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Exploring Black Women's Experiences with Perinatal Loss, Grief, and Coping
No full textThis study's purpose is to better understand the lived experiences of Black women who have experienced perinatal loss using Stroebe and Schut's (1999) Dual Process Model of Coping with Bereavement as a guiding framework. A descriptive phenomenological design was used to conduct semi-structured one-on-one interviews with a purposive recruited sample. The sample consisted of five Black mothers who had experienced a perinatal loss between 20 and 36 weeks gestation within the past five years. Colaizzi's (1978) framework was used to conduct data analysis. Each woman's unique story is detailed, following a description of the three emergent themes and seven theme clusters. The three emergent themes found were medical negligence, social relationships, and transformation. These findings build upon existing literature and offer implications for healthcare and research professionals. Future research directions are also explored
Deciphering the Impact of Aluminum Oxide Nanoparticle on Camelina sativa: An Integrated Analysis of Phenotypic Variability, Biochemical Responses, and Gene Expression Dynamics
No full textThis study investigates how aluminum oxide nanoparticle (A1₂O₃-NP) affect plant growth and development as well as genetic response in Camelina sativa. The study shows a non-linear dose-response relationship between the administration of a range of nanoparticle concentrations (0.0005%-1%) and the controls. Specifically, higher concentrations of A1₂O₃-NP significantly inhibited root length (0.001%-1%, p[less-than]0.05) and leaf numbers (at 1%, p=0.007), but significantly increased leaf length at lower concentrations (0.0005% and 0.001%, control vs 0.0005%, p [less-than] 0.001; control vs 0.001%, p = 0.004) and shoot fresh weight at higher concentrations (0.1%-1%, p=0.001) inhibited them. This finding highlights the complex interactions that exist between plant physiology and nanoparticle concentrations, indicating that, depending on the degree of exposure, A1₂O₃-NP can either promote or inhibit plant growth. This intricate relationship is further clarified by gene expression analysis, which shows notable alterations in gene regulation linked to oxidative stress and root growth. Notably, at both 0.001% and 0.1% treatment dosages, genes such as AECC1, AKT1, CAT2, SHE1, and SOD1 consistently show overexpression, suggesting a robust genetic response to nanoparticle exposure. This response, however, varies significantly across different environmental conditions, as evidenced by the substantial variability in expression levels. On the other hand, genes including GSTF6, BHLH83a, EIS3, and ABC are consistently downregulated at both treatment levels, suggesting a systematic genetic modification that may be associated with detoxification processes, regulatory pathway changes, and stress response pathways. This pattern of gene expression points to the impact of A1₂O₃-NP on biological functions in plants, potentially influencing root development, growth, and general health. The study also finds that varying amounts of oxidative stress cause distinct gene-specific responses, such as upregulated _GSTF6 and downregulated SOD1 and CAT2 genes. These results suggest a complex physiological response to oxidative stress generated by nanoparticles, with different gene variability and regulatory pathways. Overall, this study makes a substantial contribution to our knowledge of the interactions between nanoparticles and plants by illuminating possible pathways by which A1₂O₃-NP affect the growth of plants. It draws attention to the intricate genetic response to nanoparticle exposure and provides insights into the molecular mechanisms by which plants respond to environmental stressors
EXAMINING SYMPTOMS OF DEPRESSION, SILENCING THE SELF, SEXUAL RELATIONSHIP POWER AND HIV VULNERABILITY AMONG AFRICAN AMERICAN WOMEN IN THE SOUTHERN UNITED STATES
No full textBackground. HIV remains a serious concern among women in the United States (U.S.). Nineteen percent (19%) of new diagnoses are among women and the vast majority (84%) are attributed to heterosexual contact. African American women (AAW) represent 67% of all new cases of HIV among women in the Southern United States (U.S.), a significant disparity given AAW make up only 22% of the population in the South. Power differentials within relationships, referred to as sexual relationship power (SRP), may impact AAW as they make decisions about their sexual health. While navigating relational and social dynamics, women may develop psychological distress and coping mechanisms such as depression and silencing the self (STS), respectively. Understanding how depression, STS, and SRP are related and impact HIV vulnerability in this population of women may be key in developing targeted HIV prevention strategies. Illuminating factors associated with HIV vulnerability among African American women that are potentially amenable to change is critical for informing targeted HIV prevention strategies and ending the HIV epidemic. Purpose. The purpose of this research was to examine the influence of depressive symptoms, silencing the self (STS), and sexual relationship power (SRP) on the HIV vulnerability of AAW in the South. The Theory of Gender and Power guided the study and informed the data collection and analysis. Methods. A cross-sectional descriptive study utilizing purposive and snowball sampling methods was used to examine the relationships between depressive symptoms, silencing the self, and sexual relationship power on HIV vulnerability among AAW in the South. Five survey tools were used to capture respondents' information regarding depressive symptoms (PHQ-9), silencing the self (Silencing the Self Scale; STSS), sexual