رعاة المعلمين مساعدة المعلمين (صفوف الروضة-12 (في توظيف عناصر التعليم الفعال الواحد والأربعين مستخدمين 280 استراتيجية تعليمية أثبتت الأبحاث نجاحها تقدم المدارس والمناطق التعليمية من خلالها الرعاية للمعلمين ما هي الطرق التي يمكن أن كيف تقدم تغذية راجعة محددة للمعمين تمكنهم من تحسين معرفتهم ومهاراتهم ؟ كتاب لا غنى عنه للرعاة، المشرفين التربويين، القادة التربويين، وفرق المعلمين من أجل دعم النمو المهني لدى المعلمين وتزويدهم باستراتيجيات محددة وأخرى شاملة تستجيب لاحتياجات الطلاب. وصف مفصل لواحد وأربعين عنصرا ومائتين وثمانين استراتيجية للتعليم الفعال ! كنز رائع.

The Phase 3 randomized controlled trial, TBTC Study 31/ACTG A5349 (NCT02410772) demonstrated that a 4-month rifapentine-moxifloxacin regimen for drug-susceptible pulmonary tuberculosis was safe and effective. The primary efficacy outcome was 12-month tuberculosis disease free survival, while the primary safety outcome was the proportion of grade 3 or higher adverse events during the treatment period. We conducted an analysis of demographic, clinical, microbiologic, radiographic, and pharmacokinetic data and identified risk factors for unfavorable outcomes and adverse events. Among participants receiving the rifapentine-moxifloxacin regimen, low rifapentine exposure is the strongest driver of tuberculosis-related unfavorable outcomes (HR 0.65 for every 100 µg∙h/mL increase, 95%CI 0.54–0.77). The only other risk factors identified are markers of higher baseline disease severity, namely Xpert MTB/RIF cycle threshold and extent of disease on baseline chest radiography (Xpert: HR 1.43 for every 3-cycle-threshold decrease, 95%CI 1.07–1.91; extensive disease: HR 2.02, 95%CI 1.07–3.82). From these risk factors, we developed a simple risk stratification to classify disease phenotypes as easier-, moderately-harder, or harder-to-treat TB. Notably, high rifapentine exposures are not associated with any predefined adverse safety outcomes. Our results suggest that the easier-to-treat subgroup may be eligible for further treatment shortening while the harder-to-treat subgroup may need higher doses or longer treatment. Authors perform an analysis of the patient data and risk factors to evaluate unfavorable outcomes and adverse events in adults with pulmonary tuberculosis treated with a 4-month rifapentine based regimen. Low rifapentine exposure was the most clinically significant risk factor for treatment failure and tuberculosis relapse.

People with tuberculosis who complete treatment remain at risk of recurrent disease. The vaccine H56:IC31 has been shown to be safe and immunogenic in phase 1 and 2 studies, but whether it can reduce the risk of tuberculosis recurrence is unknown. In a double-blind, randomised, placebo-controlled, phase 2b trial in South Africa (five clinical trial sites) and Tanzania (one clinical trial site), we enrolled participants aged 18–60 years, without HIV, who had completed more than 5 months (22 weeks) of treatment for drug-susceptible pulmonary tuberculosis. During trial screening (≤7 days after starting treatment), two sputum samples were obtained and frozen for later comparison to recurrent isolates by whole-genome sequencing (WGS). Eligible participants were randomly assigned (1:1; block size of four) to receive two intramuscular doses in the deltoid, 56 days apart, of H56:IC31 or placebo. After the first dose of H56:IC31 or placebo, participants were followed up until study day 421 (1 year after the second dose) and checked at each visit for tuberculosis signs and symptoms. If tuberculosis was suspected, two sputum samples were obtained: one sample was tested by automated molecular test (Xpert MTB/RIF Ultra) and sent for liquid culture; and the other sample was stored frozen for later analysis by whole-genome sequencing (WGS). At the last visit (day 421), two sputum samples were obtained from all sputum-productive participants, regardless of symptoms, to detect cases of asymptomatic tuberculosis. The primary endpoint was culture-confirmed recurrent pulmonary tuberculosis (due to relapse with the same strain, reinfection by a different strain, or indeterminate) occuring during the period starting at day 70 (14 days after the second dose) and ending on day 421 (1 year after the second dose). Vaccine efficacy against recurrent tuberculosis was derived from Cox proportional hazards models. Secondary endpoints included vaccine efficacy to prevent tuberculosis relapse or reinfection independently, as differentiated by WGS, and safety and immunogenicity outcomes (H56-specific CD4 T-cell responses and humoral anti-H56 IgG responses). Primary analysis of vaccine efficacy was based on modified intention-to-treat (mITT), in all randomly assigned participants except those with tuberculosis disease recurrence or who withdrew before day 70 (or 14 days after the second dose for those who received both doses). Safety was assessed in all randomly assigned participants who received at least one dose of vaccine or placebo. The trial was registered with ClinicalTrials.gov, NCT03512249, and is complete. 831 participants (mean age 34·7 years [SD 11·1]; 229 [28%] female and 602 [72%] male; 549 [66%] Black) were enrolled from Jan 31, 2019, to Jan 20, 2022; 415 participants were randomly assigned to receive H56:IC31 and 416 to receive placebo. Follow-up was completed by March 20, 2023 (mean follow-up duration 410·1 days [SD 82·8]). In the primary mITT analysis, recurrent tuberculosis occurred in 23 of 400 participants in the H56:IC31 group (12 relapses, eight reinfections, and three indeterminate); and in 14 of 406 in the placebo group (six relapses, seven reinfections, and one indeterminate). Vaccine efficacy for prevention of recurrence was –73·8% (95% CI –246·9 to 9·8; p=0·10). Vaccine efficacy for prevention of relapse was –116·1% (–522·2 to 16·3; p=0·11) and for prevention of reinfection was –21·1% (–245·3 to 56·5; p=0·71). 2 weeks after the planned second dose, H56:IC31 had significantly increased the frequencies of H56-specific CD4 T cells expressing interferon-γ, tumour necrosis factor, interleukin (IL)-2, or IL-17 in vaccinees (median percentage of CD4 T cells, 0·35% [IQR 0·19 to 0·57]) compared with placebo (0·11% [0·09 to 0·23]; p<0·0001). H56-specific IgG responses were significantly higher in H56:IC31 recipients (median arbitrary units per mL, 6·84 [IQR 1·64 to 32·8]) than in placebo recipients (1·94 [1·05 to 3·86]; p<0·0001). A greater proportion of H56:IC31 recipients had mild-to-moderate injection site reactions than placebo recipients (165 [40%] of 415 vs 78 [19%] of 416). No treatment-related serious adverse events were reported. Two participants who received H56:IC31 and six who received placebo died. Vaccination with H56:IC31 at treatment completion for pulmonary tuberculosis did not reduce the risk of recurrent disease. H56:IC31 was well tolerated and immunogenic but might have increased the risk of relapses by endogenous strains. The European and Developing Countries Clinical Trials Partnership (EDCTP2) supported by the EU (grant number RIA2016V-1631, POR TB consortium). Additional funding to support completion of the trial was provided by the Statens Serum Institut, Aurum Institute, and the South African Tuberculosis Vaccine Initiative.

