Nevertheless They Persisted: Youth Formerly in Foster Care Who Have Experienced Trauma and Their Journey to Postsecondary Education

It is estimated that approximately 60% of children have experienced some form of trauma in their lifetime (Wiest-Stevenson & Lee, 2016). Research in the last 20 years has shown the impact of childhood trauma on human development, social development, and learning, and yet, there is very little literature in school counseling about this topic (Perry, 2001, 2006). School counselors play in essential role in identifying barriers that impede students from receiving a high-quality education (American School Counselor Association [ASCA], 2012), and are charged with reducing the educational attainment gap for the students they serve (Milsom & McCormick, 2015). There are many student populations that are at-risk of experiencing trauma, such as, children experiencing homelessness, students with disabilities, or involvement with the juvenile justice system (Fritz, 2017). Although any student could be at-risk of experiencing trauma, youth in foster care often have a history of childhood trauma (Beyerlein & Bloch, 2014). School counselors are in the position to advocate for youth by assisting them to excel academically and provide social and emotional support, especially for foster youth. Youth in foster care rarely get the opportunity to have their voices heard in the literature, particularly as it pertains to their experience with trauma. Most of the literature about trauma and education is deficit based, and does not provide insight into the lived experiences of foster youth. This dissertation study addresses the gap in the literature through a phenomenological examination of nine former foster youth’s experience of the kindergarten through grade 12 (K-12) education system. Results of this study yielded eight primary themes and 43 secondary themes based on the data. The final identification of primary themes included: within the home environment; impact on learning; within the foster care system; impactful connections; emotional impact; motivators; and posttraumatic growth. The results provide a rich and thick description of what the phenomenon of being a student who has experienced trauma during K-12 education experiences, the former foster youth’s interactions with school counselors, and the lived experience of growth despite trauma. Implications of this study include viewing trauma through a strengths-based lens, making impactful connections, and recognizing the possibility of posttraumatic growth were beneficial to the youth in this study. A discussion of the results, limitations, areas for future research, and implications for school counselors and counselor educators are provided

Mild Cognitive Impairment in Heart Failure Affects Care Transition

Objectives After attending the presentation, the audiences will be able to: Understand the importance of cognition in everyday activity and the cognitive hierarchy to guide practice. Recognize the incidence of mild cognitive impairment in individuals with heart failure. Understand how mild cognitive impairment may affect heart failure self- care practice and hospitalization readmission. Identify the evidence that support use of cognitive screen to identify mild cognitive impairment in individuals with heart failure. Compare the evidence among three cognitive screens (Mini-mental Status Exam, Montreal Cognitive Assessment and St. Louis University Mental State Exam). (Using Montreal Cognitive Assessment as an example)Identify cognitive components assessed in a cognitive screening tool Individualize care transition program that target individual’s cognitive impairments and address individual’s learning needs

An investigation of the structure-function relationship in human cervical tissue

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2008.Includes bibliographical references (leaves 198-210).The cervix plays a crucial role in maintaining a healthy pregnancy, acting as a mechanical barrier to hold the fetus inside the uterus during gestation. Altered biochemical and mechanical properties of the cervical tissue are suspected to play an important role in spontaneous pre term birth. Slight changes in the biochemical properties are known to cause softening of the cervical tissue thus weakening the structure. Premature softening of the cervical tissue is associated with spontaneous pre term birth and the clinical condition known as cervical insufficiency. "Cervical insufficiency" is clinically defined as a history of spontaneous pre term birth associated with a painless contraction-free delivery. Diagnosing cervical insufficiency remains elusive in the medical community because the etiology of this disease is unknown. Therefore, there is a need to establish a better understanding of this disease to aid in the identification and management of patients. This doctoral study explores the relationship between the biochemical and mechanical properties of human cervical tissue. The structure-function relationship is investigated by measuring the stress-response of the tissue in various modes of deformation and assaying the tissue for biochemical content. To generate material properties which reflect the tissue's biochemical content, micro-structurally based constitutive relationships are fit to the experimental data from mechanical tests. Values of the constitutive model parameters corresponding to the best fit to the material response in all modes of deformation represent the "mechanical properties" of the sample. Mechanical properties and the structural properties of the collagen and proteoglycans of each sample are compared, and it was found that the mechanical and biochemical properties vary for women with different obstetric backgrounds.(cont.) Pregnant tissue is softer than non pregnant tissue, and non pregnant tissue from women with previous vaginal deliveries is softer than non-pregnant tissue from women with no previous vaginal deliveries. These changes in mechanical characteristics correspond to a shift in biochemical content with the softer tissue having a higher collagen solubility and an altered glycosaminoglycan content. An improved knowledge of the structure-function relationship is an important first step in understanding how the microstructure of the extracellular matrix (ECM) relates to its macroscopic mechanical response. In addition, the identification of key biochemical regulators of mechanical properties can constitute the basis for pharmacological intervention to correct pathological abnormalities in tissue response.by Kristin M. Myers.Ph.D

