The Purpose of Capstone in an Entry-level Clinical Doctorate: A Scoping Review

This scoping review examined outcomes of capstones in relation to entry-level doctoral education programs within the health professions. Aims of the study included mapping existing evidence related to capstone across entry-level clinical doctorates; investigating the purpose of capstones within health professions education; and identifying future research initiatives. Researchers applied and reported via the PRISMA Extension for Scoping Reviews systematic approach, and Best Evidence Medical Education global scale. The study indicated a gap in existing literature. Few health professions described requirements for capstones as part of an entry-level doctorate. Reviewed articles offered no consistent definition, intent, process, or outcome for capstones. The majority of publications documented Kirkpatrick Level 2a educational outcomes, modification of learner attitudes and perceptions. No publications documented Level 3, 4a, or 4b educational outcomes reporting student behavioral change, change in organizational practice, or direct improvement to the health and well-being of patients or clients. The researchers recommend additional evidence-based educational research to expand the body of evidence related to the capstone

2008 Statistics

2008 Men\u27s Track and Field Statistics, George Fox College

Standardized parenteral nutrition for the transition phase in preterm infants: a bag that fits

The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks) by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA) concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase

Fecal-Sac Ingestion by Spotted Towhees

Altricial nestlings encase excrement in fecal sacs that parents remove by either ingesting them or transporting them away from the nest. Ingestion may allow energetically or nutritionally deprived parents to recapture energy or nutrients that might be lost because of nestlings\u27 inefficient digestion (the parental-nutrition hypothesis ), but ingestion may also permit parents to avoid flights from the nest that interfere with parental care (e.g., brooding young; the economic-disposal hypothesis ). We used a hypothetico-deductive approach to test the two hypotheses\u27 ability to account for fecal-sac ingestion by the Spotted Towhee (Pipilo maculatus). We confirmed the parental-nutrition hypothesis\u27 predictions that more fecal sacs should be ingested in years of food shortage (males only), late in the season when food supplies decline (both sexes), by parents that had the greatest difficulty raising young (i.e., underweight young), and that adults\u27 body condition should vary directly with their rate of fecal-sac ingestion (females only). We rejected the economic-disposal hypothesis\u27 prediction of a decline in fecal-sac ingestion with increasing brood size. The latter, plus the observation that nearly 40% of males ingest fecal sacs despite their spending virtually no time attending nests, suggests that fecal-sac ingestion is not a mechanism to avoid needless and time-consuming flights from the nest that interfere with parental care. Fecal-sac ingestion by Spotted Towhees is better interpreted as either a resource supplement to parents or as a mechanism to satiate hunger so that parents can maintain rates of feeding to dependent young

Toward a Platform-Independent Acoustic Communications and Navigation System for Underwater Vehicles

This paper presents a platform-independent acoustic communication (Acomms) system that enables multiple nodes (any combination of underwater vehicles, surface ships, and fixed beacons) to simultaneously exchange data and calculate inter-node ranges with O(1m) accuracy. The Acomms system supports two types of communications: standard asynchronous acoustic communication and synchronous communication, which enables navigation based on inter-node ranges derived from the one-way travel-times of acoustic messages between nodes. The Acomms system hardware is implemented with a dedicated software program, Linux host computers, Woods Hole Oceanographic Institution (WHOI) Micro-Modems, and precision reference clocks. The acoustic communications software configures the modem, manages all acoustic communication traffic, and acts as an interface between the vehicle-specific software and the modems and clocks. The software and related hardware have been installed on theWoods Hole Oceanographic Institution vehicles Puma, Jaguar, and Nereus, and deployed in sea trials in the North Pacific and South Atlantic.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86048/1/swebster-8.pd

Postal recruitment for genetic studies of preterm birth: A feasibility study.

