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Fides et Ratio: The Pursuit of Faith and Reason in the 21st Century Catholic University
No full textThe faculty fellows who participated in the 21st Annual Loyola Marymount University’s President’s Institute in May 2016 explored the topic of faith and reason in the 21st century Catholic university. The fellows explored the theme from the perspective of the relationship between faith and reason; our personal relationship to faith and reason; and the relationship of faith and reason to our academic disciplines in the context of our teaching, scholarship, and service. The idea that these notions compete for primacy in a Catholic university became fundamental to the exploration. This article provides an overview of the Institute’s theme and the literature that served as foundational; the essential questions that formed the basis of the presentations and activities of the Institute; an analysis of the fellows’ experiences in relation to those questions; a discussion of the themes that emerged from the fellows’ written data sets; and recommendations for Jesuit institutions considering the exploration of topics such as this with faculty
The Road to an Improved Magic Bullet: Combating Antibiotic Resistance in the Genetic Era
Get PDFAt the precipice of a new era in healthcare in the developed world, one where most decisions may soon be heavily influenced by genetics, the potential for disruption in the medical field is significant. The development of CRISPR technology in recent years has much excitement and hype around its possible utilization, and rightly so, as it may hold the key to placing new long-lasting treatments in our reach, including applications to mitigate or resolve antibiotic resistance - an issue that is quickly outpacing our capacity to address it. My thesis intends to suggest a possible framework and general timeline for the development and implementation of CRISPR-based solutions to the problem of antibiotic resistance, and its possible implications in global healthcare. The thesis begins with an introduction to microbiology, then provides significant background to establish the problem of antibiotic resistance, introduces CRISPR, and suggests improvements to existing options while discussing developments in relative order of implementation. Further development of the thesis theme may lend to the development of CRISPR-based antibiotics, establishing fabrication and distribution channels, and discussing ethical challenges to access and stewardship, among other topics ripe for development
Clinical pharmacist intervention to engage older adults in reducing use of alprazolam
No full textOBJECTIVE: To assess whether a letter explaining the risks of alprazolam can engage older adults to call a clinical pharmacist (CP) to initiate reduction in alprazolam use. DESIGN: Randomized, controlled study. SETTING: Integrated health care delivery system. PATIENTS: Patients 65 years of age and older who resided at home, had a current supply of alprazolam as of December 15, 2016, and had four outpatient dispensings of alprazolam during the previous 12 months. INTERVENTION: Patients were randomized to receive an educational outreach regarding alprazolam use reduction via a mailed letter (intervention group) or receive usual care (control group). Intervention patients/caregivers were requested to call the CP to discuss reduction of alprazolam use. For intervention patients who called and consented to participate, alternative treatment options were discussed on a case-by-case basis. MAIN OUTCOME MEASURES: Composite rate of 1) no alprazolam dispensing, 2) an alprazolam dose reduction, or 3) interchange to an alternative medication during the six-month follow-up. RESULTS: 153 and 173 patients were and were not, respectively, sent a letter. The mean age was 73 years and patients primarily were female. Thirty (19.6%) intervention patients called the CP. The composite rate was equivalent between the intervention (34.0%) and control (35.3%) groups (P = 0.822). In subanalyses, the composite rate was higher among intervention patients who did vs. those who did not call the CP (77.8% vs. 27.6%; P \u3c 0.001). CONCLUSION: A low-cost patient educational outreach coupled with CP care efficiently engaged older adults in benzodiazepine use reduction process; however, alprazolam continues to be a challenging medication for patients to discontinue
Comparison of disaster preparedness between upstate and downstate community hospitals in New York
