Digital Commons Network^™

The Italian Agreement Between The Government And The Regional Authorities: National Guidelines For Aai And Institutional Context, Martina Simonato, Marta De Santis, Laura Contalbrigo, Daniele Benedetti, Elisabetta Finocchi Mahne, Vincenzo Ugo Santucci, Silvio Borrello, Luca Farina

People and Animals: The International Journal of Research and Practice

Animal-assisted interventions (AAI) have developed considerably in the last half century, prompting various private and public realities dealing with AAI worldwide to work on and establish standards and best practice. However, AAI are still far from being regulated harmoniously. In this context, Italy offers a unique example at world level: here the spread of AAI has set in motion an ethical and legal reflection that led to the creation of the Italian National Reference Centre for AAI (NRC AAI) by ministerial decree in 2009 and the approval of National Guidelines for AAI in 2015. The Italian legislation on AAI is …

Quality And Access To Care For Cardiovascular Disease Prevalence In Women Veterans: Population Estimate Using Electronic Health Records, Meena Marie Kim-Dopp, Vanessa Gow-Lee, Linda Ferry, Sharon Jamie, Ralph Clark, Suma Singh

Loma Linda University Student Journal

Electronic Health Records are used to measure quality indicators for cardiovascular disease (CVD), but have not been tested for sensitivity and specificity. Computerized Patient Record System (CPRS) used by the Veterans Health Affairs (VHA), has active CVD clinical reminders from Healthcare Effectiveness Data & Information Set (HEDIS) that are compared nationally. San Bernardino County, CA has a 7.8% prevalence of self-reported CVD in both genders. For HEDIS measures, there is only a 4 point CVD composite score gender difference for VHA nationally, but at the Loma Linda VHA there is an 18 point gender difference (2016). Women Veterans (WV) are …

Is Engagement Alone Sufficient To Ensure “Active Learning”?, Reed Krause, Amy C. Hayton Md, Jeff Wonoprabowo, Lawrence Loo

Loma Linda University Student Journal

“Active Learning” is commonly defined as any instructional method that engages students in the learning process. However, active learning encompasses a broad range of educational methods and its impact on learning outcomes has been variable. In 2015, our IM clerkship redesigned its half-day learning sessions from a largely passive didactic style of lecturing to more active learning approaches. We further revised the curriculum in 2016 to further convert the sessions to primarily case based learning led by a faculty or resident. The goal of our intervention was to increase the Self-Reported Engagement Measure (STOBE) of each didactic session and improve …

Does Ecg And Arrhythmia Simulation Training In Adjunct To Didactics Improve Medical Students’ Clinical Skills Compared To Didactics Alone?, Reed Krause, Amy C. Hayton Md

Loma Linda University Student Journal

Medical Schools continue to face the challenge of bridging the gap between classroom education and its application in the clinical environment. Several studies have shown utility of incorporating simulation training into a variety of healthcare related topics. We hypothesize that incorporating ECG and arrhythmia simulation training in adjunction to ECG and arrhythmia didactics; it would improve Year-3 medical students’ preparedness for managing arrhythmias in the clinical setting.

Percutaneous Externally Assembled Laparoscopic (Peal) Donor Nephrectomy: A Cohort Pain Comparison, Tyler Miskin, Isaac Kelly, Matthew Pierce, Samuel Abourbih, Duane D. Baldwin

Loma Linda University Student Journal

Donor nephrectomies can be technically demanding. Donors also may not be fully psychologically prepared for their post-operative pain or cosmetic outcome. A novel Percutaneous Externally Assembled Laparoscopic (PEAL) paradigm was developed to decrease incisional pain and laparoscopic scars. The aim of this study is to compare the post-operative outcomes between donor nephrectomies performed with and without the PEAL instruments.

Glycemic Control In Insulin And Non-Insulin Dependent Diabetic Patients With St Elevation Predicts Time To Presentation, Jonathan Evans, David Hamilton, Tigran Khachatryan, Daniel K. Amponsah, Andrew Stewart, Islam Abudayyeh, Kenneth Jutzy, Eric Suh, Anthony Hilliard

Loma Linda University Student Journal

Worldwide, the annual number of people diagnosed with diabetes continues to increase. Classically, Diabetes Mellitus (DM) has been associated with silent or atypical initial symptoms and increased time to presentation in patients presenting with ST elevation myocardial infarction (STEMI) compared to non-DM patients. It is less clear whether the type of treatment or the adequacy of glycemic control impacts the time to presentation and type of symptoms. Therefore, we sought to evaluate the impact of poor glycemic control on these outcomes as measured by hemoglobin A1c.

