Exploring Students\u27 Perceptions of Academically Based Living-Learning Communities

This qualitative study employed focus group interviews to explore students\u27 perceptions of three well established academically based living-learning communities at a large, land-grant university in the Midwest. Three themes emerged that illustrated students\u27 perceptions of a culture that promoted seamless learning, a scholarly environment, and an ethos of relatedness among faculty, staff, and peers. Implications for practice and future research are discussed

Contextualized Treatment in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year after Discharge

Objective To evaluate the effect of providing a greater percentage of therapy as contextualized treatment on acute traumatic brain injury (TBI) rehabilitation outcomes. Design Propensity score methods are applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation. Participants Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures Participation Assessment with Recombined Tools-Objective- -17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale and Patient Health Questionnaire-9. Results Increasing the percentage of contextualized treatment during inpatient TBI rehabilitation leads to better outcomes, specifically in regard to community participation. Conclusions Increasing the proportion of treatment provided in the context of real-life activities appears to have a beneficial impact on outcome. Although the effect sizes are small, the results are consistent with other studies supporting functional-based interventions effecting better outcomes. Furthermore, any positive findings, regardless of size or strength, are endorsed as important by consumers (survivors of TBI). While the findings do not imply that decontextualized treatment should not be used, when the therapy goal can be addressed with either approach, the findings suggest that better outcomes may result if the contextualized approach is used

Impact of Level of Effort on the Effects of Compliance with the 3-Hour Rule

Objective To determine if patients’ level of effort (LOE) in therapy sessions during traumatic brain injury (TBI) rehabilitation modifies the effect of compliance with the 3-Hour Rule of the Centers for Medicare & Medicaid Services. Design Propensity score methodology applied to the TBI-Practice-Based Evidence (TBI-PBE) database, consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation facilities (IRF). Participants Patients (n=1820) who received their first IRF admission for TBI in the US and were enrolled for 3 and 9 month follow-up. Main Outcome Measures Participation Assessment with Recombined Tools-Objective-17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results When the full cohort was examined, no strong main effect of compliance with the 3-Hour Rule was identified and LOE did not modify the effect of compliance with the 3-Hour Rule. In contrast, LOE had a strong positive main effect on all outcomes, except depression. When the sample was stratified by level of disability, LOE modified the effect of compliance, particularly on the outcomes of participants with less severe disability. For these patients, providing 3 hours of therapy for 50%+ of therapy days in the context of low effort resulted in poorer performance on select outcome measures at discharge and up to 9 months post discharge compared to patients with <50% of 3-hr therapy days. Conclusions LOE is an active ingredient in inpatient TBI rehabilitation, while compliance with the 3-Hour Rule was not found to have a substantive impact on the outcomes. The results support matching time in therapy during acute TBI rehabilitation to patients’ LOE in order to optimize long-term benefits on outcomes

Family Involvement in Traumatic Brain Injury Inpatient Rehabilitation: A Propensity Score Analysis of Effects on Outcomes During the First Year After Discharge

Objective To evaluate the effect of family attendance at inpatient rehabilitation therapy sessions on traumatic brain injury (TBI) patient outcomes at discharge and up to 9 months postdischarge. Design Propensity score methods are applied to the TBI Practice-Based Evidence database, a database consisting of multisite, prospective, longitudinal, and observational data. Setting Nine inpatient rehabilitation centers in the United States. Participants Patients (N=1835) admitted for first inpatient rehabilitation after an index TBI. Intervention Family attendance during therapy sessions. Main Outcome Measures Participation Assessment for Recombined Tools-Objective-17 (Total scores and subdomain scores of Productivity, Out and About, and Social Relations), Functional Independence Measure, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results Participants whose families were in attendance for at least 10% of the treatment time were more out and about in their communities at 3 and 9 months postdischarge than participants whose families attended treatment less than 10% of the time. Although findings varied by propensity score method, improved functional independence in the cognitive area at 9 months was also associated with increased family attendance. Conclusions Family involvement during inpatient rehabilitation may improve community participation and cognitive functioning up to 9 months after discharge. Rehabilitation teams should engage patients’ families in the rehabilitation process to maximize outcomes

