THE MOST IMPORTANT VOICES IN THE ROOM: UNDERSTANDING THE ACADEMIC NEEDS OF US-EDUCATED LATINO ENGLISH LEARNERS IN HIGHER EDUCATION

US-educated English learners (US-ELs) immigrated to the United States as children and enrolled in school where they began learning English. Ultimately, they graduate from high school, and the majority of those wishing to continue in higher education begin in community college. These students face tremendous barriers and have lower rates of access to and completion of higher education than English monolingual students. The study examines the transitions of US-ELs from high school to community college in the years since the implementation of California Assembly Bills 705 and 1705 and the COVID-19 pandemic. The researcher used three theoretical frameworks – LatCrit, Intersectionality, and Community Cultural Wealth – to analyze the institutional structures, provide a holistic view of the students’ lived experiences, and inform the data analysis and recommendations. The study provides recommendations from the student participants on best practices to support US-ELs in community college. It also provides recommendations for policy changes at the state level. The researcher also introduces the Cultural Wealth Framework for educational leaders to guide the development of programs and structures within schools to support US-ELs in community college. The framework shifts the deficit mindset that permeates educational institutions by developing programs that protect the cultural capital that US-ELs bring to education and building trust and linguistic security in students. Most importantly, the study elevates the voices of US-educated English learners and provides insight into an important and highly motivated population of multilingual students

Living with the Choice: A Grounded Theory of Iraqi Refugee Resettlement to the U.S.

Though the United States has become a place of increasing resettlement for refugees, particularly Iraqi refugees who have been forced to flee their homeland due to violence, persecution and civil unrest, little is known about Iraqi refugee resettlement in the United States, or the way in which resettlement impacts health and adjustment. A grounded theory study was conducted to develop a substantive theory of Iraqi refugee resettlement. Participants in the qualitative study included 29 Iraqi refugees and 2 community partners who participated in face-to face interviews. Data analysis and interpretation revealed fundamental concepts related to Iraqi refugee resettlement. Results of analysis showed that for Iraqis choosing to resettle here, the outcome is dichotomous: satisfaction or regret. The outcome is influenced by contextual factors as well as facilitating and hindering intervening conditions during the basic social process of resettlement transition. Each refugee’s story is unique, yet all share common threads. This study allowed Iraqi refugees the opportunity to voice their personal experiences of resettling in America, and revealed life stories that inspire and illuminate a process that can guide health care delivery as they cope with the stresses of their journey. As a result, an in-depth storyline was established to explain the process of resettlement for Iraqi refugees. The development of this resettlement theory, grounded in Iraqi refugee experience, has the potential to guide nursing education, enhance the efficacy of practice, inform policy development and form the basis for research

Doctor of Philosophy

dissertationThis literature review will address issues to consider related to teaching numeracy and mathematics to children with disabilities in inclusive early childhood classrooms. As inclusive settings and instruction in numeracy/mathematics at an early age become more common, it is important to closely examine teaching strategies and make appropriate adaptations for young children with special needs. The purpose of this paper is to examine (a) strategies for embedding opportunities for numeracy/math development across various learning centers in a preschool classroom, and (b) instructional strategies that may be effective when teaching math and/or numeracy skills to children with special needs in inclusive early childhood settings

The role of invasive monitoring in the resuscitation of major burns: a systematic review and meta-analysis

Increasingly, in major hospitals invasive monitoring endpoints are utilised to guide the acute resuscitation of burns. The aim of this review is to evaluate effects of invasive monitoring for major burns patients (>20% total body surface area) to prevent early organ dysfunction. Five databases were searched for randomised controlled trials and cohort studies that evaluated invasive monitoring within the acute phase (first 24 hours). Invasive monitoring included transesophageal echocardiogram, central venous pressure measurement, and pulmonary artery catheterisation. Primary outcomes included multiple organ failure scores, renal and cardiac dysfunction measurements, compartment syndrome and lactate at 24 hours. Secondary outcomes included mortality and intensive care unit stay. Ten studies involving 401 major burns patients were included. Data pooled from four studies demonstrated significantly improved cardiac index at 24 hours compared to non-invasive endpoints (MD: 0.65, 95% CI: 0.46-0.82, P=0.00001). Five studies pooled showed significantly increased urine output with invasive monitoring (MD: 0.18, 95% CI: 0.03-0.34, P=0.02), whereas there was no difference in blood lactate levels (MD: -0.11, 95% CI: -0.44-0.22, P=0.43). There was a trend for lower mortality in invasive monitoring groups compared with non-invasive controls; however, the difference was not significant. There remains insufficient evidence to determine whether invasive monitoring to guide fluid resuscitation improves patient outcomes after major burn trauma. Although meta-analysis determined significantly improved cardiac index and urine output, further studies are required

A new model for standardising and treating thermal injury in the rat

Thermal burn injury methodologies are inconsistently described within the current literature. To permit the advancement of new treatments there is an urgent need for the development and standardisation of an acute rat model. We describe a rat thermal burn model that involves: anaesthesia, chronic catheterisation, skin preparation, baseline hemodynamic and physiological monitoring, and a quantifiable method to reproduce a severe full-thickness burns injury affecting ∼30% percent of the total body surface area (%TBSA). Following a 15 min post-burn period, treatment commences with an acute monitoring phase lasting up to 8 hours, which can be modified according to individual protocols. This model reflects the clinical continuum-of-care from point-of injury, a 15 min ambulance response time, a 60 min prehospital phase and hospital treatment monitoring phase. The model is validated with histological evidence of full-thickness injury, evidence of the hypermetabolic response (K+, Base Excess, lactate) and changes in complete blood counts. • It has been 50 years since Walker and Mason published their widely popular a standard animal burn model. • The model, however, lacks quantifiable methodology for the assessment of burn thickness, surface area burnt and physiological status. • We present a new standardised method for evaluation of drug and interventional therapies that mimic the clinical scenario including ambulance response, pre-hospital and hospital phases after burn

