712 research outputs found
Effectiveness of the Career and College Promise Program in Increasing College Readiness at a Rural North Carolina Community College
This study addressed the effectiveness of the North Carolina Career and College Promise (NCCCP) program using Conley’s (2010) framework for college readiness in determining and promoting college readiness for students participating in the program at a rural North Carolina community college. An explanatory sequential mixed methods design was used in this study. Phase I involved quantitative data collection and analysis from existing statistical data in the form of NCCCP student final course grades (n=886), general education math common assessment scores (n=98), and CCP student (n=27) and instructor (n=9) responses to perception college readiness surveys. The quantitative data analysis was followed by Phase II of the study; an instructor focus group convened to explore themes emerging from the quantitative data. Through analysis of data collected, the results showed that CCP students scored significantly higher than non-CCP students in final course grades and MAT 152 common assessment scores. There was no significant difference in MAT 143 common assessment scores between the two groups. This study found no significant differences in perception of college readiness between CCP and non-CCP student (n=13) groups; however, CCP instructors rated their students significantly lower in terms of college readiness than CCP students rated themselves. Common themes identified from the CCP instructor focus group included lack of depth in writing, deficiencies in reading comprehension, poor critical thinking skills, and lack of academic skills such as time management and communication. Dual enrollment programs have been identified as one means of increasing student college readiness (Bailey & Karp, 2003) and thus creating seamless pathways from the secondary schools to postsecondary institutions. Based on this study’s findings, the NCCCP program is effective at this rural western North Carolina community college in determining and promoting college readiness
Interviewing forensic mental health patients who have a history of aggression: considerations and suggestions
This paper discusses issues arising when interviewing men and women in forensic mental health services, noting that many patients in these settings have significant histories of aggression or violence. The differences between interviews conducted for assessment purposes and those that are conducted as part of treatment are noted. We identify some important considerations for interviewers. These relate to characteristics of the client, characteristics of the interviewer, and features of the mental health setting that might impact on the interview. Some practical recommendations are offered to assist forensic mental health practitioners who conduct both types of interview
A Versatile, Portable Intravital Microscopy Platform for Studying Beta-cell Biology In Vivo
The pancreatic islet is a complex micro-organ containing numerous cell types, including endocrine, immune, and endothelial cells. The communication of these systems is lost upon isolation of the islets, and therefore the pathogenesis of diabetes can only be fully understood by studying this organized, multicellular environment in vivo. We have developed several adaptable tools to create a versatile platform to interrogate β-cell function in vivo. Specifically, we developed β-cell-selective virally-encoded fluorescent protein biosensors that can be rapidly and easily introduced into any mouse. We then coupled the use of these biosensors with intravital microscopy, a powerful tool that can be used to collect cellular and subcellular data from living tissues. Together, these approaches allowed the observation of in vivo β-cell-specific ROS dynamics using the Grx1-roGFP2 biosensor and calcium signaling using the GcAMP6s biosensor. Next, we utilized abdominal imaging windows (AIW) to extend our in vivo observations beyond single-point terminal measurements to collect longitudinal physiological and biosensor data through repeated imaging of the same mice over time. This platform represents a significant advancement in our ability to study β-cell structure and signaling in vivo, and its portability for use in virtually any mouse model will enable meaningful studies of β-cell physiology in the endogenous islet niche
Pediatric Critical Care in Resource-Limited Settings-Overview and Lessons Learned.
Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs) remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU) and high dependency areas. PICU can improve the quality of pediatric care in general and, if properly organized, can effectively treat the severe complications of high burden diseases, such as diarrhea, severe malaria, and respiratory distress using low-cost interventions. Setting up a PICU in a LMIC setting requires planning, specific resources, and most importantly investment in the nursing and permanent medical staff. A thoughtful approach to developing pediatric critical care services in LMICs starts with fundamental building blocks: training healthcare professionals in skills and knowledge, selecting resource appropriate effective equipment, and having supportive leadership to provide an enabling environment for appropriate care. If these fundamentals can be built on in a sustainable manner, an appropriate critical care service will be established with the potential to significantly decrease pediatric morbidity and mortality in the context of public health goals as we reach toward the sustainable development goals
Artemisinin resistance--modelling the potential human and economic costs.
BACKGROUND: Artemisinin combination therapy is recommended as first-line treatment for falciparum malaria across the endemic world and is increasingly relied upon for treating vivax malaria where chloroquine is failing. Artemisinin resistance was first detected in western Cambodia in 2007, and is now confirmed in the Greater Mekong region, raising the spectre of a malaria resurgence that could undo a decade of progress in control, and threaten the feasibility of elimination. The magnitude of this threat has not been quantified. METHODS: This analysis compares the health and economic consequences of two future scenarios occurring once artemisinin-based treatments are available with high coverage. In the first scenario, artemisinin combination therapy (ACT) is largely effective in the management of uncomplicated malaria and severe malaria is treated with artesunate, while in the second scenario ACT are failing at a rate of 30%, and treatment of severe malaria reverts to quinine. The model is applied to all malaria-endemic countries using their specific estimates for malaria incidence, transmission intensity and GDP. The model describes the direct medical costs for repeated diagnosis and retreatment of clinical failures as well as admission costs for severe malaria. For productivity losses, the conservative friction costing method is used, which assumes a limited economic impact for individuals that are no longer economically active until they are replaced from the unemployment pool. RESULTS: Using conservative assumptions and parameter estimates, the model projects an excess of 116,000 deaths annually in the scenario of widespread artemisinin resistance. The predicted medical costs for retreatment of clinical failures and for management of severe malaria exceed US385 million for each year during which failing ACT remained in use as first-line treatment. CONCLUSIONS: These 'ballpark' figures for the magnitude of the health and economic threat posed by artemisinin resistance add weight to the call for urgent action to detect the emergence of resistance as early as possible and contain its spread from known locations in the Mekong region to elsewhere in the endemic world
A Case Control Study of Nutrient Intake Deficiencies in Patients Taking Warfarin
Introduction
We previously published the case of a woman taking warfarin who was found to have scurvy, a disease caused by a deficiency of vitamin C. This led us to hypothesize that patients taking warfarin who consume a diet limited in vitamin K rich foods may be at risk for other nutrient deficiencies. To test our hypothesis, we studied dietary nutrient intake in patients taking warfarin compared to patients with heart disease not taking warfarin.
