Search results for: Melanie Moen

Authors: Melanie Moen, Christiaan Bezuidenhout

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Cases of parents murdering their offspring are incomprehensible but sadly as old as humanity itself. The act of killing your own child is known as filicide. Revenge filicide is an act where one parent kills their own offspring for retribution for hurting and upsetting the other parent. The true extent of filicide in South Africa is unknown, but in the United States, filicide constitutes more or less 2.5% of all murders. The focus of this contribution is to extend the knowledge of revenge filicide. Data was collected through court documents and newspaper articles. Newspapers that cover murder cases are between 75% to 100% accurate compared to official sources. Often family-related murders are violent in nature, and for this reason, these crimes receive extensive media coverage. The cases of twenty revenge filicide murderers (14 male and 6 female) were qualitatively analyzed to determine the motivations and offense characteristics of revenge filicide offenders. Findings related to a loss of social identity due to rejection; extreme rage-type anger; external locus of control; sadism; a desire to cause pain, and a need to inflict harm. The initial emotional response may escalate from mild anger to a level of narcissistic rage which eventually culminates in the murdering of the child to punish and hurt the other parent and to restore control. To our knowledge, our study is the first to systematically examine the motivations related to revenge filicides from a South African perspective. Filicide is a complex phenomenon with diverse possibilities and reasons why it occurs. However, it was apparent in this study that the motivations for revenge filicides were often linked to complex personal and interpersonal relationship problems. Further research within this field is imperative.

Keywords: revenge filicide, child murder, rage, anger, narcissistic rage, parent kills child

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Authors: Melanie Verhovnik

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Media shape the image of crime, peoples’ believes, attitudes and sometimes also behaviors. Media not only gives the impression that crime is increasing, it also suggest that very violent crime is more common than it actually is. It is also no wonder that humans are more afraid of being involved in a crime committed by strangers than committed by somebody they know – because this is the media construct. With the help of three case studies, the paper analyzes how media frames crime and criminals and gives valuable hints as to what better reporting could look like.

Keywords: court reporting, offenders in media, quantitative content analysis, victims in media

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Authors: Christy M. Moen, Richard B. Townsley

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Introduction: Metastasis to the frontal bone in thyroid cancer is extremely rare. A literature review found only six cases of thyroid cancer that metastasised to the frontal bone, with two of those involving further bone sites. Case Report: The patient was originally referred to the Oral and Maxillofacial Surgery team with an isolated mass on her forehead. Biopsies were performed, which showed this was likely a metastatic deposit from thyroid cancer. CT-PET scan showed this was an isolated lesion. The patient had a total thyroidectomy, and the forehead lesion was managed with radiotherapy. On interval scanning, the patient’s bony lesion had increased in size and had new lung nodules, which likely represented further metastasis. Conclusion: Isolated bony metastases to the frontal bone are rare. An important clinical principle to remember is that a bony metastasis from an unknown primary is more likely than primary bone cancer.

Keywords: cancer, thyroid, head and neck, surgery

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Authors: Melanie Verhovnik

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School shootings are a well-known phenomenon in Germany, 14 of which have occurred to date. The first case happened half a year after the April 20th, 1999 Columbine shooting in the United States, which was at the time the most serious school shooting to have occurred anywhere in the world. The German media gave only scant attention to the subject of school shootings prior to Columbine, even though there were numerous instances of it throughout the world and several serious instances in the United States during the 1990s. A mixed method design of qualitative and quantitative content analysis was employed in order to demonstrate the main features and characteristics of core German media’s coverage of Columbine.

Keywords: Columbine, media coverage, qualitative, quantitative content analysis, school shooting

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Authors: Todd G. Morrison, C. J. Bishop, Melanie A. Morrison

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An upsurge of hatred directed at sexual- and gender-marginalized persons (SGMPs) has been documented in numerous Western nations. The denial of gender-affirmative care for trans youth; the banning of books containing queer content (no matter how innocuous); the boycotting of products affiliated with queer influencers and with pride celebrations; and the silencing of sexual- and gender-marginalized teachers and academics (and their allies) constitute key ways in which this hatred now manifests itself. The health consequences for SGMPs living in environments characterized by hatred of queer people include elevated rates of depression, anxiety, suicidality, and substance misuse. Given these sequelae, in this paper, the authors outline the challenges that academics experience when adopting an advocacy role. The authors also provide an overview of specific strategies that SGMPs may find helpful when engaging with persons committed to harming queer people.

