Search results for: Melissa Eichelberger
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 70

Search results for: Melissa Eichelberger

40 Engaging Local Communities on Large-Scale Construction Project

Authors: Melissa Teo

Abstract:

It is increasingly important that project managers develop greater capabilities to better manage the social, cultural, political, environmental and economic impacts on proposed construction projects. These challenges are best resolved in consultation with communities rather than in conflict with them. This is particularly important on controversial projects which are projects that have obtained government sanctioned ‘development approval’ but not ‘community approval’. While a rich body of research and intellectual frameworks exist in the fields of urban geography and planning to understand and manage community concerns during the pre-development approval stages of new projects, current theoretical frameworks guiding community engagement in project management are inadequate. A new and innovative research agenda is needed to guide thinking about the role of local communities in the construction process and is an important research gap that needs to be filled. Within this context, this research aims to assess the effectiveness of strategies adopted by project teams to engage with local communities so as to capture lessons learnt to apply to future projects. This paper reports a research methodology which uses Arnstein’s model of participation to better understand how power differentials between the project team and local communities can influence the adoption of community engagement strategies. A case study approach is utilizing interviews and documentary analysis of a large-scale controversial construction project in Queensland, Australia is presented. The findings will result in a number of recommendations to guide community engagement practices on future projects.

Keywords: community engagement, construction, case study, project management

Procedia PDF Downloads 232
39 A Critical Discourse Analysis of Jamaican and Trinidadian News Articles about D/Deafness

Authors: Melissa Angus Baboun

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Utilizing a Critical Discourse Analysis (CDA) methodology and a theoretical framework based on disability studies, how Jamaican and Trinidadian newspapers discussed issues relating to the Deaf community were examined. The term deaf was inputted into the search engine tool of the online website for the Jamaica Observer and the Trinidad & Tobago Guardian. All 27 articles that contained the term deaf in its content and were written between August 1, 2017 and November 15, 2017 were chosen for the study. The data analysis was divided into three steps: (1) listing and analysis instances of metaphorical deafness (e.g. fall on deaf ears), (2) categorization of the content of the articles into the models of disability discourse (the medical, socio-cultural, and superscrip models of disability narratives), and (3) the analysis of any additional data found. A total of 42% of the articles pulled for this study did not deal with the Deaf community in any capacity, but rather instances of the use of idiomatic expressions that use deafness as a metaphor for a non-physical, undesirable trait. The most common idiomatic expression found was fall on deaf ears. Regarding the models of disability discourse, eight articles were found to follow the socio-cultural model, two were found to follow the medical model, and two were found to follow the superscrip model. The additional data found in these articles include two instances of the term deaf and mute, an overwhelming use of lower case d for the term deaf, and the misuse of the term translator (to mean interpreter).

Keywords: deafness, disability, news coverage, Caribbean newspapers

Procedia PDF Downloads 203
38 Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the USA

Authors: Xin Qi Dong, Melissa Simon

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Aims: Elder mistreatment and suicidal ideation are important public health concerns among aging populations. This study will examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. Methods: Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results: Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52--4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62--3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. Conclusion: As the largest epidemiology study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation.

Keywords: suicidal ideation, elder abuse, family violence, Asian health equity

Procedia PDF Downloads 201
37 Use of a Chagas Urine Nanoparticle Test (Chunap) to Correlate with Parasitemia Levels in T. cruzi/HIV Co-Infected Patients

Authors: Yagahira E. Castro-Sesquen, Robert H. Gilman, Carolina Mejia, Daniel E. Clark, Jeong Choi, Melissa J. Reimer-Mcatee, Rocio Castro, Jorge Flores, Edward Valencia-Ayala, Faustino Torrico, Ricardo Castillo-Neyra, Lance Liotta, Caryn Bern, Alessandra Luchini

Abstract:

Early diagnosis of reactivation of Chagas disease in HIV patients could be lifesaving; however, in Latin American the diagnosis is performed by detection of parasitemia by microscopy which lacks sensitivity. To evaluate if levels of T. cruzi antigens in urine determined by Chunap (Chagas urine nanoparticle test) are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. T. cruzi antigens in urine of HIV patients (N=55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. The percentage of Chagas positive patients determined by Chunap compared to blood microscopy, qPCR, and ELISA was 100% (6/6), 95% (18/19) and 74% (23/31), respectively. Chunap specificity was 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels (determined by qPCR) and urine T. cruzi antigen concentrations (p<0.001). A cut-off of > 105 pg was chosen to determine patients with reactivation of Chagas disease (6/6). Urine antigen concentration was significantly higher among patients with CD4+ lymphocyte counts below 200/mL (p=0.045). Chunap shows potential for early detection of reactivation and with appropriate adaptation can be used for monitoring Chagas disease status in T. cruzi/HIV co-infected patients.

Keywords: antigenuria, Chagas disease, Chunap, nanoparticles, parasitemia, poly N-isopropylacrylamide (NIPAm)/trypan blue particles (polyNIPAm/TB), reactivation of Chagas disease.

Procedia PDF Downloads 345
36 The Effect of the Organization of Mental Health Care on General Practitioners’ Prescription Behavior of Psychotropics for Adolescents in Belgium

Authors: Ellen Lagast, Melissa Ceuterick, Mark Leys

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Although adolescence is a stressful period with an increased risk for mental illnesses such as anxiety and depression, little in-depth knowledge is available on the determinants of the use of psychotropic drugs (BZD/SSRIs) and the effects. A qualitative research with adolescents in Flanders was performed. Based on indepth interviews, the interviewees indicate feelings of ambiguity towards their medication use because on the one hand the medication helps to manage their mental vulnerability and disrupted lives, but on the other hand they experience a loss of control of their self and their environment. Undesired side-effects and stigma led to a negative pharmaceutical self. The interviewed youngsters also express dissatisfaction about the prescription behavior with regard to psychotropic drugs of their general practitioner (GP). They wished to have received more information about alternative non-pharmaceutical treatment options. Notwithstanding these comments, the majority of the interviewees maintained trust in their GP to act in their best interest. This paper will relate the prescription behavior in primary care to the organization of mental health care to better understand the “phamaceuticalization” and medicalization of mental health problems in Belgium. Belgium implemented fundamental mental health care reforms to collaborate, to integrate care and to optimize continuity of care. Children and adolescents still are confronted with long waiting lists to access (non-medicalized) mental health services. This access to mental health care partly explains general practitioners’ prescription behavior of psychotropics. Moreover, multidisciplinary practices have not pervaded primary health care yet. Medicalization and pharmaceuticalization of mental health vulnerabilities of youth are both a structural and cultural problem.

