Digital Commons Network^™

A Novel Lung Health Programme Addressing Awareness And Behaviour-Change Aiming To Prevent Chronic Respiratory Diseases In Rural Uganda: A Two-Year Train-The-Trainer Programme, R Jones, B Kirenga, S Buteme, S Williams, Gemert F Van

Peninsula Medical School

Chronic lung disease is a huge, growing, but under reported problem in Africa. Following a survey in rural Uganda, which found 16% of the adult population had COPD, we developed a lung health programme aiming to raise awareness in the community of the risk factors for developing chronic lung disease and how to reduce the risks. A two-year train-the-trainer programme was conducted by healthcare workers (HCWs) in Masindi District, Uganda. Strategy and preliminary education materials were co-developed in a series of meetings with stakeholders including clinicians and community members. An initial group of HCWs were trained and further refned the …

Use Of The Patient Health Questionnaire (Phq-9) In Practice: Interactions Between Patients And Physicians, Joseph Ford, Felicity Thomas, Richard Byng, Rose Mccabe

Peninsula Medical School

We analyze the use of nine-item Patient Health Questionnaire (PHQ-9), an instrument that is widely used in diagnosing and determining the severity of depression. Using conversation analysis, we show how the doctor deploys the PHQ-9 in response to the patient’s doubts about whether she is depressed. Rather than relaying the PHQ-9 verbatim, the doctor deviates from the wording so that the response options are selectively offered to upgrade the severity of the patient’s symptoms. This works in favor of a positive diagnosis and is used to justify a treatment recommendation that the patient previously resisted. This contrasted with the rest …

A Large Population-Based Study Of The Mental Health And Wellbeing Of Children And Young People In The North Of England, Barry Wright, Megan Garside, Victoria Allgar, Rachel Hodkinson, Helen Thorpe

Peninsula Medical School

Background: There has been a recent reported rise in prevalence of mental health problems among children in the United Kingdom, alongside increased referrals into specialist services. There is a need for up-to-date information regarding changing trends of young people’s mental health to allow for improved understanding and service planning. Objectives: This article aims to provide an overview of the current mental health and well-being of years 8, 9 and 11 secondary school–aged pupils from two large regions in the North of England. Method: This was a cohort cross-sectional study. Measures including the Strengths and Difficulties questionnaire, the EQ-5D-Y, social media …

Seizure And Sudden Unexpected Death In Epilepsy (Sudep) Characteristics In An Urban Uk Intellectual Disability Service, James J. Sun, Bhathika Perera, William Henley, Samantha Ashby, Rohit Shankar

Peninsula Medical School

Purpose: This study identifies epilepsy-related characteristics and SUDEP risk factors in people with epilepsy (PWE) attending an urban community ID service in the UK where managing epilepsy is not part of the service remit, to understand the care provided to this vulnerable population. Methods: An electronic database search in a north London community ID service (catchment population approx. 290,000) identified relevant ID/epilepsy characteristics in PWE to compare those with mild ID to moderate-profound ID. The SUDEP and Seizure Safety Checklist (“Checklist”), was administered to patients and families/carers. Risk management data was compared to similar data from Cornwall UK where PWE …

Letter On “Protection By Exclusion? The (Lack Of) Inclusion Of Adults Who Lack Capacity To Consent To Research In Clinical Trials In The Uk”, Sarah Griffiths, Lorna Manger, Rebecca Chapman, Lauren Weston, Ian Sherriff, Cath Quinn, Paul Clarkson, Caroline Sutcliffe, Karen Davies, Richard Byng

Peninsula Medical School

Dear editors, We read with interest the recent article regarding the lack of inclusion of people who lack capacity in trials: ‘Protection by exclusion? The (lack of) inclusion of adults who lack capacity to consent in clinical trials in the UK’. As the authors so eloquently spotlight, those without capacity in many population groups are those who are likely to be most vulnerable to frailty, comorbidities and isolation. Their exclusion from research significantly limits the specific evidence base for their care. As a research team developing and evaluating a Dementia Support Worker intervention based in primary care, we appreciate the …

