INTRASPECIFIC GENETIC VARIATION, POPULATION STRUCTURE, AND PERFORMANCE OF THE INVASIVE AQUATIC MACROPHYTE EURASIAN WATERMILFOIL (Myriophyllum spicatum) IN WATERBODIES WITH AND WITHOUT HISTORIES OF CHEMICAL HERBICIDE TREATMENT ACROSS MICHIGAN

Populations of invasive species are often subjected to novel selective forces in the form of anthropogenic control agents in their introduced ranges. These control agents, applied unevenly among populations within a species’ new range, can send invasive populations on drastically different evolutionary and ecological trajectories. In these studies, we aimed to see if different histories of chemical herbicide treatment are differentially influencing the genetic diversity, structure, and performance of populations of invasive watermilfoil (Myriophyllum spicatum and M. spicatum x M. sibiricum hybrids) from waterbodies in the state of Michigan. We sampled ten waterbodies with different histories of herbicide treatment in order to examine patterns of genetic variation amongst milfoil populations, to determine the extent of admixture among invasive watermilfoil populations, and to assess whether histories of herbicide application have an impact on the abiotic environment and/or biotic macrophyte community. We also grew invasive watermilfoil plants that were collected from waterbodies with and without histories of repeated exposure to herbicides together in mesocosms to test for tradeoffs in the expression of invasive traits. We found that genetic diversity is greater in populations with no history of herbicide treatment, populations with histories of herbicide treatment have more admixture and evidence of hybridization, and plant communities appear to be differentially shaped by histories of herbicide treatment. We also found that a history of herbicide treatment significantly affected plant survival, net growth, and mean growth rate and that these effects depended upon whether neighboring plants were from herbicide or non-herbicide treatment waterbodies. In general, plants from waterbodies with histories of herbicide treatment were more likely to survive and expressed increased growth relative to plants collected from waterbodies with no history of herbicide treatment. These findings indicate that histories of herbicide application could be selecting for populations comprised of less genetically diverse (but more admixed) individuals with potentially higher fitness for herbicide conditions. Our results suggest that repeated exposure to chemical herbicides could be selecting for increased invasiveness among invasive watermilfoil populations. This could have drastic ecological consequences and implications for the efficacy of long-term management efforts of invasive watermilfoil

“Teamshipness”: Stories of Love, Loss, and Laughter

This project seeks to examine the effects of language on readers’ perspectives of same-sex and opposite-sex relationships. I interviewed 13 people at various stages of romantic relationships and told their stories from the first-person perspective. By only using the gender-neutral first-person pronoun “I” and gendered pronouns for the speakers’ partners, each story creates ambiguity about the type of relationship (whether same- or opposite-sex) featured. By doing so, I am asking readers to view each couple as just that—a couple. Not a gay couple, a lesbian couple, or a straight couple. I am challenging all of us to examine what phrases such as “love is love” really mean and to read the experiences of romantic relationships equally

Building research initiative group: chronic illness management and adherence in transplantation (BRIGHT) study: study protocol

Protocol[Abstract] AIM: This article describes the rationale, design and methodology of the Building research initiative group: chronic illness management and adherence in transplantation (BRIGHT) study. This study of heart transplant patients will: (1) describe practice patterns relating to chronic illness management; (2) assess prevalence and variability of non-adherence to the treatment regimen; (3) determine the multi-level factors related to immunosuppressive medication non-adherence. BACKGROUND: The unaltered long-term prognosis after heart transplantation underscores an urgent need to identify and improve factors related to survival outcomes. The healthcare system (e.g. level of chronic illness management implemented) and patient self-management are major drivers of outcome improvement. DESIGN: The study uses a survey design in 40 heart transplant centres covering 11 countries in four continents. METHODS: Theoretical frameworks informed variable selection, which are measured by established and investigator-developed instruments. Heart transplant recipients, outpatient clinicians and programme's directors complete a survey. A staged convenience sampling strategy is implemented in heart transplant centres, countries and continents. Depending on the centre's size, a random sample of 25-60 patients is selected (N estimated 1680 heart transplant recipients). Five randomly selected clinicians and the medical director from each centre will be invited to participate. CONCLUSION: This is the first multi-centre, multi-continental study examining healthcare system and heart transplant centres chronic illness management practice patterns and potential correlates of immunosuppressive medication non-adherence. The knowledge gained will inform clinicians, researchers and healthcare policy makers at which level(s) interventions need to be implemented to improve long-term outcomes for transplant recipient

