Mid Illinois Hematology and Oncology Associates

While several PROMs are used to assess IPF cough severity, none have been developed and validated to the standard needed to support regulatory approval of new drugs. We set out to develop and validate a simple PROM that could be completed by patients with IPF cough to support drug approval. Following literature review and expert interviews, a one question 11-point numerical rating scale (NRS, recall=24hrs) was tested in an observational study in IPF patients, including cognitive debriefing. This led to the addition of 2 severity questions at different times of the day (Early Morning, Rest of the Day) resulting in the 3-item IPF CSS (v2). Psychometric properties were evaluated qualitatively (37 interviews) and quantitatively (N=80) in the ORV-PF-01 study (<ext-link>NCT05185089</ext-link>). Analyses were done on mean weekly scores with a focus on the Daily (last 24 hours) question. Within subject, mean scores are stable and between subject variance is low (CV%=17.8%). Floor and ceiling score effects are minimal. Test-retest reliability is good (ICC 0.81 in stable patients) and scores respond to change during treatment. Known groups validity and construct validity is shown through correlation with other cough assessments (global ratings of status/change, Leicester Cough Questionnaire). Distribution-based methods show a group mean difference of -0.7 points is clinically meaningful, and anchor-based methods show the meaningful within subject change is -1.1 points. Findings were similar for the other 2 questions. The IPF CSS v2 is a simple, valid NRS PROM for assessing cough severity in IPF; clinically relevant differences and changes are defined.

Este proyecto tiene como objetivo principal la creación de ambientes de aprendizaje positivo para promover la equidad de género entre 104 estudiantes normalistas. Se basa en la implementación de estrategias pedagógicas y prácticas educativas inclusivas que buscan transformar las percepciones y actitudes de los estudiantes hacia la equidad de género. Mediante un enfoque cualitativo, se recopilaron datos a través de entrevistas, cuestionarios y observaciones en el aula. Las estrategias implementadas incluyen talleres de sensibilización, actividades colaborativas y el uso de narrativas pedagógicas que destacan la importancia de la equidad y la inclusión. Estos métodos no solo apuntan a aumentar la conciencia sobre la equidad de género, sino también a fomentar un ambiente de respeto y colaboración entre los estudiantes. Los resultados preliminares indican que la implementación de estas estrategias ha tenido un impacto positivo en las actitudes de los estudiantes. Se observó una mayor apertura y disposición para discutir temas relacionados con la equidad de género, así como una mejora en las interacciones sociales y académicas dentro del aula, demostrando una mayor comprensión por la diversidad y la inclusión.

Communication breakdowns in PICUs contribute to inadequate parent support and poor post-PICU parent outcomes. No interventions supporting communication have demonstrated improvements in parental satisfaction or psychologic morbidity. We compared parent-reported outcomes from parents receiving a navigator-based parent support intervention (PICU Supports) with those from parents receiving an informational brochure. Patient-level, randomized trial. Two university-based, tertiary-care children's hospital PICUs. Parents of patients requiring more than 24 hours in the PICU. PICU Supports included adding a trained navigator to the patient's healthcare team. Trained navigators met with parents and team members to assess and address communication, decision-making, emotional, informational, and discharge or end-of-life care needs; offered weekly family meetings; and did a post-PICU discharge parent check-in. The comparator arm received an informational brochure providing information about PICU procedures, terms, and healthcare providers. The primary outcome was percentage of "excellent" responses to the Pediatric Family Satisfaction in the ICU 24 decision-making domain obtained 3-5 weeks following PICU discharge. Secondary outcomes included parental psychologic and physical morbidity and perceptions of team communication. We enrolled 382 families: 190 received PICU Supports, and 192 received the brochure. Fifty-seven percent (216/382) completed the 3-5 weeks post-PICU discharge survey. The mean percentage of excellent responses to the Pediatric Family Satisfaction in the ICU 24 decision-making items was 60.4% for PICU Supports versus 56.1% for the brochure (estimate, 3.57; SE, 4.53; 95% CI, -5.77 to 12.90; p = 0.44). Differences in secondary outcomes were not statistically significant. Most parents (91.1%; 113/124) described PICU Supports as "extremely" or "somewhat" helpful. Parents who received PICU Supports rated the intervention positively. Differences in decision-making satisfaction scores between those receiving PICU Supports and a brochure were not statistically significant. Interventions like PICU Supports should be evaluated in larger studies employing enhanced recruitment and retention of subjects.

One of the biggest challenges for a university-based Medical Laboratory Science (MLS) program that is not attached to a medical center is finding enough clinical sites for the student professional practice experience on a yearly basis. Some current clinical affiliates host students year after year but mergers and buy-outs, implementation of new instrumentation or information systems, as …

\n Pesquisas e projetos envolvendo a complexa interação de maciços rochosos com estruturas de suporte de túneis evoluem constantemente. A adoção de modelos numéricos sofisticados aliada ao desenvolvimento de computadores com capacidade de processamento crescente possibilitam representações mecânicas de processos complexos. Para análises geotécnicas, considerações de resistência, deformabilidade e condutividade hidráulica do maciço são encontradas em códigos computacionais com representações próximas das encontradas nas pesquisas experimentais de vanguarda da área. Por outro lado, estes mesmos códigos atribuem com frequência ao comportamento do concreto reforçado representações simplistas, muitas vezes com base na teoria da elasticidade. Implicações econômicas e de incerteza na avaliação da segurança decorrem desta forma de representação. Esta pesquisa visa a contribuir para análises da interação entre maciço e suporte de uma escavação subterrânea. Para tanto foram elaboradas simulações numéricas considerando técnicas consagradas de avaliação mecânica de uma escavação, aliadas a uma representação do concreto reforçado considerando o marcante efeito de fissuração. Com foco no comportamento do concreto foram desenvolvidas simulações numéricas de distintas estruturas de concreto reforçado selecionadas na literatura e que contam com boa instrumentação e caracterização mecânica adequada de seus materiais. Os resultados obtidos indicam a possibilidade da avaliação concomitante das complexas características do maciço assim como do concreto reforçado. Este fato contribui para a avaliação da segurança de uma escavação subterrânea com possíveis repercussões no custo das obras.\n

Parents and guardians of children with disabilities and chronic illness travel a difficult road. This appears to be especially true of parents/guardians of children with feeding and swallowing problems. These parents/guardians experience concerns that influence their children’s ability to access an appropriate education, as they often negatively affect their children’s health, nutrition, and social-emotional experiences. The particular experiences and concerns that parents/guardians of children with feeding/swallowing problems face in managing these issues in home and school settings have not been investigated. To this end, semi-structured interviews were conducted with parents/guardians of 8 children identified with feeding and/or swallowing disorders who ranged in age from 2 through 11 years. Research questions focused on descriptions of parent experiences related to their children’s feeding/swallowing problems, interactions with professionals involved in intervention, and experiences with school-based management of feeding/swallowing problems. Results may lead to development of improved preparation and training of professionals responsible for providing special education and related services for children with disabilities affecting feeding/swallowing processes.