Magnetically Focused Proton Irradiation Of Small Volume Radiosurgery Targets Using A Triplet Of Quadrupole Magnets, Patrick Mcgee, Grant Mcauley, Andrew Wroe, James M. Slater, Jerry D. Slater

Loma Linda University Student Journal

Proton therapy is an advantageous choice for the irradiation of tumors in proximity of critical structures due to rapid dose fall off and high dose deposition at target compared to dose at the surface of the patient (ie, peak-to-entrance dose ratio (P/E)). However, with target fields below 1.0 cm, as often encountered in proton radiosurgery, multiple Coulomb scattering (MCS) broadens proton beams leading to diminished P/E advantages and reduced dose delivery efficiency (DDE). Magnetic focusing tends to counteract MCS and is a promising method to reduce these undesirable effects. The purpose of this research is to investigate the advantages of …

Diffusion Tensor Imaging Findings In Pediatric Patients With Mild Traumatic Brain Injury, Tshea Dowers, B L. Bartnik, Barbara Holshouser, Stephen Ashwal, Samuel Barnes

Loma Linda University Student Journal

Approximately 14% of school age children with sports-related concussions (SRC) remain symptomatic 3 months after injury. Previous studies have used diffusion tensor imaging (DTI) to detect white matter tract changes in regions of interest in symptomatic patients; however data in the pediatric population remains limited. This study was undertaken to determine whether DTI metrics can provide valuable information in pediatric mTBI patients with persistent symptoms.

Multimodality Minimally Invasive Treatment Of Large Joint Osteoarthritis: A Pilot Trial Of Stromal Vascular Fraction From Autologous Fat Combined With Platelet-Rich Plasma, Phil Giddings, Insiyah Campwala, Subhas Gupta

Loma Linda University Student Journal

Osteoarthritis (OA) is a degenerative joint disease that can cause severe pain in those affected. Currently, there are no therapeutic drugs available to treat osteoarthritis. While total joint arthroplasties (TJA) allow for improved function, there are no less invasive, yet effective procedures that can be done for patients unwilling or unable to undergo major surgery.

Platelet-rich plasma (PRP) has been shown to reduce the symptoms of OA when injected into the affected joint. Patients treated by this method alone have improved self-reported pain (at least a 50% reduction from original value) as well as lower extremity function. While the effects …

Identification Of Unreported Sources Of Objects Containing High Release Nickel, David J. Eng, Mary A. Rasmussen, Chandler Rundle, James K. Parker, Daniel Bergman, Sharon E. Jacob

Loma Linda University Student Journal

Globally, nickel is the leading cause of allergic contact dermatitis (ACD). Nickel is ubiquitous, and published literature continues to index items most frequently associated with Ni-ACD. Unregulated nickel exposure in North America is evident by the unprecedented rates of sensitization seen in patch-tested cohorts, 18.5% in children (ages 0-18 years) and 28.1% in adults.¹ Conservative estimates of ACD within the pediatric population suggest at least one million cases in the US yearly with roughly one-quarter of those cases due to nickel.^2-3 The United States could potentially save $5.7 billion annually in health care costs, extrapolating current cost-saving data …

The Feasibility Of Percutaneous Externally Assembled Laparoscopic Nephrectomy: A New Surgical System, Benjamin West, Jerry Thomas, Mohamed Keheila, Nazih Khater, Samuel Abourbih, Salim Cheriyan, Matthew Pierce, Duane D. Baldwin, Jim Shen

Loma Linda University Student Journal

Laparoendoscopic single-site (LESS) nephrectomy provides excellent cosmetic outcomes, but is technically challenging due to loss of triangulation and increased instrument collision. A novel Percutaneous Externally Assembled Laparoscopic (PEAL) surgical system was developed to simplify minimally invasive surgery while providing a nearly scarless outcome. In this study, the feasibility of the PEAL system for nephrectomy was determined.

Comparing The Vaginal Wall Sling With Autologous Rectus Fascia And Polypropylene Sling On Outcome And Patient Satisfaction, Mohamed Keheila, Salim Cheriyan, Jim Shen, Catalino J. Bautista, Josianne Bailey, Kevin Kim, Marina Germanos, Isaac Kelly, Matthew Pierce, Andrea Staack

Loma Linda University Student Journal

Since 2011 FDA safety update on transvaginal synthetic mesh for treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP), providers are encouraged to counsel patients on risks related to synthetic mesh slings, such as dyspareunia, erosion, and extrusion. As an alternative to synthetic slings patients often choose autologous slings. We aim to compare outcome and patient satisfaction in patients, who received an autologous vaginal wall sling (VWS), rectus fascia sling (RFS), or synthetic suburethral sling (SSS) for treatment of SUI.

