KAD Africa: Trauma Management Curriculum

To increase healthy coping and reduce trauma symptoms for KadAfrica beneficiaries, we created a comprehensive curriculum guide based on our main research findings. It includes activities, tools, and information to be delivered by the cluster coaches to help promote mental health hygiene and coping skills for beneficiaries. This will help KadAfrica holistically increase the wellness, agency, and quality of life for their beneficiaries as they continue their microenterprises

Core compressor exit stage study. 1: Aerodynamic and mechanical design

The effect of aspect ratio on the performance of core compressor exit stages was demonstrated using two three stage, highly loaded, core compressors. Aspect ratio was identified as having a strong influence on compressors endwall loss. Both compressors simulated the last three stages of an advanced eight stage core compressor and were designed with the same 0.915 hub/tip ratio, 4.30 kg/sec (9.47 1bm/sec) inlet corrected flow, and 167 m/sec (547 ft/sec) corrected mean wheel speed. The first compressor had an aspect ratio of 0.81 and an overall pressure ratio of 1.357 at a design adiabatic efficiency of 88.3% with an average diffusion factor or 0.529. The aspect ratio of the second compressor was 1.22 with an overall pressure ratio of 1.324 at a design adiabatic efficiency of 88.7% with an average diffusion factor of 0.491

Core compressor exit stage study, 2

A total of two three-stage compressors were designed and tested to determine the effects of aspect ratio on compressor performance. The first compressor was designed with an aspect ratio of 0.81; the other, with an aspect ratio of 1.22. Both compressors had a hub-tip ratio of 0.915, representative of the rear stages of a core compressor, and both were designed to achieve a 15.0% surge margin at design pressure ratios of 1.357 and 1.324, respectively, at a mean wheel speed of 167 m/sec. At design speed the 0.81 aspect ratio compressor achieved a pressure ratio of 1.346 at a corrected flow of 4.28 kg/sec and an adiabatic efficiency of 86.1%. The 1.22 aspect ratio design achieved a pressure ratio of 1.314 at 4.35 kg/sec flow and 87.0% adiabatic efficiency. Surge margin to peak efficiency was 24.0% with the lower aspect ratio blading, compared with 12.4% with the higher aspect ratio blading

Do I Really Belong Here? : The Effects of Difference in Paths Through Higher Education on Graduate Student Perception on Legitimacy

Why do some master\u27s level students feel confident in completing their programs and some do not? Why do some feel connected to their department and some do not? Why do some feel legitimate as graduate students and some do not? This research proposes that there may be differences in how master\u27s students understand the graduate student role based on whether they went directly from high-school through their bachelor\u27s to their master\u27s, or if they took time off between their bachelor\u27s and master\u27s program. This thesis used in-depth interviews with twelve second-year master\u27s students at Portland State University to explore these questions: six with students who had a linear trajectory through higher education and six with students who had a break after completing their bachelor\u27s and before returning for their master\u27s (broken trajectory students). Students from both groups began their programs with questions about their ability to perform at a master\u27s level. Broken trajectory students were more likely to have thought through their chances of success and entered their programs \u27knowing\u27 that they would successfully co~plete the programs even when they questioned their academic abilities. Students from both groups overall felt a progressive increase in feelings of connection to their departments. The linear trajectory students entered their programs with some established feelings of connection with other graduate students. The broken trajectory students did not have these established connections, but desired connection with other serious students. Overall, students from both groups experienced increased feelings of legitimacy as graduate students, but the criteria by which they judged their legitimacy differed between groups. Linear trajectory students used academic ability as a primary measure of legitimacy, where broken trajectory students used having a clear understanding of why they were in graduate school as the standard to determine whether they belonged in college. The two groups also differed in the source of their student role standard: broken trajectory students used professors as their role reference group, whereas the linear trajectory students used peers and undergraduate students. This thesis closes with a discussion of the implications of this research for theory, programs, and current models of persistence