Keywords: queer people, resistance, minority rights, hate speech

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Authors: Amare Nigatu, Mågne Bratveit, Bente E. Moen

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Background: Pesticide exposure is an important public health concern in Ethiopia, but there is limited information on pesticide intoxications. Residents may have an increased risk of pesticide exposure through proximity of their homes to farms using pesticides. Also the pesticide exposure might be related to employment at these farms. This study investigated the prevalence of acute pesticide intoxications (API) by residence proximity to a nearby flower farm and assessed if intoxications are related to working there or not. Methods: A cross-sectional survey involving 516 persons was conducted. Participants were grouped according to their residence proximity from a large flower farm; living within 5 kilometers and 5-12 kilometers away, respectively. In a structured interview, participants were asked if they had health symptoms within 48 hours of pesticide exposure in the past year. Those, who had experienced this and reported two or more typical pesticide intoxication symptoms, were considered as having had API. Chi-square and independent t-tests were used to compare categorical and continuous variables, respectively. Confounding variables were adjusted by using binomial regression model. Results: The prevalence of API in the past year among the residents in the study area was 26%, and it was higher in the population living close to the flower farm (42%) compared to those living far away (11%), prevalence ratio (PR) = 3.2, 95% CI: 2.2-4.8, adjusted for age, gender & education. A subgroup living close to the farm & working there had significantly more API (56%) than those living close & did not work there (16%), adjusted PR = 3.0, 95% CI: 1.8-4.9. Flower farm workers reported more API (56%) than those not working there (13%,), adjusted PR = 4.0, 95% CI: 2.9-5.6. Conclusion: The residents living closer than 5 kilometers to the flower farm reported significantly higher prevalence of API than those living 5-12 kilometers away. This increased risk of API was associated with work at the flower farm.

Keywords: acute pesticide intoxications, self-reported symptoms, flower farm workers, living proximity

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Authors: Fabienne Baraud, Lydia Leleyter, Sandra Poree, Melanie Lemoine, Fatiha Oudghiri

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Alternative solutions to immersion at sea are searched for the huge amounts of dredged sediments around the world that might contain various types of contaminants. Possible re-uses of such materials in civil engineering appear as sustainable solutions. The French SEDIBRIC project (valorisation de SEDIments en BRIQues et tuiles) aims to replace a part of natural clays with dredged sediments in the preparation of fired bricks. The potential environmental impact of this re-use is explored to complete the technical and economic feasibility of the study. As part of the project, we investigate the environmental availability of metallic elements (Al, Ca, Cd, Co, Cr, Cu, Fe, Ni, Mg, Mn, Pb, Ti, and Zn) initially present in the dredged sediments selected for the project. Leaching tests (with H₂O, HCl, or EDTA) are conducted in the sediments than in the final bricks in order to evaluate the possible influence of some steps of the bricks manufacturing (desalination pre-treatment, firing, etc.). The desalination pre-treatment using tap water has no or few impacts on the environmental availability of the studied elements. On the opposite, the firing process (900°C) affects the value of the total content of elements detected in the bricks but also the environmental availability for various elements. For instance, Cd, Cu, Pb, and Zn are stabilized in the bricks, whereas the availability of some other elements (i.e., Cr, Ni) increases, depending on the nature of the extracting solution.

Keywords: availability, bricks, dredged sediments, metals

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Authors: Fabienne Baraud, Lydia Leleyter, Sandra Poree, Melanie Lemoine

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SEDIBRIC (valorization de SEDIments en BRIQues et tuiles) is a French project that aims to replace a part of natural clays with dredged sediments in the preparation of fired bricks in order to propose an alternative solution for the management of harbor dredged sediments. The feasibility of such re-use is explored from a technical, economic, and environmental point of view. The present study focuses on the potential environmental impact of various chemical elements (Al, Ca, Cd, Co, Cr, Cu, Fe, Ni, Mg, Mn, Pb, Ti, and Zn) that are initially present in the dredged sediments. The total content (after acid digestion) and the environmental availability (estimated by single extractions with various extractants) of these elements are determined in the raw sediments and in the obtained fired bricks. The possible influence of some steps of the manufacturing process (sediment pre-treatment, firing) is also explored. The first results show that the pre-treatment step, which uses tap water to desalinate the raw sediment, does not influence the environmental availability of the studied elements. However, the firing process, performed at 900°C, can affect the amount of some elements detected in the bricks, as well as their environmental availability. We note that for Cr, or Ni, the HCl or EDTA availability was increased in the brick (compared to the availability in the raw sediment). For Cd, Cu, Pb, and Zn, the HCl and EDTA availability was reduced in the bricks, meaning that these elements were stabilized within the bricks.

