Caregiver Experiences Of Social Need And Promotion Of Support In The Pediatric Setting: A Qualitative Study

Children are vulnerable to the long-term health impacts of unmet family needs within social determinants of health like income, food security, housing, and transportation. Efforts have grown to recognize and respond to these challenges in the pediatric setting through social needs screening and other interventions. Previous research has extensively described the pediatric provider perspective on this work. However, less is known about how caregivers experience interactions surrounding social needs in the healthcare setting and which factors may influence these perceptions. To address these gaps in knowledge, this qualitative study examined semi-structured interviews of 20 caregivers who participated in a pediatric medical-legal partnership program. The author inductively coded and analyzed the data using Dedoose. Findings examined caregivers’ lived experiences navigating social needs, the impact of these underlying histories on interactions with their children’s medical providers, and factors facilitating feelings of support within the provider-caregiver relationship. In their experiences of social needs, caregivers often felt stressed, stuck, alone, and ignored. They often downplayed or withheld their challenges from providers due to fear of misjudgment as a bad parent, fear of DCF reporting, previous negative experiences, feelings of disrespect, perceived negative assumptions, and stigma. These were drivers of distrust. Continuous opportunities for engagement, displays of genuine care, and construction of partnership fostered feelings of support, trust, and comfort among caregivers. Experiences shaped both perceptions of individual providers and the healthcare system more broadly. These findings can aid pediatric providers in promoting feelings of support among families experiencing social need by informing their approach as they structure conversations, build trusting relationships, and respond to identified needs

The Extracellular Environment\u27s Effect on Cellular Processes: An In Vitro Study of Mechanical and Chemical Cues on Human Mesenchymal Stem Cells and C17.2 Neural Stem Cells

Stem cells are widely used in the area of tissue engineering. The ability of cells to interact with materials on the nano- and micro- level is important in the success of the biomaterial. It is well-known that cells respond to their micro- and nano-environments through a process termed chemo-mechanotransduction. It is important to establish standard protocols for cellular experiments, as chemical modifications to maintenance environments can alter long-term research results. In this work, the effects of different media compositions on human mesenchymal stem cells (hMSCs) throughout normal in vitro maintenance are investigated. Changes in RNA regulation, protein expression and proliferation are studied via quantitative polymerase chain reaction (qPCR), immunocytochemistry (ICC) and cell counts, respectively. Morphological differences are also observed throughout the experiment. Results of this study illustrate the dynamic response of hMSC maintenance to differences in growth medium and passage number. These experiments highlight the effect growth medium has on in vitro experiments and the need of consistent protocols in hMSC research. A substantial opportunity exists in neuronal research to develop a material platform that allows for both the proliferation and differentiation of stem cells into neurons and the ability to quantify the secretome of neuronal cells. Anodic aluminum oxide (AAO) membranes are fabricated in a two-step anodization procedure where voltage is varied to control the pore size and morphology of the membranes. C17.2 neural stem cells are differentiated on the membranes via serum-withdrawal. Cellular growth is characterized by scanning electron microscopy (SEM), ICC and qPCR. ImageJ software is used to obtain phenotypic cell counts and neurite outgrowth lengths. Results indicate a highly tunable correlation between AAO nanopore sizes and differentiated cell populations. By selecting AAO membranes with specific pore size ranges, control of neuronal network density and neurite outgrowth length is achievable. To understand differentiation marker expressions in C17.2 NSCs and how material stiffness affects differentiation, cells are cultured on substrates of varying stiffness. qPCR is used to analyze neural stem cell, neural progenitor cell, neuron-restricted progenitor and differentiated post-mitotic neuronal cell RNA expression. Results suggest a relationship between material stiffness and neuronal development in C17.2 neural stem cells

Developing sport for girls and adolescents

This chapter presents and discusses sport participation trends among female children and adolescents, and investigates the key drivers for female participation in sport across the Individual, Social, Organisational and Environmental domains of the socio-ecological model. Sport participation rates differ according to many factors, including gender, age and residential location of participants, and the types of sport programmes, and other activities. However, consistently females participate in sport at lower rates and are more likely to drop-out of sport than males. Recently opportunities for females to play a sport of their choice have increasingly become available. Sport policies and investment, specifically targeting growth of female participation in sport, have increasingly been observed. However, there are still barriers which limit female participation in sport. At the population level, strategic policy and significant investment will be required to increase capacity of facilities and club volunteers, as well as continued cultural change regarding gender equity. © 2020 selection and editorial matter, Emma Sherry and Katie Rowe

Medium development strategies and scale down models for a high density high productivity cell line

