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In September 2016, Queen's University launched the first, fully online, 4-year Bachelor of Health Science degree program in Canada. This paper reports on the developmental structure, implementation philosophy, and challenges in the development of this competency-based program. All stakeholders directly involved in program development were invited to participate in this qualitative case study. Thirty-five interviews and three focus groups (n=14) were conducted. Interviews and focus groups were transcribed verbatim and data were analyzed using thematic design. Themes included: program vision; desired program outcomes; administrative processes for funding and recruitment; uniqueness of the program; local, regional and international impact of the program; communication and collaborations for program development; and uncertainty in long term outcomes. Findings suggest that during program development, an explicit vision of program goals encouraged buy-in at most levels of the university. There was consensus that the overarching outcome should be to provide a rigorous, high quality program with pathways to professional, basic science, global health and advocacy-based health professions. The online modality was expected to improve accessibility to degree programs, as well as address diverse student learning needs. Innovation played a vital role in the program's development and was founded in educational theory and curriculum development practices.

This study critically examined the math content knowledge (MCK) of teacher candidates (TCs) enrolled in a two-year Master of Teaching (MT) degree. Teachers require a solid math knowledge base in order to support students' achievement. Provincial and international math assessments have been of major concern in Ontario, Canada, due to declining scores. Research aimed to investigate the development of TCs' math capacities for effective teaching is important to teachers, school districts, universities, professional learning associations, and policy makers. The researchers of this study analyzed the basic numeracy skills of 151 TCs through pre- and post-tests. In addition, eight TCs took part in semi-structured interviews and shared their experiences in the MT math program. Test results indicated improvements in many areas, however, not all numeracy skills improved significantly. Interviews revealed TCs' perceptions of the math test, courses, and instructors, as well as the importance of teaching math during their practicum placements. The researchers made recommendations to teacher education programs in areas such as: establishing minimum math competency standards, enhancing coherence between MT math courses and practicum placements, and providing additional support for TCs with low math proficiency.

Bronchial premalignant lesions (PMLs) are precursors of lung squamous cell carcinoma, but have variable outcome, and we lack tools to identify and treat PMLs at risk for progression to cancer. Here we report the identification of four molecular subtypes of PMLs with distinct differences in epithelial and immune processes based on RNA-Seq profiling of endobronchial biopsies from high-risk smokers. The Proliferative subtype is enriched with bronchial dysplasia and exhibits up-regulation of metabolic and cell cycle pathways. A Proliferative subtype-associated gene signature identifies subjects with Proliferative PMLs from normal-appearing uninvolved large airway brushings with high specificity. In progressive/persistent Proliferative lesions expression of interferon signaling and antigen processing/presentation pathways decrease and immunofluorescence indicates a depletion of innate and adaptive immune cells compared with regressive lesions. Molecular biomarkers measured in PMLs or the uninvolved airway can enhance histopathological grading and suggest immunoprevention strategies for intercepting the progression of PMLs to lung cancer.

Insufficient physical activity and a sedentary lifestyle are major contributors to health risks for Canadian youth. Adolescents, particularly females, tend to experience major drop-offs in physical activity levels during high school. However, there is minimal research examining the extent to which physical and health education (PHE) courses promote physical activity and mitigate against this decline. Grounded in the theory of planned behavior (TPB), this quantitative short-term longitudinal study examined the effectiveness of Grade 9 PHE for 197 students' reports of TPB constructs, physical activity intentions, and physical activity behavior. Results were analyzed using 2 (time: Time Point 1 [T1], Time Point 2 [T2]) * 2 (condition: in PHE/not in PHE) * 2 (TPB status: higher or lower than the mean) MANCOVAs with males and females examined separately. Findings revealed there was no interaction among time, condition, and TPB status, meaning that students' physical activity intentions and TPB constructs did not change over the study. There was a significant effect of condition for females in PHE. Attitude and Physical Activity Behavior were higher at both time points, indicating that females taking PHE classes had more positive attitudes and higher physical activity behavior than females not enrolled in PHE classes. PHE teachers should focus attention on changing attitudes toward physical activity for this age group, given the importance of this construct., Physical inactivity is the highest of all modifiable risk factors for several illnesses including type 2 diabetes, obesity, and cardiovascular disease (Warburton et al., 2006). Physical inactivity and a sedentary [...]

