Browsing by Author "Koch, Sarah"

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    COMPUTING DYNAMICAL DEGREES OF RATIONAL MAPS ON MODULI SPACE
    (Cambridge, 2015) Koch, Sarah; Roeder, Roland K.; Department of Mathematical Sciences, School of Science
    The dynamical degrees of a rational map f:X⇢X are fundamental invariants describing the rate of growth of the action of iterates of f on the cohomology of X. When f has non-empty indeterminacy set, these quantities can be very difficult to determine. We study rational maps f:XN⇢XN, where XN is isomorphic to the Deligne–Mumford compactification M¯¯¯¯0,N+3. We exploit the stratified structure of XN to provide new examples of rational maps, in arbitrary dimension, for which the action on cohomology behaves functorially under iteration. From this, all dynamical degrees can be readily computed (given enough book-keeping and computing time). In this paper, we explicitly compute all of the dynamical degrees for all such maps f:XN⇢XN, where dim(XN)≤3 and the first dynamical degrees for the mappings where dim(XN)≤5. These examples naturally arise in the setting of Thurston’s topological characterization of rational maps.
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    Interprofessional spiritual care education in pediatric hematology-oncology: A pilot study
    (Wiley, 2022-03) Szilagyi, Csaba; Lion, Alex H.; Varner Perez, Shelley E.; Koch, Sarah; Oyedele, Oladele; Slaven, James E.; Montz, Kianna; Haase, Joan E.; Puchalski, Christina M.; Pediatrics, School of Medicine
    Background Evidence and clinical guidelines call care team members to address the spiritual well-being of pediatric patients, especially adolescents and young adults (AYA), with cancer and blood disorders. However, the lack of relevant training in generalist spiritual care has been a key barrier. Therefore, we aimed to improve clinicians’ capabilities by utilizing the Interprofessional Spiritual Care Education Curriculum (ISPEC) to close this gap in pediatric hematology-oncology. A model of interprofessional spiritual care entails that all team members attend to patients’ spirituality by employing generalist spiritual care skills and collaborating with spiritual care specialists such as chaplains. Methods Interdisciplinary team members providing care for AYA with cancer and blood disorders were recruited to participate in interprofessional spiritual care education. Our intervention combined an evidence-based online curriculum and in-person discussion groups. Pretest-posttest study examined changes in participants’ skills and practices to identify, address, and discuss spiritual concerns. Surveys were conducted at baseline and at 1, 3, and 6 months after the intervention. Results Participants (n = 21) included physicians, advanced practice providers, nurse coordinators, and psychosocial team members. We observed positive changes in participants’ ability (36%, P < 0.01), frequency (56%, P = 0.01), confidence (32%, P < 0.01), and comfort (31%, P = 0.02) providing generalist spiritual care baseline versus one month, with significant gains maintained through six months (Omnibus P < 0.05). Conclusions Utilizing ISPEC, interprofessional spiritual care education has a strong potential to develop pediatric hematology-oncology team members’ capabilities to attend to the spiritual aspect of whole-person care and thus contribute to the well-being of AYA with cancer and blood disorders.
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    Multipronged Approach to Controlling a Tuberculosis Outbreak Among Persons Experiencing Homelessness
    (Wolters Kluwer, 2022) Muloma, Eva; Stewart, Rebekah; Townsend, Helen; Koch, Sarah; Burkholder, Sarah; Railey, Shanica; White, Kelly; Redington-Noble, Rachel; Caine, Virginia; Medicine, School of Medicine
    In May 2009, the Marion County Public Health Department in Indiana declared a tuberculosis (TB) outbreak among persons experiencing homelessness in Marion County, began active case finding to detect additional cases, and formed a TB outbreak response team to plan and coordinate outbreak activities. Outbreak-associated cases had 1 of 2 outbreak genotypes and either reported experiencing homelessness themselves or had an epidemiologic link to a shelter or a person experiencing homelessness. The last of 53 outbreak-associated cases was detected in 2019 after more than 2 years without a case. The Marion County Public Health Department continues to address TB-related issues and implement prevention measures at homeless shelters and among persons experiencing homelessness in 2019. This example, in addition to other published guidance, can be used by jurisdictions to plan and implement their own TB outbreak prevention and response activities among persons experiencing homelessness.