No full textObjective: This study sought to determine whether differences exist in disaster preparedness between Upstate and Downstate community hospitals in New York. Design: A descriptive and analytical cross-sectional survey study was conducted using a 35-element questionnaire. These questions examined six disaster preparedness components: disaster plan development, onsite surge capacity, available materials and resources, disaster education and training, disaster preparedness funding levels, and perception of disaster preparedness. Setting: The population surveyed included community hospitals across New York. Subjects: Invitations to participate in the survey were emailed to the CEOs and disaster preparedness coordinators at 207 of the 208 community hospitals in New York. Eighty hospitals completed surveys, including 41 Upstate hospitals and 39 Downstate facilities. Main outcome measures: Responses to questions pertaining to the six disaster preparedness elements. Results: There were differences in disaster preparedness between Upstate and Downstate hospitals with respect to disaster plan development, available materials and resources, and disaster education and training. No differences were identified in onsite surge capacity, disaster preparedness funding levels, or perception of disaster preparedness. Conclusions: The results demonstrate the current condition of disaster preparedness in Upstate and Downstate community hospitals in New York. Differences in preparedness between hospitals in the two locations may reflect factors such as availability of resources and differing priorities with regard to threat levels. They also suggest opportunities for improvement in disaster preparedness, which may require additional government resources and advocacy organization efforts
Weight gain in first-semester university students: Positive sleep and diet practices associated with protective effects
No full textFor university students, alterations in sleep and diet quality are common, and the propensity for weight gain is well established. The role of sleep duration during periods of rapid weight gain is understudied. This study explored the relationships between sleep duration, diet patterns, and body composition in first-year university students. Data collection occurred during the beginning of the fall (August) and spring semesters (January). Anthropometric measures included weight, height, and percent body fat (%BF). Survey questions assessed sleep and diet quality. As a group, participants (N = 60) gained weight (1.8 ± 2.1 kg) over the 4.5-month period of study. Hierarchical cluster analysis (HCA) identified three groups based on weight change between baseline and follow-up visits. Group 1 (“maintainers”) (N = 21) gained 0.1 ± 1.3 kg, group 2 (“modest gainers”) (N = 24) gained 2.0 ± 1.7 kg, and group 3 (“major gainers”) (N = 15) gained 3.8 ± 1.8 kg. No differences in weight, body mass index (BMI), %BF, or average sleep duration existed between clusters at baseline. Minimal differences in baseline dietary behaviors between groups were noted other than maintainers used more fat, e.g., butter, to season vegetables, bread, and potatoes compared to modest gainers (p =.010). At follow-up, sleep duration significantly decreased from baseline among major gainers (7.1 ± 0.7 vs. 6.8 ± 0.7 h, p =.017) while sleep duration increased from baseline among maintainers (7.3 ± 0.9 vs. 7.6 ± 1.0 h, p =.048). Sleep duration at follow-up was significantly shorter among major gainers compared to maintainers (p =.016). Total diet scores for maintainers and modest gainers improved between visits (p =.038 and 0.002, respectively) but did not change among major gainers. Combining sleep and diet education may increase the effectiveness of interventions designed to mitigate weight gain in this high-risk population
An exploration of the intersection of race, gender and generation in African American women doing social justice work
No full textThis article examines how Black women from varying generations articulate their perceptions about race. The 183 participants, ranging in age from 21 to 69, were Black women committed to social justice work. An under-researched area is the exploration of generational perspectives about race among Black women social activists. Utilizing an exploratory sequential mixed-methods design, data were collected through six in-depth personal interviews, four focus groups, and an online survey. Intersectionality, standpoint and social identity theories were used in a complementary way to interpret the findings. Analysis of the data suggests that Millennials perceive race and social justice work differently than the Gen-Xers and Baby Boomers. The Millennials more readily acknowledge the intersectionality of their multiple identities and tend to characterize their racial experiences as gendered. Furthermore, like the Baby Boomers and Gen-Xers, the Millennials expressed a need for and a commitment to social justice work, but seemed more open to collaborating with other socially oppressed groups
Activity and exercise intolerance after concussion: Identification and management of postural orthostatic tachycardia syndrome