A Pilot Study Considering Ecoroofs as Therapeutic Landscapes

The potential for urban open spaces to convey therapeutic benefits is increasingly substantiated. More work is needed to specifically consider how low impact designs to manage stormwater such as ecoroofs perform in this context. Here, we report on a pilot study addressing: (1) factors determining whether a hospital has an ecoroof, and (2) how ecoroofs might convey therapeutic benefits. We utilized a mixed methods approach which encompassed phone interviews of hospital ecoroof managers as well as analysis of national hospital databases. We also conducted a local case study which compared cortisol samples and stress indicators from patients, staff, and caregivers visiting an ecoroof to those waiting indoors at the Oregon Health and Sciences University in Portland OR. Behavioral observations took place at this same location. In 2017, we identified 105 hospitals with ecoroofs in the contiguous United States. Our analysis of a national hospital database found two factors that significantly increased the likelihood of a hospital having an ecoroof: Medicaid discharges per year; and non-profit status. Interviews with practitioners nationally revealed a wide range of motivations but that therapy was a consideration for a majority, but notably not all, of the hospitals surveyed. They similarly noted variation in roof design, maintenance, and programming around horticultural therapy; we highlight some best practices here. Our physiological case study was limited in sample size. Preliminary findings showed that salivary cortisol levels varied by ecoroof visitor type, ranging on average from 0.09 μg/ml for caregivers to 0.30 μg/ml for patients. We did not observe any significant changes in visitor cortisol. This could be explained by low replication or the short treatment duration. Alternatively, these pilot data may indicate a gap in horticultural therapy theory vs. practice. Behavioral observations demonstrated a wide array of different uses of the ecoroof space such as cell phone use and passing by. Though preliminary, our findings suggest that therapeutic effects may vary by user type and activity and depend on roof design and goals. This study offers both information on the therapeutic potential of hospital ecoroofs as well as lessons learned regarding different approaches to researching this somewhat new topic

Capability of 2 Gait Measures for Detecting Response to Gait Training in Stroke Survivors: Gait Assessment and Intervention Tool and The Tinetti Gait Scale

Zimbelman J, Daly JJ, Roenigk KL, Butler K, Burdsall R, Holcomb JP. Capability of 2 gait measures for detecting response to gait training in stroke survivors: Gait Assessment and Intervention Tool and the Tinetti Gait Scale. Objective:To characterize the performance of 2 observational gait measures, the Tinetti Gait Scale (TGS) and the Gait Assessment and Intervention Tool (G.A.I.T.), in identifying improvement in gait in response to gait training. Design: In secondary analysis from a larger study of multimodal gait training for stroke survivors, we measured gait at pre-, mid-, and posttreatment according to G.A.I.T. and TGS, assessing their capability to capture recovery of coordinated gait components. Setting: Large medical center. Participants: Cohort of stroke survivors (N=44) greater than 6 months after stroke. Interventions: All subjects received 48 sessions of a multimodal gait-training protocol. Treatment consisted of 1.5 hours per session, 4 sessions per week for 12 weeks, receiving these 3 treatment aspects: (1) coordination exercise, (2) body weight–supported treadmill training, and (3) overground gait training, with 46% of subjects receiving functional electrical stimulation. Main Outcome Measures: All subjects were evaluated with the G.A.I.T. and TGS before and after completing the 48-session intervention. An additional evaluation was performed at midtreatment (after session 24). Results: For the total subject sample, there were significant pre-/post-, pre-/mid-, and mid-/posttreatment gains for both the G.A.I.T. and the TGS. According to the G.A.I.T., 40 subjects (91%) showed improved scores, 2 (4%) no change, and 2 (4%) a worsening score. According to the TGS, only 26 subjects (59%) showed improved scores, 16 (36%) no change, and 1 (2%) a worsening score. For 1 treatment group of chronic stroke survivors, the TGS failed to identify a significant treatment response to gait training, whereas the G.A.I.T. measure was successful. Conclusions: The G.A.I.T. is more sensitive than the TGS for individual patients and group treatment response in identifying recovery of volitional control of gait components in response to gait training

Development and Testing of The Gait Assessment and Intervention Tool (G.A.I.T.): A Measure of Coordinated Gait Components

Recent neuroscience methods have provided the basis upon which to develop effective gait training methods for recovery of the coordinated components of gait after neural injury. We determined that there was not an existing observational measure that was, at once, adequately comprehensive, scored in an objectively-based manner, and capable of assessing incremental improvements in the coordinated components of gait. Therefore, the purpose of this work was to use content valid procedures in order to develop a relatively inexpensive, more comprehensive measure, scored with an objectively-based system, capable of incrementally scoring improvements in given items, and that was both reliable and capable of discriminating treatment response for those who had a stroke. Eight neurorehabilitation specialists developed criteria for the gait measure, item content, and scoring method. In subjects following stroke (\u3e12 months), the new measure was tested for intra- and inter-rater reliability using the Intraclass Correlation Coefficient; capability to detect treatment response using Wilcoxon Signed Ranks Test; and discrimination between treatment groups, using the Plum Ordinal Regression. The Gait Assessment and Intervention Tool (G.A.I.T.) is a 31-item measure of the coordinated movement components of gait and associated gait deficits. It exhibited the following advantages: comprehensive, objective-based scoring method, incremental measurement of improvement within given items. The G.A.I.T. had good intra- and inter-rater reliability (ICC = .98, p = .0001, 95% CI = .95, .99; ICC = .83, p = .007, 95% CI = .32, .96, respectively. The inexperienced clinician who had training, had an inter-rater reliability with an experienced rater of ICC = .99 (p = .0001, CI = .97, .999). The G.A.I.T. detected improvement in response to gait training for two types of interventions: comprehensive gait training (z = −2.93, p = .003); and comprehensive gait training plus functional electrical stimulation (FES; z = −3.3, p = .001). The G.A.I.T. was capable of discriminating between two gait training interventions, showing an additive advantage of FES to otherwise comparable comprehensive gait training (parameter estimate = 1.72, p = .021; CI, .25, 3.1)

