Reduction of Moderate Cardiovascular Disease Risk Factors in Adults through Community Based Intervention Programs

Per the American Heart Association (AHA) 2016, and the Centers for Disease Control (CDC) 2016, most recent reports, cardiovascular disease (CVD) continues to be the leading cause of death nationally and globally. In the United States (U.S.), more than 600,000 adults die each ear of heart disease (CDC, 2015). The economic burden that cardiovascular disease places on society is tremendous. In the U.S. alone, the estimated direct and overall cost resulting from CVD is reported to be between 273 billion and 444 billion dollars annually (CDC/MMWR, 2011; WHO, 2016). Because of estimations like these, the U.S. Department of Health and Human Services\u27 Office of Disease Prevention and Health Promotion (OCPHP) has urged health care providers to improve cardiovascular health and quality of life through it\u27s Healthy People 2020 campaign initiative (HealthyPeople.gov, 2017). Studies have shown that one of the most effective ways to decrease risk factors for developing cardiovascular disease is through making modification to one\u27s behavior and lifestyle. In fact, the most prevalent risk factors for developing CVD are high blood pressure, high cholesterol, diabetes, poor diet, obesity, and smoking. All of which are modifiable. They can be prevented, and treated with education, behavioral modifications, and, or medications. A well proven, effective, and relatively low-cost way of achieving this is through participation in community based intervention programs aimed at reducing these modifiable risk factors. The following literature review seeks to answer the questions, among the adult population, what types of community-based interventions have shown the greatest achievements in reducing modifiable, moderate cardiovascular disease risk factors

Challenges in mathematical cognition: a collaboratively-derived research agenda

This paper reports on a collaborative exercise designed to generate a coherent agenda for research on mathematical cognition. Following an established method, the exercise brought together 16 mathematical cognition researchers from across the fields of mathematics education, psychology and neuroscience. These participants engaged in a process in which they generated an initial list of research questions with the potential to significantly advance understanding of mathematical cognition, winnowed this list to a smaller set of priority questions, and refined the eventual questions to meet criteria related to clarity, specificity and practicability. The resulting list comprises 26 questions divided into six broad topic areas: elucidating the nature of mathematical thinking, mapping predictors and processes of competence development, charting developmental trajectories and their interactions, fostering conceptual understanding and procedural skill, designing effective interventions, and developing valid and reliable measures. In presenting these questions in this paper, we intend to support greater coherence in both investigation and reporting, to build a stronger base of information for consideration by policymakers, and to encourage researchers to take a consilient approach to addressing important challenges in mathematical cognition

UNBOUND

UNBOUND showcases the graduating class from the fashion design school at Fanshawe College. We are pleased to present Unbound 2017! Our 11th Unbound theme embraces the concept of Craft and Machine , a blend of couturier techniques with technology. Unbound describes the creative spirit and achievements of our eighteen emerging Canadian fashion designers. Unbound 2017 is a professional collaboration between Fanshawe College, community and professionals in the fashion industry. As you turn the pages, admire their accomplishments - the results of three years of passion, hard work, and dedication.https://first.fanshawec.ca/famd_design_fashiondesign_unbound/1004/thumbnail.jp

Challenges in mathematical cognition: a collaboratively-derived research agenda

This paper reports on a collaborative exercise designed to generate a coherent agenda for research on mathematical cognition. Following an established method, the exercise brought together 16 mathematical cognition researchers from across the fields of mathematics education, psychology and neuroscience. These participants engaged in a process in which they generated an initial list of research questions with the potential to significantly advance understanding of mathematical cognition, winnowed this list to a smaller set of priority questions, and refined the eventual questions to meet criteria related to clarity, specificity and practicability. The resulting list comprises 26 questions divided into six broad topic areas: elucidating the nature of mathematical thinking, mapping predictors and processes of competence development, charting developmental trajectories and their interactions, fostering conceptual understanding and procedural skill, designing effective interventions, and developing valid and reliable measures. In presenting these questions in this paper, we intend to support greater coherence in both investigation and reporting, to build a stronger base of information for consideration by policymakers, and to encourage researchers to take a consilient approach to addressing important challenges in mathematical cognition

HPV-FRAME: A consensus statement and quality framework for modelled evaluations of HPV-related cancer control.