Keywords: bricks, chemical extraction, metals, sediment

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Authors: Thomas Seemann, Melanie Seemann

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The work environment has changed considerably due to the COVID pandemic. A growing body of empirical research shows that employees feel increasingly stressed and anxious. They consider themselves more detached from the organization they work for than previously. Organizations need to readjust their leadership practices to cope with this situation and rebuild work motivation and resilience. We propose a leadership tool that focuses on two key dimensions, which we call the "task channel" and the "energy channel." Managing the task channel comprises balancing the challenge [C] of a task and the corresponding skill set [S] of the individual performing the task. Recent research findings shed light on how to balance these two factors and create optimal work conditions in the workplace. Managing the energy channel comprise balancing the workload [WL] of an employee and his/her capacity to work [CW]. This ensures that the mid-term and long-term effectiveness of employees is maintained and energy depletion, fatigue, and burn-out are prevented. Organizations can actively apply strategies to leverage wellsprings and effectively reenergize their workforce. Thinking through and acting upon these factors will provide leaders with the insights they need to maximize their people's performance and, at the same time, establish a more mindful workplace.

Keywords: resilience, motivation, employee engagement, leadership

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Authors: Melanie Adrian, Elspeth McCulloch, Emily-Jean Gallant

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Resources -financial, physical, and human- are increasingly constrained in higher education. University classes are getting bigger, and the concomitant grading burden on faculty is growing rapidly. Multiple-choice exams are seen by some as one solution to these changes. How much students retain, however, and what their testing experience is, continues to be debated. Are multiple-choice exams serving students well, or are they bearing the burden of these developments? Is there a way to address both the resource constraints and make these types of exams more meaningful? In short, how do we engender evaluation methods for large-scale classes that provide opportunities for heightened student learning and enrichment? The following article lays out a testing approach we have employed in four iterations of the same third-year law class. We base our comments in this paper on our initial observations as well as data gathered from an ethics-approved study looking at student experiences. This testing approach provides students with multiple opportunities for revision (thus increasing chances for long term retention), is both individually and collaboratively driven (thus reflecting the individual effort and group effort) and is automatically graded (thus draining limited institutional resources). We found that overall students appreciated the approach and found it more ‘humane’, that it notably reduced pre-exam and intra-exam stress levels, increased ease, and lowered nervousness.

Keywords: exam, higher education, multiple-choice, law

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Authors: Saskya E. Carrera P., Ben Hankamer, Melanie Oey

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The green alga C. reinhardtii provides a platform for the cheap, scalable, and safe production of complex proteins. Despite gene expression in photosynthetic organisms being tightly regulated by light, most expression studies have analysed chloroplast recombinant protein production under constant light. Here the influence of illumination time and intensity on GFP and a GFP-PlyGBS (bacterial-lysin) fusion protein expression was investigated. The expression of both proteins was strongly influenced by the light regime (6-24 hr illumination per day), the light intensity (0-450 E m⁻²s⁻¹) and growth condition (photoautotrophic, mixotrophic and heterotrophic). Heterotrophic conditions resulted in relatively low recombinant protein yields per unit volume, despite high protein yields per cell, due to low growth rates. Mixotrophic conditions exhibited the highest yields at 6 hrs illumination at 200µE m⁻²s⁻¹ and under continuous low light illumination (13-16 mg L⁻¹ GFP and 1.2-1.6 mg L⁻¹ GFP-PlyGBS), as these conditions supported good cell growth and cellular protein yields. A ~23-fold increase in protein accumulation per cell and ~9-fold increase L⁻¹ culture was observed compared to standard constant 24 hr illumination for GFP-PlyGBS. The highest yields under photoautotrophic conditions were obtained under 9 hrs illumination (6 mg L⁻¹ GFP and 2.1 mg L⁻¹ GFP-PlyGBS). This represents a ~4-fold increase in cellular protein accumulation for GFP-PlyGBS. On a volumetric basis the highest yield was at 15 hrs illumination (~2-fold increase L⁻¹ over the constant light for GFP-PlyGBS). Optimising illumination conditions to balance growth and protein expression can thus significantly enhance overall recombinant protein production in C. reinhardtii cultures.

