Teaching about Modern Slavery: Highlighting Human Rights Principles in Evaluating Economic Systems

Evaluating economic systems relies on several different criteria, but the current public discourse places a great deal of emphasis on efficiency, which students generally understand as producing at lower cost. By using the extreme example of modern-day slavery, I am able to introduce students to the human rights framework for thinking about freedom and encourage students to question whether producing at the lowest possible cost is good for human beings and the environment

“Come, what, a siege?” : Metarepresentation in Lady Jane Cavendish and Lady Elizabeth Brackley’s The Concealed Fancies

The Concealed Fancies is a play written by Lady Jane Cavendish and Lady Elizabeth Brackley, the two eldest daughters of William Cavendish, marquis (and later duke) of Newcastle, during the English Civil War. We can feel reasonably certain that the sisters wrote it in the hope that it could be performed; however, that would have required the presence of their father, whose return is the climax of the story, from the Continental exile to which he had fled after his comprehensive defeat at the Battle of Marston Moor. Closet drama was in any case a genre with which the play had several features in common, and it is at least possible that the sisters envisaged any performance of the play at one of the two family homes of Bolsover or Welbeck as taking place in a promenade style which would have involved moving to an actual closet for part of this scene. This link between the literal, the symbolic, and the material conditions of possible performance is typical of the radical metatheatricality which characterises and configures the play. In this essay, which like the play itself is co-authored, we combine historicist and formalist approaches to the play with a cognitive pragmatic account of its verbal and non-verbal interactions to fully reveal the extent to which the play’s internal logic writes back against the external circumstances of its authors, and to highlight what a skilled and sophisticated piece of writing it is. First, we introduce theoretical frameworks from cognitive psychology and pragmatics which are used later to explore the intricacies of cognition and communication in the play. After this we offer an account of the play in its wider context before examining the detail and nature of its metarepresentations. The article ends by drawing connections between the play’s apparent preoccupation with metarepresentation and the historical context and conditions in which it was written

Review of Nutrition Requirements and Growth after Pediatric Intestinal Transplantation

Intestinal failure is characterized by malnutrition, malabsorption, and growth retardation. The most common cause of intestinal failure is short bowel syndrome. If the remaining bowel is unable to adapt to allow weaning from parenteral nutrition and achievement of enteral autonomy, then intestinal transplantation should be considered. Energy and macro- and micronutrient intakes are closely monitored pre-transplant to optimize nutrition prior to surgery. Few studies have been conducted to examine the nutritional requirements and nutritional status post-transplant. Of the studies that have been done, results have been inconsistent. The purpose of this review is to summarize the current literature related to nutrition requirements and growth after pediatric intestinal transplant. Monitoring of vitamin and mineral status is also essential in ensuring proper growth and preventing deficiencies post-transplant. Five out of six studies showed a positive growth trend at the one-year mark post-transplant. One study showed that children with a weight and height z-score of less than -2.0 had a faster catch-up growth post-transplant. Other studies reported positive growth progression within the first two years after transplant. There is still a great deal of information unknown about nutrition and growth post-transplant. Further studies need to be conducted to determine if and how nutrition requirements change post-transplant

Length of Exclusive Breastfeeding and Obesity Risk in Children at Risk for Type 1 Diabetes

Type 1 diabetes (T1D) is an autoimmune disease that occurs when T lymphocyte cells attack and destroy beta cells in the pancreas.1 The cause of T1D is considered to be a combination of genetic predisposition and environmental or lifestyle risk factors. Early introduction of diet is thought to play a role in the development of T1D as it is less common in people who were breastfed and who were introduced to solid foods at later ages. The protection that breastfeeding can offer against the development of childhood obesity and T1D in children at risk for T1D is unknown and may be related to many different factors. The purpose of this project is to review the literature on the association between infant diet, including breastfeeding and complementary foods, and the development of obesity and T1D. This information will be used to prepare a secondary analysis proposal to examine the association between length of exclusive breastfeeding and obesity risk in children at risk for T1D for submission to the Presentations and Publications Committee of the Trial to Reduce IDDM in the Genetically at Risk (TRIGR) study

Comparison of Nutrition Outcomes by Enteral Nutrition Feeding Method during Weaning from Parenteral Nutrition in Children with Intestinal Failure

