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Study protocol for a pragmatic, cluster, randomized controlled trial of a multifaceted fracture prevention model for long-term care: the PREVENT trial
No full textAbstract Background Each year, half of all long-term care (LTC) residents will sustain a fall, and many will sustain a fall-related fracture. Fifty percent of all fractures in this vulnerable cohort occur at the hip, which is a life-changing health event leading to hospitalization, impaired physical functioning, and increased risk of premature mortality. National osteoporosis guidelines for the prevention of fractures are not consistently used in LTC homes. Improving osteoporosis guideline implementation may prevent hip fractures and other fractures. This study will examine whether the PREVENT (Person-centered Routine fracture prEVENTion) model can reduce hip fracture rates over one year compared to usual care in LTC homes. Methods Our study design is a pragmatic, cluster, randomized controlled trial. We will recruit 122 for-profit and not-for-profit LTC homes across Ontario, Canada. Homes will be randomized in a 1:1 ratio to intervention (PREVENT model) or control (usual care) arms. Eligibility criteria include a minimum of 50 occupied beds and access to the PointClickCare (PCC) electronic medical record system. One or two local opinion leader(s) and a leadership team consisting of five to ten healthcare providers will be recruited within each LTC home to support the implementation of the fracture prevention knowledge translation (KT) intervention. Generalized estimating equations (GEE) will be used to examine the effect of the PREVENT intervention vs usual care on hip fracture incidence (primary outcome), adjusting for important resident and LTC home characteristics; and secondary outcomes, including new osteoporosis medication prescriptions, non-hip fracture rates, falls, hospitalizations, death, LTC quality indicators, pain, mobility, responsive behaviors, and healthcare utilization costs. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement was used to guide the development of this study protocol. Discussion Preventing hip fractures in LTC has significant health, economic, and personal benefits. To our knowledge, the PREVENT trial is the first KT study of its kind in LTC to measure hip fracture as the primary outcome. If the PREVENT trial successfully improves hip fracture rates, it may lead the way for implementing a standardized approach to preventing hip fractures in LTC homes across Canada and internationally. Trial registration ClinicalTrials.gov NCT04947722. Registered on July 1, 2021
AI Literacy for Student Success Series Workshop #1
No full textThis workshop introduces key approaches to engaging with generative artificial intelligence (AI) in academic contexts. Rather than emphasizing technical detail, the session focuses on how AI can be used to support critical thinking, what forms of background knowledge and lateral reading are required to effectively critique AI outputs, and how to make informed decisions about when and how to use AI responsibly. Participants will leave with practical strategies for integrating AI into their academic work in ways that are intentional, reflective, and ethically sound.
Learning Objectives
By the end of this workshop, participants will be able to:
Analyze how AI tools can support critical thinking, recognizing that information creation is a process shaped by context and purpose.
Apply background knowledge and lateral reading strategies to critique AI-generated outputs, acknowledging that authority is constructed and contextual.
Evaluate the credibility, limitations, and affordances of AI-generated content in relation to specific academic tasks.
Develop criteria for making informed, ethical decisions about when and how to use AI responsibly in academic work
Exploring the Lived Experience of Nurses’ Work–Life Balance Among Expatriate Nurses in Saudi Arabia
No full textWork–life balance remains a challenging issue for nurses across the globe and necessitates a deeper understanding. Despite the growing research studies on work–life balance in nurses, most focused on certain variables of work–life balance without exploring how nurses experience work–life balance. Similarly, researchers have called for healthcare organizations to put in place policies, programs, and initiatives to improve work–life balance in nurses (Rony et al., 2023). An understanding of how nurses experience work–life balance could enhance support for nurses, especially those who work in private hospitals in Saudi Arabia. The research question that guided this study was “What are the lived experiences of work–life balance among medical-surgical expatriate nurses working in a private hospital in Saudi Arabia?” A qualitative research approach using Interpretative Phenomenological Analysis (IPA) was used to explore the nurses’ complexities of work–life balance. An email was sent to the manager of the medical-surgical unit, explaining the research and the intent. The manager of the medical-surgical unit distributed the study information to all the nurses and provided my contact details for those willing to participate. Interested participants contacted me directly and independently to be part of the study. Seven female expatriate nurses from the medical-surgical department of Johns Hopkins Aramco Healthcare were identified through purposive sampling and participated in the research. Data were collected through semi-structured one-to-one interviews and analyzed using the six-step IPA process to create themes. The data analysis process was assisted by the data management software NVivo. Five major themes were created from the analysis of the narratives of the participants: ideal vs. real work–life balance of expatriate nurses, layers of sacrifice of