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Math Education: A Comprehensive Guide to Teaching the Foundations
Get PDFThis thesis investigates the critical need for strong foundational mathematics education for adults. More specifically, for incarcerated individuals who lack basic numeracy skills because of the systematic inequalities that they have faced, the need for a mathematics foundation is even higher. This work emphasizes a non-technological approach to teaching these basics through qualitative analysis, including teaching strategies and practical lessons, while recognizing the various barriers many learners face. This research serves as a guide for educators to use for how to sequence and pace lessons, address certain learning styles, and gain classroom engagement, comprehension, and long-term retention of the materials. Ultimately, this paper aims to foster a stronger understanding of the foundations of mathematics and how to prepare in the best way possible for future success
Scenario Analysis of Drinking Water Infrastructure Rightsizing in Flint, Michigan: Model Census Tract Results
No full textSustainable urban systems require appropriately sized infrastructure. However, when cities face economic and population decline, hardened infrastructure - such as drinking water distribution systems – is difficult and costly to modify. This dataset provides the results of a modeling exercise performed using EPANET (Version 2.2) to examine potential scenarios for rightsizing water infrastructure in a shrinking city. The modeling was performed utilizing a full-scale, calibrated hydraulic model of the drinking water distribution system in Flint, Michigan obtained through a Memorandum of Understanding between the City of Flint and Wayne State University.
For this analysis, in addition to a base model, we evaluate six scenarios involving either only decommissioning of pipes alone or both decommissioning and downscaling replacement of pipes. Model scenarios were run for three weeks (504 hours). The first two weeks (335 hours) were used to stabilize the system. System conditions (e.g., pressure in pounds per square inch (psi) and water age (hours)) at 15,936 locations in the system were recorded every hour, resulting in 168 measurements for each location in the system, a total of 2,677,248 measurements per hour. The minimum and maximum pressure, maximum water age (95th percentile), average pressure, and average water age (50th percentile) are computed during the third week of simulation.
This dataset describes theoretical changes associated with each scenario as well as the pressure and water age resulting from EPANET modeling. Additionally, socio-economic data are also included. This dataset is paired with a second dataset available at https://doi.org/10.22237/waynestaterepo/data/1729036800/a.
894 record dataset
Data Dictionary:
GEOID: 14-digit Census Bureau geographic identifier based on 2010 Census;Scenario: Model Scenario (0-6);MinP: Minimum Water Pressure (psi);MaxP: Maximum Water Pressure (psi);AvgP: Average Water Pressure (psi);Ag50: Average Water Age (hrs);Ag95: Maximum Water Age (hrs);AgChn50: Change in Water Age (hrs) From Base Model (Scenario 0);AgChn95: Change in Water Age (hrs) From Base Model (Scenario 0);PercVacant: Percent Vacant Parcels in Census Tract;Distress: Distressed Communities Index (DCI) [Sadler RC, Gilliland JA, Arku, G. An application of the edge effect in measuring accessibility to multiple food retailer types in Southwestern Ontario, Canada. International journal of health geographics. 2011; 10, 1-15.];PrcNW: Percent Non-White [U.S. Census Bureau, 2016-2020 American Community Survey 5-Year Estimates. Available at: www.data.census.gov. Accessed: 7 July 2024
Efficacy of Hypnosis as a Treatment for Alopecia
Get PDFTitle:
Efficacy of Hypnosis as a treatment for Alopecia
Introduction:
Hypnosis is an altered state of consciousness in which someone is more receptive to suggestions and modeling, and it can address psychological and physical symptoms that are aggravated by conscious and unconscious triggers.The intended outcome is a change in certain behaviors or patterns of thinking that patients have which can mitigate their stress load. Stress can induce and exacerbate alopecia, and patients often suffer increased stress due to the psychosocial burden of having a dermatological disease. A study showed that high levels of cortisol releasing hormones (CRH) were found to suppress hair shaft elongation and induce the regression phase of the hair cycle.
Methods:
A literature search was conducted on PubMed in October 2023 using the search terms “Hypnosis” AND “Alopecia”. Exclusion criteria included articles written in a language other than English. References that were not pertinent were removed from consideration. The literature search yielded 17 results. Three articles were excluded since they are not published in English.
Results:
There are several case reports and series that report hair regrowth and better mental wellbeing after hypnotic sessions. There have been three non controlled cohort studies. In the first study, only one patient experienced hair regrowth, while in the second one, 9 out of 12 participants had significant hair regrowth. All three studies reported an increase in well-being and a decrease in anxiety and depression.