Intense research activity in HPV modelling over this decade has prompted the development of additional guidelines to those for general modelling. A specific framework is required to address different policy questions and unique complexities of HPV modelling. HPV-FRAME is an initiative to develop a consensus statement and quality-based framework for epidemiologic and economic HPV models. Its development involved an established process. Reporting standards have been structured according to seven domains reflecting distinct policy questions in HPV and cancer prevention and categorised by relevance to a population or evaluation. Population-relevant domains are: 1) HPV vaccination in pre-adolescent and young adolescent individuals; 2) HPV vaccination in older individuals; 3) targeted vaccination in men who have sex with men; 4) considerations for individuals living with HIV and 5) considerations for low- and middle-income countries. Additional considerations applicable to specific evaluations are: 6) cervical screening or integrated cervical screening and HPV vaccination approaches and 7) alternative vaccine types and alternative dosing schedules. HPV-FRAME aims to promote the development of models in accordance with an explicit framework, to better enable target audiences to understand a model's strength and weaknesses in relation to a specific policy question and ultimately improve the model's contribution to informed decision-making

Challenges in Mathematical Cognition: A Collaboratively-Derived Research Agenda

This paper reports on a collaborative exercise designed to generate a coherent agenda for research on mathematical cognition. Following an established method, the exercise brought together 16 mathematical cognition researchers from across the fields of mathematics education,psychology and neuroscience. These participants engaged in a process in which they generated an initial list of research questions with the potential to significantly advance understanding of mathematical cognition, winnowed this list to a smaller set of priority questions, and refined the eventual questions to meet criteria related to clarity, specificity and practicability. The resulting list comprises 26 questions divided into sixbroad topic areas: elucidating the nature of mathematical thinking, mapping predictors and processes of competence development, charting developmental trajectories and their interactions, fostering conceptual understanding and procedural skill, designing effective interventions, and developing valid and reliable measures. In presenting these questions in this paper, we intend to support greater coherence in both investigation and reporting, to build a stronger base of information for consideration by policymakers, and to encourage researchers to take a consilient approach to addressing important challenges in mathematical cognition.</p

A genetic history of the pre-contact Caribbean

Humans settled the Caribbean about 6,000 years ago, and ceramic use and intensified agriculture mark a shift from the Archaic to the Ceramic Age at around 2,500 years ago1,2,3. Here we report genome-wide data from 174 ancient individuals from The Bahamas, Haiti and the Dominican Republic (collectively, Hispaniola), Puerto Rico, Curaçao and Venezuela, which we co-analysed with 89 previously published ancient individuals. Stone-tool-using Caribbean people, who first entered the Caribbean during the Archaic Age, derive from a deeply divergent population that is closest to Central and northern South American individuals; contrary to previous work4, we find no support for ancestry contributed by a population related to North American individuals. Archaic-related lineages were >98% replaced by a genetically homogeneous ceramic-using population related to speakers of languages in the Arawak family from northeast South America; these people moved through the Lesser Antilles and into the Greater Antilles at least 1,700 years ago, introducing ancestry that is still present. Ancient Caribbean people avoided close kin unions despite limited mate pools that reflect small effective population sizes, which we estimate to be a minimum of 500–1,500 and a maximum of 1,530–8,150 individuals on the combined islands of Puerto Rico and Hispaniola in the dozens of generations before the individuals who we analysed lived. Census sizes are unlikely to be more than tenfold larger than effective population sizes, so previous pan-Caribbean estimates of hundreds of thousands of people are too large5,6. Confirming a small and interconnected Ceramic Age population7, we detect 19 pairs of cross-island cousins, close relatives buried around 75 km apart in Hispaniola and low genetic differentiation across islands. Genetic continuity across transitions in pottery styles reveals that cultural changes during the Ceramic Age were not driven by migration of genetically differentiated groups from the mainland, but instead reflected interactions within an interconnected Caribbean world1,8.This work was supported by a grant from the National Geographic Society to M. Pateman to facilitate analysis of skeletal material from The Bahamas and by a grant from the Italian ‘Ministry of Foreign Affairs and International Cooperation’ (Italian archaeological, anthropological and ethnological missions abroad, DGPSP Ufficio VI). D.R. was funded by NSF HOMINID grant BCS-1032255, NIH (NIGMS) grant GM100233, the Paul Allen Foundation, the John Templeton Foundation grant 61220 and the Howard Hughes Medical Institute.Peer reviewe

