Incorporating Meaningful Occupations of Students with Moderate to Severe Intellectual Disabilities into Structured Learning Experiences with Transition Planning at a Public School System

The purpose of this capstone project was to learn from stakeholders how to identify meaningful occupations of students with moderate to severe intellectual disabilities and how to incorporate them into their structured learning experiences in school to help them prepare for adult life upon graduation at 21 years old. The project also sought to explore how to involve the students and their families in the process of identifying meaningful occupations

Exploring the effects of Acceptance and Commitment Therapy (ACT) on biomarkers of stress in breast cancer survivors

Breast cancer is the most commonly diagnosed cancer in Australian women, with advances in detection and treatment of breast cancer there is a current overall five-year survival rate of approximately 90%. For some individual breast cancer survivors, survival is associated with psychological and physiological stressors that can negatively affect well-being and quality of life as well as have a further adverse impact on long-term survival. These stressors can affect the body’s physiological stress response system, causing allostatic load (AL) and dysregulations that may be associated with symptoms such as fatigue, depression, anxiety, hypertension, and inflammation. AL is a multisystem approach to measure the cumulative negative effects that stress has on the body’s systems and overall health. Psychological and physiological stress is also associated with accelerated cellular aging and chromosome instability caused by telomere attrition. These cellular deficits can lead to an increased risk for the development of other diseases such as cardiovascular disease, diabetes and cancer recurrence. Recent research has provided evidence that mindfulness-based psychological interventions that have been developed to meet the needs of breast cancer survivors can improve their psychological well-being and quality of life. Furthermore, other research has demonstrated that these interventions can lead to a reduction in physiological stress biomarkers. Physiological stress biomarkers indicate the activity of the stress response system, therefore a reduction subsequent to participation in a psychological intervention may indicate clinical health benefits. The aim of this pilot study was to examine the effects of Acceptance and Commitment Therapy (ACT), a psychological treatment that incorporates acceptance and mindfulness strategies, on physiological and molecular biomarkers of stress and AL in breast cancer survivors. Breast cancer survivors, who had completed primary breast cancer treatment in the previous two years, were randomly allocated into three groups. Two groups attended ninety minutes of either a group-based ACT (Group 1) or Breast Cancer Education (BCE) program (Group 2) for six weeks; these two groups then crossed-over to the other intervention for a further six weeks. The third group (Group 3) was waitlisted for the first six weeks and then attended the ACT program for the subsequent six weeks. Physiological and molecular biomarkers of stress: heart rate, blood pressure, fasting blood glucose, telomere length, interleukin-6, cortisol and salivary alpha-amylase, were assessed before and after each intervention or wait-list, with a fourth measurement time point at six months after completion of the interventions. Six of these biomarkers were used to calculate the change in AL for each participant in response to the ACT intervention. The study identified a significant reduction in cumulative allostatic load in Group 3 participants following the ACT intervention, but AL was increased in Groups 1 and 2. The study did not identify a statistically significant reduction in any individual biomarker from pre- to post-6 week ACT intervention for any group however, a reduction in blood pressure in Group 1 participants after 12 weeks (ACT and BCE) was evident. These results suggest that the current ACT intervention could drive improvements in AL, but the effects are highly variable. It may be that a longer intervention is required before a change in physiological and molecular biomarkers becomes measurable. Alternatively, it is plausible that the majority of participants in this study were not under substantial stress at the beginning of the trial and therefore their stress biomarkers were not elevated and had no potential to improve. A future trial could specifically recruit participants with elevated stress biomarkers

Acting out our dam future: science-based role-play simulations as mechanisms for learning and natural resource planning

Science often does not make its way into decisions, leading to a problematic gap between scientific and societal progress. To tackle this issue, our research tests a novel science-based negotiation simulation that integrates a role-play simulation (RPS) with a system dynamics model (SDM). In RPSs, stakeholders engage in a mock decision-making process (reflecting real-life institutional arrangements and scientific knowledge) for a set period. System dynamics models (SDMs) are visual tools used to simulate the interactions and feedback within a complex system. We test the integration of the two approaches with stakeholders in New England via a series of two consecutive workshops across two states. The workshops engage stakeholders from diverse groups to foster dialogue, learning, and creativity. Participants discuss a hypothetical (yet realistic) decision scenario to consider scientific information and explore dam management options that meet one another\u27s interests. In the first workshop, participants contributed to the design of the fictionalized dam decision scenario and the SDM. In the second workshop, participants assumed another representative\u27s role and discussed dam management options for the fictionalized scenario. This presentation will briefly report on the practical design of this science-based role-play, and particularly emphasize preliminary results of workshop outcomes, which were evaluated using debriefing sessions, surveys, concept mapping exercises, and interviews. Results will determine the extent to which this new knowledge production process leads to learning, use of science, and more collaborative decision-making about dams in New England and beyond

Hemodynamic progression of aortic stenosis in adults assessed by doppler echocardiography

AbstractDoppler echocardiography was used to follow the hemodynamic severity of aortic stenosis. First, the reproducibility of repeat recordings (mean interval 28 ± 36 days) of aortic jet velocity, made by two independent observers, was tested in 38 adults with aortic stenosis and unchanged clinical status. The two recordings of maximal velocity correlated well (r = 0.96, y = 0.88x + 0.46m/s, SEE = 0.21 m/s) with a mean coefficient of variation of 3.2%. Repeat recording of left ventricular outflow tract velocity by two independent observers in 10 other patients with aortic stenosis also correlated well (r = 0.94, y = 1.06x + 0.0 m/s, SEE = 0.06 m/s) with a mean coefficient of variation of 4.6%.Next, Doppler echocardiography was used to study 42 patients with aortic stenosis (mean age 66 years) over a follow-up interval of 6 to 43 months (mean 20). Maximal aortic jet velocity increased by 0.36 m/s per year (range −0.3 to +1.0 m/s per year). Mean transaortic pressure gradient changed by −7 to +23 (mean 8) mm Hg/year. Aortic valve area by the continuity equation (n = 25) decreased by 0 to 0.5 cm2/year (mean decrease 0.1 cm2/year). year patients had a worsening of stenosis (decrease in valve area) even though they had no change or a decrease in pressure gradient, because of concurrent decreases in transaortic volume flow.Twenty-one patients (50%) developed new or progressive symptoms of aortic stenosis necessitating valve replacement. These patients had a higher maximal aortic jet velocity at follow-up (4.5 versus 3.9 m/s, p < 0.01) and a greater rate of increase in mean pressure gradient (15 versus 7 mm Hg/year, p < 0.01) than did those who remained asymptomatic; however, there were no significant differences in age, follow-up interval or maximal aortic jet velocity at entry.It is concluded that Doppler echocardiographic measures of aortic stenosis severity are reproducible. The rate of change of transaortic pressure gradient varies among patients and the gradient may not increase even when stenosis severity worsens. Although stenosis severity progresses more rapidly in patients who develop symptoms requiring valve replacement, these patients cannot be identified at the initial study