The potential of visual and participatory approaches to HIV literacy in South Africa

Includes bibliographical references (leaves 141-150).An estimated 18.8 % of South African adults aged 15-49 are currently living with HIV. While HIV literacy campaigns and other strategies have aimed to reduce HIV incidence, there remains a general lack of knowledge of the biomedical nature of the disease. This not only inhibits attempts to reduce HIV transmission, but also discourages voluntary counseling and testing (VCT), accessing clinic care and the uptake of antiretroviral therapy. This dissertation identifies the essential role played by community health workers and treatment activists who offer 'HIV literacy' in their communities and assist the formal health care system. The aim of this study was to complement these initiatives with the development and analysis of a visual and participatory HIV literacy workshop

Interhemispheric modulation of corticomotor excitability following i-wave periodicity transcranial magnetic brain stimulation (iTMS)

AIMS: Transcranial Magnetic Stimulation (TMS) has been recently demonstrated to have potential therapeutic benefits by promoting cortical plasticity through modulation of corticospinal excitability. We have previously shown in healthy adult subjects that paired-pulse TMS (1.5ms ISI) applied over Ml at 0.2Hz for 15min (known as iTMS), can raise corticospinal excitability for a period (~10min) that outlasts the intervention. Since interhemispheric changes in corticomotor excitability are considered to have fundamental importance in the control of voluntary movement, and recovery of motor function following unilateral damage, importance is placed on understanding the mechanisms involved. The aims of the current study were therefore to investigate if the raised corticomotor excitability following iTMS intervention over Ml will be paralleled by an increase in contralateral M1, and whether this may be brought about by a reduced transcallosal inhibition. Method; STUDY ONE: In eleven healthy adult volunteers (7 Male, 18-45yrs), the mean amplitude of the MEP was recorded (single pulse, 110% resting motor threshold, optimal site for first dorsal interosseous muscle on each hemisphere) pre and post 15 min of iTMS (left hemisphere, 100% of resting motor threshold). STUDY TWO: In six healthy adult volunteers (2 Male, 19-36yrs), Transcallosal Inhibition was investigated pre and post 15 minute iTMS, by delivering a conditioning pulse over the comparable site on the contralateral cortex at 110% resting motor threshold (RMT) between 9-13ms lSI. The effect of the conditioning stimulus on the test stimulus MEP amplitude was compared pre and post iTMS and was expressed as an index of lnterhemispheric Inhibition. Results: iTMS applied over the left M1 (Primary motor cortex) during study one, produced a post intervention increase in MEP amplitude for RFDI in the first post collection of 227%±34% SEM (

Nucleic acid sequence-based amplification: Relative performance and applications in HIV-1 disease monitoring and patient management