Keywords: adolescents, antidepressants, benzodiazepines, mental health system, psychotropic drugs

Procedia PDF Downloads 75
35 Role of ABC Transporters in Non-Target Site Herbicide Resistance in Black Grass (Alopecurus myosuroides)

Authors: Alina Goldberg Cavalleri, Sara Franco Ortega, Nawaporn Onkokesung, Richard Dale, Melissa Brazier-Hicks, Robert Edwards

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Non-target site based resistance (NTSR) to herbicides in weeds is a polygenic trait associated with the upregulation of proteins involved in xenobiotic detoxification and translocation we have termed the xenome. Among the xenome proteins, ABC transporters play a key role in enhancing herbicide metabolism by effluxing conjugated xenobiotics from the cytoplasm into the vacuole. The importance of ABC transporters is emphasized by the fact that they often contribute to multidrug resistance in human cells and antibiotic resistance in bacteria. They also play a key role in insecticide resistance in major vectors of human diseases and crop pests. By surveying available databases, transcripts encoding ABCs have been identified as being enhanced in populations exhibiting NTSR in several weed species. Based on a transcriptomics data in black grass (Alopecurus myosuroides, Am), we have identified three proteins from the ABC-C subfamily that are upregulated in NTSR populations. ABC-C transporters are poorly characterized proteins in plants, but in Arabidopsis localize to the vacuolar membrane and have functional roles in transporting glutathionylated (GSH)-xenobiotic conjugates. We found that the up-regulation of AmABCs strongly correlates with the up-regulation of a glutathione transferase termed AmGSTU2, which can conjugate GSH to herbicides. The expression profile of the ABC transcripts was profiled in populations of black grass showing different degree of resistance to herbicides. This, together with a phylogenetic analysis, revealed that AmABCs cluster in different groups which might indicate different substrate and roles in the herbicide resistance phenotype in the different populations

Keywords: black grass, herbicide, resistance, transporters

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34 Screening of Antiviral Compounds in Medicinal Plants: Non-Volatiles

Authors: Tomas Drevinskas, Ruta Mickiene, Audrius Maruska, Nicola Tiso, Algirdas Salomskas, Raimundas Lelesius, Agneta Karpovaite, Ona Ragazinskiene, Loreta Kubiliene

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Antiviral effect of substances accumulated by plants and natural products is known to ethno-pharmacy and modern day medicine. Antiviral properties are usually assigned to volatile compounds and polyphenols. This research work is divided into several parts and the task of this part was to investigate potential plants, potential substances and potential preparation conditions that can be used for the preparation of antiviral agents. Sixteen different medicinal plants, their parts and two types of propolis were selected for screening. Firstly, extraction conditions of non-volatile compounds were investigated: 3 pre-selected plants were extracted with 5 different ethanol – water mixtures (96%, 75%, 60%, 40%, 20 %, vol.) and bidistilled water. Total phenolic content, total flavonoid content and radical scavenging activity was determined. The results indicated that optimal extrahent is 40%, vol. of ethanol – water mixture. Further investigations were performed with the extrahent of 40%, vol. ethanol – water mixture. All 16 of selected plants, their parts and two types of propolis were extracted using selected extrahent. Determined total phenolic content, total flavonoid content and radical scavenging activity indicated that extracts of Origanum Vulgare L., Mentha piperita L., Geranium macrorrhizum L., Melissa officinalis L. and Desmodium canadence L. contains highest amount of extractable phenolic compounds (7.31, 5.48, 7.88, 8.02 and 7.16 rutin equivalents (mg/ ml) respectively), flavonoid content (2.14, 2.23, 2.49, 0.79 and 1.51 rutin equivalents (mg/ml) respectively) and radical scavenging activity (11.98, 8.72, 13.47, 13.22 and 12.22 rutin equivalents (mg/ml) respectively). Composition of the extracts is analyzed using HPLC.

Keywords: antiviral effect, plants, propolis, phenols

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33 Exploring the Link between Intangible Capital and Urban Economic Development: The Case of Three UK Core Cities

Authors: Melissa Dickinson

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In the context of intense global competitiveness and urban transformations, today’s cities are faced with enormous challenges. There is increasing pressure among cities and regions to respond promptly and efficiently to fierce market progressions, to offer a competitive advantage, higher flexibility, and to be pro-active in creating future markets. Consequently, competition among cities and regions within the dynamics of a worldwide spatial economic system is growing fiercer, amplifying the importance of intangible capital in shaping the competitive and dynamic economic performance of organisations and firms. Accordingly, this study addresses how intangible capital influences urban economic development within an urban environment. Despite substantial research on the economic, and strategic determinants of urban economic development this multidimensional phenomenon remains to be one of the greatest challenges for economic geographers. The research provides a unique contribution, exploring intangible capital through the lenses of entrepreneurial capital and social-network capital. Drawing on business surveys and in-depth interviews with key stakeholders in the case of the three UK Core Cities Birmingham, Bristol and Cardiff. This paper critically considers how entrepreneurial capital and social-network capital is a crucial source of competitiveness and urban economic development. This paper deals with questions concerning the complexity of operationalizing ‘network capital’ in different urban settings and the challenges that reside in characterising its effects. The paper will highlight the role of institutions in facilitating urban economic development. Particular emphasis will be placed on exploring the roles formal and informal institutions have in delivering, supporting and nurturing entrepreneurial capital and social-network capital, to facilitate urban economic development. Discussions will then consider how institutions moderate and contribute to the economic development of urban areas, to provide implications in terms of future policy formulation in the context of large and medium sized cities.

