Search

OBJECTIVES In recent years, Indigenous health curricula have been integrated into medical education in response to international calls to improve Indigenous health care. Instruments to evaluate Indigenous health education are urgently needed. We set out to validate a tool to measure self-reported medical student preparedness to provide culturally safe care to Indigenous Peoples. We then applied the tool to evaluate the effectiveness of the Northern Ontario School of Medicine University's (NOSM U) Indigenous health curriculum. METHODS We conducted psychometric testing of a 46-item draft NOSM Cultural Competency and Safety Tool (CAST). Testing included principal components analysis, subscale and item analysis, and the use of paired sample t -tests to examine pre- and posttest change to measure learner outcomes. The NOSM CAST was transposed to create a retrospective pre–posttest survey with single-point-in-time scoring. RESULTS Respondents included five cohorts of first-year undergraduate medical students, with 305 of 320 participating (response rate of 95.3%). The validated survey subscales included knowledge, confidence/preparedness, attitudes, intentions for advocacy, antidiscrimination, and self-reflective practice, measured using 36 scale items. Cronbach's alpha showed good to excellent internal consistency for the scales ( α range = 0.82–0.91). Composite reliability values were acceptable. The pre–posttest analysis showed statistically significant increases on four scales: knowledge [ t (254) = 15.10, P

Introduction: Out of all the modifiable risk factors for Alzheimer's disease and related dementias (ADRD), physical inactivity is the strongest. Rural residents have an increased risk for dementia and face significant barriers to accessing ADRD information, caregiving support, and memory-related services, which contributes to substandard care. Rural communities have greater barriers to participating in physical activity, and in particular exercise, due to lack of social support, travel/weather problems, and lack of facilities/equipment. The purpose of this pilot study was to implement and evaluate the feasibility and safety of a synchronous, remotely delivered, aerobic exercise (AEx) telerehabilitation program in persons with subjective cognitive decline (SCD) living in rural areas. Methods: The Minnesota Rehabilitation Intervention for Dementia Evasion for rural residents (MN RIDE) pilot study was one of five pilot studies conducted through the Center for Community Engaged Rural Dementia and Alzheimer's Research, conducted in collaboration with the Memory Keepers Medical Discovery Team. The Memory Keepers Medical Discovery Team employs a community-based participatory research model and uses a community advisory group, community-based researchers and a rural community engagement specialist to ensure research studies are aligned with rural community needs and to facilitate the recruitment of participants living in rural northern Minnesota. The MN RIDE study employed a single group, pretest-post-test design to test the feasibility and safety of an AEx-focused synchronous telerehabilitation program in rural-living middle-aged or older adults (>45 years) with SCD (indicated by answering yes to both, 'Do you perceive memory or cognitive difficulties?' and 'In the last two years, has your cognition or memory declined?'). All 36 AEx sessions (conducted over 12 weeks) were supervised remotely via smart devices and Zoom. The AEx program was classified as moderate intensity stationary cycling starting at a rating of perceived exertion (RPE) 11-12 or for 30-35 minutes in session 1, and was alternatively increased by 1-point RPE or 5-minute increments as tolerated up to RPE 12-14 for 50 minutes a session over time (by session 18). Secondarily, moderate intensity was defined as achieving an exercise heart rate of 64-76% of age-predicted maximum heart rate (HRmax). Feasibility and safety outcomes were assessed by session attendance, intensity adherence, presence of adverse events, and participant satisfaction. Results: The average age of the study sample (n=9) was 57.44±7.16 years (average age of SCD onset 53.44±7.47 years) with 14.00±5.57 years of education and 88.9% female. All patients completed the study, resulting in a dropout rate of 0%. Out of the possible 324 sessions scheduled, 276 were attended (85% session adherence). Average intensity metrics achieved over the AEx sessions were RPE 13.2±0.5 and HRmax 72.0±7.9%, which both represent of moderate intensity AEx metrics. No adverse events were reported. Conclusion: This pilot study further provides the first evidence of preliminary feasibility of synchronous audiovisual, telerehabilitation programs delivered to rural residents at risk for ADRD. Thus, exercise telerehabilitation programs that focus on AEx could be viable and useful tools to overcome situations with limited access to healthcare services such as in rural communities. Further controlled studies with greater sample size could help further expand our results.

