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"Allen, Crystal"
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The Laura Line
When Laura Dyson's seventh grade history teacher schedules a class trip to the slave shack on her grandmother's farm, Laura is forced to come to terms with her family's past and what it means for her future.
Book
Infusion parameters, safety, and practical guidance for the manual administration of subcutaneous immunoglobulin 20% (Ig20Gly)
Primary immunodeficiency diseases (PIDs), also referred to as inborn errors of immunity, constitute a group of genetic conditions that affect the immune system. The current standard of care for patients with PIDs is lifelong immunoglobulin replacement therapy, delivered by intravenous (IVIG) or subcutaneous (SCIG) infusion. Immune globulin subcutaneous (human) 20% solution stabilized with glycine (Ig20Gly) is indicated as a replacement therapy for PIDs in adults and children of any age in Europe and in patients aged 2 years and above in the USA. Typically, Ig20Gly is administered using an infusion pump; however, delivery of Ig20Gly by manual administration has recently been approved in Europe. Practical recommendations on the use of Ig20Gly manual administration are lacking; this review therefore aims to provide guidance for use of this method of administration. Additionally, we summarize the infusion parameters, safety, patient-reported outcomes, and economic benefits associated with Ig20Gly manual administration. Manual administration of Ig20Gly was shown to permit faster rates of infusion than administration via infusion pump. Patients typically infused at two or fewer infusion sites with manual administration of Ig20Gly. Safety and tolerability profiles were similar for Ig20Gly manual administration and administration by infusion pump. Overall, there were comparable levels of patient satisfaction with manual administration and infusion pump, with patient preference deemed to be a key determinator of success for either method of administration. Economic studies identified cost savings for the healthcare system through manual administration compared with IVIG or SCIG infusion by infusion pump because of the reduced equipment costs and nurse support. For infusion of Ig20Gly by manual administration, a syringe and butterfly needle are used; patients are advised to start infusion at 1–2 mL/min to prevent discomfort. Overall, manual administration of Ig20Gly offers an effective and well-tolerated alternative to administration by infusion pump.
Journal Article
Between two brothers
Isaiah \"Ice\" Abernathy has always worshiped his older brother, Seth. For years they've been not just brothers but best friends -- and as Seth starts his senior year, Ice is eager to spend as much time with his brother as he can, making memories before Seth goes to college. But when Seth announces he's leaving much earlier than expected, and then he misses an important event -- one he'd promised to attend -- it causes a major fight. Filled with regret, Ice plans to apologize to Seth later the next day, but later never comes, as he finds out Seth was in an accident -- one that leaves him in the hospital. And the doctors say he may never recover. Racked by fear and guilt, Ice chooses to step up, defy the experts, and help Seth recover in a way only he can -- by trusting in their bond and the undying love between two brothers.
Book
The Ethics of Killing “Surplus” Zoo Animals
As zoos have developed more successful captive breeding programs, they now face a question of what to do about “surplus” animals. One strategy used by European zoos in recent years has been to allow animals to breed freely, then kill unwanted offspring. I argue that this strategy wrongs the animals in question and that the justifications that have been offered for the practice are inadequate. I provide background on the practice, discuss the moral status of animals and potential grounds for the prima facie duty not to kill, and then examine and ultimately dismiss justifications for killing in this case.
Journal Article
The wall of fame game
As she awaits the arrival of a new baby sister, Mya is cornered into a bet with her enemy that forces her to spend every night studying and enters a chili cook-off despite her limited culinary skills.
Book
The Effects of Six Months of Exercise on Single- and Dual-Task Posture, Gait, and Functional Mobility Relative to Usual Care Alone Among People Living with Dementia: The ENABLED Pilot Randomized Controlled Trial
Cognitive–motor integration is the coordination of cognitive and motor processes; it is commonly impaired among people living with dementia (PWD) and may be improved through exercise. This pilot randomized controlled trial (1:1) aimed to determine the effect of 6 months of exercise on cognitive–motor integration compared to usual care in n = 42 PWD at two residential care facilities. Participants completed single- and dual-task standing (30 s of standing while counting backward by 1 s), walking (4 m walk while naming words), and timed-up-and-go (TUG) tests (TUG with a category task), measured using APDM inertial sensors at baseline and 6 months (age = 82 years, 35% female, Montreal Cognitive Assessment = 10.2 ± 5.9, NCT05488951). The adapted Otago Exercise Program involved 60 min of lower-body strength and balance exercises and walking 3x/week for 6 months. Usual care involved regular social activities and healthcare appointments. Exercise provoked increased single-task stride length and increased dual-task TUG turn velocity compared to usual care (p < 0.05). Usual care may reduce the ability to appropriately select cautious gait, as the usual care group exhibited faster dual-task gait speed at 6 months compared to the OEP plus usual care (p < 0.05), which was faster than their single-task gait speed. Our results support implementing the OEP to improve cognitive–motor integration in PWD.
