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Vindicating Moral Error Theory: A Threefold Defense Against Companions in Guilt
No full textMoral Error Theory (MET) posits that moral statements ordinarily presuppose stance-independent moral properties which fail to obtain, rendering first-order moral propositions systematically false. A major challenge to MET comes by way of Companions in Guilt (CiG) arguments, which hold that moral and epistemic normativity are on par such that the rejection of one entails the rejection of the other. CiG proponents argue, then, that if one is committed to epistemic normativity, she is justified in accepting moral normativity, thus granting her good reason to reject MET. Furthermore, CiG purports that if the error theorist rejects epistemic normativity, she loses the rational basis necessary to justify error theory, leading to self-defeat. This paper motivates three ways the error theorist can respond to CiG. First, we object to the parity premise on which CiG hinges. While the argument assumes that moral and epistemic normativity stand or fall together, we argue the sufficiently objectionable features of moral normativity do not generalize to epistemic normativity. Second, granting the parity premise, we adopt a broader Normative Error Theory (NET) and engage with those arguments which charge NET as self-defeating. We contend that the normative error theorist does not lose out on good reasons, and that she faces no self-defeat. Third, by demonstrating a dilemma created by an internal tension between the two key premises, we show that CiG either fails due to disparity or becomes dialectically redundant. By offering these three ways out of CiG, each alone sufficient to defend the error theory, we show it is overdetermined that MET is insulated from CiG
Bridging the Hearing Gap: National Insights into Insurance Coverage and Hearing Aid Utilization in Older Adults
No full textWhile out-of-pocket costs for hearing aids can deter older adults from seeking care, insurance coverage ranges from no coverage to Medicare or military-related options. This study investigated rates and temporal trends of hearing aid use by insurance status in older adults (≥65 years) from the National Health Interview Survey (n=14,039) who had complete data on insurance, hearing aid use, and self-reported hearing limitations. Rates and trends of hearing aid use were estimated using survey weights, and 16 insurance categories were created based on exclusive and combinatorial coverage, with Medicare serving as the reference group. Associations between hearing aid use and insurance status were examined using multivariable regression models adjusted for demographics, socioeconomic status, hearing limitations, and comorbidities. Among those reporting hearing limitations, 51.2% used hearing aids. In adjusted models, Military-only and Military+Medicare groups reported significantly higher rates of hearing aid use than Medicare only (OR 2.14, 95% CI 1.19–3.85; OR 1.89, 95% CI 1.66–2.51, respectively). Individuals with Private+Medicare coverage also had higher rates of hearing aid use (OR 1.32, 95% CI 1.21–1.42). No significant differences were found between Medicare only and Private only, Medicaid only, or Medicaid+Medicare groups. From 2007 to 2018, hearing aid usage remained stable across insurance categories. These findings indicate that military-related insurance coverage may facilitate greater hearing aid utilization, potentially due to complete coverage of devices and distinct health-seeking behaviors among veterans. Future efforts should examine policy reforms and stigma reduction strategies to improve hearing care access and adoption
FRAMEWORK FOR BUNDLING PAVEMENT MAINTENANCE PROJECTS USING COMPATIBILITY SCORES TO IMPROVE PROJECT DELIVERY EFFICIENCY IN TENNESSEE
No full textState Departments of Transportation (DOTs) face growing challenges in securing competitive bids for small-scale maintenance projects, often due to the limited financial value of these contracts and the overwhelming demand for contractors\u27 resources. Project bundling has emerged as a promising strategy to address these challenges by aggregating multiple smaller, similar projects into larger contracts, making them more attractive to a wider pool of contractors. Despite its potential, the lack of clear guidelines and frameworks for effective bundling remains a significant barrier. This study develops a practical framework and tool for optimizing project bundling to enhance competition and project delivery efficiency. By using an 11-year project cost dataset from the Tennessee DOT (TDOT), the research examines key factors influencing successful bundling strategies, including project compatibility, geographic proximity, and the ideal bundle size to maintain contractor interest. Validation results indicate that the framework achieved an 89% success rate for bundling compatibility and a 78% accuracy in replicating historical bundling patterns, demonstrating its ability to generate optimal project bundles. The proposed framework provides state DOTs with an actionable tool to group similar projects in ways that maximize competition, improve project delivery outcomes, and support more efficient use of public resources
Beyond the Frame: Appalachian Animistic Spirituality in the Reverend James Morrow’s Folk Art