Keywords: urban economic development, network capital, entrepreneurialism, institutions

Procedia PDF Downloads 253
32 Safeners, Tools for Artificial Manipulation of Herbicide Selectivity: A Zea mays Case Study

Authors: Sara Franco Ortega, Alina Goldberg Cavalleri, Nawaporn Onkokesung, Richard Dale, Melissa Brazier-Hicks, Robert Edwards

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Safeners are agrochemicals that enhance the selective chemical control of wild grasses by increasing the ability of the crop to metabolise the herbicide. Although these compounds are widely used, their mode of action is not well understood. It is known that safeners enhance the metabolism of herbicides, by up-regulating the associated detoxification system we have termed the xenome. The xenome proteins involved in herbicide metabolism have been previously divided into four different phases, with cytochrome P450s (CYPs) playing a key role in phase I metabolism by catalysing hydroxylation and dealkylation reactions. Subsequently, glutathione S-transferases (GSTs) and UDP-glucosyltransferases lead to the formation of Phase II conjugates prior to their transport into the vacuole by ABCs transporters (Phase III). Maize (Zea mays), was been treated with different safeners to explore the selective induction of xenome proteins, with a special interest in the regulation of the CYP superfamily. Transcriptome analysis enabled the identification of key safener-inducible CYPs that were then functionally assessed to determine their role in herbicide detoxification. In order to do that, CYP’s were codon optimised, synthesised and inserted into the yeast expression vector pYES3 using in-fusion cloning. CYP’s expressed as recombinant proteins in a strain of yeast engineered to contain the P450 co-enzyme (cytochrome P450 reductase) from Arabidopsis. Microsomes were extracted and treated with herbicides of different chemical classes in the presence of the cofactor NADPH. The reaction products were then analysed by LCMS to identify any herbicide metabolites. The results of these studies will be presented with the key CYPs identified in maize used as the starting point to find orthologs in other crops and weeds to better understand their roles in herbicide selectivity and safening.

Keywords: CYPs, herbicide detoxification, LCMS, RNA-Seq, safeners

Procedia PDF Downloads 111
31 COVID-19 and Heart Failure Outcomes: Readmission Insights from the 2020 United States National Readmission Database

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

Procedia PDF Downloads 49
30 Preparing Faculty to Deliver Academic Continuity during and after a Disaster

Authors: Melissa Houston

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Political pressures, financial restraints, and recent legislation has led to administrators’ at academic institutions to rely upon online education as a viable means for delivering education to students anytime and anywhere. Administrators at academic institutions have utilized online education as a way to ensure that academic continuity takes place while campuses are physically closed or are recovering from damages during and after disaster. There is a gap in the research as to how to best train faculty for academic continuity during and after disasters occur. The lack of available research regarding how faculty members at academic institutions prepared themselves prior to a disaster served as a major rationale for this study. The problem that was addressed in this phenomenological study was to identify the training needed by faculty to provide academic continuity during and after times of disaster. The purpose of the phenomenological study was to provide further knowledge and understanding of the training needed by faculty to provide academic continuity after a disaster. Data collection from this study will help human resource professionals as well as administrators of academic institutions to better prepare faculty to provide academic continuity in the future. Participants were recruited on LinkedIn and were qualified as having been faculty who taught traditional courses during or after a disaster. Faculty members were asked a series of open-ended questions to gain understanding of their experiences of how they acquired training for themselves for academic continuity during and after a disaster. The findings from this study showed that faculty members identified assistance needed including professional development in the form of training and support, communication, and technological resources in order to provide academic continuity. The first conclusion from this study was that academic institutions need to support their students, staff and faculty with disaster training and the resources needed to provide academic continuity during and after disasters. The second conclusion from this study is that while disasters and other academic institution incidents are occurring more frequently, limited funding and the push for online education has created limited resources for academic institutions. The need to create partnerships and consortiums with other academic institutions and communities is crucial for the success and sustainability of academic institutions. Through these partnerships and consortiums academic institutions can share resources, knowledge, and training.

Keywords: training, faculty, disaster, academic continuity

Procedia PDF Downloads 161
29 Isolation and Identification of Fungi from Different Types of Medicinal Plants Cultivated in Ecuador

Authors: Ana Paola Echavarria, Mariuxi Medina, Haydelba D'Armas, Carmita Jaramillo, Diana San Martin

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The use of medicinal plants is one of the oldest and most extended medical therapies that goes back to prehistoric times, and nowadays, they are also used in the preparation of phytopharmaceuticals with options to cure diseases. The test for the determination of fungi was carried out in the Pharmacy Pilot Plant (treatment of the leaves of the plant species) and the Microbiology Laboratory (determination of fungi of the plant species, using growth medium called Sabouraud agar plus the vegetal sample), of the Academic Unit of Chemical Sciences and Health, of the Universidad Tecnica de Machala. Subsequently, colony counting was performed, both macroscopic, which is determined in the growth medium of the seeding, and microscopic, to identify the germinative forms using blue lactophenol. The procedure was repeated in duplicate to replicate the results data. The determination of the total fungal content of the following plant species was evaluated: Cymbopogon citratus (lemon verbena), Melissa officinalis (lemon balm), Taraxacum officinale (dandelion), Artemisia absinthium (absinthe), Piper carpunya (guaviduca), Moringa oleifera (moringa), Coriandrum sativum (coriander), Momordica charantia (achochilla), Borago officinalis (borage), Aloysia citriodora (cedron), Ambrosia artemisifolia (altamisa) and Ageratum conyzoides (mastrante). The results obtained showed that all the samples of the twelve plant species studied developed filamentous fungi, with great variability of them, within the permissible limits and contemplated by the Ecuadorian Institute of Normalization (INEN), being suitable as raw material for its use in the preparation of nutraceuticals and medicinal products or phytodrugs; with the exception of A. conyzoides (mastranto) which is the only species that exceeds the regulation in the average of dilutions.