Keywords: chlamydomonas reinhardtii, light, mixotrophic, recombinant protein

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Authors: Daniel Mueller, Melanie Breitbach, Stefan Cornelius, Sarah Pakulla-Dickel, Margaretha Koenig, Anke Prochnow, Mario Scherer

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The European STR standard set (ESS) of loci as well as the new expanded CODIS core loci set as recommended by the CODIS Core Loci Working Group, has led to a higher standardization and harmonization in STR analysis across borders. Various multiplex PCRs assays have since been developed for the analysis of these 17 ESS or 23 CODIS expansion STR markers that all meet high technical demands. However, forensic analysts are often faced with difficult STR results and the questions thereupon. What is the reason that no peaks are visible in the electropherogram? Did the PCR fail? Was the DNA concentration too low? QIAGEN’s newest Investigator STR kits contain a novel Quality Sensor (QS) that acts as internal performance control and gives useful information for evaluating the amplification efficiency of the PCR. QS indicates if the reaction has worked in general and furthermore allows discriminating between the presence of inhibitors or DNA degradation as a cause for the typical ski slope effect observed in STR profiles of such challenging samples. This information can be used to choose the most appropriate rework strategy.Based on the latest PCR chemistry called FRM 2.0, QIAGEN now provides the next technological generation for STR analysis, the Investigator ESSplex SE QS and Investigator 24plex QS Kits. The new PCR chemistry ensures robust and fast PCR amplification with improved inhibitor resistance and easy handling for a manual or automated setup. The short cycling time of 60 min reduces the duration of the total PCR analysis to make a whole workflow analysis in one day more likely. To facilitate the interpretation of STR results a smart primer design was applied for best possible marker distribution, highest concordance rates and a robust gender typing.

Keywords: PCR, QIAGEN, quality sensor, STR

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Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

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In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: data security, flow cytometry, leukaemia, telematics platform, telemedicine

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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: Melanie Macgregor-Ramiasa, Isabel Hopp, Patricia Murray, Krasimir Vasilev

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Stem cells based therapies are one of the greatest promises of new-age medicine due to their potential to help curing most dreaded conditions such as cancer, diabetes and even auto-immune disease. However, establishing suitable in vitro culture materials allowing to control the fate of stem cells remain a challenge. Amongst the factor influencing stem cell behavior, substrate chemistry and nanotopogaphy are particularly critical. In this work, we used plasma assisted surface modification methods to produce model substrates with tailored nanotopography and controlled chemistry. Three different sizes of gold nanoparticles were bound to amine rich plasma polymer layers to produce homogeneous and gradient surface nanotopographies. The outer chemistry of the substrate was kept constant for all substrates by depositing a thin layer of our patented biocompatible polyoxazoline plasma polymer on top of the nanofeatures. For the first time, protein adsorption and stem cell behaviour (mouse kidney stem cells and mesenchymal stem cells) were evaluated on nanorough plasma deposited polyoxazoline thin films. Compared to other nitrogen rich coatings, polyoxazoline plasma polymer supports the covalent binding of proteins. Moderate surface nanoroughness, in both size and density, triggers cell proliferation. In association with polyoxazoline coating, cell proliferation is further enhanced on nanorough substrates. Results are discussed in term of substrates wetting properties. These findings provide valuable insights on the mechanisms governing the interactions between stem cells and their growth support.

Keywords: nanotopography, stem cells, differentiation, plasma polymer, oxazoline, gold nanoparticles

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Authors: Thelma Palaoag, Melanie Basa, Jezreel Mark Panilo

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Checking short-answer questions and essays, whether it may be paper or electronic in form, is a tiring and tedious task for teachers. Evaluating a student’s output require wide array of domains. Scoring the work is often a critical task. Several attempts in the past few years to create an automated writing assessment software but only have received negative results from teachers and students alike due to unreliability in scoring, does not provide feedback and others. The study aims to create an application that will be able to check short-answer questions which incorporate information extraction. Information extraction is a subfield of Natural Language Processing (NLP) where a chunk of text (technically known as unstructured text) is being broken down to gather necessary bits of data and/or keywords (structured text) to be further analyzed or rather be utilized by query tools. The proposed system shall be able to extract keywords or phrases from the individual’s answers to match it into a corpora of words (as defined by the instructor), which shall be the basis of evaluation of the individual’s answer. The proposed system shall also enable the teacher to provide feedback and re-evaluate the output of the student for some writing elements in which the computer cannot fully evaluate such as creativity and logic. Teachers can formulate, design, and check short answer questions efficiently by defining keywords or phrases as parameters by assigning weights for checking answers. With the proposed system, teacher’s time in checking and evaluating students output shall be lessened, thus, making the teacher more productive and easier.

