Ultrastructural alterations in adult Schistosoma mansoni caused by artemether

Progress has been made over the last decade with the development and clinical use of artemether as an agent against major human schistosome parasites. The tegument has been identified as a key target of artemether, implying detailed studies on ultrastructural damage induced by this compound. We performed a temporal examination, employing a transmission electron microscope to assess the pattern and extent of ultrastructural alterations in adult Schistosoma mansoni harboured in mice treated with a single dose of 400 mg/kg artemether. Eight hours post-treatment, damage to the tegument and subtegumental structures was seen. Tegumental alterations reached a peak 3 days after treatment and were characterized by swelling, fusion of distal cytoplasma, focal lysis of the tegumental matrix and vacuolisation. Tubercles and sensory organelles frequently degenerated or collapsed. Typical features of subtegumental alterations, including muscle fibres, syncytium and parenchyma tissues, were focal or extensive lysis, vacuolisation and degeneration of mitochondria. Severe alterations were also observed in gut epithelial cells and vitelline cells of female worms. Our findings of artemether-induced ultrastructural alterations in adult S. mansoni confirm previous results obtained with juvenile S. mansoni and S. japonicum of different ages.

Characteristics and effectiveness of diabetes self-management educational programs targeted to racial/ethnic minority groups: a systematic review, meta-analysis and meta-regression.

BACKGROUND It is not clear to what extent educational programs aimed at promoting diabetes self-management in ethnic minority groups are effective. The aim of this work was to systematically review the effectiveness of educational programs to promote the self-management of racial/ethnic minority groups with type 2 diabetes, and to identify programs' characteristics associated with greater success. METHODS We undertook a systematic literature review. Specific searches were designed and implemented for Medline, EMBASE, CINAHL, ISI Web of Knowledge, Scirus, Current Contents and nine additional sources (from inception to October 2012). We included experimental and quasi-experimental studies assessing the impact of educational programs targeted to racial/ethnic minority groups with type 2 diabetes. We only included interventions conducted in countries members of the OECD. Two reviewers independently screened citations. Structured forms were used to extract information on intervention characteristics, effectiveness, and cost-effectiveness. When possible, we conducted random-effects meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. Two reviewers independently extracted all the information and critically appraised the studies. RESULTS We identified thirty-seven studies reporting on thirty-nine educational programs. Most of them were conducted in the US, with African American or Latino participants. Most programs obtained some benefits over standard care in improving diabetes knowledge, self-management behaviors and clinical outcomes. A meta-analysis of 20 randomized controlled trials (3,094 patients) indicated that the programs produced a reduction in glycated hemoglobin of -0.31% (95% CI -0.48% to -0.14%). Diabetes knowledge and self-management measures were too heterogeneous to pool. Meta-regressions showed larger reduction in glycated hemoglobin in individual and face to face delivered interventions, as well as in those involving peer educators, including cognitive reframing techniques, and a lower number of teaching methods. The long-term effects remain unknown and cost-effectiveness was rarely estimated. CONCLUSIONS Diabetes self-management educational programs targeted to racial/ethnic minority groups can produce a positive effect on diabetes knowledge and on self-management behavior, ultimately improving glycemic control. Future programs should take into account the key characteristics identified in this review.

Blood pressure loci identified with a gene-centric array.

Raised blood pressure (BP) is a major risk factor for cardiovascular disease. Previous studies have identified 47 distinct genetic variants robustly associated with BP, but collectively these explain only a few percent of the heritability for BP phenotypes. To find additional BP loci, we used a bespoke gene-centric array to genotype an independent discovery sample of 25,118 individuals that combined hypertensive case-control and general population samples. We followed up four SNPs associated with BP at our p < 8.56 × 10(-7) study-specific significance threshold and six suggestively associated SNPs in a further 59,349 individuals. We identified and replicated a SNP at LSP1/TNNT3, a SNP at MTHFR-NPPB independent (r(2) = 0.33) of previous reports, and replicated SNPs at AGT and ATP2B1 reported previously. An analysis of combined discovery and follow-up data identified SNPs significantly associated with BP at p < 8.56 × 10(-7) at four further loci (NPR3, HFE, NOS3, and SOX6). The high number of discoveries made with modest genotyping effort can be attributed to using a large-scale yet targeted genotyping array and to the development of a weighting scheme that maximized power when meta-analyzing results from samples ascertained with extreme phenotypes, in combination with results from nonascertained or population samples. Chromatin immunoprecipitation and transcript expression data highlight potential gene regulatory mechanisms at the MTHFR and NOS3 loci. These results provide candidates for further study to help dissect mechanisms affecting BP and highlight the utility of studying SNPs and samples that are independent of those studied previously even when the sample size is smaller than that in previous studies.