Conducting community-based participatory research (CBPR) is a complex endeavor, particularly when training non-academic community members. Though examples of CBPR training programs and protocols have been published, they often address a limited set of concepts and are tailored for university or medical school students. Here, we describe the process of developing an online CBPR training program for American Indian (United States) and Indigenous (Canada) community members to conduct multi-sited ethnographic dementia research. This program is unique in its breadth and depth, as our program covers CBPR theory, methods, practical research, and administrative skills. Significantly, this program centers Indigenous methodology, pedagogy, and processes such as two-eyed seeing, storywork, and decolonization approaches. Key to this training program is a “second-generation” approach which incorporates experiential knowledge from a prior community-based researcher and academic partners and is designed to develop CBPR capacity among community-based researchers and partnering communities. In this paper, we detail the experience of the first cohort of learners and subsequent improvement of the training materials. Unique challenges related to the specific research focus (dementia), population/setting (American Indian/First Nations communities), and technology (rural digital infrastructure) are also discussed.

BackgroundDifferentiation of lymphocytic-plasmacytic enteropathy (LPE) from small cell lymphoma (SCL) in cats can be challenging.Hypothesis/objectiveHistology-guided mass spectrometry (HGMS) is a suitable method for the differentiation of LPE from SCL in cats.AnimalsForty-one cats with LPE and 52 cats with SCL.MethodsThis is a retrospective clinicopathologic study. Duodenal tissue samples of 17 cats with LPE and 22 cats with SCL were subjected to HGMS, and the acquired data were used to develop a linear discriminate analysis (LDA) machine learning algorithm. The algorithm was subsequently validated using a separate set of 24 cats with LPE and 30 cats with SCL. Cases were classified as LPE or SCL based on a consensus by an expert panel consisting of 5-7 board-certified veterinary specialists. Histopathology, immunohistochemistry, and clonality testing were available for all cats. The panel consensus classification served as a reference for the calculation of test performance parameters.ResultsRelative sensitivity, specificity, and accuracy of HGMS were 86.7% (95% confidence interval [CI]: 74.5%-98.8%), 91.7% (95% CI: 80.6%-100%), and 88.9% (95% CI: 80.5%-97.3%), respectively. Comparatively, the clonality testing had a sensitivity, specificity, and accuracy of 85.7% (95% CI: 72.8%-98.7%), 33.3% (95% CI: 14.5%-52.2%), and 61.5% (95% CI: 48.3%-74.8%) relative to the panel decision.Conclusions and clinical importanceHistology-guided mass spectrometry was a reliable technique for the differentiation of LPE from SCL in duodenal formalin-fixed paraffin-embedded samples of cats and might have advantages over tests currently considered state of the art.

Nurses in Canada face diverse challenges to their ongoing educational pursuits. As a result, they have been early adopters of courses and programs based on distance education principles and, in particular, online learning models. In the study described in this paper, nurses studying at two northern universities, in programs involving online learning, were interviewed about their learning experiences and the impact of these experiences on their practice. The study led to insights into the factors affecting teaching and learning in distance settings; the complex work-life-study roles experienced by some nurses; life and work realities in northern settings; and the sustained importance of access enabled by online learning approaches.