In recent years there have been significant advances in the understanding of the pathogenesis of HIV-1 infection. Central to this progress has been the development of accurate and reproducible methods of measuring HIV-1 RNA in plasma. This has been pivotal in studies of viral dynamics, disease progression and antiretroviral drug efficacy. This thesis describes evaluations of the performance of Nucleic Acid Sequence-Based Amplification (NASBA) technologies in quantifying HIV-1 RNA, relative to other commercial systems, investigating reproducibility, sensitivity and reliability across subtypes using a number of panels designed with either plasma dilutions of laboratory strains of HIV-1, or by selected clinical viruses of interest. Quantification of HIV-1 B and non B subtypes was investigated to study the impact of increasing diversity of HIV-1 subtypes in our clinic population. The evaluations described here involve close collaborations with assay manufacturers (as an alpha testing site) and clinical users, and have encouraged the continual improvement of viral load quantification systems, supporting the development of new versions of RT-PCR and NASBA assays. Further, attempts were made to develop an economic in house viral quantification system based on immunocapture and RT-PCR using an internal biological standard. To investigate the versatility of viral load measurement in different clinical settings, studies were performed in primary HIV-1 infection and established HIV-1 infection. A well characterised cohort of patients undergoing primary HIV-1 infection (n = 47), were evaluated for the relative performance of NASBA quantification during the initial stages of infection and followed for up to 3 years. In addition, this enabled a comparison of virological responses to therapy in early HIV-1 disease and analysis for antiretroviral resistance mutations to investigate the prevalence of resistance transmission in this recently infected group. A clinical trial of patients with established infection was undertaken to determine the practical significance of virological measures relative to immunological responses and therapeutic drug monitoring. The performance of NASBA in quantifying viral load in a wide range of studies was shown to be less sensitive than the bDNA and RT-PCR assays and also less able to amplify viruses of more diverse subtypes. In a number of studies the quantification of samples with a low viral load (>5,000 copies/ml) by NASBA was shown have greater variance. However, at higher viral copy numbers (>5,000 copies/ml), the reproducibility of results was equivalent to alternative viral load systems and other markers of disease monitoring and drug efficacy. NASBA performed adequately in characterising patients undergoing primary HIV-1 infection relative to other disease markers such as p24 antigen, anti-HIV-1 serology, and the conventional understanding of virological events during this early infection period. Further, NASBA viral load measures demonstrated that although antiretroviral therapy was very effective during this period, it was not significantly more effective than therapy initiated later. It was noted in this cohort that the frequency of resistance transmission was low for nucleoside (15%) and non-nucleoside (6%) inhibitor resistance, and absent for protease inhibitors. The investigations into an in house system showed that a modified immunocapture using latex microparticle produced inconsistent results, and a variable high background in the detection system precluded further evaluation. By comparison, the reverse transcription and amplification step was modified successfully and further optimisation of this method was undertaken within the department to allow routine use. Throughout this study, the objective has been to evaluate the current and future use of viral load measurement. This thesis has gone some way towards validating the expanding use of viral load since the identification of HIV-1 RNA as a disease marker. As long as the reliability of viral quantification systems supports the prevailing clinical environment and is evaluated in studies such as this, it may continue to act as a principal tool in HIV-1 clinical research and patient care

Voice Spoofing Countermeasures: Taxonomy, State-of-the-art, experimental analysis of generalizability, open challenges, and the way forward

Malicious actors may seek to use different voice-spoofing attacks to fool ASV systems and even use them for spreading misinformation. Various countermeasures have been proposed to detect these spoofing attacks. Due to the extensive work done on spoofing detection in automated speaker verification (ASV) systems in the last 6-7 years, there is a need to classify the research and perform qualitative and quantitative comparisons on state-of-the-art countermeasures. Additionally, no existing survey paper has reviewed integrated solutions to voice spoofing evaluation and speaker verification, adversarial/antiforensics attacks on spoofing countermeasures, and ASV itself, or unified solutions to detect multiple attacks using a single model. Further, no work has been done to provide an apples-to-apples comparison of published countermeasures in order to assess their generalizability by evaluating them across corpora. In this work, we conduct a review of the literature on spoofing detection using hand-crafted features, deep learning, end-to-end, and universal spoofing countermeasure solutions to detect speech synthesis (SS), voice conversion (VC), and replay attacks. Additionally, we also review integrated solutions to voice spoofing evaluation and speaker verification, adversarial and anti-forensics attacks on voice countermeasures, and ASV. The limitations and challenges of the existing spoofing countermeasures are also presented. We report the performance of these countermeasures on several datasets and evaluate them across corpora. For the experiments, we employ the ASVspoof2019 and VSDC datasets along with GMM, SVM, CNN, and CNN-GRU classifiers. (For reproduceability of the results, the code of the test bed can be found in our GitHub Repository

