Women and the high school principalship: metropolitan detroit principals\u27 and superintendents\u27 perceptions regarding barriers and facilitators for job attainment

WOMEN AND THE HIGH SCHOOL PRINCIPALSHIP: METROPOLITAN DETROIT PRINCIPALS\u27 AND SUPERINTENDENTS\u27 PERCEPTIONS REGARDING BARRIERS AND FACILITATORS FOR JOB ATTAINMENT by HEIDI SCHNABEL KATTULA 2011 Advisor: Dr. Michael Addonizio Major: Educational Leadership and Policy Studies Degree: Doctor of Education Through multivariate analysis, this study determined if there was a significant difference between the perceptions of men and women high school principals and superintendents in Metropolitan Detroit regarding barriers and facilitators for women who aspire to gain a position as a public high school principal in Michigan. Gender and other variables that may influence perceptions of high schools principals within Michigan\u27s Oakland, Macomb and Wayne County public high schools were examined by administering an electronic survey to each group. Participants\u27 responses were analyzed through multiple and multivariate regression. Follow-up hypothesis testing for each predictor was conducted to determine if each of the predictors had an effect in all regression equations simultaneously. The dummy variable representing the female group was the only statistically significant predictor of the Barriers and Facilitators simultaneously for the principals and superintendents

DEFINING THE ROLE OF FACTOR XIII IN VENOUS THROMBOEMBOLISM

Blood coagulation is a series of enzymatic reactions that form a clot and control bleeding in response to an injury. When this process goes awry and abnormal clots form in veins, it is called venous thromboembolism. This disease is a leading cause of death and disability in the Western world. Current anticoagulation treatments inhibit thrombus propagation but do not dissolve the existing thrombus or prevent embolization, and are also associated with bleeding risk. Further investigation is needed to identify therapeutic strategies that influence the structure and content of clots without increasing bleeding risk. We have discovered that the clotting protein, factor XIII (FXIII), plays an important role in mediating the pathophysiology of venous thrombosis. The studies presented in this dissertation give insight into FXIII’s mechanistic contribution to venous thrombosis, hemostasis, and pulmonary embolism. We anticipate these findings will be important for the development of drugs targeting FXIII and may yield a new strategy for treating venous thromboembolism. First, we determined the contribution of FXIII compartment (plasma vs. platelet FXIII) and level in clot contraction, composition, and size in in vitro and in vivo models of venous thrombosis and hemostasis. We found that plasma FXIII, but not platelet FXIII, produced high-molecular-weight fibrin crosslinks, promoted red blood cell retention, and mediated clot weight in vitro. We also demonstrated that 50% reduction in FXIII produced significantly smaller venous thrombi but did not increase bleeding in tail transection or saphenous vein puncture models in vivo. These findings suggest that partial plasma FXIII reduction may be a therapeutic strategy for reducing venous thrombosis without increasing bleeding risk. Second, we examined the effect of accelerated FXIII activation, through the FXIII Val34Leu polymorphism, on whole blood clot weight and composition. We found compared to the wild-type Val variant at high fibrinogen levels, presence of the Leu variant is associated with formation of smaller whole blood clots. These findings suggest the Val34Leu polymorphism may protect against venous thrombosis by decreasing red blood cell retention and, consequently, reducing clot size. Third, we investigated the contribution of FXIII to thrombus stability and pulmonary embolism risk. Studying the mechanisms that may predispose a venous thrombus to embolize is limited by the lack of animal models that accurately recapitulate key characteristics of the human pathophysiology. Therefore, we developed a novel mouse model of venous thromboembolism that captures characteristics of human venous thrombosis (slow forming, red blood cell- and fibrin-rich thrombi) and pulmonary embolism (spontaneous embolism of existing venous thrombi). In this model, we determined that complete FXIII deficiency increases pulmonary embolization incidence, but partial deficiency does not. These findings suggest partial FXIII reduction may beneficially decrease venous thrombosis burden without increasing pulmonary embolization risk. Furthermore, we anticipate this novel mouse model can be used to evaluate the contribution of other pulmonary embolism risk factors and has to the potential to study disease progression and treatment intervention. Collectively, these studies extend our understanding of the mechanisms that mediate venous thromboembolism and explore a previously-unrecognized, critical role for FXIII in venous thromboembolism. This dissertation highlights basic research shaping translational efforts to discover novel approaches for prevention and treatment of diseases.Doctor of Philosoph