Ehealth Technologies And The Know-Do Gap: Exploring The Role Of Knowledge Mobilisation, Sheena Asthana, Rod Sheaff, Ray Jones, Arunangsu Chatterjee

Peninsula Medical School

Background: eHealth technologies are widely believed to contribute to improving health and patients’ experience of care and reducing health system costs. While many studies explore barriers to and facilitators of eHealth innovation, we lack understanding of how this knowledge can be translated into workable, practicable and properly resourced knowledge mobilisation (KM) strategies. Aims and objectives: This paper describes the aims, methods and outputs of a large European Union funded project (eHealth Productivity and Innovation in Cornwall and the Isles of Scilly (EPIC)) to support the development of a sustainable innovation ecosystem in Cornwall and the Isles of Scilly, in order …

Constitutive Activation Of The Egfr–Stat1 Axis Increases Proliferation Of Meningioma Tumor Cells, Sara Ferluga, Daniele Baiz, David A. Hilton, Claire L. Adams, Emanuela Ercolano, Jemma Dunn, Kayleigh Bassiri, Kathreena M. Kurian, Clemens O. Hanemann

Peninsula Medical School

Abstract Background Meningiomas are the most frequent primary brain tumors of the central nervous system. The standard of treatment is surgery and radiotherapy, but effective pharmacological options are not available yet. The well-characterized genetic background stratifies these tumors in several subgroups, thus increasing diversification. We identified epidermal growth factor receptor–signal transducer and activator of transcription 1 (EGFR–STAT1) overexpression and activation as a common identifier of these tumors. Methods We analyzed STAT1 overexpression and phosphorylation in 131 meningiomas of different grades and locations by utilizing several techniques, including Western blots, qPCR, and immunocytochemistry. We also silenced and overexpressed wild-type and mutant …

After The Fire: Post-Pandemic Reflections, Daniel Martin

Peninsula Medical School

Over the space of a few months virtually everything we know has been turned on its head. In Wuhan (China) during the closing months of 2019 a spillover event occurred in which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was transferred from its animal host population into humans 1, 2. Spread mainly by respiratory droplets, the virus has a basic reproduction number (R0) of between 2-6 in an unprotected population making it more contagious than influenza, but considerably less so than measles. As SARS-CoV-2 rapidly spread across the planet, aided by our love of intercontinental travel, the local market …

Leadership In Dental Practice: A Three Stage Systematic Review And Narrative Synthesis, Sally Hanks, Lucy Spowart, Debby R.E. Cotton

Peninsula Medical School

No abstract provided.

Editorial: ‘Do We Really Need Another Review On The Effects Of Physical Activity On Alcohol And Other Drug Use Disorders?’, Adrian H. Taylor, Tom P. Thompson, Jane Horrell

Peninsula Medical School

No abstract provided.

Home Based Care: A Care Pathway Innovation For Parkinson's Disease, E Edwards, R Partridge, U Ankeny, J Langley, S Whipps, J Whipps, J Rideout, A Evans, S Bentley, M Swabey, H Matthews, N Stevens, R Chivers, T Dominey, K Triscott, C Carroll

Peninsula Medical School

No abstract provided.

A Multi-Centre Trial Of Physical Activity Assisted Reduction Of Smoking (Tars): Baseline Characteristics, And Health Trainer Led Intervention Engagement, A Taylor, A Streeter, T Thompson, S Creanor, W Ingram, P Aveyard, M Ussher, T Harris, R Murray, C Greaves, C Green, J Chynoweth

Peninsula Medical School

No abstract provided.

The Changing Face Of Neurosurgery For The Older Person, Ellie Edlmann, Peter C. Whitfield

Peninsula Medical School

No abstract provided.