Open Pedagogy Approaches: Faculty, Library, and Student Collaborations

Open Pedagogy Approaches: Faculty, Library, and Student Collaborations is a collection of case studies from higher education institutions across the United States. An open educational resource (OER) in its own right, it offers a diverse compilation of OER and open pedagogy projects grounded in faculty, library, and student collaborations. Open Pedagogy Approaches provides ideas, practical tips, and inspiration for educators willing to explore the power of open, whether that involves a small innovation or a large-scale initiative. Particularly during this pandemic, as libraries struggle against publisher limitations to offer traditional print texts in e-format, libraries are a natural partner in the creation and facilitation of open educational resources and practices. “Going open” offers innovative alternatives that can equitably shift the culture of student access and empowerment in learning. List of chapters: Editor\u27s Preface / Alexis Clifton Foreword / Robin DeRosa Introduction / Kimberly Davies Hoffman, Robert Berkman, Deborah Rossen-Knill, Kristen Totleben, Eileen Daly-Boas, Alexis Clifton, Moriana Garcia, Lev Earle, and Joe Easterly Evolving into the Open: A Framework for Collaborative Design of Renewable Assignments / Stacy Katz and Jennifer Van Allen Informed Open Pedagogy and Information Literacy Instruction in Student-Authored Open Projects / Cynthia Mari Orozco Approaching Open Pedagogy in Community and Collaboration / Caroline Sinkinson and Amanda McAndrew Open Pedagogy Big and Small: Comparing Open Pedagogy Efforts in Large and Small Higher Education Settings / Shanna Hollich and Jacob Moore Adapting Open Educational Course Materials in Undergraduate General Psychology: A Faculty-Librarian-Student Partnership / Dennis E. Schell, Dorinne E. Banks, and Neringa Liutkaite Reading British Modernist Texts: A Case in Open Pedagogy / Mantra Roy, Joe Easterly, and Bette London Humanities in the Open: The Challenges of Creating an Open Literature Anthology / Christian Beck, Lily J. Dubach, Sarah A. Norris, and John Venecek A 2-for-1 Deal: Earn Your AA While Learning About Information Literacy Using OER / Mary Lee Cunill, Sheri Brown, and Tia Esposito Mathematics Courses and the Ohio Open Ed Collaborative: Collaborative Course Content Building for Statewide Use / Daniel Dotson, Anna Davis, Amanda L. Folk, Shanna Jaggars, Marcos D. Rivera, and Kaity Prieto Library Support for Scaffolding OER-enabled Pedagogy in a General Education Science Course / Lindsey Gumb and Heather Miceli Sharing the End of the World: Students’ Perceptions of Their Self-Efficacy in the Creation of Open Access Digital Learning Objects / Sarah Hutton, Lisa Di Valentino, and Paul Musgrave Teaching Wikipedia: A Model for Critical Engagement with Open Information / Amanda Koziura, Jennifer M. Starkey, and Einav Rabinovitch-Fox “And Still We Rise”: Open Pedagogy and Black History at a Rural Comprehensive State College / Joshua F. Beatty, Timothy C. Hartnett, Debra Kimok, and John McMahon Building a Collection of Openly Licensed Student-Developed Videos / Ashley Shea Whose History?: Expanding Place-Based Initiatives Through Open Collaboration / Sean D. Visintainer, Stephanie Anckle, and Kristen Weischedel Scholarly Bridges: SciComm Skill-Building with Student-Created Open Educational Resources / Carrie Baldwin-SoRelle and Jennifer M. Swann Harnessing the Power of Student-Created Content: Faculty and Librarians Collaborating in the Open Educational Environment / Bryan James McGeary, Ashwini Ganeshan, and Christopher S. Guder Open Pedagogical Practices to Train Undergraduates in the Research Process: A Case Study in Course Design and Co-Teaching Strategies / Stephanie N. Lewis, Anne M. Brown, and Amanda B. MacDonald Open Pedagogical Design for Graduate Student Internships, A New Collaborative Model / Laurie N. Taylor and Brian Keith Adventures in a Connectivist MOOC on Open Learning / Susan J. Erickson Invitation to Innovation: Transforming the Argument-Based Research Paper to Multimodal Project / Denise G. Malloy and Sarah Siddiqui “What If We Were To Go?”: Undergraduates Simulate the Building of an NGO From Theory To Practice / Kimberly Davies Hoffman, Rose-Marie Chierici, and Amanda Spencehttps://knightscholar.geneseo.edu/geneseo-authors/1010/thumbnail.jp

Knowledge, practice and technique on hand hygiene among nurses while caring for patients