Assessing Dietary Advancement For Dysphagia Patients At Risk For Aspiration, Cedric Thiel, Thomas Murry, Brianna Crawley, Priya Krishna

Loma Linda University Student Journal

Fiberoptic endoscopic evaluation of swallowing (FEES) evaluates oral intake safety by allowing direct observation of laryngeal function before and after swallowing. The purpose of this study was to delineate the impact of abnormal vocal fold mobility and altered laryngeal sensation on dietary management in hospitalized patients previously diagnosed with aspiration.

Impact Of Macra Legislation And Mips Scores On Cost Effective Analysis For Negative Pressure Wound Therapy Devices, Jeremy W. Kubiak, Subhas Gupta

Loma Linda University Student Journal

The Medicare Access and CHIP Reauthorization Act (MACRA) changes reimbursement from a fee-for-service payment system to fee-for-value. Physicians will be scored according to the quality of their care in the MIPS program and will receive a positive or negative modifier to their Medicare reimbursement based on that score.

Ischemic Time And Risk Factors Associated With The Incidence Of Cardiogenic Shock In Patients Presenting With St Elevation Myocardial Infarction, Daniel K. Amponsah, Jonathan Evans, David Hamilton, Tigran Khachatryan, Andrew Stewart, Islam Abudayyeh, Kenneth Jutzy, Anthony Hilliard

Loma Linda University Student Journal

Cardiogenic shock (CS) is the number one predictor of mortality in patients with ST-elevation myocardial infarction (STEMI). Emergent evaluation and treatment including revascularization when indicated is recommended upon arrival to hospital. There is variation in time to presentation and total ischemic time in this patient population. We sought to evaluate the impact of ischemic time on incidence of CS and variables which may influence its presentation.

The Use Of An Anthrone Reagent To Detect Sugar Meals And Their Persistence In The Mosquito Aedes Triseriatus (Diptera: Culicidae), Stephen M. Smith, Richard M. Kurtz

The Great Lakes Entomologist

Adults of Aedes triseriatus were fed water, blood, and 10% pure and mixed solutions of glucose, fructose and sucrose. Adults were tested for fructose by the cold-anthrone test 0, 1, 4, 12, and 24 h after feeding. Water-fed males and females and blood-fed females were anthrone negative. Glucose-fed males were anthrone negative but some glucose-fed females were weakly anthrone positive immediately after feeding. Many adults fed a mixture of glucose, fructose and sucrose were anthrone negative 12 h after feeding and all were anthrone negative after 24 h. The interpretation of negatives in the anthrone test is discussed with respect …

Phenology And Trap Selection Of Three Species Of Hylaeus (Hymenoptera: Colletidae) In Upper Michigan, Virginia L. Scott

The Great Lakes Entomologist

Hylaeus basalis, H. ellipticus and H. verticalis nested in wooden traps during a two-year study in Upper Michigan. Bees were given a choice of traps with varying bore diameters, heights, and entrance orientations. Nests were completed between 1 July and 15 September. These three Hylaeus species partitioned available nest site resources (traps) based on diameter and height. H. ellipticus selected traps with smaller bore diameters than did the other two species which selected traps of the same bore diameters. H. verticalis nested in traps at higher locations than H. basalis which limited its nesting to only the two lowest heights …

Abundance And Seasonal Activity Of Weevils (Coleoptera: Curculionidae) In A Raspberry Plantation And Adjacent Sites In Southern Quebec (Canada)., Claire Levesque, Gilles-Yvon Levesque

The Great Lakes Entomologist

In a raspberry plantation and adjacent sites in southern Quebec, we collected weevils with unbaited pitfall traps and flight interception traps from early May througb late October in 1987-1989. We captured a total of 1592 weevils representing 65 species, including at least 21 Holarctic or introduced species in North America. In and around the raspberry plantation, the commonest species collected by the two methods were the short-nosed weevils of subfamilies Otiorhynchinae and Thylacitinae, mainly generalist species with root-feeding larvae. Ceutorhynchinae and Tychiinae species were also abundant in flight traps near the raspberry plantation, whereas Hylobius congener was the most abundant …

A Laboratory Infection Of Alfalfa Weevil, Hypera Postica (Coleoptera: Curculionidae), Larvae With The Fungal Pathogen Zoophthora Phytonomi (Zygomycetes: Entomophthoraceae), S. J. Roberts, J. V. Maddox, E. J. Armbrust

The Great Lakes Entomologist

Larvae of the alfalfa weevil, Hypera postica, were infected by an in vitro colony of Zoophthora phytonomi. Two spore types (infective conidia, and resting spores) were produced from infection trials. The spore type produced may be influenced by the physiological state of the larvae. Trials using field collected larvae which would produce diapausing adults formed both conidia and resting spores. Trials using larvae from a nondiapausing colony, however, formed only resting spores.

