Client Predictors of the Therapeutic Alliance in Individual Resiliency Training

Individuals with first episode psychosis (FEP) are often reluctant to seek treatment, resulting in difficulties with engagement and high dropout rates. The therapeutic alliance (TA), the affective and collaborative bond between therapist and client, is predictive of better treatment outcomes for clients with FEP; thus, it is valuable to study the predictors of the TA to elucidate how best to foster a positive alliance with these individuals. The current study examined whether baseline client characteristics including severity of symptoms, social functioning, duration of untreated psychosis, and demographic factors (age, race), were associated with the TA. The sample included clients who received Individual Resiliency Training (IRT) as part of the NAVIGATE treatment in the NIMH Recovery After An Initial Schizophrenia Episode Early Treatment Program study. Subjects (n=146) were assigned to a trained IRT therapist, and sessions were audio recorded. Four undergraduate students were trained in using the Vanderbilt Therapeutic Alliance Scale to rate the TA between client and therapist for audiotapes of session 3 of IRT. Multilevel modeling was utilized given the nested data structure. Results indicated a significant positive relationship between positive symptoms and the TA, a significant negative relationship between negative and excitative symptoms and the TA, and a significant positive relationship between age and the TA. Results suggest that treatment providers working with FEP clients should take into consideration the clients’ symptom severity and age when beginning therapy, and adaptations to treatment should be made to foster a better TA in hopes of achieving better engagement and treatment outcomes.Bachelor of Art

Sustainable Diets, Population Growth & Regional Food Production: A Case Study of Waterloo Region, Ontario

The industrialized food system poses significant human health challenges, while simultaneously compromising planetary boundaries that we depend on for human flourishing. In 2019, the Canada Food Guide was updated to represent a more nutritious and environmentally sustainable diet, consistent with the 2019 EAT-Lancet Report’s Planetary Health Diet recommendations surrounding the human and planetary health nexus. Both recommendations notably put less emphasis on meats and dairy, and more emphasis on plant-based protein and fresh vegetables and fruits. One way to encourage the transition to more nutritious food consumption is to develop and enhance the regional food environment. The food environment determines in part what the population eats, and in turn, drives demand. ‘Food environments’ are created by social environments and are the physical, social, economic, cultural, and political factors that impact the accessibility, availability, and adequacy of food within a community or region (Rideout et al., 2015). They are often responsible for affecting how consumers make food decisions. COVID-19 exposed vulnerabilities in our industrialized just-in-time system, including challenges in food security and optimal nutrition as import-dependent foods faced risks in supply due to labour and supply chain disruptions. Increased political attention on local and regional self-sufficiency at regional and national scales may offer a solution to enhance resilience within socio-ecological systems. An optimum nutritional environment (ONE) assessment bridges nutritional needs with environmental sustainability through regional planning. For this thesis, a case study foodshed analysis of Waterloo Region (WR), Ontario, was conducted in order to understand the potential for regional sufficiency in nutrient-dense food (according to the 2019 Canadian Food Guide guidelines). The nutritional requirements were then compared to the local production capacity for the population in 2020 and the projected population in 2040 and 2060. The research objectives were (1) to estimate the quantity of locally grown vegetables, fruits, legumes, and whole grains needed to meet the Region of Waterloo population’s optimal nutritional requirements in 2020, 2040, and 2060; (2) to estimate how much of these healthy food requirements for the WR population could realistically be produced through regional agriculture by the year 2040 and 2060. This study used Canadian databases to quantify and predict the opportunities and potential for WR to meet its growing population's nutritional needs within regional boundaries. The results show that consumption and production levels in fruits, vegetables, whole grains, and plant-based protein are insufficient in 2020, 2040 and 2060. There were changes in comparison to the 2006 and 2019 Canada Food Guide’s recommendations, specifically a reduction in starchy vegetables, wheat and oats, and an increase of tree nuts and meat alternatives. Agricultural land requirements that align with nutritional recommendations could be met with a 4% conversion of current agricultural land in use in 2040 and 6% in 2060. One possibility to meet these recommendations is converting land that is currently dedicated to soy and corn production. One limitation of the study is the exclusion of livestock and dairy, which contributes to a large proportion of land use. This study contributes to current foodshed analysis research, providing a replicable case study methodology for other regions to identify the current status of local food provisioning and its relationship to nutritional needs, as well as to predict and plan for future scenarios with an enhanced food environment. This research suggests that collaborative and simultaneous effort from various stakeholders is needed to support the transition to sustainable diets in Waterloo Region

Use of Telehealth in NHSC Grantee Sites

Telehealth has long been viewed as an important pathway for increasing access to care for underserved populations, while providing high quality care at low cost. The spread of telehealth in the United States, however, has been hampered by a range of reimbursement, equipment costs, and licensure barriers. In this study we examined the extent to which telehealth is being used in settings that are among the locations most in need: the National Health Service Corps (NHSC) approved grantee sites. Key Questions To what extent and how are NHSC using telehealth and telemedicine services? What are the barriers to adoption and expansion from the perspective of NHSC scholars and loan repayment participants? What contextual factors are associated with high and low use