A study was conducted to assess the knowledge, practice and technique on hand hygiene among the nurses while caring for patients in selected areas of a selected hospital. The conceptual frame work was developed on the basis of Becker and Miman’s health belief model. In this study, quantitative research approach and descriptive research design were used to achieve the objectives of the study. The study subjects were nurses from Medical Intensive care unit, Coronary care unit, Trauma Intensive care unit and Post operative ward. The nurses were selected through convenience sampling technique. Pilot study was done and all the strengths and weaknesses were analyzed. Data collection was done for 6 weeks. Assessment of practice and technique on hand hygiene among nurses was done by concealed participatory observation method and questionnaire was provided on the last two days of data collection in each of the four settings to assess the knowledge on hand hygiene among the nurses. The collected data were tabulated and analyzed using descriptive and inferential statistics. The demographic revealed that majority of the participants were females (93.9%), below 25 years (84.8%), B.Sc nurses (57.6%). 45.5% of the nurses were having total work experience of 7-12 months and 48.5% of them were having 7-12 months work experience in the current area. Only 63.3% of the nurses had previous source of information on hand hygiene and among this group 48.5% of the nurses got the information only from textbooks. It was noted that only 39.4% of the nurses had adequate knowledge on hand hygiene. It was also noted that 21 nurses (63.6%) were having the average (51%-64%) score on hand hygiene technique, whereas one nurse (3%) was having the excellent (> 80%) and good score (65 – 75%) on hand hygiene technique. It was also revealed that the practice on hand hygiene before and after procedure was poor (<50 %) for all the nurses. None of the participants were having good & excellent hand hygiene practice before and after procedures. The study findings revealed that the age of the nurses had significant association with knowledge on hand hygiene at the level of P<0.05. The age, present experience of the nurses had significant association with technique on hand hygiene at the level of P<0.01. It was also revealed that the age of the nurses had significant association with practice before and after procedure on hand hygiene of nurses at the level of P<0.001. No other demographic variables had significant association with knowledge, practice and technique on hand hygiene. It also found that there was a negative correlation between knowledge with practice and technique. It was also revealed that there was a positive correlation between practice and technique. There was no significant relationship between knowledge, practice and technique. This could be interpreted that even though the nurses had adequate knowledge, continuous monitoring was needed to enhance adherence to practice and technique on hand hygiene. It was also revealed that through the results, the researcher found that an in service education should be conducted periodically to update knowledge on hand hygiene and to improve the practices and techniques among the nurses. The researcher conducted in -service education on hand hygiene among the nurses in all of the four setting