Advanced Therapy in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year after Discharge

Objective To use causal inference methods to determine if receipt of a greater proportion inpatient rehabilitation treatment focused on higher level functions, e.g. executive functions, ambulating over uneven surfaces (Advanced Therapy, AdvTx) results in better rehabilitation outcomes. Design A cohort study using propensity score methods applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation (IRF). Participants Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission to one of 9 sites in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures: Participation Assessment with Recombined Tools-Objective-17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results Controlling for measured potential confounders, increasing the percentage of AdvTx during inpatient TBI rehabilitation was found to be associated with better community participation, functional independence, life satisfaction, and decreased likelihood of depression during the year following discharge from inpatient rehabilitation. Participants who began rehabilitation with greater disability experienced larger gains on some outcomes than those who began rehabilitation with more intact abilities. Conclusions Increasing the proportion of treatment targeting higher level functions appears to have no detrimental and a small, beneficial effect on outcome. Caution should be exercised when inferring causality given that a large number of potential confounders could not be completely controlled with propensity score methods. Further, the extent to which unmeasured confounders influenced the findings is not known and could be of particular concern due to the potential for the patient’s recovery trajectory to influence therapists’ decisions to provide a greater amount AdvTx

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Étude comparative des paramètres atmosphériques d'étoiles naines blanches déterminés par les techniques photométrique et spectroscopique

Ce mémoire présente une analyse comparative des paramètres atmosphériques obtenus à l’aide des techniques photométrique et spectroscopique. Pour y parvenir, les données photométriques et spectroscopiques de 1375 naines blanches de type DA tirées du Sloan Digital Sky Survey (SDSS) ainsi que les données spectroscopiques du Villanova White Dwarf Catalog ont été utilisées. Il a d’abord fallu s’assurer que les données photométriques et spectroscopiques étaient bien calibrées. L’analyse photométrique a démontré que la photométrie ugriz ne semblait pas avoir de problème de calibration autre que le décalage des points zéro, qui est compensé en appliquant les corrections photométriques appropriées. De plus, le fait que le filtre u laisse passer le flux à certaines longueurs d’onde dans le rouge ne semble pas affecter la détermination des paramètres atmosphériques. L’analyse spectroscopique a ensuite confirmé que l’application de fonctions de correction permettant de tenir compte des effets hydrodynamiques 3D est la solution au problème de log g élevés. La comparaison des informations tirées des données spectroscopiques des deux différentes sources suggère que la calibration des spectres du SDSS n’est toujours pas au point. Les paramètres atmosphériques déterminés à l’aide des deux techniques ont ensuite été comparés et les températures photométriques sont systématiquement plus faibles que celles obtenues à partir des données spectroscopiques. Cet effet systématique pourrait être causé par les profils de raies utilisés dans les modèles d’atmosphère. Une méthode permettant d’obtenir une estimation de la gravité de surface d’une naine blanche à partir de sa photométrie a aussi été développée.We present a comparative analysis of atmospheric parameters obtained with the so-called photometric and spectroscopic techniques. Photometric and spectroscopic data for 1375 DA white dwarfs from the Sloan Digital Sky survey (SDSS) are used, as well as spectroscopic data from the Villanova White Dwarf Catalog. We first test the calibration of the ugriz photometric system by using model atmosphere fits to observed data. Our photometric analysis indicates that the ugriz photometry appears well calibrated when the SDSS standard photometric corrections are applied. We also show that the reported red leak of the u filter does not affect the results of the photometric analysis. The spectroscopic analysis of the same data set reveals that the so-called high log g problem can be solved by applying published correction functions that take into account 3D hydrodynamical effects. However, a comparison between the SDSS and the White Dwarf Catalog spectroscopic data also suggests that the SDSS spectra still suffer from a small calibration problem. We then compare the atmospheric parameters obtained from both fitting techniques and show that the photometric temperatures are systematically lower than those obtained from spectroscopic data. This systematic offset may be linked to the hydrogen line profiles used in the model atmospheres. We finally explore the results of a technique aimed at measuring surface gravities using photometric data only

Analyse et modélisation d’étoiles naines blanches de type DB dans le Sloan Digital Sky Survey et le relevé Gaia