Background: Preterm birth (PTB) represents the leading cause of neonatal death. Large-scale genetic studies are necessary to determine genetic influences on PTB risk, but prospective cohort studies are expensive and time-consuming. We investigated the feasibility of retrospective recruitment of post-partum women for efficient collection of genetic samples, with self-collected saliva for DNA extraction from themselves and their babies, alongside self-recollection of pregnancy and birth details to phenotype PTB. Methods: 708 women who had participated in the OPPTIMUM trial (a randomised trial of progesterone pessaries to prevent PTB [ISRCTN14568373]) and consented to further contact were invited to provide self-collected saliva from themselves and their babies. DNA was extracted from Oragene OG-500 (adults) and OG-575 (babies) saliva kits and the yield measured by Qubit. Samples were analysed using a panel of Taqman single nucleotide polymorphism (SNP) assays. A questionnaire designed to meet the minimum data set required for phenotyping PTB was included. Questionnaire responses were transcribed and analysed for concordance with prospective trial data using Cohen's kappa ( k). Results: Recruitment rate was 162/708 (23%) for self-collected saliva samples and 157/708 (22%) for questionnaire responses. 161 samples from the mother provided DNA with median yield 59.0µg (0.4-148.9µg). 156 samples were successfully genotyped (96.9%). 136 baby samples had a median yield 11.5µg (0.1-102.7µg); two samples failed DNA extraction. 131 baby samples (96.3%) were successfully genotyped. Concordance between self-recalled birth details and prospective birth details was excellent ( k>0.75) in 4 out of 10 key fields for phenotyping PTB (mode of delivery, labour onset, ethnicity and maternal age at birth). Conclusion: This feasibility study demonstrates that self-collected DNA samples from mothers and babies were sufficient for genetic analysis but yields were variable. Self-recollection of pregnancy and birth details was inadequate for accurately phenotyping PTB, highlighting the need for alternative strategies for investigating genetic links with PTB

Modelling multi-scale state-switching functional data with hidden Markov models

Data sets comprised of sequences of curves sampled at high frequencies in time are increasingly common in practice, but they can exhibit complicated dependence structures that cannot be modelled using common methods of Functional Data Analysis (FDA). We detail a hierarchical approach which treats the curves as observations from a hidden Markov model (HMM). The distribution of each curve is then defined by another fine-scale model which may involve auto-regression and require data transformations using moving-window summary statistics or Fourier analysis. This approach is broadly applicable to sequences of curves exhibiting intricate dependence structures. As a case study, we use this framework to model the fine-scale kinematic movement of a northern resident killer whale (Orcinus orca) off the coast of British Columbia, Canada. Through simulations, we show that our model produces more interpretable state estimation and more accurate parameter estimates compared to existing methods.Comment: 23 pages, 8 figures, 2 tables. Supplementary material appended to submissio

Mobility and strength training with and without protein supplements for pre-frail or frail older adults with low protein intake: the Maximising Mobility and Strength Training (MMoST) feasibility randomised controlled trial protocol

Background Frailty is a common syndrome affecting older people and puts them at risk of hospitalisation, needing care or death. First signs of frailty include reduced muscle strength and mobility decline. A key cause of mobility decline as we age is sarcopenia (age related reduction in muscle strength and mass). Poor nutrition contributes to sarcopenia. A shortfall in protein is associated with reduced muscle mass and strength. This may be due to inadequate intake but also because older people have higher protein needs, especially those with multimorbidity. We need to develop effective treatment to reduce or slow the onset of frailty and mobility decline. Exercise is a recommended treatment. Protein supplements to address the shortfall in protein have the potential to enhance the benefit of regular exercise in frail or pre-frail older adults. This has yet to be definitively demonstrated. Aim To establish the feasibility of conducting an RCT evaluating mobility and strength training with or without protein supplements for people over 60 years old who are frail or pre-frail with a low protein intake. Methods A multicentre, parallel, 2-group, feasibility RCT. Participants (recruitment target = 50) with problems walking, low protein intake and classified as frail or pre-frail will be recruited from four NHS Physiotherapy community services. Participants will be randomised (secure computer-generated: 1:1) to receive 24 weeks of mobility and strength training (delivered in 16 group sessions plus home exercises) or 24 weeks of mobility and strength training with daily protein supplements. Primary feasibility objectives are to estimate 1) ability to screen and recruit eligible participants, 2) intervention fidelity, adherence, and tolerance and 3) retention of participants at follow up. Secondary objectives are to 1) test data collection procedures, 2) assess data completeness and 3) confirm sample size calculation for a definitive RCT. Registration ISRCTN Registry (ISRCTN30405954; 18/10/2022)