Introducing new retail products into the market

Master of AgribusinessAgricultural EconomicsKevin GwinnerHouse-Autry Mills is a food manufacturing company located in Eastern North Carolina. It produces a variety of products including corn meals, breaders, hushpuppies and biscuits. House-Autry Mills has been producing these types of products for over 200 years and is always looking for ways to promote and expand its business. Before House-Autry Mills decides to add a new line of products, it must conduct a lot of research and evaluate the success in this potential market. The purpose of this thesis is to look at the data available, and determine if grits will be a good fit for House-Autry, and for the market in general. Chapter I is an introduction to the entire thesis project. Much of the literature I reviewed deals with successfully bringing new products to the market. It also goes through an eight-step decision making process when determining if the project should be worked on, or if the project should be dropped at various stages. This is Chapter II of the thesis. The Methods and Data Collection section of this thesis is located in Chapter III. This chapter will go through the process of forming a focus group, screening the participants, and determining what types of questions should be asked, based on the feedback that the firm wants to receive. I also look at several data sets collected through Infoscan Resources, Inc. There are two chapters that contain the results. Chapter IV looks at the results found from the data collected, and chapter V looks at the results that were observed during the two focus groups findings. The final chapter is where my conclusion and recommendations are listed. I included the action that House-Autry Mills took, and also my thoughts on that action. The section goes through different recommendations including the market first approached, risk involved in the new product, the benefit of keeping the price competitive, and the eventual expansion of the line

Shifting sediment dynamics in the Coos Bay Estuary in response to 150 years of modification

Author Posting. © American Geophysical Union, 2021. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 126(1), (2021): e2020JC016771, https://doi.org/10.1029/2020JC016771.Estuaries worldwide have experienced modifications including channel deepening and intertidal reclamation over several centuries, resulting in altered fine sediment routing. Estuaries respond differently based on preexisting geometries, freshwater and sediment supplies, and extents and types of modification. The Coos Bay Estuary in Oregon is a relatively small estuary with complex geometry that has been extensively modified since 1865. A sediment transport model calibrated to modern conditions is used to assess the corresponding changes in sediment dynamics. Over ∼150 years, channel deepening (from ∼6.7 to 11 m), a 12% increase in area, and a 21% increase in volume have led to greater tidal amplitudes, salinity intrusion, and estuarine exchange flow. These changes have reduced current magnitudes, reduced bed stresses, and increased stratification, especially during rainy periods. Historically, fluvially derived sediment was dispersed across broad, deltaic‐style flats and through small tidal channels. Now, river water and sediments are diverted into a dredged navigation channel where an estuarine turbidity maximum (ETM) forms, with modeled concentrations >50 mg/L and measured concentrations >100 mg/L during discharge events. This “new” ETM supplies sediment to proximal embayments in the middle estuary and the shallow flats. Overall, sediment trapping during winter (and high river discharges) has increased more than two‐fold, owing to increased accommodation space, altered pathways of supply, and altered bed stresses and tidal asymmetries. In contrast to funnel‐shaped estuaries with simpler geometries and river‐channel transitions, these results highlight the importance of channel routing together with dredging in enhancing sediment retention and shifting pathways of sediment delivery.The Science Collaborative is funded by the National Oceanic and Atmospheric Administration and managed by the University of Michigan Water Center (NAI4NOS4190145).2021-06-1

Interventions for Fall Prevention: An Evidence-Based Practice Project

This project considered the following Evidence-Based Practice (EBP) question: What occupational therapy and multidisciplinary/interprofessional interventions are most effective for preventing falls, decreasing fear of falling, improving safety in performing ADLs, and increasing quality of life in community-dwelling older adults

Senior Rectial:Benjamin Cubberly, Bass-Baritone

Kemp Recital Hall Sunday Evening October 25, 1998 6:00p.m

Twelve Dispatches from the Futures of AIDS

A Dialogue between Emily Bass, Pato Hebert, Elton Naswood, Margaret Rhee, and Jessica Whitbread, with Images by Quito Ziegler and an Introduction by Alexandra Juhas

Senior Recital: Megan McDillon, Mezzo-soprano; November 13, 2021

Center for the Performing Arts Saturday, November 13, 2021 Saturday Evening 6:00 p.m

Association Between Cytokines and Liver Histology in Children with Nonalcoholic Fatty Liver Disease.

BackgroundReliable non-invasive markers to characterize inflammation, hepatocellular ballooning, and fibrosis in nonalcoholic fatty liver disease (NAFLD) are lacking. We investigated the relationship between plasma cytokine levels and features of NAFLD histology to gain insight into cellular pathways driving NASH and to identify potential non-invasive discriminators of NAFLD severity and pattern.MethodsCytokines were measured from plasma obtained at enrollment in pediatric participants in NASH Clinical Research Network studies with liver biopsy-proven NAFLD. Cytokines were chosen a priori as possible discriminators of NASH and its components. Minimization of Akaike Information Criterion (AIC) was used to determine cytokines retained in multivariable models.ResultsOf 235 subjects, 31% had "Definite NASH" on liver histology, 43% had "Borderline NASH", and 25% had NAFLD but not NASH. Total plasminogen activator inhibitor 1 (PAI1) and activated PAI1 levels were higher in pediatric participants with Definite NASH and with lobular inflammation. Interleukin-8 (IL-8) was higher in those with stage 3-4 fibrosis and lobular inflammation. sIL-2rα was higher in children with stage 3-4 fibrosis and portal inflammation. In multivariable analysis, PAI1 variables were discriminators of Borderline/Definite NASH, definite NASH, lobular inflammation and ballooning. IL-8 increased with steatosis and fibrosis severity; sIL-2rα increased with fibrosis severity and portal inflammation. IL-7 decreased with portal inflammation and fibrosis severity.ConclusionsPlasma cytokines associated with histology varied considerably among NASH features, suggesting promising avenues for investigation. Future, more targeted analysis is needed to identify the role of these markers in NAFLD and to evaluate their potential as non-invasive discriminators of disease severity