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THE EFFECT OF THE GOCOMM EDUCATIONAL INTERVENTION ON PHYSICIAN DISTRESS SURROUNDING GOC CONVERSATIONS USING THE PHYSICIAN DISTRESS INVENTORY (PDI)
Get PDFEnd-of-life (EOL) care refers to the medical, emotional, and practical support provided to individuals who are nearing the end of their lives. Goals of care (GOC) discussions involve physician exploration of patient beliefs and values, though they do not need to be primarily focused on end-of-life health-care decisions. Engaging in EOL/GOC conversations has been linked to increased quality of life, decreased healthcare costs, and more frequently receiving care in line with patient preferences. Barriers to these discussions occurring exist at both the clinician-level (e.g., inadequate communications training) and the patient-level (e.g., heightened death anxiety). This study aimed to determine if healthcare professionals who participated in the GOComm educational intervention improved their distress intolerance as a result of completing the workshop and if participants’ level of education had an impact on the degree to which distress intolerance improved. We collected data from 165 healthcare providers (HCPs). Most participants were practicing professionals from various disciplines (67.3%) with a smaller proportion of the sample were residents in training (29.7%). GOComm integrated didactic and experiential training into 4-hour workshops consisting of small groups of interprofessional teams led by trained facilitators. The curriculum covers topics ranging from using empathy when delivering bad news to asking open-ended questions when exploring patients’ values, beliefs, and preferences. We performed pre- and post-test surveys for mixed-method program evaluation. Participants reported demographic, education, and training information, and their distress intolerance and self-efficacy related to EOL/GOC discussions were evaluated. Completion of GOComm was linked to significant improvements in both distress intolerance and self-efficacy. No significant relationship was found between participants’ level of professional experience and the degree to which their distress intolerance or self-efficacy improved. There were also no significant differences found in baseline distress intolerance or baseline self-efficacy as a function of level of professional experience. The results of the GOComm workshop indicate that it is possible to improve both healthcare workers\u27 distress intolerance and self-efficacy related to GOC discussions, thereby lessening some of the barriers preventing the initiation of these critical conversations, and hopefully leading to more patients receiving the benefit of GOC conversations have to offer
DEFERRED ACTION FOR CHILDHOOD ARRIVALS EFFECT ON WELL-BEING: A SYSTEMATIC REVIEW ON LATINO RECIPIENTS
Get PDFTo many undocumented Latino immigrants, the United States of America is seen as the land of opportunity, a country that will be able to provide a better future for their family and their children, a place for the American dream. Deferred Action for Childhood Arrivals has been proof of America being the land of opportunity. Recipients are given the opportunity to do more for themselves, to build a better future than they would’ve had in their countries. Despite the controversies about immigration policies this program continues to stand; with its recipients showing their resilience to be in a country that they now call home. This program has been extremely beneficial to its recipients, granting them opportunities they did not have prior to the program being implemented. However, due to liminal legality recipients are faced with many challenges, initially leading to the question does the Deferred Action for Childhood Arrivals provide stability for its recipient’s wellbeing? The following systematic review gives insight on previous studies conducted on Latino recipients of Deferred Action for Childhood Arrivals that focuses on the well-being of its recipients, their struggles, barriers, and resilience throughout the years of being on the program
COMMUNITY VIOLENCE EXPOSURE AND EXTERNALIZING
Get PDFThe present study tested whether total lifetime exposure to violence and exposure as a witness and victim were associated with externalizing behavior concurrently and one-year later in a sample of pubertal-aged youth. Participants included 125 youth (n = 68 girls) who were recruited from small cities and rural communities (Susman et al. 2007). Girls were ages 8, 10, or 12 years old (M = 10.09 years, SD = 1.64) and boys were ages 9, 11, or 13 years old (M = 10.94 years, SD = 1.61). Youth were predominantly Caucasian or White and non-Hispanic (89.5%), but the sample also included Hispanic (3.0%), African American or Black (3.0%), Asian (1.5%), and American Indian (0.7%) youth. Data from the present study come from two timepoints, one year apart. Community violence exposure was assessed at time 1 with the My Exposure to Violence self-report questionnaire (Buka & Selner-O’Hagen, 1998) and externalizing behavior was assessed at times 1 and 3 with the parent-report Child Behavior Checklist (Achenbach & Edelbrock, 1991). Hierarchical regression was performed to test whether total community violence exposure and exposure as a witness and victim were associated with externalizing behavior at times 1 and 3 in separate models. Analyses were also performed to test whether gender moderated the associations and if there was a two-way interaction between violence exposure as a witness and victim. Total exposure to community violence and exposure as a witness were not associated with externalizing behavior at times 1 and 3, and gender did not moderate the associations (p \u3e .05). However, exposure as a victim was positively associated with externalizing behavior at time 1 in girls (b = 2.71, SE = 1.11, p = .02) but not boys (p = .95). Victimization was only positively related to externalizing behavior at time 1 at high levels of witnessed exposure (b = 4.99, SE = 2.02, p = .01). Results suggest that victimization may be a more important predictor of externalizing behavior during puberty, though results should be interpreted with caution due to the low rates of overall exposure in the sample
