Thyroid autoimmunity and function among Ugandan children and adolescents with type-1 diabetes mellitus

Introduction: Up to 30% of type-1 diabetes mellitus (T1DM) patients have co-existent thyroid   autoimmunity with up to 50% of them having associated thyroid dysfunction. Routine screening for  thyroid autoimmunity and dysfunction is recommended in all T1DM patients. However, this was not  currently practiced in Ugandan paediatric diabetes clinics. There was also paucity of data regarding   thyroid autoimmunity and dysfunction in African children and adolescents with diabetes mellitus. The objective of this study was to quantify the magnitude of thyroid autoimmunity and dysfunction in Ugandan children with TIDM.Methods: This was a cross sectional descriptive study to determine the prevalence of thyroid  autoantibodies and describe thyroid function among children and adolescents aged 1-19 years with  diabetes mellitus attending the paediatric diabetes clinic at Mulago National Referral Hospital, Kampala, Uganda. Following enrollment, we obtained details of clinical history and performed physical examination. Blood (plasma) was assayed to determine levels of antibodies to thyroid peroxidase (antiTPO), free  thyroxine (FT4) and thyrotropin (TSH). Results: The prevalence of thyroid autoimmunity was 7.3% (5/69). All antiTPO positive subjects were post pubertal, aged between 13-17 years with females comprising 3/5 of the antiTPO positive subjects. All study subjects were clinically euthyroid; however, 7.3% (5/69) of the study subjects had subclinical hypothyroidism. Conclusion: These data strengthen the argument for routine screening of all diabetic children and  adolescents for thyroid autoimmunity (particularly anti-TPO) as recommended by  international  guidelines. We also recommend evaluation of thyroid function in diabetic children and  adolescents to minimize the risk of undiagnosed thyroid dysfunction.Key words: Thyroid, autoimmunity, type 1 diabetes mellitus, childre

Partnership of a P.L.A.N: Postsecondary Linking Advocacy & Navigation at Ohio State for Young Adults' Growth and Resiliency

While in high school adolescents have a myriad of opportunities to connect with their peers and the community. As they become young adults, these opportunities decrease for a number of reasons. Add to this equation, a developmental or intellectual disability such as Autism Spectrum Disorder (ASD) or Down Syndrome; along with fewer opportunities now barriers of social communication, planning, navigation, and transportation are further limiting. To circumvent some of the challenges, an intervention specialist, speech pathologist, and occupational therapist from Dublin City Schools Postsecondary Access to Transition after High School (PATHS) program teamed with social workers from Ohio State's Nisonger Center Social Programs Department. Together they developed a collaborative class to nurture a sustainable relationship between transition students with disabilities moving from high school to adult life experiences and Ohio State students with ASD. For the Ohio State students the Postsecondary Linking Advocacy and Navigation (P.L.A.N.) class would provide an opportunity to mentor older adolescents for development of their leadership skills, and a chance to share the changes they experienced while matriculating from high school to college. In addition, the Ohio State students would reflect on how they increased their independent living skills, and share the obstacles along the way. This partnership represented a transition learning activity that supported employment, education and independent living outcomes. The benefit of linking students with disabilities still receiving school-based services with students with disabilities receiving college-level supports allows for networking, skill building, and discovery of post school success. Citizenship, resilience, independence, and creative problem-solving are at the forefront of this partnership. Together, they found opportunities to foster organic learning environments that will engage, excite and ultimately captivate all students into learning. This poster will outline the curriculum developed to address course goals of enhancing confidence and achievement at higher level; balancing a range of academic and professional responsibilities; providing role modeling for student leadership; facilitating the development of increased competencies and stronger interpersonal skills; and providing exposure to diverse perspectives and experiences. This presentation is suitable for those developing sustainable diversity and inclusion programs for a wide range of individuals with and without disabilities. Many adolescents lack the ability to problem solve and make sound decisions independently, accept the perspective of others, and serve as leaders and role models to their peers. This model could be utilized in schools, with community organizations, and on college campuses.AUTHOR AFFILIATION: Karen Krainz Edison, program manager, Nisonger Center, [email protected] (Corresponding Author); Katie Sochor, intervention specialist, Dublin City SchoolsP.L.A.N. (Postsecondary Linking Advocacy and Navigation) is a cross-collaboration between Ohio State's Nisonger Center Ace! program and Dublin City Schools' postsecondary education program, PATHS. This partnership represents a transition-learning activity that will support employment, education, and independent living outcomes. The benefit of linking students with disabilities still receiving school-based services with students with disabilities receiving college-level support allows for networking, skill building, and discovery of post-school success. Citizenship, resilience, independence, and creative problem-solving are at the forefront of this partnership. Together, we find opportunities to foster organic learning environments that will engage, excite, and ultimately captivate all students into learning

Chemical profiling and cholinesterase inhibitory activity of five Phaedranassa Herb. (Amaryllidaceae) species from Ecuador

