The exploitation of children as soldiers in the Philippines : an analysis of issues and challenges in social work practice : a thesis submitted in partial fulfillment of the requirements for the degree of Master of Social Work at Massey University, Albany, New Zealand

This study aims to explore and analyze how social workers directly working with child soldiers perceive the child soldier phenomenon in the Philippines. Specifically, it aims to come up with a picture of the child soldier phenomenon in the country, analyze the various factors or conditions contributory to the participation of children in armed conflict, explore the issues and challenges the child soldier phenomenon poses in social work practice and draw lessons or insights that can contribute to the improvement of current social work practice. This qualitative study used personal interview and instrumental case study methods in data gathering. Selected regional social workers of the government's welfare department, who have handled cases of children involved in armed conflict, served as the main source of information. They were selected through purposive sampling. Likewise, instrumental case study method was used to strengthen and enrich the data gathered using 31 selected case files of child soldiers. The information was analyzed using an ecological and structural framework. This research has shown that the child soldier phenomenon in the country is multidimensional and connected with various factors internal and external to the child. The existence of the phenomenon could not be attributed solely to a single factor but rather to combination of factors in the child's environment, which serve as a cumulative force that pushes the child to participate in the armed group. This study put forth the need for a multifaceted approach in social work practice with child soldier where all systems - micro, meso, exo, macro - in the child's immediate and distant environment are considered in the entire helping process. Likewise, it stressed the need for social work actions that provides not only immediate relief to individual child and her/his family, but also longer-term solutions that targets oppressive and unjust institutional and structural order in the society. It affirmed the importance of transformative social work practice where interventions go beyond mere palliative care and the importance of reflective practice where reflection-in-action is integral to the performance of social work profession

FUNCTIONAL ROLE OF ALDEHYDE DEHYDROGENASE-1A1 (ALDH1A1) IN BREAST CANCER METASTATIC BEHAVIOUR

Previous work in our lab indicates “stem-like” breast cancer cells can be identified by an ALDHhlCD44+phenotype and that these cells are significantly more metastatic than ALDHlowCD44‘cells. The purpose of this project was to investigate the functional role of overexpressed human ALDH1A1 in breast cancer behaviour. ALDH1A1 was stably overexpressed in MCF-7 human breast cancer cells and these cells were assessed using functional in vitro assays of metastasis (proliferation, adhesion, migration, colony formation). Despite overexpression of ALDH1A1, no significant differences were observed in malignant cell behaviour between empty vector control and MCF- 7/ALDH1A1 cells. However, it was observed that MCF-7/ALDH1A1 cells with the highest ALDH activity demonstrate a significantly higher proportion of cells in the S/G2/M phases of the cell cycle relative to the remainder of the population (p\u3c0.05). The results suggest that ALDH1A1 may not be the only ALDH isoform that plays a role in breast cancer metastasis

Agro-Ecological Zoning for Tall Wheatgrass (Thinopyrum Ponticum) as a Potential Energy and Forage Crop in Salt-Affected and Dry Lands of Argentina

Thinopyrum ponticum, is the most disseminated halophyte speciescultivated for forage on hydro-halomorphic soils in the world. Theobjective of the present work was to identify the geographicareas fordevelopment of tall wheatgrass on halomorphic soils in Argentina, for forageand as feedstock for bioenergy. To define the agroclimate in Argentina, we considered the thermal and hydric limits of the species in its place of originand in locations where it is successfully cultivated around the world. The maps corresponding to the bioclimatic indices were drawn using a GIS, andthe map obtained by overlaying them defined the agroclimatic suitability. Thiszoning was finally superimposed on the drylands saline and alkaline soils inthecountry, thus defining the agro-ecological suitability of Argentina forthis species under different moisture regimes: moist-subhumid,dry-subhumid, semiarid to arid climate. The the agro-ecological zoning showsthe potential growing areas for tall wheatgrass in Argentina on soils withhalomorphism processes under dry climates.Fil: Falasca, Silvia Liliana. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación de Recursos Naturales. Instituto de Clima y Agua; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Miranda del Fresno, Ma. Carolina. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Humanas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pitta-alvarez, Sandra Irene. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Micología y Botánica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Micología y Botánica; Argentin

Oral Transmucosal Delivery of Fentanyl Citrate for Breakthrough Cancer Pain Relief