Discussion:
Hypnosis can be an effective complementary treatment for patients suffering from alopecia, especially those with concurrent self esteem issues
Characterizing Cold Water Drownings in the Great Lakes
No full textSince the COVID-19 outbreak in 2020, Great Lakes drownings have increased. The Great Lakes are a unique and understudied environment due to being cold, fresh water, and resuscitation protocols and guidelines being derived from warm, primarily salt water environments. We analyzed open sources materials to find records of Great Lakes drownings from 2021-2023 and analyze the data looking for trends in cold and warm water drownings.
We found 80.0-85.0% of the included drowning victims were male and had an average age of 38.0-39.0 years old. 40.0%-57.7% of Great Lakes drowning deaths were in cold water; of those, Lake Michigan had the highest number of cold water drownings each year, while Lake Huron and Lake Superior had the least.
The drowning victims in this cohort were predominantly adult men. Additionally, almost 50% of Great Lakes drownings were cold water drownings. These results do not suggest cold water is protective, although drowning and near drowning survival rates are needed to definitively determine whether there is a significant difference. This study provided strong reasoning and foundation for further studies in cold water resuscitation. This is an unmet need, especially within Great Lakes states, and could help improve mortality of cold water drownings
Predicting Risk of Atrial Fibrillation in Hematopoietic Stem Cell Transplant
Get PDFBackground
Atrial fibrillation (AF) in hematopoietic stem cell transplant (HSCT) recipients is associated with significant morbidity. We have previously reported that obstructive sleep apnea (OSA), older age and presence of dilated left atrium (LA) are significant predictors of AF early post HSCT. In the current study, we sought to evaluate if TSH pre HSCT and serum electrolytes and eGFR at engraftment in patients undergoing HSCT are associated with increased risk of AF.
Methods
This is a single center retrospective study, involving 748 consecutive patients undergoing autologous and allogenic HSCT from 2012 to 2022. Patients’ charts were reviewed to acquire clinical information (age, gender, HTN, body mass index [BMI], Obstructive sleep apnea [OSA], TSH, and LA volume index that was obtained from pre-HSCT echocardiogram, in addition to potassium [K], magnesium [Mg], and eGFR at time of engraftment [ENG]).
Results
For the 748 patients, the median age at HSCT was 61. Majority of patients were male (57%). Most common diagnoses were Myeloma (42.5%), acute leukemia (19.5%), lymphoma (19.5%), myelodysplastic syndromes and myeloproliferative neoplasms (11%). A total of 116 (15.5%) patients developed AF early post-HSCT. AF patients’ mean LA measurement was 37.3ml/m2, whereas non-AF patients’ mean measure was 30.6ml/m2 (P-value: 0.002). For age at HSCT, AF patients’ mean was 62.4 years old and non-AF patients’ mean was 57.4 years old (P-value: \u3c0.001). OSA diagnosis, 39 (29.5%) of AF patients had OSA and 67 (11.3%) of non-AF patients had OSA (P-value: \u3c0.001). At time of ENG, AF patients had higher mean K of 4.1 (P-value: 0.001) and lower mean eGFR of 81.1 (P-value\u3c0.001) versus non-AF patients with mean K of 3.7 and eGFR of 94.3. In the multivariable regression analysis, larger LA size (P-value: 0.016), older age at HSCT (P-value: 0.001), diagnosis of OSA (P-value: \u3c0.001), and higher K (P-value: 0.010) and lower GFR (P-value: 0.007) at ENG were significant predictors of AF. Male gender, HTN, BMI, use of ATG or Melphalan based chemotherapies, pre-HSCT TSH, and Mg at ENG were not predictive of AF post-HSCT (table 1).