ENGLISH NEW-LANGUAGE TEACHERS’ PERCEPTIONS OF ONLINE ASYNCHRONOUS AND ONLINE SYNCHRONOUS PROFESSIONAL DEVELOPMENT AND TEACHER EFFICACY
Get PDFThe purpose of this study is to examine English new-language teachers’ perceptions of online asynchronous and online synchronous professional development and teacher efficacy. English new-language students score significantly lower than others on standardized tests. This study analyzes online professional development for English new-language teachers to enhance teacher efficacy and thus bridge the achievement gap. This multiple-case study included four participants between the ages of 25 and 40. All participants are teachers certified to teach English to speakers of other languages, have a year or more of teaching experience, and are bilingual. The research methodologies used to inform this study include interviews, observations, professional development, and artifacts as main data sources. The participants went through two rounds of interviews and were observed in the classroom. The teachers were observed during professional development and the researcher collected artifacts from professional development for analysis. The researcher triangulated the data from these main data sources to identify codes, which were then developed into themes. The codes and themes were used to answer the research questions. The results of this study can make online professional development for English new-language teachers more efficient and help increase teacher efficacy
THE RESILIENCE OF TRIO UPWARD BOUND STUDENTS
Get PDFThis phenomenological qualitative study examined the intersection between TRIO Upward Bound participation and resilience theory to determine how participation in TRIO Upward Bound impacted the resiliency of its at-risk youth participants. Accordingly, the participants of this study are alumni of the federally funded TRIO Upward Bound program, a pre-collegiate initiative designed to increase the enrollment and persistence rates of at-risk youths by helping to prepare them for success at postsecondary institutions. The researcher examined the construct of resilience to provide an alternate measure of the efficacy of these programs. The researcher used artifacts, photo-elicitation, and interviews to gather data. Thematic analysis was employed to generate themes and subthemes that captured the essence of the participants’ experiences. The findings of this study conclude that TRIO Upward Bound provides participants with significant academic, environmental, and social-emotional support that enhances their resiliency levels and promotes their overall development as young adults. This research adds to the literature on pre-collegiate programs and resiliency theory. The results of this study aid in our knowledge of effective strategies for the development and implementation of pre-collegiate and out-of-school programs
STREPTOZOTOCIN-INDUCED DIABETES INCREASES KIDNEY TOXICITY IN RATS EXPOSED TO OCHRATOXIN A
Get PDFDue to the rising occurrence of diabetes in the population and the prevalence of OTA exposure via ingestion of contaminated foodstuffs, there is a need to assess the possible renal interaction of a diabetic disease state in concurrence with OTA exposure. Sprague Dawley rats were treated with streptozotocin to induce experimental diabetes and then orally exposed to 0.5 mg/kg body weight OTA once a day for 21 days. Renal biomarkers and light microscopy were evaluated to assess the interaction between diabetic nephropathy and OTA exposure. LLC-PK1 proximal tubule cells were used as an in vitro model to assess the potential mechanism involved in this interaction. Numerical data were analyzed with t-test or ANOVA with Tukey’s post-hoc. All indications of significance were at p \u3c 0.05. Histopathological findings of diabetic animals treated with OTA showed increased inflammation, tubular degeneration, glomerular degeneration, interstitial fibrosis, necrosis and cast formation. Classic and novel biomarker assessment indicated that the interaction between DN and OTA exposure exacerbated renal damage and significant tubular damage. These assessments support that the interaction between diabetic nephropathy and OTA exposure exacerbated renal damage and inflammation. The LLC-PK1 porcine proximal tubule cell line was used to assess the interaction of glucose levels and OTA exposure on cell viability. LC50 of the high glucose groups (17.5 mM glucose, 30 mM glucose, and 5 mM/30 mM glucose) were significantly lower from that of the 5 mM group indicating enhanced toxicity of OTA. The effects of the combination treatment (STZ/OTA) were greater than for animals exposed to either treatment alone. These findings were supported by biomarker profiles which reveal greater effects on serum creatinine, serum protein, KIM-1, and NGAL in the STZ/OTA-treated animals compared to those treated with STZ or OTA alone. These results indicate that exposure to environmental mycotoxins such as OTA may represent an increased risk to diabetics compared to non-diabetic individuals. The demonstration that kidney cells grown in high glucose media were more sensitive to OTA suggests that increased glucose levels of plasma and/or urine may contribute directly to such interactive toxicity of diabetes and OTA exposure
EVALUATION OF MICROGLIA’S STRUCTURAL VARIATIONS WITHIN AN ORGANOTYPIC HIPPOCAMPAL SLICE MODEL AFTER REGIONALIZED TOXIC INJURY