No full textBackground and Purpose: Postural orthostatic tachycardia syndrome (POTS) is increasingly recognized as a complication affecting recovery from concussion. Individuals with POTS demonstrate refractory dizziness, lightheadedness, cognitive dysfunction, fatigue, headache, chronic pain, nausea and gastrointestinal dysmotility, activity and exercise intolerance, syncope, and tachycardia. Subtypes of POTS may include hypovolemia, hyperadrenergic states, autonomic neuropathy, and underlying autoimmunity, which may variably impact response to rehabilitation in varying ways. The subtle presentation of POTS postconcussion is often mistaken for underlying anxiety, conversion disorder, or lack of motivation for recovery. This article will present clinical features of POTS that may arise after concussion, and propose a role for physical therapists in the diagnosis and management of POTS during concussion recovery. Summary of Key Points: Data recorded and entered into a database during clinic visits from a large pediatric institution indicate that 11.4% of individuals diagnosed with POTS report onset of symptoms within 3 months of sustaining a concussion. Activation of the sympathetic nervous system can result in lightheadedness, shortness of breath, chest pain, tachycardia, palpitations on standing or with exertion, and activity and exercise intolerance. Identified comorbidities in people with POTS such as joint hypermobility and autoimmune disorders can further influence recovery. Recommendations for Clinical Practice: Physical therapists may identify signs and symptoms of POTS in a subset of individuals who remain refractory to typical interventions and who exhibit symptom exacerbation with orthostatic activity. Incorporation of an individualized POTS exercise program into current established concussion interventions may be useful, with emphasis on initial recumbent exercises and ongoing physical therapy assessment of exercise tolerance for dosing of activity intensity and duration. Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A211)
The crack of dawn or the protest: Resistance, anticolonialism and the New Left on a brief theory of Claude Bourdet
No full textThe influence of anthropogenic edge effects on primate populations and their habitat in a fragmented rainforest in Costa Rica
No full textWhen a forest is fragmented, this increases the amount of forest edge relative to the interior. Edge effects can lead to loss of animal and plant species and decreased plant biomass near forest edges. We examined the influence of an anthropogenic forest edge comprising cattle pasture, coconut plantations, and human settlement on the mantled howler (Alouatta palliata), white-faced capuchin (Cebus capucinus), Central American spider monkey (Ateles geoffroyi), and plant populations at La Suerte Biological Research Station (LSBRS), Costa Rica. We predicted that there would be lower monkey encounter rate, mean tree species richness, and diameter at breast height (DBH) in forest edge versus interior, and that monkeys would show species-specific responses to edge based on diet, body size, and canopy height preferences. Specifically, we predicted that howler monkeys would show positive or neutral edge effects due to their flexible folivorous diet, large body size, and preference for high canopy, capuchins would show positive edge effects due to their diverse diet, small body size, and preference for low to middle canopy, and spider monkeys would show negative edge effects due their reliance on ripe fruit, large body size, and preference for high upper canopy. We conducted population and vegetation surveys along edge and interior transects at LSBRS. Contrary to predictions, total monkey encounter rate did not vary between the forest edge and forest interior. Furthermore, all three species showed neutral edge effects with no significant differences in encounter rate between forest edge and interior. Interior transects had significantly higher mean tree species richness than edge transects, and interior trees had greater DBH than edge trees, although this difference was not significant. These results suggest that forest edges negatively impact plant populations at La Suerte but that the monkeys are able to withstand these differences in vegetation
Assessment of the newborn with antenatal exposure to drugs
No full textThis chapter deals with assessment of newborn with antenatal exposure to drugs. A thorough assessment of newborn involves evaluation for possible in utero exposure to tobacco, alcohol, marijuana, and other pharmacologic agents either prescribed or from illicit use. Recognizing varying risks associated with specific substances used in utero will aid the provider in providing appropriate support and care for each newborn and family impacted by substance use disorders. A newborn exposed to in utero cigarette smoke may demonstrate jitteriness and hypertonicity from exposure to nicotine. There is no specific withdrawal syndrome reported in newborns exposed to in utero cocaine. Antenatal exposure to cocaine has significant impact on fetal growth due to restriction of placental blood flow resulting in decreased birth weight, length, and head circumference in term newborns. Newborns exposed to marijuana prenatally have an association with decreased executive functioning skills including poor impulse control, visual memory, and attention deficit