Proactive Management of Acute Oedema Following Hand and Minor Burn Injury

Burn injury is a unique trauma. The inflammatory process initiated with burn injury adversely influences all of the Starling equation variables, resulting in increased transvascular fluid filtration, so that oedema as a product of burn injury is more readily formed than in other forms of trauma. Localised wound oedema forms due to minor burn injury, with increasing systemic oedema associated with increased size of burn. It is now recognised that a marked inflammatory and immune response is created with non-severe burn injury, indicating a systemic component with all burns. The effect of oedema formation on the course of the burn healing is well described in the literature, due to its impact on the zone of stasis in the wound and its potential to result in progressive tissue loss or conversion if poorly managed. Burn conversion leads to an increase in the area and depth of the burn wound, necessitating surgical intervention, which increases the risk of scarring. Burn scarring may lead to altered function and poor aesthetic outcomes, which have the potential to adversely affect patient psychological well-being. Despite the influence of oedema on the healing of the burn wound and therefore the scar worn for life, there is little evidence to guide clinicians who aim to proactively manage this oedema, with only two published, controlled trials investigating methods to improve peripheral oedema in burn injury. The aim of the series of studies described in this thesis is to provide a holistic approach to the management of oedema following acute burn injury. To be able to effectively treat oedema, the clinician needs to be able to accurately assess the affected limb and wound for oedema. Oedema management in burn injury is often based on the clinicians’ preference of intervention, without good understanding of the optimal parameters of application or efficacy. Therefore, evidence is required for optimising the management of oedema in the acute burn injured patient. Furthermore, the hand’s unique anatomical structure that produces functional dexterity adds complexity to the assessment and management of oedema formation in the hand. Burn injury to the hand is common, as hands provide interaction with the world, and are generally vulnerable during activities of daily living. In the event of major accidents, the hands are reflexively used to protect the face and body, further predisposing them to significant injury. The ability to accurately measure oedema guides clinicians in their treatment of acute burn wound oedema. Current objective measures of oedema often lack sensitivity, increase pain, introduce a risk of infection from equipment contact with open wounds, or are cumbersome for repeated use in the clinical environment. They are also influenced by the cooperation of the patient, and burn injury often results in significant pain, impaired movement, and may require the use of medications that modify behaviour. As a result, oedema is usually assessed visually or through palpation of the tissue, noting the loss of skin creases or pitting of soft tissue. These assessments are subjective based on the clinician’s experience and do not provide objective measures that can be repeated between testers or between sessions. Demonstrating the effectiveness of proactive oedema management following acute burn injury is therefore dependent on the ability to accurately assess the oedema using a valid, reliable and sensitive objective measure. There is a lack of high-quality prospective studies investigating oedema management techniques in burn injury populations. In a 2011 systematic review, there was only one published randomised control trial, which investigated the use of electrical stimulation in addition to standard interventions for managing hand burn oedema, while a second conference presentation was reported as part of the review. There have been no further published studies in this space, providing clinicians with little guidance as to the optimal parameters to manage oedema in this challenging injury cohort. Measuring oedema in this patient group is similarly challenging. The study series in this thesis addresses the challenge of measuring hand burn oedema and wound healing. Bioimpedance spectroscopy (BIS) is a technology that has demonstrated reliability and validity for measuring whole body and limb oedema in burns patients during fluid resuscitation, and is sufficiently sensitive to measure oedema change with wound healing. Another BIS variable, Phase Angle, is validated to be a measure of cell health, as it measures the flow of current across the cell with respect to the voltage. Increased lag in the current is the result of increased cell mass and cell wall integrity (a healthier cell), resulting in an increased Phase Angle. This has been demonstrated to increase with healing in chronic wound populations, but has not been validated in acute burn injury. The first study in this thesis is a method validation study, investigating the measurement of hand volumes using a novel application of BIS. A technique to measure hand volumes using BIS has been described previously, however the burn injured hand is compromised by wounds. The guidelines for the use of BIS require that electrodes are placed on intact skin. The study compared different electrode configurations on the hand and arm to the previously described configuration in a non-injured population, to determine if different electrode configurations are valid for measuring hand volumes. The key findings of this study were that, when compared to previously described electrode positions on the dorsum of the hand and forearm, alternative electrode combinations on the volar surface of the hand and forearm, and an electrode array on the palm of the hand and the dorsum of the forearm, were both valid for measuring hand oedema volumes in an uninjured population. These outcomes provide novel evidence to guide electrode placements to measure hand volume using BIS where wounds precluded the use of standard electrode arrays. The second study in this series is a validation study, informed by and used the electrode positions assessed in the first study, to determine the validity and reliability of BIS for measuring hand (oedema) volumes in a burn injured population. Repeated hand volume measures were obtained in 100 patients presenting with hand burn injury with BIS, and with water displacement volumetry as a gold standard comparison. The results of this study demonstrated that the electrode positions assessed as valid for measuring hand volumes in an uninjured population in the first study, were valid, reliable and sensitive for measuring oedema in the hand following burn injury, showing high correlation with the gold standard comparator. This technique was used to assess the primary outcome – oedema volume change – in the third study of this series. The following studies in this thesis are intervention research, investigating techniques designed to proactively manage oedema in acute burn injury. The third study described in this thesis is the first randomised controlled trial to investigate different methods of applying compression to the hand to manage acute burn oedema. Compression is a commonly used technique to control oedema, reported to be applied based on clinician preference, which is dependent on the way each clinician was taught. In this study, 100 patients (the largest of its kind to the best of my knowledge), presenting with burn injury involving a portion of the hand were randomised to receive one of three commonly used methods of applying compression, to provide evidence as to which is the most effective at controlling acute burn wound oedema in the hand. In this study, the two most common methods of fabricating a custom compression glove using cohesive bandage were shown to be both equally effective at reducing post burn oedema in the hand, and both were more effective for reducing hand burn oedema than the control condition being an off the shelf compression glove. The patients in this study were also provided education regarding exercise to maintain function and promote oedema reduction, oedema management advice including elevation of the hand above the level of the heart at rest, and ensuring normal use of the hand while respecting the wound environment to minimise the risk of infection. These interventions resulted in significantly greater hand range of movement between test sessions, and a significant improvement in the QuickDASH (Disability of Arm, Shoulder and Hand) patient reported outcome measure. The effect of a low energy, long duration electrical stimulation on the acute burn wound was investigated in study four. Electrical stimulation has been demonstrated to improve the rate of healing of chronic wounds, and aid the reduction of oedema in a number of populations, including patients with hand burn injury when used in addition to standard physiotherapy. The novel application of electrical stimulation in this study utilised a small patient applied stimulation device for more than 20 hours per day for a period of up to 14 days, with the current applied across the wound with electrodes placed either side of the injured tissue on intact skin. This was designed as a within-patient control, randomised trial. Patients with similar size and similar depth burns to multiple limbs participated in this study. Electrical stimulation was applied to one wound, with the contralateral wound serving as the control wound. The outcomes investigated were change in oedema, as measured by the BIS variable R0, measuring the impedance of the extra-cellular fluid; and wound healing, measured by the BIS variable Phase Angle, and compared to clinical photography of the wounds, which were assessed by a consultant burns surgeon to determine wound re-epithelialisation, or healing. Phase Angle and wound impedance were demonstrated to be associated with wound healing. Electrical stimulation applied to a minor burn was shown to increase the rate of oedema reduction in the wound compared to the control wound, and increased Phase Angle at a faster rate than in the control wound, indicating an increase in cell and tissue health. This thesis presents a study series whereby the first two studies validated a new method of measuring hand burn oedema quickly, with minimal imposition on the patient. This method was demonstrated as viable and applicable in acute burn patients, in both research and clinical practice contexts, and informed the ensuing studies in this series. The final two studies presented in this thesis are randomised controlled trials investigating the proactive management of oedema in acute burn injury, and contribute significant new knowledge to the literature, providing guidance to the burn clinician who manages acute oedema to prevent conversion of the burn wound and deterioration in function. When presented with a hand burn injury, the clinician will be able to appropriately manage the ensuing oedema with a custom compression glove fabricated using a cohesive bandage with either of the most common methods therapists are taught. In addition, in minor burn wounds, the use of a small, easy to use, low energy long duration electrical stimulation device as an adjunct to standard burn wound care, will increase oedema reduction and improve the rate of wound healing compared to standard wound care alone

