Challenges Facing Young Adults with Complex Communication Needs Entering the Adult Health Care System

Barbara Abbott, PhD, OTR/L is a school-based occupational therapist currently working with students grades K-12 in four schools in Kent, WA. The purpose of our project was to identify the most effective service delivery models and/or components of interventions for young adults with complex communication needs to understand their health information. We conducted a systematic review to critically appraise literature published between the years of 1990-2018 to address our research question. Our research yielded a total of seven qualitative and 12 quantitative studies to address our research question. Qualitative data found that individuals with complex communication needs (CCN) experience significant challenges in adulthood with managing and communicating their health needs. Quantitative research identified seven evidence-based interventions that improved health knowledge, health literacy, and health advocacy skills for improving participation in the adult healthcare system. The overarching recommendation from the studies highlighted the importance of promoting self-advocacy and self-determination to navigate the system and manage individual health needs. There is a need for professionals to help prepare these young adults throughout the transition phase from pediatric to the adult healthcare system. Our subsequent knowledge translation product entailed developing a tri-fold pamphlet intended for school administrators and school-based occupational therapists. It includes qualitative data and evidence based interventions to improve health literacy and self-advocacy skills for young adults with communication challenges in the school setting. Outcomes data collected from school based occupational therapists indicated that the research findings in the pamphlet were widely new information for them. Additionally, they reported positive reactions to the pamphlet. Occupational therapists surveyed agreed that teaching health education is within their scope of practice in the school setting, and reported an interest in incorporating a health education intervention for students with disabilities into their services. Future research is recommended for developing additional evidence-based interventions for preparing these young adults to advocate for their health needs. Recommendations for future translation of knowledge include catering the information in the pamphlets to specific audiences, such as one pamphlet for occupational therapists and a separate pamphlet for school administrators, with suggestions regarding support for families and educators

The Syrian Refugee Crisis

Our primary goal in this presentation is to provide a comprehensive review of literature as it pertains to the influence of the Syrian Refugee crisis in Jordan, Turkey and Germany.These countries have experienced an enormous influx of refugees which has caused a need for economic and political concern. First, we will examine the history of Syrian Civil War that led to the displacement of Syrian individuals and families. Second, we will evaluate the effects of Syrian migration on the economical and political situation in Jordan, Turkey, Germany. We will discuss the various policies implemented in each of the countries that either hinder or promote development and sustainability due to the change in population. We will propose policies that are both beneficial to the structure of these countries and supportive of the humanitarian well-being of the refugees themselves. In conclusion, we will discuss the implications that the refugee crisis has on the USA as well as practical steps we can take in our locally to support the incoming Syrian refugees who will resettle in our communities

Using Research, Innovation and Collaboration to link Undergraduate and DPT Students

Purpose Research demonstrates a lack of connectedness between undergraduate (UG) and graduate students at universities around the U.S. This stems from: A lack of awareness of available resources and programs A lack of mentorship Insufficient face-to-face interaction COVID-19 Pandemic. UG students have reported receiving little information surrounding their prospective fields of study,2 including the field of physical therapy (PT). Establishing continued relationships among faculty and students aids in retention rates,3 and graduate mentorship programs reduce feelings of isolation.4 The purpose of this work was to develop systems to increase connectedness for UG students in alignment with the PT Moves Me Campaign established by APTA. Description A needs assessment was conducted in 2021 with UG and DPT students. Results aligned with our research and prompted further action. A PT Club and Peer Mentoring Program (PMP) were established in 2022 in an attempt to promote the profession and bridge the gaps in connectedness between the undergraduate and DPT students at CSP. The PT Club is innovative in that it intentionally links UG and DPT students. Many institutions have a Pre-PT club, catering only to UG students. Through the initiation of the PT Club, prospective UG students receive structure, guidance, and direction from current CSP DPT students and faculty. The PMP pairs UG students with a current DPT student, which helps develop personal relationships. UG students are also able to observe DPT student research, integrated clinical experiences, or lectures/labs. Peer mentoring guides have been created based on UG student needs as they matriculate through UG studies. Observation The CSP PT Club has hosted multiple meetings and attended various club marketing events on campus, catering to UG and DPT students alike. Students were able to vote on topics they would like to explore further and this includes review of the DPT application process, observation hours and clinical experiences, various specialties, and practice settings. There are several students actively involved in the program. Through the PMP, undergraduate students became involved in various DPT class lectures and labs, participated in DPT research, and collaborated with their DPT peer mentors to establish confidence and preparedness to take the next steps in their academic career. Conclusion The PT Club and PMP were established in response to a needs assessment that was previously conducted. Both have been successful in connecting UG students to the DPT program, which aligns with research and the PT Moves Me campaign by APTA. 6 Succession of the PT Club and mentorship roles will be established each Spring to ensure sustainability of systems established. Implications Implementing PMP and and PT Club at universities with both UG and graduate PT programs will be beneficial to students in both programs, allowing for the sharing of valuable information and guidance that isn’t always accessible to students. This will also help expand the reach of institutions by increasing engagement of PT students and prospective students alike

