Increasing Knowledge and Skills of Graduate Students Using Experiential Education

This study examined the impact of experiential education through the utilization of vignettes on graduate student knowledge, skills, and attitudes in the area of written language disorders. Graduate students enrolled in a written language disorders class completed assessment measures designed to examine clinical understanding and confidence when preparing to teach a client exhibiting a written language disorder. The impact of the use of vignettes in the learning process was measured using pre- and post-tests, class surveys, and focus group interviews. Students demonstrated significant improvement in their knowledge, skills, and attitudes regarding written language disorders. All pre- and post-course comparisons were significant (p \u3c .01). Therefore, the use of vignettes in a graduate level written language disorders course created learning experiences which resulted in the transformation of factual and theoretical knowledge into active clinical understanding and clinical confidence

A practical guide to assessment of ventricular diastolic function using doppler echocardiography

AbstractDoppler assessment of diastolic function has become a standard part of routine echocardiographic examination and imparts information relevant to a patient's functional class, management and prognosis. This review describes the Doppler patterns of diastolic function relative to physical signs and physiology. A continuum of Doppler patterns of diastolic function exists, including normal diastolic function, impaired relaxation, pseudonormal filling, restriction, constriction and tamponade. These patterns evolve from one to another in a single individual, with changes in disease evolution, treatment and loading conditions. New applications of continuous wave Doppler, color Doppler M-mode and Doppler tissue imaging are refining our understanding of diastolic function

Model Based Estimation of Posaconazole Tablet and Suspension Bioavailability in Hospitalized Children Using Real-World Therapeutic Drug Monitoring Data in Patients Receiving Intravenous and Oral Dosing

Invasive fungal infections are a major cause of morbidity and mortality for immunocompromised patients. Posaconazole is approved for treatment and prophylaxis of invasive fungal infection in adult patients, with intravenous, oral suspension, and gastroresistant/delayed-released tablet formulations available. In Europe, until very recently, posaconazole was used off-label in children, although a new delayed-release suspension approved for pediatric use is expected to become available soon. A population pharmacokinetic model was developed which uses posaconazole therapeutic drug monitoring data following intravenous and oral dosing in hospitalized children, thus enabling estimation of pediatric suspension and tablet oral bioavailability. In total, 297 therapeutic drug monitoring plasma levels from 104 children were included in this analysis. The final model was a one-compartment model with first-order absorption and nonlinear elimination. Allometric scaling on clearance and volume of distribution was included a priori. Tablet bioavailability was estimated to be 66%. Suspension bioavailability was estimated to decrease with increasing doses, ranging from 3.8% to 32.2% in this study population. Additionally, concomitant use of proton pump-inhibitors was detected as a significant covariate, reducing suspension bioavailability by 41.0%. This is the first population pharmacokinetic study to model posaconazole data from hospitalized children following intravenous, tablet, and suspension dosing simultaneously. The incorporation of saturable posaconazole clearance into the model has been key to the credible joint estimation of tablet and suspension bioavailability. To aid rational posaconazole dosing in children, this model was used alongside published pharmacodynamic targets to predict the probability of target attainment using typical pediatric dosing regimen

Hermitian boson mapping and finite truncation

Starting from a general, microscopic fermion-to-boson mapping that preserves Hermitian conjugation, we discuss truncations of the boson Fock space basis. We give conditions under which the exact boson images of finite fermion operators are also finite (e.g., a 1+2-body fermion Hamiltonian is mapped to a 1+2-body boson Hamiltonian) in the truncated basis. For the most general case, where the image is not necessarily exactly finite, we discuss how to make practical and controlled approximations.Comment: 12 pages in RevTex with no figures, Los Alamos preprint # LA-UR-94-146

Evidence Report: Risk of Decompression Sickness (DCS)

The Risk of Decompression Sickness (DCS) is identified by the NASA Human Research Program (HRP) as a recognized risk to human health and performance in space, as defined in the HRP Program Requirements Document (PRD). This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. Given that tissue inert gas partial pressure is often greater than ambient pressure during phases of a mission, primarily during extravehicular activity (EVA), there is a possibility that decompression sickness may occur

Linking gastrointestinal microbiota and metabolome dynamics to clinical outcomes in paediatric haematopoietic stem cell transplantation

