African American Adults’ Experiences with the Health Care System: In Their Own Words

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and attitudes, and (5) improving health care experiences. These findings indicate that perceptions of discrimination and racism were prevalent among African Americans in this study, and that the expectation of a negative interaction is a barrier to seeking care. Authors discuss prevention and public health implications of these findings and make recommendations for health care practitioners

Work and Well-being in the Knowledge Economy: Evaluating the Effects of a Summer Employment Program for Youth from Low Income Neighborhoods

This study assessed the influence of an employment program and participant demographic characteristics on several indicators of psychosocial well-being for 125 youth residing in low-income neighborhoods that were recruited by an urban-based social services agency in Southwestern Ontario to participate in the program. A one-group pretest-posttest design was used to collect quantitative data on four independent and five dependent variables. The study’s results suggest the employment program had no effect on the selected indicators but certain demographic characteristics yielded significant associations with the dependent variables. Youth living with both of their parents at the same time perceived themselves as more intelligent, while youth born outside of Canada exhibited less attachment to their neighborhoods and lower self-esteem. The study’s implications for designing and implementing gender-specific and culturally competent programs for youth seeking inclusion within the knowledge economy are discussed

A mathematical model quantifies proliferation and motility effects of TGF--β\beta on cancer cells

Transforming growth factor (TGF) $\beta$ is known to have properties of both a tumor suppressor and a tumor promoter. While it inhibits cell proliferation, it also increases cell motility and decreases cell--cell adhesion. Coupling mathematical modeling and experiments, we investigate the growth and motility of oncogene--expressing human mammary epithelial cells under exposure to TGF--$\beta$. We use a version of the well--known Fisher--Kolmogorov equation, and prescribe a procedure for its parametrization. We quantify the simultaneous effects of TGF--$\beta$ to increase the tendency of individual cells and cell clusters to move randomly and to decrease overall population growth. We demonstrate that in experiments with TGF--$\beta$ treated cells \textit{in vitro}, TGF--$\beta$ increases cell motility by a factor of 2 and decreases cell proliferation by a factor of 1/2 in comparison with untreated cells.Comment: 15 pages, 4 figures; to appear in Computational and Mathematical Methods in Medicin

Comparison of Grade Point Average and Personal Adjustment for Selected Groups of Freshman Home Economics Students at an Oklahoma High School

This study is concerned with the comparison of grade point averages and personal adjustment scores of a sample of disadvantaged students and a random sample of their classmates. The main objective is to determine if being economically "disadvantaged" is detrimental to the academic achievement and personal adjustment of a student. The Bell Adjustment Inventory with six areas of adjustment is used to identify the personal adjustment. A further aspect of the study is to determine if higher grade point averages correspond with better personal adjustment scores and if lower grade point averages correspond with poor personal adjustment.Home Economics Educatio

Variational Data Assimilation With Telemac. Proof Of Concept For Model State Correction On The Berre Lagoon 3D-Model

TELEMAC is a component of the open-source integrated suite of solvers TELEMAC-MASCARET for use in the field of free-surface flow that solves the Reynolds Averaged Navier-Stokes equations. Generally speaking, uncertainties in the model formulation itself due to simplified physics and also in the input fields to the model such as the boundary conditions, initial conditions and hydraulic parameters translate into errors in the simulated hydraulic variables. In spite of significant advances in numerical schemes, description of geographical data (topography, bathymetry) and environmental conditions (hydrologycal and meteorological fields), the representation of the true state of a system as well as its forecasted state remains imperfect and some of these limits can be overcome combining observations with simulation via data assimilation techniques. This paper presents the implementation of a 3D-Var FGAT variational data assimilation algorithm as a proof of concept for improving TELEMAC simulations and forecast. The demonstration is made on the Berre lagoon application with TELEMAC-3D: the salinity state is sequentially corrected assimilating in-situ salinity measurements

A Variational Data Assimilation Algorithm to Estimate Salinity in the Berre Lagoon with TELEMAC-3D

Numerical Aspect

Assessment Practices and Experiences of Sex Trafficking in Caseloads of Service Providers Working with High Risk Youth in Indiana

With increased recognition of sex trafficking, calls have been made for greater identification and screening. Lack of awareness and assessment likely contribute to low identification of sex trafficking victims. The present study examined assessment practices, confidence in detecting trafficking, and experiences with DMST survivors in the caseloads of service providers in the past year. Employees at high-risk settings were recruited, resulting in a sample of 76 providers representing 21 agencies. Data revealed that while general risk factors were typically assessed, sex trafficking-specific risk factors and experiences were assessed less often. Approximately 30% of participants indicated they worked with at least one sex trafficking victim in the past year. However, 44% of participants indicated low confidence in detection. Approximately 23% of participants had completed sex trafficking training, but few differences emerged between those with and without prior training. Increased training, assessment, and evaluations of the effectiveness of training programs are recommended

Food Protein-Induced Enterocolitis Syndrome as a Cause for Infant Hypotension

Infants with food protein-induced enterocolitis syndrome (FPIES) may present to the emergency department (ED) with vomiting and hypotension. A previously healthy, 5-month-old male presented with vomiting and hypotension 2 to 3 hours after eating squash. The patient was resuscitated with intravenous fluids, antibiotics, and admitted for presumed sepsis. No source of infection was ever found and the patient was discharged. The patient returned 8 days later with the same symptoms after eating sweet potatoes; the diagnosis of FPIES was made during this admission. Two additional ED visits occurred requiring hydration after new food exposure. FPIES should be considered in infants presenting with gastrointestinal complaints and hypotension. A dietary history, including if a new food has been introduced in the last few hours, may help facilitate earlier recognition of the syndrome

Implications of pediatric extracorporeal cardiopulmonary resuscitation simulation for intensive care team confidence and coordination: A pilot study

Introduction Extracorporeal cardiopulmonary resuscitation (ECPR) is associated with improved outcomes in select populations, however, crisis resource management (CRM) in this setting is logistically challenging. This study evaluates the impact of ECPR simulation on self-perceived confidence and collaboration of intensive care unit team members. Methods This is a prospective observational study analyzing data obtained between July 2018–December 2019. This study focused on non-surgical members of critical care team consisting of pediatric intensivists, resident physicians, registered nurses, respiratory therapists. Participants were expected to perform cardiopulmonary resuscitation (CPR) during the ECPR event, participate in code-team responsibilities and provide ancillary support during cannulation. Pre- and post-simulation surveys employed the Likert scale (1 = not at all confident, 5 = highly confident) to assess self-perceived scores in specified clinical competencies. Results Twenty-nine providers participated in the simulation; 38% had prior ECPR experience. Compared to mean pre-study Likert scores (2.4, 2.4, 2.5), post-simulation scores increased (4.2, 4.4, 4.3) when self-evaluating: confidence in assessing patients needing ECPR, confidence in participating in ECPR workflow and confidence in performing high-quality CPR, respectively. Post-simulation values of \u3e3 were reported by 100% of participants in all domains (p \u3c .0001). All participants indicated the clinical scenario and procedural environment to be realistic and appropriately reflective of situational stress. Additionally, 100% of participants reported the simulation to improve perceived team communication and teamwork skills. Conclusion This study demonstrated preliminary feasibility of pediatric ECPR simulation in enhancing independent provider confidence and team communication. This self-perceived improvement may establish a foundation for cohesive CRM, in preparation for a real life ECPR encounter