British Obesity And Metabolic Surgery Society Guidelines On Perioperative And Postoperative Biochemical Monitoring And Micronutrient Replacement For Patients Undergoing Bariatric Surgery—2020 Update, Mary O'Kane, Helen M. Parretti, Jonathan Pinkney, Richard Welbourn, Carly A. Hughes, Jessica Mok, Nerissa Walker, Denise Thomas, Jennifer Devin, Karen D. Coulman, Gail Pinnock, Rachel L. Batterham, Kamal K. Mahawar, Manisha Sharma, Alex I. Blakemore, Iris Mcmillan, Julian H. Barth

Peninsula Medical School

No abstract provided.

The Role Of Topography, Soil, And Remotely Sensed Vegetation Condition Towards Predicting Crop Yield, Trenton E. Franz, Sayli Pokal, Justin P. Gibson, Yuzhen Zhou, Hamed Gholizadeh, Fatima Amor Tenorio, Daran Rudnick, Derek M. Heeren, Matthew F. Mccabe, Matteo Ziliani, Zhenong Jin, Kaiyu Guan, Ming Pan, John Gates, Brian Wardlow

School of Natural Resources: Faculty Publications

Foreknowledge of the spatiotemporal drivers of crop yield would provide a valuable source of information to optimize on-farm inputs and maximize profitability. In recent years, an abundance of spatial data providing information on soils, topography, and vegetation condition have become available from both proximal and remote sensing platforms. Given the wide range of data costs (between USD $0−50/ha), it is important to understand where often limited financial resources should be directed to optimize field production. Two key questions arise. First, will these data actually aid in better fine-resolution yield prediction to help optimize crop management and farm economics? Second, what …

The European Union Military: A Debate On The Need For A Common Defense Mechanism, Gonzalo Secaira

CMC Senior Theses

In a region affected by death and destruction brought on by two devastating world wars, the European Union has held peace and economic stability as its primary objective. Since its creation, the EU has expanded both in size and scope, becoming on the largest economic global actors in the world. In recent years, the EU has looked towards expanding its competencies to include common security and defense policies. Efforts on behalf of the EU to further integrate EU members have faced mixed reactions and opposition. One of these policies, the funding, and implementation of a European Union military has been …

The Impact Of Demonetization On Digitization And Transaction Technologies In India, Gauri Taneja

CMC Senior Theses

On 8^th November, 2016, Prime Minister of India, Narendra Modi announced the demonetization of all ₹500 (approx. USD 7) and ₹1,000 (approx. USD 14) denominations of banknotes of the Mahatma Gandhi Series issued by the Reserve Bank of India. Overnight, 86% of the currency in circulation was cancelled in an economy where 80% of transactions are cash based. The goal behind this scheme was two-fold – to reduce corruption and black money in the Indian Economy, as well as to increase financial inclusion and create a more digitalized economy. In this paper, I look at the impact …

What Is The Effect Of Social Capital On Community Resiliency Against Social Decay?, James Dail

CMC Senior Theses

This thesis builds off of the work of Robert Putnam and Charles Murray by using a fixed effects regression model and a first difference regression model to see if there is a relationship between the number of community institutions within a county and that county’s resiliency against social decay. Historically, it has been difficult to determine if there is a causal relationship in either direction between these variables because they are endogenous. That is, the underlying factors that determine whether a county will have low levels of social capital also determine whether the same county will have high levels of …

Antifungal Defense Molecules From Bacterial Symbionts Of North American Trachymyrmex Ants, Georgia Scherer

CMC Senior Theses

Defensive symbioses, in which microbes provide molecular defenses for an animal host, hold great potential as untapped sources of therapeutically useful antibiotics. Fungus-growing ants use antifungal defenses from bacterial symbionts to suppress pathogenic fungi in their nests. Preliminary chemical investigations of symbiotic bacteria from this large family of ants have uncovered novel antifungal molecules with therapeutic potential, such as dentigerumycin and selvamicin.

