Search results for: Jill Pell

Authors: Khawlah Al-Khalidi

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Prevalence of lower third molar impactions and angulations among Yemeni population The purpose of this study was to look into the prevalence of lower third molars in a sample of patients from Ibb University Affiliated Hospital, as well as to study and categorise their position by using Pell and Gregory classification, and to look into a possible correlation between their position and the indication for extraction. Materials and methods: This is a retrospective, observational study in which a sample of 200 patients from Ibb University Affiliated Hospital were studied, including patient record validation and orthopantomography performed in screening appointments in people aged 16 to 21. Results and discussion: Males make up 63% of the sample, while people aged 19 to 20 make up 41.2%. Lower third molars were found in 365 of the 365 instances examined, accounting for 91% of the sample under study. According to Pell and Gregory's categorisation, the most common position is IIB, with 37%, followed by IIA with 21%; less common classes are IIIA, IC, and IIIC, with 1%, 3%, and 3%, respectively. It was feasible to determine that 56% of the lower third molars in the sample were recommended for extraction during the screening consultation. Finally, there are differences in third molar location and angulation. There was, however, a link between the available space for third molar eruption and the need for tooth extraction.

Keywords: lower third molar, extraction, Pell and Gregory classification, lower third molar impaction

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Authors: Carolyn Whyte, Tina Halai, Sonita Koshal

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Aim: There are many methods available to assess the potential difficulty of third molar surgery. This study investigated various factors to assess whether they had a bearing on the difficulties encountered. Study design: A retrospective study was completed of 62 single mandibular third molar teeth removed under day case general anaesthesia between May 2016 and August 2016 by 3 consultant oral surgeons. Method: Data collection was by examining the OPG radiographs of each tooth and recording the necessary data. This was depth of impaction, angulation, bony impaction, point of application in relation to second molar, root morphology, Pell and Gregory classification and Winters Lines. This was completed by one assessor and verified by another. Information on medical history, anxiety, ethnicity and age were recorded. Case notes and surgical entries were examined for any difficulties encountered. Results: There were 5 cases which encountered surgical difficulties which included fracture of root apices (3) which were left in situ, prolonged bleeding (1) and post-operative numbness >6 months(1). Four of the 5 cases had Pell and Gregory classification as (B) where the occlusal plane of the impacted tooth is between the occlusal plane and the cervical line of the adjacent tooth. 80% of cases had the point of application as either coronal or apical one third (1/3) in relation to the second molar. However, there was variability in all other aspects of assessment in predicting difficulty of removal. Conclusions: Of the cases which encountered difficulties they all had at least one predictor of potential complexity but these varied case by case.

Keywords: impaction, mandibular third molar, radiographic assessment, surgical removal

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Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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Authors: Albena Ivanova, Jill Kurp, Austin Hampe

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Cereal products in the US contain rich information on the front of the package (FOP) as well as point-of-purchase (POP) summaries provided by the store. These summaries frequently are confusing and misleading to the consumer. This study explores the relationship between perceived quality, objective quality, price, and value in the cold cereal industry. A total of 270 cold cereal products were analyzed and the price, quality and value for different summaries were compared using ANOVA tests. The results provide evidence that the United States Department of Agriculture Organic FOP/POP are related to higher objective quality, higher price, but not to a higher value. Whole grain FOP/POP related to a higher objective quality, lower or similar price, and higher value. Heart-healthy POP related to higher objective quality, similar price, and higher value. Gluten-free FOP/POP related to lower objective quality, higher price, and lower value. Kid's cereals were of lower objective quality, same price, and lower value compared to family and adult markets. The findings point to a disturbing tendency of companies to continue to produce lower quality products for the kids’ market, pricing them the same as high-quality products. The paper outlines strategies that marketers and policymakers can utilize to contribute to the increased objective quality and value of breakfast cereal products in the United States.

Keywords: cereals, certifications, front-of-package claims, consumer health.

