An adolescent girl with signs and symptoms of anaphylaxis and negative immunologic workup: a case report.

BackgroundThe increasing incidence of allergies and allergic reactions among children and adults has become a major public health concern. The etiology of allergic reactions can often be confirmed based on a detailed history and supportive testing. However, there are cases where the underlying factors are more complex and difficult to identify.Case presentationHere we present the case report of a 14-year-old Caucasian  girl with weight loss and a 3-year history of reported angioedema culminating in five intensive care unit admissions over the course of 2.5 months. Her initial clinical presentation included hypotension, dyspnea, and reported facial edema, but allergy and immunological workup were negative. A psychiatric workup identified an eating disorder with food restriction, comorbid major depression, obsessive compulsive disorder, and posttraumatic stress disorder. A close collaboration between Adolescent Medicine, Allergy and Immunology, and Psychiatry helped disentangle medical from psychiatric problems, including fluoxetine medication effects, as well as develop a treatment plan that was acceptable to the family. The angioedema was ultimately diagnosed as factitious disorder.ConclusionsThis patient's treatment highlights the importance of a multidisciplinary team approach, a multifactorial etiology that needed to be addressed by multiple specialists, and the importance of long-term treatment and support

Validation of Wrinkling-to-Delamination Adhesion Measurement Technique

Polymer thin films have a wide range of applications that span several different industries. Their optical clarity as well as their mechanical rigidness result in their versatile use in applications such as contact lenses, wearable sensors, and flexible electronics. These applications require precise adhesion, so the need for a simple, quantitative adhesion measurement technique is critical. Several methods have already been developed that quantify the adhesion of flexible thin films attached to rigid substrates. However, when the thin films are rigid and the substrates compliant, these methods are insufficient. In the authors’ previous work, an adhesion measurement technique was developed that took advantage of well-characterized surface buckling instabilities that formed when the system was placed in lateral compressive strain, exploiting the wrinkling to delamination transition that occurred. This technique was proven to work for a narrow range of materials. Therefore, the focus of this paper was to validate this wrinkling to delamination adhesion measurement technique by utilizing a variety of film-substrate systems with varying surface energies and substrate moduli. In the authors’ previous work, the technique was validated using polystyrene (PS) and poly(methyl methacrylate) (PMMA) as high surface energy polymer thin films and poly(dimethyl siloxane) (PDMS) as a low surface energy substrate. In this work, Teflon AF 1600, a polytetrafluoroethylene copolymer, was utilized as a low surface energy thin film and bovine gelatin as a high surface energy substrate to determine the limitations of this adhesion technique

Teaching Outside the Box: Student and Teacher Perceptions of Flexible Learning Environments Outside the 21st Century Classroom

The purpose of this study was to ascertain student and teacher perceptions of the environment in which student learning takes place and their perceptions of how it has helped them in the cognitive and social domains. Data collected were through student and teacher perception surveys, student and teacher perception questionnaires, classroom observations, student focus group discussions, and teacher interviews. Themes that emerged from the data sources were student interactions, students' autonomy in personalizing their learning space, teacher perceptions of comfort in the classroom, and student perceptions of comfort in the classroom. The findings of this study point to four recommendations for educational leaders to ensure the effective implementation of new and dynamic learning spaces: (1) consult and support teacher and students, (2) provide professional development, (3) visit campuses and other learning spaces, and (4) add color. In order for real change to take place, teachers need to enquire about and embrace student preferences and allow for the discomfort that will be present when trying something new. Teachers must be willing to relinquish control of the learning experience for the student in order to allow for possibilities in personalized learning on the part of the student. They must risk initial failure in order to allow for greater successes in the long run

Toy for Preschoolers with Deaf-Blindness

There are approximately 70,000-100,000 people living in America that are diagnosed as deaf-blind. Since children with deaf-blindness are an extreme minority in the US, research, toys and technological advancements for these children get overlooked. As a result, the developmental processes of children with deaf-blindness are delayed by several years, compared to normal children, due to the lack of resources available to encourage learning. According to Virginia’s Department of Education standards of learning for preschoolers, development physically, mathematically,of environmental awareness and of a sense of self are core requirements for Kindergarten. Therefore, there is a need for a toy that will provide stimulation to develop physical, social, and cognitive progression to keep children with deaf-blindness on a normal learning curve. Our design consists of components each of which stimulate one of the development goals. The first component is a chair that promotes proper posture. The second component is a colored and vibrating drum game to stimulate mathematical development through pattern recognition. The third component is a Braille exposure game to stimulate literacy development, by associating a Braille word with an object or concept. The fourth component is an apparatus that can be placed over the chair that contains dangling objects where the child can reach out to explore their surrounding environment. Under the supervision and interaction of a parent/guardian, the child will develop socially through human interaction and feedback suggested in the provided instruction manual. Our team has been conducting research online and consulting professionals that have worked, or are currently working, in the deaf-blind field; therefore we gathered information on how children with deaf-blindness typically react to certain stimuli and various developmental concerns, to aid with the design of the toy components. With this foundation, our group drafted a variety of design concepts. We weighed out the positives, negatives, and overall efficiency of each concept which lead us to produce our final design. Then we presented our final design to our faculty advisor, perfect our idea and move forward with materials selection. Our next step in the design process is to test the efficiency of different materials and methods that we selected for the stimulatory components through experimentation and computation of engineering principles behind the design. Unfortunately our group encountered a problem in the design process, we are behind in the construction of the chair components due to the amount of time it took to complete the machine shop class. Once our testing is completed, we will begin to construct and complete the full prototype of our product.https://scholarscompass.vcu.edu/capstone/1003/thumbnail.jp

