Appreciative inquiry in evaluating the integrated primary oral health services in Quebec Cree communities

Introduction: L'intégration de la santé buccodentaire aux soins de santé primaires a été présentée comme une stratégie visant à réduire les inégalités en santé buccodentaire parmi les populations prioritaires telles que les communautés autochtones. Cependant, il existe encore peu de programmes de soins de santé buccodentaire intégrés aux soins primaires mis en œuvre dans le monde. Par conséquent, les objectifs de ce projet de recherche doctorale étaient: 1) de cartographier systématiquement les programmes disponibles et de faire le portrait de leurs résultats sur les soins intégrés de santé buccodentaire primaires dans les communautés autochtones, et 2) d'explorer comment et dans quelle mesure l'intégration de la santé buccodentaire dans les soins primaires répond aux besoins en santé buccodentaire des communautés cries du Québec. Méthodes: Objectif 1) Une étude de portée a été réalisée selon le cadre méthodologique proposé par Arksey & O'Malley et son extension par Levac et ses collègues. Nous avons effectué des recherches systématiques dans des bases de données électroniques, dans la littérature grise, ainsi que dans des sites Web d'organisations de santé autochtones, et les résultats ont été compilés à l'aide d'un résumé numérique et d'une analyse qualitative de contenu. Objectif 2) Une étude de cas multiples avec une approche qualitative et une méthodologie d'évaluation développementale a été utilisée pour explorer les soins de santé buccodentaire primaires au Conseil cri de la santé et des services sociaux de la Baie James (CCSSSBJ). En utilisant le modèle 4D d'enquête appréciative comme cadre conceptuel, un total de six discussions de groupe et 36 entretiens individuels ont été menés avec des patients autochtones, des prestataires de soins de santé et des gestionnaires. La collecte de données comprenait un examen de la documentation, des discussions de groupe et des entretiens individuels approfondis. L'analyse thématique a été utilisée pour l'analyse des données et a été réalisée autant à l'aide du logiciel Atlas-ti, que manuellement. Résultats: L'étude de portée a identifié 30 programmes de soins de santé buccodentaire primaires intégrés pour les communautés autochtones en Australie et en Amérique du Nord. Ces programmes ont été classés en quatre groupes: programmes de promotion et de prévention de la santé buccodentaire; services dentaires globaux; modèle de services fly-in, fly-out; et des services à distance utilisant une plateforme de télédentisterie. Ces programmes se sont avérés efficaces en améliorant leur l'accès aux soins de santé buccodentaire, les connaissances et les comportements perçus en matière de santé buccodentaire et l'état de santé buccodentaire. Les résultats de l'étude de cas ont révélé que la planification stratégique du CCSSSBJ a réussi à intégrer la santé buccodentaire aux soins de santé primaires. Les stratégies intégrées de soins buccodentaires au CCSSSBJ étaient déployés tant aux niveaux micro, méso que macro. Un leadership fort, une gestion organisée et structurée, des soins centrés sur le patient, la continuité des soins et des réseaux coordonnés, la co-localisation et des soins adaptés culturellement ont été les clés de succès. Les participants à l'étude souhaitaient une meilleure adéquation en ressources humaines et des rôles professionnels sans ambiguïté au niveau méso; augmenter la gestion de l'information au niveau méso dans le domaine grâce à une meilleure planification des rendez-vous, des dossiers de santé électroniques et des protocoles et directives d'orientation normalisés; ainsi que la sensibilisation aux médecines traditionnelles et l'incorporation des pratiques autochtones au niveau macro et dans le domaine normatif. De plus, les soins centrés sur le patient étaient rendus possibles par un environnement favorable et une prise de décision partagée, tandis que les soins de continuité relationnelle étaient facilités par la permanence professionnelle et une communication efficace. Conclusion: Les résultats de l'étude de la portée suggèrent que les programmes de soins de santé buccodentaire primaires intégrés, axés sur la communauté et culturellement appropriés, semblent efficaces et pertinents pour améliorer l'état de santé buccodentaire et l'accès aux soins des communautés autochtones. Notre étude de cas suggère que l'organisation du CCSSSBJ a intégré efficacement la santé buccodentaire. L'organisation pourrait étendre le niveau d'intégration à une intégration complète en élargissant les programmes publics de santé buccodentaire, en optimisant les ressources humaines, en améliorant la gestion organisationnelle, en favorisant une communication efficace et en intégrant les pratiques traditionnelles. Des évaluations basées sur les particularités de divers groupes de population sont nécessaires pour mieux comprendre les facteurs associés à l'intégration durable de la santé buccodentaire dans les services de santé.Introduction: The integration of oral health into primary health care has been introduced as a strategy to decrease oral health disparities among priority populations such as Indigenous communities. However, still there are few integrated primary oral health care programs implemented around the world. Therefore, the objectives of this doctoral research project were: 1) to systematically map the available programs and their outcomes on the integrated primary oral health care in Indigenous communities, and 2) to explore how and to what extent the integration of oral health into primary care addresses the oral health needs of the Quebec Cree communities. Methods: Objective 1) The scoping review was performed following the methodological framework proposed by Arksey & O'Malley and its extension by Levac and colleagues. We performed systematic searches through electronic databases, Indigenous health organizational websites as well as grey literature, and the findings were summarized using numeral summary and qualitative content analysis. Objective 2) A multiple-case-study design within a qualitative approach and developmental evaluation methodology was used to explore the primary oral health care at the Cree Board of Health and Social Services of James Bay (CBHSSJB). Using the 4D model of appreciative inquiry as a study framework, a total of six focus group discussions and 36 individual interviews were conducted with patients, health care providers, and administrators. Data collection included documentation review, focus group discussions, and individual in-depth interviews. Thematic analysis was used for data analysis and was performed with the help of Atlas-ti software as well as manually. Results: The scoping review identified 30 programs on integrated primary oral health care for Indigenous communities in Australia and North America. These programs were classified into four groups: oral health promotion and prevention programs; comprehensive dental services; fly in, fly out dental services; and remote services using a teledentistry platform. These programs were found to be effective in improving oral health care access, oral health services, perceived oral health knowledge and behaviors, and oral health status of Indigenous people. The case study results found that CBHSSJB’s strategic planning has successfully integrated oral health within primary health care. The integrated oral health care strategies at CBHSSJB were distributed across micro, meso, and macro levels. Strong leadership, organized and structured administration, patient-centered care, continuity of care and coordinated networks, co-location, and culturally competent care were the keys for its success. Study participants, on the other hand, wished for better human resourcing and unambiguous professional roles at the meso level; augmenting information management at the meso level in the functional domain through better appointment scheduling, electronic health records, and standardized referral protocols and guidelines; as well as raising awareness of traditional medicines and incorporation of Indigenous oral health practice at the macro level and in the normative domain. In addition, patient-centered care was enabled by the supportive environment and shared decision-making, while relational continuity care was facilitated by professional permanence and effective communication. Conclusion: The scoping review results suggest that community-based and culturally appropriate integrated primary oral health care programs seem to be efficient and pertinent in improving the oral health status and access to care of Indigenous communities. Our case study suggests that the CBHSSJB organization has efficiently integrated oral health. The organization could extend the level of integration into full integration by expanding public oral health programs, optimizing human resources, improving organizational management, promoting effective communication, and integrating traditional oral health practices. Population-based evaluations are needed to better understand the factors associated with sustainable oral health integration in various populations

