THE COMPONENTS NECESSARY IN A CLINICAL DAY PROGRAM FOR A SUCCESSFUL TRANSITION TO TRADITIONAL SCHOOL

The purpose of this research was to determine what components of academic and therapeutic clinical day programs ensure success for students with mental health diagnoses as they transition back to conventional educational settings. This study focused on the importance of developing students\u27 capabilities to fulfill their own needs within Maslow’s Hierarchy of Needs through coping skills, academic skills, and ensuring those skills transition to their traditional home school setting. The research questions guiding this study were: 1. How is “successful reintegration” defined for students with mental health concerns by the students, families, teachers, and other school staff? 2. What program components are present in effective clinical day programs? The methodology for this research was an evaluative case study approach, with interviews serving as the primary form of data collection. Three staff members at two clinical day programs that serve middle and high school students provided valuable insight into what components of the programs help students prepare for the transition back to traditional schools. The study findings indicated that enhancing students\u27 capacity to independently use therapeutic and academic skills significantly improved the likelihood of a successful transition to their home school. The most important themes that came from the research included skills to help students meet their needs within the Hierarchy of Needs, individualization of the clinical day program, and the various possible outcomes. This study provides the foundation for further development of clinical day programs that focus on the therapeutic skills and academic skills necessary for students to successfully transition from a more restrictive environment to a less restrictive setting. It also leads to continuing research in methods to ensure students’ ability to continue utilizing the skills learned across various settings

Efficacy of Multi-Modal Migraine Prophylaxis Therapy on Hyperacusis Patients.

ObjectivesTo evaluate the efficacy of a multi-modal migraine prophylaxis therapy for patients with hyperacusis.MethodsIn a prospective cohort, patients with hyperacusis were treated with a multi-modal step-wise migraine prophylactic regimen (nortriptyline, verapamil, topiramate, or a combination thereof) as well as lifestyle and dietary modifications. Pre- and post-treatment average loudness discomfort level (LDL), hyperacusis discomfort level measured by a visual analogue scale (VAS), and scores on the modified Khalfa questionnaire for severity of hyperacusis were compared.ResultsTwenty-two of the 25 patients (88%) reported subjective resolution of their symptoms following treatment. Post-treatment audiograms showed significant improvement in average LDL from 81.3 ± 3.2 dB to 86.4 ± 2.6 dB (P < .001), indicating increased sound tolerability. The VAS discomfort level also showed significant improvement from a pre-treatment average of 7.7 ± 1.1 to 3.7 ± 1.6 post-treatment (P < .001). There was also significant improvement in the average total score on modified Khalfa questionnaire (32.2 ± 3.6 vs 22.0 ± 5.7, P < .001).ConclusionsThe majority of patients with hyperacusis demonstrated symptomatic improvement from migraine prophylaxis therapy, as indicated by self-reported and audiometric measures. Our findings indicate that, for some patients, hyperacusis may share a pathophysiologic basis with migraine disorder and may be successfully managed with multimodal migraine prophylaxis therapy

Youth Perspectives on the Effects of a Family-centered Media Literacy Intervention to Encourage Healthier Eating

A pretest-posttest field test with control group (N = 189 parent-child dyads) tested a structural model representing youths' (ages 9-14) perspectives to examine the efficacy of a family-centered, media literacy-oriented intervention promoting fruit and vegetable consumption. The intervention facilitated critical discussion about nutrition and media, mentored by the parent. Results showed that youths' increases in fruit and vegetable consumption flowed from parent-child discussion of nutrition labels, which was predicted by child-initiated discussion, critical thinking about media sources, and critical thinking about media content. Multivariate analyses revealed that the intervention was productive for all participating age groups and for all dependent variables. The results suggest that a developmental progression from critical thinking about source to critical thinking about content affects behavior change and can be catalyzed through media literacy education and encouragement to discuss media messages (i.e. practice) with parents

Medford Fire-Rescue Public Relations Campaign

60 pagesThis report is the result of three terms of work by students in the University of Oregon’s School of Journalism and Communication. During fall term 2013, students in Strategic Communications Research (J495) conducted primary and secondary research to learn more about issues related to Medford’s Police and fire facilities, with the intent of addressing both Department’s issues as a single project. At the beginning of winter term, it was determined that each Department would best be served by individual reports. In winter term 2014, students in Strategic Planning and Cases (J453) used the research conducted in J495 to identify strategic communications issues. In spring term 2014, Public Relations Campaigns (J454) students developed a public relations campaign designed to assist Medford Fire-Rescue in addressing identified communications issues

