The development of a culturally-informed cervical cancer screening and prevention mhealth intervention for African American women.

Background: Significant strides have been made in reducing the burden of cervical cancer and HPV. Between pap smear screenings and HPV vaccinations, there has been a reduction in cervical cancer incidence in the United States. Unfortunately, those reductions have not been experienced by all ethnic groups. Cervical cancer disparities are a threat to the health of African American women, and innovation in education and the healthcare experience is needed to eliminate this threat. This study aimed to develop and evaluate a culturally tailored intervention using mHealth services to improve cervical cancer and HPV knowledge. Methods: The development and evaluation of this mHealth intervention involved two phases. The first phase included the culturally tailoring of health messages using a community advisory board of African American women. By meeting in person and virtually, the women were able to tailor twenty-four messages to be disseminated using mHealth. The second phase of this study involved testing of the intervention and evaluation. African American women were recruited and then assessed on their baseline knowledge of cervical cancer and their experiences of discrimination in medical settings. Participants were then assigned to either the control or intervention group. Those in the intervention group received health messages three times a week for four weeks on their mobile phones. After four weeks had passed, both the control and intervention group were reassessed on their cervical cancer knowledge. mHealth was evaluated for its acceptability, appropriateness, and feasibility using three evaluation measures and qualitative interviews. Results: Forty-eight women were recruited for this study, with non-random assignment of twenty-five to the intervention group and twenty-three to the control. The baseline scores on the cervical cancer awareness measure indicated a need for education in both groups. Additionally, all participants expressed having experienced some form of discrimination in medical settings. Using a paired-samples t-test the complete-case analysis shows an improvement in cervical cancer knowledge for women in the intervention group. Conclusions: mHealth intervention shows potential in educating African American women about cervical cancer and HPV. Using mobile phone technology allowed the women to be educated at their convenience and to return to the material later. Future research and practice should consider using the mHealth intervention with hard-to-reach populations or as educational material along with appointment reminders

Transformational Intervention for Principal Leadership (TrIPLe): A Feasibility Study of an Innovative Professional Development Workshop for Principals of Schools with Exclusionary Discipline

As leaders in schools, principals are responsible for ensuring that all students have equal access to a high-quality education, that faculty and staff are supported and provided opportunities to grow professionally, and that their school environment is equipped to adequately meet the needs of all students. Principals’ responsibilities compel them to critically evaluate and change ineffective educational policies and practices that create negative consequences for students and negative work environments for their faculty and staff. Transformational leadership is a broad perspective that describes how leaders inspire their followers to perform beyond expectation to carry out significant changes in organizations. Research shows that principals’ transformational leadership practices and behaviors positively influence their relationships with teachers, teachers’ attitudes and ability to become active problem-solvers in their schools, and their schools’ overall climate. These elements are all needed to transform ineffective school policies and practices, such as zero tolerance policies and exclusionary discipline practices. Numerous studies have shown that zero tolerance policies and exclusionary discipline practices in schools are ineffective as they do not deter student misbehavior but instead have negative academic and social-emotional consequences for students, contribute to racial disparities in disciplinary outcomes, and lead to antagonistic relationships between faculty and students. Research demonstrates that in schools with principals who have more favorable attitudes toward school exclusion, students are more likely to receive out-of-school suspension and expulsion. Because zero tolerance and exclusionary discipline are ineffective disciplinary policies and practices that lead to inequitable educational opportunities for minority students and negative school climates, principals must address the use of these discipline methods in their schools. This study investigates a novel professional development workshop, Transformational Intervention for Principal Leadership (TrIPLe), that seeks to decrease elementary and middle school principals’ over-reliance on zero tolerance policies and overuse of exclusionary discipline practices. The current study aims to determine TrIPLe’s feasibility and acceptability for future implementation in a school district by using the Delphi method to collect qualitative and quantitative data from members of three groups directly involved in TrIPle’s implementation: elementary and middle school principals, school psychologists, and business leaders.Doctor of Philosoph

Simulación computacional de procesos de producción, caso de estudio: Proceso de producción de queso en la planta de lácteos FCP-ESPOCH

La simulación es una poderosa técnica para la resolución de problemas al imitar el comportamiento de los sistemas del mundo real, por lo que es aplicable a un sinnúmero de campos como la estadí­stica, la economí­a, la fí­sica, o la industria en donde principalmente se aplica en el desarrollo de un proyecto cientí­fico orientado a la optimización de los procesos de producción de una lí­nea de fábrica que requiere de un estudio profundo de los parámetros, variables, constantes, y procedimientos que intervienen en su funcionamiento. Este documento, presenta un estudio del proceso de producción de queso de la planta de lácteos FCP-ESPOCH (Facultad de Ciencias Pecuarias – Escuela Superior Politécnica de Chimborazo) a través de la teorí­a de colas, con el objetivo de generar un modelo de simulación computacional que represente lo más fielmente posible a los procesos de producción de la planta y se convierta en una herramienta de apoyo a la toma de decisiones y experimentación de los elementos del sistema. Para ello, se ha seguido una metodologí­a que orienta la realización de los siguientes pasos: formulación del problema; recolección de datos y análisis; identificación de los modelos matemáticos; desarrollo del modelo computacional de simulación; y validación del modelo de simulación. Los resultados del análisis de las variables: recepción diaria de leche cruda (entrada), y producción diaria de queso (salida) arrojaron que: el modelo de simulación computacional es válido para la experimentación sobre el proceso de producción de queso de la planta de lácteos FCP-ESPOCH