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Authors: Bethany Leake, Samantha Caton, Paul Norman, Jill Edmondson

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With the majority of the UK population residing in urban areas and with the pressures both environmentally and socially on rural agriculture, the role of urban food production, particularly urban horticulture (UH), is increasingly important in the future of UK food security. UH has the potential to provide an important contribution to urban diets and to provide additional benefits to human health and well-being. While allotments are the traditional focus of UH and play an important role, as access to this type of land is limited and unequal across cities, other forms of UH space, such as domestic growing, will need to be utilized to provide a significant contribution to urban diets. It is theorized that this smaller scale of growing may also be a more accessible way of engaging novice growers in UH. A collaborative research project, Urban Harvest, was designed between the University of Sheffield and Sheffield-based food organizations, which aimed to engage inexperienced gardeners in UH by providing them with home food-growing kits (Grow-Kits). Grow-Kits were provided to 189 participants across Sheffield in 2022, 48% of whom had never grown food before. Data collected through surveys and interviews will help us to evaluate the effect of small-scale food growing on health and wellbeing and the potential of this type of scheme to encourage future UH engagement. This data and increasing evidence on the co-benefits of UH have important implications not only for local food security but also for urban health inequalities and the potential use of this activity for preventative healthcare.

Keywords: urban horticulture, health and wellbeing, food security, nutrition

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Authors: Harry Mccallum

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In the last decade, there has been an upsurge in documentary theatre projects that seek to address issues arising from ‘the Troubles’ by theatre and community organisations such as The Playhouse, Kabosh, and The Verbal Arts Centre. This movement has been supported by a variety of funding agencies who have identified the importance of the instrumental use of theatre for generating societal development. However, with this upsurge in interest comes complications surrounding the subjectivity of evaluations and an understanding of their empirical impact on society. This largely theoretical led-discussion promotes the engagement of Jill Dolan’s ‘utopian performatives’ (2005) within the remit of documentary theatre for peacebuilding practices in Northern Ireland.‘Utopian Performatives’ are described as being profound moments in a theatre production that transforms audience members into a state of ‘hopeful feeling’.As a concept, they are situated within the discourse surrounding audience reception and the ‘affective turn’ (Brennan, 2004; Clough and Halley, 2007; Ahmed, 2014), which indicates its persistence on a short-term ephemeral outlook. It is therefore important to understand how this short-term ‘affect’ can expand into a longer-term ‘effect.’ Through this interdisciplinary study between ‘peace’ and ‘theatre’ studies, I am proposinga theoretical framework that examines how these individual ‘utopian performatives’ at the personal level can lead to a change at the societal level. The framework understands that ‘utopian performatives’ have the capacity to generate discussion and empower audience members to actively strive for a ‘positive peace’; something which is evidently absent in a contemporary Northern Ireland.

Keywords: theatre, peacebuilding, conflict transformation, northern Ireland

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Authors: Mukunda Upreti, Jill Storry, Rafael Björk, Emilie Louvet, Johan Normark, Sven Bergström

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Borrelia duttonii and most other relapsing fever species are Gram-negative bacteria which cause a blood borne infection characterized by the binding of bacterium to erythrocytes. The bacteria associate with two or more erythrocytes to form clusters of cells into rosettes. Rosetting is a major virulence factor and the mechanism is believed to facilitate persistence of bacteria in the circulatory system and the avoidance of host immune cells through masking or steric hindrance effects. However, the molecular mechanisms of rosette formation are still poorly understood. This study aims at determining the molecules involved in the rosette formation phenomenon. Fractionated serum, using different affinity purification methods, was investigated as a rosetting agent and IgG and at least one other serum components were needed for rosettes to form. An IgG titration curve demonstrated that IgG alone is not enough to restore rosette formation level to the level whole serum gives. IgG hydrolysis by IdeS ( Immunoglobulin G-degrading enzyme of Streptococcus pyogenes) and deglycosylation using N-Glycanase proved that the whole IgG molecule regardless of saccharide moieties is critical for Borrelia induced rosetting. Complement components C3 and C4 were also important serum molecules necessary to maintain optimum rosetting rates. The deactivation of complement network and serum depletion with C3 and C4 significantly reduced the rosette formation rate. The dependency of IgG and complement components also implied involvement of the complement receptor (CR1). Rosette formation test with Knops null RBC and sCR1 confirmed that CR1 is also part of Borrelia induced rosette formation.

