Western University Research Articles

An exploratory analysis of moderating effects in a non-randomized, quasi-experimental evaluation of a college-based mental health literacy curriculum

Objective: To assess possible moderating variables that influence the effectiveness of a college-based mental health literacy curriculum, Mental Health Awareness and Advocacy (MHAA). Participants: Students at a Western University in the United States (MHAA treatment group: N = 474; Comparison group: N = 575). Methods: Using a non-randomized, quasi-experimental design over six semesters (2017–2019), students in the treatment and control groups reported on key demographic factors, experiences with mental health, and their knowledge, self-efficacy, and behaviors related to mental health literacy in a pretest/post-test format. Linear mixed effects models were used to assess moderation. Results: MHAA curriculum’s efficacy varied based on participants’ current depression and anxiety levels, whether they had prior personal experience with a mental health concern, whether they had been diagnosed with a mental health concern, and whether they had experienced suicidal thoughts. Conclusions: Reducing anxiety and depression among students may increase the efficacy of the MHAA program.

Rapid Changes in Cerebrovascular Compliance During Vasovagal Syncope

Background: The rapid reduction in arterial blood pressure (ABP) during vasovagal syncope (VVS) is associated with a characteristic decline in diastolic cerebral blood velocity (CBV) and maintained systolic CBV as measured by transcranial Doppler. This increased pulsatility was originally considered to be indicative of a “dysfunctional” increase in cerebrovascular resistance (CVR). Conversely, it may be due to increased cerebrovascular compliance (Ci) that partially attenuates the cerebral effects of rapid hypotension. We tested the hypothesis that Ci supports CBV during pre-syncope in VVS. Method: Finger ABP and right middle cerebral artery blood velocity (MCAv) were recorded from 15 otherwise healthy patients (n = 11 female, 40 ± 16 years, 24.9 ± 4.0 kg/m2) at rest and during head-up tilt (80°, 5 to 28 min). Individual ABP and CBV waveforms of every second heartbeat during VVS were input into a modified Windkessel model to calculate Ci and CVR. MCAv pulsatility was determined as pulse amplitude (systolic MCAv-diastolic MCAv) and Pulsatility Index (Pi; pulse amplitude/mean MCAv). Linear mixed models assessed the contribution of Ci to changes in CBV and Pi. Within-subject mediation analysis investigated the possibility of Ci mediating the relation between blood pressure (i.e., mean ABP and pulse pressure, PP) and cerebrovascular pulsatility. Results: Diastolic and systolic ABP decreased progressively during presyncope, resulting in a nadir reduction of mean ABP of Δ24 ± 9 mmHg at end-tilt (all p ≤ 0.04 vs mid-tilt). Mean MCAv decreased by 22 ± 12% prior to end-tilt (p < 0.01 vs mid-tilt). CVR decreased progressively for 10s prior to end-tilt (p ≤ 0.04 vs mid-tilt). Pi increased significantly, with peak increases occurring at 4 s prior to end-tilt (77 ± 50%, p < 0.01 vs mid-tilt). The increase in Ci (307 ± 223%, p < 0.01 vs mid-tilt) significantly contributed to changes in MCAv (χ2 =10.6, p < 0.01) and Pi (χ2 = 4.9, p = 0.03). Correlations of PP and ABP with Pi were not significant. However, PP was related to MCAv pulse amplitude (total effect: b = 1.57) and Ci ( b = -0.01, both p < 0.01). Ci partially mediated (indirect effect: b = -0.78, p < 0.01) the direct relation between PP and MCAv pulse amplitude ( b = 0.79, p = 0.01). Conclusion: These data provide evidence that Ci attenuates the fall in CBV under conditions of falling PP. Cerebrovascular regulation in VVS appears to be functioning as in healthy populations. However, this regulation is not suffcient to preserve flow in the presence of such extreme and rapid reductions in ABP. USRI — Western University, Natural Sciences and Engineering Research Council of Canada (NSERC, Grant No. RGPIN-2018-06255). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Cerebrovascular Compliance during Progressive Hypotension in Patients with Autonomic Failure

