The Truth to Transitioning: Development of a Trans* Specific Occupational Therapy Practice Framework Involving an Integrative Care Model

Transgender and gender-diverse (TGD) clients are underserved by occupational therapy practitioners (OTPs) throughout their transition journey. This research based capstone involved completing stakeholder interviews with OTPs and TGD individuals to inform and update an existing occupational therapy model and improve best-practice standards within OT practice when providing services to TGD individuals.https://engagedscholarship.csuohio.edu/ot_capstone_posters/1053/thumbnail.jp

A comparative study of environmentally responsible design adoption by architects, facility managers, and interior designers

The design and building industry has a tremendous impact on the environment that is often negative when environmentally responsible design (ERD) strategies are not adopted. The purpose of this exploratory, descriptive study was to determine the firm and practitioner characteristics that impact the adoption of ERD strategies, to ascertain practitioners’ knowledge of ERD strategies and certified products, and to document the adoption of ERD strategies using Rogers’ model of the innovation adoption process. The web-based, national survey utilized a purposive sample of 146 architects, facility managers, and interior designers who belonged to professional organizations (AIA, IFMA, ASID, and IIDA) that disseminated the self-administered questionnaire to members in eight states. Data were analyzed using a combination of descriptive and inferential statistics. As determined by the mode, the typical practitioner was an interior designer, between 31-50 years old, with a bachelor’s degree, who had been in practice for 15+ years specializing in corporate office design, and was NCIDQ certified but was not a LEED AP. The typical firm had 1-19 employees, including 1-5 interior designers but no architects, and had a sustainability policy in place. Major findings included: 1) practitioners have a moderate to good understanding of many ERD strategies; 2) they are familiar with product certification programs, although the programs are not well understood; and 3) the overwhelming majority are in the final stage of the adoption process. If the general population of practitioners is understood to be similar to the participants in ways that are relevant to this research investigation, it is clear that environmental responsibility is an important criterion in the design of the built environment. However, facility managers consistently scored lower than architects or interior designers regarding knowledge of ERD strategies and products. This is of concern because they are typically responsible for the built environment after the initial construction project has been completed. The results provide insight into the design and building industry’s understanding and use of environmentally responsible design strategies. This information can be used to create educational opportunities for practitioners and to facilitate a dialog to move the industry towards a more environmentally responsible future

What Happened Last Night? Sleep, Sex, and Recollection

Previous research has repeatedly illustrated the beneficial influence of sleep on memory processes. Further, evidence has demonstrated the power of sexual valance to enhance memory for certain types of stimuli. The present study investigated the possible interaction effect between sleep and sexual valance on recollection memory in 44 undergraduate and graduate student participants at Eastern Kentucky University, based upon a method by Alger, Lau, & Fishbein (2012); however, in the current study, recollection memory items were words received audibly rather than visually. Behavioral data, electroencephalography (EEG), and skin conductance data was collected to assess memory performance, sleep progress, autonomic nervous system activity, and sleep-related behavior. Results indicated a significant interaction effect between condition (sleep/awake) and image type (sexual/nonsexual): words paired with sexual images were best recalled by sleep participants, while awake participants recalled nonsexual images better than sexual images

International Trade and Third Parties\u27 Conflict-Joining Propensities: The Political Economy of Conflict Expansion

In recent years, a renewed interest in the differences between dyadic conflicts and complex, multiparty disputes has developed within international relations (Vasquez and Valeriano 2010; Valeriano and Vasquez 2010). The conflict expansion literature focuses heavily on how traditional realist variables – such as alliances, shared borders, and rivalries – facilitate the spread of conflict, but these studies largely ignore other incentives to join disputes, such as the protection of an economic relationship. Absent a few notable exceptions (Polachek 1980; Aydin 2008), questions concerning the role that economic interdependence plays in conflict expansion have remained generally unanswered. This dissertation seeks to address the economic incentives to join ongoing disputes. Are states likely to join into conflicts as third parties to protect their economic relationships? I approach this question in three parts. First, I investigate states’ conflict-joining propensities with regard to bilateral trade ties, making note of the evolution of the international economy from 1885-2001. I find that states are more likely to join disputes at higher levels of trade dependence and higher levels of trade concentration, but where the economy is more liberalized, the probability of joining is lower even at high values of trade dependence. Second, I investigate whether states that abstain seek alternative markets to substitute trade jeopardized by the outbreak of a trade partner’s conflict. States might do this to avoid conflict participation and also to ensure that their own economic health is preserved. If such circumvention occurs, then we should expect trade values to fall between a state and its disputatious trade partners, while trade values between non-disputant trade partners should simultaneously rise. I do not find support for these hypotheses. Finally, I question not only whether states are willing to skirt conflict by diverting trade, but also whether they can. Here I assess how different trade components affect the probability of military intervention, arguing that the unique nature of primary commodities renders these goods virtually non-substitutable. Because of this, third parties whose economies rely heavily on trade in primary goods are more likely to intervene to protect their lifeline of resources. I find some support my primary hypotheses

Implementation of health-focused interventions in vulnerable populations: protocol for a scoping review.