BackgroundHematopoietic malignancies are extremely common in pet dogs and represent nearly 30% of the malignancies diagnosed in this population each year. Clinicians commonly use existing tools such as physical exam findings, radiographs, ultrasound and baseline blood work to monitor these patients for treatment response and remission. Circulating biomarkers, such as prostate specific antigen or carcinoembryonic antigen, can be useful tools for monitoring treatment response and remission status in human cancer patients. To date, there has a been a lack of useful circulating biomarkers available to veterinary oncology patients.MethodsCirculating plasma nucleosome concentrations were evaluated at diagnosis, throughout treatment and during remission monitoring for 40 dogs with lymphoma, acute myelogenous leukemia and multiple myeloma. Additionally, C-reactive protein and thymidine kinase-1 levels were recorded.ResultsPlasma nucleosome concentrations were significantly higher at diagnosis and progressive disease than they were when dogs were in remission. All but two dogs had plasma nucleosome concentrations that returned to the low range during treatment. These two dogs had the shortest progression free and overall survival times. Dogs with the highest plasma nucleosome concentrations had a significantly shorter first progression free survival than dogs with lower plasma nucleosome concentrations at diagnosis. Plasma nucleosome concentrations correlated better with disease response and progression than either thymidine kinase or C reactive protein.ConclusionsPlasma nucleosome concentrations can be a useful tool for treatment monitoring and disease progression in dogs with hematopoietic malignancies.

Waste from dairy production is one of the largest sources of contamination from antimicrobial resistant bacteria (ARB) and genes (ARGs) in many parts of the world. However, studies to date do not provide necessary evidence to inform antimicrobial resistance (AMR) countermeasures. We undertook a detailed, interdisciplinary, longitudinal analysis of dairy slurry waste. The slurry contained a population of ARB and ARGs, with resistances to current, historical and never-used on-farm antibiotics; resistances were associated with Gram-negative and Gram-positive bacteria and mobile elements (ISEcp1, Tn916, Tn21-family transposons). Modelling and experimental work suggested that these populations are in dynamic equilibrium, with microbial death balanced by fresh input. Consequently, storing slurry without further waste input for at least 60 days was predicted to reduce ARB spread onto land, with > 99 % reduction in cephalosporin resistant Escherichia coli. The model also indicated that for farms with low antibiotic use, further reductions are unlikely to reduce AMR further. We conclude that the slurry tank is a critical point for measurement and control of AMR, and that actions to limit the spread of AMR from dairy waste should combine responsible antibiotic use, including low total quantity, avoidance of human critical antibiotics, and choosing antibiotics with shorter half-lives, coupled with appropriate slurry storage.

Abstract Gastrointestinal (GI) toxicosis is a common side effect of cytotoxic chemotherapy treatment in humans and dogs. Measurement of cytokeratin 18 (CK18), an intracellular structural protein released during epithelial apoptosis, and Alpha1‐Antitrypsin (A1AT) in faeces provides a mechanism for evaluating damage to the intestinal mucosa secondary to cytotoxic chemotherapy. Our goal was to evaluate the clinical utility of plasma CK18 and faecal A1‐AT levels as non‐invasive biomarkers of cytotoxic chemotherapy induced GI toxicity. We conducted a prospective cohort study in dogs (N = 10) with osteosarcoma undergoing amputation followed by carboplatin chemotherapy. We hypothesized that plasma CK18 and faecal A1‐AT levels would increase following carboplatin administration due to drug‐induced GI epithelial damage/apoptosis, and that plasma CK18 and faecal A1‐AT levels would correlate with severity of GI toxicity. Mean baseline plasma CK18 concentration was variable amongst patients; however, CK18 concentration prior to carboplatin chemotherapy treatment was not significantly different from CK18 levels after treatment. There was significant intra and inter‐patient variability in mean faecal A1‐AT levels at baseline. Mean A1‐AT concentration did not change significantly from day 0 to day 21. Gastrointestinal toxicity was minimal; therefore, we were unable to determine the association of plasma CK18 and faecal A1‐AT concentrations with development of GI toxicosis. In this study population, plasma CK18 and faecal A1‐AT concentration were not clinically useful biomarkers for the detection of GI toxicosis secondary to carboplatin administration. Further prospective evaluation of CK18 and A1‐AT as biomarkers of drug‐induced GI toxicity is warranted in a larger cohort of dogs receiving cytotoxic chemotherapy. AVMA clinical trial registration number: AAHSD004827.