Keywords: complement components C3 and C4, complement receptor 1, Immunoglobulin G, Knops null, Rosetting

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Authors: Jill Garner, Belinda Lange, Sheila Lennon, Maayken van den Berg

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Currently, there are approximately one billion people worldwide affected by a neurological condition. Many of whom are assessed and treated by a physiotherapist in a variety of settings. There is a lack of consensus in the literature related to what is clinically assessed by physiotherapists in people with neurological conditions. This study aimed to explore assessment in people with neurological conditions, including how health care setting, experience, and therapeutic approach, may influence neurological assessment. A national survey targeted Australian physiotherapists who assess adults with neurological conditions as part of their clinical practice. The survey consisted of 39 questions and was distributed to physiotherapists through the Australian Physiotherapy Association, and Chief Allied Health Officers across Australia and advertised on the National Neurological Physiotherapy Facebook page. In total, 395 respondents consented to the survey from all states within Australia. Most respondents were female (85.4%) with a mean (SD) age of 35.7 years. Respondents reported working clinically in acute, community, outpatients, and community settings. Stroke was the most assessed condition (58.0%). There is variability in domains assessed by Australian physiotherapists, with common inclusions of balance, muscle strength, gait, falls and safety, function, goal setting, range of movement, pain, coordination, activity tolerance, postural alignment and symmetry and upper limb. There is little evidence to support what physiotherapists assess in practice, in different settings, and in different states within Australia and not enough information to develop a decision tree regarding what is important for assessment in different settings. Further research is needed to explore this area and develop a consensus around best practices.

Keywords: physiotherapy, neurological, assessment, domains

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Authors: Melanie Tang

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According to Nietzsche, the eternal recurrence is his most important idea. However, it is perhaps his most cryptic and difficult to interpret. Early readings considered it as a cosmological hypothesis about the cyclic nature of time. However, following Nehamas’s ‘Life as Literature’ (1985), it has become a widespread interpretation that the eternal recurrence never really had any theoretical dimensions, and is not actually a philosophy of time, but a practical thought experiment intended to measure the extent to which we have mastered and perfected our lives. This paper endeavours to challenge this line of thought becoming scholarly consensus, and to carry out a more complex analysis of the eternal recurrence as it is presented in Thus Spoke Zarathustra. In its wider scope, this research proposes that Thus Spoke Zarathustra — as opposed to The Birth of Tragedy — be taken as the primary source for a study of Nietzsche’s Aesthetics, due to its more intrinsic aesthetic qualities and expressive devices. The eternal recurrence is the central philosophy of a work that communicates its ideas in unprecedentedly experimental and aesthetic terms, and a more in-depth understanding of why Nietzsche chooses to present his conception of time in aesthetic terms is warranted. Through hermeneutical analysis of Thus Spoke Zarathustra and engagement with secondary sources such as those by Nehamas, Karl Löwith, and Jill Marsden, the present analysis challenges the ethics of self-perfection upon which current interpretations of the recurrence are based, as well as their reliance upon a linear conception of time. Instead, it finds the recurrence to be a cyclic interplay between the self and the world, rather than a metric pertaining solely to the self. In this interpretation, time is found to be composed of an intertemporal rather than linear multitude of will to power, which structures itself through tensional cycles into an experience of circular time that can be seen to have aesthetic dimensions. In putting forth this understanding of the eternal recurrence, this research hopes to reopen debate on this key concept in the field of Nietzsche studies.

Keywords: Nietzsche, eternal recurrence, Zarathustra, aesthetics, time

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Authors: Joyly Jill Apud

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Corruption is an all-encompassing issue worldwide. Many attempts have been done to address such cases especially by the government through increasing transparency. The Philippine government increased the mechanism of transparency by opening to public its financial transactions through Full Disclosure Policy – mandating all local governments to post in their websites all financial transactions (Philippine Public Transparency Reporting Project, 2011). For transparency to be fully realized, the challenge lies in creating a mechanism where the constituents are encouraged to engage as social auditors. In line of the said challenge, the study focused in Davao City, Philippines measuring the respondent’s awareness, access and utilization of Full Disclosure Policy (FDP). Particularly, this study determined the significant difference on the awareness, access and utilization of respondents when grouped according to sector and the significant relationship between respondents’ awareness and in the access and utilization of FDP reports. The study used descriptive-correlation, Mean, Anova and Pearson R as statistical treatment. The 120 respondents are from the different sectors of Davao City. These are the Academe, Youth, LGUs, NGOs, Business, and Church groups. The awareness of the respondents was measured in three main categories: Existence of the Policy, Content of the Policy and the Manner of Publication. Access and Utilization of the FDP reports is divided into three: Budget Reports, Procurement Reports and Special Purpose Fund Reports. Results showed that the respondents are moderately aware of the Policy. Though it manifested that the respondents are aware of the disclosure, they are unaware of the Full Disclosure Policy and Full Disclosure Policy Portal. Moreover, the respondents seldom access and utilize all the FDP reports. Further results revealed that there is a significant difference in the awareness and the access and utilization of FDP when grouped according to sector. Moreover, significant relationship in the awareness and the access and utilization of the FDP is evident. It showed that the higher the awareness on FDP, the higher the level of access and utilization on the FDP reports.

