From Particularities to Context: Refining Our Thinking on Illness Narratives.

This paper examines how illness narratives are used in medical education and their implications for clinicians' thinking and care of patients. Ideally, collecting and reading illness narratives can enhance clinicians' sensitivity and contextual thinking. And yet these narratives have become part of institutionalizing cultural competency requirements in ways that tend to favor standardization. Stereotyping and reductionistic thinking can result from these pedagogic approaches and obscure structural inequities. We end by asking how we might best teach and read illness narratives to fulfill the ethical obligations of listening and asking more informative clinical interview questions that can better meet the needs of patients and the community

Serious Games for Public Safety: How Gamified Education Can Teach Ontarians Emergency Preparedness

According to the Canadian Emergencies act, a national emergency is an urgent, critical situation that threatens the health and safety of Canadians (Department of Justice of Canada, 2022). Emergencies can also take on many forms: pandemics, natural disasters, civil unrest, or armed conflict. Currently, the Provincial Emergency Response Plan implemented by the Chief of Emergency Management Ontario is the framework that keeps Ontarians safe, allowing for organizations and municipalities to organize disaster relief, send out emergency alerts, and educate Ontario residents on emergency preparedness (PERP, 2019). This paper explores how serious games can prepare the public for emergencies based on response frameworks currently in use in metropolitan Ontario, Canada (cities such as Toronto, Ottawa, and Hamilton). This example was selected because it represents modern urban settings that require response plans and provides a framework that can be used to elaborate on. This paper will present the positive features of serious game applications concerning public safety and emergency management education. Case studies of serious game applications currently used for public health and safety purposes will be examined. Serious games may be a useful instrument for public safety education to enhance existing emergency preparedness and public safety education frameworks

A Lagrangian formulation for the Oldroyd B fluid and the second principle of thermodynamics

We show that the Oldroyd B fluid model is the Eulerian form of a Lagrangian model with an internal variable that satisfies the second principle of thermodynamics under some conditions on the initial value of the internal variable. We similarly derive a compressible version of the Oldroyd B model and several nonlinear versions thereof. We also derive Lagrangian formulations of the Zaremba-Jaumann and Oldroyd A fluid models. We discuss whether or not these new models satisfy the second principle

The Difficult-to-Control Asthmatic: A Systematic Approach

With the judicious use of inhaled corticosteroids, β2 agonists, and leukotriene modifiers, most patients with asthma are easily controlled and managed. However, approximately 5% of asthmatics do not respond to standard therapy and are classified as "difficult to control." [1] Typically, these are patients who complain of symptoms interfering with daily living despite long-term treatment with inhaled corticosteroids in doses up to 2,000 μg daily. Many factors can contribute to poor response to conventional therapy, and especially for these patients, a systematic approach is needed to identify the underlying causes. First, the diagnosis of asthma and adherence to the medication regimen should be confirmed. Next, potential persisting exacerbating triggers need to be identified and addressed. Concomitant disorders should be discovered and treated. Lastly, the impact and implications of socioeconomic and psychological factors on disease control can be significant and should be acknowledged and discussed with the individual patient. Less conventional and novel strategies for treating corticosteroid-resistant asthma do exist. However, their use is based on small studies that do not meet evidence-based criteria; therefore, it is essential to sort through and address the above issues before reverting to other therapy

MET Alterations Are Associated With Osimertinib Resistance in EGFR Mutant Lung Cancers, a Meta-Analysis

Osimertinib is a third-generation tyrosine kinase inhibitor (TKI) that has been used to treat EGFR mutant lung cancers, especially those with EGFR T790M mutation. Resistance to osimertinib is likely associated with acquired genetic alterations in these cancer cells. Mesenchymal epithelial transition (MET) is a tyrosine kinase and its amplification is frequently seen in osimertinib resistant patients. To investigate whether the presence of MET alteration is associated with osimertinib resistance, a meta-analysis was conducted using published observations of EGFR mutant lung cancer patients treated with osimertinib. Frequencies of MET alterations are variable, ranging from 0-43% in osimertinib resistant patients. MET alteration is predominantly amplification, although missense mutation is seen in a few cases. Majority of the MET alterations are acquired following osimertinib treatment. Individual progression free survivals are available in two studies, and the presence of MET alteration is associated with PFS shorter than 12 months (p=0.01). These findings suggest monitoring MET alterations in osimertinib treated patient may predict resistance. With appropriate adjustment of treatment, better outcomes are likely to be achieved

Les savoirs d’expérience : un outil d’affranchissement potentiel au service du développement du pouvoir d’agir des personnes et des collectivités ?