relationship power (Sexual Relationship Power Scale; SRPS); HIV knowledge (HIV Knowledge Questionnaire; KQ-18); and HIV vulnerability (Safe Sex Behavior Questionnaire; SSBQ) among AAW residing in the Southern U.S. Results. The findings reveal that all of the participants acknowledged some level of depressive symptoms (100%) as measured by the PHQ-9 tool, with 80.4% of participants reporting that they experience minimal to mild depressive symptoms and 19.7% participants reporting moderate to severe symptoms. The findings indicated that depressive symptoms and STS are associated in this sample of AAW. It was noted that as depressive symptoms increased, STS also increased, while SRP decreased. Thus, indicating women who felt more empowered within the spaces of their relationships exhibited less STS behaviors. Discussion. Vulnerability to HIV disproportionately affects AAW in the Southern U.S. The Theory of Gender and Power provided a lens for examining the impact of depressive symptoms, STS, and SRP among this group of AAW residing in Southern U.S. Implications of this study include clear indications of a need to increase mental health awareness, address the behavior of silencing the self, and intervene to reduce depressive symptoms among this population of women. Nurses are uniquely positioned to interact with AAW in the healthcare arena as the first contact with the patient. Increased use of screening tools such as the PHQ-9 at provider visits to detect those AAW who are experiencing depressive symptoms may assist with initiating therapy and/or referrals for mental health care. Awareness of the impact gender and power has in women's relationships can optimize HIV prevention efforts among women. Ultimately, these findings are useful in informing future nursing research and practice with HIV prevention interventions aimed at optimizing the health of AAW who are vulnerable to HIV
Education and Confidence of Nursing Care in Patients with Autism
No full textAutism Spectrum Disorder affects roughly 1 in 100 people and can range in severity. Nurses are trained to care for a variety of patients; however, preliminary review of literature indicates that nurses are underprepared to care for patients with autism. The purpose of this study was to investigate the preparedness and competence of nursing care for patients with ASD at multiple stages in their careers and in various specialties. A researcher-developed survey was sent to current East Carolina University nursing students in doctorate, masters, and baccalaureate programs. The survey investigated both education and personal feelings of confidence in providing nursing care to patients with autism across the various programs. Results indicate lack of education and experience in clinical practice in caring for patients with autism. These results indicate a need for change in the nursing curriculum and clinical practice to better equip students as they prepare for professional careers
SCHOOL TRANSFORMATION: EXAMINING THE IMPLEMENTATION OF PROFESSIONAL LEARNING CYCLES TO INCREASE COLLECTIVE TEACHER EFFICACY IN A RURAL MIDDLE SCHOOL IN NORTH CAROLINA
No full textThe state of education is impacted by many variables. Teachers, administration, schools and districts are constantly in a high stakes race to grow students academically. Administration is charged with creating a culture in which teachers are provided the capacity for teachers to grow professionally in order to continue to grow students at a rate which keeps them at or above pace with their peers. Studies indicate that professional development and collective teacher efficacy are linked to increased teacher effectiveness and student achievement. Utilizing Bandura's social cognitive theory to understand human behavior and influences in conjunction with conceptual theories of professional development and learning cycles, a framework for professional learning was developed. This mixed methods action research inquiry sought to discover if an implementation of professional learning cycles would positively impact collective teacher efficacy. Teachers and support staff met weekly and engaged in four 8-week professional learning cycles with targeted instructional focuses. Each week these educators participated in a structured task with the focus of the instructional target. Qualitative and quantitative data was collected through pre- and post-surveys and concluded with a focus group interview. The findings indicated that teachers were positively impacted by participating in the structured learning cycles which provided authentic professional growth relevant to the specific needs of the participants and learners. Increases were also reported in overall collective efficacy. This framework for professional learning was found to be replicable in any instructional setting, and its design allows for targeted school improvement needs to be addressed
Effect of Metformin Treatment in Gestational Diabetes Mellitus on Infant Mesenchymal Stem Cell Metabolism