Keywords: colonies, fungi, medicinal plants, microbiological quality, Sabouraud agar

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28 Nutritional Impact in Patients Who Underwent Sleeve-Type Bariatric Surgery

Authors: Melissa Mattos, Camila Lima, Ibraim Castro, Augusto Carioca, Saulo Magalhães, Paula Freitas, Keciany Oliveira

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Obesity is a chronic, multifactorial, relapsing disease that has increased dramatically over the years. Its control is considered a public health issue, and more and more treatments and interventions are being studied to reduce its prevalence. When interventions in lifestyle and the use of drugs do not generate lasting results, bariatric procedures emerge as a resource for obesity control. The main guidelines for the treatment of obesity emphasize the need for pre-procedure and post-procedure nutritional monitoring to avoid nutritional deficiencies that may occur. The individual who undergoes bariatric surgery needs to understand the changes that will be necessary for life in view of the intense anatomical and metabolic changes that result from surgical techniques. To assess the nutritional profile of patients who undergo bariatric surgery, we analyzed data from the medical records of all people who underwent sleeve-type bariatric surgery from January to June 2022 at a clinic in the City of Fortaleza. 38 patients were analyzed, 32 women and 6 men in the pre-surgical period, 6 and 12 months after surgery. The data showed an average weight loss of 24.45% at 6 months and 30.85% at 12 months, with a reduction of 21.32% and 30.41%, respectively, in the fat percentage, also indicating that 13.15% used drugs for weight loss during this period, leading to reflection on the isolated long-term efficacy of bariatric surgery, requiring multidisciplinary follow-up for a change in lifestyle. Only 12 individuals, corresponding to 31.57%, reached eutrophic BMI 12 months after surgery, 20 individuals remained overweight, corresponding to 52.63% of the sample, and 6 individuals (15.78%) remained in the BMI obese class I. As for body composition, there was a 52.39% reduction in fat mass and a 12.82% reduction in muscle mass, and 21% of individuals underwent cholecystectomy. Sleeve-type bariatric surgery promoted significant weight loss after 1 year of the procedure, with a reduction in body fat percentage and fat mass. Most patients were still overweight and had a significant reduction in muscle mass.

Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve

Procedia PDF Downloads 36
27 Co-Creating an International Flipped Faculty Development Model: A US-Afghan Case Study

Authors: G. Alex Ambrose, Melissa Paulsen, Abrar Fitwi, Masud Akbari

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In 2016, a U.S. business college was awarded a sub grant to work with FHI360, a nonprofit human development organization, to support a university in Afghanistan funded by the State Department’s U.S. Agency for International Development (USAID). A newly designed Master’s Degree in Finance and Accounting is being implemented to support Afghanistan’s goal of 20% females in higher education and industry by 2020 and to use finance and accounting international standards to attract capital investment for economic development. This paper will present a case study to describe the co-construction of an approach to an International Flipped Faculty Development Model grounded in blended learning theory. Like education in general, faculty development is also evolving from the traditional face to face environment and interactions to the fully online and now to a best of both blends. Flipped faculty development is both a means and a model for careful integration of the strengths of the synchronous and asynchronous dynamics and technologies with the combination of intentional sequencing to pre-online interactions that prepares and enhances the face to face faculty development and mentorship residencies with follow-up post-online support. Initial benefits from this model include giving the Afghan faculty an opportunity to experience and apply modern teaching and learning strategies with technology in their own classroom. Furthermore, beyond the technological and pedagogical affordances, the reciprocal benefits gained from the mentor-mentee, face-to-face relationship will be explored. Evidence to support this model includes: empirical findings from pre- and post-Faculty Mentor/ Mentee survey results, Faculty Mentorship group debriefs, Faculty Mentorship contact logs, and student early/end of semester feedback. In addition to presenting and evaluating this model, practical challenges and recommendations for replicating international flipped faculty development partnerships will be provided.

Keywords: educational development, faculty development, international development, flipped learning

Procedia PDF Downloads 153
26 Investigating The Use Of Socially Assistive Robots To Support Learner Engagement For Students With Learning Disabilities In One-to-one Instructional Settings

Authors: Jennifer Fane, Mike Gray, Melissa Sager

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Children with diagnosed or suspected learning disabilities frequently experience significant skill gaps in foundational learning areas such as reading, writing, and math. Remedial one-to-one instruction is a highly effective means of supporting children with learning differences in building these foundational skills and closing the learning gap between them and their same-age peers. However, due to the learning challenges children with learning disabilities face, and ensuing challenges with self-confidence, many children with learning differences struggle with motivation and self-regulation within remedial one-to-one learning environments - despite the benefits of these sessions. Socially Assistive Robots (SARs) are an innovative educational technology tool that has been trialled in a range of educational settings to support diverse learning needs. Yet, little is known about the impact of SARs on the learning of children with learning differences in a one-to-one remedial instructional setting. This study sought to explore the impact of SARs on the engagement of children (n=9) with learning differences attending one-to-one remedial instruction sessions at a non-profit remedial education provider. The study used a mixed-methods design to explore learner engagement during learning tasks both with and without the use of a SAR to investigate how the use of SARs impacts student learning. The study took place over five weeks, with each session within the study followed the same procedure with the SAR acting as a teaching assistant when in use. Data from the study included analysis of time-sample video segments of the instructional sessions, instructor recorded information about the student’s progress towards their session learning goal and student self-reported mood and energy levels before and after the session. Analysis of the findings indicates that the use of SARs resulted in fewer instances of off-task behaviour and less need for instructor re-direction during learning tasks, allowing students to work in more sustained ways towards their learning goals. This initial research indicates that the use of SARs does have a material and measurable impact on learner engagement for children with learning differences and that further exploration of the impact of SARs during one-to-one remedial instruction is warranted.

Keywords: engagement, learning differences, learning disabilities, instruction, social robotics.