In this study, the bacterial symbionts of North American Trachymyrmex fungus-growing ants are investigated for antifungal molecules. Plate-based bioassays using ecologically-relevant fungal pathogens confirmed that these bacteria have antifungal activity. In order to purify and identify the antifungal …

Air Pollution’S Effect On The Labor Force At The State Level, Benjamin Culberson

CMC Senior Theses

The health effects of air pollution are well established, ranging from increased rates of cancer to cardiovascular disease. Furthermore, a growing body of literature shows that air pollution has a tangible, negative impact on the labor force. However, in their efforts to avoid the endogeneity of air pollution and labor production, the current literature focuses on specific industries at a local level. The objective of this thesis is to expand this research to a state level by using naturally occurring weather events called air stagnations as a proxy for air pollution. These air stagnations correlate with increased levels of air …

Examining Protein-Protein Interactions Within The Esx-4 Secretion System Of Mycobacterium Smegmatis, Sophie Boerboom

CMC Senior Theses

Bacteria use secretion systems to export proteins from inside of the bacterium into the periplasm, extracellular space, or host cell. Within the Mycobacterium genus, the type VII secretion systems (T7SS) transport products across the unusually thick and waxy mycobacterial envelope. T7SS are of particular importance because they are involved in the virulence of pathogenic mycobacteria. Mycobacteria have as many as five distinct T7SS called ESX systems. ESX-1, 3, and 5, have demonstrated roles in viability and virulence in certain pathogenic species like M. tuberculosis and M. marinum. Our research focuses on the ESX-4 apparatus, the ancestral system that gave rise …

Observing The Effects Of Antimalarial Drug Availability On Women’S Work Absenteeism, Rei Imada

CMC Senior Theses

This study aims to provide insight on how availability of antimalarial drugs can help alleviate the economic burden of malaria. Much of the existing literature that looks into the effects of antimalarial drug availability focuses on the associated health benefits, but fails to draw a link to the economic benefits that may also be incurred. Using data from the 2015-2016 Tanzania Demographic and Health Survey and Malaria Indicator Survey, this study performs a series of multiple regressions to observe how increased availability of artemisinin-based combination therapies (ACTs), a front-line antimalarial drug in most African countries, affects likelihood of work absenteeism …

Effects Of Sleep Deprivation And The Link To Alzheimer’S Disease In Night Shift Workers, Aracelia Aldrete

CMC Senior Theses

Alzheimer’s Disease (AD) is a degenerative neurologic disorder that is often defined by beta-amyloid (Aβ) plaques. These Aβ plaques are formed from protein pieces that are incorrectly cleaved from an amyloid precursor protein (APP). These protein segments, cleaved from APP, are toxic due to increased “stickiness”. They cling together to create protofibrils that eventually mature into neuronal plaques. Aβ plaques lead to neuronal cell death causing classic AD symptoms: memory loss, a decline in speech and motor control, and personality changes. One connection between high Aβ plaques levels and AD is chronic sleep loss or disruption. Night shift workers, even …

Corporate Social Responsibility And Corporate Financial Performance: An Examination Into Fortune 500 And Djsi Firms Within Consumer-Facing Industries, Samantha Lee

CMC Senior Theses

This paper examines the relationship between a firm’s Corporate Social Responsibility (CSR) and its Corporate Financial Performance (CFP) in nine consumer-facing industries classified by the Fortune 500. Unlike prior research on the matter, the firms investigated in this study consist only of firms on both the Fortune 500 for the year 2018 and the Dow Jones Sustainability Index (DJSI) between the years 2005-2018 in order to define a clear measurement of CSR. In order to gauge investor and market sentiment, CFP is measured primarily by the firm’s stock performance in comparison to the S&P 500 as a basis. The results …

Surfacing Contexts Of Violence In Novel Forms Of The Reproductive Justice Framework Through Lessons From Latin America: A Study Of Brutality, Migration And Bodily Autonomy And Progressive Solutions For Use In Public Health, Angelica M. Campos

