A retrospective observational study to estimate use of biomarkers to predict severity of community acquired pneumonia in children

Purpose: Multiple studies have investigated the role of biomarkers in predicting pneumonia severity in adults but minimal research exists for children. The aim of this study was to determine if the following biomarkers: white blood cell count (WBC), platelet count, C-reactive protein (CRP), procalcitonin (PCT), neutrophil-lymphocyte ratio, neutrophil count, or band count predict community associated pneumonia (CAP) severity in children. Methods: A retrospective chart review was conducted on pediatric patients (aged 60 days to 18 years) diagnosed with CAP, admitted to a regional, tertiary hospital. Patients were stratified into two severity cohorts, mild (no ICU care), and moderate /severe (required ICU care). Biomarker values were then compared between the severity cohorts and area under the curve (AUC), cut-off values, performance characteristics were calculated. Results: A total of 108 patients met inclusion criteria. Among the biomarkers examined, elevated levels of CRP (51.7 mg/L in mild vs. 104.8 mg/L in moderate/severe, p = 0.003, PCT (0.29 ng/ml in mild vs. 4.02 ng/ml in moderate/severe, p = 0.001) and band counts (8% in mild vs. 15% moderate/severe, p = 0.009) were associated with increased pneumonia severity. In predicting moderate/severe CAP, PCT had the highest AUC of 0.77 (p = 0.001) followed by bands AUC of 0.69 (p = 0.009) and CRP AUC of 0.67 (p = 0.003). The cut-off for PCT of 0.55ng/ml had a sensitivity of 83% and a specificity of 65%. A cut-off level of 53.1 mg/L for CRP had a sensitivity of 79% and specificity of 52%. A cut off level of 12.5% bands had a sensitivity of 61% and specificity of 71%. Conclusion: Biomarkers, in particular PCT, obtained early in hospitalization appear to perform as predictors for CAP severity in children and may be beneficial in guiding CAP management

Out of Control: Growth and Indirect Discrimination in Ada and Canyon Counties' Rental Processes

Minimal research has been done on race in evictions and the rental process, and those studies that have been performed have been limited to narrow geographical regions (Thomas, 2017; Desmond, 2016). Additionally, research hasn’t been extended to Idaho, a state that is recognized for its rapid population growth. Research on evictions’ impact on New Americans is essentially nonexistent. Employing the Naïve Bayes Model, a modification of the Naïve Bayes Model, and content analysis of interviews, this study sought to uncover the impact of racial discrimination and growth in the eviction process. The results proved that black and Latinx minorities are evicted at higher rates than their white and Asian counterparts and that a lack of tenant protections and rapidly increasing housing prices, among other things, have played pivotal roles in Idaho’s eviction rates, specifically of racial minorities.

Parent-Child Sex Communication Prompts, Approaches, Reactions, and Functions According to Gay, Bisexual, and Queer Sons

Minimal research on parent-child sex communication between parents and gay, bisexual, and queer (GBQ) adolescent sons prevents the formulation of interventions that would buffer or brake this youth population’s risks for HIV/STI. We sought to describe the perspectives of GBQ adolescent males on this process and the potential ways they think parents can address their sons’ informational needs, including countering youth access of sexually explicit media. We conducted 30 semi-structured interviews with GBQ male youth aged 15–20 years. Thematic and content analysis revealed four central themes: prompts and triggers, parents’ approaches, sons’ reactions, and the functions assigned to sex communication. Parents can be sources of reliable sexual health information and may be leveraged for future HIV/STI risk reduction work.