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25 Short-Term Association of In-vehicle Ultrafine Particles and Black Carbon Concentrations with Respiratory Health in Parisian Taxi Drivers

Authors: Melissa Hachem, Maxime Loizeau, Nadine Saleh, Isabelle Momas, Lynda Bensefa-Colas

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Professional drivers are exposed inside their vehicles to high levels of air pollutants due to the considerable time they spend close to motor vehicle emissions. Little is known about ultrafine particles (UFP) or black carbon (BC) adverse respiratory health effects compared to the regulated pollutants. We aimed to study the short-term associations between UFP and BC concentrations inside vehicles and (1) the onset of mucosal irritation and (2) the acute changes in lung function of Parisian taxi drivers during a working day. An epidemiological study was carried out on 50 taxi drivers in Paris. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively. On the same day, the frequency and the severity of nose, eye, and throat irritations were self-reported by each participant and a spirometry test was performed before and after the work shift. Multivariate analysis was used to evaluate the associations between in-taxis UFP and BC concentrations and mucosal irritation and lung function, after adjustment for potential confounders. In-taxis UFP concentrations ranged from 17.9 to 37.9 × 103 particles/cm³ and BC concentrations from 2.2 to 3.9 μg/m³, during a mean of 9 ± 2 working hours. Significant dose-response relationships were observed between in-taxis UFP concentrations and both nasal irritation and lung function. The increase of in-taxis UFP (for an interquartile range of 20 × 103 particles/cm3) was associated to an increase in nasal irritation (adjusted OR = 6.27 [95% CI: 1.02 to 38.62]) and to a reduction in forced expiratory flow at 25–75% by −7.44% [95% CI: −12.63 to −2.24], forced expiratory volume in one second by −4.46% [95% CI: −6.99 to −1.93] and forced vital capacity by −3.31% [95% CI: −5.82 to −0.80]. Such associations were not found with BC. Incident throat and eye irritations were not related to in-vehicle particles exposure; however, they were associated with outdoor air quality (estimated by the Atmo index) and in-vehicle humidity, respectively. This study is the first to show a significant association, within a short-period of time, between in-vehicle UFP exposure and acute respiratory effects in professional drivers.

Keywords: black carbon, lung function, mucosal irritation, taxi drivers, ultrafine particles

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24 The Sociology of the Facebook: An Exploratory Study

Authors: Liana Melissa E. de la Rosa, Jayson P. Ada

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This exploratory study was conducted to determine the sociology of the Facebook. Specifically, it aimed to know the socio-demographic profile of the respondents in terms of age, sex, year level and monthly allowance; find out the common usage of Facebook to the respondents; identify the features of Facebook that are commonly used by the respondents; understand the benefits and risks of using the Facebook; determine how frequent the respondents use the Facebook; and find out if there is a significant relationship between socio-demographic profile of the respondents and their Facebook usage. This study used the exploratory research design and correlational design employing research survey questionnaire as its main data gathering instrument. Students of the University of Eastern Philippines were selected as the respondents of this study through quota sampling. Ten (10) students were randomly selected from each college of the university. Based on the findings of this study, the following conclusion were drawn: The majority of the respondents are aged 18 and 21 old, female, are third year students, and have monthly allowance of P 2,000 above. On the respondents’ usage of Facebook, the majority of use the Facebook on a daily basis for one to two (1-2) hours everyday. And most users used Facebook by renting a computer in an internet cafe. On the use of Facebook, most users have created their profiles mainly to connect with people and gain new friends. The most commonly used features of Facebook, are: photos application, like button, wall, notification, friend, chat, network, groups and “like” pages status updates, messages and inbox and events. While the other Facebook features that are seldom used by the respondents are games, news feed, user name, video sharing and notes. And the least used Facebook features are questions, poke feature, credits and the market place. The respondents stated that the major benefit that the Facebook has given to its users is its ability to keep in touch with family members or friends while the main risk identified is that the users can become addicted to the Internet. On the tests of relationships between the respondents’ use of Facebook and the four (4) socio-demographic profile variables: age, sex, year level, and month allowance, were found to be not significantly related to the respondents’ use of the Facebook. While the variable found to be significantly related was gender.

Keywords: Facebook, sociology, social networking, exploratory study

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23 Science Anxiety Levels in Emirati Pre-Service Teachers

Authors: Martina Dickson, Hanadi Kadbey, Melissa Mcminn

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Research has shown that anxiety and trepidation towards learning about science is prevalent among elementary school teachers in Western countries. It has also been shown repeatedly that pre-service and in-service teachers who show signs of anxiety towards science are; a) less likely to teach it at all, where they have some autonomy over this, b) less likely to teach it effectively c) ultimately that their students have lower attainment scores in science. It is therefore critically important to gauge pre-service teachers’ science anxiety levels early on whilst there are still possibilities to overturn some of the reasons behind these fears and avert these serious issues occurring later on. This study takes place in the capital of the United Arab Emirates (U.A.E.) in the context of training local elementary school teachers. In the U.A.E., where Emirati teachers are already in the vast minority and attrition rates are high, it is important to offer as much support to pre-service teachers as possible. If pre-service teachers are graduating with high levels of science anxiety unabated, according to the research there is a very real concern that as generalist primary school teachers, their science teaching will be far from optimal. The aims of this research study were to ascertain the science anxiety levels of pre-service elementary teachers and to identify particular areas of their science anxiety, if appropriate. We surveyed 200 Emirati pre-service teachers and found that levels of science anxiety were directly related to their perceptions of performance in science exams, laboratory experiments and inquiry approaches to science learning. Whilst some studies have shown that science anxiety can decrease as students gain confidence in science knowledge by studying courses, we did not see this effect in our study. This is based upon a theoretical framework which holds that in some cases, science anxiety is related to lack of exposure to, or insecurity with science content itself which in some cases is alleviated by the students’ covering of material and greater confidence in the subject. Exploring this variable allowed us to explore whether students educated in schools influenced by the educational reform in Abu Dhabi have differing science anxiety levels from those who were educated prior to the reforms. We discuss the possible implications of these findings to the future teaching of science in Abu Dhabi public schools.

