30921 research outputs found
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Infection risk and role of antibiotic prophylaxis in acute myeloid leukemia patients receiving lower intensity chemotherapy: A literature review
No full textPatients with acute myeloid leukemia (AML) are at high risk for infections due to chemotherapy-induced neutropenia. AML patients who receive lower dose chemotherapy are typically elderly patients who have comorbid conditions or have failed initial therapy. Antibiotic prophylaxis use is not clearly understood in this patient population, but early studies were conducted to study the incidence of infections and the use of antibiotic prophylaxis to reduce the risk of infections. The purpose of this literature review was to determine the incidence of infections in patients with AML, if antibiotic use leads to reduced incidence of infections and the role of antibiotic prophylaxis in patients with AML who received lower intensity chemotherapy. This review searched the PubMed database for relevant papers that addressed the research question using the following search terms: leukemia, infections, febrile neutropenia and chemotherapy. Four retrospective studies were identified using this approach and are included in this review. Comparing the four retrospective studies, there was a significant number of patients infected with Gram negative bacteria and the most common pathogens were Enterobacteriaceae and Pseudomonas aeruginosa. Increased incidence of infections were observed during cycles 1 and 2 of chemotherapy. In one of the studies, despite use of antibiotic prophylaxis, infections occurred and induced the growth of antibiotic resistant bacteria. In another study, the use of antibiotic prophylaxis significantly decreased the incidence of infections in patients with severe neutropenia. Due to the increased incidence of infections in the early chemotherapy cycles, antibiotic prophylaxis has a potential role during this time period especially for severely neutropenic patients. Febrile neutropenia could be the only sign of infection for AML patients so close monitoring during this time period would allow for early detection of infections and prompt treatment with antibiotics. Further studies are required in order to clarify the role of antibiotic prophylaxis, its indication and duration of use in this patient population
Future directions for patient engagement in research: a participatory workshop with Canadian patient partners and academic researchers
No full textBackground
Patient engagement in research (also commonly referred to as patient or patient and public involvement in research) strives to transform health research wherein patients (including caregivers and the public) are regularly and actively engaged as multidisciplinary research team members (i.e. patient partners) working jointly towards improved health outcomes and an enhanced healthcare system. To support its mindful evolution into a staple of health research, this participatory study aimed to identify future directions for Canadian patient engagement in research and discusses its findings in the context of the international literature.
Methods
The study met its aim through a multi-meeting pan-Canadian virtual workshop. Participants (n = 30) included Strategy for Patient-Oriented Research-funded academic researchers and patient partners identified through a publicly available database, personal and professional networks and social media. All spoke English, could access the workshop virtually, and provided written informed consent. The workshop was composed of four, 1.5–3-h virtual meetings wherein participants discussed the current and preferred future states of Canadian patient engagement in research. Workshop discussions (i.e. data) were video and audio recorded. Themes were generated through an iterative process of inductive thematic analysis that occurred concurrently with the multi-week workshop.
Results
Our participatory and iterative process identified 10 targetable areas of focus for the future of Canadian patient engagement in research. Five were categorized as system-level (systemic integration; academic culture; engagement networks; funding models; compensation models), one as researcher-level (engagement processes), and four crossed both levels (awareness; diversity and recruitment; training, tools and education; evaluation and impact). System level targetable areas called for reshaping the patient engagement ecosystem to create a legitimized and supportive space for patient engagement to be a staple component of a learning health system. Researcher level targetable areas called for academic researchers and patient partners to collaboratively generate evidence and apply knowledge to inform values and behaviours necessary to foster and sustain supportive health research spaces that are accessible to all.
