Optimizing a Disease Severity Scale for Evaluating Travelers\u27 Diarrhea in Adults

Primary efficacy endpoints for interventional products targeting travelers’ diarrhea (TD) prevention have been predominately based on stool frequency. However, reliance on stool-based endpoints alone may obscure potentially meaningful differences in illness profiles. A single, standardized scoring system optimized for use in adult travelers is needed to accurately measure TD severity and enable more robust estimates of treatment or intervention effectiveness. The purpose of this quantitative secondary data analysis was to describe the variability in TD signs and symptoms across traditional severity metrics such as stool output, identify which symptoms were significantly associated with a negative impact on activity, and determine whether a TD scoring system that considers other symptomology could be optimized for use in future studies using the IRT and CTT frameworks. Data were obtained from two interventional studies: TrEAT TD, a multi-site TD treatment trial, and OEV-118—a placebo-controlled ETEC vaccine efficacy trial in travelers. Correlation, regression and multiple correspondence analyses were performed across multiple signs and symptoms to assess impact on activity and a TD severity score was established. Conclusions were (a) the new TD score significantly benefits the estimation of impact on activity over any individual sign or symptom, and (b) there was a benefit to reduction in overall TD disease severity when applied to a previously conducted vaccine efficacy trial. The use of a single optimized scoring system may better capture illness severity than commonly utilized metrics and moves the field towards current recommendations for TD management. Additionally, the use of the TD severity score may be an improved efficacy metric than stool frequency for future vaccine trials

Queering Colombia\u27s Peace Process: A case study of LGBTI inclusion

Colombia has suffered under its current armed conflict for more than half a century. There is finally a glimmer of hope with the progression of peace talks between the Colombian government and the country’s largest guerrilla group, the Revolutionary Armed Forces of Colombia (FARC). These talks began in 2012 and have experienced a number of successes and failures thus far. However, they have been regularly praised and revered as a model for the world, particularly with regard to their efforts surrounding victims of the armed conflict. This capstone paper focuses on one particular group of victims, lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals. The experience of LGBTI people in armed conflicts has been historically excluded from peace processes. I explore how Colombia’s peace process has approached the LGBTI experience through interviews with LGBTI activists, analysis of the actions taken by the negotiators, and my own observations throughout my internship in Bogotá, Colombia. This case study highlights the complexity of social discrimination and violence against LGBTI individuals in Colombia and that occurs within the context of the armed conflict. The efforts conducted by LGBTI organizations reveal the critical role of truth and memory initiatives and capacity building. While much work has been done to ensure the inclusion of an LGBTI agenda in the peace process, Colombia is left with many unanswered questions about what a post-conflict society will look like for LGBTI victims of the armed conflict

A Comparison of High School Graduation Predictors Between Two Ontario Student Cohorts

While a number of factors have already been shown to impact variations in graduation rates among students in Canada, there is little research examining the changing impact of these factors on Ontario students’ secondary education completion over time. This research draws on data from two Grade 9 cohorts (2006 and 2011) from the Toronto District School Board in order to unpack how predictors of high school graduation change over time. In particular, we use multivariate analysis to examine whether predictors (including gender, race, parental education, household income, suspension, academic achievement, special education needs, and Grade 9 absenteeism) are significant by cohort of students and if there are gaps in secondary school success between subgroups. Findings demonstrate that high school completion is increasing over time and that there is a diminishing importance of parental education and neighbourhood household income as a predictor of high school graduation. However, we do find evidence of persistent under-achievement among students of certain racial backgrounds, lower academic streams, and those with high rates of absenteeism. We argue that additional data infrastructure in Ontario and beyond are necessary to identify how our findings generalize to the province as a whole.Bien qu’il ait déjà été démontré qu’un certain nombre de facteurs influencent les variations des taux d’obtention de diplôme chez les élèves au Canada, peu de recherches se sont penchées sur les conséquences de ces facteurs sur l’achèvement des études secondaires des élèves ontariens au fil du temps. La présente recherche repose sur des données recueillies auprès de la Commission scolaire du district de Toronto concernant deux promotions de 9e année (2006 et 2011) et vise à déterminer comment les indicateurs relatifs à l’obtention des diplômes d’études secondaires évoluent au fil du temps. Plus particulièrement, nous recourons à une analyse multivariée pour déterminer si les indicateurs (notamment le sexe, la race, le niveau d’éducation des parents, le revenu du ménage, la suspension, le rendement scolaire, les besoins en matière d’éducation spécialisée et l’absentéisme en 9e année) sont significatifs par groupe d’élèves et s’il y a des écarts en matière de réussite au secondaire entre les sous-groupes. Les résultats obtenus prouvent que le taux d’achèvement des études secondaires augmente au fil du temps et que l’importance de l’éducation des parents et du revenu moyen des ménages du quartier en tant que facteurs prédictifs de l’obtention du diplôme d’études secondaires diminue. Cependant, nous observons la persistance de mauvais résultats chez les élèves de certaines minorités raciales, dans les classes inférieures et chez ceux qui ont un taux d’absentéisme élevé. Nous estimons que des infrastructures de données supplémentaires sont nécessaires en Ontario et ailleurs pour savoir si les résultats que nous avons obtenus s’appliquent à l’ensemble de la province