War and National Renewal: Civil Religion and Blood Sacrifice in American Culture

Wars are often associated with a rhetoric of renewal or new beginnings. This essay explores this claim through the lens of civil religion and a recent book by Carolyn Marvin and David Ingle, Blood Sacrifice and the Nation, which combines Emile Durkheim with Réné Girard in proposing that modern national cohesion depends on blood sacrifice. I unpack some of the paradoxes raised by this theory of national renewal in the context of 9/11, with a special focus on the sacred status of the flag and the special attention given to uniformed serviceman in the American body politic.

Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption

Coffee, a major dietary source of caffeine, is among the most widely consumed beverages in the world and has received considerable attention regarding health risks and benefits. We conducted a genome-wide (GW) meta-analysis of predominately regular-type coffee consumption (cups per day) among up to 91 462 coffee consumers of European ancestry with top single-nucleotide polymorphisms (SNPs) followed-up in ~30 062 and 7964 coffee consumers of European and African-American ancestry, respectively. Studies from both stages were combined in a trans-ethnic meta-analysis. Confirmed loci were examined for putative functional and biological relevance. Eight loci, including six novel loci, met GW significance (log10Bayes factor (BF)>5.64) with per-allele effect sizes of 0.03-0.14 cups per day. Six are located in or near genes potentially involved in pharmacokinetics (ABCG2, AHR, POR and CYP1A2) and pharmacodynamics (BDNF and SLC6A4) of caffeine. Two map to GCKR and MLXIPL genes related to metabolic traits but lacking known roles in coffee consumption. Enhancer and promoter histone marks populate the regions of many confirmed loci and several potential regulatory SNPs are highly correlated with the lead SNP of each. SNP alleles near GCKR, MLXIPL, BDNF and CYP1A2 that were associated with higher coffee consumption have previously been associated with smoking initiation, higher adiposity and fasting insulin and glucose but lower blood pressure and favorable lipid, inflammatory and liver enzyme profiles (P<5 × 10-8).Our genetic findings among European and African-American adults reinforce the role of caffeine in mediating habitual coffee consumption and may point to molecular mechanisms underlying inter-individual variability in pharmacological and health effects of coffee.

Potential health-care service utilization substitution effects induced by case management for emergency department frequent users

BACKGROUND: In most of the emergency departments (ED) in developed countries, a subset of patients visits the ED frequently. Despite their small numbers, these patients are the source of a disproportionally high number of all ED visits, and use a significant proportion of healthcare resources. They place a heavy economic burden on hospital and healthcare systems budgets overall. Several interventions have been carried out to improve the management of these ED frequent users. Case management has been shown in some North American studies to reduce ED utilization and costs. In these studies, cost analyses have been carried out from the hospital perspective without examining the costs induced by healthcare consumed in the community. However, case management might reduce ED visits and costs from the hospital's perspective, but induce substitution effects, and increase health service utilization outside the hospital. This study examined if an interdisciplinary case-management intervention-compared to standard ED care -reduced costs generated by frequent ED users not only from the hospital perspective, but also from the healthcare system perspective-that is, from a broader perspective taking into account the costs of healthcare services used outside the hospital. METHODS: In this randomized controlled trial, 250 adult frequent emergency department users (5 or more visits during the previous 12 months) who visited the ED of the University Hospital of Lausanne, Switzerland, between May 2012 and July 2013 were allocated to one of two groups: case management intervention (CM) or standard ED care (SC), and followed up for 12 months. Depending on the perspective of the analysis, costs were evaluated differently. For the analysis from the hospital's perspective, the true value of resources used to provide services was used as a cost estimate. These data were obtained from the hospital's analytical accounting system. For the analysis from the health-care system perspective, all health-care services consumed by users and charged were used as an estimate of costs. These data were obtained from health insurance providers for a subsample of participants. To allow comparisons in a same time period, individual monthly average costs were calculated. Multivariate linear models including a fixed effect "group" were run using socio-demographic characteristics and health-related variables as controlling variables (age, gender, educational level, citizenship, marital status, somatic and mental health problems, and risk behaviors).