L’étude des naines blanches repose principalement sur la détermination de leurs paramètres atmosphériques et physiques, tels que la température effective, la gravité de surface, la composition chimique de l’atmosphère, la masse, l’âge et la luminosité. Grâce aux grands relevés, le Sloan Digital Sky Survey (SDSS) et Gaia en particulier, qui ont rendu accessibles des données photométriques, spectroscopiques ainsi que la parallaxe trigonométrique pour des milliers de naines blanches, il est maintenant possible de déterminer ces quantités pour un très grand nombre de naines blanches. Une analyse comparative des paramètres atmosphériques des naines blanches DA et DB dans le SDSS et Gaia est présentée dans cette thèse. Cette analyse permet d’identifier certaines lacunes au niveau des modèles d’atmosphère, notamment les profils d’élargissement Stark dans les modèles d’atmosphère riches en hydrogène ainsi que les profils d’élargissement van der Waals dans ceux riches en hélium qui ne semblent pas tout à fait satisfaisants. Cette analyse permet aussi de révéler la présence de plusieurs systèmes binaires non-résolus de types DA+DA, DA+DC, DA+DB ainsi que DB+DB. Comme les techniques photométrique et spectroscopique ne permettent pas de déterminer tous les paramètres directement, il faut faire appel à la relation masse-rayon pour obtenir les autres quantités d'intérêt. Les parallaxes trigonométriques du relevé Gaia permettent de mettre à l’épreuve cette relation et de conclure à sa validité. Les naines blanches de type DB sont moins bien comprises du fait de leur rareté, donc une attention particulière leur est accordée. L’analyse des distributions de gravité de surface, de masse et d’abondance d’hydrogène révèle la présence de plusieurs objets d’intérêt, tels que des DB massives ou magnétiques. En particulier, la distribution des abondances d’hydrogène montre des naines blanches ayant des quantités bien différentes de cet élément dans leur atmosphère, ce qui suggère qu’elles ont suivi des canaux évolutifs différents. La fraction de naines blanches de type DB en fonction de la température reste relativement constante entre 40,000 K et 25,000 K, puis augmente graduellement jusqu’à atteindre son maximum à 15,000 K. Cette fluctuation est cohérente avec les deux canaux évolutifs et le scénario de dilution convective, c'est-à-dire que certaines DB ont conservé leur atmosphère riche en hélium durant toute leur évolution tandis que d’autres sont d’anciennes DA qui se sont transformées lorsque la mince couche superficielle d’hydrogène est diluée dans la couche convective d’hélium située en dessous. L’origine de l’hydrogène atmosphérique est cependant toujours sujette à débat. La plupart des DBA montrent des abondances beaucoup trop élevées pour pouvoir être expliquées par une origine résiduelle. Ces abondances élevées ne cadrent pas non plus dans le scénario de dilution convective, mettant un doute sur l’origine résiduelle. Une solution possible à ce dilemme serait qu’une couche d’hydrogène flotte à la surface de la naine blanche, donnant ainsi l’illusion d’une plus grande abondance. Cette hypothèse est testée à l’aide de nouveaux modèles chimiquement stratifiés.The study of white dwarf stars relies heavily on the determination of their atmospheric and physical parameters, such as effective temperature, surface gravity, chemical composition, mass, age and luminosity. Thanks to surveys like the Sloan Digital Sky Survey (SDSS) or Gaia, photometric and spectroscopic data, as well as trigonometric parallaxes were made publicly available for a large number of white dwarfs, making it possible to determine the parameters listed above for very large samples. A comparative analysis of the atmospheric parameters of type DA and type DB white dwarfs from the SDSS and Gaia is presented in this thesis. This analysis reveals that the Stark broadening profiles in pure hydrogen model atmospheres as well as the van der Waals broadening treatment in helium-rich atmospheres need to be revisited. The comparison of photometric and spectroscopic effective temperatures and masses unveils the presence of DA+DA, DA+DC, DA+DB, as well as DB+DB unresolved double degenerate systems. The photometric and spectroscopic techniques can only determine a few parameters directly. To obtain the other quantities of interest, one must rely on evolutionary models and the mass-radius relation. The exquisite Gaia trigonometric parallaxes offer the opportunity to put this relation to the test for a large number of white dwarfs. It is found that the theoretical mass-radius relation is valid. The DB white dwarfs are less well understood than their hydrogen-rich counterpart since they are rarer. Therefore, a thorough analysis of the DB white dwarf population is presented. The analysis of the surface gravities and mass distribution reveals the presence of several objects of particular interest, massive or magnetic DB stars for example. The hydrogen abundance distribution also reveals that white dwarfs have very different quantities of that element in their atmosphere, in the same temperature range, suggesting that they must have followed different evolutionary channels. The fraction of DB stars remains somewhat constant between 40,000 K and 25,000 K and steadily increases below this temperature, reaching its peak value around 15,000 K. This is in line with the two evolutionary channels and the convective dilution scenario, where some DA transform into DB stars when the thin hydrogen layer at the surface is mixed in the underlying helium convection zone, while some DB stars retain their helium-rich atmosphere throughout their evolution. The origin of this photospheric hydrogen, however, is still up for debate. Most DBA white dwarfs have hydrogen abundances way too high to have a residual origin resulting from the convective dilution scenario. One possible solution to this dilemma is that a small residual hydrogen layer still floats on the surface, thus giving the illusion of a higher hydrogen content. This hypothesis is tested with new chemically stratified model atmospheres

