The Optimization of Financial Investment in Project Safety Practices

This research paper explains the notable benefits to pursing a comprehensive safety plan complete with the most cost-effective safety practices in the industry. Through communication with environmental health and safety professionals within the construction industry, it was determined that certain safety practices are deemed essential on any active jobsite. Enforcing mandatory jobsite safety training to all individuals entering a jobsite serves as the first line of defense when attempting to protect individuals and mitigate risk. This educational and effective safety practice highlights the potential safety concerns of a jobsite while also mitigating contractor liability if an accident were to occur. From a field management perspective, introducing a “Crane Boss” or other equivalent critical scope management position was viewed as a helpful addition for minimizing risk. Such a position would be responsible for managing the coordination and execution of high-risk scopes such as crane picks or concrete pours serving to decrease the potential for issues when addressing these scopes of work. Both of these safety programs provide great potential for cost savings and other lucrative returns while requiring a small investment of resources. For these reasons, such implementations are considered essential additions to any productive and successful jobsite

Ecophysiology and population genetics of Frangula caroliniana (Walt) Gray (Rhamnaceae)

Frangula caroliniana (Walt.) Gray (or Rhamnus caroliniana Walt.) (Carolina buckthorn) is a woody species distributed throughout the southeastern United States. Due to its ornamental characteristics and the various soil conditions in which it grows, there is interest in promoting the species as a nursery crop within and beyond its native range. Concerns about the invasive potential of F. caroliniana need to be alleviated before it is promoted in horticultural commerce. These concerns are based on the aggressive spread of related species introduced to North America, including Rhamnus cathartica L. (common buckthorn). Thus, I sought to assess the landscape fitness of F. caroliniana by comparing some of its ecophysiological traits to those of R. cathartica . In addition, I determined the genetic structure of F. caroliniana through analysis of populations indigenous to 16 states. Frangula caroliniana fixed carbon at rates that permitted its survival in soils that ranged from dry to wet, but plants with inundated roots did not survive. Cold stratification at 4°C for up to 112 days enhanced seed germination of F. caroliniana, but its seeds were more resistant to germination than were seeds of R. cathartica. Vernal bud break of F. caroliniana occurred 5.7 days later than that of R. cathartica, and depth of cold hardiness of F. caroliniana (-21°C) may permit use of provenance-based selections of the species in regions where winters are harsher than those of the native habitat. While fruit set per unit stem length and unit leaf area of F. caroliniana was only 41% of that of R. cathartica, seedlings of both species established similarly in field soils. Analysis of amplified polymorphism fragment length (AFLP) markers revealed two distinct groups of genotypes of F. caroliniana; the first group was comprised of plants from South Carolina, which had the highest source of genetic variation, and the second consisted of the other sampled F. caroliniana populations from 15 states. I conclude that the fitness for managed landscapes of F. caroliniana is promising, and that F. caroliniana lacks the capacity to be as invasive as R. cathartica

Obesity and dental caries in children in Scotland: trends, inequalities, and the reach and impact of the Childsmile Programme

Background: Childhood dental caries and obesity are global public health non-communicable disease challenges. Despite recent improvements, caries experience remains highly prevalent among Scotland’s children with wide inequalities, with one half of children from the poorest areas suffer caries by 5-years-old, with extraction of teeth under general anaesthetic being the most common reason children are electively admitted to hospital. Ten percent of Primary 1 children (typically aged 5-years-old) in Scotland have obesity, with higher rates seen in more deprived areas. Caries and obesity share socioeconomic determinants that underpin these large inequalities, with sugar consumption being one of the key causative factors for both conditions. Both conditions are among the first observable outcomes of poor health in the early years and markers of poor health in adulthood. There may be opportunities within the Childsmile programme (Scotland’s national oral health improvement programme) to intervene to tackle common risk factors of caries and obesity, however, as of yet it is unclear what relationship exists between the two conditions in childhood. Furthermore, it is unknown to what extent the problem is for children with co-existing caries and obesity and if inequalities exist in this group. Aims: To examine the interrelationship between obesity and dental caries in Primary 1 schoolchildren in Scotland over time (2011 to 2018). To measure socioeconomic inequalities in childhood obesity and dental caries, separately and together. To explore the reach and impact of the national child oral health improvement programme for Scotland, Childsmile, in preventing childhood obesity and caries. Methods: Population-level repeated cross-sectional data linkage and secondary analysis of pseudonymised, individual-level National Health Service data on caries experience and obesity, from multiple cohorts of Primary 1 children in Scotland, between 2011/12 and 2017/18 and a measure of area-based deprivation (Scottish Index of Multiple Deprivation) from the child’s home postcode have been used. The thesis compares access to school-based dental inspections; primary care prevention; and Childsmile interventions between children with the co-existing conditions and their peers with neither condition adjusted by area-based socioeconomic deprivation, schoolyear, sex, and age. Results: The prevalence of caries experience in Primary 1 children has been reducing over all in Scotland from 32.9% in 2011/12 to 29.5% in 2017/18, although absolute inequalities remain large and consistent, with the difference in prevalence between the most and least deprived being 37.5% in 2011/12 and 34.1% in2017/18. The prevalence of obesity has plateaued overall (9.8% in 2011/12; 10.1% in 2017/18), however, this has masked a small but steady rise is prevalence in the 10% most deprived areas (11.8% in 2011/12; 12.9% in 2017/18). Prevalence of co-existing obesity and caries was 3.4% over the study period with large, persistent inequalities. In children from the 20% most deprived areas, 5.6% hadco-existing conditions in contrast with 1.4% from the 20% least deprived areas (adjusted odds ratio=6.63; 95% confidence interval = [6.16to7.14]). Children with coexisting conditions were less likely to attend primary dental-care than their peers, and in those who attended dental practice, were less likely to receive prevention (fluoride varnish, toothbrushing instruction, or dietary advice). Childsmile nursery-supervised toothbrushing access among children with co-existing conditions was similar to children with neither condition and children with co-existing conditions were more likely to be referred to a Childsmile Dental Health Support Worker, but less likely to be contacted by a DHSW and have the intervention delivered. Conclusion: Inequalities have been identified in young children with caries experience, obesity, and co-existing caries and obesity in Scotland, compounded by reduced and variable access to preventive dental services in children with co-existing conditions. Further efforts are needed to develop and improve preventive care, adopting a commonr risk factor approach, and the pathways for children with co-existing caries and obesity and integrate oral health to wider healthcare systems for these children to mitigate against health inequalities. Upstream, midstream, and downstream interventions must be considered to maximise the impact and reduce prevalence and inequalities