Copyright of Agrokreatif: Jurnal Ilmiah Pengabdian Kepada Masyarakat is the property of IPB University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Differentiation of lymphocytic‐plasmacytic enteropathy (LPE) from small cell lymphoma (SCL) in cats can be challenging. Hypothesis/Objective Histology‐guided mass spectrometry (HGMS) is a suitable method for the differentiation of LPE from SCL in cats. Animals Forty‐one cats with LPE and 52 cats with SCL. Methods This is a retrospective clinicopathologic study. Duodenal tissue samples of 17 cats with LPE and 22 cats with SCL were subjected to HGMS, and the acquired data were used to develop a linear discriminate analysis (LDA) machine learning algorithm. The algorithm was subsequently validated using a separate set of 24 cats with LPE and 30 cats with SCL. Cases were classified as LPE or SCL based on a consensus by an expert panel consisting of 5‐7 board‐certified veterinary specialists. Histopathology, immunohistochemistry, and clonality testing were available for all cats. The panel consensus classification served as a reference for the calculation of test performance parameters. Results Relative sensitivity, specificity, and accuracy of HGMS were 86.7% (95% confidence interval [CI]: 74.5%‐98.8%), 91.7% (95% CI: 80.6%‐100%), and 88.9% (95% CI: 80.5%‐97.3%), respectively. Comparatively, the clonality testing had a sensitivity, specificity, and accuracy of 85.7% (95% CI: 72.8%‐98.7%), 33.3% (95% CI: 14.5%‐52.2%), and 61.5% (95% CI: 48.3%‐74.8%) relative to the panel decision. Conclusions and Clinical Importance Histology‐guided mass spectrometry was a reliable technique for the differentiation of LPE from SCL in duodenal formalin‐fixed paraffin‐embedded samples of cats and might have advantages over tests currently considered state of the art.

This article examines evidence of academic skill development and transfer related to the taking of a first year Inquiry-based seminar course designed to enhance a range of self-directed learning skills and their transferability to other learning contexts. The study compares a sample of academic work from two groups of Social Sciences students, one comprised of students who had taken the Inquiry course and the other who had not. The student work consists of (1) papers submitted by participants who were asked for the best paper they had written at university; and (2) descriptive narratives provided by participants of the steps they took in researching and writing that paper. Qualitative and quantitative analysis by multiple raters using a blinded protocol was conducted. The results show both meaningfully higher paper and skill assessments for students who had taken the inquiry seminar and evidence of transfer of skills and strategy to other learning contexts, supporting the hypothesis that transfer of core skills occurs under particular learning conditions that can be fostered through course design and enhanced through specific pedagogical objectives.

This paper examines whether a single first-year inquiry-based seminar can have a lasting impact on students' academic skills. Fifty-four Inquiry students and 71 comparable students participated in three performance tests: a research skills exercise; an evaluation of oral presentation ability; and a test of critical reasoning and teamwork skills. In addition, participants completed a questionnaire focusing on learning approaches and experiences. The study demonstrates the feasibility of measuring long-term effects of relatively small educational interventions. Findings indicate that although universities may not be developing the skills they assume, a single first-year inquiry seminar can have far reaching effects on academic skill development and these skills are typically lasting.

BackgroundPeripheral blood hematopoietic cell transplantation (PBHCT) is a feasible treatment option for dogs with B-cell lymphoma.ObjectiveTo examine apheresis and PBHCT outcomes in dogs diagnosed with T-cell lymphoma (TCL).AnimalsFifteen client-owned dogs diagnosed with high-grade TCL.MethodsAfter high-dose cyclophosphamide and rhG-colony-stimulating (rhG-CSF) factor treatment, peripheral blood mononuclear cells were collected using cell separators. The harvested cells then were infused after varying doses of total body irradiation (TBI). Postirradiation adverse effects were managed symptomatically and dogs were discharged upon evidence of hematopoietic engraftment.ResultsMore than 2 × 10(6) CD34+ cells/kg were harvested from 15/15 dogs. Thirteen of 15 (87%) dogs engrafted appropriately, whereas 2 (13%) of the dogs died in the hospital. One dog developed cutaneous B-cell lymphoma 120 days post-PBHCT. The median disease-free interval and overall survival (OS) of the 13 dogs transplanted in first remission from the time of PBHCT were 184 and 240 days, respectively. Stage and substage of disease at diagnosis had no effect on OS. Two of 13 (15%) dogs were alive 741 and 772 days post-PBHCT.Conclusions and clinical importancePBHCT may be considered as a treatment option for dogs with TCL.

