Master of Science

thesisPatient safety has received unprecedented attention over the past decade. Some of that attention has been focused on the occurrence and prevention of harm from Adverse Drug Events (ADEs). Between 19 and 61 percent of ADEs are preventable. In order to prevent ADEs, they must first be detected. Several methods have been used to detect ADEs, including voluntary reporting, intensified surveillance, and computerized monitoring. Computerized monitoring has been shown to be complimentary to other methods in detecting ADEs. However, very little research has been completed on this method in pediatrics. Pediatric patients pose unique challenges and risks because of physiological immaturity, lack of testing and information on medications, availability of appropriate medication formulations and strengths, and incomplete cognitive and communication development. This study examined the modification and implementation of an adult computerized ADE monitoring tool at one pediatric medical center. It was implemented into the daily practice of pharmacy operations without increasing the pharmacy resources. Pharmacists printed daily reports containing alerts of possible ADEs. They investigated each of the alerts and noted whether an ADE occurred and how much time was needed to investigate. The main objective of this study was to increase the detection of ADEs in the pediatric population. iv Over the 12-week study, 181 ADEs were identified via the computerized monitoring tool. An additional 88 ADEs were voluntarily reported. Overall, this represented a rate of 6.6 ADEs per 100 admissions and 14.8 ADEs per 1,000 patient days. This result represented a significant increase in the detection of ADEs (p<0.0001) as compared to the same timeframe from the previous year. The computerized monitoring tool had a positive predictive value (PPV) of 4.8 percent. It took an average of 6.1 minutes to investigate alerts associated with an ADE, which was significantly higher than the time it took to investigate alerts not associated with an ADE (p<0.0001). Of the ADEs found with this tool, 10.5 percent were considered preventable. The use of a modified computerized ADE monitoring tool in the pediatric environment increased the overall detection of ADEs and warrants continued research

An Evaluation of Purebred Bull Pricing: Implications for Beef Herd Management

The selection of herd bulls is important in determining profitability of commercial ranchers and cow-calf operators as well as purebred producers. In this research, the key attributes of bulls – based on visual, performance, and ultrasound data – are valued using a traditional hedonic pricing model. The data are collected from the annual bull test trial and sale at Southern Illinois University Carbondale. The results suggest that buyers at the SIUC Beef Evaluation Station are willing to pay more for bull characteristics associated with calving ease and weaning weights. For instance bulls with a combination of both lower birth weight Expected Progeny Differences (EPDs) and high yearling weight EPDs than average can command premiums of over $1,150 per head or 67 percent above the average sale price. Farm managers can use this information in the selection of herd bulls while purebred operators can attempt to select for the most valuable traits.Livestock Production/Industries,

Common Ravens Disrupt Greater Sage-grouse Lekking Behavior in the Great Basin, USA

Expansion of human enterprise has contributed to increased abundance and distribution of common ravens (Corvus corax; ravens) across sagebrush (Artemisia spp.) ecosystems within western North America. Ravens are highly effective nest predators of greater sage-grouse (Centrocercus urophasianus; sage-grouse), a species of high conservation concern. Sage-grouse population trends are estimated using count survey data of males attending traditional breeding grounds, known as leks. We sought to investigate associations of ravens to sage-grouse lek sites and document interactions between the sage-grouse and ravens as well as those between sage-grouse and other animals observed around leks. First, we used extensive raven point counts and sage-grouse lek observation data collected across Nevada and California, USA, from 2009–2019 to evaluate spatial associations between sage-grouse and ravens while accounting for other environmental covariates. We found that ravens were more likely to be observed closer to lek sites, especially as leks increased in size. Second, we used a subset of the lek dataset from 2006–2019 to describe behavioral changes of male sage-grouse in the presence of ravens and other predators. Our analysis indicated that ravens are attracted to lek sites and were associated with disrupting lekking sage-grouse by causing flushes or ceasing displaying behaviors. These results suggest that adult and yearling sage-grouse perceive ravens as a reason to alter breeding activity, and ravens may adversely influence their reproduction during the lekking stage. Additionally, standardized techniques to count sage-grouse on leks for population trend analyses could be biased low if raven presence during surveys is not accounted for

Governor of the glnAp2 promoter of Escherichia coli

Low-affinity sites for the activator NRI∼P (NtrC∼P) that map between the enhancer and the glnAp2 promoter were responsible for limiting promoter activity at high concentrations of NRI∼P in intact cells and in an in vitro transcription system consisting of purified bacterial components. That is, the low-affinity sites constitute a ‘governor’, limiting the maximum promoter activity. As the governor sites are themselves far from the promoter, they apparently act either by preventing the formation of the activation DNA loop that brings the enhancer-bound activator and the promoter-bound polymerase into proximity or by preventing a productive interaction between the enhancer-bound activator and polymerase. The combination of potent enhancer and governor sites at the glnAp2 promoter provides for efficient activation of the promoter when the activator concentration is low, while limiting the maximum level of promoter activity when the activator concentration is high.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75402/1/j.1365-2958.2002.03211.x.pd