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER): a protocol for a program of research

Abstract Background The Enhancing Mental and Physical health of Women through Engagement and Retention or EMPOWER program represents a partnership with the US Department of Veterans Health Administration (VA) Health Service Research and Development investigators and the VA Office of Women’s Health, National Center for Disease Prevention and Health Promotion, Primary Care-Mental Health Integration Program Office, Women’s Mental Health Services, and the Office of Patient Centered Care and Cultural Transformation. EMPOWER includes three projects designed to improve women Veterans’ engagement and retention in evidence-based care for high-priority health conditions, i.e., prediabetes, cardiovascular, and mental health. Methods/Design The three proposed projects will be conducted in VA primary care clinics that serve women Veterans including general primary care and women’s health clinics. The first project is a 1-year quality improvement project targeting diabetes prevention. Two multi-site research implementation studies will focus on cardiovascular risk prevention and collaborative care to address women Veterans’ mental health treatment needs respectively. All projects will use the evidence-based Replicating Effective Programs (REP) implementation strategy, enhanced with multi-stakeholder engagement and complexity theory. Mixed methods implementation evaluations will focus on investigating primary implementation outcomes of adoption, acceptability, feasibility, and reach. Program-wide organizational-, provider-, and patient-level measures and tools will be utilized to enhance synergy, productivity, and impact. Both implementation research studies will use a non-randomized stepped wedge design. Discussion EMPOWER represents a coherent program of women’s health implementation research and quality improvement that utilizes cross-project implementation strategies and evaluation methodology. The EMPOWER Quality Enhancement Research Initiative (QUERI) will constitute a major milestone for realizing women Veterans’ engagement and empowerment in the VA system. EMPOWER QUERI will be conducted in close partnership with key VA operations partners, such as the VA Office of Women’s Health, to disseminate and spread the programs nationally. Trial registration The two implementation research studies described in this protocol have been registered as required: Facilitating Cardiovascular Risk Screening and Risk Reduction in Women Veterans: Trial registration NCT02991534 , registered 9 December 2016. Implementation of Tailored Collaborative Care for Women Veterans: Trial registration NCT02950961 , registered 21 October 2016

Differential Genetic Susceptibility to Child Risk at Birth in Predicting Observed Maternal Behavior

This study examined parenting as a function of child medical risks at birth and parental genotype (dopamine D4 receptor; DRD4). Our hypothesis was that the relation between child risks and later maternal sensitivity would depend on the presence/absence of a genetic variant in the mothers, thus revealing a gene by environment interaction (GXE). Risk at birth was defined by combining risk indices of children's gestational age at birth, birth weight, and admission to the neonatal intensive care unit. The DRD4-III 7-repeat allele was chosen as a relevant genotype as it was recently shown to moderate the effect of environmental stress on parental sensitivity. Mothers of 104 twin pairs provided DNA samples and were observed with their children in a laboratory play session when the children were 3.5 years old. Results indicate that higher levels of risk at birth were associated with less sensitive parenting only among mothers carrying the 7-repeat allele, but not among mothers carrying shorter alleles. Moreover, mothers who are carriers of the 7-repeat allele and whose children scored low on the risk index were observed to have the highest levels of sensitivity. These findings provide evidence for the interactive effects of genes and environment (in this study, children born at higher risk) on parenting, and are consistent with a genetic differential susceptibility model of parenting by demonstrating that some parents are inherently more susceptible to environmental influences, both good and bad, than are others

Visualization and Identification of IL-7 Producing Cells in Reporter Mice

Interleukin-7 (IL-7) is required for lymphocyte development and homeostasis although the actual sites of IL-7 production have never been clearly identified. We produced a bacterial artificial chromosome (BAC) transgenic mouse expressing ECFP in the Il7 locus. The construct lacked a signal peptide and ECFP (enhanced cyan fluorescent protein ) accumulated inside IL-7-producing stromal cells in thoracic thymus, cervical thymus and bone marrow. In thymus, an extensive reticular network of IL-7-containing processes extended from cortical and medullary epithelial cells, closely contacting thymocytes. Central memory CD8 T cells, which require IL-7 and home to bone marrow, physically associated with IL-7-producing cells as we demonstrate by intravital imaging