Conclusion
In our single center retrospective study, we found that compared to patients who did not develop AF early post-HSCT, the AF patients, in addition to having dilated LA, being older and more OSA, surprisingly they had higher K and lower eGFR at day of ENG. A limitation of our study is the diagnosis of OSA, which sometimes was not supported with a sleep study or diagnosis came from an external practitioner. Another limitation of our study would be the fluctuations in electrolytes around time of engraftment and overhydration due to IV fluids during the inpatient stay. Further research is needed to develop a risk calculator to identify high risk patients and study the effects of prophylactic therapies on the incidence of post-HSCT AF
Perception of Trust, Virtual Care, and Access Among the Uninsured Population: A Multi-Site Study at Student Run Free Clinics
Get PDFIntroduction/Problem:
Since the onset of the COVID-19 pandemic, utilization of virtual visits has significantly increased. Advantages of virtual visits include lower healthcare costs and improved access to healthcare. Although one of the main goals of implementing virtual visits is to increase access to the underserved population, there have been few studies with a focus on the opinions of African Americans or the uninsured. Moreover, distrust in physicians and healthcare, although universal, is more prevalent among the African American and uninsured populations. It is also known that trust leads to better self-reported health outcomes, patient satisfaction, health behaviors, quality of life, and symptom severity. Therefore, identifying ways to increase trust is essential to improving healthcare, especially among the underserved.
The aim of our study is to evaluate the knowledge, attitudes, and experiences of the uninsured community living in Detroit regarding virtual care and trust in physicians and the healthcare system. We hypothesize that factors such as virtual care and free clinic use will be correlated with increased trust.
Methods/Interventions:
This project involves three student-run free clinics located in a large Midwestern metropolitan city. We are conducting a survey-based research study evaluating the knowledge, attitudes, and experiences of uninsured people in Detroit with virtual healthcare services, physician trust, and trust in the overall healthcare system using combined, previously published, survey instruments. The data will be analyzed by a report of the demographics and average responses. Then, using Student’s t-tests and ANOVA via the SPSS platform, the effect of virtual care and free clinic use on trust will be evaluated.
Results
Data collection is currently in progress. At this point in time, we have a sample size of 32 uninsured participants above the age of 18 years and approximately an 89% response rate. We aim to have over 50 participants by the conference deadline in order to extrapolate more meaningful interpretations from data analysis. Currently, 71.8% of the participants are African American and 75% earn less than $40,000 per year. Our initial findings show that 84.4% of participants have utilized free clinics before, with 96.4% of those reporting an extremely or mostly positive experience. Furthermore, preliminary analysis finds that 90.6% of participants trust their physician’s judgment about their medical care. In regard to telemedicine, 43.8% have previously accessed health care via phone or video chat, although only 23.8% of users report obtaining “better access to healthcare services by use of telemedicine”.
Conclusion
Further research is necessary to illuminate perceptions of access and trust in free clinics and telehealth services in underserved populations and to determine mechanisms which can be implemented to improve these views
Anatomy and Physiology of Intraosseous Infusion
Get PDFThe introduction of fluids and medications via intraosseous (IO) infusion is highly dependent upon many unique aspects of bone anatomy and physiology. Key considerations include differences in the medullary cross-sectional area between insertion sites, age- and location-dependent variation in the distribution of red and yellow bone marrow, volume and pressure capacity within the venous system, and the influence of hormones and other chemical messengers on vasomotor tone. In addition to an exploration of these concepts, this chapter will also discuss the physiologic basis for pharmacokinetic relationships reported in the prevailing literature and propose methods to optimize the use of IO infusion in the care of critically ill patients
M4-Intern Mentorship Project
Get PDFWayne State University School of Medicine (WSUSOM) in 2018 formed Learning Communities (LCs), that facilitate student engagement, comradery, and mentoring. These programs include medical student-premed, near-peer, and faculty/attending mentorships. There has been an identified gap in mentorship between near-peer and faculty/attending mentorship, and that is near-peer mentors at WSUSOM have yet to complete the residency process to guide other students through it. Moreover, faculty/attending mentors are more removed from residency and may not have relevant advice for students. As resident physicians are recent graduates, they are more likely to provide relevant insight about residency applications, academic challenges, and efficiency than attendings. We aim to assess the extent of the gap between faculty/attending and peer mentorships. MS4 at WSUSOM (N=33) self-reported their: confidence in transitioning to residency; the gaps they believe such mentorship will fill; and whether they, themselves, would participate in an MS-resident fellowship program. Results indicated that MS4s feel somewhat confident in their abilities to transition to residency. They believe that a resident-MS mentorship would help in the interview and application process, as well as, the residency program choosing process. Furthermore, if given the opportunity, all the students would consider joining the program. We are currently looking at Wayne State School of Medicine MS4’s proficiency in leadership, empathy and communication via a likert scale, and using this to drive our implementation of our program. We hope to implement a student-resident mentorship program, to reassure students on their journey to residency