Keywords: information extraction, short-answer question, natural language processing, application

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Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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Authors: Gabrielle Veloso, Melanie Porter, Kelsie Boulton, Adam Guastella

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The aim of the current systematic review was to examine child and parent factors and their associations with parent sensitivity towards children with Autism Spectrum Disorder (ASD). Eight bibliographic databases were used to identify peer-reviewed journal articles examining these associations via quantitative analyses, with parent sensitivity measured via validated and reliable observation coding systems. Thirty-one studies were finalized as having met full criteria for inclusion. The review found agreement across studies that parent sensitivity was positively associated with the child’s initiations and responsiveness toward their parent, with more frequent parent-directed behaviors providing greater opportunity for parents to act and react in sensitive manner. There was also substantial evidence that parent sensitivity predicted later growth in child language ability and child social skills. Other factors such as child attachment, parent insightfulness toward their child, and parent resolution of the diagnosis were also identified across a number of studies as being positively associated with parent sensitivity, however, interpretations of these findings were limited by the absence of covariates identified in the literature as explaining much of the variance in parent sensitivity. With respect to non-significant associations, the literature reliably found that parents showed sensitivity toward their child with ASD, regardless of child age, ASD symptomology, concurrent child social skills, and concurrent child cognitive abilities. The robust associations found in this review and their potential explanations can serve as a jump off point in identifying an understanding protective and risk factors for families of children with ASD. With regard to future directions in research, assessment of the studies’ methodological quality identified points for improvement with respect to the measurement of parent sensitivity, as well as the consideration of several important methodological confounds that may be controlled for in statistical analyses.

Keywords: ASD, autism, parenting, parent sensitivity

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Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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Authors: Nadine Wiesmann, Melanie Viel, Christoph Buhr, Rachel Tanner, Wolfgang Tremel, Juergen Brieger

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Recidivation of tumors and the development of resistances against the classical anti-tumor approaches represent a major challenge we face when treating cancer. In order to master this challenge, we are in desperate need of new treatment options beyond the beaten tracks. Zinc oxide nanoparticles (ZnO NPs) represent such an innovative approach. Zinc oxide is characterized by a high level of biocompatibility, concurrently ZnO NPs are able to exert anti-tumor effects. By concentration of the nanoparticles at the tumor site, tumor cells can specifically be exposed to the nanoparticles while low zinc concentrations at off-target sites are tolerated well and can be excreted easily. We evaluated the toxicity of ZnO NPs in vitro with the help of immortalized tumor cell lines and primary cells stemming from healthy tissue. Additionally, the Chorioallantoic Membrane Assay (CAM Assay) was employed to gain insights into the in vivo behavior of the nanoparticles. We could show that ZnO NPs interact with tumor cells as nanoparticulate matter. Furthermore, the extensive release of zinc ions from the nanoparticles nearby and within the tumor cells results in overload with zinc. Beyond that, ZnO NPs were found to further the generation of reactive oxygen species (ROS). We were able to show that tumor cells were more prone to the toxic effects of ZnO NPs at intermediate concentrations compared to fibroblasts. With the help of ZnO NPs covered by a silica shell in which FITC dye was incorporated, we were able to track ZnO NPs within tumor cells as well as within a whole organism in the CAM assay after injection into the bloodstream. Depending on the applied concentrations, selective tumor cell killing seems feasible. Furthermore, the combinational treatment of tumor cells with radiotherapy and ZnO NPs shows promising results. Still, further investigations are needed to gain a better understanding of the interaction between ZnO NPs and the human body to be able to pave the way for their application as an innovative anti-tumor agent in the clinics.

Keywords: metal oxide nanoparticles, nanomedicine, overcome resistances against classical treatment options, zinc oxide nanoparticles