Storytelling for impact: the creation of a storytelling program for patient partners in research

Abstract Storytelling is a powerful means to evoke empathy and understanding among people. When patient partners, which include patients, family members, caregivers and organ donors, share their stories with health professionals, this can prompt listeners to reflect on their practice and consider new ways of driving change in the healthcare system. However, a growing number of patient partners are asked to ‘share their story’ within health care and research settings without adequate support to do so. This may ultimately widen, rather than close, the gap between healthcare practitioners and people affected by chronic disease in this new era of patient and public involvement in research. To better support patient partners with storytelling in the context of a patient-oriented research network, Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network adapted an existing in-person storytelling workshop for patient educators within a hospital setting. The result is a 6-week virtual program called Storytelling for Impact, which guides patients, family members, caregivers and organ donors in developing impactful stories and sharing them at health care and research events, e.g., conferences. The online series of synchronous workshops is co-facilitated by story coaches, who are program alumni and Can-SOLVE CKD staff with trained storytelling experience. Each story follows a structure that includes a call to action, which aims to positively impact the priority-setting and delivery of care and research in Canada. The program has been a transformational process for many who have completed it, and numerous other health organizations have expressed interest in sharing this tool with their own patient partners. As result, we have also created an asynchronous online program that can be used by other interested parties outside our network. Patient partners who share their stories can be powerful mediators for inspiring changes in the health care and research landscape, with adequate structured support. We describe two novel programs to support patient partners in impactful storytelling, which are applicable across all health research disciplines. Additional resources are required for sustainability and scale up of training, by having alumni train future storytellers.Plain English summary Storytelling is a powerful means to evoke empathy and understanding among people. When patient partners share their stories with health professionals, this can prompt listeners to reflect on their practice and consider new ways of improving the healthcare system. However, as a growing number of patient partners are asked to ‘share their story’ within health care and research settings, there is often not enough tools and resources to support them in preparing their stories in a way that will be impactful for the audience members. Our kidney research network sought to create a novel in-person storytelling program to address this gap within our health research context. The result is a 6-week program called Storytelling for Impact, which guides patient partners—which includes patients, family members, caregivers and organ donors—in developing impactful stories and sharing them in a formal setting. The program is led by story coaches, who are patient partners and staff with trained storytelling experience. Participants are encouraged to include a call to action in their story, which aims to outline clear ways in which health professionals can facilitate positive change in health research or care. Many participants have described the program as transformational, and numerous other health organizations have expressed interest in sharing this tool with their own patient partners. As a result, we have also created a second online program that can be used by other interested parties outside our network. This paper highlights the adaptation process, content, participant feedback and next steps for the program

Administration of thimerosal-containing vaccines to infant rhesus macaques does not result in autism-like behavior or neuropathology

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Some anecdotal reports suggest that ASD is related to exposure to ethyl mercury, in the form of the vaccine preservative, thimerosal, and/or receiving the measles, mumps, rubella (MMR) vaccine. Using infant rhesus macaques receiving thimerosal-containing vaccines (TCVs) following the recommended pediatric vaccine schedules from the 1990s and 2008, we examined behavior, and neuropathology in three brain regions found to exhibit neuropathology in postmortem ASD brains. No neuronal cellular or protein changes in the cerebellum, hippocampus, or amygdala were observed in animals following the 1990s or 2008 vaccine schedules. Analysis of social behavior in juvenile animals indicated that there were no significant differences in negative behaviors between animals in the control and experimental groups. These data indicate that administration of TCVs and/or the MMR vaccine to rhesus macaques does not result in neuropathological abnormalities, or aberrant behaviors, like those observed in ASD

“A General Separation of Colored and White”: the WWII riots, military segregation, and racism(s) beyond the White/Nonwhite binary

This article uses archival research to explore important differences in the discursive and institutional positioning of Mexican American and African American men during World War II. Through the focal point of the riots which erupted in Los Angeles and other major cities in the summer of 1943, I examine the ways in which black and Mexican ‘rioters’ were imagined in official and popular discourses. Though both groups of youth were often constructed as deviant and subversive, there were also divergences in the ways in which their supposed racial difference was discursively configured. I also consider the experiences of each group in the WWII military, a subject that has received little attention in previous work on the riots. Though both groups were subject to discrimination and brutality on the home front, only African Americans were segregated in the military - a fact that profoundly influenced the 1943 riots. Examining the very different conditions under which these men served, as well as the distinct ways in which their presence within the military and on the home front was interpreted and given meaning by press, law enforcement and military officials helps to illuminate the uneven and complex workings of racism in America, disrupting the common conceptualization of a definitive white/nonwhite color line