Episodes of breakthrough cancer pain are relatively common occurrences for patients undergoing cancer treatments. Characterized by pain unrestrained by traditional medications, these physical burdens impose a significant degree of suffering. In order to control and eliminate this pain, Actiq, a pharmaceutical lollipop, has been developed to provide rapid oral transmucosal delivery of fentanyl citrate, a potent medicinal narcotic. To elucidate the pharmacokinetics of the drug under various dosages, a computer model of fentanyl diffusion in the oral cavity was designed in COMSOL. Upon solving the model process, concentration profiles of fentanyl in the mucosa over time were developed for various dosages. Sensitivity analyses were also performed to determine the effects of several parameters on fentanyl diffusion. The resulting concentration profiles showed that peak concentrations of 0.00079 g/m3, 0.0016 g/m3, and 0.0032 g/m3 for 200 ?g, 400 ?g, and 800 ?g dosages, respectively, were achieved at approximately 800 seconds. Additionally, based upon the sensitivity analyses, the fentanyl solubility and the lollipop radial dissolution rate have the greatest impact on fentanyl concentration and diffusion. Future research can be performed to optimize the drug diffusion by altering these two parameters, ultimately yielding a more effective Actiq product

Dietary intake alters behavioral recovery and gene expression profiles in the brain of juvenile rats that have experienced a concussion

Concussion and mild traumatic brain injury (mTBI) research has made minimal progress diagnosing who will suffer from lingering symptomology or generating effective treatment strategies. Research demonstrates that dietary intake affects many biological systems including brain and neurological health. This study determined if exposure to a high fat diet (HFD) or caloric restriction (CR) altered post-concussion susceptibility or resiliency using a rodent model of pediatric concussion. Rats were maintained on HFD, CR, or standard diet (STD) throughout life (including the prenatal period and weaning). At postnatal day 30, male and female rats experienced a concussion or a sham injury which was followed by 17 days of testing. Prefrontal cortex and hippocampus tissue was collected for molecular profiling. Gene expression changes in BDNF, CREB, DNMT1, FGF-2, IGF1, LEP, PGC-1α, SIRT1, Tau, and TERT were analyzed with respect to injury and diet. Analysis of telomere length (TL) using peripheral skin cells and brain tissue found that TL in skin significantly correlated with TL in brain tissue and TL was affected by dietary intake and injury status. With respect to mTBI outcomes, diet was correlated with recovery as animals on the HFD often displayed poorer performance than animals on the CR diet. Molecular analysis demonstrated that diet induced epigenetic changes that can be associated with differences in individual predisposition and resiliency to post-concussion syndrome

Exploring Patient Perspectives on Bedside Procedures: A Mixed Methods Study

INTRODUCTION Medical procedures are often performed on patients as part of their hospital stay. Common medical procedures include paracentesis, thoracentesis, lumbar punctures, knee arthrocentesis and central line insertions. These procedures can be performed at the patient’s bedside or in Interventional Radiology (IR). Much research has been done to improve procedural education and patient outcomes. However, little is known about the patient’s perspective. We explored how patients felt about their medical procedures and compared patient satisfaction between the bedside and IR groups.   METHODS We conducted a mixed-methods study (May – August, 2014), on consenting medical inpatients that had procedures performed as part of their hospital stay. Participants completed a 13-item satisfaction survey (Cronbach’s alpha =0.99). Patients also had the option of participating in a semi-structured interview. Transcripts of the interviews were analyzed using principles of grounded theory with common themes identified using open coding.   RESULTS Of the 96 eligible participants, 29 (30%) completed the survey and 12 (13%) patients completed the interview. Participants in the bedside group reported less wait time, compared with those in the IR group (median 2 hours, IQR 1-24 versus 24 hours, IQR 24-48 hrs respectively, p =0.009).  However, participants in IR group reported higher satisfaction with the time it took to complete the procedure itself (4.91 ± 0.30 vs 4.07 ± 1.14; p = 0.02 where 5 = very satisfied and 1 = very dissatisfied). In addition, patients reported higher satisfaction with their aftercare when returning from IR (p=0.05).  Overall, survey results suggests that irrespective of group assignment, participants were satisfied with their procedure  (4.79  ± 0.42). Of those who consented to the interview (n-12), the majority of the comments were positive (92%). Predominant themes included communication, attributes of the health care professionals, procedural comfort, efficiency, outcome and timing of the procedure.  Some negative comments pertained to patients’ sense of lack of control over information and timing of the procedure, transport and pain during the procedure. Interview results suggest that patients were satisfied with their procedure, but felt a lack of control in the process.  DISCUSSION AND CONCLUSIONS Results from the survey and the interview were concordant as patients reported being satisfied with their medical procedure. We found that there are significant differences between the bedside and IR group that make a profound impact on patient experience including wait time, efficiency and aftercare. The bedside group had higher patient satisfaction with wait times while IR group scored higher on efficiency and aftercare. Both are reasonable trade offs and support the notion that overall satisfaction is similar between the bedside and IR groups. Although patients reported high satisfaction with medical procedures, they noted that transport, timing of procedures, and communication are in need of improvement. Specifically, our findings support the need for quality improvement projects surrounding communication as participant satisfaction on this item varied depending on provider. Good communication can lead to a patient’s improved understanding of their medical procedure [1]. Limitations of this study include that is a single-center study and a small sample size. Overall, patients reported being satisfied with their medical procedures.