Conclusions
Future directions for Canadian patient engagement in research span 10 interconnected targetable areas that require strong leadership and joint action between patient partners, academic researchers, and health and research institutions if patient engagement is to become a ubiquitous component of a learning health system
Hazard assessment of legacy contaminated sites: bioassay-driven analysis of complex mixtures in fish
No full textEcological risk assessment (ERA) of contaminated groundwater presents significant limitations due to its often-complex chemical composition and to dynamic processes affecting exposure of organisms in receiving surface waters. The overall aim of this thesis was to better inform ERA of legacy-contaminated sites where groundwater contamination could reach surface water and may impact freshwater organisms. Groundwater mixtures were collected from a pesticide packaging and handling facility in Manitoba, Canada with samples defined as reference zone (RZ), moderate industrial activity zone (MIAZ), and high industrial activity zone (HIAZ) based on historical site activities and chemical characterization of groundwater. Bioassay-driven analyses in combination with molecular assessments were used to characterize the potential ecotoxicological hazard posed by groundwater from a legacy contaminated site to fathead minnow (Pimephales promelas, FHM) as a model organism. To reduce live-animal testing, the potential for molecular assessments in early life stages (ELS) of FHM before independent feeding was evaluated using a novel transcriptomics tool, EcoToxChip, to predict apical responses at higher levels of biological organizations. The potential for laboratory toxicity responses to be predictive of outdoor mesocosms responses was also evaluated. RZ treatments were not toxic to FHMs relative to negative control, and therefore, served as an appropriate site-reference to which effects observed at MIAZ and HIAZ treatments were compared. Overall results revealed that oxidative stress could be the main mechanism of toxicity of contaminants present in MIAZ and HIAZ groundwater mixtures, which included pesticides, hydrocarbons, volatile organic compounds, and degradation products. This toxic mechanism could have led to mortality, deformity, increased swimming activity, and anxiety-like behavior, genotoxicity, hepatotoxicity, and impaired reproductive fitness observed in FHMs in laboratory. No such responses were observed in outdoor mesocosms, hence laboratory assays overestimated effects relative to the more environmentally relevant scenario. We found that molecular responses were predictive of apical outcomes and effects observed in ELS were predictive of those observed in adult fish. Therefore, this thesis supports the use of novel transcriptomics approaches in ELS of fish as an input of mechanistic information and an alternative to live animal and field-level testing for ERAs of complex mixtures found at comparable sites.October 202
Assessing in vitro methodologies for the determination of protein digestibility, amino acid digestibility, and protein quality
No full textThis study examined the potential of two in vitro static digestion models, namely the pH-drop and INFOGEST 2.0, to determine in vitro protein digestibility and amino acid digestibility in assessing protein quality. The pH-drop model directly measured in vitro protein digestibility for the subsequent calculation of the in vitro Protein Digestibility Corrected Amino Acid Score (IV-PDCAAS) value. However, the INFOGEST model digestion products were analyzed by three methods: i) OPA derivatization, ii) total nitrogen via Kjeldahl, and iii) individual amino acid analysis to determine in vitro protein digestibility and IV-PDCAAS. The latter analysis was additionally used to assess in vitro amino acid digestibility, subsequently used to calculate in vitro Digestible Indispensable Amino Acid Score (IV-DIAAS). Among the four assessment methods, the OPA assay and total amino acid analysis from the INFOGEST digestion products demonstrated closer associations with in vivo PDCAAS compared to the pH-drop model and the Kjeldahl analysis. However, the pH-drop model, with a straightforward and simple approach, exhibited better repeatability across measurements. Using three popular assays, the PDCAAS, the DIAAS, and the Protein Efficiency Ratio (PER), to evaluate protein quality and permitted protein content claims of samples, it was observed that there was no difference in terms of protein content claims determined when using the in vivo or four in vitro methodologies. The results indicated that the PDCAAS generally offered higher protein permitted claims than the DIAAS and the PER methods and their respective protein content claims, highlighting that the selection of assessment methods impacts the limiting amino acid and protein quality and extends to subsequent claims for the sample.
In conclusion, the pH-drop model is straightforward and highly repeatable; however, the INFOGEST model showed a closer correlation with in vivo data. Additionally, the in vitro static INFOGEST digesta proved versatile in evaluating various aspects of protein quality in both in vitro protein and amino acid digestibility through amino acid analysis. Both models can be valuable screening tools for protein quality assessment. Further development of these in vitro methodologies can offer effective and sustainable non-animal testing alternatives for protein quality assessment and protein content claims on product packaging.October 202
Canon ball: a dive into the deep end of diversifying texts in grades 6–12 English Language Arts classrooms
No full textIn my role as a high school English Language Arts teacher, and more recently as a literacy coach, I have observed that the canonical texts used in senior-years classrooms reflect a complete lack of diversity and representation. The dearth of texts authored by Indigenous, Black, Asian, Hispanic and/or 2SLGBTQ+ voices necessitates an urgent conversation around diversifying the texts being used in our senior-years ELA classrooms. While the importance of representation in story is well documented in the literature, there is less known about how teachers recognize and enact this call for diversity. Informed by the powerful rationale for diversifying texts, this study explores how grade 6–12 English Language Arts teachers recognize and enact the call to diversify texts in their classrooms. In five half-day professional learning sessions (PLS), eight teachers participated in book clubs to explore middle grade and young adult texts written by diverse voices. This study was grounded in the research question, How do teachers recognize and enact the call to diversify texts in ELA? More specifically the study explored:
• How do teachers define and select diverse texts for their classrooms?
