Implementation plan of health and safety processes

An auditor was asked to review an organisation’s Health and Safety procedures to assess compliance with the new legislation imposed by The Health and Safety Act 2015. Then the organisation approached an internal source to conduct a strategic plan in order to target issues of health and safety risk. An implementation plan will be designed to achieve the auditors recommendations and improve the organisation’s Health and Safety practices. Research and audit of the current policies and procedures used at the organisation must be conducted in order to gain a better understanding of the current issues and from there develop action plans and a strategy on how to reach those action plans. Current documentation of policies and an interview with management will be analysed to detail the potential action plans.Once the research has been conducted, results will be used to determine conclusions

International, Regional, and National Data Sets

As part of an internship with the University Library, I worked alongside my mentor, Loyd Mbabu, and other librarians in order to create an online research guide that could help students find international statistics more easily. The guide contains an interactive world map, as well as online resources organized by region, nation, and topic. To view the site, please visit: http://guides.lib.umich.edu/globalstatsUniversity Library's Michigan Library Scholarshttp://deepblue.lib.umich.edu/bitstream/2027.42/113202/1/Capstone Presentation Aug 28 - Mena Hermiz.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/113202/2/Archive - Research Guide - International, Regional and National Data Sets.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/113202/3/Sample Research Question from Research Guide.pdfDescription of CapstonePresentation_Aug28_MenaHermiz.pdf : Capstone PresentationDescription of Archive_ResearchGuide_Pages.pdf : ArchiveDescription of Sample_Research_Question.pdf : Sample Questio

Manual Moodle 2.4 para el profesor

El presente manual es el fruto del trabajo y la experiencia de los técnicos del Gabinete de Tele-Educación de la Universidad Politécnica de Madrid que desde el año 2005 vienen gestionando y prestando soporte a la herramienta Moodle para toda la comunidad universitaria. Se trata de una actualización del manual realizado en 2012 para la versión 2.2. Anteriormente, este equipo realizó un manual para el profesor adaptado hasta la versión 1.9. Ese manual tenía como partida el libro “Using Moodle” y se completó con la documentación existente en su momento y las aportaciones del personal de nuestro equipo. Para tener una visión general de la información de este manual, siga leyendo la descripción que se presenta a continuación

Narratives of Happiness in South Korea

Global Independent Study, Summer 2017 -- South Koreahttps://deepblue.lib.umich.edu/bitstream/2027.42/138974/1/Hermiz_Poster.pd

Manual Moodle 2.6 para el profesor

El presente manual es el fruto del trabajo y la experiencia de los técnicos del Gabinete de Tele-Educación de la Universidad Politécnica de Madrid que desde el año 2005 vienen gestionando y prestando soporte a la herramienta Moodle para toda la comunidad universitaria. Se trata de una actualización del manual realizado en 2012 para la versión 2.2. Anteriormente, este equipo realizó un manual para el profesor adaptado hasta la versión 1.9. Ese manual tenía como partida el libro “Using Moodle” y se completó con la documentación existente en su momento y las aportaciones del personal de nuestro equipo. Para tener una visión general de la información de este manual, siga leyendo la descripción que se presenta a continuación

EMOTION CAPTURE: EMOTION MIMICRY USING FACIAL MOTION CAPTURE

This study explored the application of facial motion capture to Autism Spectrum Disorder therapy. The FaceShift technology was utilized in a behavior change intervention for children with ASD. The intervention focused on using facial expressions to display emotions. The results of the study exhibit that all students involved achieved a higher percent in both facial expressions attempted and successfully demonstrated in intervention over baseline. However, this increase was not maintained in generalization. Without a successful generalization the intervention would not be recommended in its current framework. Recommendations for further research are provided