Objective: To evaluate the difference in time to achieve enteral autonomy, survival, and linear growth velocity by parenteral nutrition (PN) weaning strategy in children with intestinal failure. Methods: Analysis of retrospectively reviewed medical record data included comparison of time to PN wean since the date of the first clinic visit, survival time, and differences in height z-scores between PN wean and two-years post-wean by whether an enteral tube feeding (TF) was used during the weaning process. Results: 32 of 49 children (65%) received an enteral TF with or without oral diet during the two-year follow-up period. Median time to weaning did not differ significantly between those who received a TF (21.5 months [IQR;10.3, 37.8]) vs. oral diet alone (19.0 months [IQR; 14.5, 40.0]). The probability of survival did not differ by TF status with only one death in the TF group. Linear growth velocity between the time of PN weaning to two-years post-wean did not significantly differ by TF status. Children who weaned via oral diet alone had a similar decrease in height z-score vs. those who received a TF (-0.14 vs. -0.15, respectively); however, a greater increase in z-score between years 1 and 2 post-wean was observed (+0.27 vs. +0.11, respectively). Conclusions: No association between weaning strategy and outcomes in children with IF was observed. Linear growth velocity declines during the first year after PN weaning but rebounds in year two. Future studies should examine the long-term benefits of oral feeding vs. TF on intestinal adaptation

Methods of Determining Energy Requirements in Critically Ill Adults Before the Publication of New Critical Care Guidelines

Background: Energy requirements can be difficult to determine in the critically ill population due to the presence of catabolic stress. The 2009 Guidelines for the Provision and Assessment of Nutrition Support Therapy Parenteral and Enteral Nutrition and in the Adult Critically Ill Patient recommend that energy requirements be calculated by predictive equations or weight-based equations or measured by indirect calorimetry (IC) and that nutrition efficacy may be monitored through nitrogen balance (24-hour Urinary Urea Nitrogen) or non-protein calorie:nitrogen ratio. Very few studies have reported the required energy assessment methods used by Registered Dietitian Nutritionists (RDNs) in the critical care setting and no studies have reported the use of laboratory tests to monitor efficacy of nutrition. The purpose of the study is to examine practices for estimating energy requirements in critically ill patients by RDNs prior to publication of the updated critical care guidelines in 2016. Methods: The study sample included patients currently included in the trauma registry at Grady Memorial Hospital (GMH). Patients who were in motor vehicle accidents (excluding trains), who were admitted to the Intensive Care Unit at GMH between July 4, 2014 and September 28, 2015, and who required at least five days of mechanical ventilation during admission were included. Demographic characteristics (gender, race, and age), anthropometric characteristics (body mass index classification), clinical characteristics (number of days on the ventilator, ICU days, time to death)), and nutrition assessment methods (energy assessment method used, weight used in assessment, and laboratory monitoring recommendations) were extracted from the electronic medical record. Results: The vast majority of Registered Dietitian Nutritionists (98%) used a simple weight-based equation during the initial nutrition assessment. Approximately 1/3 of the Registered Dietitian Nutritionists used the actual patient body weight (36.8%) with the remaining primarily using a recommended body weight based on a selected BMI. Nine different weight-based equations were used with the equation 25-30 kcal/kg used most often (87.9%). Indirect calorimetry was not recommended by the RDNs during the first two weeks of admission for any patient. RDNs recommended prealbumin to monitor nutrition status (within 2 weeks of admission) in 21.6% of patients. Conclusions: We observed inconsistencies in the equations, weights, and monitoring laboratory tests used by RDNs. This variability can be attributed to a lack of specificity in the 2009 critical care guidelines, which justifies the need for updated recommendations in 2016. Future studies should examine change in nutrition assessment practices by RDNs since publication of the 2016 guidelines

Mapping the Lived Experiences of Bisexuals

Bisexuality is often met with binegativity, dismissal, and marginalization due to misconception of identity and behavior and its consideration as a transitional phase before the adoption of a monosexual identity. There is a lack of in-depth research regarding bisexuality apart from lesbian, bisexual, gay, and transgender/sexual studies; it is important to understand and differentiate bisexuality as a separate identity rather than a subset of heterosexual or homosexual identities. The purpose of this qualitative, phenomenological study was to explore the lived experiences of bisexuals through the lens of sexual configurations theory (SCT). SCT is a relatively new theory that has yet to enjoy broad empirical support; it theorizes sexuality as a social construct grounded in relativism. The theory and its mapping diagram allow for the possibility of a framework and visual depiction of bisexual lived experiences. Six people who identified as bisexual, who were recruited through listervs of professional organizations, and social organization networks, participated in in-depth interviews. The interviewees described their experiences with attractions and partners as whole gender/sex identities, relationships to gender/sex norms, genders, and personal attributes as having equal or greater importance than sex. Results indicate that the SCT diagram is a viable tool in understanding and describing lived experiences in a visual capacity. Implications for positive social change include providing knowledge that scholar-practitioners, mental health providers, and educators can use to support and affirm the bisexual identity and behaviors of clients. The research also lends further support to the SCT as an explanatory framework for sexuality

A PRDX1-FOXO3 signaling pathway acts as a redox sensor controlling FOXO3 subcellular localization and target gene transactivation