No full textOffspring born to women with gestational diabetes mellitus (GDM) experience long- and short-term health consequences that may be partially mitigated through effective and timely treatment of maternal hyperglycemia. Metformin is an effective anti-diabetic agent that is increasingly prescribed to pregnant women for the treatment of GDM. However, metformin readily crosses the placenta into fetal circulation and concerns regarding the potential impact on fetal development have not been adequately addressed. While investigations conducted in animal models have produced controversial findings, randomized controlled trials in humans have reported altered postnatal growth during infancy and childhood among offspring exposed to metformin in utero. Furthermore, the underlying causal mechanisms by which metformin exerts lasting effects on offspring remain unclear. Nevertheless, the use of human umbilical cord derived mesenchymal stem cells (MCSs) has recently gained recognition as a robust model for studying infant cellular outcomes, and current evidence demonstrates that outcome measures from infant MSCs are tightly correlated with longitudinal measures of infant clinical outcomes, such as adiposity measured from birth to 4-6 years of life; thus, infant MSCs present a unique opportunity to study infant cellular outcomes. To investigate the impact of in utero metformin on infant MSC energy metabolism, we collected infant MSCs from exclusively diet controlled (A1DM-MSCs) or metformin treated (Met-MSCs) GDM pregnancies. In aim one of this dissertation, we investigated the impact of in utero metformin exposure on infant MSC substrate oxidation and insulin action under basal conditions and in response to excess fatty acids using radiolabeled glucose, oleate, and palmitate tracers. Measurements of MSC lipid accumulation and mitochondrial content markers were also conducted, in addition to metformin concentrations in cord blood plasma samples. Met-MSCs displayed lower rates of oleate oxidation under basal conditions, compared to A1DM-MSC, despite no differences in mitochondrial content or lipid availability. Additionally, differences in oleate oxidation were no longer apparent under conditions of excess fatty acids. We also reported a large variability among cord blood plasma metformin concentrations, which did not associate with measures of maternal metformin dosing. In aim two of this dissertation, we examined the impact of in utero metformin exposure on infant MSC mitochondrial capacity and control of respiratory flux across physiologic energy demands in the presence of substrates specific to respiratory complex I (CI), CII, and fatty acid oxidation using cellular respirometry. We also investigated the relationship between metformin exposure measures and MSC mitochondrial outcomes. Met-MSCs exhibited lower mitochondrial maximal capacity and diminished CII-linked respiration and respiratory conductance compared to A1DM-MSCs. We also reported relationships between length of in utero metformin exposure and mitochondrial protein expression of CII and citrate synthase. Collectively, these data demonstrate that infant MSCs adaptively respond to in utero metformin exposure, as evident by the lasting effects observed in infant MSCs in the absence of metformin. These findings are clinically relevant and will help inform clinicians of the potential effects of prescribing metformin to pregnant women diagnosed with GDM on the developing fetus, thus increasing the level of care provided
A UNIQUE MITOCHONDRIAL BIOENERGETIC PATHWAY UNDERLIES ACUTE MYELOID LEUKEMIA SURVIVAL AND CHEMORESISTANCE
No full textIn his early research on cancer cell metabolism, Otto Warburg made the hypothesis that the respiration of cancer cells has become damaged. The insult to cancer cell respiration, Warburg proposed, was either 1) a decrease in oxygen consumption, or 2) with undiminished oxygen consumption, the coupling of respiration and ATP synthesis has become broken. Herein, using multiple models of acute myeloid leukemia (AML) (i.e., chemosensitive and chemoresistant), we present evidence that supports the early hypothesis of Otto Warburg. Specifically, we discovered that 1) AML mitochondria present with defects in respiration that are masked by increases in mitochondrial content and 2) under basal conditions, AML mitochondria consume, rather than synthesize, ATP. The ATP consumption of AML cells confers a survival advantage and poises AML cells to participate in a futile cycle that mimics an alternating current circuit model. In chapter I, we provide a background on acute myeloid leukemia bioenergetics that establishes the groundwork for the research outlined in this dissertation. Specifically, our previous research discovered that relative to normal blood cells, AML cells are characterized by two important mitochondrial phenotypes: 1) AML cells present with deficiencies in oxidative phosphorylation (i.e., OxPhos) that are more pronounced in the context of chemoresistant disease; and, 2) AML import extramitochondrial ATP into the mitochondrial matrix space where it inhibits respiratory flux. In Chapter II, we discovered that, universally, the AML mitochondrion presents with 1) reductions in respiratory flux, driven by intrinsic lesions in the electron transport system, that were associated with 2) a utilization of ATP synthase as an F1-ATPase proton pump to sustain the mitochondrial membrane potential. Sustaining polarization across the inner mitochondrial membrane via F1-ATPase activity conferred chemoresistance to AML. Importantly however, chemoresistant AML were re-sensitized to chemotherapy when F1-ATPase mediated polarization was disrupted using mitochondrial-targeted lipophilic small molecules. In Chapter III, we discovered that reactivation of AML OxPhos induces BAX-independent cytotoxicity that, based on unpublished data in Chapter IV, appears to involve cytotoxic ROS production. Collectively, this dissertation proposes a unique model of AML mitochondrial bioenergetics where ATP consumption, rather than ATP synthesis, supports AML survival and confers resistance to chemotherapy. Furthermore, this dissertation presents a novel AML-specific mitochondrial pathway that can be selectively targeted by 1) disrupting F1-ATPase mediated polarization of the mitochondrial membrane, or 2) reactivating AML OxPhos
THE EFFECTS OF HIP AND HAMSTRING MUSCLE STRENGTH ON DYNAMIC KNEE VALGUS AND JOINT TORQUES DURING A DOUBLE LEG DROP JUMP AND DOUBLE LEG SQUAT