Brachial Artery Pseudoaneurysm Secondary to a Sessile Osteochondroma in an Avid Teenage Basketball Player

PURPOSE: Osteochondromas (OCE) are typically characterized as benign cartilaginous neoplasms occurring as either solitary lesions or as part of multiple hereditary exostosis (MHE). In some instances, they may cause pain due to irritation of nearby musculoskeletal structures such as ligaments, tendons, nerves and vessels. Growth of these lesions is often slow and mimics skeletal growth. Rapid change in the size of an OCE warrants investigation due to concern for malignant transformation. Presented here is the case of a 17 year old male who noted rapid ongoing growth in a humeral osteochondroma secondary to development of a brachial artery pseudoaneurysm. METHODS: 17 year old male avid basketball player presents with history of MHE who is status post resection of OCE lesions about his knee. He reported a one year history of significant and progressive growth of a lesion in his right medial upper arm associated with mechanical pain (especially during basketball), night pain and occasional numbness. Physical exam revealed a large, firm and relatively immobile non-pulsatile mass just distal to the axilla without adjacent adenopathy. CT scan revealed a 10 cm mass with subjacent cortical irregularity concerning for a mass/sarcoma with hemorrhage versus pseudoaneurysm. MRI was most suggestive of a pseudoaneurysm with displacement of the neurovascular structures. MRA and CT angiogram confirmed the suspected pseudoaneurysm. He subsequently underwent successful resection and repair of the pseudoaneurysm in addition to resection of the offending exostosis by Orthopaedic oncology. His recovery to date has been unremarkable. DISCUSSION: Vascular complications associated with OCE are rare, with around 100 reported in the literature. The most common location for vascular findings is typically the popliteal artery, likely secondary to the knee being a common location for OCE’s, frequent trauma to the area and the relative tethering of this artery about the knee. The humerus is decidedly an uncommon location despite the shoulder’s large range of motion. Conclusion: Rapid or ongoing enlarging OCE’s require prompt medical attention and work up. Whereas sarcomatous degeneration needs to always be considered, other etiologies such as pseudoaneurysms need to be included in the differential diagnosis. Presented is a case report of the rare complication of an OCE leading to a brachial artery pseudo-aneurysm in the upper extremity. Recognition of this potential diagnosis aided in appropriate imaging without disastrous open or needle biopsy and an ultimate successful outcome.https://scholarlycommons.henryford.com/merf2019caserpt/1067/thumbnail.jp

Produkt- und Kommunikationspolitik im Stadtmarketing - Die Hamburger Olympiabewerbung aus Sicht von Marketingexperten

In Kooperation mit dem Marketing Club Hamburg und der Ipsos GmbH haben Masterstudierende der Nordakademie Graduate School im Sommer 2015 eine qualitative Erhebung unter Marketingexperten durchgeführt. 13 Experten mit entsprechender Leitungsfunktion im Marketing haben hier ihre Wahrnehmung der Stadt und die relevanten Standortfaktoren, die eine Stadt aus Marketingsicht heutzutage mitbringen muss, dargestellt

Marketingstandort Hamburg - so what?

In Kooperation mit dem Marketing Club Hamburg und der Ipsos GmbH haben Masterstudierende der Nordakademie Graduate School im Sommer 2015 eine qualitative Erhebung unter Marketingexperten durchgeführt. 13 Experten mit entsprechender Leitungsfunktion im Marketing haben hier ihre Wahrnehmung der Stadt und die relevanten Standortfaktoren, die eine Stadt aus Marketingsicht heutzutage mitbringen muss, dargestellt