It is estimated that 50 million people in the world live with dementia, 60-70% of whom suffer from Alzheimer's disease (AD). Different factors are involved in the development of AD, including a reduction in the cholinergic neurotransmission level. The Amaryllidaceae plant family contains an exclusive, large, and still understudied alkaloid group characterized by a singular skeleton arrangement and a broad spectrum of biological activities. The chemistry and biodiversity of Ecuadorian representatives of the Phaedranassa genus (Amaryllidaceae) have not been widely studied. In this work, five Ecuadorian Phaedranassa species were examined in vitro for their activity towards the enzymes acetyl- (AChE) and butyrylcholinesterase (BuChE), and the alkaloid profile of bulb extracts was analyzed by GC-MS. The species Phaedranassa cuencana and Phaedranassa dubia showed the most AChE and BuChE inhibitory activity, respectively. To obtain insight into the potential role of the identified alkaloids in these inhibitory effects, docking experiments were carried out, and cantabricine showed in silico inhibitory activity against both cholinesterase structures. Our results show that Amaryllidaceae species from Ecuador are a potential source of new drugs for the palliative treatment of AD

Metodología propuesta para el desarrollo de productos dirigida a las micro y pequeñas empresas de la localidad de Engativá en el sector: fabricación de prendas de vestir.

El siguiente proyecto es el resultado de la investigación realizada por los integrantes del semillero de investigación AXONES de la Facultad de Ingeniería Industrial durante el periodo transcurrido desde el primer semestre de 2009 hasta el primer semestre de 2010 en la localidad de Engativa aplicada al sector de fabricación de prendas de vestir. La primera fase del proyecto consistió en calcular la muestra de empresas a las cuales se les aplicaría la prueba piloto y la encuesta corregida, se realizó la prueba piloto y las correcciones basadas en la aplicación de la prueba. El resultado de esta fase fue la encuesta corregida. La segunda fase fue el diagnóstico basado en la aplicación de la encuesta con la cual se logró recolectar la información necesaria para el desarrollo de la metodología a través del proceso de tabulación y análisis. En la tercera fase se identificaron las variables que serian la base para el planteamiento de la metodología y la elaboración de las guías correspondientes al mejoramiento de cada variable con las cuales se busca que los microempresarios obtengan herramientas que les permitan desarrollar sus productos y obtener ventajas competitivas en su mercado.The next project is the result of research carried out by members of the research nursery AXONES Faculty of Industrial Engineering during the period since the first half of 2009 to the first half of 2010 in the neighborhood of Engativa applied to the manufacturing sector clothing. 6 The first phase consisted of calculating the sample of enterprises which would apply to the pilot and corrected survey, pilot test was performed and corrections based on the application of the test. The result of this phase was a survey corrected. The second phase was the diagnosis based on the implementation of the survey which was able to collect the information necessary for the development of the methodology through the process of tabulation and analysis. In the third phase variables were identified that would be the basis for the approach of the methodology and the development of guidelines for the improvement of each variable with which it seeks to obtain microentrepreneurs tools to develop their products and gain competitive advantage in their market

Más allá de la formación: La percepción de los graduados y empleadores de enfermería, Imbabura-Ecuador

OBJECTIVE: To determine the satisfaction of graduates and employers in relation to nursing training in an Ecuadorian Higher Education Institution. METHOD: quantitative approach study, with descriptive, cross-sectional scope, in a non-probabilistic sample by convenience, of 128 nursing professionals and 27 employers, to whom a questionnaire with adequate psychometric properties Cronbach's alpha [0.95] was applied. RESULTS: The study population is characterised by being young adults, 72.6% of graduates were female and 77.8% of employers were female. 78.7% of the graduates were highly satisfied with the training competences and their relevance to professional performance, in contrast to the employers, where 50.2% were satisfied. CONCLUSION: Continuous assurance of the quality of nursing training will require permanent feedback from graduates and employers as a mechanism of good practice for the improvement of the different substantive processes of the Higher Institution. Professional quality is self-perceived by 56.20% of the graduates at a high level; it is noteworthy that the perception of employers on the quality of the professional is 65.8%, i.e. 0.7 points above that of the graduates. Keywords: Competences, education, nursing, employers, graduates, satisfaction.Las Instituciones de Educación Superior requieren garantizar la pertinencia y relevancia de su oferta académica y de las competencias que desarrollan los graduados, para convertirse en profesionales competitivos en un mercado caracterizado por cambios constantes, donde la educación superior cumple una función social significativa. El objetivo de este artículo Determinar la satisfacción de graduados y empleadores en relación con la formación de Enfermería en una Institución de Educación Superior Ecuatoriana. Se empleó como método el estudio de enfoque cuantitativo, con alcance descriptivo, transeccional, en una muestra no probabilística por conveniencia, de 128 profesionales de enfermería y 27 empleadores, a los cuales se aplicó un cuestionario con propiedades psicométricas adecuados alfa de Cronbach [0.95]. Se obtuvieron como resultados que la población de estudio se caracteriza por ser adulta joven, de sexo femenino en el 72,6% de graduados y el 77,8% en empleadores. Un 78,7% de graduados se encuentra altamente satisfecho de las competencias de formación y su pertinencia en el desempeño profesional, a diferencia de los empleadores en donde un 50,2% se encuentra satisfecho. Como conclusión, se determinó que el aseguramiento continuo de la calidad de la formación en enfermería, requerirá una retroalimentación permanente de sus graduados y de los empleadores, como un mecanismo de buenas prácticas para el perfeccionamiento de los diferentes procesos sustantivos de las Institución Superior. La calidad profesional, es auto percibida por el 56,20% de los graduados en un nivel alto; llama la atención que la percepción de los empleadores sobre la calidad del profesional es del 65,8%, es decir 0,7 puntos por encima de los graduados. Palabras clave: competencias, educación, enfermería, empleadores, graduados, satisfacció