Keywords: pre-service teachers, science anxiety, United Arab Emirates, educational reform

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22 Rheumatoid Arthritis, Periodontitis and the Subgingival Microbiome: A Circular Relationship

Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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21 Loss of Function of Only One of Two CPR5 Paralogs Causes Resistance Against Rice Yellow Mottle Virus

Authors: Yugander Arra, Florence Auguy, Melissa Stiebner, Sophie Chéron, Michael M. Wudick, Van Schepler-Luu, Sébastien Cunnac, Wolf B. Frommer, Laurence Albar

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Rice yellow mottle virus (RYMV) is one of the most important diseases affecting rice in Africa. The most promising strategy to reduce yield losses is the use of highly resistant varieties. The resistance gene RYMV2 is homolog of the Arabidopsis constitutive expression of pathogenesis related protein-5 (AtCPR5) nucleoporin gene. Resistance alleles are originating from African cultivated rice Oryza glaberrima, rarely cultivated, and are characterized by frameshifts or early stop codons, leading to a non-functional or truncated protein. Rice possesses two paralogs of CPR5 and function of these genes are unclear. Here, we evaluated the role of the two rice candidate nucleoporin paralogs OsCPR5.1 (pathogenesis-related gene 5; RYMV2) and OsCPR5.2 by CRISPR/Cas9 genome editing. Despite striking sequence and structural similarity, only loss-of-function of OsCPR5.1 led to full resistance, while loss-of-function oscpr5.2 mutants remained susceptible. Short N-terminal deletions in OsCPR5.1 also did not lead to resistance. In contrast to Atcpr5 mutants, neither OsCPR5.1 nor OsCPR5.2 knock out mutants showed substantial growth defects. Taken together, the candidate nucleoporin OsCPR5.1, but not its close homolog OsCPR5.2, plays a specific role for the susceptibility to RYMV, possibly by impairing the import of viral RNA or protein into the nucleus. Whereas gene introgression from O. glaberrima to high yielding O. sativa varieties is impaired by strong sterility barriers and the negative impact of linkage drag, genome editing of OsCPR5.1, while maintaining OsCPR5.2 activity, thus provides a promising strategy to generate O. sativa elite lines that are resistant to RYMV.

Keywords: CRISPR Cas9, genome editing, knock out mutant, recessive resistance, rice yellow mottle virus

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20 The Need of Sustainable Mining: Communities, Government and Legal Mining in Central Andes of Peru

Authors: Melissa R. Quispe-Zuniga, Daniel Callo-Concha, Christian Borgemeister, Klaus Greve

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The Peruvian Andes have a high potential for mining, but many of the mining areas overlay with campesino community lands, being these key actors for agriculture and livestock production. Lead by economic incentives, some communities are renting their lands to mining companies for exploration or exploitation. However, a growing number of campesino communities, usually social and economically marginalized, have developed resistance, alluding consequences, such as water pollution, land-use change, insufficient economic compensation, etc. what eventually end up in Socio-Environmental Conflicts (SEC). It is hypothesized that disclosing the information on environmental pollution and enhance the involvement of communities in the decision-making process may contribute to prevent SEC. To assess whether such complains are grounded on the environmental impact of mining activities, we measured the heavy metals concentration in 24 indicative samples from rivers that run across mining exploitations and farming community lands. Samples were taken during the 2016 dry season and analyzed by inductively-coupled-plasma-atomic-emission-spectroscopy. The results were contrasted against the standards of monitoring government institutions (i.e., OEFA). Furthermore, we investigated the water/environmental complains related to mining in the neighboring 14 communities. We explored the relationship between communities and mining companies, via open-ended interviews with community authorities and non-participatory observations of community assemblies. We found that the concentrations of cadmium (0.023 mg/L), arsenic (0.562 mg/L) and copper (0.07 mg/L), surpass the national water quality standards for Andean rivers (0.00025 mg/L of cadmium, 0.15 mg/L of arsenic and 0.01 mg/L of copper). 57% of communities have posed environmental complains, but 21% of the total number of communities were receiving an annual economic benefit from mining projects. However, 87.5% of the communities who had posed complains have high concentration of heavy metals in their water streams. The evidence shows that mining activities tend to relate to the affectation and vulnerability of campesino community water streams, what justify the environmental complains and eventually the occurrence of a SEC.

Keywords: mining companies, campesino community, water, socio-environmental conflict

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19 Going Viral: Expanding a Student-Run COVID-19 Journal Club to Social Media

Authors: Joseph Dodson, Robert Roth, Alexander Hodakowski, Leah Greenfield, Melissa Porterhouse, Natalie Maltby, Rachel Sadowsky

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Introduction: Throughout the COVID-19 pandemic, countless research publications were released regarding SARS-CoV-2 and its variants, suggested treatments, and vaccine safety and efficacy. Daily publication of research became overwhelming for health professionals and the general public to stay informed. To address this problem, a group of 70 students across the four colleges at Rush University created the “Rush University COVID-19 Journal Club.” To broaden the available audience, the journal club then expanded to social media. Methods: Easily accessible and understandable summaries of the research were written by students and sent to faculty sponsors for feedback. Following the revision, summaries were published weekly on the Rush University COVID-19 Journal Club website for clinicians and students to use for reference. An Instagram page was then created, and information was further condensed into succinct posts to address COVID-19 “FAQs.” Next, a survey was distributed to followers of the Instagram page with questions meant to assess the effectiveness of the platform and gain feedback. A 5-point Likert scale was used as the primary question format. Results: The Instagram page accrued 749 followers and posted 52 unique posts over a 2 year period. Preliminary results from the surveys demonstrate that over 80% of respondents strongly agree that the Instagram posts 1) are an effective platform for the public presentation of factual COVID-19-related information; 2) provide relevant and valuable information; 3) provide information that is clear, concise, and can be easily understood. Conclusion: These results suggest that the Rush COVID-19 Journal Club was able to successfully create a social media presence and convey information without sacrificing scholarly integrity. Other academic institutions may benefit from the application of this model to help students and clinicians with the interpretation and evaluation of research topics with large bodies of evidence.