CMC Senior Theses

In the last 5 years, Latin America has witnessed a tenacious wave of pañuelo verde and #NiUnaMenos activism. Sparked by increasing mortality rates associated with unsafe, clandestine abortions and femicide, the praxes and fundamental elements of these social movements have proven themselves useful not only in garnering international attention on issues relating to bodily autonomy, but in the synthesis of their respective sociopolitical solutions as well. In the United States, similar efforts have been spearheaded by the lauded reproductive justice framework, which has often been credited for centering the plight of women of color in both reproduction and social justice. …

Formal Savings Uptake As A Catalyst For Remittances In Sub-Saharan Africa, Jordan Kouassi

CMC Senior Theses

This paper explores the effects of savings account ownership on remittances and payment services in Sub-Saharan Africa through the lens of a field experiment executed in Central Malawi. Remittances are a major form of financial support for SSA and Sub-Saharan Africans. Through the use of a cross section analysis I find a positive significant relationship between account ownership and the likelihood to send and receive a remittance. Specifically, I find account ownership can increase the likelihood of sending a remittance by 8.75 times and increase the likelihood of receiving a remittance by 10.18 times.

The Necessity For Sustainable Development In Indonesia: A Governmental Analysis And Carbon Neutral Coliving Recommendation, Michael Wirth

CMC Senior Theses

This thesis explores two distinct topics: first, Indonesia’s current emissions and implementation of sustainability practices; second, the current state of coliving spaces and a proposal of a sustainable space in Indonesia,. The two topics are connected by the fact that the implementation of sustainability practices within Indonesia are necessary from more than just an environmental standpoint, but also from the economic and governmental perspectives.

We exemplify the necessity for sustainable transition within the country through three critical points: first, we show that Indonesia’s exceptional tourist growth is highly dependent on sustaining the natural wonders within the country; second, current coal …

The Mediating Role Of Positive Emotion Socialization On Maternal Alexithymia’S Detrimental Impact Towards Child’S Adaptive Regulatory Capacity, Madeleine Ding

CMC Senior Theses

The current study examined the relations between maternal alexithymia and child’s negative outcomes in the form of behavioral problems and adaptive regulatory capacity, as indexed by respiratory sinus arrhythmia (RSA). It also explores the main and mediating role of positive emotion socialization. Participants consisted of 155 mother-child dyads within a 25-mile radius of a college in Southern California (Mothers M_age=33.1 years, SD=5.5; Children M_age=42.01 months, SD=4.68; 51% male children). The Toronto Alexithymia Scale-26 (TAS-26) and the Child Behavior Checklist (CBCL) were given to mothers to report on alexithymic traits and their child’s internalizing and externalizing behaviors, …

Children’S Development And Crisis: Comparing Developmental Best Practices Against Aid Program Curricula, Martha Baker

CMC Senior Theses

Using the monitoring, evaluation and learning for adaptive management model (MEL4AM), this paper examines how international organizations translate productive criteria for early childhood development (ECD) into emergency response programming for children. Early childhood is a crucial developmental time in individual’s lives and adverse experiences undermine, among other things, language development, self-regulatory capabilities, and child-caregiver interactions. International aid organizations are operationalizing the research on ECD best practices into site-level programming. This thesis examines whether the developmental needs of these children in crisis are being met through these efforts and offers two in-depth case studies: Sesame Workshop’s intervention for Syrian refugee children …

Republicanism’S Globalist Problem: How The Inevitability Of International Engagement Undermines States’ Capacity For Self-Governance, Andrew R. Ciacci

CMC Senior Theses

This thesis examines the difficulties philosophical theories have in adapting to international issues. This work primarily focuses on the philosophical theory of government known as “Republicanism”. According to republicanism, the government’s overarching goal is to promote freedom, which republicans understand as the ability to pursue choices without being under the arbitrary power of others. After establishing its merits, I lay out the core principles of republicanism as are most clearly articulated in Phillip Pettit’s work, Republicanism: A Theory of Freedom and Government. The second chapter then examines how Pettit applies his own view to analyze the state of Republican freedom …