Keywords: corruption, e-governance, budget transparency, participation

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Authors: Jill Villarreal, Kristalyn Cooksey, Kai Lloyd, Daniel Ha

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Little research has been conducted to examine college students' reading attitudes, including students' perceptions of reading behaviors and reading abilities. This is problematic, as reading assigned course material is a critical component to an undergraduate student's academic success. For this study, flyers were electronically disseminated to instructors at 24 public and 10 private U.S. institutions in “Reading-Intensive Departments” including Psychology, Sociology, Education, Business, and Communications. We requested the online survey be completed as an in-class activity during the fall 2019 and spring 2020 semesters. All participants voluntarily completed the questionnaire anonymously. Of the participants, 280 self-identified their race as Black and 280 self-identified their race as White. Of the participants, 177 self-identified their gender as Male and 383 self-identified their Gender as Female. Participants ranged in age from 18-24. Factor analysis found four dimensions resulting from the questions regarding reading. The first we interpret as “Reading Proficiency”, accounted for 19% of the variability. The second dimension was “Reading Anxiety” (15%), the third was “Textbook Reading Ability” (9%), and the fourth was “Reading Enjoyment” (8%). Linear models on each of these dimensions revealed no effect of Age, Gender, Race, or Income on “Reading proficiency”. The linear model of “Reading Anxiety” showed a significant effect of race (p = 0.02), with higher anxiety in white students, as well as higher reading anxiety in female students (p < 0.001). The model of “Textbook Reading Ability” found a significant effect of race (p < 0.001), with higher textbook problems in white students. The model of “Reading Enjoyment” showed significant effects of race (p = 0.013) with more enjoyment for white students, gender (p = 0.001) with higher enjoyment for female students, and age (p = 0.033) with older students showing higher enjoyment. These findings suggest that gender, age, and race are important factors in many aspects of college students' reading attitudes. Further research will investigate possible causes for these differences. In addition, the effectiveness of college-level programs to reduce reading anxiety, promote the reading of textbooks, and foster a love of reading will be assessed.

Keywords: age, college, gender, race, reading

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Authors: Jill Steel

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Introduction: Animal-assisted learning (AAL) interventions are increasing exponentially, yet a paucity of quality research in the field exists. The aim of this study was to evaluate how the promotion of emotional wellbeing, through AAL, in this case, a dog, may support children’s engagement with reading in a Primary 1 classroom. Research indicates that dogs can provide emotional support to children; by forming a trusting attachment with a non-critical ‘friend’ who confers unconditional positive regard on the child, confidence may be boosted and anxiety reduced. By promoting emotional wellbeing through interactions with the dog, it is hoped that children begin to associate reading with feelings of wellbeing, which then results in increased engagement with reading. Methodology: A review of the literature was conducted. The relationship between emotional wellbeing and learning was explored, followed by an examination of the literature relating to Animal-Assisted Therapy and AAL. Scottish educational policy and legislation were analysed to establish the extent to which AAL might be suitable for the Scottish pedagogical context. An empirical study was conducted in a mainstream Primary 1 classroom over a four-week period. An inclusive approach was adopted whereby all children that wanted to interact with the dog were given the opportunity to do so, and all 25 children subsequently chose to participate. Children were not withdrawn from the classroom. Primary methods included interviews, observations, and questionnaires. Three focus children were selected for closer study. Main Results: Results were remarkably close to previous research and literature. Children’s emotional wellbeing was boosted, and engagement in reading improved. Principal Conclusions and Implications for Field: It was concluded that AAL could support emotional wellbeing and, in turn, promote children’s engagement with reading. The main limitation of the study was its short-term nature, and a longer randomised controlled trial with a larger sample, currently being undertaken by the author, would provide a fuller answer to the research question. Barriers to AAL include health and safety concerns and steps to ensure the welfare of the dog.