Background: Haematopoietic stem cell transplantation is a curative procedure for a variety of conditions. Despite major advances, a plethora of adverse clinical outcomes can develop post-transplantation including graft-versus-host disease and infections, which remain the major causes of morbidity and mortality. There is increasing evidence that the gastrointestinal microbiota is associated with clinical outcomes post-haematopoietic stem cell transplantation. Herein, we investigated the longitudinal dynamics of the gut microbiota and metabolome and potential associations to clinical outcomes in paediatric haematopoietic stem cell transplantation at a single centre. Results: On admission (baseline), the majority of patients presented with a different gut microbial composition in comparison with healthy control children with a significantly lower alpha diversity. A further, marked decrease in alpha diversity was observed immediately post-transplantation and in most microbial diversity, and composition did not return to baseline status whilst hospitalised. Longitudinal trajectories identified continuous fluctuations in microbial composition, with the dominance of a single taxon in a significant proportion of patients. Using pam clustering, three clusters were observed in the dataset. Cluster 1 was common pre-transplantation, characterised by a higher abundance of Clostridium XIVa, Bacteroides and Lachnospiraceae; cluster 2 and cluster 3 were more common post-transplantation with a higher abundance of Streptococcus and Staphylococcus in the former whilst Enterococcus, Enterobacteriaceae and Escherichia predominated in the latter. Cluster 3 was also associated with a higher risk of viraemia. Likewise, further multivariate analysis reveals Enterobacteriaceae, viraemia, use of total parenteral nutrition and various antimicrobials contributing towards cluster 3, Streptococcaceae, Staphylococcaceae, Neisseriaceae, vancomycin and metronidazole contributing towards cluster 2. Lachnospiraceae, Ruminococcaceae, Bifidobacteriaceae and not being on total parenteral nutrition contributed to cluster 1. Untargeted metabolomic analyses revealed changes that paralleled fluctuations in microbiota composition; importantly, low faecal butyrate was associated with a higher risk of viraemia. Conclusions: These findings highlight the frequent shifts and dominations in the gut microbiota of paediatric patients undergoing haematopoietic stem cell transplantation. The study reveals associations between the faecal microbiota, metabolome and viraemia. To identify and explore the potential of microbial biomarkers that may predict the risk of complications post-HSCT, larger multi-centre studies investigating the longitudinal microbial profiling in paediatric haematopoietic stem cell transplantation are warranted

Sex differences in cancer mechanisms

We now know that cancer is many different diseases, with great variation even within a single histological subtype. With the current emphasis on developing personalized approaches to cancer treatment, it is astonishing that we have not yet systematically incorporated the biology of sex differences into our paradigms for laboratory and clinical cancer research. While some sex differences in cancer arise through the actions of circulating sex hormones, other sex differences are independent of estrogen, testosterone, or progesterone levels. Instead, these differences are the result of sexual differentiation, a process that involves genetic and epigenetic mechanisms, in addition to acute sex hormone actions. Sexual differentiation begins with fertilization and continues beyond menopause. It affects virtually every body system, resulting in marked sex differences in such areas as growth, lifespan, metabolism, and immunity, all of which can impact on cancer progression, treatment response, and survival. These organismal level differences have correlates at the cellular level, and thus, males and females can fundamentally differ in their protections and vulnerabilities to cancer, from cellular transformation through all stages of progression, spread, and response to treatment. Our goal in this review is to cover some of the robust sex differences that exist in core cancer pathways and to make the case for inclusion of sex as a biological variable in all laboratory and clinical cancer research. We finish with a discussion of lab- and clinic-based experimental design that should be used when testing whether sex matters and the appropriate statistical models to apply in data analysis for rigorous evaluations of potential sex effects. It is our goal to facilitate the evaluation of sex differences in cancer in order to improve outcomes for all patients

The Maine Annex, vol. 1, no. 4

The Maine Annex, published by the students of the University of Maine at the Brunswick Campus, was launched January 10, 1947. Editors introduced the publication as the product of a group of progressive students attending the Brunswick Campus. The goal of the publication, according to editors, was to tell the story of our life on this campus. The four-page, tabloid-sized paper included display advertising from area businesses. Among front-page news was a stage performance by American poet, educator, writer, and Brunswick, Maine native son, Robert Peter Tristram Coffin

The Maine Annex, vol. 1, no. 1

The Maine Annex, published by the students of the University of Maine at the Brunswick Campus, was launched January 10, 1947. Editors introduced the publication as the product of a group of progressive students attending the Brunswick Campus. The goal of the publication, according to editors, was to tell the story of our life on this campus. The four-page, tabloid-sized paper included display advertising from area businesses. Following World War II, the federal G.I. Bill enabled approximately 2.3 million, predominantly white male Veterans to receive a post-secondary education. To accommodate increased enrollment, in 1946 the University of Maine established the Brunswick Campus at the former Brunswick Naval Air Station. The remote campus operated until spring 1949, when Veteran registrations waned. Among stories covered in the first issue of The Maine Annex includes The Fate of Your College Dollar, by Bill Nisbet, which discusses how student tuition and fees were distributed