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Concepts In Animal Parasitology, Chapter 60: Monogenea Van Beneden, 1858 (Class) [Platyhelminthes], Griselda Pulido-Flores
Concepts In Animal Parasitology, Chapter 60: Monogenea Van Beneden, 1858 (Class) [Platyhelminthes], Griselda Pulido-Flores
Concepts in Animal Parasitology
An overview of the class Monogenea van Beneden, 1858, mainly ectoparasites of the skin, fins, gills, and urinary bladder of fishes, amphibians, and some reptiles. Includes discussion of their classification (both historical and current), general morphology, life cycles, and taxonomy.
Chapter 60 in Concepts in Animal Parasitology, by Griselda Pulido-Flores. 2024. S. L. Gardner and S. A. Gardner, editors. Zea Books, Lincoln, Nebraska, United States. doi: 10.32873/unl.dc.ciap060
Concepts In Animal Parasitology, Chapter 64: Phthiraptera (Order): Lice [Arthropoda], Lajos Rózsa, Haylee J. Weaver
Concepts In Animal Parasitology, Chapter 64: Phthiraptera (Order): Lice [Arthropoda], Lajos Rózsa, Haylee J. Weaver
Concepts in Animal Parasitology
An overview of lice, order Phthiraptera, including discussion of their general morphology, feeding, host range, host distribution, life cycle, macroecology, transmission, effects on hosts and role as vectors, host defenses, conservation, evolutionary origins, phylogeny, lice nuclear genome, taxonomy, and medical implications including their control.
Chapter 64 in Concepts in Animal Parasitology, by Lajos Rózsa and Haylee J. Weaver. 2024. S. L. Gardner and S. A. Gardner, editors. Zea Books, Lincoln, Nebraska, United States. doi: 10.32873/unl.dc.ciap064
A Phenomenological Study Of Middle School Reading Teachers' Lived Experiences Of Learning Management Systems During The Covid-19 Pandemic And Their Impact On Reading Instruction, Rebekah L. Hadley
Doctor of Education Dissertations
During the COVID-19 pandemic, many school districts were forced to switch to remote learning, which presented a new and challenging experience for teachers. The study described the experiences of middle school reading teachers’ use of learning management systems (LMSs) during the COVID-19 pandemic and their impact on reading instruction. The study focused on a school district in southeastern North Carolina with 19 middle schools and three reading teachers per grade level. The primary method of data collection used in the study was interviews. The interviews revealed that teachers faced several challenges when using LMSs, such as limited knowledge of LMS, …
Genomic Surveillance Of Sars-Cov-2 Sequence Variants At Universities In Southwest Idaho, Jennifer R. Chase, Laura Bond, Daniel J. Vail, Milan Sengthep, Adriana Rodriguez, Joe Christianson, Stephanie F. Hudon, Julia Thom Oxford
Genomic Surveillance Of Sars-Cov-2 Sequence Variants At Universities In Southwest Idaho, Jennifer R. Chase, Laura Bond, Daniel J. Vail, Milan Sengthep, Adriana Rodriguez, Joe Christianson, Stephanie F. Hudon, Julia Thom Oxford
Biology Faculty Publications and Presentations
Although the impact of the SARS-CoV-2 pandemic on major metropolitan areas is broadly reported and readily available, regions with lower populations and more remote areas in the United States are understudied. The objective of this study is to determine the progression of SARS-CoV-2 sequence variants in a frontier and remote intermountain west state among university-associated communities. This study was conducted at two intermountain west universities from 2020 to 2022. Positive SARS-CoV-2 samples were confirmed by quantitative real-time reverse transcription-polymerase chain reaction and variants were identified by the next-generation sequencing of viral genomes. Positive results were obtained for 5355 samples, representing …
Connecting Conservation: Modeling And Socializing Climate Connectivity For Land Conservation, Melissa M. Clark
Connecting Conservation: Modeling And Socializing Climate Connectivity For Land Conservation, Melissa M. Clark
Doctoral Dissertations