Keywords: SARS-CoV-2, COVID-19, public health, social media, SARS-CoV-2 vaccine, SARS-CoV-2 variants

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18 Evaluation to Assess the Impact of Newcastle Infant Partnership Approach

Authors: Samantha Burns, Melissa Brown, Judith Rankin

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Background: As a specialised intervention, NEWPIP provides a service which supports both parents and their babies from conception to two years, who are experiencing issues which may affect the quality of their relationship and development of the infant. This evaluation of the NEWPIP approach was undertaken in response to the need for rich, in-depth data to understand the lived experiences of the parents who experienced the service to improve the service. NEWPIP is currently one of 34 specialised parent–infant relationship teams across England. This evaluation contributes to increasing understanding of the impact and effectiveness of this specialised service to inform future practice. Aim: The aim of this evaluation was to explore the perspectives and experiences of parents or caregivers (service users), to assess the impact of the NEWPIP service on the parents themselves and the relationship with their baby. Methods: The exploratory nature of the aim and focus on service users’ experience and perspectives provided scope for a qualitative approach for this evaluation. This consisted of 10 semi-structured interviews with parents who had received the service within the last two years. Recruitment involved both purposive and convenience sampling. The interviews took place between February 2021 – March 2021, lasting between 30-90 minutes and were guided by open-ended questions from a topic guide. The interviews adopted a narrative approach to enable the parents to share their lived experiences. The researchers transcribed the interviews and analysed the data thematically by using a coding method which is grounded in the data. Results: The analysis and findings from the data gathered illuminated an approach which supports parents to build a better bond with their baby and provides a safe space for parents to heal through their relationships. While the parents shared their experiences, the interviews were intended to receive feedback, so questions were asked about what could be improved and what recommendations could be offered to Children North East. Guided by the voice of the parents, this evaluation provides recommendations to support the future of the NEWPIP approach. Conclusions: The NEWPIP approach appears to successfully provide early and flexible support for new parents, increasing a parent’s confidence in their ability to not only cope but thrive as a new parent.

Keywords: maternal health, mental health, parent infant relationship, therapy

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17 Prognosis of Patients with COVID-19 and Hematologic Malignancies

Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

Abstract:

Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

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16 Basil Plants Attract and Benefit Generalist Lacewing Predator Ceraeochrysa cubana Hagen (Neuroptera: Chrysopidae) by Providing Nutritional Resources

Authors: Michela C. Batista Matos, Madelaine Venzon, Elem F. Martins, Erickson C. Freitas, Adenir V. Teodoro, Maira C. M. Fonseca, Angelo Pallini

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Aromatic plant species are capable of producing and releasing volatile organic compounds spontaneously, which can repel or attract beneficial insects such as generalist predators of herbivores. Attractive plants could be used as crop companion plants to promote biological control of pests. In order to select such plants for future use in horticulture fields, we assessed the attractiveness of the aromatic plants Ocimum basilicum L. (basil), Mentha piperita L. (peppermint), Melissa officinalis L. (lemon balm) and Cordia verbenacea DC (black sage) to adults of the generalist lacewing predator Ceraeochrysa cubana Hagen (Neuroptera: Chrysopidae). This predator is commonly found in agroecosystems in Brazil and it feeds on aphids, mites, small caterpillars, insect eggs and scales. We further tested the effect of these plant species on the survival, development and oviposition of C. cubana. Finally, we evaluated the survival of larvae and adults of C. cubana when only flowers of basil were offered. Females of C. cubana were attracted to basil but not to the remaining aromatic plants. Larvae survival was higher when individuals had access only to basil leaf than when they had access to peppermint, lemon balm, black sage or water. Adult survival on leaf treatments and on water was no longer than three days. Flowers of basil enhanced predator larvae survival, yet they did not reach adulthood. Adults fed on basil flowers lived longer compared with water, but they did not reproduce. Basil is a promising aromatic plant species to be considered for conservation biological control programs. Besides being attractive to adults of the generalist predator, it benefits larvae and adults by providing nutritional resources when prey or other resources are absent. Financial support: CNPq, FAPEMIG and CAPES (Brazil).

Keywords: basil, chrysopidae, conservation biological control, companion plants

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15 The Feminism of Data Privacy and Protection in Africa

Authors: Olayinka Adeniyi, Melissa Omino

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The field of data privacy and data protection in Africa is still an evolving area, with many African countries yet to enact legislation on the subject. While African Governments are bringing their legislation to speed in this field, how patriarchy pervades every sector of African thought and manifests in society needs to be considered. Moreover, the laws enacted ought to be inclusive, especially towards women. This, in a nutshell, is the essence of data feminism. Data feminism is a new way of thinking about data science and data ethics that is informed by the ideas of intersectional feminism. Feminising data privacy and protection will involve thinking women, considering women in the issues of data privacy and protection, particularly in legislation, as is the case in this paper. The line of thought of women inclusion is not uncommon when even international and regional human rights specific for women only came long after the general human rights. The consideration is that these should have been inserted or rather included in the original general instruments in the first instance. Since legislation on data privacy is coming in this century, having seen the rights and shortcomings of earlier instruments, then the cue should be taken to ensure inclusive wholistic legislation for data privacy and protection in the first instance. Data feminism is arguably an area that has been scantily researched, albeit a needful one. With the spate of increase in the violence against women spiraling in the cyber world, compounding the issue of COVID-19 and the needful response of governments, and the effect of these on women and their rights, fast forward, the research on the feminism of data privacy and protection in Africa becomes inevitable. This paper seeks to answer the questions, what is data feminism in the African context, why is it important in the issue of data privacy and protection legislation; what are the laws, if any, existing on data privacy and protection in Africa, are they women inclusive, if not, why; what are the measures put in place for the privacy and protection of women in Africa, and how can this be made possible. The paper aims to investigate the issue of data privacy and protection in Africa, the legal framework, and the protection or provision that it has for women if any. It further aims to research the importance and necessity of feminizing data privacy and protection, the effect of lack of it, the challenges or bottlenecks in attaining this feat and the possibilities of accessing data privacy and protection for African women. The paper also researches the emerging practices of data privacy and protection of women in other jurisprudences. It approaches the research through the methodology of review of papers, analysis of laws, and reports. It seeks to contribute to the existing literature in the field and is explorative in its suggestion. It suggests a draft of some clauses to make any data privacy and protection legislation women inclusive. It would be useful for policymaking, academic, and public enlightenment.