Journal Article
Cutaquig® Is Well Tolerated in Immunodeficient Patients Who Did Not Tolerate Other Subcutaneous Immunoglobulin Products
Objective: Subcutaneous immunoglobulin (SCIG) treatment is generally tolerable, but some patients may experience adverse events to one or more SCIG products. We investigated whether 16.5% Cutaquig® treatment offered a tolerable and safe alternative treatment for immunodeficient patients. Methods: A one-year prospective cohort study was conducted at a single center in Ottawa, Canada. Adult immunodeficient patients who reported previous intolerability, adverse events, or other difficulty to other 20% SCIG product(s) were recruited to start on 16.5% Cutaquig®. Treatment tolerability, safety, and quality of life were observed and described. Results: Seven out of ten patients tolerated Cutaquig®. There were no serious or severe adverse events related to the treatment. Three moderate infections were reported (two urinary tract infections and one injection site infection). The mean serum IgG level at the end of the study was comparable to baseline levels recorded before the study: 9.6 ± 4.5 vs. 7.6 ± 4.3 g/L, p = 0.07. The overall health and health domain changes in the SF-36 and quality of life tests using the EQ visual analog scale improved by 21.5% (p = 0.38), 16.7% (p = 0.29), and 7.7% (p = 0.23), respectively. Conclusions: Cutaquig® may be used as an alternative treatment option for patients who did not tolerate 20% SCIG products.
Journal Article
Liability and Narrowly Targeted Wars
Targeted killings have traditionally been viewed as a dirty tactic, even within war. However, I argue that just combatants actually have a prima facie duty to use targeted strikes against military and political leadership rather than conventional methods of fighting. This is because the leaders of a military engaging in aggression are typically responsible for the wrongful harms they threaten, whereas significant numbers of their solders usually will not be. Conventional warfare imposes significant risks on soldiers who are not liable to be killed, violating their rights. Narrowly targeted strikes frequently provide a less-wrongful alternative. Consequently, there is a prima facie duty to conduct such strikes, and to exercise \"due care\" if engagement with conventional forces becomes necessary.
Journal Article
Action of Thiazide on Renal Interstitial Calcium
Background Although thiazides increase urinary sodium excretion, they also decrease urinary calcium excretion. Recent studies in our laboratory have shown that increased dietary salt significantly reduces interstitial fluid calcium in Dahl salt-sensitive (DS) rats, and this was associated with a rise in blood pressure and increased urinary calcium excretion. Owing to the vasorelaxant actions of increased extracellular fluid calcium, we reasoned that the antihypertensive action of hydrochlorothiazide (HCTZ), a commonly used thiazide, may be the result of increased interstitial fluid calcium as a consequence of decreased urinary calcium excretion. Methods To test this hypothesis, DS and Dahl salt-resistant (DR) rats were given high salt alone or in combination with HCTZ for 1 week. Renal cortical interstitial fluid calcium was determined by the zero net flux method. Results High salt decreased cortical interstitial fluid calcium (1.69 ± 0.25 vs. 1.13 ± 0.05 mmol/l; P < 0.05) in DS rats as previously reported; thiazide treatment had no effect on the high salt interstitial fluid calcium response in salt-sensitive animals. However, thiazide decreased interstitial fluid calcium in DS on a normal salt diet. Cortical interstitial fluid calcium was unchanged by dietary salt in DR rats, and thiazide did not alter this interstitial fluid calcium response. Conclusion We interpret these data to mean that (i) short-term thiazide treatment does not reduce blood pressure by restoring renal cortical interstitial fluid calcium concentration and (ii) a decrease in renal cortical interstitial fluid calcium may not contribute to the increased renal vasoconstriction seen in salt-sensitivity.
Journal Article
Seafarers’ Descriptions of the Influence of Non-Technical Skills Training within Maritime Safety
Non-technical skills training (NTST) is a mandatory class for shipboard deck and engineering officers, and those looking to upgrade only. The purpose of this qualitative descriptive study was to explore the seafarers’ descriptions of the influence of non-technical skills training (NTST) within maritime safety. This study emerged from a gap in the existing literature regarding a need to create cohesion and a shared identity for seafarers to lower the human-error rate on ships from an astounding 80 to 96%. This research explores Albert Bandura’s social cognitive theory (SCT) of triadic reciprocal determinism (TRD) of behavioral, personal/cognitive, and environmental factors within maritime safety. The research questions were created to explain how seafarers describe the non-technical skills training (NTST) of social cognitive theory (SCT) within maritime safety. Purposive sampling was used to recruit a minimum of 20 seafarers for online questionnaires. Data were collected using multiple-choice questions, semi-structured questions, and ten individual Zoom interviews. Thematic analysis was used to code the four themes which include safety within the maritime industry, behavioral factors, cognitive and personal behaviors, environmental factors. The study findings are that training, including the themes outlined from non-technical skills (NTS), would be beneficial to all crew members, not just those required to take the course. Future research should be additional training methods from aspects of social cognitive theory, which can continue to aid in lowering the accident rate.
Dissertation