Development and Testing of The Gait Assessment and Intervention Tool (G.A.I.T.): A Measure of Coordinated Gait Components

Recent neuroscience methods have provided the basis upon which to develop effective gait training methods for recovery of the coordinated components of gait after neural injury. We determined that there was not an existing observational measure that was, at once, adequately comprehensive, scored in an objectively-based manner, and capable of assessing incremental improvements in the coordinated components of gait. Therefore, the purpose of this work was to use content valid procedures in order to develop a relatively inexpensive, more comprehensive measure, scored with an objectively-based system, capable of incrementally scoring improvements in given items, and that was both reliable and capable of discriminating treatment response for those who had a stroke. Eight neurorehabilitation specialists developed criteria for the gait measure, item content, and scoring method. In subjects following stroke (\u3e12 months), the new measure was tested for intra- and inter-rater reliability using the Intraclass Correlation Coefficient; capability to detect treatment response using Wilcoxon Signed Ranks Test; and discrimination between treatment groups, using the Plum Ordinal Regression. The Gait Assessment and Intervention Tool (G.A.I.T.) is a 31-item measure of the coordinated movement components of gait and associated gait deficits. It exhibited the following advantages: comprehensive, objective-based scoring method, incremental measurement of improvement within given items. The G.A.I.T. had good intra- and inter-rater reliability (ICC = .98, p = .0001, 95% CI = .95, .99; ICC = .83, p = .007, 95% CI = .32, .96, respectively. The inexperienced clinician who had training, had an inter-rater reliability with an experienced rater of ICC = .99 (p = .0001, CI = .97, .999). The G.A.I.T. detected improvement in response to gait training for two types of interventions: comprehensive gait training (z = −2.93, p = .003); and comprehensive gait training plus functional electrical stimulation (FES; z = −3.3, p = .001). The G.A.I.T. was capable of discriminating between two gait training interventions, showing an additive advantage of FES to otherwise comparable comprehensive gait training (parameter estimate = 1.72, p = .021; CI, .25, 3.1)

Evaluation of Three Electronic Noses for Detecting Incipient Wood Decay

Tree assessment methodologies, currently used to evaluate the structural stability of individual urban trees, usually involve a visual analysis followed by measurements of the internal soundness of wood using various instruments that are often invasive, expensive, or inadequate for use within the urban environment. Moreover, most conventional instruments do not provide an adequate evaluation of decay that occurs in the root system. The intent of this research was to evaluate the possibility of integrating conventional tools, currently used for assessments of decay in urban trees, with the electronic nose–a new innovative tool used in diverse fields and industries for various applications such as quality control in manufacturing, environmental monitoring, medical diagnoses, and perfumery. Electronic-nose (e-nose) technologies were tested for the capability of detecting differences in volatile organic compounds (VOCs) released by wood decay fungi and wood from healthy and decayed trees. Three e-noses, based on different types of operational technologies and analytical methods, were evaluated independently (not directly compared) to determine the feasibility of detecting incipient decays in artificially-inoculated wood. All three e-nose devices were capable of discriminating between healthy and artificially-inoculated, decayed wood with high levels of precision and confidence. The LibraNose quartz microbalance (QMB) e-nose generally provided higher levels of discrimination of sample unknowns, but not necessarily more accurate or effective detection than the AromaScan A32S conducting polymer and PEN3 metal-oxide (MOS) gas sensor e-noses for identifying and distinguishing woody samples containing different agents of wood decay. However, the conducting polymer e-nose had the greater advantage for identifying unknowns from diverse woody sample types due to the associated software capability of utilizing prior-developed, application-specific reference libraries with aroma pattern-recognition and neural-net training algorithms