SINAM: A Rare Case Leading to Respiratory Failure

Introduction: Statins are commonly prescribed in primary care offices daily; however, they are not exempt from adverse effects. Statin-induced myopathies are best described on a continuum, as patients can range widely in presentation. The most extreme of cases displaying respiratory distress, quadriparesis, dysphagia, and rhabdomyolysis. Cases on the severe end of the spectrum with respiratory failure are exceedingly rare and should be shared with the medical community in order to gain more insight into the types of statins most at risk for causing complications, most effective treatments based on disease severity, as well as characteristics and objective findings among affected patients in order to diagnose and treat in a time-effective manner. Case Description: The patient was a healthy, physically active 79-year-old male with past medical history of CVA in 2018 without residual deficits, controlled type 2 diabetes, HTN, and sleep apnea on CPAP presenting in February of 2020 with worsening quadriparesis, dysarthria, and dyspnea over the past 3 months. Physical exam revealed extreme muscle weakness of 3/5 in upper extremities, 4/5 in lower extremities, unable to raise arms above a 45 degree angle, normal cranial nerve exam. CT of the head/ neck was negative, moderate stenosis in carotid US of 50-60%, and MRI of head showing no acute changes. CPK elevated over 4,000 with elevated AST &ALT in the 300s. Autoimmune work up was nonrevealing. EMG showed possible myopathy vs motor axonal polyradiculoneuropathy vs demyelinating polyneuropathy. Treatment was conservative and discharged to subacute rehab (SAR). Over the course of 2 weeks at SAR, his weakness progressed with CPK \u3e7,000 with continued elevated liver function prompting a transfer to Henry Ford for escalation of care in March of 2020. An exhaustive work up was completed with negative autoimmune panel and EMG showing chronic myopathy. History revealed he had been maintained on Atorvastatin 20 mg after his CVA in October of 2018 and began to manifest weakness in December 2019 with discontinuation in February 2020. MRI revealed diffuse muscular edema (Figure A). He was initially treated conservatively with intravenous fluids and over the course of 7 days had progressive dyspnea and dysphagia leading to respiratory failure and intubation. Muscle biopsy (Figure B) with anti-HMGCr IgG confirming statin-induced necrotizing myopathy. He was promptly treated with IV solumedrol for 5 days with transition to 60 mg prednisone daily with IVIG 2g/kg x 5 days. Despite treatment, the patient continued to decline with increasing CPK and inability to liberate from the ventilator. Given his prior wishes was terminally weaned per family request and passed soon after. Discussion: The rapid decline of an otherwise healthy patient should prompt further inquiry as to the most efficacious treatment regimens; however, making the diagnosis can be challenging as it is a rare condition with a prevalence in less than 1% of statin-compliant patients. SINAM patients typically present with progressively worsening symmetrical proximal muscle weakness with CK levels in the thousands despite discontinuation of statins [1, 7]. Other findings include MRI showing muscle edema, atrophy, and/or fatty infiltration, positive anti-HMGCr, EMG positive for myopathy, and muscle biopsy displaying active necrosis [2]. Several case reports show widely varying time courses of 2 months to 10 years after the initiation of statin therapy to symptomatic necrotizing myopathies [2, 7]. Therefore, SINAM should be considered as a differential in the patient with new onset myopathies with past or current use of statins. The type of statins most likely to cause this condition were Atorvastatin, Simvastatin, Lovastatin, and Fluvastatin due to their lipophilic nature and ability to enter muscle cells [2]. Many patients are diagnosed when their most debilitating symptom is proximal muscle weakness; however, retrospective studies have shown that up to one-third of autoimmune myopathy cases had respiratory complications with 5 of these patients requiring intubation [4]. Our patient was unique in that despite the use of aggressive immunosuppression progressed to respiratory failure. To date there are no reported cases of death due to SINAM. This then begs us to consider, are all cases treated similarly? On the already murky topic of a standardized treatment regime for a rare disease, it is important to consider treating these patients based on severity of disease symptoms. It is standard of care for SINAM to stop the offending statin and begin immunosuppressive therapy. Treatment consists of prednisone with either methotrexate, azathioprine, or mycophenolate mofetil [1, 2], a third agent (IVIG or rituximab) can be added in severe cases; patients who received two or more immunosuppressive agents showed better outcomes [1, 2, 4]. In many studies, IVIG showed more favorable responses within the first 3 months of initiating treatment, however, its benefit seemed to dissipate after the 6 month mark [3, 4]. For patients presenting with severe weakness and/or dysphagia, IV methylprednisolone is recommended for 1-3 days with transition to high-dose oral steroids with taper, IVIG for 1-6 months, and a third agent such as cyclophosphamide, rituximab, or cyclosporine [3]. Rituximab has shown a great deal of benefit in many studies for its ability to increase muscle function and reduce immune-mediated muscular damage [3]. It is unknown the optimal dosage or combination of therapy that would be the most efficacious treatment, however, many studies have shown promise when using the agents described above. Due to the autoimmune nature of SINAM, relapses occurred often when immunosuppression is weaned or discontinued [1, 2, 4] and patients likely will require a life-long steroid-sparing agent [4]. There is no agreed upon maintenance therapy for these patients unable to be weaned off of immunosuppression and further studies are needed to answer this question. Conclusion: Our patient presented with statin-induced necrotizing autoimmune myopathy that progressed to respiratory failure. SINAM is a rare complication of statin therapy that has high morbidity with rare mortality. SINAM should be on the differential in patients presenting with new onset progressive weakness who have been exposed to statin therapy. The mainstay of treatment is immunosuppressive therapy; however, the optimal regimen and duration is unknown and further studies are required to discern optimal treatment.https://scholarlycommons.henryford.com/merf2020caserpt/1050/thumbnail.jp