Abstract Introduction Despite increasing dementia rates, few culturally informed cognitive assessment tools exist for Indigenous populations. The Canadian Indigenous Cognitive Assessment (CICA) was adapted with First Nations on Manitoulin Island, Canada, and provides a brief, multi‐domain cognitive assessment in English and Anishinaabemowin. Methods Using community‐based participatory research (CBPR) methods, we assessed the CICA for inter‐rater and test–retest reliability in 15 individuals. We subsequently evaluated validity and established meaningful CICA cut‐off scores in 55 individuals assessed by a geriatrician. Results The CICA demonstrated strong reliability (intra‐class coefficient = 0.95 [0.85,0.98]). The area under the curve (AUC) was 0.98 (0.94, 1.00), and the ideal cut‐point to identify likely cases of dementia was a score of less than or equal to 34 with sensitivity of 100% and specificity of 85%. Discussion When used with older First Nations men and women living in First Nations communities, the CICA offers a culturally safe, reliable, and valid assessment to support dementia case‐finding.

Educational values are closely related to literary works. Literary works (including novel) always reveal good values that are beneficial to its readers. Educational values can also be referred to a message. The element of message becomes the idea underlying the creation of the literary works. It is expected to be interpreted by the readers to be used as educational values as well as social control that can be used as a guide to interact in real life. Therefore, the aim of the study was to describe the educational values contained in the novel Uhibbuka Fillah (Aku Mencintaimu Karena Allah) by Ririn Rahayu Astuti Ningrum with the approach of literary sociology. Data collection techniques were documentation techniques. The data were analyzed using the content analysis. The results showed that the educational values found in the novel Uhibbuka Fillah (Aku Mencintaimu Karena Allah) by Ririn Rahayu Astuti Ningrum consisted of religious, moral, social, and cultural. (1) The values of religious education, encompassing about loving all things must be due to Allah, having resignation, increasing the knowledge of religion, accustoming to fasting and sunnah prayer, covering aurat, and ghadhdhul bashar (holding sight). (2) The values of moral education, including about obedience to parents, good morals, sincerity and honesty. (3) The values of social education, including about love to orphans, help, and keep promises to others. (4) The value of cultural education is about the palace building that has implied meaning. The findings are very well used as the example in shaping positive values in real life. Nilai-nilai pendidikan sangat erat kaitannya dengan karya sastra. Setiap karya sastra yang baik (termasuk novel) selalu mengungkapkan nilai-nilai luhur yang bermanfaat bagi pembacanya. Nilai-nilai pendidikan dalam karya sastra dapat disebut juga sebagai amanat atau pesan. Unsur amanat atau pesan menjadi gagasan yang mendasari diciptakannya karya sastra tersebut. Hal tersebut diharapkan dapat ditafsirkan oleh pembaca agar bisa dijadikan sebagai ilmu atau nilai pendidikan sekaligus kontrol sosial yang bisa dijadikan pedoman berinteraksi dalam kehidupan yang nyata. Oleh karena itu, penelitian ini bertujuan untuk mendeskripsikan nilai-nilai pendidikan yang terkandung dalam novel Uhibbuka Fillah (Aku Mencintaimu Karena Allah) karya Ririn Rahayu Astuti Ningrum dengan pendekatan sosiologi sastra. Data dalam penelitian kualitatif deskriptif ini berupa kata, kalimat, atau wacana yang bersumber dari novel Uhibbuka Fillah (Aku Mencintaimu Karena Allah) karya Ririn Rahayu Astuti Ningrum. Teknik pengumpulan data yang digunakan adalah teknik dokumentasi, simak, dan catat. Analisis data dilakukan dengan content analysis. Berdasarkan hasil analisis dapat disimpulkan bahwa nilai-nilai pendidikan yang ditemukan dalam novel Uhibbuka Fillah (Aku Mencintaimu Karena Allah) karya Ririn Rahayu Astuti Ningrum terdiri dari nilai pendidikan agama, moral, sosial, dan budaya. (1) Nilai-nilai pendidikan agama, mencakup ajaran untuk mencintai segala sesuatu harus karena Allah, tawakkal hanya kepada Allah, mendalami ilmu agama, membiasakan puasa dan sholat sunnah, menutup aurat, dan ghadhdhul bashar (menundukkan atau menahan pandangan). (2) Nilai-nilai pendidikan moral, mencakup ajaran untuk taat dan patuh kepada orang tua, berakhlak baik, berbuat tulus dan jujur. (3) Nilai-nilai pendidikan sosial, mencakup ajaran untuk mencintai anak yatim, tolong menolong, dan menepati janji kepada orang lain. (4) Nilai pendidikan budaya antaranya mengenai bangunan keraton yang memiliki makna tersirat. Dari keseluruhan nilai-nilai pendidikan yang terdapat dalam novel ini, sangatlah baik digunakan sebagai contoh dalam membentuk dan menanamkan nilai-nilai positif dalam kehidupan nyata