Natural Enemies Of Alfalfa Weevil, Hypera Postica (Coleoptera: Curculionidae), In Minnesota, Kathy L. Flanders, Edward B. Radcliffe, Craig A. Krueger

The Great Lakes Entomologist

Alfalfa weevil, Hypera postica, is present throughout Minnesota. How- ever, economically damaging populations seldom occur, due to a combination of natural enemies and adverse climatic conditions. Five natural enemies of alfalfa weevil were found in Minnesota. Microctonus aethiopoides (Hymenoptera: Braconidae), a parasitoid of adults, was recovered from 43 of 65 counties surveyed during 1984 and 1985. Tetrastichus incertus (Hymenoptera: Eulophidae) and Bathyplectes curculionis (Hymenoptera: Ichneumonidae), para­sitoids of larvae, were each recovered from 13 of 15 counties surveyed during 1991-1993. Bathyplectes anurus, another parasitoid of larvae, was recovered from one county In 1991, four counties in 1992, and six …

Agonopterix Alstroemeriana (Oecophoridae) And Other Lepidopteran Associates Of Poison Hemlock (Conium Maculatum) In East Central Illinois, May R. Berenbaum, Terry L. Harrison

The Great Lakes Entomologist

Poison hemlock (Conium maculatum) (Apiaceae), a noxious Eurasian weed extensively naturalized throughout North America, is characteristically attacked by few insects. Over the past two decades, an introduced oecophorid caterpillar, Agonopterix alstroemeriana, has been reported infesting poison hemlock, its sole host in its area of indigeneity, in parts of the northeastern and western United States. We report for the first time evidence of established midwestern populations of this species. We also report poison hemlock as a host plant for the polyphagous lepidopterans Eupithecia miserulata, Trichoplusia ni, and Spilosoma virginica.

Achieving Success With Pbis: A Teacher’S Role, Chris Williams Mrs., Adrienne Boisson

Georgia Association for Positive Behavior Support Conference

The goal of this presentation is to help high school teachers feel less overwhelmed with the idea of implementing PBIS in their daily routine.

1. By clearly delineating the PBIS initiative: a definition of what PBIS is and what PBIS isn’t, how PBIS can impact your school culture, and the importance of data sharing
2. By offering a step-by-step guide of what it looks like to implement PBIS in your classroom on a daily/weekly/monthly basis
3. By providing PBIS resources and strategies: Examples of PBIS best practices utilized within Newton County High Schools

Field Recognition Of Adult Acentrella And Heterocloeon (Ephemeroptera: Baetidae), R. D. Waltz

The Great Lakes Entomologist

The highly developed anterior process of the mesothorax, is described as a useful field character for identifying adults of Acentrella and Heterocloeon in the Nearctic. This presumed adult synapomorphy suggests a sister relation- ship of the two genera.

Significant Range Extension Of Leptotes Marina (Lepidoptera: Lycaenidae) Into New York State, Wayne K. Gall, Robert F. Andrle

The Great Lakes Entomologist

(excerpt)

The Marine Blue, Leptotes marina (Reakirt) (Lepidoptera: Lycaenidae), is resident from the southwestern United States south through Mexico to Guatemala, with strays reported no further northeast than extreme northwestern Indiana and extreme south-central Ohio (Opler and Krizek 1984, Scott 1986, Shull 1987, Opler and Maliku 11992, Parshall 1993). Although L. marina may be easily overlooked in the field (Iftner, Shuey and Calhoun 1992), the paucity of published records, e.g., two in Illinois (Irwin and Downey 1973), one in Indiana (Shull 1987), and one in Ohio (Parshall 1993), may truly reflect the rarity of strays in the northeastern portion of …

The Development Of A Sex Pheromone Lure For The American Plum Borer, Euzophera Semifuneralis (Lepidoptera: Pyralidae), A Major Pest Of Cherry In Michigan., D. J. Biddinger, W. Roelofs, A. J. Howitt