Molecular identification of hookworm isolates in humans, dogs and soil in a tribal area in Tamil Nadu, India

Background : Hookworms (Necator americanus and Ancylostoma duodenale) remain a major public health problem worldwide. Infections with hookworms (e.g., A. caninum, A. ceylanicum and A. braziliense) are also prevalent in dogs, but the role of dogs as a reservoir for zoonotic hookworm infections in humans needs to be further explored. Methodology/Principal Findings : As part of an open-label community based cluster-randomized trial in a tribal area in Tamil Nadu (India; 2013-2015), a total of 143 isolates of hookworm eggs from human stool were speciated based on a previously described PCR-RFLP methodology. The presence of hookworm DNA was confirmed in 119 of 143 human samples. N. americanus (100%) was the most prevalent species, followed by A. caninum (16.8%) and A. duodenale (8.4%). Because of the high prevalence of A. caninum in humans, dog samples were also collected to assess the prevalence of A. caninum in dogs. In 68 out of 77 canine stool samples the presence of hookworms was confirmed using PCR-RFLP. In dogs, both A. caninum (76.4%) and A. ceylanicum (27.9%) were identified. Additionally, to determine the contamination of soil with zoonotic hookworm larvae, topsoil was collected from defecating areas. Hookworm DNA was detected in 72 out of 78 soil samples that revealed presence of hook-worm-like nematode larvae. In soil, different hookworm species were identified, with animal hookworms being more prevalent (A. ceylanicum: 60.2%, A. caninum: 29.4%, A. duodenale: 16.6%, N. americanus: 1.4%, A. braziliense: 1.4%). Conclusions/Significance : In our study we regularly detected the presence of A. caninum DNA in the stool of humans. Whether this is the result of infection is currently unknown but it does warrant a closer look at dogs as a potential reservoir

Natural History of Cryptosporidial Infection in a Birth Cohort in a South Indian Semi-Urban Slum

Infectious diseases are a leading cause of childhood mortality. Five of the top 10 causes of death among children living in middle and low income countries are attributed to diseases of infectious origin. Although during the past few decades (between 1970 and 2013), the number of deaths among under-five children worldwide has reduced by more than 64%, an estimated 6.3 million children under the age of five were reported to have died in 2013 and 64% of all childhood deaths have been attributed to infectious causes. In order to reach United Nations Millennium Development Goal (MDG) 4 of decreasing childhood mortality by two thirds by 2015, there is a drive to control and prevent deaths from preventable infectious diseases by prioritizing them in various child health programmes . Several aspects of cryptosporidial infections, and host factors that modify the infection amongst children in this birth cohort have been explored. The impact of the findings on public health issues, particularly relevant to control of cryptosporidial infections are highlighted here. Cryptosporidium spp. is a common cause of parasitic diarrhoea throughout the world and is one of top five pathogens causing moderate to severe diarrhoea among children in developing countries. Despite this, the epidemiology of cryptosporidiosis in endemic settings is poorly understood. This study is innovative because it is the largest birth cohort study on the natural history of childhood cryptosporidiosis. The integration of molecular and serological methods for the diagnosis of cryptosporidial infection, coupled with the intensive bi-weekly follow-up helped capture the true burden of childhood cryptosporidiosis, and found it to be higher than reported earlier. Almost all children in the study acquired cryptosporidial infection by three years of age indicating a high rate of transmission in endemic areas, most likely through asymptomatically infected individuals. This study is the first to explore whether prior natural infection offered subsequent protection from infection or disease. The study found that an earlier infection did not offer protection from infection later in life. High rates and early infection with no subsequent protection requires public health interventions aimed at routes of transmission, rather than vaccines. The results of the study provide important insights in understanding the natural history and epidemiology of cryptosporidiosis in slum communities in India where there is sustained transmission, through multiple routes. The risk factors identified in this study can help develop scientifically sound, geographically relevant and socially sustainable measures that will effectively reduce the transmission of cryptosporidiosis in this and other endemic communities. As opposed to the developed countries where water is the primary mode of transmission, in the Indian setting, the transmission of cryptosporidiosis seems to occur through multiple routes (waterborne, human-to-human and animal-to-human). Personal hygiene and safe animal handling/tethering practices hence would be the leading public health interventions in this Indian setting for short-term benefits. Social interventions such as improvement in maternal literacy, reduction of poverty and provision of basic amenities like access to safe drinking water and sanitation may also help reduce transmission in the long run, but the effect of such intervention can only be ascertained over a longer time frame. Such interventions would also involve the participation of disciplines not directly related to health, such as education, social welfare and local administration