Seeking Care at Free Episodic Health Care Clinics in Appalachia

Background: People who live in rural Appalachia experience a wide variety of problems when seeking access to health care. Health care disparities continue to be one of the most complex and prevalent problems, and many barriers exist for impoverished men and women such as a lack of education, complications with health insurance, and personal distrust of healthcare providers. Purpose: A critical gap in the literature is the unheard voice of persons in rural underserved areas. The purpose of this study was to explore the perspectives of persons in rural Appalachia who seek healthcare services at free episodic health care clinics, a common alternative source of care. Methods: In Fall 2017, a qualitative approach was used to discover the perceptions of 12 men and women in rural Appalachia who were seeking medical care at a Remote Area Medical Clinic. A transdisciplinary research group provided insight and assistance with thematic analysis in Spring 2018–Spring 2019. Results: Five overall themes emerged capturing the essence of how rural Appalachians view the experience of seeking healthcare, which include difficulties with insurance/finances, inconsistency in care, isolation in rural areas, seeking solutions, and need to feel valued. Implications: A rich description of participant experiences portrays real-life complexities for Appalachian men and women who seek healthcare. Understanding the perceptions of persons who seek healthcare and the essence of their experiences is the first step in determining future sustainable solutions for social justice

Behavior and Ecology of the Giant Otter (Pteronura brasiliensis) in Oxbow Lakes of the Manú Biosphere Reserve, Perú

The Giant Otter (Pteronura brasiliensis) is an endangered otter of Amazonian lakes and rivers. It is the only otter of 13 extant species to breed cooperatively in family groups, with young of several years helping to raise younger siblings. I studied giant otters' behavior and ecology in 4 oxbow lakes (or "cochas") in the Manú Biosphere Reserve, Perú during 2003-2006. The objectives of this research were: 1) to investigate whether oxbow lakes return to random or predictable faunal communities after annual flooding; 2) to document seasonal and annual patterns in the diets of giant otters on two phytoplankton-dominated oxbow lakes; and 3) to document and characterize helping behavior in giant otters. I initially classified the four study lakes into 2 lake types, phytoplankton-dominated lakes and macrophyte-dominated lakes. I obtained data on their faunal communities, limnology, and otter diet through four seasons of 2003, and during the dry-seasons of 2004-2006. I show that lakes' bird communities and caiman populations, and to a lesser degree fish communities, respond predictably by lake identity and type. Lake communities also responded to seasonal changes in 2003 data, but generalization to other years is complicated by the destructive flood in January of that year. I studied giant otters' diet using visual observations, and demonstrated seasonal and annual changes not previously reported for the species. Giant otters shift to more intensive use of small cichlid prey found in edge habitats when with young cubs in the dry season. In studying the giant otters' behavior, I showed that hunting skills and helping activities generally increase with age. This observation is consistent with a pattern of "slow learning" suggested by the Skills Hypothesis of Heinsohn (1991). I observed considerable variation in dispersal age and helping contribution within families, particularly with respect to defensive behaviors against potential threats. Finally, the elderly matriarch in one family switched from being a provider of large prey to a beggar from other family members in 2007, apparently from the effects of old age. During 8 days of observation, her offspring assisted her through sharing prey and other types of assistance

Lung protection after severe thermal burns with adenosine, lidocaine, and magnesium (ALM) resuscitation and importance of shams in a rat model

The management of severe burns remains a complex challenge. Adenosine, lidocaine, and magnesium (ALM) resuscitation therapy has been shown to protect against hemorrhagic shock and traumatic injury. The aim of the present study was to investigate the early protective effects of small-volume ALM fluid resuscitation in a rat model of 30% total body surface area (TBSA) thermal injury. Male Sprague–Dawley rats (320–340 g; n = 25)were randomly assigned to: 1) Sham (surgical instrumentation and saline infusion, without burn, n = 5), 2) Saline resuscitation group (n = 10), or 3) ALM resuscitation group (n = 10). Treatments were initiated 15-min after burn trauma, including 0.7 mL/kg 3% NaCl ± ALM bolus and 0.25–0.5 mL/kg/h 0.9% NaCl ± ALM drip, with animals monitored to 8.25-hr post-burn. Hemodynamics, cardiac function, blood chemistry, hematology, endothelial injury markers and histopathology were assessed. Survival was 100% for Shams and 90% for both ALM and Saline groups. Shams underwent significant physiological, immune and hematological changes over time as a result of surgical traums. ALM significantly reduced malondialdehyde levels in the lungs compared to Saline (P = .023), and showed minimal alveolar destruction and inflammatory cell infiltration (P < .001). ALM also improved cardiac function and oxygen delivery (21%, P = .418 vs Saline), reduced gut injury (P < .001 vs Saline), and increased plasma adiponectin (P < .001 vs baseline). Circulating levels of the acute phase protein alpha 1-acid glycoprotein (AGP) increased 1.6-times (P < .001), which may have impacted ALM's therapeutic efficacy. We conclude that small-volume ALM therapy significantly reduced lung oxidative stress and preserved alveolar integrity following severe burn trauma. Further studies are required to assess higher ALM doses with longer monitoring periods

Identifying the risk : A prospective cohort study examining postpartum haemorrhage in a regional Australian health service

Acknowledgements The authors would like to acknowledge the midwifery and medical staff who assisted in the data collection for this study and the women who consented to participate. Funding The research study was generously funded through an early career grant awarded by Wishlist: Sunshine Coast Health Foundation. The grant funded a research midwife to undertake study co-ordination, data collection and entry.Peer reviewedPublisher PD