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Authors: Mary Elizabeth Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Injuries due to interpersonal violence are a common reason for emergency department (ED) visits amongst the American pediatric population. Gun violence, in particular, is associated with high morbidity, mortality as well as financial costs. Patterns of pediatric ED usage may be an indicator of risk for future violence, but very little data on the topic exists. Objective: The aims of this study were to assess for frequencies of ED usage for previous interpersonal violence, mental/behavioral issues, sexual/reproductive issues and concerns for abuse in youths presenting to EDs due to physical assault injuries (PAIs) compared to firearm injuries (FIs). Methods: In this retrospective case-control study, ED charts of children ages 8-19 years who presented with injuries due to interpersonal violent encounters from 2014-2017 were reviewed. Data was collected regarding all previous ED visits for injuries due to interpersonal violence (including physical assaults and firearm injuries), mental/behavioral health visits (including depression, suicidal ideation, suicide attempt, homicidal ideation and violent behavior), sexual/reproductive health visits (including sexually transmitted infections and pregnancy related issues), and concerns for abuse (including physical abuse or domestic violence, neglect, sexual abuse, sexual assault, and intimate partner violence). Logistic regression was used to identify predictors of gun violence based on previous ED visits amongst physical assault injured versus firearm injured youths. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed, 251 (62%) of which were due to physical assault injuries (PAIs) and 156 (38%) due to firearm injuries (FIs). The majority of both PAI and FI patients had no previous history of ED visits for violence, mental/behavioral health, sexual/reproductive health or concern for abuse (60.8% PAI, 76.3% FI). 19.2% of PAI and 13.5% of FI youths had previous ED visits for physical assault injuries (OR 0.68, P=0.24, 95% CI 0.36 to 1.29). 1.6% of PAI and 3.2% of FI youths had a history of ED visits for previous firearm injuries (OR 3.6, P=0.34, 95% CI 0.04 to 2.95). 10% of PAI and 3.8% of FI youths had previous ED visits for mental/behavioral health issues (OR 0.91, P=0.80, 95% CI 0.43 to 1.93). 10% of PAI and 2.6% of FI youths had previous ED visits due to concerns for abuse (OR 0.76, P=0.55, 95% CI 0.31 to 1.86). Conclusions: There are no statistically significant differences between physical assault-injured and firearm-injured youths in terms of ED usage for previous violent injuries, mental/behavioral health visits, sexual/reproductive health visits or concerns for abuse. However, violently injured youths in this study have more than twice the number of previous ED usage for physical assaults and mental health visits than previous literature indicates. Data comparing ED usage of victims of interpersonal violence to nonviolent ED patients is needed, but this study supports the notion that EDs may be a useful place for identification of and enrollment in interventions for youths most at risk for future violence.

Keywords: child abuse, emergency department usage, pediatric gun violence, pediatric interpersonal violence, pediatric mental health, pediatric reproductive health

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Authors: Mary H Moen, Lauren H. Mandel

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Creating a sense of community in online learning is important for student engagement and success. The integration of discussion forums within online learning environments presents an opportunity to explore how this computer mediated communications format can cultivate a sense of community among students in accelerated master’s degree programs. This research has two aims, to delve into the ways instructors utilize this communications technology to create community and to understand the feelings and experiences of graduate students participating in these forums in regard to its effectiveness in community building. This study is a two-phase approach encompassing qualitative and quantitative methodologies. The data will be collected at an online accelerated Master of Library and Information Studies program at a public university in the northeast of the United States. Phase 1 is a content analysis of the syllabi from all courses taught in the 2023 calendar year, which explores the format and rules governing discussion forum assignments. Four to six individual interviews of department faculty and part time faculty will also be conducted to illuminate their perceptions of the successes and challenges of their discussion forum activities. Phase 2 will be an online survey administered to students in the program during the 2023 calendar year. Quantitative data will be collected for statistical analysis, and short answer responses will be analyzed for themes. The survey is adapted from the Classroom Community Scale Short-Form (CSS-SF), which measures students' self-reported responses on their feelings of connectedness and learning. The prompts will contextualize the items from their experience in discussion forums during the program. Short answer responses on the challenges and successes of using discussion forums will be analyzed to gauge student perceptions and experiences using this type of communication technology in education. This research study is in progress. The authors anticipate that the findings will provide a comprehensive understanding of the varied approaches instructors use in discussion forums for community-building purposes in an accelerated MLIS program. They predict that the more varied, flexible, and consistent student uses of discussion forums are, the greater the sense of community students will report. Additionally, students’ and instructors’ perceptions and experiences within these forums will shed light on the successes and challenges faced, thereby offering valuable recommendations for enhancing online learning environments. The findings are significant because they can contribute actionable insights for instructors, educational institutions, and curriculum designers aiming to optimize the use of discussion forums in online accelerated graduate programs, ultimately fostering a richer and more engaging learning experience for students.