The current study investigated the prevalence, or lack thereof, of imposter phenomenon in music therapy students. Imposter phenomenon (IP) is an internal experience that describes feelings of fraudulence an individual may encounter, regardless of their achievements. A sample of music therapy students ( n = 7) at a large, Midwestern AMTA-approved university were recruited to participate in one-time focus groups. An interpretive phenomenological analysis was performed on the transcripts, resulting in the development of three recurrent themes of discussion regarding IP: (a) uncertainty in transitions, (b) challenges of the music therapy profession, and (c) awareness and impact of IP constructs and patterns. These findings provide insight into the prevalence of IP in this population, and inform professors, supervisors, and other key stakeholders about the needs may of developing music therapy students. In addition, these findings aid in further solidifying and modifying the guiding theoretical framework of this study.

Abstract Study Objectives Most epidemiological studies assess sleep duration using questionnaires. Interpreting this information requires understanding the extent to which self-reported habitual sleep reflects objectively assessed sleep duration, particularly among African Americans, who disproportionately experience poor sleep health. Methods Among African-American participants of the Jackson Heart Sleep Study, we investigated differences in questionnaire-based self-assessed average sleep duration and self-assessed wake-bed time differences compared to actigraphy-based assessments of total sleep time (TST) and average time in bed (TIB). Linear regression models provided estimates of concordance between actigraphy-based and self-reported sleep duration. Results Among 821 adults, self-assessed average sleep duration was lower than self-assessed wake-bed time differences (6.4 ± 1.4 vs. 7.5 ± 1.7 h, p < 0.0001). Mean actigraphy-based TST was 6.6 ± 1.2 h, and actigraphy-based average TIB was 7.6 ± 1.2 h. Self-assessed average sleep duration and actigraphy-based TST were moderately correlated (r = 0.28, p < 0.0001). Self-assessed average sleep duration underestimated actigraphy-based TST by −30.7 min (95% confidence intervals [CI]: −36.5 to −24.9). In contrast, self-assessed wake-bed time differences overestimated actigraphy-based TST by 45.1 min (95% CI: 38.6–51.5). In subgroup analyses, self-assessed average sleep duration underestimated actigraphy-based measures most strongly among participants with insomnia symptoms. Conclusions Among African Americans, self-assessed average sleep duration underestimated objectively measured sleep while self-assessed wake-bed time differences overestimated objectively measured sleep. Sleep measurement property differences should be considered when investigating disparities in sleep and evaluating their associations with health outcomes.

Background: High adherence and engagement are critical components of successful lifestyle interventions for health outcomes. Gaps persist in understanding the multifaceted factors influencing older participants’ ability to adhere and engage with health behavior interventions. Methods: Using data from two pilot randomized clinical trials evaluating a nutrition program in older adults at increased risk for dementia, we evaluated participant-level factors influencing adherence and engagement with the recommended diet and program. Additional qualitative themes were used to provide context. Both trials are registered on ClinicalTrials.gov (Pilot A: NCT0417176 on 23 March 2021 and Pilot B: NCT06121986 on 30 October 2023). Results: Better income, cognitive functioning, emotion regulation, quality of life, and independence in activities of daily living were associated with better dietary adherence, while being non-White, living in a rural area, having higher depressive symptoms, worse health symptoms, and worse sleep quality were negatively associated with adherence. Higher education, cognitive function, anxiety, and previous weight challenges were associated with better program engagement. Conclusions: Adherence and engagement were impacted by a combination of individual factors, including cognition, mood, physical health, as well as the broader socioeconomic context. Our findings highlight the ways psychological and social determinants of health may impact adherence to lifestyle interventions.