Safe haven infant protection : incidence of use and characteristics of surrendered infants and relinquishing users

Background: Safe Haven Infant Protection (SHIP) laws are variously-titled state-level laws that permit infants to be surrendered to designated persons and/or places in a generally anonymous fashion with prescribed limits on prosecution. Objective: The objective of this study was to determine the number of infants surrendered under SHIP laws in the United States, detail the characteristics of surrendered Safe Haven (SH) infants and relinquishing users, and directly compare the SH infant/relinquishing user population and the discarded infant/discarding mother populations. Methods: Non-profit reports and communications, government documents and communications, and media reports provided the basis of the national SH estimate. Data were collected over a three year period. A second data base combining 206 surrendered SH infant/relinquishing user cases from the states of California, Illinois, Michigan and New Jersey was built using data from multiple convenience-based government, non-profit and media sources. Third, a data base combining New Jersey\u27s 33 SH infants and 27 discarded infants was created using data from the State of New Jersey and media sources. Results: National Tally-A total 1,479 infants were identified as surrendered under SHIP law as of December 31, 2008. Four state sample-Both male and female infants have been surrendered. Infants of various ethnicities have also been surrendered. Most SH infants are given up on their first day of life and most are born in hospitals. Most relinquishing users chose a hospital for their surrender site. February and March are the most common months of SH infant surrender. The maternal age range for SH relinquishment is 15-42 years of age. New Jersey-Survival of SH infants is significantly higher than that of discarded infants. One-half of infants are discarded during the winter months and 1/3 of SH infants are relinquished in spring months. Black infants were statistically overrepresented among discarded and SH infants. Conclusion: SH law is being used more than previously reported. SH law is being used as expected in relation to infant gender, infant race/ethnicity, mode of maternal age, and day of use. SH is being used by a broader range of maternal ages and by women who gave birth in hospital in numbers greater than expected. SHIP laws appear to reach a portion of their intended audience with SH infants surviving significantly more than discarded infants

A Weakly Nonlinear Analysis of Impulsively-Forced Faraday Waves

Parametrically-excited surface waves, forced by a periodic sequence of delta-function impulses, are considered within the framework of the Zhang-Vi\~nals model (J. Fluid Mech. 1997). The exact impulsive-forcing results, in the linear and weakly nonlinear regimes, are compared with numerical results for sinusoidal and multifrequency forcing. We find surprisingly good agreement between impulsive forcing results and those obtained using a two-term truncated Fourier series representation of the impulsive forcing function. As noted previously by Bechhoefer and Johnson (Am. J. Phys. 1996), in the case of two equally-spaced impulses per period there are only subharmonic modes of instability. The familiar situation of alternating subharmonic and harmonic resonance tongues emerges for unequally-spaced impulses. We extend the linear analysis for two impulses per period to the weakly nonlinear regime for one-dimensional waves. Specifically, we derive an analytic expression for the cubic Landau coefficient in the bifurcation equation as a function of the dimensionless fluid parameters and spacing between the two impulses. As the capillary parameter is varied, one finds a parameter region of wave amplitude suppression, which is due to a familiar 1:2 spatio-temporal resonance between the subharmonic mode of instability and a damped harmonic mode. This resonance occurs for impulsive forcing even when harmonic resonance tongues are absent from the neutral stability curve. The strength of this resonance feature can be tuned by varying the spacing between the impulses. This finding is interpreted in terms of a recent symmetry-based analysis of multifrequency forced Faraday waves by Porter, Topaz and Silber (Phys. Rev. Lett. 2004, Phys. Rev. E 2004).Comment: 13 pages, 10 figures, submitted to Physical Review