Journey of candidates who were unmatched in the Canadian Residency Matching Service (CaRMS): A phenomenological study

Background: Each year, a number of medical students are unmatched in the Canadian Residency Matching Service (CaRMs) match. There is little information on the experiences of unmatched candidates. This study seeks to explore the experiences of applicants who were unmatched in the first iteration of their CaRMS applications Methods: We interviewed 15 participants who were previously unmatched, using a semi-structured interview guide to ask them of their experiences on the following domains: the overall unmatched experience; circumstances leading to their unmatched status; resources employed; barriers experienced; recommendations; and, their eventual career outcomes. We independently identified major themes from field notes to code the data using a phenomenology approach. Results: Our participants universally reported negative emotions, concerns regarding privacy and confidentiality breaches, and stigma faced (real or perceived). Systemic challenges included: lack of information, pressures faced from undergraduate medical education, and logistical issues such as financial challenges, licensing and scheduling issues. The utility of peer support differed for individual participants, but all those who had support from other unmatched candidates felt that to be useful. Conclusions: Our participants reported significant challenges faced after being unmatched. Based on these experiences, we identified four major recommendations to support candidates through their unmatched journey

L’intégration des évaluations de l’apprentissage autorégulé dans les activités d’évaluation dans les professions de la santé : un appel à l’action

How well have healthcare professionals and trainees been prepared for the inevitable demands for new learning that will arise in their future? Given the rapidity with which ‘core healthcare knowledge’ changes, medical educators have a responsibility to audit whether trainees have developed the capacity to effectively self-regulate their learning. Trainees who engage in effective self-regulated learning (SRL) skilfully monitor and control their cognition, motivation, behaviour, and environment to adaptively meet demands for new learning. However, medical curricula rarely assess trainees’ capacity to engage in this strategic process. In this position paper, we argue for a paradigm shift toward assessing SRL more deliberately in undergraduate and postgraduate programs, as well as in associated licensing activities. Specifically, we explore evidence supporting an innovative blend of principles from the science on SRL, and on preparation for future learning (PFL) assessments. We propose recommendations for how program designers, curriculum developers, and assessment leads in undergraduate and postgraduate training programs, and in licensing bodies can work together to develop integrated assessments that measure how and how well trainees engage in SRL. Claims about lifelong learning in health professions education have gone unmatched by responsive curricular changes for far too long. Further neglecting these important competencies represents a disservice to medical trainees and a potential risk to the future patients they will care for.Dans quelle mesure les professionnels de la santé et les étudiants ont-ils été préparés aux exigences inévitables de nouveaux apprentissages qui se présenteront à eux à l’avenir? Étant donné la rapidité avec laquelle les « connaissances de base en matière de soins de santé » évoluent, les enseignants en médecine ont la responsabilité de vérifier si les étudiants ont développé la capacité d’autoréguler adéquatement leurs apprentissages. Ceux qui pratiquent efficacement l’apprentissage autorégulé (AAR) surveillent et contrôlent habilement leur cognition, leur motivation, leur comportement et leur environnement pour s’adapter à la nécessité de nouveaux apprentissages. Cependant, les programmes d’études médicales évaluent rarement la capacité des étudiants à s’engager dans ce processus stratégique. Dans cet exposé de position, nous plaidons en faveur d’un changement de paradigme vers une évaluation plus ciblée de l’AAR dans les formations doctorale et postdoctorale, ainsi que pour les activités d’évaluation. Plus précisément, nous explorons les résultats convaincants de l’emploi d’un mélange innovant de principes issus de la recherche en matière d’AAR et d’évaluations de la préparation à l’apprentissage futur. Nous proposons des recommandations pour une collaboration entre les responsables de la conception de programmes d’études, ceux de l’élaboration du cursus, ceux chargés de l’évaluation dans les programmes d’études prédoctorales et postdoctorales et les organismes responsables de l’octroi d’un titre de compétence en vue de créer des évaluations intégrées qui mesurent la méthode et la qualité de l’AAR chez les étudiants. Les programmes d’études tardent encore à traduire dans la pratique la reconnaissance de l’importance de l’apprentissage tout au long de la vie dans l’éducation médicale. Continuer à négliger ces compétences importantes ne ferait que nuire aux étudiants en médecine et potentiellement à leurs futurs patients