Part 1 - Background: Maternal prenatal adversity often results in changes to the hypothalamic- pituitary-adrenal axis (HPA axis) function, such as greater cortisol secretion. Recent evidence suggests that fetal exposure to elevated cortisol levels may cause structural changes to key limbic regions integral to regulation of the HPA axis such as the amydala and hippocampus in children. In the early postnatal months these same structures are particularly vulnerable to the quality of maternal care and parenting styles. However, the relative impact and interaction of such factors is still underreported. Methods: 24 healthy 7-8 year old children (male:female=13:11) underwent an MRI. Amygdala and hippocampal volumes were assessed and used in multiple regression models to determine the impact of prenatal cortisol and postnatal maternal sensitivity. Results: Larger right hippocampal volumes were associated with increases in late gestation cortisol levels (4.6 mm3/nmol of cortisol; FDR corrected p<0.005). Increases in 6th month maternal sensitivity predicted a decrease in right hippocampal volumes at a trend level (FDR corrected p=0.09). There was no interaction effect between cortisol and sensitivity. There were no significant effects on left hippocampus or bilateral amygdala volumes. No sex differences were noted. Discussion: Given previous work we had expected greater amygdala volume and reduced hippocampal volumes to associate with increases in cortisol and decreases in sensitivity. Our results suggest that there may indeed be a programming effect on children’s hippocampi by prenatal cortisol. Findings may be reflective of a positive adaptive response or resilience to adverse prenatal environments. Part 2 - Introduction: Emotion regulation (ER) is an integral component to mental health. ER is thought to incorporate limbic as well prefrontal regions in several cognitive top-down circuits to utilize higher-order executive functions to adequately monitor and inhibit emotion when necessary. However, only recently has research targeted the developmental trajectories of these circuits from childhood. Methods: 29 healthy children aged 7-8 years (mean 7.34 ± 0.48) underwent functional magnetic resonance imaging (fMRI) with an implicit emotion go/nogo cognitive task to assess the developmental state and interaction between cognitive and emotional circuitry using functional connectivity (FC) in this age group. Results: Central executive networks (CEN) and salience networks (SN) showed more diffuse FC than mature networks, with greater inter-network connectivity. During exposure to fearful stimuli, there was greater connectivity within CEN and SN during go trials. Nogo trials were associated with more limbic-cognitive network interaction during concurrent exposure to fearful stimuli than neutral stimuli, Connectivity with the dACC was found to be common between limbic and CEN seeded networks. Discussion: Results indicate that cognitive networks are present but generally less mature than previous results from adult populations. Particularly, diffuse connectivity between the insula and PCC was negatively correlated indicating a developing switch between resting and salience networks. Additionally, greater connectivity for response inhibition tasks (nogo) during fearful stimuli exposure in the dACC, amygdala, anterior prefrontal, and DLPFC, suggests a maturing emotion regulation network, capable of managing cognitive tasks during emotional stimuli presentation. / Thesis / Master of Science (MSc)

Background: Death is a common occurrence in the Intensive Care Unit (ICU), and the circumstances surrounding a patient’s death can have a lasting influence on the wellbeing of families and nursing staff alike. Culture is an important influence on an individual’s perspective of end-of-life (EOL) care and a ‘good death’, and, as such, cultural sensitivity is an essential element of high quality EOL care in the ICU. Nurses are well situated to facilitate culturally sensitive EOL care within the ICU; however, there is a significant paucity of knowledge regarding ICU nurses’ perceptions of a culturally sensitive EOL nursing practice and their experiences delivering this within an adult ICU. Aims: The purpose of this study was to explore ICU nurses’ perceptions of delivering culturally sensitive care within their current EOL practice, and thus better understand how culturally sensitive EOL care can be supported within adult ICUs. Design and Methods: An Interpretive Description methodology was utilized to explore the perceptions of seven (n=7) Canadian ICU nurses regarding culturally sensitive EOL care. Maximum variation and theoretical sampling were used to recruit registered nurses from ICUs in two hospitals in Southern Ontario, Canada. Data were generated using semi-structured interviews and field notes and was concurrently analyzed using a constant comparative and reflexive approach. Study rigour was supported through the use of reflexive journaling/memoing, data triangulation, and peer debriefing. Results: Analysis of the data led to the construction of three themes which described nurses’ perceptions of providing EOL care within the ICU: 1) culturally sensitive EOL care is truly person-centered care, 2) dissonance between culturally sensitive EOL care and the biomedical model of care in the ICU, and 3) needing support to adopt a more relational approach to care in the ICU. Conclusion and Implications: Study findings highlight that ICU nurses perceive that culturally sensitive EOL care primarily involves building a strong therapeutic relationship and being truly person-centered when delivering care. However, the context surrounding nursing practice in the ICU creates many barriers to adopting this relational approach to care; thus, multifaceted support is needed for culturally sensitive EOL nursing practice to be bolstered and sustained. / Thesis / Master of Science in Nursing (MSN) / Patients in the Intensive Care Unit frequently die and the circumstances surrounding these deaths affects both family members’ and nurses’ wellbeing. Culture is an important influence on an individual’s needs during the end-of-life period and on their views about a ‘good death’. As such, when caring for dying patients, healthcare professionals need to be sensitive to the culture of each patient and family. In the Intensive Care Unit, nurses play an important role in making sure end-of-life care is culturally sensitive. The goal of this study was to learn more about nurses’ perceptions and experiences of providing culturally sensitive end-of-life care within adult Intensive Care Units. This study found that nurses working in Intensive Care Units feel culturally sensitive end-of-life care mainly involves being truly person-centered and this requires staying open-minded and building strong relationships with patients and their families. Nurses in this study also indicated that they face many obstacles when trying to be culturally sensitivity during end-of-life care and some of these were created by their practice environment. This research shows that if nurses are to deliver culturally sensitive end-of-life care within critical care settings they need significant support in various forms, which likely includes a change in the unit culture.