• What motivations and barriers exist in using diverse texts in the classroom?
• How are teachers facilitating learning with diverse texts?
In order to engage these questions, I invited teacher participants to book clubs where they explored middle grade and young adult texts written by diverse voices. Book clubs provided the framework of a shared text through which the teacher-readers could think more deeply about the importance of diversity and representation. To ensure that teachers had multiple entry points into the concepts of power and privilege, I provided language and conceptual frameworks that were spiralling, recursive, and interconnected.May 202
Joint content and shape adaptive transforms based on a GMRF model for coding arbitrary-shaped image segments
No full textIn image compression, shape-adaptive (SA) transform coding has been shown to outperform traditional block-based transform coding by better capturing the underlying textures of image regions. However, constructing optimal transforms for arbitrarily shaped image segments remains a challenging task. This thesis proposes a novel method for developing SA transforms by utilizing a non-causal finite lattice homogeneous Gauss-Markov random field (GMRF) model. The Karhunen-Loeve transform (KLT) of the GMRF model is employed as a compact, parameterized representation of the KLT for arbitrarily shaped image segments, with the model parameters effectively characterizing the image texture. This approach offers a significant advantage over existing SA transforms in the literature, as it allows for the optimization of the transform for each image segment. Specifically, if the GMRF model accurately describes the segment's texture, the resulting KLT will be the optimal transform for that segment.
A key aspect of the proposed method is the introduction of a modified version of asymmetric Neumann boundary conditions, which are designed to maintain a high transform coding gain, even for arbitrarily shaped image segments. This enhancement ensures that the transform coding process is robust and effective across diverse image shapes and textures.
Additionally, by employing a set of GMRF parameters estimated from a training set of images, the aforementioned approach is extended to enable joint content and shape adaptive transform (JCSAT) coding. This approach allows for the simultaneous adaptation to both the content and shape of image segments, leading to more efficient compression.
Experimental results demonstrate that JCSAT coding surpasses the performance of other known SA transforms, as well as the widely used 2D-discrete cosine transform (2D-DCT), in terms of energy compaction efficiency and coding gain. This research makes an important contribution to the adaptive transform coding of images, providing a more flexible and optimal solution for coding arbitrarily shaped image regions in image and video compression applications.University of Manitoba graduate fellowshipFebruary 202
Knowledge and power in the academy: faculty and staff equity, diversity, and inclusion training in Canadian post-secondary institutions
No full textMost Canadian post-secondary institutions have publicly identified reconciliation and other equity, diversity, and inclusion (EDI) priorities in their goal statements and strategic plans. However, it is not clear how (or if) they are ensuring the institutional capacity exists to make the type of transformative changes these goals imply. It is argued here that a critical, yet overlooked component of this capacity building is meaningful EDI training for faculty and staff. The literature argues that those in positions of power and privilege have been culturally conditioned to not see violence and oppression in our institutions. If this is so, it becomes vital that EDI training initiatives provide an opportunity to critically analyze the impact of personal power and power embedded in institutional structures. However, the review also revealed the most common type of EDI training offered is superficial and does not support the development of a more critical lens through which to interrogate power. As the evidence to support these concerns has been largely anecdotal, this study set out to gather a more comprehensive, descriptive data set that provides a snapshot of faculty and staff EDI training initiatives across Canadian post-secondary institutions. This study takes a pragmatic approach to data gathering and uses a mixed methods approach to support the investigation of complex systems and processes. Based on issues raised in the literature review, a national survey was designed to support the gathering of large amounts of both quantitative and qualitative (descriptive) data from those doing “EDI work”. A focus group was then held that allowed for a deeper examination of key issues raised in the survey. Findings echoed concerns that most EDI training for faculty and staff is superficial and does not get at deeper issues related to power and equity. The analysis also revealed that differing perceptions of safety may be a critical factor impacting the perceived need for EDI training and the type of training typically offered. Galtung’s Violence Triangle model frames the research as it broadens the concept of “violence” and helps elucidate power imbalances and the mechanisms that both create and maintain them.February 202
Field monitoring and numerical modelling of the ice dam at Sundance Rapids
No full textManitoba Hydro’s Limestone Generating Station, located on the Nelson River in Manitoba, experiences increased winter water levels in the station tailrace and reduced energy production potential due to a large ice dam that forms downstream at Sundance Rapids. Previous work included the development of a CRISSP2D site model to simulate the complex ice and hydraulic conditions and the establishment of a field monitoring campaign (2019/20) to collect site-specific hydraulic and meteorological data.