Medford Police Public Relations Plan

27 pagesThis report is the result of three terms of work by students in the University of Oregon’s School of Journalism and Communication. During fall term 2013, students in Strategic Communications Research (J495) conducted primary and secondary research to learn more about issues related to Medford’s police and fire facilities, with the intent of addressing both department’s issues as a single project. At the beginning of winter term, it was determined that each department would best be served by individual reports. In winter term 2014, students in Strategic Planning and Cases (J453) used the research conducted in J495 to identify strategic communications issues. In spring term 2014, Public Relations Campaigns (J454) students developed a public relations campaign designed to assist the Medford Police in addressing identified communications issues

Public Relations Plan Medford Emergency Management

37 pagesThis report is the result of three terms of work by students in the University of Oregon’s School of Journalism and Communication. During fall term 2013, students in Strategic Communications Research (J495) conducted primary and secondary research to learn more about issues related to Medford Emergency Management. In winter term 2014, students in Strategic Planning and Cases (J453) used the research conducted in J495 to identify strategic communications issues. In spring term 2014, Public Relations Campaigns (J454) students developed a public relations campaign designed to assist Medford Emergency Management in addressing identified communications issues

Strategies to Increase Early Discharges to Reduce Avoidable Patient Days and Improve Patient Flow

CREATING ALGORITHMS TO INCREASE THE NUMBERS OF HOSPITAL MORNING DISCHARGES RESULTING IN IMPROVED PATIENT FLOW Discharging a percentage of patients early in the day helps to improve patient flow. This results in a reduction of Emergency Department congestion as well as peaks in patient numbers in the early to late afternoon on patient care units. A cardiac unit in an academic tertiary medical center created a goal to increase the number of their discharges by 11 AM and to streamline key discharge planning activities. A root cause analysis was initiated and after identifying several barriers, two KPIs were developed using improvement measures of operational excellence. Post KPI inception, metric goals were exceeded within the established timeline. Next steps include reviewing DRG specific readmission rates to make sure there are no negative impacts as a result of the established countermeasures. In addition, the unit will provide coaches for other care units interested in adopting these strategies

Comprehensive characterization of PTEN mutational profile in a series of 34,129 colorectal cancers

Loss of expression or activity of the tumor suppressor PTEN acts similarly to an activating mutation in the oncogene PIK3CA in elevating intracellular levels of phosphatidylinositol (3,4,5)-trisphosphate (PIP3), inducing signaling by AKT and other pro-tumorigenic signaling proteins. Here, we analyze sequence data for 34,129 colorectal cancer (CRC) patients, capturing 3,434 PTEN mutations. We identify specific patterns of PTEN mutation associated with microsatellite stability/instability (MSS/MSI), tumor mutational burden (TMB), patient age, and tumor location. Within groups separated by MSS/MSI status, this identifies distinct profiles of nucleotide hotspots, and suggests differing profiles of protein-damaging effects of mutations. Moreover, discrete categories of PTEN mutations display non-identical patterns of co-occurrence with mutations in other genes important in CRC pathogenesis, including KRAS, APC, TP53, and PIK3CA. These data provide context for clinical targeting of proteins upstream and downstream of PTEN in distinct CRC cohorts.Loss of the tumour suppressor gene PTEN leads to the activation of pro-tumourigenic signalling pathways. Here, the authors analyse sequencing data from a large cohort of colorectal cancer patients harbouring PTEN mutations and identify distinct patterns of associations with genomic and clinical features

On the temperature dependence of enzyme-catalyzed rates

One of the critical variables that determine the rate of any reaction is temperature. For biological systems, the effects of temperature are convoluted with myriad (and often opposing) contributions from enzyme catalysis, protein stability and temperature-dependent regulation, for example. We have coined the phrase "macromolecular rate theory (MMRT)" to describe the temperature dependence of enzyme-catalysed rates independent of stability or regulatory processes. Central to MMRT is the observation that enzyme-catalysed reactions occur with significant values of ∆Cp(‡) that are in general negative. That is, the heat capacity (∆Cp) for the enzyme-substrate complex is generally larger than ∆Cp for the enzyme-transition state complex. Consistent with a classical description of enzyme catalysis (Pauling), a negative value for ∆Cp(‡) is the result of the enzyme binding weakly to the substrate and very tightly to the transition state. This observation of negative ∆Cp(‡) has important implications for the temperature dependence of enzyme-catalysed rates. Here, we lay out the fundamentals of MMRT. We present a number of hypotheses that arise directly from MMRT including a theoretical justification for the large size of enzymes and the basis for their optimum temperatures. We rationalise the behaviour of psychrophilic enzymes and describe a "psychrophilic trap" which places limits on the evolution of enzymes in low temperature environments. One of the defining characteristics of biology is catalysis of chemical reactions by enzymes and enzymes drive much of metabolism. Therefore we also expect to see characteristics of MMRT at the level of cells, whole organisms and even ecosystems.</p