Background: Cerebral perfusion during reductions in arterial pressure (AP) can be supported transiently by a Windkessel mechanism that increases cerebrovascular compliance (Ci). This defense mechanism exists in healthy participants during rapid standing and in patients during vasovagal syncope. However, it remains unknown whether the rise in Ci with falling AP exhibits a threshold effect. Thus, we tested the hypothesis that increased Ci is passive to a reduction in AP and starts to increase only after a threshold has been reached. To test this hypothesis, it was necessary to study a population that tolerates progressive large reductions in BP without a loss of consciousness. Therefore, we analyzed Ci changes during a graded head-up tilt (HUT) from patients with autonomic failure (AF). Methods: Finger AP and right middle cerebral artery blood velocity (MCAv) were recorded from 5 AF patients (n = 5 male, 61 ± 23 years, 25 ± 5 kg/m2) at supine rest and during graded-HUT (30, 45, 60 degrees). Tilt gradients increased incrementally every 5 minutes until AP reached a critically low value prompting termination of HUT. The total time in HUT was 11 ± 4 min. Individual AP and MCAv waveforms during supine rest and graded HUT (one waveform every 5 s) were assessed with a modified Windkessel model to calculate Ci and cerebrovascular resistance (CVR). Pulse pressure (PP) was calculated as systolic AP − diastolic AP. A threshold value for the increase in Ci was determined as five consecutive cardiac cycles greater than the average supine Ci plus 2 standard deviations. Results: Graded HUT resulted in an overall reduction in AP (85 ± 18 to 50 ± 7 mmHg), PP (72 ± 22 to 32 ± 19 mmHg), mean MCAv (62 ± 12 to 35 ± 7 cm/s), and CVR (1.4 ± 0.1 to 1.0 ± 0.3 mmHg/cm/s; all p < 0.05 vs supine). Ci increased by 905 ± 756% (p = 0.04 vs supine). The threshold effect was evident as Ci began to increase progressively after PP fell by 15 ± 3 mmHg and AP fell by 12 ± 2 mmHg. Conclusions: Our results provide evidence that Ci increases after a threshold reduction in PP and AP in the apparent absence of autonomic support. These data support the idea that increasing Ci during reductions in AP represents a pressure-dependent Windkessel mechanism. Of interest, our findings provide clinical insight into how AF patients compensate for such large reductions in pressure without the assistance of CVR as a defense mechanism. NSERC USRA — Western University, Natural Sciences and Engineering Research Council of Canada (NSERC, Grant No. RGPIN-2018-06255). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Investigating feedback-associated stress and mindfulness in undergraduate physiology students and other higher education programs

Study objective: Students who engage with and learn from academic feedback have developed what is known as feedback literacy skills. Being able to learn from feedback is an exceptionally powerful way of growing as a student; however, the process of receiving feedback can be stressful. This can lead to behaviours such as avoidance, denial or diminishing the importance of feedback, which can impact learning. Providing students with the skills needed to learn from feedback and to manage feedback associated stress is therefore increasingly relevant to student success and wellbeing. Feedback literacy skills include managing affect (emotions), focus, and self-advocacy, which are skills that are supported by mindfulness. Mindfulness is being present, on purpose, and without judgement, and is a proven practice that helps to reduce and manage stress. This study is of post-secondary students’ perceptions concerning feedback literacy, mindfulness, and stress, and their thoughts on digital mindfulness tools intended to support students who experience feedback-associated stress. Hypothesis: Students with higher mindfulness skills will also have higher feedback literacy skills and will also have lower stress. Methodology: Students were recruited from across several disciplines (+1000 students), including Physiology and Pharmacology, Dentistry, Occupational Therapy, Information and Media Studies, and Law, along with students supported by the Learning Development and Success Centre at Western University. The study included an online survey ( n=237) and focus groups ( n=6). Gender and program were both included in the survey; however, due to limited sample size, no additional analysis of these factors was conducted. Coding and thematic analysis was conducted by three faculty and two graduate research assistants. Summary of results: The survey data demonstrates that students with greater mindfulness have significantly greater feedback literacy, as well as lower stress. Thematic analysis of focus group data shows a broad range of affective and behavioural responses were shaped by how students perceive their own abilities, circumstances, and feedback itself. Thematic analysis also suggests there is a developmental trajectory for both mindfulness and feedback literacy as graduate students discussed more mindfulness and feedback literacy skills. Discipline-specific views on mindfulness and stress were also apparent. Conclusion: Survey results indicate that students who are more mindful have higher feedback literacy skills; however, when mindfulness and feedback literacy were discussed in focus groups, data suggests that few students considered explicitly linking mindfulness to academic feedback. Students across the various programs expressed vastly different familiarity with mindfulness and feedback literacy. All students expressed interest regarding the development of digital mindfulness tools to alleviate feedback-associated stress and offered recommendations for their implementation. These recommendations were discipline-specific and included the development of program competencies with respect to feedback literacy and wellness. Internal grants from the University of Western Ontario and the Schulich School of Medicine and Dentistry. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

E-Cigarette Aerosol Alters Pulmonary Surfactant Function

Introduction: E-cigarette (EC) and vaping use continue to remain popular, particularly in young populations despite several clinical reports of vaping associated lung injury. One of the first compounds that EC aerosols comes into contact within the lungs during a deep inhalation is pulmonary surfactant. A complex mixture of lipids and proteins, surfactant reduces surface tension in the lungs maintaining compliance and preventing collapse. Currently, information on how EC aerosols impacts pulmonary surfactant remains limited, particularly in the in vivo scenario. We hypothesized that exposure to EC aerosol will impair the surface tension reducing ability of surfactant. Methods: In vitro EC aerosol exposure : Bovine Lipid Extract Surfactant (BLES) was used as a model surfactant in a direct exposure syringe system. BLES (2ml) was placed in a syringe (30ml) attached to an EC. The generated aerosol was drawn into the syringe and then expelled, repeated 30 times. In vivo EC aerosol exposure : Male and female Wistar rats were exposed to vehicle or menthol flavoured EC aerosol. Rats were exposed for 15 minutes for either a single or multiple (up to 8) exposures, with control animals receiving room air. Animals were euthanized and bronchoalveolar lavage was performed to collect surfactant. Analyzing surfactant function: Samples underwent dynamic compression and expansion, and biophysical analysis after exposure, completed using a constrained drop surfactometer (CDS). Results: Significant increases in minimum surface tensions were observed after exposure to EC aerosol across 20 compression/expansion cycles. Surfactant function was altered in vitro independent of vaping device, temperature, or inclusion of nicotine. Vehicle aerosol exposure produced alterations in surfactant properties, however addition of menthol flavouring significantly increased surface tensions compared to control and vehicle exposure. Preliminary in vivo studies indicate that aerosol exposure is well-tolerated by both male and female animals. Further experiments will analyze the function of surfactant isolated from these animals. Discussion: EC aerosols alter surfactant function through increases in minimum surface tension in vitro. This effect was more pronounced with menthol flavoured EC aerosol. It is anticipated that our in vivo experiments will corroborate these findings. Ultimately, impairment of surfactant due to EC aerosol exposure may contribute to lung dysfunction and susceptibility to further injury. Western University, NSERC, OGS. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Investigation of the Role of Aging on Pulmonary Microvascular Endothelial Cell Barrier Function During Mechanical Ventilation

Elderly individuals have substantially elevated morbidity and mortality following pulmonary insult that require mechanical ventilation (MV) to sustain respiratory function. It is not known if an altered response to MV contributes to the worsened outcomes in the elderly. MV is associated with injury to pulmonary microvascular endothelial cells (PMVEC), leading to a compromised vascular barrier, and fluid and protein leakage within the tissue. However, the precise impact that age has on the vascular endothelium during MV is unknown. We hypothesized that aging augments PMVEC barrier dysfunction during MV. To address this hypothesis, young and aged mice were ventilated at a tidal volume of 20 mL/kg for 3 hours. To assess microvascular permeability, lungs were lavaged and abundance of the serum protein, immunoglobulin M, within the lavage fluid was measured. Lung tissue was dissociated into single cells and RNA was collected for single-cell RNA sequencing (scRNAseq). Subsequent analysis was performed using the Seurat package in R to give insight into the role of specific cell types, with a particular emphasis on microvascular endothelial cells. To directly assess molecular mechanisms directly in the cells, PMVEC were isolated from a separate cohort of non-ventilated young and aged mice and cultured in vitro. Cells were grown to confluency, then assessed for barrier integrity by Evans blue-labelled albumin leak across monolayers and immunofluorescence staining of cell junctional adherens and tight junction proteins, VE-cadherin and claudin-5. Compared to young, aged-ventilated animals had a significant increase in immunoglobulin M in their lavage fluid. Analysis of scRNAseq data revealed more robust activation and inflammation in the endothelial cells from aged animals following MV. Endothelial monolayers from aged animals in vitro exhibited a significant increase in albumin flux, which was associated with poor VE-cadherin and claudin-5 junction formation. In conclusion, PMVEC from aged mice exhibit compromised barrier function, leading to augmented permeability following MV. The age-dependent loss in barrier function appears to be due to an impaired ability to re-establish functional cell-cell junctions. These findings suggest that the aged vascular barrier is more susceptible to injury from MV, due to impaired PMVEC cell-cell junction integrity. Our results may highlight molecular pathways involved in predisposing aged individuals to worsened outcomes during MV, which can help in developing targeted therapeutics. Funded by Lawson Health Research Institute, CIHR, the Ontario Graduate Scholarship, and Western University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Online teaching readiness of staff during the COVID-19 pandemic: Ege University sample