Security in Peer-to-Peer SIP VoIP

VoIP (Voice over Internet Protocol) is one of the fastest growing technologies in the world. It is used by people all over the world for communication. But with the growing popularity of internet, security is one of the biggest concerns. It is important that the intruders are not able to sniff the packets that are transmitted over the internet through VoIP. Session Initiation Protocol (SIP) is the most popular and commonly used protocol of VoIP. Now days, companies like Skype are using Peer-to-Peer SIP VoIP for faster and better performance. Through this project I am improving an already existing Peer-to-Peer SIP VoIP called SOSIMPLE P2P VoIP by adding confidentiality in the protocol with the help of public key cryptography

Womankind Service Trip

STEP Category: Service-Learning and Community ServiceMy BUCK-I-SERV trip to New York City consisted of like-minded students serving at an organization called Womankind, which is dedicated on bringing refuge, recovery, support, and renewal to domestic violence survivors. We worked on painting and repairing the site’s infrastructure to make the place more inclusive and welcoming for the current residents living there.The Ohio State University Second-year Transformational Experience Program (STEP)Academic Major: Psycholog

Methods for the Study of Downsizing: A Review

There has been a world-wide increase in the incidences of downsizing practice across economies and across organizations. This has been considered as the basis for coping with increasing competition. The present paper looks into some studies on downsizing. The focus of the paper is majorly on the research methodology used in these studies. This paper analyses the methods used for the study of downsizing and suggests the ideal methods of study for: a) organizational outcomes, and b) individual outcomes, which include the victims, the survivors and the implementers. The suggestion is to have context specific and issue specific studies with more emphasis towards the triangulation of qualitative and quantitative methods to increase the soundness of the study.

Work in progress: a quantitative study of effectiveness in group learning

It is generally assumed that group studies are more effective for students than individual studies. The objective of this work in progress is to quantitatively evaluate and analyze the effect of collaborative studies on individual student’s performance. This effort would help the student stimulate interest in group learning and collaboration along with exposing them towards multiple problem solving approaches while working individually or in groups. This way the students are challenged to use their existing knowledge and approach, and augment it further with the knowledge and approach provided by group partners. While there are several efforts that focus on developing new group learning techniques, we intend to study the efficacy of previously proposed techniques under various test settings for EE and CS courses without significantly diverting from the course framework

Determining General and Specific Purpose Transfers : An Integrated Approach

This study attempts to provide an alternative methodology to calculate the horizontal equalization transfers. This methodology follows the Australian horizontal equalization principle using a panel model methodology where both revenue and expenditure side considerations are involved. First, it applies the Canadian model in calculating the fiscal capacity equalization. Then the expenditure side equalization has been carried out for two services - education and health. Results of the exercise indicate that the transfers suggested by the panel model are more progressive than the TFC recommended transfers.horizontal equalization transfers, education, health, fiscal capacity equalization

