LMDA Canada Newsletter, 2002/2003

Contents include: Report from the Chair, Toward New Developmental Structures, Challenging Assumptions: Vancouver 2002, Inside/Outside at the Mini-Conference: Toronto 2002, True Confessions: I was a Process Junkie!, Playwrights\u27 Development Centres: Establishing a New Network, LMDA Canada: Membership Contact Listhttps://soundideas.pugetsound.edu/lmdanewsletter/1024/thumbnail.jp

Operational Modeling with Health Economics to Support Decision Making for COPD Patients

© Health Research and Educational Trust. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1111/1475-6773.13652Objective: To assess the impact of interventions for improving the management of chronic obstructive pulmonary disease (COPD), specifically increased use of pulmonary rehabilitation (PR) on patient outcomes and cost-benefit analysis. Data sources: We used the national Hospital Episode Statistics (HES) datasets in England, local data and experts from the hospital setting, National Prices and National Tariffs, reports and the literature around the effectiveness of PR programmes. Study Design: The COPD pathway was modelled using discrete event simulation (DES) to capture the patient pathway to an adequate level of detail as well as randomness in the real world. DES was further enhanced by the integration of a health economic model to calculate the net benefit and cost of treating COPD patients based on key sets of interventions. Data Collection/Extraction methods: A total of 150 input parameters and 75 distributions were established to power the model using the HES dataset, outpatient activity data from the hospital and community services, and the literature. Principal Findings: The simulation model showed that increasing referral to PR (by 10%, 20%, or 30%) would be cost-effective (with a benefit-cost ratio of 5.81, 5.95, 5.91, respectively) by having a positive impact on patient outcomes and operational metrics. Number of deaths, admissions and bed days decreased (i.e. by 3.56 patients, 4.90 admissions, 137.31 bed days for a 30% increase in PR referrals) as well as quality of life increased (i.e. by 5.53 QALY among 1540 patients for the 30% increase). Conclusions: No operational model, either statistical or simulation, has previously been developed to capture the COPD patient pathway within a hospital setting. To date, no model has investigated the impact of PR on COPD services, such as operations, key performance, patient outcomes and cost-benefit analysis. The study will support policies around extending availability of PR as a major intervention.Peer reviewedFinal Accepted Versio

Pathways of change : shifting connectivities in the world city network, 2000-08

This is an empirical paper that measures and interprets changes in intercity relations at the global scale in the period 2000-08. It draws on the network model devised by the Globalization and World Cities (GaWC) research group to measure global connectivities for 132 cities across the world in 2000 and 2008. The measurements for both years are adjusted so that a coherent set of services/cities is used. A range of statistical techniques is used to explore these changes at the city level and the regional scale. The most notable changes are: the general rise of connectivity in the world city network; the loss of global connectivity of US and sub-Saharan African cities (Los Angeles, San Francisco and Miami in particular); and, the gain in global connectivity of south Asian, Chinese and eastern European cities (Shanghai, Beijing and Moscow in particular)

Keeping Up with the Preemies: Early Interventions in Occupational Therapy for Children Born Premature

Objectives: 1. Identify areas of occupational performance that may be impacted by premature birth. 2. Understand current themes of interventions for promoting development after premature birth. 3. Apply evidence-based practice to interventions for children born prematurely. PICO: What is the evidence to support the use of early interventions in the scope of OT to promote development in children born prematurely? Presentation: 53:1

Early school outcomes for extremely preterm infants with transient neurological abnormalities

AIM: To determine if transient neurological abnormalities (TNA) at 9 months corrected age predict cognitive, behavioral, and motor outcomes at 6 years of age in extremely preterm infants. METHOD: A cohort of 124 extremely preterm infants (mean gestational age 25.5wks; 55 males, 69 females), admitted to our unit between 2001 and 2003, were classified based on the Amiel-Tison Neurological Assessment at 9 months and 20 months corrected age as having TNA (n=17), normal neurological assessment (n=89), or neurologically abnormal assessment (n=18). The children were assessed at a mean age of 5 years 11 months (SD 4mo) on cognition, academic achievement, motor ability, and behavior. RESULTS: Compared with children with a normal neurological assessment, children with TNA had higher postnatal exposure to steroids (35% vs 9%) and lower adjusted mean scores on spatial relations (84 [standard error {SE} 5] vs 98 [SE 2]), visual matching (79 [SE 5] vs 91 [SE 2]), letter-word identification (97 [SE 4] vs 108 [SE 1]), and spelling (76 [SE 4] vs 96 [SE 2]) (all p<0.05). INTERPRETATION: Despite a normalized neurological assessment, extremely preterm children with a history TNA are at higher risk for lower cognitive and academic skills than those with normal neurological findings during their first year of school

An examination of preservice teachers’ initial attempts to use instructional scaffolding