INTRODUCTION: Vulnerable populations face significant challenges in navigating the care continuum, ranging from diagnosis of illness to linkage and retention in healthcare. Understanding how best to move individuals within these vulnerable populations across the care continuum is critical to improving their health. A large body of literature has focused on evaluation of implementation of various health-focused interventions in this population. However, we do not fully understand the unique challenges to implementing healthcare interventions for vulnerable populations. This study aims to examine the literature describing implementation of health service interventions among vulnerable populations to identify how implementations using the Consolidated Framework for Implementation Research are adapted. Findings from this review will be useful to implementation scientists to identify gaps in evidence and for adapting similar interventions in unique settings. METHODS AND ANALYSIS: This study protocol outlines a scoping review of the peer-reviewed and grey literature, using established approaches delineated in Arksey and OMalleys scoping review framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. Search strategies will be developed and refined by a medical librarian in collaboration with the research team. Searches will be conducted in electronic databases (CINAHL, Cochrane, PsychINFO, PubMed, Social Services Abstracts, Web of Science, Google and Google Scholar) and limited to studies published between 1 August 2009 and 1 June 2020. Additionally, hand searches will be conducted in three relevant journals-Implementation Science, Systematic Reviews and BMJ Open. English-language studies and reports meeting inclusion criteria will be screened independently by two reviewers and the final list will be abstracted and charted in duplicate. ETHICS AND DISSEMINATION: This is a review of the literature; ethics approval is not indicated. We will disseminate findings from this study in peer-reviewed journals as well as presentations to relevant stakeholders and conferences

A randomized assessment of adding the kinase inhibitor lestaurtinib to first-line chemotherapy for FLT3-mutated AML

The clinical benefit of adding FMS-like tyrosine kinase-3 (FLT3)-directed small molecule therapy to standard first-line treatment of acute myeloid leukemia (AML) has not yet been established. As part of the UK AML15 and AML17 trials, patients with previously untreated AML and confirmed FLT3-activating mutations, mostly younger than 60 years, were randomly assigned either to receive oral lestaurtinib (CEP701) or not after each of 4 cycles of induction and consolidation chemotherapy. Lestaurtinib was commenced 2 days after completing chemotherapy and administered in cycles of up to 28 days. The trials ran consecutively. Primary endpoints were overall survival in AML15 and relapse-free survival in AML17; outcome data were meta-analyzed. Five hundred patients were randomly assigned between lestaurtinib and control: 74% had FLT3-internal tandem duplication mutations, 23% FLT3–tyrosine kinase domain point mutations, and 2% both types. No significant differences were seen in either 5-year overall survival (lestaurtinib 46% vs control 45%; hazard ratio, 0.90; 95% CI 0.70-1.15; P = .3) or 5-year relapse-free survival (40% vs 36%; hazard ratio, 0.88; 95% CI 0.69-1.12; P = .3). Exploratory subgroup analysis suggested survival benefit with lestaurtinib in patients receiving concomitant azole antifungal prophylaxis and gemtuzumab ozogamicin with the first course of chemotherapy. Correlative studies included analysis of in vivo FLT3 inhibition by plasma inhibitory activity assay and indicated improved overall survival and significantly reduced rates of relapse in lestaurtinib-treated patients who achieved sustained greater than 85% FLT3 inhibition. In conclusion, combining lestaurtinib with intensive chemotherapy proved feasible in younger patients with newly diagnosed FLT3-mutated AML, but yielded no overall clinical benefit. The improved clinical outcomes seen in patients achieving sustained FLT3 inhibition encourage continued evaluation of FLT3-directed therapy alongside front-line AML treatment. The UK AML15 and AML17 trials are registered at www.isrctn.com/ISRCTN17161961 and www.isrctn.com/ISRCTN55675535 respectively

Effectiveness of combining feedback about lung age or exhaled carbon monoxide levels with Very Brief Advice (VBA) and support for smoking cessation in primary care compared to giving VBA and support alone – protocol for a randomized controlled trial within the Breathe Well research program