As the climate changes, species must either adapt, relocate, or face extinction. This pressing reality underscores the importance of promoting climate connectivity, which ensures that habitats and landscapes remain interconnected, allowing species to move and adapt as climate conditions shift. Given the challenges posed by ongoing climate change, it is crucial that land conservation decisions incorporate climate connectivity. Conservation goals should be informed by the latest connectivity models and be practical for implementation by on-the-ground practitioners. This dissertation aims to bridge the gap between these two critical needs, which are not always well-integrated in conservation work. Modeling connectivity in a …
Th2 And Th17-Associated Immunopathology Following Sars-Cov-2 Breakthrough Infection In Spike-Vaccinated Ace2-Humanized Mice, Tianyi Zhang, Nicholas Magazine, Michael C. Mcgee, Mariano Carossino, Gianluca Veggiani, Konstantin G. Kousoulas, Avery August, Weishan Huang
Th2 And Th17-Associated Immunopathology Following Sars-Cov-2 Breakthrough Infection In Spike-Vaccinated Ace2-Humanized Mice, Tianyi Zhang, Nicholas Magazine, Michael C. Mcgee, Mariano Carossino, Gianluca Veggiani, Konstantin G. Kousoulas, Avery August, Weishan Huang
Faculty Publications
Vaccines have demonstrated remarkable effectiveness in protecting against COVID-19; however, concerns regarding vaccine-associated enhanced respiratory diseases (VAERD) following breakthrough infections have emerged. Spike protein subunit vaccines for SARS-CoV-2 induce VAERD in hamsters, where aluminum adjuvants promote a Th2-biased immune response, leading to increased type 2 pulmonary inflammation in animals with breakthrough infections. To gain a deeper understanding of the potential risks and the underlying mechanisms of VAERD, we immunized ACE2-humanized mice with SARS-CoV-2 Spike protein adjuvanted with aluminum and CpG-ODN. Subsequently, we exposed them to increasing doses of SARS-CoV-2 to establish a breakthrough infection. The vaccine elicited robust neutralizing antibody …
Cationic Charge-Shifting Polymers As Improved Vectors For Nucleic Acid Delivery, Alexander Fortenberry
Cationic Charge-Shifting Polymers As Improved Vectors For Nucleic Acid Delivery, Alexander Fortenberry
Electronic Theses and Dissertations
This work investigates the development and application of charge-shifting polycations for gene delivery, focusing on their synthesis, characterization, and applications for in vitro mRNA delivery. Utilizing poly(2-vinyl-4,4-dimethylazlactone) (PVDMA), this study explores modifications with various reactive handles, such as alcohol, thiol, and amine groups, to create cationic amide-, ester-, and thioester-functionalized polycations. These modifications aim to exploit the charge-shifting capabilities of the polycations to form stable polyplexes with nucleic acids, promoting the efficient intracellular release of the genetic cargo.Initial studies first examine the charge-shifting properties of PVDMA-based polycations under different pH and temperature conditions. This work highlights the potential of these …
Ecological And Evolutionary Ramifications Of Host-Parasite Interaction In Aquatic And Model Ecosystems, Akacia Halliday-Isaac
Ecological And Evolutionary Ramifications Of Host-Parasite Interaction In Aquatic And Model Ecosystems, Akacia Halliday-Isaac
Electronic Theses and Dissertations
Host-parasite interactions are ubiquitous and have negative risks and consequences on individual, population, and evolutionary scales. These risks and consequences include altered population densities, changes in interspecies interactions, and rapid changes in host phenotypes. In this thesis, I seek to understand the ecological and evolutionary ramifications of host-parasite interactions within ecosystems. To do this, I investigated the presence and environmental correlates of potential host-parasite interactions in a freshwater ecosystem and used a model ecosystem to explore how past host-parasite coevolution affects community assembly dynamics and future adaptation in the presence of new stressors. To examine the presence of potentially parasitic …
Equine Rescue Success In The United States: A Statistical Analysis, Carly J. Cave
Equine Rescue Success In The United States: A Statistical Analysis, Carly J. Cave
Honors Theses and Capstones