expatriate nurses, expatriate nurses' experience of work–life balance, what enhances work–life balance, and the effect of work–life imbalance. The major sub-themes created included the reality that the scale of work is higher, the impact of cultural diversity, the misconception of time-off, social isolation and emptiness, as well as coping strategies. The findings from the participants highlighted what expatriate nurses wanted such as flexible scheduling, reduced working week hours, and social connections, which will enable healthcare leaders and management to develop strategies to support work–life balance for nurses. This research showed that expatriate nurses in Saudi Arabia face complex challenges when trying to navigate between work and personal life which can potentially affect their social, mental, and physical health. The findings of this study provide a strong basis for future research on the study of work–life balance of other nursing specialties and expatriate workers in the hospital. Additional studies may include the use of interventional studies to address work–life balance among expatriate nurses. Interventional studies could also be conducted to evaluate the effect of work–life balance initiatives. Likewise, future studies may include a comparison of the experience of expatriate nurses working in Johns Hopkins Aramco Healthcare to other health organizations in the Eastern Region, and in other Provinces in Saudi Arabia as well as among the other GCC countries. Future research can extend the study of work–life balance to include other expatriate nurses in other nursing specialties, other expatriate workers in the hospital, such as physicians, social workers, pharmacists, and physiotherapists
“We Don’t Tolerate it but Yes, it Does Happen”: Structural Facilitators and Barriers to Addressing Harm in Graduate Supervision
No full textEffective graduate supervision is recognized as an essential part of preparing the next generation of researchers and educators. Quality graduate supervision has been shown to contribute to graduate student satisfaction, well-being, and completion. Correspondingly, research suggests that poor supervision negatively impacts student well-being and retention. In spite of the extant research, supervisory harm is still a major problem globally and in Canadian research-intensive universities. I engaged a qualitative case study to examine the issue of graduate supervisory harm in one Canadian research-intensive university. Specifically, I sought to answer the question: to what extent do the policies and processes of the Canadian research-intensive university under study facilitate and/or limit the ability of leaders in graduate education to address harm in graduate supervision? I reviewed relevant policies, procedures, and best practice resources used by the institution under study in order to prepare for 10 semi-structured interviews with current or past leaders in graduate education who could speak to experiences at 10 of the 13 faculties involved in graduate education. Employing a critical lens, I conducted a structural analysis of my findings, concluding that addressing supervisory harm has economic, political, regulatory, cultural, and educational elements and therefore requires interventions in each of those dimensions. Key interventions include revision of student funding approaches, additional options for complaint review, changes to leader hiring practices, mobilization of faculty association members, redesign of disclosure office practices, policy updates, statistics monitoring, workload changes, formal recognition of supervision, development of a supervisory culture, faculty development for graduate supervisors and education leaders, and specific training for graduate students
Far-field boundary conditions for airfoil simulation at high angle of attack in steady, incompressible, and two-dimensional flow
No full textAbstract Accurate far-field boundary conditions (BCs) are crucial for simulating airfoils at high angles of attack, where lift and drag can be comparable and moments become significant. In this study, we investigate the effects of different BCs on a NACA 0012 airfoil in incompressible and steady flow, using the Spalart-Allmaras turbulence model at an angle of attack of 45 ∘ and a high Reynolds number. We apply the impulse form of the lift, drag, and moment equations to a control volume coincident with the square computational domain. Our results confirm that satisfying the lift equation requires modeling the airfoil as a point vortex, but they also reveal the importance of including a point source to capture significant drag effects. Omitting the point source creates artificial blockage at the domain sidewalls reminiscent of wind-tunnel blockage. A “Lagally-Filon” correction for cases with laterally-constrained BCs is derived, demonstrating that it substantially improves agreement with the wind tunnel blockage correction. While combining a point vortex and point source is consistent with both lift and drag, additional minor corrections are needed for the moment equation. These corrections may become essential for designs sensitive to aerodynamic moments, such as vertical-axis wind turbines. Overall, this work emphasizes the need for an appropriate point source term in far-field BCs to achieve more accurate airfoil simulations at high angles of attack
Integrated Transmission and Distribution Expansion Planning Considering Customer Actions and Distributed Energy Resources