The instant transition to online learning during the pandemic led to some neglections in instructional design and planning, with online teaching readiness seen as a major issue within this context. The authors of this study therefore believe that the readiness of instructors for providing online learning is a critical concern for such a transition and its future implications. In this survey/descriptive study, the authors investigated instructors’ online teaching readiness through an adapted version of Chi’s Online Teaching Readiness Questionnaire, which includes both open-ended and multiple-option questions, with code-theme relationships also presented. The data collection tool was administered to 200 instructors from different faculties working at Ege University, which is a western state university in Turkey. The findings from the questionnaire show that to a large extent, the instructors feel ready for online teaching. The authors share their suggestions on future research and applications in the last section of the paper.

Sensitized serotonin-mediated vasodilation in a mouse model of carcinoid disease

Background: Carcinoid tumors secrete vasoactive hormones such as serotonin that impact cardiovascular function. In consequence, patients with metastatic carcinoid disease are at risk for carcinoid syndrome, characterized by profound cutaneous flushing, hypotension, and syncope. Our recent work demonstrates that in patients with carcinoid metastases, higher serotonin levels are associated with lower vascular resistance. However, it is unknown if the vascular sensitivity to serotonin is affected by carcinoid disease. The receptor that mediates the potential vasodilatory effects of serotonin in carcinoid disease is also unknown. Therefore, we hypothesize that serotonin-mediated vasodilation is increased by carcinoid metastases. To test this, we assessed vascular reactivity to serotonin ex vivo in a mouse model of carcinoid disease. Methods: J:Nu nude mice (10 weeks) received intrasplenic injection of 2x107 BON1 neuroendocrine tumor cells (BON1, n=5) or PBS-vehicle (VEH, n=5), and were monitored for 10 weeks to allow the development of liver carcinoid metastases. Animals were then euthanized, and mesentery arteries were harvested. Isolated, pressurized mesentery arteries were pre-constricted with phenylephrine. The dose-response vasodilation to serotonin and acetylcholine was measured. These dose responses were repeated in the presence of 5-HT2B receptor antagonist LY272015 or nitric oxide synthase inhibitor L-NAME. Endothelium-independent vasodilation to sodium nitroprusside was also assessed. Data are mean ± SEM. Results: Mesentery arteries from BON1 mice had a greater vasodilation in response to serotonin compared with arteries from VEH mice (65±6% vs. 44±8%, p=0.04). Incubation with L-NAME partially inhibited the vasodilation to serotonin in the BON1 arteries (42±10%, p=0.04), but not in VEH arteries (30±11%, p=0.17). LY272015 did not affect the serotonin-induced vasodilation in the BON1 or VEH arteries (BON1: 52±10%, p=0.14, VEH: 49±17%, p=0.39). In contrast to serotonin, the vasodilation to acetylcholine did not differ between BON1 and VEH arteries (77±9% vs. 61±16%, p=0.19). There were also no differences in the vasodilation to sodium nitroprusside between groups (p=0.42). Arteries from BON1 mice had a trend for greater vasoconstriction in phenylephrine compared with VEH mice (51±7% vs. 37±9%, p=0.06). Conclusions: These findings demonstrate that serotonin-mediated vasodilation is sensitized in a mouse model of carcinoid disease. This is potentially accompanied by enhanced α-adrenergic-mediated vasoconstriction, which may be a compensatory mechanism in response to sensitized vasodilatory mechanisms. Western University of Health Sciences Intramural Grant (BHM). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Flexible learning dimensions in higher education: aligning students’ and educators’ perspectives for more inclusive practices

