Advancing Youth-Led Programs through Evaluation at Vumundzuku-bya Vana: Our Children's Future

Special Studies Experience -- Zonkizizwe, South Africa -- Summer 2015 -- Partner Agencies: Vumundzuku-bya Vana: Our Children's Futurehttp://deepblue.lib.umich.edu/bitstream/2027.42/116185/1/Poster_McCullough.pd

YOUNG ADULT BOOK COVER DESIGN AND ITS IMPACT ON READER INTEREST

A book cover is one of the first steps in selling a book and is vital in catching a reader’s attention. Still, many book covers in the young adult fiction market are ineffective at reaching their target audience. Since the birth of young adult books, cover design styles have changed drastically, yet little research has been done. Because of this lack of research, two new surveys were built to investigate what specific elements and styles of current young adult book covers appeal to readers. One survey was for readers, and one survey was for professionals working in the publishing industry. Results showed that book cover design appeal is subjective, as results were reasonably balanced across different design elements and styles

Fate of the lower extremity in patients with VA-ECMO via femoral cannulation

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Femoral cannulation is associated with limb complications including ischemia, limb loss, arterial infections and wound infections. This study aims to evaluate these complications and management related to successful outcomes. Methods: A retrospective review was conducted in 17 patients requiring VA- ECMO support via femoral cannulation from 1/ 2010 till 4/2012. After cannulation, all patients had near infared spectroscopy (NIRS) monitoring after cannula placement and most had placement of distal arterial perfusion catheters (DPC). At decannulation, all patients had femoral cutdown with closure of arteriotomies by primary repair or patch angioplasty with bovine pericardium. Primary study endpoints included ischemia, limb loss, arterial infection; secondary endpoints were wound infection and post-discharge symptoms. Results: Seventeen patients were supported with VA-ECMO during the study period with arterial cannula size of 16-20 French. All patients had NIRS monitoring after cannula placement and 13/17 patients had DPC placement, with no subsequent ischemia. Two of 4 patients without DPC developed ischemia; one was decannulated and the other resolved spontaneously. At decannulation, open arterial repair was performed as described. In this study population, simple wound infection occurred in 3/17with Vacuum Assisted Closure (VAC) devices were placed at the timed if appropriate. There were no arterial infections and no instances of limb ischemia requiring amputation. There were no complaints of rest pain during outpatient follow-up. Conclusions: Limb complications related to femoral cannulation for VA-ECMO can lead to prolonged morbidity and limb loss. NIRS and placement of DPC, primary repair of arteriotomy or patch angioplasty, along with aggressive wound care, can dramatically decrease rates of limb ischemia, limb loss and infection

Associations of Objectively Measured Light-Intensity Activity on Metabolic Risk Factors in Female Adults

Metabolic syndrome (MetSy) has been defined as a collection of metabolic irregularities that increase the risk of cardiovascular disease, type 2 diabetes, and all-cause mortality. Women are at an even greater risk for developing MetSy when compared to men with prevalence increasing with age. Moderate to vigorous physical activity (MVPA) has shown consistent association with decreases in risk of MetSy; however, light physical activity (LPA) has been studied less often in comparison. PURPOSE: The purpose of this study was to examine relationships between accelerometer-determined LPA and MetSy risk factors (waist circumference (WC), glucose, high density lipoprotein (HDL), triglycerides, systolic blood pressure (SBP), and diastolic blood pressure (DPB)) across women of different age groups. METHODS: A cross-sectional study design was used to examine 68 female participants, ages 20-65, employed in sedentary careers working in an urban area in the south central United States. Venous blood samples were taken from the antecubital area of the arm from all participants who had fasted at least eight hours prior to their scheduled appointment times. Physical activity data was collected for seven days via hip-worn accelerometers with LPA being measured based on Freedson cut-points (100-1951 counts per minute). MetSy was diagnosed based on the criteria set forth by the National Cholesterol Education Program in 2002. Data were analyzed using regression analysis with SPSS version 20.0. Between-subject analysis was conducted for four age groups (group1=20-35; group2=36-45; group3=46-55; group4=55 and older) using LPA, WC, glucose, HDL, triglycerides, SBP, and DPB. RESULTS: Between-subject regression analysis showed HDL as a significant MetSy risk factor in a full model (p=0.02) and a model with age groups as the only independent variable (p=0.00). Post-hoc Tukey tests showed significance differences in HDL among groups 4 and 2 (confidence interval (CI): 4.03, 35.92; p=0.00), and groups 4 and 3 (CI: 6.06, 39.63; p=0.00). Significance dropped below the apriori level of 0.05 in a model based on LPA. Post-hoc Tukey tests revealed non-significant (α\u3e0.05) associations between LPA levels (high, medium, low) and all MetSy values. CONCLUSION: The relationship between LPA and MetSy risk factors has been studied less frequently than MVPA in relation to MetSy risk factors. Based on these findings LPA is not significantly related with these risk factors. Future studies should continue to explore the relationship between LPA and MetSy risk factors among both men and woman, and in different settings