Self-directed learning, stress and the adult learner /

The purpose of this correlational study was to investigate the relationship between the degree of self-directed learning readiness and stress for level one nursing students and level two nursing students. One hundred female nursing students participated in the study who were attending an Ontario Community College. Data were collected from the main nursing campus and the satellite nursing campus using the random sample method. Instruments used were said to be valid and reliable for testing self-directed learning readiness and stress respectively. Data were analyzed using frequency response to each item, means and standard deviation, and the Pearson product correlation between selfdirected learning readiness and stress. The results of the study show that there is a difference in the relationship between the degree of self-directed learning readiness and stress between the level one nursing students and the level two nursing students. Such results will be of particular interest to nursing instructors and administrators when planning for delivery of programs to such students.

Learning English as an adult: a narrative of women's improvised and empowered lives /

This thesis is a narrative inquiry of learning English as an adult. It stories the journey of 7 women, including me, and unravels lived experiences that serve as learning models. Learning English as an adult presents challenges and results in lifelong implications both in personal and professional life. Every learner's experience is imique and, when reflected upon, each experience is a valuable source of knowledge for constructing meanings and forging new identities. The stories are testimony to the participants' lives: interrupted yet improvised, silenced yet roused, dependent yet independent, intimidated yet courageous, vulnerable yet empowered. The personal experiences elucidate the passion, the inner voices, the dreams, and the rewards that compel persistence in learning a new language and releaming new social roles. The stories provide encouragement and hope to other women who are learning or will learn English in their adult years, and the lived experiences will offer insights for English language teachers. This thesis employs the phenomenology methodology of research with heuristic (discovery) and hermeneutical (interpretative) approaches using the reflective-responsivereflexive writing and interviewing methods for data gathering and unravelling. The narrative inquiry approach reaffirms that storytelling is an important tool in conducting research and constructing new knowledge. This thesis narrates a new story about sharing experiences, interconnecting, and continuing to learn.

The only child grows up: exploring adult only-child educators /

The purpose of this study was to examine the experiences of adult only-child educators. The researcher explored the extent to which the experiences of growing up in a one-child family influenced the participants' professional experiences. This was a qualitative study. A narrative case study approach was used, and data were collected from 4 participants through 1 -to- 1 interviews. The narratives were analyzed, and common themes were identified. The findings showed that many of the participants' only-child experiences have influenced their professional roles as educators. This was largely with respect to their interactions with students. These participants valued positive relationships founded on genuine care and concern for their students. The participants also fostered a positive educational environment that provided high levels of support for the social learning and character development of their students. There are several implications for educational practice resulting from this study. Educators and other school personnel must be critically aware of meeting the socialization needs of their students. Consideration must be given to developing schoolwide initiatives related to the social skills development and character education of students. In addition, preservice and inservice teacher education programs must ensure that educators are prepared to provide rich environments where relationships with students are central and social learning opportunities are prevalent.

Dialogue journal writing: a tool for critical reflection in the adult ESL learner

This study attempted to determine whether or not dialogue journal writing encouraged critical reflection in the adult ESL (English as a Second Language) learner. According to research in adult education and anecdotal evidence, the process ofdialogue journal writing can facilitate critical reflection in the adult learner. However, little research has been conducted to examine whether or not journal writing can facilitate critical reflection in the second language learner. As a result, ten low-intermediate level adult ESL students from Brock University's Intensive English Language Programme participated in a dialogue journal writing programme in their writing class. The participants wrote journal entries over a 10-week period, and were interviewed once throughout the process to determine their perceptions ofthe journal writing experience. They also were observed by the researcher throughout the journal writing sessions to establish whether any behaviours or intrusions might affect the participants' writing processes. After the content ofthe journals and the interviews, and the observations made by the researcher were analysed, it was confirmed that, for these participants, dialogue journal writing did not necessarily encourage critical reflection. Moreover, the participants' perceptions ofjournal writing were that it helped them to practise the syntax, vocabulary, and rhetorical patterns ofEnglish; nevertheless, it did not foster critical reflection or thinking.

The transformation of teachers: an adult learning approach

The study focused on the teacher as an adult learner rather than an instructor. A sample of three hundred and three elementary school teachers completed a two-part Likert survey questionnaire. The instrument was developed by the researcher in an attempt to operationalize Mezirow's Theory of Perspective Transformation. The four sub-scales collected information about teachers as they perceived themselves as adult learners and the way they conceptualize critical SelfReflection, Meaning perspectives and New Insights (Mezirow, 1978, 1981, 1989, 1990) within a framework of Mezirow's concept of Transformative Learning. Survey research methodology was used. Frequency distributions, means, and standard deviation were calculated. Reliability analysis and Pearson 'r' correlations established the internal consistency of items It Cross tabulations to describe differences in responses across demographic valuables were computed. The survey results indicated that teachers perceived themselves as self-directed learners. The findings support the need for a better understanding of the teacher as an adult learner so that teacher inservice programs and teacher supervision and evaluation can provide a viable learning alternative to the existing models used in practice.