In today’s diverse schools, meeting individual literacy needs of students is one of the most challenging aspects of teaching. Instructional scaffolding is a powerful tool that many literacy teachers use to meet the challenge. While the term denotes a wide array of strategies, most teachers use scaffolding in some form or another in their classrooms. Many consider it to be one of the most effective instructional procedures available (Cazden, 1992; Graves, Graves, & Braaten, 1996)

An Examination of Preservice Literacy Teachers’ Initial Attempts to Provide Instructional Scaffolding

In today’s diverse schools, meeting individual literacy needs of students is one of the most challenging aspects of teaching. Instructional scaffolding is a powerful tool that many literacy teachers use to meet the challenge. While the term denotes a wide array of strategies, most teachers use scaffolding in some form or another in their classrooms. Many consider it to be one of the most effective instructional procedures available (Cazden, 1992; Graves, Graves, & Braaten, 1996)

Joyful by nature : approaches to investigate the evolution and function of joy in non-human animals

This work was supported by Grant #0333 from the Templeton World Charity Foundation (TWCF) and a Brian Mason Technical Trust Fund grant to X. J. N. and A. H. T.The nature and evolution of positive emotion is a major question remaining unanswered in science and philosophy. The study of feelings and emotions in humans and animals is dominated by discussion of affective states that have negative valence. Given the clinical and social significance of negative affect, such as depression, it is unsurprising that these emotions have received more attention from scientists. Compared to negative emotions, such as fear that leads to fleeing or avoidance, positive emotions are less likely to result in specific, identifiable, behaviours being expressed by an animal. This makes it particularly challenging to quantify and study positive affect. However, bursts of intense positive emotion (joy) are more likely to be accompanied by externally visible markers, like vocalisations or movement patterns, which make it more amenable to scientific study and more resilient to concerns about anthropomorphism. We define joy as intense, brief, and event-driven (i.e. a response to something), which permits investigation into how animals react to a variety of situations that would provoke joy in humans. This means that behavioural correlates of joy are measurable, either through newly discovered 'laughter' vocalisations, increases in play behaviour, or reactions to cognitive bias tests that can be used across species. There are a range of potential situations that cause joy in humans that have not been studied in other animals, such as whether animals feel joy on sunny days, when they accomplish a difficult feat, or when they are reunited with a familiar companion after a prolonged absence. Observations of species-specific calls and play behaviour can be combined with biometric markers and reactions to ambiguous stimuli in order to enable comparisons of affect between phylogenetically distant taxonomic groups. Identifying positive affect is also important for animal welfare because knowledge of positive emotional states would allow us to monitor animal well-being better. Additionally, measuring if phylogenetically and ecologically distant animals play more, laugh more, or act more optimistically after certain kinds of experiences will also provide insight into the mechanisms underlying the evolution of joy and other positive emotions, and potentially even into the evolution of consciousness.Publisher PDFPeer reviewe

The regeneration-responsive element careg monitors activation of Müller glia after MNU-induced damage of photoreceptors in the zebrafish retina.

In contrast to mammals, zebrafish can regenerate their damaged photoreceptors. This capacity depends on the intrinsic plasticity of Müller glia (MG). Here, we identified that the transgenic reporter careg, a marker of regenerating fin and heart, also participates in retina restoration in zebrafish. After methylnitrosourea (MNU) treatment, the retina became deteriorated and contained damaged cell types including rods, UV-sensitive cones and the outer plexiform layer. This phenotype was associated with the induction of careg expression in a subset of MG until the reconstruction of the photoreceptor synaptic layer. Single-cell RNA sequencing (scRNAseq) analysis of regenerating retinas revealed a population of immature rods, defined by high expression of rhodopsin and the ciliogenesis gene meig1, but low expression of phototransduction genes. Furthermore, cones displayed deregulation of metabolic and visual perception genes in response to retina injury. Comparison between careg:EGFP expressing and non-expressing MG demonstrated that these two subpopulations are characterized by distinct molecular signatures, suggesting their heterogenous responsiveness to the regenerative program. Dynamics of ribosomal protein S6 phosphorylation showed that TOR signaling became progressively switched from MG to progenitors. Inhibition of TOR with rapamycin reduced the cell cycle activity, but neither affected careg:EGFP expression in MG, nor prevented restoration of the retina structure. This indicates that MG reprogramming, and progenitor cell proliferation might be regulated by distinct mechanisms. In conclusion, the careg reporter detects activated MG, and provides a common marker of regeneration-competent cells in diverse zebrafish organs, including the retina

PULSE - Winter 2016, Issue Two

PULSE is the bi-quarterly student-run lifestyle magazine of Central Washington University.https://digitalcommons.cwu.edu/pulse/1002/thumbnail.jp