Comparison of ecosystem processes in a woodland and prairie pond with different hydroperiods

Shallow lakes and ponds constitute a significant number of water bodies worldwide. Many are heterotrophic, indicating that they are likely net contributors to global carbon cycling. Climate change is likely to have important impacts on these waterbodies. In this study, we examined two small Minnesota ponds; a permanent woodland pond and a temporary prairie pond. The woodland pond had lower levels of phosphorus and phytoplankton than the prairie pond. Using the open water oxygen method, we found the prairie pond typically had a higher level of gross primary production (GPP) and respiration (R) than the woodland pond, although the differences between the ponds varied with season. Despite the differences in GPP and R between the ponds the net ecosystem production was similar with both being heterotrophic. Since abundant small ponds may play an important role in carbon cycling and are likely to undergo changes in temperature and hydroperiod associated with climate change, understanding pond metabolism is critical in predicting impacts and designing management schemes to mitigate changes

Who is the Teacher and Who is the Student? The Dual Service- and Engaged-Learning Pedagogical Model of Anatomy Academy

Anatomy Academy is a simultaneous service-learning experience for preprofessional school undergraduate students and preclinical professional students acting as classroom paraprofessional teachers (Mentors), and engaged-learning experience for fourth to sixth grade elementary school children (Students). Using didactic and kinesthetic active learning teaching strategies in small-group classroom environments, Mentors taught anatomy, physiology, and nutrition concepts to Students. In this study of the program's early years (2012-2014), overall objectives of improving Mentors' pedagogical confidence; and Students' science interest, science knowledge, and exercise self-efficacy were assessed. Mentors showed (89% response of 595 surveyed) improvement in content delivery (P < .001), student engagement (P < .001), classroom management (P < .001), and professionalism (P = .0001). Postprogram Mentor reflections were categorized into 7 major themes that demonstrated personal growth through the service-learning opportunity: (1) realization of an ability to make a difference in the world now; (2) acknowledgment of the importance of listening in teaching; (3) recognition that lives can and will change with "a little love"; (4) insight into the effectiveness of guiding Students through material rather than lecturing; (5) awareness of the value of respect in the learning environment; (6) cognizance of the power of individualized attention to motivate Students; and (7) reflection of one's own personal growth through the open influence of Students. Students showed (88% response of 1259 surveyed) improvement in science knowledge (P = .014) and exercise self-efficacy (P = .038), but not science interest (P = .371). Thus, while Students are learning more science and becoming more aware of their health, we need to be more overt in our presence as scientists in the educational arena

Cryptic diversity of a widespread global pathogen reveals expanded threats to amphibian conservation

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Biodiversity loss is one major outcome of human-mediated ecosystem disturbance. One way that humans have triggered wildlife declines is by transporting disease-causing agents to remote areas of the world. Amphibians have been hit particularly hard by disease due in part to a globally distributed pathogenic chytrid fungus (Batrachochytrium dendrobatidis [Bd]). Prior research has revealed important insights into the biology and distribution of Bd; however, there are still many outstanding questions in this system. Although we know that there are multiple divergent lineages of Bd that differ in pathogenicity, we know little about how these lineages are distributed around the world and where lineages may be coming into contact. Here, we implement a custom genotyping method for a global set of Bd samples. This method is optimized to amplify and sequence degraded DNA from noninvasive skin swab samples. We describe a divergent lineage of Bd, which we call BdASIA3, that appears to be widespread in Southeast Asia. This lineage co-occurs with the global panzootic lineage (BdGPL) in multiple localities. Additionally, we shed light on the global distribution of BdGPL and highlight the expanded range of another lineage, BdCAPE. Finally, we argue that more monitoring needs to take place where Bd lineages are coming into contact and where we know little about Bd lineage diversity. Monitoring need not use expensive or difficult field techniques but can use archived swab samples to further explore the history—and predict the future impacts—of this devastating pathogen

Conservation decisions under pressure: Lessons from an exercise in rapid response to wildlife disease

Novel outbreaks of emerging pathogens require rapid responses to enable successful mitigation. We simulated a 1‐day emergency meeting where experts were engaged to recommend mitigation strategies for a new outbreak of the amphibian fungal pathogen Batrachochytrium salamandrivorans. Despite the inevitable uncertainty, experts suggested and discussed several possible strategies. However, their recommendations were undermined by imperfect initial definitions of the objectives and scope of management. This problem is likely to arise in most real‐world emergency situations. The exercise thus highlighted the importance of clearly defining the context, objectives, and spatial–temporal scale of mitigation decisions. Managers are commonly under pressure to act immediately. However, an iterative process in which experts and managers cooperate to clarify objectives and uncertainties, while collecting more information and devising mitigation strategies, may be slightly more time consuming but ultimately lead to better outcomes

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens