The nursing profession perpetuates an outdated model that fails to address the health concerns of racialized gender-diverse people. Evidence supports that this population experiences poorer health outcomes, care-avoiding habits, and incompetent healthcare providers. A literature review illuminated gaps in the nursing lens when considering gender-diverse identities outside of Whiteness. An intersectionality framework and cultural humility were used to explore the contexts in which nurses provide care. To fill this knowledge gap, the proposed research question was: How prepared are nurses to provide care to racialized gender-diverse people? A questionnaire was developed by modifying three pre-existing instruments. The online questionnaire served as a pilot feasibility study to collect preliminary baseline descriptive cross-sectional data about Ontario nurses' training, education, knowledge, attitudes, and beliefs about racialized gender-diverse people. Findings indicated potential gaps in training and education that may affect racialized gender-diverse peoples' healthcare. Recommendations are provided for future research and interventions.

In 2014 SÖRAB constructed a continuous biological treatment system (KBR) to handle leachate waterfrom the landfill at the facility in Löt, north of Stockholm. The KBR is mainly focused on removal ofammonium nitrogen which would otherwise be released in to the recipient and contribute toeutrophication and damage to the environment. This project has focused on replacing the currentcarbon source in the process Brenntaplus VP1 and evaluating the efficiency of denitrification andeconomy of transitioning to a new carbon source. The carbon sources glycerol and ethanol wereevaluated and compared to Brenntaplus VP1 for the denitrification efficiency and microbial profile.The experiments were performed in laboratory conditions and in pilot scale using leachate water fromLöt. The reduction of ammonia was evaluated by chemical precipitation, addition of carbon sources bymeasuring ammonia-N and nitrate-N under aerobic (nitrification) and anaerobic (denitrification)conditions. The combination of ethanol and glycerol showed an enhanced denitrification and increasedmicrobial community both in lab and pilot scale studies with reduced hydraulic retention time. Therate of nitrate reduction was 0.23 mgNO3-N 1 -1 h -1 for ethanol/glycerol compared to 0.12-0.17mgNO 3- -N 1 -1 h -1 for Brenntaplus VP1 in pilot scale. The results indicate that using ethanol, glycerolor a mix of the two as a substitute for Brenntaplus VP1 is viable. This has been based on laboratoryand pilot scale studies. Each of the carbon sources examined during this project have showed a uniqueimpact on the process and its parameters such as: denitrification rate, microbial density and microbialcomposition. The carbon sources had an impact with temperature fluctuation and faster denitrificationcompared to the conventional KBR system. This implies that the carbon sources tested in this projectcan be advantageous and beneficial for Sörab depending on the carbon source availability and theseasonal variations. / Under 2014 konstruerade SÖRAB ett kontinuerligt biologiskt reningsverk (KBR) för att hanteralakvatten från deponin för ickefarligt avfall vid anläggningen i Löt, norr om Stockholm. KBR ärfrämst konstruerad för rening av ammoniumkväve som annars skulle släppas ut till recipienten ochbidra till övergödning och skador på miljön i området. Detta projekt har fokuserat på att ersätta dennuvarande kolkällan Brenntaplus VP1 som används i processen och utvärdera effektiviteten idenitrifieringen samt ekonomin vid övergång till en ny kolkälla. Kolkällorna glycerol och etanol varde kolkällor som valdes för utvärdering i detta projekt, dessa jämfördes med Brenntaplus VP1 i desseffekt på denitrifikationseffektivitet och mikrobiell sammansättning under laboratorieförhållanden ochi pilotskala. Möjligheten att reducera ammoniumkoncentrationen i lakvattnet utvärderades genomkemisk fällning och genom mätning av ammoniumkväve och nitratkväve under aeroba (nitrifikation)och anaeroba (denitrifikation) förhållanden. Kombinationen av etanol och glycerol indikerade enförbättrad denitrifikation och ökad mikrobiell densitet både i laboratorie- och pilotskala med reduceradhydraulisk retentionstid. Nitratreduktionshastigheten var 0,23 mgNO 3- -N 1 -1 h -1 för blandningen avetanol/glycerol jämfört med 0,12 - 0,17 mgNO 3- -N 1 -1 h -1 för Brenntaplus VP1 i pilotskala. Resultatenindikerar att användning av etanol, glycerol eller en blandning av de två har goda förutsättningar föratt ersätta Brenntaplus VP1. Var och en av de tre kolkällorna som undersöktes under detta projekt harvisat en unik inverkan på processen och dess parametrar såsom: denitrifikationshastighet, mikrobielldensitet och mikrobiell sammansättning. Genom att byta kolkälla i KBR kan prestandan ökas genomatt minska den hydrauliska retentionstiden samtidigt som systemet tycks bli mindre känsligt förtemperatursvängningar. Kolkällorna som utvärderats i detta projekt kan därför vara fördelaktiga för SÖRAB beroende på dess tillgänglighet och pris.