No full textReverend James Morrow (1955-2023) was a Signs Following preacher at the Edwina Church of God in Jesus Christ’s Name in Cocke County, Tennessee. In addition to preaching, he created an extensive body of vibrant folk art. This thesis examines the folk artistry of Reverend Morrow through the lenses of animism, kinship, and place, exploring how his paintings construct an interconnected Appalachian spirituality. Morrow’s work, deeply rooted in the natural environment of the Appalachian Mountains, presents a distinct animistic worldview in which the landscape, animals, and human figures are dynamically engaged with one another. His paintings illuminate a historical and religious dialogue where nature serves as both a setting and an active participant in genealogical and spiritual narratives. First, this study describes Morrow’s depiction of place, emphasizing how his art frames the natural environment as a living witness to local history and religious practice. Through analysis of several paintings, this section explores how in Morrow’s artwork natural landscapes function as both sacred and historical texts. The study then shifts to focus on the role of kinship, both human and non-human, in Morrow’s visual narratives. His work presents animals not only as religious symbols but also as autonomous agents within the larger spiritual landscape. By considering a wider range of Morrow’s paintings, this section examines how Morrow’s art visualizes genealogical connections, reinforcing a sense of place-based identity that extends across generations. This thesis situates Morrow’s folk artistry within broader discussions of animism, Appalachian religious history, and environmental spirituality. By highlighting his paintings’ deep engagement with local history and ecological stewardship, this analysis serves as a case study of Appalachian animism, arguing that Morrow’s work constructs unique artistic and theological bridges between past and present, nature and religion, and human and non-human kinship networks
Addressing Physical Inactivity in Older Adults: Socioecological Barriers and Solutions Across Rural Communities
No full textPhysical inactivity among older adults is a critical public health issue across the United States, exacerbated by urban-rural disparities that limit active living opportunities, particularly in underserved and rural areas. Physical activity plays a key role in reducing chronic disease risk, preventing fall-related injuries, and improving mental well-being in older populations. This qualitative study examined the socioecological barriers to physical activity and identified actionable solutions that can be tailored to diverse communities nationwide, focusing on insights from East Tennessee. Eleven participants—six community partners and five older adults with varying physical activity levels—participated in one-hour focus groups in March/April 2024. The facilitation of separate sessions allowed for targeted discussions that integrated lived experiences and professional perspectives. Using a semi-structured interview guide, participants shared their attitudes, beliefs, and behaviors related to physical activity and provided practical recommendations for improvement. Key barriers to physical activity included individual factors (physical, psychological, and social health), organizational limitations (capacity and program overlap), and community issues (rurality and infrastructure absence). These barriers disproportionately impact lower-income and marginalized older adults, underscoring the need for multi-level community interventions. Proposed solutions emphasized peer relationships, developing culturally tailored programming, implementing inclusive marketing strategies, and encouraging multi-sectoral collaborations to address regional disparities and promote equitable access to physical activity opportunities for all older adults. By integrating these insights, community health initiatives can more effectively support active lifestyles and overall well-being among rural older adults. This study provides a framework for creating sustainable, tailored interventions to bridge gaps in physical activity access for this population
Stereotypes of Aging: An Exploratory Study on the Lived Experience of Ageism
No full textIntroduction: Ageism, the prejudice against older people based on unfavorable and false assumptions, is so pervasive in our society that we frequently fail to recognize it. However, it is evident that ageism has a number of negative effects on people\u27s physical and mental health, as well as society at large. Many times, the unfavorable stereotypes that support ageism misrepresent older people as forgetful, physically frail and lonely, giving a negative view of aging. This presentation highlights aging stereotypes. Methodology: Three focus groups were conducted with 29 participants aged 55+ at a senior center in Johnson City, Tennessee. The participants were divided into groups based on age: 55–64, 65–74, and 75+. They were then instructed to complete a Societal Stereotypes of Senior Citizens Checklist by identifying stereotypes they have been affected by and stereotypes they felt were the most harmful. The focus groups were then conducted and lasted an hour on average. Data were transcribed and analyzed using Atlas.ti qualitative software. Results: Four of the stereotypes that were most frequently selected in both categories included: (1) Mental and physical deterioration are inevitable in old age, (2) Older workers cannot work as effectively as younger workers, (3) Aging makes it difficult to learn new skills and (4) Aging is a depressing experience. Experiences shared during the focus groups demonstrated these stereotypes. Participants highlighted misconceptions and discriminations faced or personally experienced due to aging. Implications: Experiencing discrimination due to age can have an impact on a person’s mental and physical health, self-esteem, and overall wellbeing. These findings highlight the misconceptions around aging and the discrimination experienced as a result of ageist stereotypes in our society. Raising awareness about these negative stereotypes is crucial for reducing ageism. Keywords: Ageism, Aging Stereotypes, Discrimination, Senior
Integrin αMβ2 as a Key Regulator of the Anti-Inflammatory Cholinergic Response in Macrophages and Neutrophils.