The high inflation that has characterized the post-pandemic period in the United States has increased the costs of horse ownership for private owners and equine rescue organizations, which are facing critical pressures. Over 200,000 equines are at risk for neglect or slaughter in the United States each year, which far exceeds the capacity to house these equines at rescue organizations. While demand on these organizations is high, their ability to afford appropriate resources for their care is insufficient. This study examined geographical and economic factors that impact equine rescues’ success in taking in at-risk equines and adopting them to forever …
Distribution Of Tick Species On Free-Ranging Ungulates In Northern New England, Karisa Graham
Distribution Of Tick Species On Free-Ranging Ungulates In Northern New England, Karisa Graham
Honors Theses and Capstones
In Northern New England, ungulates are often parasitized by ticks, which is one of the leading causes for the decline in population. Ungulates are a good host for ticks, specifically deer ticks and winter ticks, and these ticks cause many tick-borne diseases in humans as well. The purpose of this study was to assess passive sampling from harvested animals as a means of tick surveillance in Vermont and New Hampshire. Ticks were collected from deer and moose and mapped throughout the two states by ArcGIS to visualize the trends in distribution. Relative abundance was greater in southeastern Vermont, with no …
Application Of Three Of Selected Medicinal Plant Extracts In Brunei Darussalam To Improve Shelf Life Of Poultry Product, Hazirah Abd Hamid, Namasivayam Navaranjan, Zohrah Sulaiman, Aida Maryam Binti Hj Basri
Application Of Three Of Selected Medicinal Plant Extracts In Brunei Darussalam To Improve Shelf Life Of Poultry Product, Hazirah Abd Hamid, Namasivayam Navaranjan, Zohrah Sulaiman, Aida Maryam Binti Hj Basri
ASEAN Journal on Science and Technology for Development
Abstract. Bioactive compounds from plant derived in food application become increasingly in demand due to natural and nutritionally safe products. Due to some issues concerning food safety on the excessive use of synthetic preservatives; the present study aims to investigate the natural alternatives to synthetic antimicrobial food additives. The chicken meat’s shelf life was studied by adopting bio-based antimicrobial agents using three of selected native medicinal plants; P. betle, A. catechu, and A. tricolor, against common foodborne pathogens; E. coli, P. aeruginosa, S. aureus, and Salmonella spp. The overall results revealed that, all study extracts possessed antioxidant properties by DPPH …
Clark Magazine, Winter 2024, Clark University
Clark Magazine, Winter 2024, Clark University
Clark Magazine
The Winter 2024 edition of Clark Magazine. Clark Magazine is a twice-yearly publication primarily geared towards Clark University Alumni.
The cover story is 'The Mushroom Moment: In a bust of popularity, the once-humble fungus has captured the kitchen and conquered our culture. Clark mycologist David Hibbett believes he knows why'.
Tuberculosis Treatment Loss To Follow-Up In Children Exposed At Home: A Prospective Cohort Study, Meredith B. Brooks, Brittney J. Van De Water, Leonid Lecca, Chuan-Chin Huang, Letizia Trevisi, Carmen Contreras, Jerome T. Galea, Roger Calderon, Rosa Yataco, Megan Murray, Mercedes C. Becerra
Tuberculosis Treatment Loss To Follow-Up In Children Exposed At Home: A Prospective Cohort Study, Meredith B. Brooks, Brittney J. Van De Water, Leonid Lecca, Chuan-Chin Huang, Letizia Trevisi, Carmen Contreras, Jerome T. Galea, Roger Calderon, Rosa Yataco, Megan Murray, Mercedes C. Becerra
Social Work Faculty Publications
Background: Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a significant public health problem. It is important to understand what drives LTFU in children – a population whose treatment and management depend on an adult caregiver – to better provide support services to families affected by TB.
Methods: We conducted a prospective cohort study of household contacts in Lima, Peru (2009–12). Using multilevel logistic regression analysis, we explored individual-level characteristics of children and their adult household members with TB disease to identify risk factors for LTFU among children initiated on treatment for TB.