No full textThe continued connection of distributed energy resources (DERs) gives rise to research into integrated transmission and distribution system planning, which coordinates the actions of transmission and distribution system planners. The existing literature on integrated system planning demonstrates that including DERs in the planning process results in system cost savings. Additionally, the literature shows that effective cost allocation can influence investment in DERs. However, to the best of our knowledge, the existing literature does not account for customer actions that determine not only the level of DER output but the underlying motivation for DER adoption. In this thesis, a planning framework is proposed that models customer DER adoption and usage decisions based on the costs they pay for electricity service. The planning framework consists of four stages: a first planning stage, a cost allocation stage, a customer decisions stage, and a second planning stage. The framework is tested on a 36-bus system, and the results indicate that incorporating customer decisions into an integrated planning model can lead to overall system cost savings, reductions in the costs paid by DER and certain non-DER customers, decreased loading on transmission and distribution lines, and reduced reliance of distribution systems on transmission-connected generation to meet energy needs. Ultimately, this thesis demonstrates that the full potential of DERs is realized when a planning framework can capture the benefits they provide to both customers and the power system
Analysis of low-loading electrodes for PEM water electrolyzers
No full textProton exchange membrane water electrolysis (PEMWE) technology is one of the cleanest methods of producing green hydrogen. The widespread adoption of this technology by industries is hindered by the operating and investment costs associated with the use of precious metal catalysts, such as iridium (for the anode side) and platinum (for the cathode side). Moreover, comparing data across the proton exchange membrane water electrolyzer (PEMWE) research community is challenging due to variations in materials used, cell assembly, and testing conditions. In the first study, different sources of performance variation are addressed, and a key finding highlights the importance of temperature in determining reaction kinetics and overall cell performance. Using different cell hardware with identical materials resulted in a maximum deviation of 50 mV. Furthermore, choosing the right testing equipment is a crucial factor, as inaccuracies in collected data can mislead the research at the cost of time, effort, and expense. Potentiostat is the right test equipment for electrochemical systems, enabling accurate measurements and reliable testing. The compression ratio, which is often not reported, has a significant influence on cell performance. An optimal compression ratio is needed to achieve good performance, as over- or under-compression leads to elevated high frequency resistance (HFR). A need to standardize the materials used and cell hardware is demonstrated, as the discrepancy in cell performance arises from these two sources. Other challenges to commercialization of PEMWE include catalyst instability, membrane degradation, poor microstructure of the anode catalyst layer (ACL), reduced active area utilization, and mass transport limitations, especially at high current densities. In the other study, we explore the use of pore formers to create desired microstructures for PEMWE anodes. Low-loading anodes with modified porosities were fabricated using commercial catalysts and carbon-based pore formers. The pore former added catalyst-coated membranes (CCMs) were manufactured inhouse, enabling precise control over the porosity of the catalyst layer. The results highlight that we can achieve slightly higher mass current density with the addition of vulcan carbon. Furthermore, the obtained data indicate that the pore former can indeed improve active area utilization
Exploring the Bidirectional Relationship Between Exercise and the Gut Microbiota: Impact of Training Intensity and a Supplement Intervention
No full textExercise and the gut microbiota interact bidirectionally, whereby exercise training influences the structure of the gut microbiota, and the gut microbiota and its metabolites may influence exercise performance. Despite growing recognition of this relationship, the influence of exercise intensity, category, and volume on the gut microbiota remains unknown, and strategies aimed at leveraging the gut microbiota to improve exercise performance are underexplored. Gut-derived metabolites such as short-chain fatty acids (SCFAs) have been proposed to influence skeletal muscle metabolism in ways that may improve performance, and synbiotics represent an exogenous strategy for increasing SCFA production. Following a 6-week, domain-based, cycling intervention in healthy adults, we demonstrated that heavy- and severe-, but not moderate-intensity exercise training increased gut microbiota alpha diversity. We also observed distinct gut microbiota profiles between exercise responders (i.e., POST intervention increase of >3.5ml·kg−1·min−1 in V̇O2max) and non-responders (increase in V̇O2max < 3.5ml·kg−1·min−1), with the bacterial genus Holdemanella consistently emerging as a feature of non-response, and markers of gut inflammation also being associated with non-responders. In a cross-sectional study of competitive athletes, we showed that exercise training category (i.e., endurance, mixed, or sprint/power) and volume (i.e., weekly training hours) together explained the greatest proportion of variation in gut microbiota profiles. Within-category analysis showed that sprint/power athletes' gut microbiota was the most sensitive to training volume, whereas endurance athletes were the least sensitive. Between-category comparisons at each training volume showed that category-specific gut microbiota profiles were most apparent at lower training volumes (≤ 15 hours a week), and became less distinct at > 15 hours. Distinct dietary patterns were also observed in endurance-categorized athletes, while sprint/power and mixed athletes