Prevalence & risk factors for soil transmitted helminth infection among school children in south India

Background & objectives: Soil-transmitted helminths (STH) are a major public health problem in tropical and sub-tropical countries, affecting the physical growth and cognitive development in schoolage children. This study was aimed to assess the prevalence and risk factors of STH infection among school children aged 6-14 yr in Vellore and Thiruvanamalai districts in south India. Methods: Children aged 6-14 yr, going to government and government aided schools (n=33, randomly selected) in Vellore and Thiruvanamalai districts were screened to estimate the prevalence of STH, and a case control study was done on a subset to assess the risk factors for the infection. Results: The prevalence of STH was 7.8 per cent, varying widely in schools from 0 to 20.4 per cent, in 3706 screened children. Hookworm (8.4%) rates were high in rural areas, while Ascaris (3.3%) and Trichuris (2.2%) were more prevalent among urban children. Consumption of deworming tablets (OR=0.25, P<0.01) offered protection, while residing in a field hut (OR=6.73, P=0.02) and unhygienic practices like open air defaecation (OR=5.37, P<0.01), keeping untrimmed nails (OR=2.53, P=0.01) or eating food fallen on the ground (OR=2.52, P=0.01) were important risk factors for STH infection. Interpretation & conclusions: Our study indicated that school children with specific risk factors in the studied area were vulnerable subpopulation with elevated risk of STH infection. Identifying risk factors and dynamics of transmission in vulnerable groups can help to plan for effective prevention strategies

A Cross-Sectional study of Neuropsychiatric problem in patients with Traumatic Brain Injury Treated in a Tertiary Care Rehabilitation Center.

OBJECTIVES: 1. To measure and describe the nature and prevalence of neuropsychiatric problems and psychiatric disorder after Traumatic Brain Injury (TBI). 2. To measure disability consequent to TBI. 3. To study the association if any between socio-demographic variables, trauma related variables, cognitive status, presence of psychiatric illness prior to TBI and co-morbidities with the occurrence of neuropsychiatric problems and disability. METHODS : Adult patients with TBI, who are admitted in Rehabilitation Institute who fulfil selection criteria are recruited into the study. The using standard tools neuropsychiatic symptoms, cognitive status, disability were measured. Clinical interview and review of records gave information about TBI and psychiatric disorders. Descriptive analysis of the outcomes was done. Comparison was made between different groups with appropriate statistical tools. Univariate regression analyses were performed for all associated factors. Multivariate analysis was done for factors found to be associated by adjusting for other factors. RESULTS : In the subjects under study 30% had psychiatric disorders. 94 % of them had neuropsychiatric symptoms. Operation having been performed on them increased the risk significantly by 5 times for both outcomes. Indicating more severe head injury leads to greater neuropsychiatric morbidity. Distribution of NPI scores was skewed to right. Its median was 11.5 with interquartile range from 5 to 8. Symptoms of depression, agitation/aggression and irritability/lability had high care-giver distress. Symptoms of appetite change, irritability/lability, agitation/aggression and apathy and indifference had high burden scores on the patients. Alcohol consumption at the time of injury and severity of injury measured in GCS was associated with worse level of functioning in Ranchos Los Amigos Level of Cognitive functioning scale. The same were associated with patients not assessable for cognitive function through Addenbrooke’s Cognitive Examination- Revised test. Distribution of Disability scores was skewed to right. It had a median of 7.25 with an interquartile range of 4 to 17.Presence of weakness in more than one limb was significantly associated with greater disability as measured by Disability Rating Scale. CONCLUSION : The prevalence of psychiatric disorder and neuropsychiatric symptoms in patients with traumatic brain injury admitted in the tertiary care Physical Medicine and Rehabilitation facility was very high. Needing a neurosurgery, a marker for severe injury was significantly associated with these. Presence of weakness of 2 or more limbs and consumption of alcohol at the time of injury was significantly associated with higher disability. The neuropsychiatric symptoms of agitation/aggression, irritability and weight/ appetite change were the most burdensome symptoms to patients and caregivers. Treatment of patients with TBI should involve a multidisciplinary approach, in which there is a close collaboration between neurologist/neurosurgeon, physiatrist, family physician, social worker, psychologist, family members, patient and the psychiatrist