Keywords: animal-assisted learning, emotional wellbeing, reading, reading to dogs

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Preetham Shankapal, Jill King, Kori Murray, Corby Martin, Paula Giselman, Jason Hicks, Owen Carmicheal

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Activation of reward and satiety networks in the brain while processing palatable food cues, as well as functional connectivity during rest has been studied using functional Magnetic Resonance Imaging of the brain in various obesity phenotypes. However, functional connectivity within the reward and satiety network during food cue processing is understudied. 14 obese individuals underwent two fMRI scans during viewing of Macronutrient Picture System images. Each scan included two blocks of images of High Sugar/High Fat (HSHF), High Carbohydrate/High Fat (HCHF), Low Sugar/Low Fat (LSLF) and also non-food images. Seed voxels within seven food reward relevant ROIs: Insula, putamen and cingulate, precentral, parahippocampal, medial frontal and superior temporal gyri were isolated based on a prior meta-analysis. Beta series correlation for task-related functional connectivity between these seed voxels and the rest of the brain was computed. Voxel-level differences in functional connectivity were calculated between: first and the second scan; individuals who saw novel (N=7) vs. Repeated (N=7) images in the second scan; and between the HC/HF, HSHF blocks vs LSLF and non-food blocks. Computations and analysis showed that during food image viewing, reward network ROIs showed significant functional connectivity with each other and with other regions responsible for attentional and motor control, including inferior parietal lobe and precentral gyrus. These functional connectivity values were heightened among individuals who viewed novel HS/HF images in the second scan. In the second scan session, functional connectivity was reduced within the reward network but increased within attention, memory and recognition regions, suggesting habituation to reward properties and increased recollection of previously viewed images. In conclusion it can be inferred that Functional Connectivity within reward network and between reward and other brain regions, varies by important experimental conditions during food photography viewing, including habituation to shown foods.

Keywords: fMRI, functional connectivity, task-based, beta series correlation

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Authors: Jill Steel

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The interlinked issues of emotional wellbeing and attainment continue to dominate international educational discourse. Reading skills are particularly important to attainment in all areas of the curriculum, and illiteracy is associated with reduced wellbeing and life prospects, with serious ramifications for the wider economy and society. Research shows that reading attainment is influenced by reading motivation and frequency. Reading to Dogs (RTD) is increasingly applied to promote reading motivation and frequency in schools despite a paucity of empirical evidence, specifically examining the influence of RTD on emotional wellbeing and engagement with reading. This research aims to examine whether RTD is effective in promoting these positive outcomes among children aged eight to nine years. This study also aims to inform much needed regulation of the field and standards of practice, including both child and dog welfare. Therefore, ethical matters such as children’s inclusion and safety, as well as the rights and wellbeing of dogs infuse the study throughout. The methodological design is a mixed method longitudinal study. A UK wide questionnaire will be distributed to teachers between January and June 2020 to understand their perceptions of RTD. Following this, a randomised controlled trial (N = 100) will begin in August 2020 in two schools of a comparable demographic, with N= 50 in the intervention school, and N= 50 in a waiting list control school. Reading and wellbeing assessments will be conducted prior to and immediately post RTD, and four weeks after RTD to measure sustained changes. The reading assessments include New Group Reading Test, Motivation to Read Profile (Gambrell et al., 1995), as well as reading frequency and reading anxiety assessments specifically designed for the study. Wellbeing assessments include Goodman’s SDQ, (1997) and pupil self-reporting questionnaires specifically designed for the study. Child, class teacher, and parent questionnaires and interviews prior to, during and post RTD will be conducted to measure perceptions of the impact of RTD on mood and motivation towards reading. This study will make a substantial contribution to our understanding of the effectiveness of RTD and thus have consequences for the fields of education and anthrozoology.