Understanding the relationship between land use and the dynamics of nitrate (NO3−) is the key to constrain sources of NO3− export in order to aid effective management of waterways. In this study, isotopic compositions of NO3− (δ15N–NO3− and δ18O–NO3−) were used to elucidate the effects of land use (agriculture in particular) and rainfall on the major sources and sinks of NO3− within the Western Port catchment, Victoria, Australia. This study is one of the very few studies carried out in temperate regions with highly stochastic rainfall patterns, enabling a more comprehensive understanding of the applications of NO3− isotopes in catchment ecosystems with different climatic conditions. Longitudinal samples were collected from five streams with different agriculture land use intensities on five occasions – three during dry periods and two during wet periods. At the catchment scale, we observed significant positive relationships between NO3− concentrations (p δ15N–NO3− (p 3− in our study sites. Artificial fertiliser was the dominant source of NO3− during the wet periods. In addition to artificial fertiliser, nitrified organic matter in sediment was also an apparent source of NO3− to the surface water during the dry periods. Denitrification was prevalent during the wet periods, while uptake of NO3− by plants or algae was only observed during the dry periods in two streams. The outcome of this study suggests that effective reduction of NO3− load to the streams can only be achieved by prioritising management strategies based on different rainfall conditions.

Conducting community-based participatory research (CBPR) is a complex endeavor, particularly when training non-academic community members. Though examples of CBPR training programs and protocols have been published, they often address a limited set of concepts and are tailored for university or medical school students. Here, we describe the process of developing an online CBPR training program for American Indian (United States) and Indigenous (Canada) community members to conduct multi-sited ethnographic dementia research. This program is unique in its breadth and depth, as our program covers CBPR theory, methods, practical research, and administrative skills. Significantly, this program centers Indigenous methodology, pedagogy, and processes such as two-eyed seeing, storywork, and decolonization approaches. Key to this training program is a "second-generation" approach which incorporates experiential knowledge from a prior community-based researcher and academic partners and is designed to develop CBPR capacity among community-based researchers and partnering communities. In this paper, we detail the experience of the first cohort of learners and subsequent improvement of the training materials. Unique challenges related to the specific research focus (dementia), population/setting (American Indian/First Nations communities), and technology (rural digital infrastructure) are also discussed. [ABSTRACT FROM AUTHOR]