Manual Moodle 3.1 para el profesor

El presente manual es el fruto del trabajo y la experiencia de los técnicos del Gabinete de Tele-Educación de la Universidad Politécnica de Madrid que desde el año 2005 vienen gestionando y prestando soporte a la herramienta Moodle para toda nuestra comunidad universitaria. Se trata de una actualización del manual realizado en 2012 para la versión 2.2. Anteriormente, este equipo realizó un manual para el profesor adaptado hasta la versión 1.9. Ese manual tenía como partida el libro “Using Moodle” y se completó con la documentación existente en su momento y las aportaciones del personal de nuestro equipo. Para tener una visión general de la información de este manual, siga leyendo la descripción que se presenta a continuación

Phase II Trial of IL-12 Plasmid Transfection and PD-1 Blockade in Immunologically Quiescent Melanoma.

PurposeTumors with low frequencies of checkpoint positive tumor-infiltrating lymphocytes (cpTIL) have a low likelihood of response to PD-1 blockade. We conducted a prospective multicenter phase II trial of intratumoral plasmid IL-12 (tavokinogene telseplasmid; "tavo") electroporation combined with pembrolizumab in patients with advanced melanoma with low frequencies of checkpoint positive cytotoxic lymphocytes (cpCTL).Patients and methodsTavo was administered intratumorally days 1, 5, and 8 every 6 weeks while pembrolizumab (200 mg, i.v.) was administered every 3 weeks. The primary endpoint was objective response rate (ORR) by RECIST, secondary endpoints included duration of response, overall survival and progression-free survival. Toxicity was evaluated by the CTCAE v4. Extensive correlative analysis was done.ResultsThe combination of tavo and pembrolizumab was well tolerated with adverse events similar to those previously reported with pembrolizumab alone. Patients had a 41% ORR (n = 22, RECIST 1.1) with 36% complete responses. Correlative analysis showed that the combination enhanced immune infiltration and sustained the IL-12/IFNγ feed-forward cycle, driving intratumoral cross-presenting dendritic cell subsets with increased TILs, emerging T cell receptor clones and, ultimately, systemic cellular immune responses.ConclusionsThe combination of tavo and pembrolizumab was associated with a higher than expected response rate in this poorly immunogenic population. No new or unexpected toxicities were observed. Correlative analysis showed T cell infiltration with enhanced immunity paralleling the clinical activity in low cpCTL tumors