Driven by the rise of recent technologies and long-standing interest in accommodating diverse student needs, the demand for flexibility in higher education has intensified. Moreover, the COVID-19 pandemic has intensified studies investigating online learning effects, reflecting shifting preferences and demands in education. Although prior research recognizes diverse flexibility practices, a narrow focus on instructional delivery limits its potential. Bridging this gap requires re-envisioning flexible learning by involving students, educators, and institutions in the transformation process. Therefore, this study aims to investigate and compare students’ and educators’ perspectives and experiences of five dimensions of flexibility (deadlines, modality, assessment type, grading and weighting, and course correspondence). The study involves a quantitative and qualitative survey, composed of Likert scale and open-ended questions. The survey respondents were students (N = 315) and educators (N = 100) at Western University across different years and programs. The quantitative component reveals a general alignment between student and educator preferences across flexibility dimensions. Noteworthy preferences include collaborative deadline setting, non-timed and take-home assessments, and more frequent, lower-weighted tasks. Students’ increased preference for hybrid learning, despite a general preference for in-person formats, underscores the value placed on flexibility and adaptability. Qualitative findings illuminate the broader implications of flexibility that can be organized into the following four themes: (1) flexibility humanizes teaching and learning, (2) flexibility recognizes diverse student populations, (3) flexibility provides broad accommodation and increases accessibility, and (4) flexibility can offer immediate relief but poses long-term consequences. In conclusion, this study emphasizes the multifaceted nature of flexibility in higher education, offering a nuanced understanding of the impact of flexibility on students, educators, and institutions, encouraging further exploration and evidence-based policy decisions. Beyond academia, the research suggests potential reshaping of the higher education landscape, positioning flexibility as a fundamental element to foster a more inclusive, supportive, and effective learning environment for both students and educators.

Prevalence of Alcohol Use Disorders and Self Esteem Levels among Undergraduate Students: A Cross-Sectional Study at Kampala International University's Western Campus, Uganda

This cross-sectional study conducted at Kampala International University's Western Campus (KIU-WC) in Western Uganda aimed to investigate the prevalence of alcohol use disorders and assess self-esteem levels among undergraduate students. Utilizing the Alcohol Use Disorders Identification Test (AUDIT) and the Rosenberg Self-esteem Scale, data were collected from 366 participants to explore the relationship between alcohol consumption and self-esteem within the academic environment. Results revealed that 33.1% of participants acknowledged alcohol use, with 18.6% identified as being at a higher risk of alcohol use disorder. Among alcohol users, the prevalence of alcohol use disorders (AUDIT score ≥20) was 33.9%, leading to an overall prevalence of 11% across the entire undergraduate student population. Self-esteem scores ranged from 11 to 30, with a median of 18. Findings indicated that 7.9% of respondents exhibited low self-esteem, while 91% demonstrated normal self-esteem, and 1.1% showcased high self-esteem. These findings underscore the need for targeted interventions to address alcohol use disorders and promote positive self-esteem among university students in Uganda. Keywords: Prevalence, Alcohol, Disorders, Self-esteem, Undergraduate Students, Uganda.

Alternative Epistemologies and Experimental Philosophy. Considerations Starting from the Reading of the Doctoral Thesis Socio-epistemological aspects of contemporary Islamic feminism in Romania and Israel. A contribution to the promotion of experimental p

Reading the doctoral thesis Socio-epistemological aspects of contemporary Islamic feminism in Romania and Israel. A contribution to the promotion of the experimental philosophy supported by Mr. Salem Samih at the Western University of Timișoara, under the guidance of Prof. Florin Lobonț, allowed me to reflect on feminist epistemology and how it can be the basis for recovering factual data from sociological research for philosophizing, reinterpreted in a non-objectivist social constructionist manner.

Socio-Economic and Demographic Determinants of Safe Sex Practices among Young Adults: Insights from Kampala International University, Western Campus

This study aimed to assess young adults' knowledge and practices that affect safe sex behavior among university students in Uganda, with a particular focus on Kampala International University Western Campus. The study was conducted at the university's Western Campus, involving medical students aged 19-25. The sample size was 249. The study used Raosoft's online sample size calculator and simple random sampling techniques to obtain respondents. Data collection involved self-administered questionnaires consisting of 29 closed-ended questions. The study found a negative relationship between socio-economic and demographic factors and safe sex behaviors among young adults at Kampala International University. However, the relationship between socio-demographic factors and safe sex behaviors was not statistically significant. The findings revealed a positive and significant relationship between knowledge, practice and safe sex behaviors among young adults at Kampala International University Western Campus. Recommendations include providing comprehensive sex education to all young adults at Kampala International University to enable them to learn about sexuality and the risks associated with it. Comprehensive sex education should be holistic, incorporating age-appropriate and culturally appropriate information about reducing the risk of being sexually unsafe. Keywords: Safe sex, young adult, university students, questionnaire, Uganda.