Keywords: accelerated online learning, discussion forums, LIS programs, sense of community, g

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Authors: Moen Torill, Rismark Marit, Astrid M. Solvberg

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In Norway, every municipality shall provide an educational psychological service, EPS, to support kindergartens and schools in their work with children and youths with special needs. The EPS focus its work on individuals, aiming to identify special needs and to give advice to teachers and parents when they ask for it. In addition, the service also give priority to prevention and system intervention in kindergartens and schools. To master these big tasks university courses are established to support EPS counsellors' continuous learning. There is, however, a need for more in-depth and systematic knowledge on how they experience the courses they attend. In this study, EPS counsellors’ reflection logs during a particular course are investigated. The research question is: what are the content and priorities of the reflections that are communicated in the logs produced by the educational psychological counsellors during a post-graduate course? The investigated course is a credit course organized over a one-year period in two one-semester modules. The altogether 55 students enrolled in the course work as EPS counsellors in various municipalities across Norway. At the end of each day throughout the course period, the participants wrote reflection logs about what they had experienced during the day. The data material consists of 165 pages of typed text. The collaborating researchers studied the data material to ascertain, differentiate and understand the meaning of the content in each log. The analysis also involved the search for similarity in content and development of analytical categories that described the focus and primary concerns in each of the written logs. This involved constant 'critical and sustained discussions' for mutual construction of meaning between the co-researchers in the developing categories. The process is inspired by Grounded Theory. This means that the concepts developed during the analysis derived from the data material and not chosen prior to the investigation. The analysis revealed that the concept 'Useful' frequently appeared in the participants’ reflections and, as such, 'Useful' serves as a core category. The core category is described through three major categories: (1) knowledge sharing (concerning direct and indirect work with students with special needs) with colleagues is useful, (2) reflections on models and theoretical concepts (concerning students with special needs) are useful, (3) reflection on the role as EPS counsellor is useful. In all the categories, the notion of useful occurs in the participants’ emphasis on and acknowledgement of the immediate and direct link between the university course content and their daily work practice. Even if each category has an importance and value of its own, it is crucial that they are understood in connection with one another and as interwoven. It is the connectedness that gives the core category an overarching explanatory power. The knowledge from this study may be a relevant contribution when it comes to designing new courses that support continuing professional development for EPS counsellors, whether for post-graduate university courses or local courses at the EPS offices or whether in Norway or other countries in the world.

Keywords: constructing and circulating knowledge, educational-psychological counsellor, higher education, professional development

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Authors: Melanie Ostermann, Eivind Birkeland, Ying Xue, Alexander Sauter, Mihaela R. Cimpan

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Background: New reliable and robust techniques to assess biological effects of nanomaterials (NMs) in vitro are needed to speed up safety analysis and to identify key physicochemical parameters of NMs, which are responsible for their acute cytotoxicity. The central aim of this study was to validate and evaluate the applicability and reliability of an impedance-based flow cytometry (IFC) technique for the high-throughput screening of NMs. Methods: Eight inorganic NMs from the European Commission Joint Research Centre Repository were used: NM-302 and NM-300k (Ag: 200 nm rods and 16.7 nm spheres, respectively), NM-200 and NM- 203 (SiO₂: 18.3 nm and 24.7 nm amorphous, respectively), NM-100 and NM-101 (TiO₂: 100 nm and 6 nm anatase, respectively), and NM-110 and NM-111 (ZnO: 147 nm and 141 nm, respectively). The aim was to assess the biological effects of these materials on human monoblastoid (U937) cells. Dispersions of NMs were prepared as described in the NANOGENOTOX dispersion protocol and cells were exposed to NMs at relevant concentrations (2, 10, 20, 50, and 100 µg/mL) for 24 hrs. The change in electrical impedance was measured at 0.5, 2, 6, and 12 MHz using the IFC AmphaZ30 (Amphasys AG, Switzerland). A traditional toxicity assay, Trypan Blue Dye Exclusion assay, and dark-field microscopy were used to validate the IFC method. Results: Spherical Ag particles (NM-300K) showed the highest toxic effect on U937 cells followed by ZnO (NM-111 ≥ NM-110) particles. Silica particles were moderate to non-toxic at all used concentrations under these conditions. A higher toxic effect was seen with smaller sized TiO2 particles (NM-101) compared to their larger analogues (NM-100). No interferences between the IFC and the used NMs were seen. Uptake and internalization of NMs were observed after 24 hours exposure, confirming actual NM-cell interactions. Conclusion: Results collected with the IFC demonstrate the applicability of this method for rapid nanotoxicity assessment, which proved to be less prone to nano-related interference issues compared to some traditional toxicity assays. Furthermore, this label-free and novel technique shows good potential for up-scaling in directions of an automated high-throughput screening and for future NM toxicity assessment. This work was supported by the EC FP7 NANoREG (Grant Agreement NMP4-LA-2013-310584), the Research Council of Norway, project NorNANoREG (239199/O70), the EuroNanoMed II 'GEMN' project (246672), and the UH-Nett Vest project.