No full textInflammation underlies numerous diseases, including sepsis, rheumatoid arthritis, atherosclerosis, and diabetes, representing a significant global health burden where current anti-inflammatory therapies often prove insufficient. Recent studies emphasize the role of nervous system, particularly the vagus nerve, in regulating inflammation via the activation of cholinergic anti-inflammatory pathway. This pathway, mediated by α7-nicotinic acetylcholine receptors (α7nAChR) on leukocytes, suppresses inflammation in various tissues and organs, including the lungs, spleen, liver, and gastrointestinal tract, by inhibiting NF-κB activation and pro-inflammatory cytokine release. While α7nAChR agonists show promise, clinical trials remain inconclusive, suggesting additional contributing factors. Our previous work demonstrated α7nAChR regulation of macrophage migration via integrin αMβ2. Here, using LPS-induced endotoxemia, neutrophil swarming, macrophage migration assays, and leukocyte signaling analysis, we reveal a critical link between αMβ2 and α7nAChR beyond migration. Strikingly, the cholinergic anti-inflammatory response was abolished in integrin αM-deficient mice during endotoxemia. α7nAChR agonist (PNU-282987) treatment, protective in wild-type mice, worsened survival, characterized by increased mortality and exacerbated symptoms, in αM-deficient mice. Mechanistically, α7nAChR activation in αM-/- macrophages failed to suppress TNFα expression, highlighting αMβ2\u27s role in α7nAChR-mediated NF-κB inhibition. Furthermore, α7nAChR activation in αM-deficient mice did not enhance macrophage recruitment or reduce neutrophil migration to the lungs during LPS-induced endotoxemia, demonstrating αMβ2\u27s importance in α7nAChR-driven immune cell trafficking. Consistently, α7nAChR activation decreased wild-type, but not αM-deficient, neutrophil swarming towards Candida albicans via integrin αMβ2 deactivation, likely through conformational changes induced by α7nAChR signaling. These findings demonstrate a reciprocal relationship: αMβ2 contributes to cholinergic anti-inflammatory signaling, and α7nAChR stimulation modulates αMβ2-mediated leukocyte migration. These results identify integrin αMβ2 as a crucial component of α7nAChR-mediated anti-inflammatory signaling, suggesting that targeting αMβ2 in conjunction with α7nAChR may offer a more effective therapeutic strategy for inflammatory diseases, with significant implications for developing improved cholinergic anti-inflammatory therapies
Clarinet and Klezmer Music: Exploring the Shift from Oral to Written Pedagogy
No full textThe clarinet is a traditional member of the klezmer band, yet it was integrated into this ensemble later than other instruments. Klezmer music is traditionally taught by rote, which poses challenges for today’s clarinetists, particularly those lacking aural skills. Without a solid foundation in aural skills, these musicians may struggle to replicate melodies and rhythms accurately, making it difficult to perform authentically within the klezmer tradition. During the klezmer revival in the late 1970s, however, the USA saw an increase in notated music, largely carried by traveling klezmorim (klezmer musicians). Despite this growth, written literature often fails to capture key elements central to klezmer music due to the lack of interactive feedback. This research highlights existing resources for clarinetists that often overlook crucial steps in learning the klezmer style. My exploration of written and notated literature has revealed a lack of specificity in essential techniques. While pre-recorded videos provide more detailed guidance, they still fall short in addressing unique klezmer elements. Many instructional materials, including method books and audio recordings, do not adequately cover these specific techniques, hindering a clarinetist\u27s ability to learn effectively. Additionally, the absence of interactive feedback in instructional videos can lead to doubt and uncertainty in a student’s progress. I will be exploring the resources available to me as a resident of East Tennessee to understand how modern klezmer musicians in the region have learned the style. To gain insights, I will conduct interviews with two members of the klezmer band Dor L’Dor, focusing on essential techniques and advice for aspiring klezmer musicians. Keywords: Ethnomusicology, klezmer, folkmusic, rote, clarinet, pedagog