Online Versus In-person Mathematics Instruction: A Comparison of Two Instructional Models

Our paper explores the differences between online and traditional, in-person teaching and learning modalities, looking specifically at courses preparing teachers to be mathematics teacher leaders. In the context of current research on the teaching and learning of mathematics in an online setting, we share our own experiences. We describe the preparation for and teaching of online mathematics, focusing on establishing norms and the use of technology. The changing teaching and learning opportunities of the 21st century require discussion of these vital issues. We include stories of interactions between candidates and teachers and among groups of candidates in mathematics courses, detailing not just the discursive and work-sharing tools but the nature and nuance of these interactions and how they mediate mathematics learning. We share our online teaching and learning experiences, drawing on research to frame our impressions. By identifying key similarities and differences between instructional modalities and by reflecting critically on our own successes and challenges, we present a vision of online teaching and learning for mathematics courses, in particular those for mathematics specialists, that can be effective, inclusive, and relational

Nutrition Education in Food Pantries: Perceptions of Pantry Personnel towards Implementation

Extension programming can be effective at delivering nutrition education to food pantry clients. This study aimed to understand the perceptions of food pantry personnel towards nutrition education. A mixed methods survey was administered to food pantry personnel (n=53). Most (62.3%) reported their food pantry was church-affiliated, and few (22.6%) reported any Extension collaboration. Qualitative themes included perceptions that nutrition education was resource intensive, clients were not interested in nutrition education, and differing attitudes towards nutrition education. When working with food pantries, Extension should educate personnel about the importance of nutrition education, offer resources, and facilitate programming

Social Science Considerations for Integrating Aviation Technology, Emergency Services, and Human Resilience

Unmanned aerial systems (UAS) have a range of innovative applications within the field of disaster management, underscoring the potential to enhance human security by integrating UAS across phases of disasters. This paper highlights important social science challenges that must be addressed to ensure the effective integration of UAS, the complex team of teams that respond to disasters, and the populations affected by disasters. Expanding upon points of intersection between UAS capabilities and disaster management identified in recent research, UAS uses in disaster management and corresponding psychosocial considerations are discussed. Broadly, these considerations focus on the training and development of the disaster management multiteam system (MTS) as well as the well-being of disaster responders and the populations they serve. Considerations for mitigation (resilient team infrastructure), preparation (education and training), response (an integrated MTS; responder health), and recovery (population resilience) phases of disaster management are discussed to pave the way for future research and application in this area

Integrating Aviation Technology, Emergency Services, and Human Resilience: Considerations from Social Scientists

Unmanned aerial systems (UAS) have a range of applications within the field of disaster response. This presentation offers a novel framework of psychosocial considerations designed to advance UAS and disaster management integration. Social scientists highlight important challenges to the effective integration of three primary entities: UAS, the team of teams that responds to disasters, and populations affected by disasters. The presentation adopts an emerging theoretical perspective on the intersection between UAS capabilities and disaster phases and extends it by bringing necessary attention to social science issues. Specifically, the framework outlines psychosocial considerations and areas of improvement for preparation (training), response (incident command), and recovery (occupational health; population resilience) phases of disaster management. First, training curricula must involve the full disaster response multiteam system (MTS; i.e., team of teams) in cross-training that builds a shared identity by operationalizing UAS as a component team. Second, disaster response MTSs must establish incident command structures that incorporate UAS into team communication and coordination networks. Third, the implications of stressors unique to UAS operation need to be better understood in the context of existing cyclical effects of work stress on disaster responder performance and well-being. Finally, as crisis communication affects disaster-impacted communities, populations must be able to leverage UAS as a mechanism for, and not a barrier against, recovery from disaster. Across the globe, disasters threaten human security. This presentation provides a necessary interdisciplinary perspective on implementing UAS in disaster management to help the world better prepare for, respond to, recover from, and mitigate disasters