The Priority Given to Sustainability by Industrial Designers within an Industry 4.0 Paradigm

Industrial design is intrinsically linked to manufacturing; however, what is required of industrial design to adapt to new changes brought on by Industry 4.0 in manufacturing is unknown. Current literature gives little insight into how industrial designers need to evolve to the current developments in manufacturing to remain value drivers in an Industry 4.0 paradigm. There is minimal research describing the link between industrial design, Industry 4.0 and the effect this will have on sustainability. We conducted an extensive survey of 190 respondents from 53 countries to establish the present state of industrial design practice globally and to better understand the priority sustainability is given by practicing industrial designers. Qualitative data showed a desire for improved sustainable processes; however, quantitative data contradicted this, showing “sustainability” as one of the lowest ranked areas of importance in design practice for industrial designers. While sustainability—especially in manufacturing—demands more prominent change as industrial design adapts to an Industry 4.0 manufacturing paradigm, it seems that junior industrial designers do not currently see this as a priority.

Punitive by negligence? The myths and reality of penal nationalism in the Czech Republic

Penal populism has repeatedly been described as influencing penal policies, with harsh penal practices presented as evidence of its influence. However, little attention has yet been paid to its role in the development of penal policies in post-authoritarian countries, which generally have large prison populations. Some minimal research has suggested that Central European countries were driven by penal nationalism following the 1989 revolutions. I examine this claim for the Czech Republic, using Garland (2013) 's framework of the five dimensions of a penal state. My analysis of political manifestoes shows that Czech politicians did not employ “law and order” rhetoric. The country's penal reforms were led by lenient penal elites. Nevertheless, a lack of analysis, coordination and sufficient funding resulted in a failure to properly identify or tackle the causes of the country's high imprisonment rate. Even though it gradually became more difficult to impose prison sentences, insufficient attention was paid to the length of the sentences Czech prisoners were serving. The large Czech prison population thus seems to be the result of state actors’ negligence, but not of penal populism nor of penal nationalism.

Assessing Cardiometabolic Health Risk in Children Living With Grandparent Primary Caregivers: Interim Analysis

Minimal research has been conducted on the effect that grandparents as primary caregivers have on the cardiometabolic health of children who live with them, even though a number of studies have examined the influence of parent caregivers. As a first step towards filling that gap, we examined physiological and behavioral indicators of cardiometabolic health risk among children (aged 7 to 12 years) living with grandparent primary caregivers in Oregon and Washington. We measured body mass index and total cholesterol/glycohemoglobin (HbA1c), as well as physical activity/sleep and diet. In this preliminary analysis of our findings with 10 dyads (mean age 64.2 ± 4.0 years for grandparents; 9.3 ± 1.9 years for grandchildren), we report that on most of the indicators - obesity, physical activity, sleep, and diet - these children’s levels were comparable to national averages across all household types (not differentiated by type of family structure). However, 25% of the grandchildren (n=2) participating in our study had a total cholesterol level ≥ 200, compared to 7.4% of children from a nationally representative dataset. Similarly, 14% of the grandchildren (n=1) participating in our study had HbA1c ≥ 6.5%, compared to < 0.5% of children from a nationally representative dataset. Our findings suggest that these children may be at higher cardiometabolic health risk (e.g., hyperlipidemia). Further investigations with a larger sample and more examination of cardiometabolic risk profiles including lipids/blood glucose assessment are required to validate our preliminary findings.

Excellence in Rehabilitation of Aging Persons Award: Developing a Function-Focused Approach to Pain Management for Older Adults with Chronic Low Back Pain

The overarching goal of our research program is to improve physical function and participation in older adults with chronic musculoskeletal conditions, particularly low back pain (LBP). Despite the fact that LBP is a common problem for older adults and is associated with poor outcomes in this vulnerable age group, little research has focused on LBP in people over age 65. With minimal research available, clinicians do not have clear evidence-based guidance regarding management of older adults with LBP. This presentation will focus on our pathway towards developing a focused treatment algorithm designed to prevent and address the pain-related disability found in older adults with LBP. Our work has largely focused on the identification of potentially modifiable "rehabilitation risk factors" that are associated with pain and functional limitations, as well as the development of interventions to address these risk factors. Specifically, we will discuss our findings relative to trunk muscle impairments and clinical hip impairments in the context of the older adult with low back pain.