Etiological study of bone marrow aspiration cytology in children in a tertiary care government hospital in India with a special focus on adolescent females

Background: Bone marrow aspiration (BMA) cytology is a common and cheap technique which reveals the marrow cellularity, its structure, and stages of differentiation of different blood cells. Objectives: The objectives of the study were to study the etiology and the common presentation in patients undergoing BMA in pediatric age group with special focus on the adolescent females. Materials and Methods: This cross-sectional descriptive study was carried out in the Department of Pediatrics and Pathology of a Medical College Hospital of Bihar, India. The study was done from May 1, 2018, to April 31, 2019, on 259 cases. BMA was carried out and relevant clinical history, physical examination, and laboratory data were retrieved. Results: Out of 259 cases, 1 case was excluded from the final analysis due to inadequate marrow. Male-to-female ratio was 1.16:1. The most common indication was unexplained anemia (46.5%) and pancytopenia (26.7%). The most common etiological diagnosis was nutritional anemia (27.5%) followed by hypoplastic anemia (22%). Among adolescents (>11–18 years), male:female ratio decreased to 1:1 where nutritional anemia was the most common cause followed by hypoplastic anemia. Conclusion: The common hematological disorders prevailing in our community in pediatric age group are nutritional anemia, hypoplastic anemia, and acute leukemia

Random Mutagenesis and Selection for RubisCO Function in the Photosynthetic Bacterium Rhodobacter capsulatus

Ribulose 1, 5-bisphosphate carboxylase/oxygenase (RubisCO) catalyzes a reaction of fundamental importance, the incorporation and reduction of atmospheric carbon dioxide into organic matter. This enables organisms to grow autotrophically, that is at the expense of CO2 as the sole carbon source. Despite its key role, all RubisCO enzymes found in nature are plagued by their susceptibility to inhibition by oxygen and are among the most sluggish biological catalysts found in nature. Based on the sequence of its component amino acids, RubisCO has been classified into four molecular forms: form I, form II, form III, and form IV (RubisCO-like proteins, RLPs). Whereas enzyme forms I, II and III catalyze CO2 fixation, the form IV proteins cannot perform this function, presumably due to the absence of appropriate active-site residues. Substitutions were made in the Cholorobium tepidum RLP (CtRLP) active-site residues to reflect their identities in bonafide RubisCOs (Mut) but they had no effect on the RLP’s ability to function as a RubisCO. Additional secondary structural changes had also been introduced in the CtRLP by deleting a CD loop that is absent in RubisCOs and by inserting a β-hairpin structure that is absent in RLPs (MutCD∆βH). Yet after all the changes were introduced, no RubisCO activity was observed (1). Thus, as a part of this research thesis, the DNA encoding MutCD∆βH was randomly mutagenized and bioselection was carried out in Rhodobacter capsulatus, SB I/II-, a RubisCO knockout strain, to select for mutations that may complement for RubisCO activity. Apart from RLPs that are completely devoid of RubisCO activity, there are functional differences even among forms I, II and III. Upon sequence comparisons, residue 165 of Rhodopsuedomonas palustris form II RubisCO was identified as a unique active-site residue that was divergent among the three forms of RubisCO (threonine in form I, isoleucine in form II and valine in form III). In order to examine the importance of this residue for RubisCO function, it was substituted with an alanine (a neutral substitution), threonine (resembling form I RubisCO) or a valine (resembling form III RubisCO) in the form II RubisCO (cbbM) from R. palustris. To assess the functional competency of these mutants, they were complemented in the RubisCO knock-out strain of R. capsulatus, strain SB I/II-. Whereas the I165A and I165T mutants were unable to support growth under photoautotrophic conditions, the I165V enzyme could. To identify other regions in the protein structure that could complement the negative phenotypes conferred by I165A and the form-I-like I165T substitutions, random mutagenesis and bioselection in R. capsulatus SBI/II- was performed with I165A and I165T mutant genes. It has been possible to identify an A165V substitution as a pseudo-revertant of the original I165A mutant. However, it was not possible to identify other potential suppressor mutations. A problem was identified with the methodology that could likely interfere with the efficient recovery of suppressor mutations. Once this problem is resolved, the suppressor recovery and analysis will likely reveal other residues that play a vital role in the function of the enzyme.No embarg

Optimization methods and Quadratic Programming

Optimization is the process of maximizing or minimizing the objective function which satisfies the given constraints. There are two types of optimization problem linear and nonlinear. Linear optimization problem has wide range of applications, but all realistic problem cannot be modeled as linear program, so here non-linear programming gains its importance. In the present work I have tried to find the solution of non-linear programming Quadratic problem under different conditions such as when constraints are not present and when constraints are present in the form of equality and inequality sign. Graphical method is also highly efficient in solving problems in two dimensions. Wolfe’s modified simplex method helps in solving the Quadratic programming problem by converting the quadratic problem in successive stages to linear programming which can be solved easily by applying two – phase simplex method. A variety of problems arising in the area of engineering, management etc. are modeled as optimization problem thus making optimization an important branch of modern applied mathematics