INTRODUCTION: In 2015, smoking prevalence in Republic of Macedonia was 36% in men and 21% in women We aim to assess the effectiveness and cost-effectiveness of two methods of motivating smokers to quit smoking compared with very brief advice (VBA) alone. Тo date, there are no studies investigating smoking cessation treatment in Republic of Macedonia. METHODS/DESIGN: RCT with process evaluation and cost-effectiveness analysis within 31 general practices in Republic of Macedonia recruiting smokers currently smoking >10 cigarettes per day, aged >35 years, attending primary care practices for any reason, regardless of motivation to quit smoking. Respondents will be randomized into one of three groups: (1) VBA and assessment and communication of lung age; (2) VBA and additional assessment and communication of exhaled carbon monoxide (CO) levels; or (3) control group – VBA. All participants who attempt to quit smoking will be offered behavioral support based on the UK standard program for smoking cessation. Primary outcome: Proportion of smokers who are quit at 4 weeks (7-day point prevalence, confirmed by salivary cotinine level). Secondary outcomes: Proportion who have attempted to quit smoking or have quit smoking, a proportion that has reduced the number of cigarettes and motivation to quit smoking; cost-effectiveness analysis calculating cost per quality-adjusted life year. We will evaluate the fidelity to the intervention and will explore patients’ and GPs’ experience and the acceptability of the study intervention by interview. DISCUSSION: The study will evaluate the effectiveness of combining feedback about lung age or exhaled CO levels with VBA and support for smoking cessation in primary care compared to giving VBA and support alone. It will explore how willing primary care physicians are to perform such interventions and the acceptability and effectiveness of such interventions to patients in Republic of Macedonia. TRIAL REGISTRATION: The study is registered on the ISRCTN registry (ISRCTN54228638)

Multimethod Evaluation of the VA’s Peer-to-Peer Toolkit for Patient-Centered Medical Home Implementation

BACKGROUND: Effective implementation of the patient-centered medical home (PCMH) in primary care practices requires training and other resources, such as online toolkits, to share strategies and materials. The Veterans Health Administration (VA) developed an online Toolkit of user-sourced tools to support teams implementing its Patient Aligned Care Team (PACT) medical home model. OBJECTIVE: To present findings from an evaluation of the PACT Toolkit, including use, variation across facilities, effect of social marketing, and factors influencing use. INNOVATION: The Toolkit is an online repository of ready-to-use tools created by VA clinic staff that physicians, nurses, and other team members may share, download, and adopt in order to more effectively implement PCMH principles and improve local performance on VA metrics. DESIGN: Multimethod evaluation using: (1) website usage analytics, (2) an online survey of the PACT community of practice’s use of the Toolkit, and (3) key informant interviews. PARTICIPANTS: Survey respondents were PACT team members and coaches (n=544) at 136 VA facilities. Interview respondents were Toolkit users and nonusers (n=32). MEASURES: For survey data, multivariable logistic models were used to predict Toolkit awareness and use. Interviews and open-text survey comments were coded using a “common themes” framework. The Consolidated Framework for Implementation Research (CFIR) guided data collection and analyses. KEY RESULTS: The Toolkit was used by 6,745 staff in the first 19 months of availability. Among members of the target audience, 80% had heard of the Toolkit, and of those, 70% had visited the website. Tools had been implemented at 65% of facilities. Qualitative findings revealed a range of user perspectives from enthusiastic support to lack of sufficient time to browse the Toolkit. CONCLUSIONS: An online Toolkit to support PCMH implementation was used at VA facilities nationwide. Other complex health care organizations may benefit from adopting similar online peer-to-peer resource libraries.Keywords: evaluation, implementation research, primary care redesign, patient-centered care, quality improvemen

Embedding the Ni-SOD mimetic Ni-NCC within a polypeptide sequence alters specificity of the reaction pathway

This document is the Accepted Manuscript version of a Published Work that appeared in final form in the Inorganic Chemistry, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see http://doi.org/10.1021/ic301175f.The unique metal abstracting peptide (MAP) asparagine-cysteine-cysteine (NCC) binds nickel in a square planar 2N:2S geometry and acts as a mimic of the enzyme nickel superoxide dismutase (Ni-SOD). The Ni-NCC tripeptide complex undergoes rapid, site-specific chiral inversion to DLD-NCC in the presence of oxygen. Superoxide scavenging activity increases proportionally with the degree of chiral inversion. Characterization of the NCC sequence within longer peptides with absorption, circular dichroism (CD), and magnetic CD (MCD) spectroscopies and mass spectrometry (MS) shows that the geometry of metal coordination is maintained, though the electronic properties of the complex are varied to a small extent due to bis-amide, rather than amine/amide, coordination. In addition, both the Ni-tripeptides and Ni-pentapeptides have a −2 charge. The study here demonstrates that the chiral inversion chemistry does not occur when NCC is embedded in a longer polypeptide sequence. Nonetheless, the superoxide scavenging reactivity of the embedded Ni-NCC module is similar to that of the chirally inverted tripeptide complex, which is consistent with a minor change in reduction potential for the Ni-pentapeptide. Together, this suggests that the charge of the complex could affect the SOD activity as much as a change in primary coordination sphere. In Ni-NCC and other Ni-SOD mimics, changes in chirality, superoxide scavenging activity, and oxidation of the peptide itself all depend on the presence of dioxygen or its reduced derivatives (e.g., superoxide), and the extent to which each of these distinct reactions occurs is ruled by electronic and steric effects that emenate from the organization of ligands around the metal center