Cet article propose des modalités pour une articulation des savoirs pratiques et professionnels dans des contextes d’apprentissage et d’intervention sociale. Car les savoirs d’expériences des professionnels peuvent être envisagés comme un ensemble d’outils supplémentaires qui visent à faciliter l’adaptation des personnes aidées. Il s’agit d’insister sur l’importance de la contribution des personnes aidées à la définition du problème et des solutions. L’article montre aussi que l’application des savoirs pratiques ne peut être appréhendée indépendamment des contextes dans lesquels l’intervenant évolue. Il examine enfin les rapports entre la prise en compte des savoirs d’expériences et le développement du pouvoir d’agir des personnes aidées.This article presents various modalities to help articulate practical and professional knowledge in learning and social intervention contexts. Experiential knowledge of professionals can be envisaged as a set of supplementary tools used to facilitate the adaptation of those being helped. The authors point out the importance of these recipients’ contribution to the problem definition and to the solutions. The article shows that the application of practical knowledge cannot be understood independently of the contexts within which the professional evolves. Finally, they examine the link between experiential knowledge and the development of recipients’ empowerment.Este artículo propone modalidades para una articulación de los saberes prácticos y profesionales en contextos de aprendizaje y de intervención social. Pues los saberes experienciales de los profesionales pueden ser contemplados como un conjunto de herramientas adicionales que tiende a facilitar la adaptación de las personal ayudadas. Se trata de insistir sobre la importancia de la contribución de las personas ayudadas a la definición del problema «y» de soluciones. Asimismo el artículo muestra que la aplicación de saberes prácticos no puede ser aprehendida independientemente de los contextos en los cuales el interviniente se desarrolla. Por terminar examina los vínculos entre la toma en cuenta de los saberes experienciales y el desarrollo del poder de actuar de las personas ayudadas

Resource competition affects plankton community structure; evidence from trait-based modeling

Understanding the phenology of phytoplankton species is a challenge and despite a lot of theoretical work on competition for resources, this process is under-represented in deterministic models. To study the main driver of the species selection, we used a trait-based model that keeps phenotypic variability through physiological trait parameterization. Next, we validated the results by using the toxic dinoflagellate Alexandrium minutum which is a toxic species. Due to their monitoring, we show that harmful algae are ideal models for studying ecological niches and for contributing to this more global challenge. As a first step, a dimensionless model of an estuary (France) was built with water temperature and water exchanges deduced from a hydro-dynamic model. The biological parametrization takes into account the size (from pico- to microphytoplankton) and the type of assimilation. The results show that temperature, competition for nutrients and dilution are important factors regulating the community structure and Alexandrium minutum dynamics (more especially the bloom initiation and magnitude). These drivers contribute to the determination of the ecological niche of A. minutum, influence the shape of its blooms and provide potential explanations of its interannual variability. This approach makes the community structure more flexible in order to study how environmental forcings could drive its evolution

Occurrence of Kanamycin-Resistant Bacteria Relative to Anthropogenic Pollution Along Richland Creek in Nashville, TN​

The overuse of antibiotics has caused an increase in antibiotic-resistant (AR) bacteria, which is a serious public health concern. Previous studies showed a significant correlation between anthropogenic pollution and AR bacteria. This project aims to identify AR bacteria in Richland Creek relative to local anthropogenic pollution. Water samples were collected at four locations along Richland Creek in Nashville, Tennessee. Bacteria resistant to the antibiotic kanamycin were isolated from the water samples, identified to genera using DNA barcoding, and compared among the sites. We expect to see a greater abundance and diversity of kanamycin-resistant bacteria closer to the end than near the head of the creek. This research project can help describe the diversity of AR bacteria species present in the stream in different areas of Nashville and has public health consequences if the disparities in the distribution of AR bacteria correlate to human activity and/or socioeconomic differences along the stream

Développer le pouvoir d’agir des personnes et des collectivités : Quelques enjeux relatifs à l’identité professionnelle et à la formation des praticiens du social

L’application de la notion d’empowerment au champ des pratiques sociales comporte de nombreux défis théoriques et pratiques. À la suite d’une publication antérieure dans laquelle il est proposé de circonscrire ce phénomène au développement d’un pouvoir d’agir (DPA) des personnes et des collectivités, nous suggérons ici quelques points de repère conceptuels susceptibles de faciliter le développement de cette perspective d’intervention.The application of the concept of empowerment into social practice involves a lot of theoretical and practical challenges. In a previous article, we proposed a conceptual translation of this phenomena called “développement du pouvoir d’agir (DPA) des personnes et des collectivités”. In this paper, we suggest some new conceptual guide marks which could help the empowerment practice

Anti-Asian Bullying and Harassment: Symptoms of racism in K-12 schools during COVID-19

The COVID-19 pandemic has posed many challenges for K-12 students. However, these challenges have not been experienced equally across student groups. There has been a significant increase in mainstream media coverage of anti-Asian racism, but very little attention has been given to Asian American youth, who are not immune from incidents of bullying and harassment in our K-12 schools. This brief discusses how Asian American and Pacific Islander (AAPI)1 students face unique challenges associated with bullying and harassment because of their racial and ethnic identity. We examine the historical context of bullying and harassment of Asian Americans and how that persists as anti-Asian racism today. Finally, we propose policy solutions to create a more positive learning environment and address racist attitudes towards this specific community. Notably, we propose that K-12 leaders disaggregate data by ethnic subgroup, collect more comprehensive data on school bullying, harassment, and victimization disaggregated by AAPI ethnic subgroups, and invest in culturally sustaining mental health resources and curriculum