No full textINTRODUCTION: Amongst the injuries that occur in the lower extremities, anterior cruciate ligament (ACL) injuries have been shown to be the most common lower extremity injury impacting the young adult and athletic populations on a year-to-year basis and these injuries are typically occurring via non-contact mechanisms. Insights into the mechanisms of these non-contact ACL injuries can give researchers guidance as to which direction prevention strategies should utilized rather than the implementation of broad neuromuscular and proprioceptive training protocols in use today. While knee valgus has been shown to be a risk factor for ACL, the role of proximal hip muscle strength and hamstring strength to prevent this knee valgus has not been established. PURPOSE: The purpose of this research was to determine the effect of hip and hamstring muscle strength on knee abduction angles and torques during double leg squats and drop jumps. METHODS: 20 healthy subjects were recruited and enrolled in the study. The Humac NORM dynamometer was used to assess muscle strength from the hip extensors, hip abductors, knee flexors, and knee extensors. Subjects then performed double leg squats and double leg drop jumps while motion analysis and force plate data were simultaneously collected. DATA REDUCTION: Lower extremity angles and torques were calculated from the motion and force plate data. Strength testing data (EMG, Humac Position, and Humac Torque) was collected from the Humac Norm Dynamometer. STATISTICAL APPROACH: We divided the overall group of participants into categories of strong vs. weak overall hip extensor and knee flexor strength. We then compared the knee abduction angles and joints torques between the two groups. We also explored the relationship between hip extensor and knee flexor strength on knee abduction angles and torques through a correlational analysis. RESULTS: Only the hip extensor showed significant correlations and significant differences between high vs low muscle strength with any of the knee angles or torques during the double leg drop jump task. Findings of this current investigation indicate that the strength values for only the hip extensor muscle group are indicative of a relationship between strength and knee valgus angles/torques. During the double leg drop jump task, the hip extensor strength group significantly predicted knee flexion angle at initial contact and knee flexion angle at peak vertical ground reaction force accounting for 26% and 24% of the variance respectively, leaving 74% and 76% of the variance unaccounted for by all other muscle strength variables. CONCLUSION: The current study found no statistically significant relationships between the maximum isokinetic strength between the knee extensor, knee flexor, and hip abductor muscle groups with the peak knee valgus angles and torques displayed during double leg drop jumps and squats. Findings of this current investigation indicate that the strength values for only the hip extensor muscle group are indicative of a relationship between muscle strength and knee valgus angles/torques based off a correlational analysis and stepwise regression
Constructing Cultural Chronology in the North Carolina Coastal Plain: Stratigraphic Investigations at Barber Creek (31pt259)
No full textBarber Creek is a stratified prehistoric site located on a relict sand dune in eastern North Carolina. Previous research has determined multiple components are present at Barber Creek, however, two previous analyses into the chronological sequence identified varying numbers of occupation zones. The purpose of this study was to reconstruct the stratigraphic and cultural chronology of the central portion of Barber Creek and compare the results to the previous investigations from other portions of the site. This study identified three occupation zones buried in approximately one meter of aeolian sands. These occupation zones date to the Early Archaic, Middle to Late Archaic, and Early to Middle Woodland periods. The results of this research are consistent with the two previous analyses and solidify the occurrence of three occupation zones at Barber Creek. Interestingly, the previous stratigraphic analyses conducted on Barber Creek have lacked Middle/Late Archaic period diagnostic artifacts. A stemmed biface was identified during this study and is the closest evidence for the presence of a Middle/Late Archaic period at Barber Creek. After more than a decade of research, we have established a strong understanding of the stratigraphic and chronological sequence of Barber Creek however much can still be learned about who could have utilized the site and for what purposes throughout the three occupation components
Women Writing Women: Native Female Authors Asserting Power Through Fiction
No full textFemale Native authors are taking the literary world by force, producing many texts that challenge the patriarchal status quo. Utilizing their ethnic identities to add new perspectives on the problems facing Native American communities, these women frequently upend systems of power in their narratives. In a collection of texts ranging from speculative short fiction, true-crime novels, and dystopian science fiction novels, I will examine how Native women illustrate the power of knowing their history. These Native women create female characters that anticipate trauma and fight back before it can happen commenting on the gravity of the violence facing Native women in the United States. They create female characters who live at the crossroads of their identity but use that dual perspective to upend systems of health and justice in their communities. They also create female characters who heal and bind their communities with the stories they tell. In this analysis I will show how traditional Native elements can be woven into modern fiction to disrupt tropes and systems that have permeated society for too long, leaving Native women at the margins. In these texts they take center stage