Results: A total of …
Redefining Ed Utilization: A Rabies Post-Exposure Prophylaxis Perspective, David Bennington
Redefining Ed Utilization: A Rabies Post-Exposure Prophylaxis Perspective, David Bennington
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
Rabies, though rare in the United States, remains a lethal viral disease with significant public health implications. Post-exposure prophylaxis (PEP) through timely administration of rabies vaccines and rabies immune globulin (RIG) is critical for preventing the progression of the virus following potential exposure. However, the current system of healthcare delivery in the United States has witnessed an alarming trend: the unnecessary utilization of emergency department (ED) visits for rabies PEP, including follow-up vaccinations. This paper aims to examine and address this issue through a review of the factors contributing to the inappropriate use of ED services for rabies treatment.
Through …
The Garden Of Hela Cells: Bridging Biomedical Advancements, Unveiling Racial Disparities, And Confronting Ethical Frontiers, Jacqueline Rim
The Garden Of Hela Cells: Bridging Biomedical Advancements, Unveiling Racial Disparities, And Confronting Ethical Frontiers, Jacqueline Rim
Renée Crown University Honors Thesis Projects - All
No abstract provided.
The Effect Of Health Disparities On Infant Mortality Rates In The Northeast Region Of Brazil, Isabela Mcdonald
The Effect Of Health Disparities On Infant Mortality Rates In The Northeast Region Of Brazil, Isabela Mcdonald
Renée Crown University Honors Thesis Projects - All
No abstract provided.
Effects Of Opioid Use On Maternal And Fetal Health & Addressing Barriers To Recovery, Olivia Battell
Effects Of Opioid Use On Maternal And Fetal Health & Addressing Barriers To Recovery, Olivia Battell
Renée Crown University Honors Thesis Projects - All
No abstract provided.
Tissue-Specific Localization Of Tick-Borne Pathogens In Ticks Collected From Camels In Kenya: Insights Into Vector Competence, Rua Khogali, Armanda Bastos, Joel L. Bargul, Dennis Getange, James Kabii, Daniel Masiga, Jandouwe Villinger
Tissue-Specific Localization Of Tick-Borne Pathogens In Ticks Collected From Camels In Kenya: Insights Into Vector Competence, Rua Khogali, Armanda Bastos, Joel L. Bargul, Dennis Getange, James Kabii, Daniel Masiga, Jandouwe Villinger
All Peer-Reviewed Publications
Background: Tick-borne pathogen (TBP) surveillance studies often use whole-tick homogenates when inferring tick-pathogen associations. However, localized TBP infections within tick tissues (saliva, hemolymph, salivary glands, and midgut) can inform pathogen transmission mechanisms and are key to disentangling pathogen detection from vector competence. Methods: We screened 278 camel blood samples and 504 tick tissue samples derived from 126 camel ticks sampled in two Kenyan counties (Laikipia and Marsabit) for Anaplasma, Ehrlichia, Coxiella, Rickettsia, Theileria, and Babesia by PCR-HRM analysis. Results: Candidatus Anaplasma camelii infections were common in camels (91%), but absent in all samples from Rhipicephalus pulchellus, Amblyomma gemma, Hyalomma dromedarii, …
Gut Dysbiosis Correlates With Covid-19 Severity, Ednita Escobar
Gut Dysbiosis Correlates With Covid-19 Severity, Ednita Escobar
CMC Senior Theses
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) impacts not only respiratory but also gut and oral microbiomes, influencing the manifestations of COVID-19. Each person’s unique microbiome consists of microorganisms such as bacteria, fungi, and viruses, some of which are symbiotic and others potentially harmful. Alterations in the gut microbiome, specifically, can affect the severity and symptoms of COVID-19. A review of studies indicate a pattern of gut dysbiosis in COVID-19 patients characterized by a decrease in beneficial microbiota and/or an increase in opportunistic pathogens. This gut imbalance correlates with disease severity, suggesting that the gut microbiome plays a significant role …
Re-Evaluation Of Lethal Radiation Dose In Drosophila Melanogaster Using 350 Kev Electrons, Dariia Hozhenko
Re-Evaluation Of Lethal Radiation Dose In Drosophila Melanogaster Using 350 Kev Electrons, Dariia Hozhenko
All Graduate Theses, Dissertations, and Other Capstone Projects