Methods
The warfarin (n=59) and control groups (n=24) comprised convenience samples of patients with heart disease over age 60 years. Patients completed a three-day food diary and reported use of supplements.
Results
Based on diet history, the most common deficiencies were vitamin D (100% both groups), vitamin E (93% warfarin, 92% control), vitamin A (71% warfarin, 71% control), vitamin K (66% warfarin, 58% control), vitamin C (58 % warfarin, 46% control) and pantothenic acid (69% warfarin, 71% control) with no significant differences in intake deficiencies between warfarin and control groups.
Conclusion
All of our patients had nutritional intake deficiencies. This may be due to Appalachian dietary habits and not the low vitamin K diet. It seems prudent to recommend multivitamins, however, universal multivitamin supplementation has not been supported by randomized controlled trials. More study is needed to determine the reason for poor nutritional intake in our Appalachian population and to determine whether similar results are evident in a larger sample
Targeting chondroitinase ABC to axons enhances the ability of chondroitinase to promote neurite outgrowth and sprouting.
BACKGROUND:There is currently no effective treatment for promoting regeneration of injured nerves in patients who have sustained injury to the central nervous system such as spinal cord injury. Chondroitinase ABC is an enzyme, which promotes neurite outgrowth and regeneration. It has shown considerable promise as a therapy for these conditions. The aim of the study is to determine if targeting chondroitinase ABC expression to the neuronal axon can further enhance its ability to promote axon outgrowth. Long-distance axon regeneration has not yet been achieved, and would be a significant step in attaining functional recovery following spinal cord injury. METHODOLOGY/PRINCIPAL FINDINGS:To investigate this, neuronal cultures were transfected with constructs encoding axon-targeted chondroitinase, non-targeted chondroitinase or GFP, and the effects on neuron outgrowth and sprouting determined on substrates either permissive or inhibitory to neuron regeneration. The mechanisms underlying the observed effects were also explored. Targeting chondroitinase to the neuronal axon markedly enhances its ability to promote neurite outgrowth. The increase in neurite length is associated with an upregulation of β-integrin staining at the axonal cell surface. Staining for phosphofocal adhesion kinase, is also increased, indicating that the β-integrins are in an activated state. Expression of chondroitinase within the neurons also resulted in a decrease in expression of PTEN and RhoA, molecules which present a block to neurite outgrowth, thus identifying two of the pathways by which ChABC promotes neurite outgrowth. CONCLUSIONS / SIGNIFICANCE:The novel finding that targeting ChABC to the axon significantly enhances its ability to promote neurite extension, suggests that this may be an effective way of promoting long-distance axon regeneration following spinal cord injury. It could also potentially improve its efficacy in the treatment of other pathologies, where it has been shown to promote recovery, such as myocardial infarction, stroke and Parkinson's disease
Impacts of coastal infrastructure on shoreline response to major hurricanes in southwest Louisiana
© The Author(s), 2022. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Cadigan, J., Bekkaye, J., Jafari, N., Zhu, L., Booth, A., Chen, Q., Raubenheimer, B., Harris, B., O’Connor, C., Lane, R., Kemp, G., Day, J., Day, J., & Ulloa, H. Impacts of coastal infrastructure on shoreline response to major hurricanes in southwest Louisiana. Frontiers in Built Environment, 8, (2022): 885215. https://doi.org/10.3389/fbuil.2022.885215.The Rockefeller Wildlife Refuge, located along the Chenier Plain in Southwest Louisiana, was the location of the sequential landfall of two major hurricanes in the 2020 hurricane season. To protect the rapidly retreating coastline along the Refuge, a system of breakwaters was constructed, which was partially completed by the 2020 hurricane season. Multi-institutional, multi-disciplinary rapid response deployments of wave gauges, piezometers, geotechnical measurements, vegetation sampling, and drone surveys were conducted before and after Hurricanes Laura and Delta along two transects in the Refuge; one protected by a breakwater system and one which was the natural, unprotected shoreline. Geomorphological changes were similar on both transects after Hurricane Laura, while after Delta there was higher inland sediment deposition on the natural shoreline. Floodwaters drained from the transect with breakwater protection more slowly than the natural shoreline, though topography profiles are similar, indicating a potential dampening or complex hydrodynamic interactions between the sediment—wetland—breakwater system. In addition, observations of a fluidized mud deposit in Rollover Bayou in the Refuge are presented and discussed in context of the maintenance of wetland elevation and stability in the sediment starved Chenier Plain.Funding for the study has been partially provided by the National Science Foundation through grants NSF 2139882, 2139883, 1829136, 1848650, and 1939275, as well as through the United States Army Corps of Engineers Regional Sediment Management program. Student support provided through the National Science Foundation Graduate Research Fellowship Program and the Louisiana Coastal Science Assistantship Program
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