Keywords: cytotoxicity, high-throughput, impedance, nanomaterials

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Authors: Leigh Ann Wilson, Melanie Borrego

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The purpose of institutional learning outcomes (ILOs) is to assess what students across the university know and what they do not. The issue is gathering this information in a systematic and usable way. This presentation will explain how one institution has engineered this process for both student success and maximum faculty curriculum and course design input. At Brandman University, there are three levels of learning outcomes: course, program, and institutional. Institutional Learning Outcomes (ILOs) are mapped to specific courses. Faculty course developers write the signature assignments (SAs) in alignment with the Institutional Learning Outcomes for each course. These SAs use a specific rubric that is applied consistently by every section and every instructor. Each year, the 12-member General Education Team (GET), as a part of their work, conducts the calibration and assessment of the university-wide SAs and the related rubrics for one or two of the five ILOs. GET members, who are senior faculty and administrators who represent each of the university's schools, lead the calibration meetings. Specifically, calibration is a process designed to ensure the accuracy and reliability of evaluating signature assignments by working with peer faculty to interpret rubrics and compare scoring. These calibration meetings include the full time and adjunct faculty members who teach the course to ensure consensus on the application of the rubric. Each calibration session is chaired by a GET representative as well as the course custodian/contact where the ILO signature assignment resides. The overall calibration process GET follows includes multiple steps, such as: contacting and inviting relevant faculty members to participate; organizing and hosting calibration sessions; and reviewing and discussing at least 10 samples of student work from class sections during the previous academic year, for each applicable signature assignment. Conversely, the commitment for calibration teams consist of attending two virtual meetings lasting up to three hours in duration. The first meeting focuses on interpreting the rubric, and the second meeting involves comparing scores for sample work and sharing feedback about the rubric and assignment. Next, participants are expected to follow all directions provided and participate actively, and respond to scheduling requests and other emails within 72 hours. The virtual meetings are recorded for future institutional use. Adjunct faculty are paid a small stipend after participating in both calibration meetings. Full time faculty can use this work on their annual faculty report for "internal service" credit.

Keywords: assessment, assurance of learning, course design, institutional learning outcomes, rubrics, signature assignments

Procedia PDF Downloads 280

Authors: Heather Fulford, Melanie Liddell

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The recruitment and retention of high quality employees can prove to be challenging for social enterprises, particularly in some of the core business support functions such as marketing, communications, IT and finance. This holds true for social enterprises in urban contexts, where roles with more attractive remuneration in these business functions can often be found quite readily in the private sector. For social enterprises situated in rural locations, the challenges of staff recruitment and retention are even more acute. Such challenges can lead to a skills deficit in rural social enterprises, which can, at best, hinder their growth potential, and worse, jeopardise their chances of survival. This in turn, can have a negative impact on the sustainability and resilience of the surrounding rural community in which the social enterprise is located. The purpose of this paper is to report on aspects of a collaborative initiative established to stimulate innovation and business growth in remote rural businesses in Scotland. Launched in 2010, this initiative was designed to attract young students and graduates from the region to stay in the region upon completion of their studies, and to attract others from outside the region to re-locate there post-university. To facilitate this, SMEs in the region were offered wage subsidies to encourage them to recruit a student or graduate on a work placement for up to one year to participate in an innovation or business growth-oriented project. A number of the employers offering work placements were social enterprises. Through analysis of the placement project and role specifications devised by the participating social enterprises, an overview is provided of their business development needs and the skills they require to stimulate innovation and growth. Scrutiny of the reflective accounts compiled by the students and graduates at the close of their work placements highlights the benefits they derived from being able to put their academic knowledge and skills into action within a social enterprise. Examination of interviews conducted with a sample of placement employers reveals the contribution the students and graduates made during the business development projects with the social enterprises. The challenges of hosting such placements are also discussed. The paper concludes with indications of the lessons learned and an outline of the wider implications for other remote rural locations in which social enterprises play an important role in the local economy and life of the community.

Keywords: resilience, rural development, regeneration, regional development, recruitment, resource management, retention, remuneration

Procedia PDF Downloads 315

Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

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The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

Procedia PDF Downloads 92

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

Procedia PDF Downloads 108

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

Procedia PDF Downloads 100

Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

Procedia PDF Downloads 152