Maternal Investment Influences Expression of Resource Polymorphism in Amphibians: Implications for the Evolution of Novel Resource-Use Phenotypes

Maternal effects—where an individual's phenotype is influenced by the phenotype or environment of its mother—are taxonomically and ecologically widespread. Yet, their role in the origin of novel, complex traits remains unclear. Here we investigate the role of maternal effects in influencing the induction of a novel resource-use phenotype. Spadefoot toad tadpoles, Spea multiplicata, often deviate from their normal development and produce a morphologically distinctive carnivore-morph phenotype, which specializes on anostracan fairy shrimp. We evaluated whether maternal investment influences expression of this novel phenotype. We found that larger females invested in larger eggs, which, in turn, produced larger tadpoles. Such larger tadpoles are better able to capture the shrimp that induce carnivores. By influencing the expression of novel resource-use phenotypes, maternal effects may play a largely underappreciated role in the origins of novelty

Evaluating the Biomechanics of the Pediatric Foot in Turner Syndrome

Turner syndrome is a genetic disorder that can present clinically with multiple concurrent comorbidities. This case report describes a 12-year-old girl with Turner syndrome who was referred for podiatric medical assessment and explores the application of optoelectronic stereophotogrammetry in the biomechanical assessment of the foot and lower limb. A four-segment kinematic foot model using 14-mm reflective markers was applied to the foot and lower limb of the patient to track motion at the tibia, rearfoot, forefoot, and hallux. Kinematic results presented in this case study illustrate evidence of excessive foot pronation throughout the stance phase of gait. Whether excessive pronation is a general characteristic of foot function in Turner syndrome remains to be confirmed, but the findings presented suggest that a comprehensive evaluation of foot biomechanics in patients with Turner syndrome may be warranted

Methods to Describe Referral Patterns in a Canadian Primary Care Electronic Medical Record Database: Modelling Multilevel Count Data

Background: A referral from a family physician (FP) to a specialist is an inflection point in the patient journey, with potential implications for clinical outcomes and health policy. Primary care electronic medical record (EMR) databases offer opportunities to examine referral patterns. Until recently, software techniques were not available to model these kinds of multi-level count data. Objective: To establish methodology for determining referral rates from FPs to medical specialists using the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) EMR database. Method: Retrospective cohort study, mixed effects and multi-level negative binomial regression modelling with 87,258 eligible patients between 2007 and 2012. Mean referrals compared by patient sex, age, chronic conditions, FP visits, and urban/rural practice location. Proportion of variance in referral rates attributable to the patient and practice levels. Results: On average, males had 0.26, and females 0.31 referrals in a 12-month period. Referrals were significantly higher for females, increased with age, FP visits, and number of chronic conditions (p\u3c.0001). Overall, 14% of the variance in referrals could be attributed to the practice level, and 86% to patient level characteristics. Conclusions: Both patient and practice characteristics influenced referral patterns. The methodologic insights gained from this study have relevance to future studies on many research questions that utilize count data, both within primary care and broader health services research. The utility of the CPCSSN database will continue to increase in tandem with data quality improvements, providing a valuable resource to study Canadian referral patterns over time

Primary visual cortex excitability is not atypical in acquired synaesthesia

A wealth of data suggests that psychedelic drugs elicit spontaneous perceptual states that resemble synaesthesia although it is unclear whether these different forms of synaesthesia share overlapping neural mechanisms. Multiple studies have shown that developmental and trained synaesthesia is characterized by selective hyperexcitability in primary visual cortex and it has been proposed that cortical hyperexcitability may contribute to induced and acquired synaesthesia. This study tested the prediction that a case of acquired synaesthesia (LW) would display selectively elevated primary visual cortex excitability, as reflected in lower transcranial magnetic stimulation (TMS) phosphene thresholds, but no difference in motor thresholds, relative to controls. In contrast to this prediction, LW’s phosphene threshold was well within the threshold range of controls. These results suggest that acquired synaesthesia is not characterized by atypical visual cortex excitability