Anxiety is a mental illness that can have significant deleterious impacts on an individual’s functioning. Although anxiety has been studied in older adults, there is conflicting evidence on differences in anxiety as a function of age. Anxiety sensitivity is a construct that is positively related to anxiety but has limited research in older adults. Extant literature suggests that older adults experience less anxiety sensitivity than do younger adults. According to Socioemotional Selectivity Theory, this may be due to older adults letting go of the things that make them anxious. The current study proposed that age impacts self-rated anxiety such that it is lower in older adults than it is in middle-aged adults and posits that anxiety sensitivity may mediate the relationship between anxiety and age. The results suggested a significant indirect effect but no direct effect, precluding the presence of mediation. There was a significant relationship between age and anxiety sensitivity. Further examination revealed that the relationship between age and anxiety sensitivity was not significant for people under 60 years old, but it remained significant for participants 60 years and older.

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abstract: Excessive drinking in adolescence is a public health issue with major consequences on both an individual and societal level. Elucidating genetic and environmental influences could be particularly informative for prevention efforts. One potential source of genetic influence is sensitivity to environmental influences. It was hypothesized that parent knowledge would interact with genetic sensitivity to the environment to indirectly reduce risk for alcohol problems through less adolescent rule breaking behavior. Participants (N=316) provided genetic data and reported their rule breaking behavior and past year frequency of heavy drinking, and participants’ custodial parents reported their perceived knowledge of their child’s activities. A novel index of genetic sensitivity to environmental influence was created using published methylation quantitative trait locus data from the frontal lobe. Study hypotheses were mostly not supported. The study results likely reflect the poor distribution of study variables and the limitations of the current study’s sensitivity gene score. The current study underscored the importance of adhering to methodological rigor and explored alternate conceptualizations and methods that future research could use to elucidate the role of inherited to sensitivity to environmental influences in adolescent drinking. / Dissertation/Thesis / Doctoral Dissertation Psychology 2020

Numerous studies show that a low level of response to the intoxicating effects of alcohol is considered a risk factor for future alcoholism. However, assessing this sensitivity usually requires administering a controlled dose of alcohol, which has a number of inherent problems. Early observations in our lab suggest that the response to anesthetics that show cross tolerance with alcohol, like ketamine, are blunted in nonhuman primates at risk for high alcohol intake, and may be a viable measure of future alcohol consumption. This study was designed to test potential predictors of future alcohol consumption using the change in ketamine across repeated exposures (i.e., tolerance). In addition, potential mediating factors of alcohol consumption, including early temperament and behavior, were assessed. Subjects were 16 three-year-old, alcohol naïve rhesus macaque males raised by their biological mothers. Ketamine Exposure-Each subject was exposed to three 10.0 mg/kg intramuscular doses of ketamine. The time from injection to recovery from anesthetic was recorded for each dose, to be used as a measure of subject's sensitivity and developed tolerance. Alcohol Intake Assessment-Two weeks after the final ketamine dose, subjects were allowed ad libitum access to a palatable 8.4% alcohol solution for two-hours a day, five days a week, for six weeks. During the Two-Choice phase of testing, subjects were simultaneously given ad libitum access to the 8.4% alcohol solution and to a sweetened solution for two-hours a day, five days a week, for four weeks. Solution consumption was recorded daily and averaged across the weeks for each phase of alcohol testing. Temperament and Behavior-As infants, all subjects participated in a bio-behavioral assessment (BBA), when they were between 90 and 120 days of age. Data collected during the BBA on subjects' temperament (Vigilance, Gentleness, Confidence, and Nervousness) and Behavior (Activity and Emotionality) were used in analyses. Results showed a relationship between the tolerance developed between ketamine doses and average alcohol consumption during the Alcohol-Only phase (r = 0.61, R2 = 0.372, F (1,14) = 8.300, p = 0.012). Average alcohol consumption during the Alcohol-Only phase was also related to ratings of Confidence (r = 0.499, R2=0.249, F(1,14)=4.647, p = 0.049), Activity (Day 1: r = 0.503, R2 = 0.253, F(1,14) = 4.732, p = 0.047; Day 2: r = 0.455, R2 = 0.207, F(1,14) = 3.652, p = 0.077), and Emotionality (r = 0.466, R2 = 0.217, F(1,14) = 3.885, p=0.069). The results of this study suggest that change in ketamine recovery time and early life temperament and behaviors may be measures of future risk for alcohol abuse disorders. This data is limited by the small sample size and future study is necessary to further tease out the relationships between these variables and alcohol consumption.