Get PDFThe dendritic cells of the CNS, the microglia (MG), are an initiation point of the immunological response within the post blood-brain barrier (BBB) compartment. Microglia morphology drastically changes in response to cell stress to a much different non-dendritic morphology. This investigation postulates that if the first MG responses to toxic injury are isolated and studied in greater morphological detail there is much to be learned about MG metamorphosis from a baseline (M2) to an activated (M1) state. The organotypic hippocampal slice was the experimental setting used to investigate microglial response to toxic injury. This isolates dendritic cellular responses and associated post-BBB cells dynamics from the impact of nonspecific of in-vivo blood-derived factors. Within the context of biochemically verified precise toxic cell injury/death (induced with mercury or cyanide in combination with 2-deoxy-glucose) to a specific region within a cultured hippocampal slice, MG’s morphological response near and distal to the site of toxicological insult was evaluated. There was up to 35% increase in MG activation proximally to injury (CA3 region) and no changes distally (DG region) when compared to control slices treated with PBS. Maximum MG activation consisted of a 3 plus-fold increase in the distance between the nucleus membrane and the cell membrane, which underscores an extensive and quantifiable amount of membrane rearrangement. In between baseline and activated MG morphologies, 5 intermediate morphologies (or morphological variations) are described as it relates to its cell body, nucleus, and dendrites. The result from this study reconciles details of MG’s structure to its holistic characteristics in relation to parenchymal cell stress within a cultured CNS tissue sample
COMPARISON OF PROFESSIONAL IMPRESSIONS OF HIKIKOMORI ACROSS CULTURES: A SECONDARY DATA ANALYSIS
Get PDFThis study examined the impressions of two hikikomori vignettes by professionals across different countries to determine possible similarities or differences across countries. Originally viewed as a cultural disorder, hikikomori has been observed in different countries. This study used an existing data set of a 2010 study to review diagnostic impressions using the ICD-10 and DSM-IV-TR coding systems, as well as a free response. Additionally, this study reviewed professional impressions on the best treatment for hikikomori. This study reviewed these responses based on country of origin and cultural type. A correlation was found between ICD-10 and DSM-IV-TR diagnosis, country, and cultural type. No relationship was found between free response or treatment type, country, and cultural type. This study also reviewed professional impressions on the influence of parents and the development of hikikomori. Results showed that professionals did believe parents had some influence on the development of hikikomori. Most common types of diagnosis and treatment were noted across countries and cultural types as well
ELECTROCHEMICAL INVESTIGATIONS OF POLYVALENT VS MONOVALENT BINDING ON DNA SENSORS AND SYNTHESIS OF DNA OLIGONUCLEOTIDES CAPABLE OF OXIDATIVE CROSSLINKING
Get PDFThis thesis describes two projects: i) experiments aimed at electrochemically differentiating polyvalent binding and monovalent binding of “DNA stars” on gold electrodes ii) experiments to synthesize DNA oligonucleotides that are capable of crosslinking under electrochemical control. We describe the design, synthesis and purification of “DNA stars”, and their binding to gold electrodes displaying complementary strands functionalized with a “redox reporter”, methylene blue. Square wave voltammetry was utilized to compare the effect of binding of complementary strand and various DNA stars. Though we were able to distinguish the binding of complementary strand and DNA stars, we could not conclusively state this was because of polyvalent binding. Our second project showed that we can detect crosslinking using denaturing gel electrophoresis, and that we can use MALDI mass spectrometry to determine if carbazole hydrazides act as nucleophiles to functionalize DNA strands. These strands have the potential to be electrochemically crosslinked
DOES DBT-INFORMED TREATMENT ADDRESS COMORBID SYMPTOMS OF SOCIAL ANXIETY FOR ADOLESCENT EATING DISORDER PATIENTS IN A DAY PROGRAM? EXPLORING EMOTION REGULATION AS A MECHANISM FOR CHANGE
Get PDFEating disorders, such as Anorexia Nervosa (AN) and Bulimia Nervosa (BN), often begin in adolescence and can be extremely challenging to treat effectively (Dawson, 2018; Martin & Golden 2014; Robatto et al., 2024). Eating disorder behaviors such as acute caloric restriction, excessive exercise, binging and purging can cause dangerous medical complications, while comorbid psychological conditions can lead to suicidal ideation and self-harm behaviors (American Psychiatric Association, 2022; Dancyger & Fornari, 2005; Martin & Golden, 2014). Social anxiety is one such comorbid disorder that can be a barrier to patients fully engaging in treatment (Goodwin & Fitzgibbon, 2002; Smith, 2018). Deficits in emotion regulation, including limited awareness and clarity of emotions, are evident in both those with eating disorders and social anxiety (Ben-Porath et al., 2014; Hempel, Vanderbleek & Lynch, 2018; Turk et al., 2005). This study sought to examine the effectiveness of implementing DBT treatment in a partial hospitalization program for eating disorder patients aged 8-21. It was hypothesized that DBT would be more effective than treatment as usual in reducing eating disorder behaviors, decreasing symptoms of social anxiety and improve participants’ ability to regulate emotions. Results found that DBT was more effective than treatment as usual in addressing eating disorder pathology measured by increase in BMI (d=2.014) and percent change in weight (d=1.92). Results did not support the hypotheses that DBT treatment would lead to decreased symptoms of social anxiety and greater ability to regulate emotions. Providers treating eating disorder patients with comorbid social anxiety should address social anxiety as it is a significant barrier to treatment. Future research would benefit from examining engagement in treatment for both individuals and families and to better understand whether DBT adequately addresses willfulness in this population