Adult perceptions of student involvement in schoolyard gardening /

The purpose of this research is to investigate through adult perceptions what factors have enabled and limited student participation in schoolyard gardening, and how to support student involvement in schoolyard gardening. It is a collective case study of three schools in the Toronto District School Board (TDSB, Ontario, Canada) that are currently running a schoolyard gardening project. Sixteen interviews were conducted during May and June, 2005, and photos of the three schoolyard gardens were taken. The results show that the common factors that have enabled student participation in schoolyard gardening at the three schools are teacher's initiative and commitment, principal's leadership and support, parental involvement and donations, and the TDSB's EcoSchools program and workshops. The common limiting factors are time, money, and the unions' "work-to-rule" issue. The ways to support student involvement include teachers integrating the gardening into the curriculum; parents making donations to the school and creating a family gardening culture; principals supporting in money or budget and taking the lead; the TDSB providing funding, awards, incentives, and more maintenance; and the Ontario Ministry of Education supplying funding, curriculum link, and teacher training.

Adult Participants’ Experiences of a Sport Program Implementing the Easy-Play Model: Implications for an Active Lifestyle

The Easy-Play Model is a useful framework for facilitating sport among a diverse group of participants of different ages and ability levels. The model’s focus on de-emphasizing competitiveness in an effort to establish an optimally competitive environment has facilitated positive play experiences. This study investigated the experiences of players who have been a part of a weekly soccer program implementing the Easy-Play Model. In-depth interviews of 8 participants provided insight concerning the benefits and weaknesses of the approach and the notable experiences of the players. Results provided data confirming the model’s effectiveness in facilitating positive social interactions, safe play experiences where injury is generally a negligible concern, and productive opportunities to be physically active through sport. This study of the Easy-Play Model sets the foundation for future research which should further add to our understanding of productive ways to engage people in physical activity through sport.

Creating a Space for Self-Transformation: Factors of Success for Adult Literacy Learners with Specific Learning Difficulties

A significant number of adults in adult literacy programs in Ontario have specific learning difficulties. This study sought to examine the holistic factors that contributed to these learners achieving their goals. Through a case study design, the data revealed that a combination of specific learning methods and strategies, along with particular characteristics of the instructor, participant, and class, and the evidence of self-transformation all seemed to contribute to the participant's success in the program. Instructor-directed teaching and cooperative learning were the main learning methods used in the class. General learning strategies employed were the use of core curriculum and authentic documents, and using phonics, repetition, assistive resources, and using activities that appealed to various learning styles. The instructor had a history of both professional development in the area of learning disabilities as well as experience working with learners who had specific learning difficulties. There also seemed to be a goodness of fit between the participant and the instructor. Several characteristics of the participant seemed to aid in his success: his positive self-esteem, self-advocacy skills, self-determination, self-awareness, and the fact that he enjoyed learning. The size (3-5 people) and type of class (small group) also seemed to have an impact. Finally, evidence that the participant went through a self-transformation seemed to contribute to a positive learner identity. These results have implications for practice, theory, and further research in adult education.

Imagery, Technology, and Remote Adult Aboriginal Teacher Candidates: A Brock University Pilot Project

The aim of this thesis is to explore the relationship between imagery, technology, and remote adult Aboriginal teacher candidates through the computer software Elluminate Live. It focuses on the implications that the role imagery plays in third generation distance education with these learners and the new media associated therein. The thesis honours the Medicine Wheel teachings and is presented within this cyclical framework that reflects Indigenous philosophies and belief systems. In accordance, Sharing Circle as methodology is used to keep the research culturally grounded, and tenets of narrative inquiry further support the study. Results indicate there are strong connections to curricula enhanced with imagery—most notably a spiritual connection. Findings also reveal that identity associated to geographical location is significant, as are supportive networks. Third generation distance education, such as Elluminate Live, needs to be addressed before Aboriginal communities open the doors to all it encompasses, and although previous literature peers into various elements, this study delves into why the graphical interface resonates with members of these communities. Of utmost importance is the insight this thesis lends to the pedagogy that may possibly evoke a transformative learning process contributing to the success rate of Aboriginal learners and benefit Aboriginal communities as a whole.