The Great Lakes Entomologist

Pheromone components of the American plum borer, Euzophera semifuneralis, were defined by use of the electroantennogram screening technique and capillary gas chromatographic retention times of sex pheromone gland constituents. Field studies showed that greatest attraction was achieved with a 1 mg load rate of a 4-component blend in a rubber septum. This blend consisted of a 2:1 ratio of Z,E-9,12-14:ALD and Z9-14:ALD and an equal amount of the corresponding alcohols in a 2:1 ratio, respectively. Commercial lures were used to compare the flight patterns of the American plum borer, peachtree borer (Synanthedon exitiosa), and lesser peachtree borer (Synanthedon …

Checklist Of The Ants Of Michigan (Hymenoptera: Formicidae), George C. Wheeler, Jeanette N. Wheeler, Paul B. Kannowski

The Great Lakes Entomologist

A total of 113 species of ants is recorded by county from the state of Michigan. The list is based upon literature records and specimens in the authors' collections and those of the University of Michigan Museum of Zoology and the Michigan State University Department of Entomology. The list includes 3 species in Ponerinae, 44 in Myrnucinae, 6 in Dolichoderinae, and 60 in Formicinae. Ten species represent new state records. Five distribution pat- terns are evident: statewide (39 species), southern counties only (5), southern 3/4th of Lower Peninsula (10), Lower Peninsula (17), and Upper Peninsula (2). Forty species have been …

Dytiscidae And Noteridae Of Wisconsin (Coleoptera). V. Distribution, Habitat, Life Cycle, And Identification Of Species Of Hydroporinae, Except Hydroporus Clairville Sensu Lato, William L. Hilsenhoff

The Great Lakes Entomologist

Thirty species in 11 genera of Hydroporinae were collected in Wisconsin over the past 32 years, excluding those in Hydorporus s.l. Fourteen species of Hygrotus were found; other genera were represented by one to four species. Species keys and notes on identification are provided for adults of all species that occur or may occur in Wisconsin. Information on distribution and abundance in Wisconsin, habitat, and life cycle is provided for each species based on a study of 34,628 adults. Life cycles were predominantly univoltine, with adults overwintering and larvae completing development from late spring to late summer, depending on the …

Comparative Study Of Life Histories, Laboratory Rearing, And Immature Stages Of Euschistus Servus And Euschistus Variolarius (Hemiptera: Pentatomidae), Joseph Munyaneza, J. E. Mcpherson

The Great Lakes Entomologist

A comparative study was conducted of the field life histories of Euschistus servus and E. varialarius in southern Illinois, their life cycles under controlled laboratory conditions, and their immature stages.

The results indicate that E. servus is bivoltine and E. variolarius is univoltine. Adults of both species emerged from overwintering sites during early April, began feeding and copulating on leaves of common mullein (Verbascum thapsus) and surrounding vegetation, and reproduced shortly thereafter. Neither eggs and first instars of either species, nor second instars of E. variolarius, were collected in the field. Seasonal occurrences of the adults and subsequent immature stages …

Between-Site Variation In Suitability Of Salix Cordata As A Host For Altica Subplicata (Coleoptera: Chrysomelidae), Dennis J. Milanowski, Catherine E. Bach

The Great Lakes Entomologist

To investigate local adaptation of insect herbivore populations to host plant populations, willow flea beetles (Altica subplicata) were collected from two distant sites in northern Michigan (Grass Bay, GB; Pte. Aux Chenes, PAC) and reared on host plants (Salix cordata) collected from each of the sites. Larval development (measured by molt frequency and length of larval stage) was significantly faster on PAC plants than on GB plants but did not differ for the two beetle populations. For both populations of beetles, mean pupal weight was also greater on PAC plants than on GB plants. Thus, there was no evidence for …

Conceiving And Executing Operation Gauntlet: The Canadian-Led Raid On Spitzbergen, 1941, Ryan Dean, P. Whitney Lackenbauer

Canadian Military History

In August and September 1941, Canadian Brigadier Arthur Potts led a successful but little known combined operation by a small task force of Canadian, British, and Norwegian troops in the Spitzbergen (Svalbard) archipelago in the Arctic Ocean. After extensive planning and political conversations between Allied civil and military authorities, the operation was re-scaled so that a small, mixed task force would destroy mining and communications infrastructure on this remote cluster of islands, repatriate Russian miners and their families to Russia, and evacuate Norwegian residents to Britain. While a modest non-combat mission, Operation Gauntlet represented Canada’s first expeditionary operation in the …