Keywords: animal assisted intervention, reading to dogs, welfare, wellbeing

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Authors: Samantha A. Cintron, Janet Pierce, Mihaela E. Sardiu, Diane Mahoney, Jill Peltzer, Bhanu Gupta, Qiuhua Shen

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High output heart failure (HOHF) is characterized a high output state resulting from an underlying disease process and is commonly caused by obesity. As obesity levels increase, more individuals will be at risk for obesity-related HOHF. However, the underlying pathophysiologic mechanisms of obesity-related HOHF are not well understood and need further research. The aim of the study was to describe the differences in leukocyte transcriptomes of morbidly obese patients with HOHF and those with non-HOHF. In this cross-sectional study, the study team collected blood samples, demographics, and clinical data of six patients with morbid obesity and HOHF and six patients with morbid obesity and non-HOHF. The study team isolated the peripheral blood leukocyte RNA and applied stranded total RNA sequencing. Differential gene expression was calculated, and Ingenuity Pathway Analysis software was used to interpret the canonical pathways, functional changes, upstream regulators, and mechanistic and causal networks that were associated with the significantly different leukocyte transcriptomes. The study team identified 116 differentially expressed genes; 114 were upregulated, and 2 were downregulated in the HOHF group (Benjamini-Hochberg adjusted p-value ≤ 0.05 and log2(fold-change) of ±1). The differentially expressed genes were involved with cell proliferation, mitochondrial function, erythropoiesis, erythrocyte stability, and apoptosis. The top upregulated canonical pathways associated with differentially expressed genes were autophagy, adenosine monophosphate-activated protein kinase signaling, and senescence pathways. Upstream regulator GATA Binding Protein 1 (GATA1) and a network associated with nuclear factor kappa-light chain-enhancer of activated B cells (NF-kB) were also identified based on the different leukocyte transcriptomes of morbidly obese patients with HOHF and non-HOHF. To the author’s best knowledge, this is the first study that reported the differential gene expression in patients with obesity-related HOHF and demonstrated the unique pathophysiologic mechanisms underlying the disease. Further research is needed to determine the role of cellular function and maintenance, inflammation, and iron homeostasis in obesity-related HOHF.

Keywords: cardiac output, heart failure, obesity, transcriptomics

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Authors: Louise Bunce, Jill Childs, Adam J. Lonsdale, Naomi King

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A major concern for the Social Work profession concerns the frequency of burn-out and high turnover of staff. The characteristic of resilience has been identified as playing a crucial role in social workers’ ability to have a satisfying and successful career. Thus a critical role for social work education is to develop resilience in social work students. We currently need to know more about how to train resilient social workers who will also increase the academic standing of the profession. The specific aim of this research was to quantify characteristics that may contribute towards resilience and academic success among student social workers in order to mitigate against the problems of burn-out and low academic standing. These three characteristics were competence (effectiveness at mastering the environment), autonomy (sense of control and free will), and relatedness (interacting and connecting with others), as specified in Self-Determination Theory (SDT). When these three needs are satisfied, we experience higher degrees of motivation to succeed and wellbeing. Thus when these three needs are met in social work students, they have the potential to raise academic standards and promote wellbeing characteristics that contribute to the development of resilience. The current study tested the hypothesis that higher levels of autonomy, competence, and relatedness, as defined by SDT, will predict levels of academic success and resilience in social work students. Two hundred and ten social work students studying at a number of universities completed well-established questionnaires to assess autonomy, competence, and relatedness, level of academic performance and resilience (The Brief Resilience Scale). In this scale, students rated their agreement with items e.g., ‘I bounce back quickly after hard times’ and ‘I usually come through difficult times with little struggle’. After controlling for various factors, including age, gender, ethnicity, and course (undergraduate or postgraduate) preliminary analysis revealed that the components of SDT provided useful predictive value for academic success and resilience. In particular, autonomy and competence provided a useful predictor of academic success while relatedness was a particularly useful predictor of resilience. This study demonstrated that SDT provides a valuable framework for helping to understand what predicts academic success and resilience among social work students. This is relevant because the psychological needs for autonomy, competence and relatedness can be affected by external social and cultural pressures, thus they can be improved by the right type of supportive teaching practices and educational environments. These findings contribute to the growing evidence-base to help build an academic and resilient social worker student body and workforce.