Effects of Bacteroides-Based Microecologics against Antibiotic-Associated Diarrhea in Mice

Antibiotic-associated diarrhea (AAD) is a self-limiting disease mediated by antibiotic therapy. In clinical practice, several types of probiotics are used in treating AAD, but minimal research has been done on Bacteroides-based microecologics. Our aim was to evaluate the therapeutic effects of Bacteroidetes uniformis FGDLZ48B1, B. intestinalis FJSWX61K18, Bifidobacterium adolescentis FHNFQ48M5, and B. bifidum FGZ30MM3 and their mixture on AAD in mice. The lincomycin hydrochloride-induced AAD models were gavaged with a single strain or a probiotic mixture for a short period to assess the changes in colonic histopathology and cytokine concentrations, intestinal epithelial permeability and integrity, short-chain fatty acids (SCFAs), and the diversity of intestinal microbiota. Our data indicated that both the sole use of Bacteroides and the combination of Bacteroides and Bifidobacterium beneficially weakened systemic inflammation, increased the recovery rate of tissue structures, increased the concentrations of SCFAs, and restored the gut microbiota. Moreover, the probiotic mixture was more effective than the single strain. Specifically, B. uniformis FGDLZ48B1 combined with the B. adolescentis FHNFQ48M5 group was more effective in alleviating the pathological features of the colon, downregulating the concentrations of interleukin (IL)-6, and upregulating the expression of occludin. In summary, our research suggests that administration of a mixture of B. uniformis FGDLZ48B1 and B. adolescentis FHNFQ48M5 is an effective approach for treating AAD.

ANALYSIS OF VISITORS’ EXPERIENCES AT THE OLD MELBOURNE GAOL

Visitation to the dark past of history is growing where more tourist is confronting concepts of mortality. Still, it appears to have minimal research on dark tourist experiences in the context of prison museums, particularly the Old Melbourne Gaol. The aim of the research is to analyse visitors’ experiences and provide recommendation for improvement. The relevance of the research is understanding dark tourist experiences will give insight into how service offerings can be improved in prison museums. The researcher conducted a qualitative study using thematic analysis to understand visitor experiences better and provide recommendation for future visitation. Purposive sampling was used to explore mixed reviews from the widely used platform called TripAdvisor. One of the key findings is that most visitors are international tourists accompanied by family or friends visiting towards the end of the year, which means that service offerings should be geared towards this group. Furthermore, the overall visitor experience is positive, and emerging themes narrates the authenticity of carceral life, interactive experience and exciting reenactments at the Old Melbourne Goal. Lastly, the findings reveal the need to reconsider the role of customer service as it influences the overall satisfaction of visitors and strengthen substantial aspects of service offerings to increase visitation and enhance the visitor experience.

Influence of Corporate Governance on Performance in Public Hospitals in Embu County, Kenya

Corporate governance is important to the performance of Public Hospitals (PHs) all over the world. This study investigated the Influence of Corporate Governance on Performance in PHs in Embu County, Kenya. The objective of the study was to assess how board characteristics influence performance in PHs in Embu County. The study’s main problem was to assess the performance in PHs using level of customer satisfaction, level of employees’ satisfaction and efficiency. Given that there is minimal research in corporate governance on management of PHs especially in Embu County, the study addressed challenges faced by management, thus helping formulate policies and strategic guidance for County Governments (CGs). The Stewardship Leadership Theory and Organizational Leadership Style were used to develop the theoretical framework on corporate governance. The information was gathered from 140 respondents using questionnaires. Quantitative data was analyzed using Descriptive Statistics whereas Qualitative data was analyzed using Content Analysis Method. The findings were then recapitulated to ascertain whether PHs have put in place policies and guidelines that conduct best practices of corporate governance. Some of the outcome were; PHs complied with the application of corporate governance but failed to implement it fully; the PHs adhered to most of the regulations and government policies but failed to fully adhere to corporate governance guidelines on board characteristics. Finally, the summary and recommendations were then prepared for policy formulation and future use in research on corporate governance on performance in PHs in Embu County, Kenya and globally.