The Moderating Role of PSSM on the Relationship Between ACEs and Cannabis Use in South Central Appalachia
No full textResearch indicates that exposure to higher numbers of adverse child experiences (ACEs) contributes to higher rates of cannabis use in adulthood (Collazos et al., 2024). Importantly, psychological sense of school membership (PSSM) has been found to be negatively associated with substance use in adolescent samples (Geate et al., 2018). However, the moderating role of PSSM on the relationship between ACEs and cannabis use has not yet been explored, nor has it been explored in the Appalachian region specifically. Thus, the present study aimed to examine whether the strength of the relationship between ACE scores and cannabis use varied based on college students’ PSSM in Appalachia. It was hypothesized that a higher sense of school membership would weaken the relationship between ACEs and cannabis use. The data was gathered from an online survey conducted through Sona during 2020-2021 in the Central Appalachian region of Tennessee. Participants consisted of 149 college students aged 18-25 (M = 20.9, SD = 1.88; 76.9% female; 73.1% Caucasian). College students self-reported their ACE score (Felitti et al., 1998), their PSSM (Goodenow, 1993), and the frequency of their lifetime cannabis use. A linear moderated regression was conducted through Hayes (2022) PROCESS Macro v4.2, and the overall model was not significant. Additionally, there was no direct effect of ACEs or PSSM on cannabis use, and the effect of the interaction between ACEs and PSSM on cannabis use was not significant, contrary to the hypothesis. Overall, these results suggest that neither ACEs, PSSM, nor the interaction between the two impacted college students’ cannabis use. Given that cannabis is illegal in the state of Tennessee, results may have been impacted by participants’ hesitancy to disclose their cannabis use
A Qualitative Exploration of Patient Experiences with Hospital Care During Suicidal Crises
No full textIntroduction. Suicide is the second leading cause of death for people aged 10 to 34 and is currently a major public health concern (Strashny et al., 2023). Many people who experience suicidal ideation seek help from a hospital, with 40 out of 10,000 visits to emergency departments being for suicidal ideation (Strashny et al., 2023). Prior research regarding individuals’ personal experiences with hospital care for suicidality is lacking. Given the limited research, examining care provided by hospital staff and how that care is perceived by patients (e.g., what is helpful versus unhelpful) could help suicide prevention efforts. The purpose of the current study is to explore individuals’ first-hand accounts of hospital care provided for suicidality, which may help inform future intervention strategies. Method. Data were taken from a mixed methods study examining college students’ help-seeking experiences for suicidal crises. The current sample (n = 19) includes participants who endorsed seeking help from a hospital for their suicidal crisis (Mage = 22.2, SD = 11.8, 84.2% female, 94.7% White). Participants responded to open-ended questions about what the hospital did for them, what they found helpful or unhelpful, and what they perceived as satisfactory or unsatisfactory. Results. Reflexive thematic analysis will be used to explore participants’ experiences and final results will be completed by the time of the conference. It is hypothesized that findings will align with prior research, which suggests patients find it helpful when they are treated with gentle care, the situation\u27s complexity is understood, and their emotional experiences are prioritized alongside physical treatment. References. Strashny A, Cairns C,& Ashman JJ. (2023). Emergency department visits with suicidal ideation: United States, 2016–2020. NCHS Data Brief, 463. https://dx.doi.org/10.15620/ cdc:125704