The Impacts of Visible Green Spaces on the Mental well-being of University Students

The benefits of green spaces on individuals’ health have been widely acknowledged due to their inherent natural qualities. Currently, university students are experiencing significantly higher levels of mental health problems than other social groups. There is a scarcity of studies examining the association between built environment factors and mental health issues among university students, particularly in the Chinese context. University campuses in China are physically isolated, secluded communities, and in this respect, they differ markedly from the spatial organisation patterns of Western universities. Therefore, this study focuses on the correlation between the extent of green space exposure within closed university campuses and the occurrence of mental health issues among resident students. A deep-learning methodology incorporating streetscape images, remote sensing data, and multilevel linear modelling is employed in order to facilitate a comprehensive analysis. The results demonstrate a negative correlation between green space exposure on campus and the level of mental health issues among university students. Individual socio-demographic characteristics, such as whether a person has a partner, are also found to influence the level of mental health issues that they experience. In addition, a significant relationship is found between travel patterns and mental health issues, with students who walked regularly having a lower incidence of mental health issues than those who drove. Our research indicates that, in order to foster healthier communities and enhance social inclusion, urban planners should prioritise the development of greener campuses and urban transport services to improve accessibility to green spaces.

Assessment of Factors Associated With the Acquisition of Competencies among Undergraduate Nursing Students in Ugandan Universities

Purpose: Like other developing countries, Uganda grapples with the critical challenge of equipping nursing students with essential clinical competencies. These competencies encompass vital nursing skills, knowledge, attitudes, and behaviors crucial for effective nursing practice. This study assessed student perceptions and confidence in applying acquired clinical skills among undergraduate nursing students in Ugandan universities.
 Methodology: A descriptive cross-sectional study was used to assess bachelor's in nursing students from central and western Ugandan universities. Data were entered into Excel and exported to SPSS version 22. Results were presented using frequencies, pie charts, percentages, and tables. Chi-square tests were conducted to assess associations of the variables in the study.
 Findings: The study showed that acquisition of clinical competencies is positively correlated with students’ perceptions (r=0.775) (p=0.000), Institutional factors(r=0.668) (p=0.000), clinical learning environment (r=0.556) (p=0.000), clinical feedback (r=0.439) (p=0.000). The study further shows that 69.9% (n=70) had adequate clinical learning experience, while 31% (n=31) had inadequate clinical learning experience. This implies moderate student supervision, feedback, and an unfavorable clinical learning environment. Competency acquisition in student nurses is positively influenced by the active involvement of students' perceptions, institutional factors, and a supportive clinical learning environment. A sufficient amount of clinical experience is pivotal in developing competent student nurses.
 Unique Contribution to Theory, Practice and Policy: Management should always invite experienced professionals to share career experiences to enhance realistic perceptions among nursing students. Students should be given more time to practice in clinical settings, and management should advocate for including student attitude tests in orientation programs across nursing and clinical training universities.

Leveraging Space-Flown Technologies to Deliver Healthcare with Holographic Physical Examinations.

INTRODUCTION: Musculoskeletal injuries are one of the more common injuries in spaceflight. Physical assessment of an injury is essential for diagnosis and treatment. Unfortunately, when musculoskeletal injuries occur in space, the flight surgeon is limited to two-dimensional videoconferencing and, potentially, observations made by the crew medical officer. To address these limitations, we investigated the feasibility of performing physical examinations on a three-dimensional augmented reality projection using a mixed-reality headset, specifically evaluating a standard shoulder examination.METHODS: A simulated patient interaction was set up between Western University in London, Ontario, Canada, and Huntsville, AL, United States. The exam was performed by a medical student, and a healthy adult man volunteered to enable the physical exam.RESULTS: All parts of the standard shoulder physical examination according to the Bates Guide to the Physical Exam were performed with holoportation. Adaptation was required for the palpation and some special tests.DISCUSSION: All parts of the physical exam were able to be completed. The true to anatomical size of the holograms permitted improved inspection of the anatomy compared to traditional videoconferencing. Palpation was completed by instructing the patient to palpate themselves and comment on relevant findings asked by the examiner. Range of motion and special tests for specific pathologies were also able to be completed with some modifications due to the examiner not being present to provide resistance. Future work should aim to improve the graphics, physician communication, and haptic feedback during holoportation.Levschuk A, Whittal J, Trejos AL, Sirek A. Leveraging space-flown technologies to deliver healthcare with holographic physical examinations. Aerosp Med Hum Perform. 2024; 95(4):214-218.