Precision in redox signaling is attained through posttranslational protein modifications such as oxidation of protein thiols. The peroxidase peroxiredoxin 1 (PRDX1) regulates signal transduction through changes in thiol oxidation of its cysteines. We demonstrate here that PRDX1 is a binding partner for the tumor suppressive transcription factor FOXO3 that directly regulates the FOXO3 stress response. Heightened oxidative stress evokes formation of disulfide-bound heterotrimers linking dimeric PRDX1 to monomeric FOXO3. Absence of PRDX1 enhances FOXO3 nuclear localization and transcription that are dependent on the presence of Cys31 or Cys150 within FOXO3. Notably, FOXO3-T32 phosphorylation is constitutively enhanced in these mutants, but nuclear translocation of mutant FOXO3 is restored with PI3K inhibition. Here we show that on H2O2 exposure, transcription of tumor suppressive miRNAs let-7b and let-7c is regulated by FOXO3 or PRDX1 expression levels and that let-7c is a novel target for FOXO3. Conjointly, inhibition of let-7 microRNAs increases let-7-phenotypes in PRDX1-deficient breast cancer cells. Altogether, these data ascertain the existence of an H2O2-sensitive PRDX1-FOXO3 signaling axis that fine tunes FOXO3 activity toward the transcription of gene targets in response to oxidative stress. The public health significance of this research lies in the fact that elevated levels of oxidative stress in a major cancer risk factor. In breast cancer it has been found that post-menopausal women, who are generally at increased risk for breast cancer development, show an even higher level of oxidative stress markers. Unfortunately, antioxidant therapies have proven ineffectual. If we can gain a deeper understand of how these oxidative stress induced redox-signaling pathways work, it is possible to develop more effective therapies for those at-risk patients for whom therapies fail

The Relationship between the Source of Protein Intake and Obesity Risk in Children

Background: Previous research has reported a relationship between high protein intake (\u3e15% of energy) during early childhood and an increased risk of obesity later in life. However, few studies have investigated this relationship during middle childhood to early adolescence or examined the effects of different sources of protein. Objective: The aim of this study was to investigate the relationship between the source of protein intake (animal vs. plant) and body mass index (BMI) in children between the ages 6-14 years. Participants/setting: 285 healthy 6-14 year old (male n=154) Caucasian and African American (n=171) children from Pittsburgh, Pennsylvania completed a food frequency questionnaire. Main outcome measures: Median protein intake (grams) by total, animal, and plant protein and BMI-for-age classification. Statistical analysis: The Kruskal-Wallis test was used to evaluate differences in median protein intake (grams) by weight classification (normal weight [BMI 5th%ile to \u3c85th%ile], overweight [BMI 85th%tile to \u3c95th%tile], obese [BMI \u3e95th%tile]). Correlation statistics were also conducted to examine the relationship between protein intake and BMI. Results: The population used in the data analysis included 285 children/early adolescents (median age 9.8 ± 2.1 years; 53% boys; 40% Caucasian). Data from 11 children were excluded due to outliers or missing data. Girls had a significantly higher BMI than boys (20.1 vs. 18.2 kg/m2, respectively; P=P=P= Conclusions: We observed a significant curvilinear versus linear trend in total protein and animal and plant protein intake by weight classification in middle-aged children that may be due to under-reporting in overweight and obese children. Total percent protein intake was significantly higher in children of normal weight. Future longitudinal studies using multiple measures of body fatness should be conducted to determine the relationship between protein intake and BMI during middle childhood to early adolescence

Explicit teaching of models to enrich physical science learning

Good teaching inducts students into science as a human endeavour and demonstrates that scientific knowledge arises from a process of model construction, testing and review. The historical evolution of scientific knowledge is the development and refinement of models to explain scientific observations. The explicit use of models in teaching facilitates metacognitive engagement, which can lead to improved conceptual understanding (Kenyon et al., 2008). The Science curriculum in Victoria, Australia is modelled on the Australian national curriculum and begins with an explicit aim of students developing an understanding of “the nature of scientific inquiry and the ability to use a range of scientific inquiry methods.” Models are mentioned frequently in the more detailed curriculum statements. For example, the curriculum strand “Science as a human endeavour” includes the following statement: “Scientific understanding, including models and theories, are contestable and are refined over time through a process of review by the scientific community.” In this work we present examples of the representation of models in the secondary physical science curriculum and highlight opportunities for enriching the teaching of science through the explicit introduction of the history and nature of the model, with an emphasis on linking to metacognition (Avargil et al., 2017). REFERENCES Avargil, S., Lavi, R., & Dori, Y. (2017). Students’ Metacognition and Metacognitive Strategies in Science Education, in Y.J. Dori, Z.R. Mevarech, & D.R. Baker (ed.). Cognition, metacognition, and culture in STEM education: Learning, teaching and assessment, Springer International Publishing AG, 33-64. Kenyon, L., Schwarz, C. & Hug, B. (2008), The Benefits of Scientific Modeling. Science and Children, 46(2), 40-44