OBJECTIVE: Because training in pediatric disaster medicine (PDM) is neither required nor standardized for pediatric residents, we designed and integrated a PDM course into the curriculum of a pediatric residency program and assessed if participation increased participants' knowledge of managing disaster victims. METHODS: We adapted and incorporated a previously studied PDM course into a small-sized pediatric residency program. The curriculum consisted of didactic lectures and experiential learning via simulation with structured debriefing. With IRB approval, the authors conducted a longitudinal series of pretests and posttests to assess knowledge and perceptions. RESULTS: Sixteen eligible residents completed the intervention. Before the course, none of the residents reported experience treating disaster victims. Pairwise comparison of scores revealed a 35% improvement in scores immediately after completing the course (95% confidence interval, 22.73%-47.26%; P < 0.001) and a 23.73% improvement 2 months later (95% confidence interval, 7.12%-40.34%; P < 0.01). CONCLUSIONS: Residents who completed this course increased their knowledge of PDM with moderate retention of knowledge gained. There was a significant increase in perceived ability to manage patients in a disaster situation after this educational intervention and the residents' confidence was preserved 2 months later. This PDM course may be used in future formulation of a standardized curriculum.

This pilot study investigated the efficacy of a supplemental Active Learning intervention that was administered with grammar workbook software in remedial-level composition classrooms at Seminole State College. The study analyzed student response data in a pre-test and post-test instrument in four classrooms; two followed standard methods while two incorporated the additional experimental intervention. The groups are identified in this study as either “Standard” or “Experimental,” according to the method administered in the classroom. The intervention was designed based on five grammar topic areas which correspond with content assessed in the pre-test and post-test. The Active Learning method required students to prepare a short, guided presentation on selected grammar topics. Findings showed that there was no significant change in improvement between the pre-test and post-test among the Standard or the Experimental groups, due in part to a relatively small sample size. A positive change approaching significant level occurred in the Experimental group in topic areas related to critical thinking. No significant or near-significant change was observed in the topic areas related to memorization in either group. Recommendations were made for further sampling, modification, and future applications of the intervention used in the study and for continued testing of grammar software used for instruction in Developmental Writing classes at Seminole State College.

Here the nature of gas phase processes and their implications for flow and transport were examined using a pilot-scale, 2-dimensional, laboratory tank instrumented for direct, in situ trapped gas measurements. Experimental conditions mimicked an unconfined, homogeneous sand aquifer with horizontal flow. Key areas of investigation included i) trapped gas dissolution following a water table fluctuation; and ii) gas phase dynamics within a hydrocarbon plume experiencing dissolved gas production via biodegradation. In the first experiment, dissolution occurred as a diffuse, wedge-shaped front propagating down-gradient in the tank over time, with enhanced dissolution at depth. Front advancement at the deepest monitoring point was 4.1 - 5.7x faster. This dynamic, depth-dependent pattern was mainly attributed to increased dissolved gas solubility. An estimated 12% increase in quasi-saturated hydraulic conductivity (Kqs) also contributed to greater dissolution at depth. Overall, the dissolution front near the water table advanced 1 m down-gradient in 344 days, suggesting that gas trapped shallowly will likely persist for significant periods of time. The utility of total dissolved gas pressure sensors for simple in-well measurements to detect trapped gas and monitor its dissolution were also demonstrated. During the second experiment, biodegradation occurred under variable redox conditions, ranging from denitrification to methanogenesis. Significant in situ increases in trapped gas were observed within the tank over 330 days. Maximum gas saturations never exceeded 27% of pore volume even during continued dissolved gas production, indicating ebullition upon reaching a gas phase mobilization threshold. Consequently, associated reductions in Kqs were restricted to a factor of 2 or less, but still appeared to alter the groundwater flow field. While trapped gas increases within the biodegradation plume were expected, declines in gas saturations were also observed. Thus, the overall pattern of trapped gas growth exhibited high spatial and temporal variability. Influencing factors included changes in hydrocarbon inputs and microbial controls on redox zonation, in addition to ebullition and changes in groundwater flow; emphasizing that gas phase growth in contaminant plumes will be highly complex and dynamic in the natural systems. Given the impacts on hydraulic conductivity, and the fate and transport of volatile compounds, an improved understanding of quasi-saturated conditions will be beneficial for various groundwater applications, from recharge and paleoclimate studies to site characterizations and remediation strategies. / Dissertation / Doctor of Philosophy (PhD)

In recent years, the rapid advancement of Unmanned Aircraft Systems (UAS) has led to an increasingly complex National Airspace System (NAS), necessitating a comprehensive understanding of factors that impact pilot visual acquisition and detection of other aircraft (including manned fixed-wing, rotorcraft, and UAS). The objective of this study is to investigate factors that affect pilot performance in visually acquiring and detecting other manned-fixed wing aircraft and manned rotorcraft using a multi-method approach, incorporating qualitative and quantitative data analysis. A diverse sample of pilots with varying flight experience participated in the study. Participants were exposed to a series of flight test scenarios in a high-fidelity flight test campaign using different flight paths and detecting different types of aircraft, designed to replicate real-world airspace encounters with other aircraft. Post-flight interviews were conducted, and situational awareness questionnaires and NASA Task Load Index (NASA-TLX) were administered to capture insights on the pilots’ experiences. The goal was to determine the level at which aircraft characteristics, test subjects’ situational awareness and workload, flight conditions, and environmental conditions influenced visual acquisition and detection. All interviews were subjected to several cycles of meticulous coding and subcoding processes to discern both individual and co-occurring factors affecting visual detection capabilities. Additionally, a rigorous statistical analysis was executed on the data derived from the situational awareness questionnaires and NASA-TLX to extract quantitative insights into pilot-centric metrics influencing visual detection. The amalgamated results from both the qualitative and quantitative analyses were synthesized to construct a comprehensive representation of all variables influencing visual detection, in addition to delineating the parallels between factors that affect visual acquisition in both manned fixed-wing and rotorcraft detection scenarios.

The causality dilemma between dysbiosis and cancer has given rise to numerous studies both exploring the mechanisms behind cancer progression and the associative shifts in the microbiota upon carcinogenesis. Aside from the hallmark study of Dr. Barry Marshall in establishing the true causal relationship between Helicobacter pylori and gastric adenocarcinoma, studies have only been successful in adding associative links of carcinogenesis mediated by bacteria to the literature. The current field is limited in its ability to establish causative relationships, and further work is needed to construct a reference community whose physiological responses reflect global community responses. In this thesis, the organism Lactobacillus acidophilus was selected as a pilot strain for the development of a novel framework to establish the fitness and physiological changes that occur when bacteria engage the human epithelial environment. The pilot strain was revived from the American Type Culture Collection (ATCC), verified through 16S rRNA Sanger sequencing, and grown in its conventional culture medium and human tissue culture medium to establish baseline growth rates and gauge its physiological responses to an in vitro tumor microenvironment. A set of standard conditions was proposed for growth under human tissue culture conditions. Finally, a metabolic study and spot plate assay were performed to elucidate the anabolic deficits and viability of this strain in human tissue culture medium, respectively. This research was performed to better understand the environmental and metabolic requirements for this pilot strain to inhabit the human epithelial environment, and to establish a workflow that will set the foundation for an appropriate clinical study to demonstrate the causative relationship between dysbiosis and carcinogenesis.

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