Abstract 477: Tumor treating fields (TTFields) targeted self assembling nanoparticles for pancreatic cancer treatment: In vitro and in vivo assessment

Abstract Tumor Treating Fields (TTFields) is a novel, non-invasive and safe treatment modality, which is prescribed to be used in conjunction with classical anticancer chemotherapeutic drugs. TTFields when used alone are safe, but their use in combination with classical chemotherapy continues to offer drug related adverse reactions which ultimately impacts the patient compliance. To address this challenge, we earlier reported meticulously optimized self-assembling cationic-anionic polymer nanoparticles (S-CAP NPs) with average particle size of about 200 nM, encapsulation efficiency of 55-65 % and sustained drug release over 60 h. We also reported that, TTFields were capable of destabilizing the S-CAP NPs leading to targeted drug release. The results were also corroborated with in vitro cytotoxicity and colony formation studies in presence of TTFields using multiple pancreatic cancer cell lines. After establishing the proof-of-concept, the objective was to assess the in vitro cellular uptake of S-CAP NPs. For this, fluorescent dye loaded S-CAP NPs were developed and subjected to cellular uptake analysis. The in vitro cellular uptake studies confirmed the enhanced uptake of S-Cap NPs by passive diffusion in the pancreatic cancer cell lines compared to normal pancreatic epithelial cell line. The studies corroborated preferential cellular uptake of S-Cap NPs by the pancreatic tumor. Among all the formulations, the chitosan- bovine serum albumin S-CAP NPs was most optimum and was used for in vivo safety studies. For this, in vivo acute and repeated dose 28-day toxicity of the optimum placebo S-CAP NPs was conducted in Sprague Dawley rats (Western University of Health Sciences Protocol #R20IACUC031) and OECD guidelines. The in vivo studies showed a LD50 value above 2000 mg/kg and NOAEL value of 1000 mg/kg. These high doses safety of S-CAP NPs confirmed the potential of this approach for future preclinical efficacy studies followed by clinical translation. Lastly, the in vitro stability studies were conducted as per the ICH guidelines for a period of 36 months and the formulations were concluded to be stable. The tumor targeting potential, in vivo safety and stability of S-CAP NPs, establish their translational potential for TTFields triggered targeted drug release in cancer treatment. This approach will not only reduce the adverse effect associated with combination of TTFields and chemotherapy but can also be explored as a platform technology for management of other cancers. This study is supported by AACR-Novocure tumor treating fields research fellowship. Citation Format: Preshita Prafulla Desai, Sunil Prabhu. Tumor treating fields (TTFields) targeted self assembling nanoparticles for pancreatic cancer treatment: In vitro and in vivo assessment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 477.

UMA ANÁLISE SOBRE A PRESENÇA/AUSÊNCIA DAS MULHERES

This article is a clipping of the Master’s thesis research, linked to the Graduate Program, Stricto Sensu, in Society, Culture and Borders, of the State University of Western Paraná, campus Foz do Iguaçu. The central theme permeates the reflections on the visibility/invisibility of women in society based on patriarchal precepts. The study had a qualitative approach, with documentary and bibliographic research. Therefore, this article aims to discuss briefly about the role of women in history, considering the delimitation of time space in the interior of Brazil in the first half of the twentieth century, and the importance of women’s participation in spaces of power and institutionalized political decisions. It is considered relevant in this study to show that although the analyzes are focused on specific historical context, the problems and many challenges faced by women are still visible today, making a timeless systematic.

