The Art of Faking A Smile: A Layered Account of Mental Illness And/In Relating

In this thesis, I desire to give a relational account of my mental illness by exploring memories where I recall discovering symptoms and attempting to reach out for help. I inquire into how mental illness affects those around me and how others affect my mental illness. I vulnerably navigate the social interactions in which I have been silenced and silenced others. These moments are important spaces to consider engaging the discourse through efforts of interrogating stigma. By opening my “self” and “body” to others, I construct a space where mental illness is conceived of as a relational accomplishment. As stories of mental illness emerge from isolated experiences toward social ones, silenced voices are able to speak more loudly within a community of people who see themselves through/within each other

Unique Molecular Features in High-Risk Histology Endometrial Cancers

Endometrial cancer is the most common gynecologic malignancy in the United States and the sixth most common cancer in women worldwide. Fortunately, most women who develop endometrial cancer have low-grade early-stage endometrioid carcinomas, and simple hysterectomy is curative. Unfortunately, 15% of women with endometrial cancer will develop high-risk histologic tumors including uterine carcinosarcoma or high-grade endometrioid, clear cell, or serous carcinomas. These high-risk histologic tumors account for more than 50% of deaths from this disease. In this review, we will highlight the biologic differences between low- and high-risk carcinomas with a focus on the cell of origin, early precursor lesions including atrophic and proliferative endometrium, and the potential role of stem cells. We will discuss treatment, including standard of care therapy, hormonal therapy, and precision medicine-based or targeted molecular therapies. We will also discuss the impact and need for model systems. The molecular underpinnings behind this high death to incidence ratio are important to understand and improve outcomes

11. Why Live Tiny? A New Multi-dimensional Model

Over the past decade, living in tiny houses has become increasingly popular among Americans of all ages. While the lifestyle has received much attention through reality TV shows, blogs, and on social media sites recently (Ford & Gomez‐Lanier, 2017), little or no systematic research exists on what motivates individuals wanting to live “tiny”. To provide first insights into this new phenomenon, 30 people at varying stages of their tiny house journeys were interviewed. Audio recordings of the interviews (average interview: 67 mins) were transcribed and then analyzed in NVivo v11.0 using a blend of inductive and deductive coding strategies. Based on emerging themes, the authors develop a new multi-dimensional model of tiny living that centers around five core motivators of the Good Life: pursuit of autonomy, new experiences, sense of security, meaningful relationships, and value-consistent lifestyle. They conclude with a discussion on how prior strains and other structural forces can mediate this existential quest for the Good Life. Key words: Tiny house, lifestyle, downsizing, good life, alternative lifestyle, minimalism Ford, J., & Gomez‐Lanier, L. (2017). Are tiny homes here to stay? A review of literature on the tiny house movement. Family and Consumer Sciences Research Journal, 45(4), 394-405

Stronger Together: Tiny-housers’ Views of Community

Over the last decade, tiny homes (generally described as homes smaller than 500 ft2) have grown in popularity thanks to recent representation in the media (Ford and Gomez‐Lanier 2017). An increasing number of people have begun to adopt this reimagined way of living, and some tiny-housers have sought to live near other tiny-housers, forming tiny house communities (Kilman 2016, Mangold et al. Forthcoming). Little systematic research focusing on the tiny-housers views of community exists. To provide initial insights, 30 interviews were conducted with people at various stages in their tiny house journeys. The 30 interviews were transcribed and analyzed in Nvivo 11. Preliminary findings suggest that many of these tiny-housers want to redefine the normative American concept of community by rejecting sub-urban frameworks and borrowing elements from both strong place and interest-based community models. They seek to accomplish this vision through one or more of the following: (i) increased community participation, (ii) shared spaces and resources, and (iii) development of significant relationships with neighbors rooted in mutual support and frequent interaction. While participants strive for this type of community, they also insist upon a clear recognition of personal space and boundaries. Participants also express an interest in having diverse communities, yet desire to maintain many common interests and goals. These community elements are not entirely unique to the tiny house movement. The small space, however, both encourages and facilitates this kind of community participation. Key words: Tiny house, lifestyle, downsizing, good life, alternative lifestyle, minimalism Ford, Jasmine and Lilia Gomez‐Lanier. 2017. Are Tiny Homes Here to Stay? A Review of Literature on the Tiny House Movement. Family and Consumer Sciences Research Journal 45(4):394-405. Kilman, Charlie. 2016. Small House, Big Impact: The Effect of Tiny Houses on Community and Environment. Undergraduate Journal of Humanistic Studies 2. Mangold, Severin, Chelsey Willoughby, Devin Hing, Codey Collins and Toralf Zschau. Forthcoming. Why Live Tiny? A New Multi-Dimensional Model. Sociological Spectrum

Predictors of Opioid and Alcohol Pharmacotherapy Initiation at Hospital Discharge Among Patients Seen by an Inpatient Addiction Consult Service