Practice Guidelines for Teledermatology

Previous American Telemedicine Association (ATA) Teledermatology Practice Guidelines were issued in 2007. This updated version reflects new knowledge in the field, new technologies, and the need to incorporate teledermatology practice in a variety of settings, including hospitals, urgent care centers, Federally Qualified Health Centers, school-based clinics, public health facilities, and patient homes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140294/1/tmj.2016.0137.pd

Simulación Numérica del Efecto de un Mecanismo de Estratificación de Aire en un Quemador de Alta Velocidad

In this work, staged air combustion in a high speed burner was analyzed by mean of numerical simulation in order to determine its effects on temperature distribution and pollutant chemical species formation such as CO and NOx. The simulations were achieved using the commercial software ANSYS FLUENT as a design tool to predict the behavior of the thermal system and to establish operation conditions with or without staged air. Eddy Dissipation model was used for combustion simulation, while k - ε Realizable and Discrete Ordinates models were utilized for turbulence and radiation simulation, respectively. Results show that staged air mechanism allows better flame stabilization, combustion reactions initiation and fuel-air mixing. The CO formation was different in reaction zone and NOx emissions were not significantly influenced by the staged air.En este trabajo se analizó por medio de simulación numérica el efecto de la estratificación de aire en un quemador de alta velocidad con el fin de determinar su efecto sobre la distribución de temperatura, la estabilidad de llama y la formación de especies químicas contaminantes como CO y NOx. Las simulaciones se realizaron utilizando el software comercial ANSYS FLUENT para predecir el comportamiento del sistema con y sin uso del mecanismo de suministro de aire por etapas. En cada simulación se empleó el modelo Eddy Dissipation para la combustión, mientras que los modelos k - ε Realizable y Ordenadas Discretas fueron usados para la simulación del flujo turbulento y la radiación, respectivamente. Los resultados muestran que el uso de un mecanismo para estratificar el aire favorece la estabilización de llama, la iniciación de las reacciones de combustión y el mecanismo de mezclado. La formación de CO presentó diferencias en la zona de reacción y las emisiones de NOx no fueron significativamente influenciadas por el mecanismo de estratificación de aire

Cross-cultural conceptualization of a good end of life with dementia: A qualitative study

BACKGROUND: Research on the nature of a "good death" has mostly focused on dying with cancer and other life-limiting diseases, but less so on dementia. Conceptualizing common cross-cultural themes regarding a good end of life in dementia will enable developing international care models. METHODS: We combined published qualitative studies about end of life with dementia, focus group and individual interviews with the researchers, and video-conferencing and continuous email discussions. The interviews were audio-recorded and transcribed verbatim. The data were analyzed thematically, and the researchers developed common themes referring to their original studies. RESULTS: Fourteen qualitative researchers representing 14 cross-cultural studies covering qualitative data of 121 people with dementia and 292 family caregivers. The researchers and data were from eight countries UK, The Netherlands, Japan, Portugal, Germany, Canada, Brazil, and Ireland. Three focus groups, five individual interviews, and video-conferencing were conducted and feedback on multiple iterations was gained by 190 emails between May 2019 and April 2020 until consensus was achieved. Nine cross-culturally common themes emerged from the discussions and shared interpretation of the data of persons with dementia and family caregivers. Three represent basic needs: "Pain and Symptoms Controlled," "Being Provided Basic Care," and "A Place like Home." Other themes were "Having Preferences Met," "Receiving Respect as a Person," "Care for Caregivers," "Identity Being Preserved," "Being Connected," and "Satisfaction with Life and Spiritual Well-being." "Care for Caregivers" showed the greatest difference in emphasis across cultures. Good relationships were essential in all themes. CONCLUSIONS: The common cross-cultural themes comprise a framework underpinned by value placed on personhood and dignity, emphasizing that interdependency through relationships is essential to promote a good end of life with dementia. These themes and valuing the importance of relationships as central to connecting the themes could support care planning and further development of a dementia palliative care model. TRIAL REGISTRATION: The Graduate School and Faculty of Medicine Kyoto University (R1924-1)