Medium Development at Regeneron continues to enhance fed batch culture productivity. These efforts have been enabled through the development of high throughput scale down models in shake flasks and the ambr® 250. Design of Experiment (DOE) approaches have been applied to optimize the operating conditions in the small scale models leading to performance for growth and titer that match benchtop bioreactor with no off-set. The development of these representative scale down models and our approach to medium development will be described. A medium development case study will be presented from a recent Regeneron fed batch process with a cell line achieving high cell densities and depleting the culture of key amino acids. The traditional medium development approach of supplementing the culture with the depleted nutrients was unsuccessful: high amino acid consumption rates required large amounts of amino acids resulting in significantly increased culture osmolality and reduced productivity. Leveraging high throughput culture systems and multifactor DOEs, multiple medium composition factors in combination were rapidly evaluated. Mathematical models relating medium input factors to process outputs are generated that allow for process optimization. Using this approach, a new feeding strategy was developed that limits increases in osmolality and yields titers approaching 10g/L in both the scale down systems and a process that has been implemented for clinical scale manufacturing of a monoclonal antibody

Applying self-determination theory to understand the motivation for becoming a physical education teacher

This study explored the reasons people choose physical education teaching as a profession and investigated the relationship of these choices with motivation. Physical education pre-service teachers (n = 324) completed the Academic Motivation Scale (AMS) and a measure of reasons for choosing physical education teaching. Confident interpersonal service reasons were linked with intrinsic motivation; whereas sport and physical activity reasons were related to extrinsic motivation. Enrolling because teaching seemed easy was linked with amotivation. Motivation was similar for different course entry methods, however, females were more intrinsically motivated than males and third year students were lower in motivation than other year levels. © 2008 Elsevier Ltd. All rights reserved.C

Progress and gaps in reproductive health services in three humanitarian settings: mixed-methods case studies

Background Reproductive health (RH) care is an essential component of humanitarian response. Women and girls living in humanitarian settings often face high maternal mortality and are vulnerable to unwanted pregnancy, unsafe abortion, and sexual violence. This study explored the availability and quality of, and access barriers to RH services in three humanitarian settings in Burkina Faso, Democratic Republic of the Congo (DRC), and South Sudan. Methods Data collection was conducted between July and October 2013. In total, 63 purposively selected health facilities were assessed: 28 in Burkina Faso, 25 in DRC, and nine in South Sudan, and 42 providers completed a questionnaire to assess RH knowledge and attitudes. Thirty-four focus group discussions were conducted with 29 members of the host communities and 273 displaced married and unmarried women and men to understand access barriers. Results All facilities reported providing some RH services in the prior three months. Five health facilities in Burkina Faso, six in DRC, and none in South Sudan met the criteria as a family planning service delivery point. Two health facilities in Burkina Faso, one in DRC, and two in South Sudan met the criteria as an emergency obstetric and newborn care service delivery point. Across settings, three facilities in DRC adequately provided selected elements of clinical management of rape. Safe abortion was unavailable. Many providers lacked essential knowledge and skills. Focus groups revealed limited knowledge of available RH services and socio-cultural barriers to accessing them, although participants reported a remarkable increase in use of facility-based delivery services. Conclusion Although RH services are being provided, the availability of good quality RH services was inconsistent across settings. Commodity management and security must be prioritized to ensure consistent availability of essential supplies. It is critical to improve the attitudes, managerial and technical capacity of providers to ensure that RH services are delivered respectfully and efficiently. In addition to ensuring systematic implementation of good quality RH services, humanitarian health actors should meaningfully engage crisis-affected communities in RH programming to increase understanding and use of this life-saving care

Development of scale down models for perfusion bioreactor medium optimization

Due to the complex nature of balancing \u3e50 individual media components, the development and optimization of bioreactor medium for high performing perfusion bioreactors is a resource intensive, multivariate problem that greatly benefits from the availability of predictive high through-put scale-down models that simulate the bioreactor system. For that purpose, both a 10 mL long-term block model and 50 mL shaker tube model were developed and optimized to settings that balance oxygen transfer, culture health, and productivity. The long-term block model was limited by the volume needed for culture sampling; as a result, the shaker tube model was developed with a 7.5x increase in working volume. This shaker tube model was then applied to adequately characterize cell nutrient consumption profiles and subsequently inform medium development through multivariate design of experiments (DOE). Within two rounds of studies in the scale-down models, Regeneron’s first-generation perfusion medium formulation achieved approximately 100% increase in productivity compared to the initial medium. The improved nutrient strategy optimized in shaker tubes translated to several cell lines in the benchtop and pilot scale bioreactor perfusion system, indicating the predictive capabilities of the small-scale model. These results highlight the benefits of using small-scale models to shorten development time for perfusion process implementation