Organizational Characteristics of High- and Low-Clozapine-Utilization Clinics in the Veterans Health Administration

Objective: Treatment-resistance schizophrenia occurs in 20-30% of patients. Clozapine is the only medication proven effective for treatment-resistant schizophrenia. However, less than 25% of treatment-resistant schizophrenia patients receive clozapine in most settings. Therefore, this study was conducted to identify facilitators and barriers to clozapine use, to inform development of interventions to maximize appropriate clozapine-utilization. Methods: Seventy semi-structured phone interviews were conducted with five high- and five low-utilization VA Medical Centers, from different US regions including urban and rural areas. Interviewees were key informants of clozapine processes, including mental health leadership, psychiatrists, clinical pharmacists and advanced practice nurses. Interviews were analyzed using an emergent thematic strategy to identify barriers and facilitators to clozapine prescribing. Results: Key elements associated with high-utilization included integration of non-physician psychiatric providers and clear organizational processes and infrastructure for treatment of severe mental illness (e.g. clozapine clinics, larger mental health intensive case management services). Low-utilization was associated with lack of champions to support clozapine processes and limited-capacity care systems. Obstacles identified at both high- and low-utilization sites included complex time-consuming paperwork, reliance on few individuals to facilitate processes, and issues related to transportation for patients living far from care facilities. Conclusions: Implementation efforts to organize, streamline and simplify clozapine processes, development of a multidisciplinary clozapine clinic, increasing the size and capacity of existing clinics, and provision of transportation are reasonable targets to increase clozapine utilization

Graduate Student Reflections on Mentorship in a Training and Outreach Program for Families of Children with Autism Spectrum Disorder

Undergraduate (n = 19) and graduate students (n = 8) participated in a two semester training program focused on learning about Autism Spectrum Disorder (ASD) and how to create individualized communication supports for families of children with ASD. The focus of this paper is on the graduate students’ training and mentoring experiences. Graduate students’ philosophies of mentoring undergraduate students and their final reflections of the experience were analyzed for themes and subthemes. Mentoring philosophies yielded four major themes: role of the mentor, mentoring goals, the mentor-mentee relationship, and learning. Graduate student reflections on their skills gained, what they learned about themselves, their leadership, and the challenges they faced were also categorized into themes. Analyses revealed undergraduate student ratings and qualitative comments regarding graduate student support. Implications and future directions for the development of hands-on training programs allowing graduate students in Communication Sciences and Disorders to assume mentorship roles will be discussed

Anaphylatoxin Receptors C3aR and C5aR1 Are Important Factors That Influence the Impact of Ethanol on the Adipose Secretome

Background and aims: Chronic ethanol exposure results in inflammation in adipose tissue; this response is associated with activation of complement as well as the development of alcohol-related liver disease (ALD). Adipose communicates with other organs, including liver, via the release of soluble mediators, such as adipokines and cytokines, characterized as the “adipose secretome.” Here we investigated the role of the anaphaylatoxin receptors C3aR and C5aR1 in the development of adipose tissue inflammation and regulation of the adipose secretome in murine ALD (mALD).Methods: Wild-type C57BL/6 (WT), C3aR−/−, and C5aR1−/− mice were fed Lieber-DeCarli ethanol diet for 25 days (6% v/v, 32% kcal) or isocaloric control diets; indicators of inflammation and injury were assessed in gonadal adipose tissue. The adipose secretome was characterized in isolated adipocytes and stromal vascular cells.Results: Ethanol feeding increased the expression of adipokines, chemokines and leukocyte markers in gonadal adipose tissue from WT mice; C3aR−/− were partially protected while C5aR1−/− mice were completely protected. In contrast, induction of CYP2E1 and accumulation of TUNEL-positive cells in adipose in response to ethanol feeding was independent of genotype. Bone marrow chimeras, generated with WT and C5aR1−/− mice, revealed C5aR1 expression on non-myeloid cells, likely to be adipocytes, contributed to ethanol-induced adipose inflammation. Chronic ethanol feeding regulated both the quantity and distribution of adipokines secreted from adipocytes in a C5aR1-dependent mechanism. In WT mice, chronic ethanol feeding induced a predominant release of pro-inflammatory adipokines from adipocytes, while the adipose secretome from C5aR1−/− mice was characterized by an anti-inflammatory/protective profile. Further, the cargo of adipocyte-derived extracellular vesicles (EVs) was distinct from the soluble secretome; in WT EVs, ethanol increased the abundance of pro-inflammatory mediators while EV cargo from C5aR1−/− adipocytes contained a greater diversity and more robust expression of adipokines.Conclusions: C3aR and C5aR1 are potent regulators of ethanol-induced adipose inflammation in mALD. C5aR1 modulated the impact of chronic ethanol on the content of the adipose secretome, as well as influencing the cargo of an extensive array of adipokines from adipocyte-derived EVs. Taken together, our data demonstrate that C5aR1 contributes to ethanol-mediated changes in the adipose secretome, likely contributing to intra-organ injury in ALD