Keywords: feminism, women, law, data, Africa

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14 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study

Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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13 School and Family Impairment Associated with Childhood Anxiety Disorders: Examining Differences in Parent and Child Report

Authors: Melissa K. Hord, Stephen P. Whiteside

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Impairment in functioning is a requirement for diagnosing psychopathology, identifying individuals in need of treatment, and documenting improvement with treatment. Further, identifying different types of functional impairment can guide educators and treatment providers. However, most assessment tools focus on symptom severity and few measures assess impairment associated with childhood anxiety disorders. The child- and parent-report versions of the Child Sheehan Disability Scale (CSDS) are measures that may provide useful information regarding impairment. The purpose of the present study is to examine whether children diagnosed with different anxiety disorders have greater impairment in school or home functioning based on self or parent report. The sample consisted of 844 children ages 5 to 19 years of age (mean 13.43, 61% female, 90.9% Caucasian), including 281 children diagnosed with obsessive compulsive disorder (OCD), 200 with generalized anxiety disorder (GAD), 176 with social phobia, 83 with separation anxiety, 61 with anxiety not otherwise specified (NOS), 30 with panic disorder, and 13 with panic with agoraphobia. To assess whether children and parents reported greater impairment in school or home functioning, a multivariate analysis of variance was conducted. (The assumptions of independence and homogeneity of variance were checked and met). A significant difference was found, Pillai's trace = .143, F (4, 28) = 4.19, p < .001, partial eta squared = .04. Post hoc comparisons using the Tukey HSD test indicated that children report significantly greater impairment in school with panic disorder (M=5.18, SD=3.28), social phobia (M=4.95, SD=3.20), and OCD (M=4.62, SD=3.32) compared to other diagnoses; whereas parents endorse significantly greater school impairment when their child has a social phobia (M=5.70, SD=3.39) diagnosis. Interestingly, both children and parents reported greater impairment in family functioning for an OCD (child report M=5.37, SD=3.20; parent report M=5.59, SD=3.38) diagnosis compared to other anxiety diagnoses. (Additional findings for the anxiety disorders associated with less impairment will also be presented). The results of the current study have important implications for educators and treatment providers who are working with anxious children. First, understanding that differences exist in how children and parents view impairment related to childhood anxiety can help those working with these families to be more sensitive during interactions. Second, evidence suggests that difficulties in one environment do not necessarily translate to another environment, thus caregivers may benefit from careful explanation of observations obtained by educators. Third, results support the use of the CSDS measure by treatment providers to identify impairment across environments in order to more effectively target interventions.

Keywords: anxiety, childhood, impairment, school functioning

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12 Effect of Pulsed Electrical Field on the Mechanical Properties of Raw, Blanched and Fried Potato Strips

Authors: Maria Botero-Uribe, Melissa Fitzgerald, Robert Gilbert, Kim Bryceson, Jocelyn Midgley

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French fry manufacturing involves a series of processes in which structural properties of potatoes are modified to produce crispy french fries which consumers enjoy. In addition to the traditional french fry manufacturing process, the industry is applying a relatively new process called pulsed electrical field (PEF) to the whole potatoes. There is a wealth of information on the technical treatment conditions of PEF, however, there is a lack of information about its effect on the structural properties that affect texture and its synergistic interactions with the other manufacturing steps of french fry production. The effect of PEF on starch gelatinisation properties of Russet Burbank potato was measured using a Differential Scanning Calorimeter. Cation content (K+, Ca2+ and Mg2+) was determined by inductively coupled plasma optical emission spectrophotometry. Firmness, and toughness of raw and blanched potatoes were determined in an uniaxial compression test. Moisture content was determined in a vacuum oven and oil content was measured using the soxhlet system with hexane. The final texture of the french fries – crispness - was determined using a three bend point test. Triangle tests were conducted to determine if consumers were able to perceive sensory differences between French fries that were PEF treated and those without treatment. The concentration of K+, Ca2+ and Mg2+ decreased significantly in the raw potatoes after the PEF treatment. The PEF treatment significantly increased modulus of elasticity, compression strain, compression force and toughness in the raw potato. The PEF-treated raw potato were firmer and stiffer, and its structure integrity held together longer, resisted higher force before fracture and stretched further than the untreated ones. The strain stress relationship exhibited by the PEF-treated raw potato could be due to an increase in the permeability of the plasmalema and tonoplasm allowing Ca2+ and Mg2+ cations to reach the cell wall and middle lamella, and be available for cross linking with the pectin molecule. The PEF-treated raw potato exhibited a slightly higher onset gelatinisation temperatures, similar peak temperatures and lower gelatinisation ranges than the untreated raw potatoes. The final moisture content of the french fries was not significantly affected by the PEF treatment. Oil content in the PEF- treated potatoes was lower than the untreated french fries, however, not statistically significant at 5 %. The PEF treatment did not have an overall significant effect on french fry crispness (modulus of elasticity), flexure stress or strain. The triangle tests show that most consumers could not detect a difference between French fries that received a PEF treatment from those that did not.

Keywords: french fries, mechanical properties, PEF, potatoes

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11 Preliminary Efficacy of a Pilot Paediatric Day Hospital Program Project to Address Severe Mental Illness, Obesity, and Binge Eating

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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