Effective Communication in the Nonprofit Sector: A Communication Training and Development Program

The goal of this paper was to create a manual for communication trainers to use with nonprofit organizations. In this paper, I will review literature associated with training and development (more specifically, literature related to training and development approaches, adult learning, and assessment) as well as group theories used to develop my curriculum (such as conflict management, listening, verbal dynamics, nonverbal communication, and team meetings). I will then describe the process of creating a training program for a local nonprofit organization, detail my lesson plans and participant guidebook, and end with details such as the training schedule and approximate budget

Towards a Comprehensive Solution for a Vision-based Digitized Neurological Examination

The ability to use digitally recorded and quantified neurological exam information is important to help healthcare systems deliver better care, in-person and via telehealth, as they compensate for a growing shortage of neurologists. Current neurological digital biomarker pipelines, however, are narrowed down to a specific neurological exam component or applied for assessing specific conditions. In this paper, we propose an accessible vision-based exam and documentation solution called Digitized Neurological Examination (DNE) to expand exam biomarker recording options and clinical applications using a smartphone/tablet. Through our DNE software, healthcare providers in clinical settings and people at home are enabled to video capture an examination while performing instructed neurological tests, including finger tapping, finger to finger, forearm roll, and stand-up and walk. Our modular design of the DNE software supports integrations of additional tests. The DNE extracts from the recorded examinations the 2D/3D human-body pose and quantifies kinematic and spatio-temporal features. The features are clinically relevant and allow clinicians to document and observe the quantified movements and the changes of these metrics over time. A web server and a user interface for recordings viewing and feature visualizations are available. DNE was evaluated on a collected dataset of 21 subjects containing normal and simulated-impaired movements. The overall accuracy of DNE is demonstrated by classifying the recorded movements using various machine learning models. Our tests show an accuracy beyond 90% for upper-limb tests and 80% for the stand-up and walk tests

Sleep Telemedicine: Patient Satisfaction and Treatment Adherence

Objective: Obstructive sleep apnea is common, but access to diagnosis remains limited. Telemedicine may allow greater access to care; however, its effect on patient satisfaction and treatment adherence is unknown. This study compares patient satisfaction and continuous positive airway pressure (CPAP) adherence of patients seen by videoconference with those seen in person. Materials and Methods: New patients seen via video or in person at a sleep center completed a survey, with three questions pertaining to satisfaction with the provider. Questions were scored 1–5; the sum was the patient satisfaction score. CPAP adherence was retrospectively analyzed in patients who met the physician via video or in person. Percentage of nights CPAP was used for ‡ 4 h and average minutes of CPAP use per night over 2 consecutive weeks were compared. Results: A Mann–Whitney test compared patient satisfaction of the 90 subjects (of whom, 56 met physician in person and 34 via video). Mean scores (in person, 14.82; video, 14.91; p = 0.851) did not differ between groups. Mann–Whitney tests compared CPAP adherence in the 172 subjects (of whom, 111 met physician in person and 61 via video). Mean percentage of nights CPAP was used ‡ 4 h (in person, 71%; video, 65%; p = 0.198) and the average minutes per night of CPAP use (in person, 340.55; video, 305.31; p = 0.153) did not differ between groups. Conclusions: The findings indicate that patients were equally satisfied with their provider and adherent to CPAP treatment whether they were seen in person or via video. Videoconferencing may improve access to patient care without reducing patient satisfaction or treatment adherence