Rural&ndash;Urban Differences in Behavioral Outcomes among Adults with Lifetime History of Traumatic Brain Injury with Loss of Consciousness: 2016&ndash;2019 Ohio BRFSS

This study examined if the associations between lifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) and unhealthy alcohol use or mental health problems differ by location of living (rural vs. urban). The lifetime history data of TBI with LOC, location of living, unhealthy alcohol use (binge drinking, heavy drinking), and mental health problems (depression diagnosis, number of poor mental health days) were sourced from the 2016, 2017, 2018, and 2019 Ohio Behavioral Risk Factory Surveillance Surveys, and the final sample included 16,941 respondents. We conducted multivariable logistic regressions to determine the odds ratios for each of the five outcomes between individuals living in rural vs. urban areas and between individuals with vs. without a lifetime history of TBI with LOC. No interaction between location of living and lifetime history of TBI with LOC was observed for any outcomes, indicating rurality did not modify these relationships. Living in a rural area was associated with decreased binge drinking or heavy drinking but not mental health outcomes. Lifetime history of TBI with LOC was associated with an increased risk of binge drinking, heavy drinking, depression diagnoses, and poor general mental health, regardless of location of living. Our findings support the need for TBI screenings as part of mental health intake evaluations and behavioral health screenings. Though rurality was not associated with mental health outcomes, rural areas may have limited access to quality mental health care. Therefore, future research should address access to mental health services following TBI among rural residents

Repenser la douleur

On estime qu’au Québec et au Canada, un individu sur cinq souffre de douleur chronique. Or, la preuve n’est plus à faire : le modèle de soins traditionnel, qui se concentre exclusivement sur la maladie, est ici particulièrement mal adapté. Comme c’est le cas pour d’autres affections chroniques, l’approche la plus efficace se révèle être interdisciplinaire, soutenue, intégrée, centrée sur le patient. L’amélioration de la prise en charge passera par l’établissement d’un nouveau dialogue entre chercheurs, cliniciens et patients, qui permettra de prendre en compte tous les enjeux de la douleur, en dépassant le cadre proprement médical. Le temps est venu de « repenser la douleur ». C’est dans cette perspective que s’est tenu en septembre 2007, à Montréal, le premier Colloque francophone sur la douleur. Le présent ouvrage est adapté des interventions d’experts issus de disciplines habituellement sollicitées, comme la médecine, les sciences infirmières, la psychologie, la neurophysiologie ou la biologie, et d’autres spécialités plus inattendues, comme la bio-éthique, le droit, la philosophie et la sociologie. Ces textes accessibles et éclairants et les quatre discussions thématiques qui les accompagnent font l’état des lieux de la recherche sur la douleur chronique, saisi à l’occasion d’une rencontre marquante dans l’histoire d’un domaine en pleine évolution