Comparing the effectiveness of two verbal problem solving strategies: Solve It! and CUBES

The purpose of this study was to find which problem solving strategy was more effective for special education students in the general education classroom; CUBES or Solve It! The students completed a pre-test, solving five single step and five multi-step word problems. The students then received four instructional and activity sessions on the CUBES and Solve It! strategies. The results indicated that the six fourth grade special education participants increased their problem solving skills after using each strategy. The Solve It! strategy resulted in a larger increase then the CUBES strategy. The students showed a slightly larger decrease in the number of single step incorrect problems using the Solve It! strategy. The CUBES strategy showed a slightly larger decrease in the number of multi-step problems incorrect. The research demonstrated that the use of CUBES and Solve It! was beneficially to the special education students who receive their math instruction in the general education classroom. This study demonstrated the high demand for all students to develop successful problem solving skills. The research also indicated that with the use of a problem solving strategy, special education students can increase their problem solving abilities. Further research is needed to determine all the factors that lead to an increase in the students’ problem solving abilities

The Quality Improvement Program for Sepsis Fallouts: Utilizing Education and an Order Set to Improve Compliance with SEP-1

Background: Sepsis is a multisystem disease that occurs when the human body reacts to a severe infection in the body. Sepsis is a life-threatening response that can lead to multisystem organ failure and even death. Sepsis is the number one cost of hospitalization and is estimated to be $62 billion annually (Sepsis Alliance, 2022). This disease affects at least 1.7 million adults yearly in the United States, and nearly 270,000 die from it (National Institute of General Medical Statistics [NIGMS], 2021). Purpose: This Doctor of Nursing Practice (DNP) project aimed to improve the compliance rate of the sepsis bundle with evidence-based practices by educating physicians in the Emergency Department (ED) on the SEP-1 guidelines and the utilization of a sepsis order set. Methods: The quality improvement project educated 100% of ED physicians on the SEP-1 guidelines and how to utilize the order set. Chart reviews were performed monthly, and the outcomes were compared to scores collected from pre-interventional education. Results: Key findings from the project implementation show a statistically significant increase in the sepsis order set\u27s utilization and compliance with the sepsis SEP-1 bundle. Pre-intervention showed 71.8% adherence, and post-intervention showed 75% adherence to the bundle criteria. Conclusion: The DNP project accentuated the need for hospitals and emergency departments to prioritize the implementation of an educational program with the SEP-1 evidence-based standards. Interventional education was highly effective in improving bundle compliance in the emergency department for adult patients diagnosed with sepsis. Keywords: adults, sepsis bundle, sepsis guidelines, bundle compliance, complianc

A Computerized Marine Data and Information System-Endex/Oasis

The volume of international and national environmental data and information in the marine, earth and atmospheric sciences has created the need to systematically organize, handle, manipulate, store and retrieve this material utilizing sophisticated computer hardware and provide the scientist, student, planner and decision-maker with the awareness and accessibility of available data and information. Consonant with the objectives outlined for NOAA and the need generated by the explosion of information and data in this area, the National Oceanic and Atmospheric Administration(NOAA), Environmental Data Service (EDS) and the National Oceanographic Data Center (NODC), have an ongoing development effort in the Envirorrmental Data Index and theOceanic and Atmospheric Scientific Information System (ENDEX/OASIS) It provides a one - stop service on a marginal costrecovery basis that is available to the public for computerized searching of references to technical literature, data, and research dealing with the environmental sciences and marine and coastal resources

The role of T cell receptor signal intensity in T helper 17 cell development

PhD ThesisT-helper (Th) 17 cells are a subset of CD4+ T cells defined through the release of the cytokine interleukin-17a (IL-17a). Activation of these cells is critical for protection against some extracellular bacterial and fungal pathogens. However, a dysregulated Th17 response targeted against self is thought to play an important role in the immunopathology of a number of autoimmune conditions including Inflammatory Bowel Disease (IBD), Multiple Sclerosis (MS) or inflammatory arthritides. Further understanding of the mechanisms that influence the development of Th17 cells may aid future therapeutic targeting of these cells. Whilst the role of the cytokine milieu in Th cell polarisation is relatively well characterised, the degree of signalling through the TCR can also shape the form of the Th cell response. Both the density of antigenic peptide available and the affinity of the antigenic peptide for a particular TCR can contribute to the degree of TCR signalling. The hypothesis of this project was that TCR signal intensity could alter the development of Th17 cells from a naive precursor population. In particular, it was of interest to determine how citrullination of a putative TCR contact amino acid in an antigenic peptide could alter the Th cell response observed. The 5/4E8 T-cell receptor transgenic (TCR Tg) mouse provides a model in which >80% of T-cells specifically recognise an immunodominant epitope derived from the G1 domain of aggrecan – peptide-84-103 (p84-103). This model allowed for the examination of these factors and the underlying mechanism ex vivo using a purified naive CD4+ T cell population in coculture with LPS-matured dendritic cells (mDCs). The data presented in this thesis show the activation, proliferation and effector responses of naive 5/4E8 TCR Tg T cells to alterations in both cognate peptide (p89- 103) density and affinity through citrullination of a putative TCR contact residue (R93Cit). Interestingly, by reducing TCR signal strength the observed response shifts from one dominated by the Th2 phenotype to Th17 cells. Linking the degree of TCR activation to Th cell phenotype was the intensity of IL-2 signalling that in turn shaped the balance between phosphorylated STAT3 and STAT5. Compared to p89-103-primed T cells, T cells responding to R93Cit produced less IL-2, expressed lower levels of the ILiii 2 receptor subunit CD25, and showed reduced levels of STAT5 phosphorylation, whilst STAT3 activation was unaltered. IL-2 blockade in p89-103-primed T-cells selectively reduced STAT5 but not STAT3 phosphorylation, and concomitantly enhanced Th17 development. In summary, this work indicates the impact that changes to the intensity of TCR signalling can have on the murine Th17 response. Indeed, these data illustrate how a disease-relevant post-translational modification such as citrullination can promote Th17 development by altering the balance between STAT5 and STAT3 activation in responding T cells.Arthritis Research U