6th Annual Focus on Creative Inquiry Poster Forum Program

The poster forum today displays a few of the more than 400 projects initiated by Clemson University Creative Inquiry teams. What is Creative Inquiry? It is small-group learning for all students. It is the imaginative combination of engaged learning and undergraduate research. Ultimately, it is the creation of an Ah-ha! Moment - and it is unique to Clemson University. Creative Inquiry establishes small teams of undergraduate students that work with faculty mentors to take on problems that spring from their own curiosity, from a professor\u27s challenge, or from the pressing needs of the world around them. Students take ownership of their projects. They ask questions, they take risks, and they get answers

Reducing Exposures to Mercury

Mercury is an environmental contaminant affecting neurological development, the immune system and cardiac health. Air emissions become environmental pollutants impacting air, water and land. Consumption of mercury-contaminated fish can create public health concerns, primarily to pregnant women and their fetuses. New York State\u27s public policy response addresses incidental exposures with annual fish advisories and restrictions on mercury emissions and products sold or used. Additional public policy responses to the mercury problem can include: direct notification of advisories to fish consumers, enhanced public health notification of benefits and risks of consuming fish, labeling requirements on mercury-containing products, and expanded scientific data collection to track mercury interactions in the atmosphere to determine confounding factors contributing to mercury exposures