exhibited more similar dietary profiles. Six weeks of supplementation with a novel synbiotic formulation did not impact endurance performance outcomes or substrate oxidation during heavy-intensity cycling, nor did it produce substantial changes in gut microbiota composition or modulate fecal SCFA concentrations in trained cyclists. Within the synbiotic group, blood lactate concentrations were numerically lower throughout the 20km time trial after the intervention compared to baseline, although this did not reach statistical significance. This thesis highlights the impact of exercise intensity, training category, and training volume on the gut microbiota. Additionally, this work increases our understanding of microbial modulating therapies on endurance performance outcomes and provides direction for future investigations exploring the bidirectional role of exercise and the gut microbiota
Enhancing immunocastration awareness as a win-win alternative to traditional castration methods
No full textImmunocastration (IC) is a welfare-friendly alternative to surgical castration in pigs. In Brazil, IC is widely adopted, with usage exceeding 85% of the national pig production system. This study explored the factors, motivations, challenges, perceived benefits, and future considerations associated with IC adoption from the perspective of key stakeholders in the Brazilian pork industry. Twenty-one semi-structured interviews, each lasting approximately one hour, were conducted with pig producers currently using IC (n=3), pig producer who previously used IC but is not currently using it (n=1), veterinarians and technical experts (n=10), industry stakeholders (n=3), decision-makers from pork production and vaccine industries (n=4), and slaughterhouse representatives (n=3). Interviews were transcribed and analyzed using deductive thematic analysis. Five main themes emerged: (1) National contextual motivations, where economic and technical incentives, industry infrastructure, personal values, and consumer expectations influenced adoption decisions; (2) Operational infrastructure for IC adoption, highlighting the importance of coordinated training, knowledge sharing, evidence-based practices, regulatory alignment, and adaptation to farm conditions to ensure effective implementation; (3) Implementation challenges, which included technical, operational, animal-related, and economic barriers that created initial resistance but were largely overcome with proper planning; (4) Perceived benefits, such as improvements in animal welfare, labor efficiency, and production outcomes, which reinforced adoption and stakeholder satisfaction; and (5) Future directions and alternatives, including strategies to engage hesitant producers and consideration of options such as raising entire males or using gene editing technologies to address welfare and productivity goals. Overall, results indicate that IC adoption in Brazil was supported by a coordinated supply chain approach combining education, collaboration, and policy guidance. The study emphasizes that successful adoption depends not only on the technology itself but also on stakeholder engagement, infrastructure, and context-specific support mechanisms
Toward Improved Electronic Structure of Molecules and Solids: Development Of New Exchange Functionals
No full textThis thesis advances both the methodological foundations and applied frontiers of electronic structure theory toward sustainable energy and environmental applications. It unites the development of new density functional approximations with first-principles design of functional materials, aiming for accuracy, efficiency, and transferability across molecular, solid-state, and low-dimensional systems. The work begins with a rigorous exposition of the many-body problem and the Kohn–Sham density functional theory (DFT) framework, emphasizing the need for accurate exchange–correlation modeling to overcome the limitations of local and semilocal approximations—namely self-interaction, delocalization, and band-gap errors. Building upon this, a generalized formalism for range-separated generalized gradient approximation (GGA) exchange was developed, yielding analytical short- and long-range damping functions and a modular Fortran 90 implementation suitable for hybrid functional construction. The first part of the thesis applies state-of-the-art DFT to clean-energy materials design. Using the HSE06 screened hybrid functional, Cu-doped Ba₃CaNb₂O₉ and Ba₂YNbO₆ were identified as promising visible-light photoelectrocatalysts for water splitting, where Cu substitution and oxygen vacancies jointly modulate the band structure and enhance charge separation. Complementarily, PBE-D3 calculations revealed a new two-dimensional metallic Li₂BC sheet, intrinsically and extrinsically stable, with exceptional hydrogen storage (10.98 wt%), lithium-ion storage (3352 mAh g⁻¹), and pollutant-sensing potential. Motivated by the insights and limitations revealed through these studies, the second part of the thesis advances the methodological frontiers of DFT via the development of new exchange and hybrid models. The Ghosh–Oshi–Salahub (GOS) GGA exchange functional introduces a rational, damping-controlled enhancement factor that satisfies ab initio constraints. Building on this foundation, the Ghosh–Salahub (GS) and Ghosh–Salahub–Gill (GSG) screened hybrid functionals achieve balanced and transferable accuracy across molecular, transition-metal, and solid-state systems. Benchmarks against the Ghosh–Oshi–Salahub-0 (GOS-0) database confirm their performance comparable to, or exceeding, established hybrids such as PBE0 and HSE06. Together, these developments bridge practical materials discovery with theoretical innovation, charting a coherent pathway toward next-generation electronic-structure modeling and sustainable materials design