Conformational Change and Topological Stability of Proteins

The conformation and topology of a protein changes when stabilizing forces are absent, but the mechanisms by which these changes occur remains elusive. This dissertation aims to broaden the understandings. On the conformational level, the M20 loop conformers of E. coli dihydrofolate reductase are interrogated to identify factors responsible for their stability as well as to determine how one conformer might change into another. Molecular dynamics is used to simulate the open, closed and occluded conformers (observed in X-ray crystal structures) under a series of different single ligand conditions. Analysis shows that all open conformers move to a similar new conformation. Free energy methods examine the stability of the new loop conformer relative to the others. External perturbation molecular dynamics simulations and normal mode analysis methods examine possible M20 loop pathways occurring either when one loop conformer is forced to change into another or when a ligand is pulled out of its binding site. On the topological level, conserved residue-residue interaction networks found among three different protein superfamilies (the all α-helix death domains, the α/β-plaits and the all β-sheet immunoglobulins), each of different secondary structure but sharing the Greek-Key topology, are assessed for any inherent stability they might contain relative to randomly selected interaction networks. This assessment is achieved by simulating one protein from each family at different temperatures, ranging from 300 to 600 K, and observing that adding thermal energy to the system causes the random interaction networks to fall apart more easily than the conserved networks. When considered together, the conformational and topological projects, although very different from each other, both demonstrate the same idea - that regardless of scale, instability causes change and vice versa. This dissertation is divided into five chapters: Introduction, Theoretical Background, M20 Loop Conformers of Dihydrofolate Reductase, Conserved Contact Networks of Greek-Key Proteins and Summary

Giving a Voice to the Suffering Silent: The Role of Patient Advocacy in Improving Access to Global Pain Care

The undertreatment of pain is a major public health issue worldwide. According to the World Health Organization (WHO), the gold standard for the treatment of severe, chronic pain is morphine; however, access to this treatment in the majority of developing countries is difficult to impossible for a number of reasons. Well-documented and universal barriers include supply and delivery systems that are ill-equipped to adequately manage opioid medication accountability, regulatory barriers and national policies that do not recognize pain as important, and lack of health care professional education and awareness, as well as fear of regulatory retribution. Current research has shown that only 19% of the world demonstrates acceptable environments for hospice, just one illustration of the dire circumstances for people living and dying with pain. For more than a decade, researchers have worked to define barriers to accessing pain care and determine ways to overcome them. Work is underway around the world to help thoughtfully and systematically overcome these barriers. More recently, pain care, particularly for severe pain at the end of life, has been framed as a human right and moral imperative through various professional organization declarations, position statements and published research. This singular message has the power to help overcome the barriers stated above. However, the inclusion of the voice of the humans actually suffering from pain as a transformative force has been largely overlooked as an essential part of the advocacy process. This research explores the role of the patient advocate in helping to improve pain care, and identifies a crossroads of current efforts where efforts to raise awareness among people with pain, providers, policy makers and the general public can and have made a difference. It also explores the possibility of an international information exchange explicitly for the use of pain advocates to share their victories and help determine best practices that can be adapted in countries with similar environmental conditions.Master of Public Healt

Мои воспоминания об Иване Георгиевиче Спасском

Стислі спогади автора про відомого вченого-нумізмата й музейника І.Г. Спаського та його сім’ю.Краткие воспоминания автора об известном ученом-нумизмате и музейщике И.Г. Спасском и его семье.Short author’s memories about known scientist-numismatist and museum-worker I.G. Spassky and his family

Adult education and place: a vital link for learning cities. PASCAL Briefing Paper 5

No abstract available

Reduced TCR-dependent activation through citrullination of a T-cell epitope enhances Th17 development by disruption of the STAT3/5 balance

Citrullination is a post-translational modification of arginine that commonly occurs in inflammatory tissues. Because T-cell receptor (TCR) signal quantity and quality can regulate T-cell differentiation, citrullination within a T-cell epitope has potential implications for T-cell effector function. Here, we investigated how citrullination of an immunedominant T-cell epitope affected Th17 development. Murine na¨ıve CD4+ T cells with a transgenic TCR recognising p89-103 of the G1 domain of aggrecan (agg) were co-cultured with syngeneic bone marrow-derived dendritic cells (BMDC) presenting the native or citrullinated peptides. In the presence of pro-Th17 cytokines, the peptide citrullinated on residue 93 (R93Cit) significantly enhanced Th17 development whilst impairing the Th2 response, compared to the native peptide. T cells responding to R93Cit produced less IL-2, expressed lower levels of the IL-2 receptor subunit CD25, and showed reduced STAT5 phosphorylation, whilst STAT3 activation was unaltered. IL-2 blockade in native p89-103-primed T cells enhanced the phosphorylated STAT3/STAT5 ratio, and concomitantly enhanced Th17 development. Our data illustrate how a post-translational modification of a TCR contact point may promote Th17 development by altering the balance between STAT5 and STAT3 activation in responding T cells, and provide new insight into how protein citrullination may influence effector Th-cell development in inflammatory disorders