Background:To what extent steroid hormones contribute to lung cancer in male and female never smokers and smokers is unclear. We examined expression of hormone receptors in lung tumors by sex and smoking. Methods:Patients with primary non-small cell lung cancer were recruited into an Intergroup study in the United States and Canada, led by SWOG (S0424). Tumors from 813 cases (450 women and 363 men) were assayed using immunohistochemistry for estrogen receptor (ER)-α, ER-β, progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Linear regression was used to examine differences in expression by sex and smoking status. Cox proportional hazard models were used to estimate survival associated with the receptors. All statistical tests were two-sided. Results:In ever smokers, postmenopause and oral contraceptive use were associated with lower nuclear ER-β (P = .02) and total (nuclear + cytoplasmic) PR expression (P = .02), respectively. Women had lower cytoplasmic ER-α (regression coefficient [β], or differences in H-scores = -15.8, P = .003) and nuclear ER-β (β = -12.8, P = .04) expression than men, adjusting for age, race, and smoking. Ever smokers had both higher cytoplasmic ER-α (β = 45.0, P < .001) and ER-β (β = 25.9, P < .001) but lower total PR (β = -42.1, P < .001) than never smokers. Higher cytoplasmic ER-α and ER-β were associated with worse survival (hazard ratio = 1.73, 95% confidence interval [CI] = 1.15 to 2.58, and HR = 1.59, 95% CI = 1.08 to 2.33, respectively; quartiles 4 vs 1). Conclusions:Lower expression of nuclear ER-β in women supports the estrogen hypothesis in lung cancer etiology. Increasing cytoplasmic ER-α and ER-β and decreasing PR protein expression may be mechanisms whereby smoking disrupts hormone pathways.

BackgroundDelirium is a frequent and detrimental complication of inpatient hospitalization. Multicomponent intervention in selected groups has been shown to prevent and treat delirium, though little data exists on the effect of intervention in neurological patients. We studied the efficacy of a multicomponent delirium care pathway implemented on a largely neurology and neurosurgery hospital ward among unselected patients.MethodsWe incorporated a multicomponent delirium care pathway into the workflow of a university hospital for patients older than 50 years. The pathway involved risk-stratification for development of delirium, delirium screening, and non-pharmacologic behavioral prevention and intervention. We then retrospectively reviewed admissions before and after implementation of the care pathway. Our primary endpoint was incidence of delirium; secondary endpoints included delirium days, length of stay, restraint use, readmission rates, and discharge disposition.ResultsSeven hundred ninety eight admissions from before the delirium care pathway went into effect and 797 admissions from afterwards were reviewed. Baseline characteristics between groups were similar. Delirium incidence between the two groups did not change (7.0% before vs 7.2% after, p = 0.89). Length of stay among delirious patients significantly decreased after implementation of the delirium care pathway (9.60 before vs 7.06 after, β = - 0.16, adjusted p-value = 0.001).ConclusionImplementation of a delirium care pathway on a neurosciences ward was not associated with changes in the rate of delirium development, though length of stay among delirious patients decreased. In a largely neurologic population, multicomponent intervention to prevent and treat delirium may not change delirium incidence, but may be effective in mitigating delirium complications.

Intrauterine growth retardation (IUGR) is associated with neurological deficits including cerebral palsy and cognitive and behavioral disabilities. The pathogenesis involves oxidative stress that leads to periventricular white matter injury with a paucity of mature oligodendrocytes and hypomyelination. The molecular mechanisms underlying this damage remain poorly understood. We used a rat model of IUGR created by bilateral ligation of the uterine artery at embryonic Day 19 that results in fetal growth retardation and oxidative stress in the developing brain. The IUGR rat pups showed significant delays in oligodendrocyte differentiation and myelination that resolved by 8 weeks. Bone morphogenetic protein 4 (BMP4), which inhibits oligodendrocyte maturation, was elevated in IUGR brains at postnatal time points and returned to near normal by adulthood. Despite the apparent recovery, behavioral deficiencies were found in 8-week-old female animals, suggesting that the early transient myelination defects have permanent effects. In support of these in vivo data, oligodendrocyte precursor cells cultured from postnatal IUGR rats retained increased BMP4 expression and impaired differentiation that was reversed with the BMP inhibitor noggin. Oxidants in oligodendrocyte cultures increased BMP expression, which decreased differentiation; however, abrogating BMP signaling with noggin in vitro and in BMP-deficient mice prevented these effects. Together, these findings suggest that IUGR results in delayed myelination through the generation of oxidative stress that leads to BMP4 upregulation.

We determined Ar/Ar eruption ages of eight extrusions from the Pleistocene Coso volcanic field, a long-lived series of small volume rhyolitic domes in eastern California. Combined with ion-microprobe dating of crystal ages of zircon and allanite from these lavas and from granophyre geothermal well cuttings, we were able to track the range of magma-production rates over the past 650 ka at Coso. In ≤230 ka rhyolites we find no evidence of protracted magma residence or recycled zircon (or allanite) from Pleistocene predecessors. A significant subset of zircon in the ~85 ka rhyolites yielded ages between ~100 and 200 Ma, requiring that generation of at least some rhyolites involves material from Mesozoic basement. Similar zircon xenocrysts are found in an ~200 ka granophyre. The new age constraints imply that magma evolution at Coso can occur rapidly as demonstrated by significant changes in rhyolite composition over short time intervals (≤10’s to 100’s ka). In conjunction with radioisotopic age constraints from other young silicic volcanic fields, dating of Coso rhyolites highlights the fact that at least some (and often the more voluminous) rhyolites are produced relatively rapidly, but that many small-volume rhyolites likely represent separation from long-lived mushy magma bodies.