Introduction Several studies have found celiac disease may be associated with a variety of cardiac manifestations. Atrial fibrillation (AF) is one of the most common arrhythmias that can cause significant morbidity. However, the risk of atrial fibrillation in patients with celiac disease according to epidemiological studies remains unclear. The aim of this meta-analysis study is to assess the risk of atrial fibrillation in patients diagnosed with celiac disease compared to controls. Methods A systematic literature review was conducted in MEDLINE, EMBASE, Cochrane databases from inception through December 2017 to identify studies that evaluated the risk of atrial fibrillation in patients with celiac disease. We included randomized controlled trial, cross sectional and cohort studies that reported the odds ratio, relative risk, hazard ratio, and standardized incidence ratio comparing the risk of developing atrial fibrillation among patients with celiac disease, versus patients without celiac disease as control. The Newcastle-Ottawa scale was used to determine the quality of the studies. Effect estimates from individual studies were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. Results Celiac disease is an autoimmune condition. This inflammatory state predisposes patients to develop AF. After a review of the literature, four observational studies with a total of 64,397 participants were enrolled. The association between celiac disease and increased risk of atrial fibrillation was significant, with a pooled OR of 1.38 (95% CI: 1.01-1.88). No publication bias as assessed by the funnel plots and Egger's regression asymmetry test with p = 0.54. However, the heterogeneity of the included studies was high (I2 = 96). Conclusion A significant association between celiac disease and risk of atrial fibrillation was reported in this study. There is a 38% increased risk of atrial fibrillation. Additional studies are needed to clarify the mechanistic link between atrial fibrillation and celiac disease. Some of the limitations of this study are that all were observational studies, some were medical registry-based and there was high heterogeneity between studies.

Following the successful launch of CP3 and CP4, the PolySat team noticed an unreliable uplink to both satellites. A significant problem with the PolySat COMM system is poor receive sensitivity of the communications system. Efforts have been made to improve the uplink margin, but without proper characterization of the receiver sensitivity, the problem cannot be fully addressed. By developing an accurate method of measuring receive sensitivity, a methodical approach can be used to properly diagnose the communication system and link budget. Two revisions of the PolySat COMM system will be measured and compared. An in-depth study of the PolySat COMM system will be performed, providing an interesting look at possible causes of the inconsistent uplink and methods of improving the COMM system. For future bus development, this test setup can be used to accurately measure the receive sensitivity.

Coal plays a significant role in electricity production worldwide and will into the foreseeable future. Technologies that improve efficiency and lower emissions are becoming more popular. High pressure reactors and oxyfuel combustion can offer these benefits. Designing new reactors effectively requires accurate single particle modeling. This work models a high-pressure, high-temperature, high-heating rate, entrained-flow, char oxidation data set to generate kinetic parameters. Different modeling methods were explored and a sensitivity analysis on char burnout was performed by varying parameters such as total pressure, O2 partial pressure, O2 and CO2 mole fractions, gas temperature, diameter, and pre-exponential factor. Pressure effects on char burnout modeling were found to be dependent on the set of kinetic parameters chosen. Using kinetic parameters from Hurt-Calo (2001) as opposed to values obtained from Niksa-Hurt (2003) yielded a trend seen in real data sets, that reaction order changes with temperature. Varying O2 mole fraction and partial pressure showed the most significant changes in char burnout. Varying diameter, total pressure, the pre-exponential factor, CO2 environment, and gas temperature all changed the char burnout extent as well. The effect of changing those parameters decreases in the order they are listed. Increasing any of these parameters resulted in an increase in char burnout except for particle diameter and CO2 mole fraction which led to a decrease. Char formation pressure affects reactivity, and a peak in reactivity is shown in this work at the 6 atm condition.