Radiation dosimetry from a 350 KeV electron beam and its impact on Drosophila melanogaster response serve as the focal points of this study. While previous research has established an LD50 (lethal radiation dose for 50 % of the population) exceeding 452 Gy across mainly all developmental stages, this investigation extends the understanding by examining dose-dependent differences throughout development, from the pupae stage into adulthood. Fruit flies, irradiated at their most sensitive stage, the egg phase, displayed a notable reduction in effective LD50, especially when accounting for long-term effects. Specifically, the LD50 values decreased to approximately 59 Gy for the maximum …
Examination Of Nursing Staffs’ Perceptions Of The Covid-19 Vaccine Using The Health Belief Model, Aidan Cossio, Wilson Cobb, Addison Fugitt, Sandra Nielsen, Matthew Hesson-Mcinnis, Marilyn Prasun
Examination Of Nursing Staffs’ Perceptions Of The Covid-19 Vaccine Using The Health Belief Model, Aidan Cossio, Wilson Cobb, Addison Fugitt, Sandra Nielsen, Matthew Hesson-Mcinnis, Marilyn Prasun
Faculty Publications - Mennonite College of Nursing
Background:
The coronavirus (COVID-19) pandemic profoundly impacted patient care across the United States.
Objective:
To examine nursing staffs’ perceptions of the COVID-19 vaccine using the Health Belief Model (HBM) as a theoretical framework.
Methods:
A cross-sectional, anonymous, web-based survey was completed by practicing nursing staffs throughout the United States. Analyses involved descriptive and comparative statistics.
Results:
Of the 294 nursing staff who completed surveys, 50% were between 18 and 37 years of age, and 73.1% were registered nurses, with 49.3% employed in a hospital setting. Nursing staff reported their primary reason for vaccination was concern for others (mean: 84.44; SD: …
Stress Biology: Complexity And Multifariousness In Health And Disease, Emily M. Sontag
Stress Biology: Complexity And Multifariousness In Health And Disease, Emily M. Sontag
Biological Sciences Faculty Research and Publications
Preserving and regulating cellular homeostasis in the light of changing environmental conditions or developmental processes is of pivotal importance for single cellular and multicellular organisms alike. To counteract an imbalance in cellular homeostasis transcriptional programs evolved, called the heat shock response, unfolded protein response, and integrated stress response, that act cell-autonomously in most cells but in multicellular organisms are subjected to cell-nonautonomous regulation. These transcriptional programs downregulate the expression of most genes but increase the expression of heat shock genes, including genes encoding molecular chaperones and proteases, proteins involved in the repair of stress-induced damage to macromolecules and cellular structures. …
Factors Affecting Electrocoagulation Process For Different Water Types: A Review, Shahad Fadhil Abed Al-Rubaye, Naseer A. Alhaboubi, Aiman H. Al-Allaq
Factors Affecting Electrocoagulation Process For Different Water Types: A Review, Shahad Fadhil Abed Al-Rubaye, Naseer A. Alhaboubi, Aiman H. Al-Allaq
Mechanical & Aerospace Engineering Faculty Publications
Raw water must meet specific physical, chemical, and biological requirements to be suitable for drinking. There are various techniques available for treating wastewater, and aside from conventional methods that involve chemicals, electrocoagulation is an efficient and advanced approach. Electrocoagulation has proven effective in treating many pollutants, including bacteria, viruses, iron, fluoride, sulfate, boron, hardness, and turbidity. Total suspended solids, organic and inorganic materials, chemical oxygen demand COD, biochemical oxygen demand BOD, and color. It finds extensive application in treating different types of water and wastewater due to its exceptional ability to remove diverse contaminants. Recently, electrocoagulation has garnered significant attention …
An Efficient And Trusted Deep Learning Framework For Real-Time Ppe Detection In Secure Iomt Environment, Anusha Verma
An Efficient And Trusted Deep Learning Framework For Real-Time Ppe Detection In Secure Iomt Environment, Anusha Verma
Browse all Theses and Dissertations
Occupationally-acquired infections impact thousands of healthcare workers (HCWs) in the U.S., with many cases preventable through proper use of personal protective equipment (PPE). This study seeks to develop a robust system to enhance PPE compliance and reduce infection risks among HCWs. The objectives of this thesis are twofold: (1) to create a hybrid machine learning model that combines object detection and keypoint detection to ensure correct donning and doffing of PPE, and (2) to design a real-time feedback system using LED indicators and a display interface to offer actionable guidance to HCWs during PPE usage. The goal is to optimize …