Knowledge and attitudes of medical students toward death: a cross-sectional comparative study between an Arab and a Western University

BackgroundCultural factors influence attitudes toward death, and gender disparities are evident. Prior studies show that medical students have limited knowledge about death and are uncomfortable with it. Moreover, there is limited research that has examined factors that influence medical students’ knowledge and attitudes toward death.ObjectivesThe objectives of the study were to compare cultural and gender differences in relation to knowledge and attitudes toward loss and grief and to screen for complicated grief among medical students at the Arabian Gulf University and the University of Toronto.MethodsA cross-sectional study was disseminated to medical students at both universities in 2022. The variables in the survey included four parts: demographic characteristics of the participants, religious observance, history of encountering loss of a loved one, grief following loss, attitude toward death, and learning about how to deal with grief and death during medical school. The brief grief questionnaire and the death attitude profile-revised scales were used.ResultsThe study sample consisted of 168 medical students, with 74.1% being female. Complicated grief scores were higher among Arabian Gulf University students (3.87 ± 2.39) than among University of Toronto students (2.00 ± 1.93) and were higher for participants with a higher degree of religious observance in both schools (p < 0.05). Death avoidance (p = 0.003), approach acceptance (p < 0.001), and escape acceptance (p = 0.038) domains were significantly higher among Arabian Gulf University students than among University of Toronto students. Almost three-quarters of University of Toronto students reported not being taught about grief, compared to 54% of Arabian Gulf University students.ConclusionsArabian Gulf University medical students scored higher on complicated grief, most likely due to cultural and religious factors. Females at both institutions as well as those who indicated a higher level of religious observance reported higher scores of complicated grief. The study highlights how cultural and religious beliefs influence medical students’ attitudes toward death and bereavement. It provides valuable insight into the knowledge and attitudes of medical students toward loss.

Impact of the Removable Partial Denture Components on the Prognosis of the Abutment Teeth: An Exploratory Clinical Study

Introduction Partial edentulism is considered one of the challenging topics in dentistry. The main objectives of the patient are to restore function and esthetics. However, the dentist’s main goals are preserving the remaining teeth supporting structures and restoring the patient’s quality of life. A Removable Partial Denture (RPD) design should be considered carefully for each case, as there are clinical and personal variables for each patient that will impact the prognosis of the denture. With the growing need for RPD, design principles require more research to improve the preservation of abutment teeth. This study aims to clinically evaluate the abutment teeth and supporting tissues before and after RPD placement and to correlate these clinical findings with the RPD components. Methods: Patients were recruited from the dental clinic at Schulich Dentistry, Western University in London, Ontario, Canada. Abutment teeth were evaluated for the following clinical parameters: Tooth Mobility (TM), caries, defective restorations, tooth fracture, Probing Depth (PD), Gingival Recession (GR), bleeding on probing (BOP) and Plaque Index (PI). These clinical measurements were collected at the time of RPD insertion and at least two years after. Clinical parameters were analyzed using Kruskal Wallis H, Mann-Whitney U and Chi-Squared tests. Results: 34 participants were recruited, and 40 cast metal RPDs were evaluated. The mean age of participants was 73.8 years, and the mean duration of denture use was 37.6 months. Most frameworks assessed were Kennedy Class III RPDs. Caries were significantly associated with rest type, wherein occlusal rests showed an increased incidence of caries compared to cingulum rests. The retentive clasp arm type was associated with a mean difference in PD, wherein cast circumferential and wrought wire clasp arms had deeper PD after RPD insertion than Infra gingival clasps (I-bars). Conclusion: The results of this study suggest clasp arms and occlusal rests influence dental disease. Larger samples and more clinical studies are needed to confirm the role of specific RPD components on the abutment teeth prognosis.

The Faults of Neoliberal Education: Examining International Students’ Experiences within Korean Higher Education

The overwhelming negativity towards neoliberalism has focused on policies that have reduced academic life to strictly corporate terms and how the customer education model has led to the demise of civic and democratic values. Following Western universities' models, Korean education has adopted the same values and policies, inheriting the subsequent issues and problems that lie therein. This paper continues the call for resisting neoliberalism by exposing its negative impact on the acculturation experiences of international students in Korea. The study participants used transactional language to describe their feelings of marginalization and invisibility and the impoverished ways their host university treated them. Utilizing a qualitative case study methodology set within the framework of neoliberalism, this paper documents how neoliberal policies have been ideologically ingrained in Korean higher education. It highlights the necessity of reforming current policies to deter acculturative stress. It is hoped that the findings inspire resistance to the neoliberal ideology that Korean policymakers have subconsciously followed.&#x0D; &#x0D; Received: 23 December 2023 / Accepted: 19 February 2024 / Published: 5 March 2024