This research expanded on previous work by performing three years of winter field monitoring (2020/21–2022/23) and assessing the CRISSP2D models’ ability to simulate on-site observations. The goal was to expand the current understanding of the ice dam that forms at Sundance Rapids to aid in the future development of mitigation techniques to reduce the impact on tailwater levels and energy production at the Limestone Generating Station.
Analysis of ice dam impacts on tailrace staging confirmed that over the three winters release was driven by thermal conditions. No thermal condition consistently correlated to release, revealing that other factors influence event variability. Quantitative analysis indicated that ice dam strength impacts the magnitude of release events. Qualitative observations found that discharge may impact thermal release by transporting more/less above 0°C water over the rapids.
CRISSP2D energy budget component calculations were modified to improve the comparison between simulated and observed. Following modifications, the model was able to simulate ice dam growth successfully. However, it was determined that the existing thermal release mechanism could not capture release as observed on site. Future work should focus on improving the understanding of ice dam release and the factors that impact it (i.e., discharge, ice dam strength) to assist in developing a site-specific release mechanism in CRISSP2D.Northern Scientific Training ProgramMay 202
An evaluation of fitness to stand trial assessment practices across Canada
No full textForensic assessments play a crucial role in the Canadian criminal legal system. One of the most common forensic assessments is fitness to stand trial evaluations, which determine whether an individual can competently engage with the legal system. While the United States is currently facing a “competency crisis” due to overwhelming demand for fitness assessments, the extent to which Canada is experiencing similar concerns is unknown. The present study used a mixed methods exploratory design to survey Canadian forensic mental health (FMH) service providers to a) capture a snapshot of the FMH services available in each province and b) determine and compare each province’s current demand and capacity to meet demands for fitness evaluations. Forty FMH sites and 2031 designated inpatient forensic beds were identified across Canada, representing a 16% increase in sites and 31% increase beds since 2006. Thus far, data has been captured from 12 of these sites. The study also conducted semi-structured interviews of service providers involved in the operation of FMH sites across Canada to identify factors influencing our ability to meet fitness demands and highlight recommendations for policy and practice. Reflexive thematic analysis of study interviews (n = 11) identified four themes in participant responses including Challenges to Providing FMH Care, A Growing Burden on the FMH System, Stigma and Lack of Support, and Identified Needs and Attempts at Change. This study underscores the urgent need for enhanced communication, education, and standardized data collection across Canadian FMH services, alongside expanded forensic training and broadening the scope of practice for forensic psychologists. Addressing these issues is essential for averting further crisis in Canada and ensuring just and efficient FMH care.October 202
The agential torrent: an a/r/tographic exploration of face-to-face classroom encounters
No full textAfter two years (2019-2021) of frustrating online crisis teaching in response to COVID-19, I came to a new appreciation of what I had previously taken for granted in my classroom teaching experiences. Provoked by a tangible feeling of loss, this thesis investigates the abiding question of how to better understand and describe the experience of bodies participating in an educational setting. Using a/r/tography and self-study research methodologies, and by applying the onto-epistemology of agential realism and an embodied cognition framework, this paper and graphic novel examines the agential and embodied nature of face-to-face classroom interactions (both human and non-human). The paper attempts to describe the intensely interconnected, multifaceted, and overwhelmingly complicated relations (involving actants) continually forming and reforming - a torrent of agency. Three a/r/tographic renderings are employed in the graphic novel: (1) intra-actions between agential classroom bodies are comprised of waves; (2) the nature of these multi-layered and interweaving intra-actions is entangled; and (3) the ongoing and discursive nature of these intra-actions results in emergence. This resplendent maelstrom of classroom phenomena is contrasted with the diminutive and capitalistic neoliberal educational narrative. The research was provoked by the imposed juxtaposition of these two paradigms during the onset of COVID-19 and subsequent moves to sustain society and the education system through online crisis learning. The paper concludes with discussion questions as prompted in the graphic novel to further the reader’s collaborative study of face-to-face learning.February 202