Keywords: education, resilience, self-determination theory, student social workers

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Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

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Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

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Authors: Jill Stephenson, Marie Vaganay, Robert Cameron, Caoimhe McGurk, Neil Hewitt

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Purpose: The key aim of the research was to identify the secondary stressors experienced by businesses affected by single or repeated flooding and to determine to what extent businesses were affected by these stressors, along with any resulting impact on health. Additionally, the research aimed to establish the likelihood of businesses being re-exposed to the secondary stressors through assessing awareness of flood risk, implementation of property protection measures and level of community resilience. Design/methodology/approach: The chosen research method involved the distribution of a questionnaire survey to businesses affected by either single or repeated flood events. The questionnaire included the Impact of Event Scale (a 15-item self-report measure which assesses subjective distress caused by traumatic events). Findings: 55 completed questionnaires were returned by flood impacted businesses. 89% of the businesses had sustained internal flooding while 11% had experienced external flooding. The results established that the key secondary stressors experienced by businesses, in order of priority, were: flood damage, fear of reoccurring flooding, prevention of access to the premise/closure, loss of income, repair works, length of closure and insurance issues. There was a lack of preparedness for potential future floods and consequent vulnerability to the emergence of secondary stressors among flood affected businesses, as flood resistance or flood resilience measures had only been implemented by 11% and 13% respectively. In relation to the psychological repercussions, the Impact of Event scores suggested that potential prevalence of post-traumatic stress disorder (PTSD) was noted among 8 out of 55 respondents (l5%). Originality/value: The results improve understanding of the enduring repercussions of flood events on businesses, indicating that not only residents may be susceptible to the detrimental health impacts of flood events and single flood events may be just as likely as reoccurring flooding to contribute to ongoing stress. Lack of financial resources is a possible explanation for the lack of implementation of property protection measures among businesses, despite 49% experiencing flooding on multiple occasions. Therefore it is recommended that policymakers should consider potential sources of financial support or grants towards flood defences for flood impacted businesses. Any form of assistance should be made available to businesses at the earliest opportunity as there was no significant association between the time of the last flood event and the likelihood of experiencing PTSD symptoms.

Keywords: flood event, flood resilience, flood resistance, PTSD, secondary stressors

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Authors: Jill Round

Abstract:

In the economic system, the financial sector plays a crucial role as an intermediary between market participants, other financial institutions, and customers. Financial institutions such as banks have to make decisions to satisfy the demands of all the participants by keeping abreast of regulatory change. In recent years, progress has been made regarding frameworks, development of rules, standards, and processes to manage risks in the banking sector. The increasing focus of regulators and policymakers placed on risk management, corporate governance, and the organization’s culture is of special interest as it requires a well-resourced risk controlling function, compliance function, and internal audit function. In the past years, the relevance of these functions that make up the so-called Three Lines of Defense has moved from the backroom to the boardroom. The approach of the model can vary based on the various organizational characteristics. Due to the intense regulatory requirements, organizations operating in the financial sector have more mature models. In less regulated industries there is more cloudiness about what tasks are allocated where. All parties strive to achieve their objectives through the effective management of risks and serve the identical stakeholders. Today, the Three Lines of Defense model is used throughout the world. The research looks at trends and emerging issues in the professions of the Three Lines of Defense within the banking sector. The answers are believed to helping to explain the increasing regulatory requirements for the banking sector. While the number of supervisory practices increases the risk management requirements intensify and demand more regulatory compliance at the same time. The Structural Equation Modeling (SEM) is applied by making use of conducted surveys in the research field. It aims to describe (i) the theoretical model regarding the applicable linearity relationships, (ii) the causal relationship between multiple predictors (exogenous) and multiple dependent variables (endogenous), (iii) taking into consideration the unobservable variables and (iv) the measurement errors. The surveys conducted on the research field suggest that the observable variables are caused by various latent variables. The SEM consists of the 1) measurement model and the 2) structural model. There is a detectable correlation regarding the cause-effect relationship among the performed supervisory practices and the increasing scope of regulation. Supervisory practices reinforce the regulatory density. In the past, controls were placed after supervisory practices were conducted or incidents occurred. In further research, it is of interest to examine, whether risk management is proactive, reactive to incidents and supervisory practices or can be both at the same time.

Keywords: risk management, structural equation model, supervisory practice, three lines of defense

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Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

Abstract:

Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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Authors: Jonathan Sahu, Jill Aylott

Abstract:

Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

Abstract:

Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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