The development of imaging biomarkers for the diagnosis of human prion disease

Future therapeutic trials in human prion disease will require the use of biomarkers of disease activity such as MRI in order to assess efficacy of treatment. Whilst the development of biomarkers is of importance it is also necessary to be able to understand and interpret what imaging findings characterise at post-mortem and furthermore how they correlate with clinical symptoms. In this thesis I investigate whether both conventional and quantitative imaging parameters can act as biomarkers to predict disease progression in symptomatic patients. I also assess what conventional MRI findings represent on a microstructural level and how imaging findings correlate with clinical symptoms of prion disease such as sleep disturbance. This work is detailed in four projects, the first of which I investigate if abnormalities found on conventional MRI brain scans, PRNP genotype and prion strain can act as predictors of disease progression in patients with the sporadic form of prion disease. I was unable to show that conventional MR brain imaging helps to predict disease progression in this patient group, but I was able to show that codon 129 remains the main predictor of disease progression and strain subtype has an additional effect. In the second project I test the hypothesis that MTR, a quantitative imaging parameter can predict disease progression in symptomatic patients. I found that both on cross-sectional and longitudinal analysis there were significant differences in symptomatic patients and that there was a strong correlation with the MRC Scale score, clinical outcome measure, and MTR value in patients with symptomatic disease which could be used as a clinical biomarker in combination to predict response to therapeutics in future clinical trials. In the third project I focus on investigating the prevalence of sleep disturbance and its association with other features of disease and imaging findings. I found that sleep disturbance was highly prevalent in all forms of prion disease. I also found that there was a significant association found between thalamic signal change seen on MRI scan and sleep symptomatology. In order to capture more data on the diversity of sleep symptoms in this population I constructed the Prion Disease Sleep Questionnaire a bedside screening tool that can be used to both record and monitor the incidence and severity of sleep disturbance. In the final project I assess if specific histopathological findings on post-mortem correlate with cortical imaging abnormalities seen on DWI in patients diagnosed with sporadic CJD. I found that there were significant difference between patients with and without cortical ribboning present on their MRI brain scans those with DWI signal change had more frontal cortex spongiosis than those that didn’t. There was also a modest correlation identified between the 3 histopathological parameters: PrPSc, deposition, gliosis and spongiosis

An Interpretive Phenomenological Study of Adult Students’ Subjective Theories of Critical Thinking in Anatomy and Physiology

Critical thinking is a vital skill for the success of recent graduates, both to increase academic success and improve employability after graduation, especially in health science fields. However, many adult students fail to engage in critical thinking, especially in core courses such as anatomy and physiology (A&P). The purpose of this interpretive phenomenological qualitative study was to better understand adult students’ subjective theories regarding critical thinking and how adult students perceive the use of and any barriers or challenges to critical thinking in A&P while enrolled at Technical University. The theoretical framework that grounded this study was the Paul-Elder theory of critical thinking. Three research questions guided this study involving adult students’ subjective theories regarding critical thinking along with their perceptions of any barriers or challenges to critical thinking in A&P. Data from one-on-one semistructured interviews with 12 adult health science students who recently completed their first term of A&P were analyzed to identify common codes, categories, and themes. Results showed that the majority of adult students’ subjective theories regarding critical thinking aligned with the Paul-Elder definition of critical thinking, but their examples of critical thinking were actually examples of cognitive elaboration. Barriers included lack of time management, lack of note-taking skills, and didactic course structure inhibiting critical thinking in A&P. A faculty development workshop was designed to increase faculty’s understanding of students’ subjective theories regarding and barriers to critical thinking along with methods to mitigate barriers and develop course materials to encourage critical thinking in courses. An increase in critical thinking may improve student retention and clinical performance, contributing to better patient care and level of employability

Innovations of the assessment system in introductory statistics subject

This paper presents the results of a study investigating the innovations in the assessment system implemented in an introductory statistics subject (STAT131) at the University of Wollongong (UOW). For several years, innovations have been introduced to STAT131 particularly in the assessment system. These included the approaches of assignments, summary and mid-session test in 2003; assignments, laboratory work and midsession test from 2004 to 2005; four tests and three make-up tests in 2006; six tests with three compulsory and two optional tests in 2007; four tests (the best of three test marks were chosen) and opportunity to re-sit the tests in 2008; five tests and retests assignments with a competency requirement of 65% to 70% from 2009 to 2010; and finally the draft and final of the assignment (in the Headstart program) and a group draft and final assignment within session, and three tests and retests assignments with competency 70% required for all assessments in 2011. The findings reveal that there was improvement in the learning outcomes where the failure rate dropped from 18% in 2010 to 13% in 2011 and students in 2011 outperformed than in 2010 in their mean final marks. Furthermore, a dramatic increase in the higher grades of 64% in 2011 was the highest on record since 2000. The paper concludes with a discussion on the issues arise and followed by suggestions for further research