Background: Medications for opioid use disorder (MOUD) and alcohol use disorder (MAUD) are effective and under-prescribed. Hospital-based addiction consult services can engage out-of-treatment adults in addictions care. Understanding which patients are most likely to initiate MOUD and MAUD can inform interventions and deepen understanding of hospitals’ role in addressing substance use disorders (SUD). Objective: Determine patient- and consult-service level characteristics associated with MOUD/MAUD initiation during hospitalization. Methods: We analyzed data from a study of the Improving Addiction Care Team (IMPACT), an interprofessional hospital-based addiction consult service at an academic medical center. Researchers collected patient surveys and clinical data from September 2015 to May 2018. We used logistic regression to identify characteristics associated with medication initiation among participants with OUD, AUD, or both. Candidate variables included patient demographics, social determinants, and treatment-related factors. Results: Three hundred thirty-nine participants had moderate to severe OUD, AUD, or both and were not engaged in MOUD/MAUD care at admission. Past methadone maintenance treatment (aOR 2.07, 95%CI (1.17, 3.66)), homelessness (aOR 2.63, 95%CI (1.52, 4.53)), and partner substance use (aOR 2.05, 95%CI (1.12, 3.76) were associated with MOUD/MAUD initiation. Concurrent methamphetamine use disorder (aOR 0.32, 95%CI (0.18, 0.56)) was negatively associated with MOUD/MAUD initiation. Conclusions: The association of MOUD/MAUD initiation with homelessness and partner substance use suggests that hospitalization may be an opportunity to reach highly-vulnerable people, further underscoring the need to provide hospital-based addictions care as a health-system strategy. Methamphetamine\u27s negative association with MOUD/MAUD warrants further study

Lessons Learned from the Implementation of a Medically Enhanced Residential Treatment (Mert) Model Integrating Intravenous Antibiotics and Residential Addiction Treatment

BACKGROUND: Hospitalizations for severe infections associated with substance use disorder (SUD) are increasing. People with SUD often remain hospitalized for many weeks instead of completing intravenous antibiotics at home; often, they are denied skilled nursing facility admission. Residential SUD treatment facilities are not equipped to administer intravenous antibiotics. We developed a medically enhanced residential treatment (MERT) model integrating residential SUD treatment and long-term IV antibiotics as part of a broader hospital-based addiction medicine service. MERT had low recruitment and retention, and ended after six months. The goal of this study was to describe the feasibility and acceptability of MERT, to understand implementation factors, and explore lessons learned. METHODS: We conducted a mixed-methods evaluation. We included all potentially eligible MERT patients, defined by those needing ≥2 weeks of intravenous antibiotics discharged from February 1 to August 1, 2016. We used chart review to identify diagnoses, antibiotic treatment location, and number of recommended and actual IV antibiotic-days completed. We audiorecorded and transcribed key informant interviews with patients and staff. We conducted an ethnographic analysis of interview transcripts and implementation field notes. RESULTS: Of the 45 patients needing long-term intravenous antibiotics, 18 were ineligible and 20 declined MERT. 7 enrolled in MERT and three completed their recommended intravenous antibiotic course. MERT recruitment barriers included patient ambivalence towards residential treatment, wanting to prioritize physical health needs, and fears of untreated pain in residential. MERT retention barriers included high demands of residential treatment, restrictive practices due to PICC lines, and perceptions by staff and other residents that MERT patients “stood out” as “different.” Despite the challenges, key informants felt MERT was a positive construct. CONCLUSIONS: Though MERT had many possible advantages; it proved more challenging to implement than anticipated. Our lessons may be applicable to future models integrating posthospital intravenous antibiotics and SUD care

The Smart Airport App, Transit.io: The Travel Optimizer

Jacqueline Andrews, Devin Burke, Uvika Chaturvedi, Jake Collins, Pranav Gupta, Vikrant Neb, Harsh Somani, and Alyssa Williams were all seniors in industrial engineering in the spring semester of 2016. They were members of Team 3 in the course titled Human Factors and Work Analysis (IE 486). This course explores the application of engineering, computer sciences, information sciences, and psychological principles and methods to the analysis and design of human work systems. In this article, the students describe their development of an application prototype to improve the airport travel experience

Maximal Voluntary Activation of the Elbow Flexors Is under Predicted by Transcranial Magnetic Stimulation Compared to Motor Point Stimulation Prior to and Following Muscle Fatigue

Transcranial magnetic (TMS) and motor point stimulation have been used to determine voluntary activation (VA). However, very few studies have directly compared the two stimulation techniques for assessing VA of the elbow flexors. The purpose of this study was to compare TMS and motor point stimulation for assessing VA in non-fatigued and fatigued elbow flexors. Participants performed a fatigue protocol that included twelve, 15 s isometric elbow flexor contractions. Participants completed a set of isometric elbow flexion contractions at 100, 75, 50, and 25% of maximum voluntary contraction (MVC) prior to and following fatigue contractions 3, 6, 9, and 12 and 5 and 10 min post-fatigue. Force and EMG of the bicep and triceps brachii were measured for each contraction. Force responses to TMS and motor point stimulation and EMG responses to TMS (motor evoked potentials, MEPs) and Erb's point stimulation (maximal M-waves, Mmax) were also recorded. VA was estimated using the equation: VA% = (1−SITforce/PTforce) × 100. The resting twitch was measured directly for motor point stimulation and estimated for both motor point stimulation and TMS by extrapolation of the linear regression between the superimposed twitch force and voluntary force. MVC force, potentiated twitch force and VA significantly (p < 0.05) decreased throughout the elbow flexor fatigue protocol and partially recovered 10 min post fatigue. VA was significantly (p < 0.05) underestimated when using TMS compared to motor point stimulation in non-fatigued and fatigued elbow flexors. Motor point stimulation compared to TMS superimposed twitch forces were significantly (p < 0.05) higher at 50% MVC but similar at 75 and 100% MVC. The linear relationship between TMS superimposed twitch force and voluntary force significantly (p < 0.05) decreased with fatigue. There was no change in triceps/biceps electromyography, biceps/triceps MEP amplitudes, or bicep MEP amplitudes throughout the fatigue protocol at 100% MVC. In conclusion, motor point stimulation as opposed to TMS led to a higher estimation of VA in non-fatigued and fatigued elbow flexors. The decreased linear relationship between TMS superimposed twitch force and voluntary force led to an underestimation of the estimated resting twitch force and thus, a reduced VA