Investigating the crosstalk between hepatic stellate cells and antigen presenting cells in pancreatic cancer liver metastases

Metastatic pancreatic cancer is a fatal disease with a lack of effective therapies. Patients do not respond to standard chemotherapy and show in clinical trials resistance to immune checkpoint therapies. The tumour microenvironment (TME) consists of a diverse network of cellular components whose dynamic and complex interactions drive a conducive milieu for immune evasion and metastatic progression. The cancer associated fibroblast (CAF) is a major component of the TME that can suppress anti-tumour immunity by inducing a dense fibrotic reaction which can physically impede immune cell infiltration and function, and through engaging in a reciprocal interaction with antigen presenting cells (APC). CAFs, however, are a heterogenous population that can be tumour promoting or restraining. A better understanding of CAF heterogeneity, their interactions with immune cells, and how this affects anti-tumour immunity, is therefore crucial to design better treatment strategies for metastatic pancreatic cancer patients. This thesis describes the use of a platelet derived growth factor receptor β-enhanced green fluorescent reporter (PDGFRβ-eGFP) mouse model to investigate the heterogeneity of the tissue resident fibroblasts in pancreatic cancer liver metastases, termed tumour associated hepatic stellates (taHSCs). In addition, the thesis addresses how tumour associated macrophages (TAMs) affect taHSC activation state and how TAMs can modulate taHSC subtypes. It was observed that in liver metastatic bearing PDGFRβ-eGFP mice the administration of an anti-CSF1 neutralising antibody to deplete TAMs, reduced taHSC activation and changed taHSCs subtypes in metastatic tumours. Moreover, TAM depletion increased CD8 T cell infiltration and reduced tumour burden in liver metastases. Interestingly, dendritic cells (DC) the professional APC numbers also decreased in tumour bearing livers of anti-CSF-1 treated animals compared to control IgG treated mice. Immune tolerance in pancreatic cancer liver metastases is mediated through suppression of CD8 T cell cytotoxic response against cancer cells. Studies utilising a genetically engineered mouse model of pancreatic ductal adenocarcinoma (KPC; LSL-KrasG12D/+, Trp53R172H, Pdx1-Cre), demonstrated that the lack of tumour cell killing by CD8 T cells is due DC impairment in the TME. The research described in this thesis also explores whether and how taHSCs affect DC activation by (i) using the PDGFRβ-eGFP reporter mouse model to uncover the spatial proximity of taHSCs and DCs in liver metastases, and (ii) performing in vitro assays to determine how culture activated hepatic stellate cells (aHSCs) affect DC migration and activation. Immunofluorescent analyses of taHSCs and DC populations in liver metastases, demonstrated DCs accumulated in areas where taHSCs were abundant, in contrast few DCs were observed in regions that were lacking taHSC infiltration. In vitro, flow cytometry analyses of DC maturation markers MHCII, CD80 and CD86, demonstrated that aHSCs promote an immature DC phenotype. Furthermore in vitro analysis showed that aHSCs reduce the expression the DC migration marker CCR7 and that aHSCs can inhibit DC migration capacity towards chemoattractant factors. Therefore, this thesis uncovers that during pancreatic cancer liver metastasis, DCs accumulate in taHSC rich areas in vivo and that ex vivo, aHSC inhibit DC migration towards chemoattractant factors and reduce DC maturation. Thus, during pancreatic cancer liver metastasis, taHSC might function as traps for DCs by retaining DCs within fibrotic areas and reducing their activation state. Altogether, these data uncover diverse taHSC subtypes in metastatic tumour lesions and show that the depletion of TAMs reshapes taHSC subtypes. Moreover, taHSCs might contribute to the generation of an immune suppressive TME in pancreatic cancer liver metastases by trapping DCs in fibrotic areas