EMINENT DOMAIN General Provisions and Condemnation Procedure: Provide a Comprehensive Revision of Provisions Regarding the Power of Eminent Domain

The Act amends the definition of blight, and adds a definition of public use and economic development. The Act amends the process and the powers of eminent domain. The Act increases the procedural requirements of eminent domain, including new notice provisions, additional rights for the condemnee, and new requirements for the condemnor. The Act increases procedural safeguards for property owners by enhancing notice requirements. The Act takes the power of eminent domain out of the hands of development authorities and gives the power to elected officials

SCREEN TIME BEYOND GAMING AND SOCIAL MEDIA: EXCESSIVE AND PROBLEMATIC USE OF OVER THE TOP (OTT) PLATFORMS AMONG COLLEGE STUDENTS DURING COVID-19 PANDEMIC

There is a gap in existing literature regarding Over the Top (OTT) platform use contributing to the excessive and problematic screen time. We aimed to assess OTT platform use among college students and its associations with increased screen time, mental well-being, COVID-19 related anxiety and personality traits. A total of 1039 students from a college in India were invited to participate in this web-based survey. A majority of participants used OTT platforms regularly. Subscription to paid OTT platforms, poor mental well-being were associated with problematic OTT use; whereas personality trait of conscientiousness seemed to offer protection against problematic OTT use

Developing a ludic framework for counteracting interventions for dementia: A narrative and analytic review

This is the final version. Available on open access from IP Innovative Publication via the DOI in this recordAs the field of medicine tries to tap into various facets of gamification, the potential of video games and gaming-based interventions has become a hotbed of interesting activity in the Dementia circles of medical research. This paper, exploratory in nature is a bid to find common grounds for the fields of neurosciences, psychology, and psychiatry with the sub-field of ludology in a hope to find unique insights from the benefits of interdisciplinary research and extrapolating findings from gaming addiction.From the perspective of game studies, the paper will draw from elements of concepts like flow, immersion and engagement in a bid to understand the various tools that can be of use if people ailing from neurocognitive disorders were to engage in gaming activity. This paper will lay the framework that will enable the beginning of a matching gaming exercises based on cognitive deficits and psychological profiling of clients diagnosed with neurocognitive disorders and advance the fields of neurosciences and psychology.By combining the findings from existing studies and original work this paper will propose both a means to study the possible effects of gaming-based interventions and suggest ways to streamline and optimize the use of gamification in patient care

SCREEN TIME BEYOND GAMING AND SOCIAL MEDIA: EXCESSIVE AND PROBLEMATIC USE OF OVER THE TOP (OTT) PLATFORMS AMONG COLLEGE STUDENTS DURING COVID-19 PANDEMIC

There is a gap in existing literature regarding Over the Top (OTT) platform use contributing to the excessive and problematic screen time. We aimed to assess OTT platform use among college students and its associations with increased screen time, mental well-being, COVID-19 related anxiety and personality traits. A total of 1039 students from a college in India were invited to participate in this web-based survey. A majority of participants used OTT platforms regularly. Subscription to paid OTT platforms, poor mental well-being were associated with problematic OTT use; whereas personality trait of conscientiousness seemed to offer protection against problematic OTT use