A Case Study In Prospective Program Evaluation, Sarai Rosemary Combs
A Case Study In Prospective Program Evaluation, Sarai Rosemary Combs
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
Evaluation is a helpful tool in public health to provide transparency about community interventions and programs. The following is a prospective evaluation of a case study, looking at a recently designed program by the Lexington-Fayette County Health Department, as a capstone project for the Health Management and Policy concentration of the Masters in Public Health program of the College of Public Health. The health department developed a series of online training modules to increase knowledge of Methicillin-resistant staphylococcus aureus (MRSA) and other similar organism outbreaks and how to respond to these outbreaks. The program targets were Fayette County Public School …
Characteristics Of Congenital Syphilis Cases In Kentucky 2019-2023, Ines Roy
Characteristics Of Congenital Syphilis Cases In Kentucky 2019-2023, Ines Roy
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
Abstract:
Background: The incidence of congenital syphilis (CS) has increased both in the United States (US) and globally and remains a public health concern. In Kentucky alone, there has been a significant increase in CS cases, from 9 cases in 2019 to 27 cases in 2023. CS is a preventable disease, but testing and immediate treatment are critical to prevent its spread. We have limited knowledge regarding Kentucky’s characteristics and behavioral factors that may be associated with this rise. The goal of this study is to identify characteristics and potential risk factors that contribute to the rise of CS in …
A Case Study In Program Evaluation, Iantha Wright
A Case Study In Program Evaluation, Iantha Wright
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
The framework for program evaluation is a systematic way of improving and accounting for public health actions by providing practical, feasible, ethical, and accurate information. As a practical, non-prescriptive tool, it guides public health professionals through the essential steps in program evaluation. The framework uses the six steps to understand how to improve and conduct assessments effectively. Additionally, it emphasizes integrating stakeholders and using ongoing evaluation strategies to plan effective interventions, improve existing programs, and demonstrate the efficient use of resources.
Demographic And Behavioral Characteristics Of People Who Help Others Inject Drugs: A Study Of People Who Inject Drugs In Appalachia Kentucky, Ryli Hockensmith
Demographic And Behavioral Characteristics Of People Who Help Others Inject Drugs: A Study Of People Who Inject Drugs In Appalachia Kentucky, Ryli Hockensmith
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
Aim: This study aims to understand the demographic and behavioral characteristics of people who inject drugs (PWID) who assist others with injection, hereafter “injection assistors,” and assess the characteristics of injection assistors compared to PWID who do not assist others with injection in Appalachian Kentucky.
Methods: A cross sectional secondary data analysis of data collected from 433 PWID enrolled in the ongoing Kentucky Outreach Service (KyOSK) was performed. Logistic regression analyses were performed to compare injection assistors to those who do not assist others on demographic, behavioral, service usage, and harm reduction characteristics.
Results: In total, 128 (29%) PWID reported …
Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff
Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.
Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). …
A Case Study In Program Evaluation, Sierra L. Williams
A Case Study In Program Evaluation, Sierra L. Williams
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
The Lexington-Fayette County Health Department (LFCHD) developed an education program targeted toward infectious disease outbreaks. The program ensures timely reporting and action during an infectious disease outbreak within the Fayette County Public Schools (FCPS) system. I have been tasked with evaluating the program and its implementation of training modules through pre and post-surveys to determine if the program is significantly increasing the overall knowledge of program participants and make recommendations for how program aspects can be improved.