Mechanical and biochemical properties of human cervical tissue

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2005.Includes bibliographical references (leaves 97-103).The mechanical integrity of cervical tissue is crucial for maintaining a healthy gestation. Altered tissue biochemistry can cause drastic changes in the mechanical properties of the cervix and contribute to premature cervical dilation and delivery. This work presents an investigation of the mechanical and biochemical properties of cervical samples from human hysterectomy specimens. Three clinical cases were investigated: non-pregnant hysterectomy patients with previous vaginal deliveries, non-pregnant hysterectomy patients with no previous vaginal deliveries, and pregnant hysterectomy patients at time of cesarean section. Tissue samples for the three clinical cases were tested mechanically and analyzed for biochemical content. Tissue samples were tested in confined and unconfined compression, and biochemical assays measured cervical tissue hydration, collagen content, collagen extractability, and sulfated glycosaminoglycan content. The non-pregnant tissue was found to be significantly stiffer than the pregnant tissue. Collagen extractability was significantly higher in the pregnant tissue. This study represents a first important step towards the attainment of an improved understanding of the complex interplay between the molecular structure of cervical tissue and its macroscopic mechanical properties.by Kristin M. Myers.S.M

The inflation response of the posterior bovine sclera

An in vitro inflation test method was developed to characterize the mechanical behavior of the bovine posterior sclera. The method used digital image correlation to provide a spatially resolved, full-field deformation map of the surface of the posterior sclera in response to controlled pressurization. A series of experiments were performed in the range of 2-6 kPa (15-45 mmHg) to characterize the load-unload displacement response at various pressure rates and the time-dependent displacement response at different applied pressures. The magnitude of the displacement was largest in the peripapillary region, mainly between the apex and the optic nerve head. Further, the results showed that bovine scleral tissue exhibited nonlinear and viscoelastic behavior characterized by a rate-dependent displacement response, hysteresis during unloading and creep. The creep rate was insensitive to the applied pressure, suggesting that the tissue can be modeled as a quasilinear viscoelastic material in the physiological pressure range of 2-6 kPa

Anisotropic material properties of the human uterus

The mechanical function of the uterus is crucial for the protection of the fetus during a healthy pregnancy. Early contractile activation of uterine tissue can lead to preterm labor and birth (PTB). In 2014, 9.56 percent of pregnancies ended in PTB; it is also the leading cause of death in children under five years of age. Characterizing the material properties of uterine tissue is important for understanding the mechanical failures of the uterus and the causes of PTB. In this study, a workflow of experiments and data processing techniques were employed. 78 uterine specimens were collected from consenting 28 patients who underwent hysterectomy. A four-level ramp-hold indentation test was performed. IFEA was performed to fit four material parameters to the experimental data: Young's Modulus E, Poisson’s ratio v, the fiber stiffness factor ksi, and the fiber angle concentration b. Within each uterus, significant differences in Young’s Modulus E and Poisson’s ratio n were observed at different locations and different layers, indicating the heterogeneity of the human uterine material properties. However, the fitted values for fiber stiffness x and angle concentration b exhibited a wide spread with no significant differences observed across comparison groups. There were also no obvious differences between patients with different parities, as suggested in previous studies

Changes in the biochemical constituents and morphologic appearance of the human cervical stroma during pregnancy

Objective: The cervix is the lower portion of the uterus. It is composed of fibrous tissue and its mechanical integrity is crucial for maintaining a healthy gestation. During normal pregnancy, the cervical extracellular matrix (ECM) remodels in preparation for labor. The objective of this study was to investigate the biochemical and morphological changes in cervical stroma associated with physiological remodeling during normal pregnancy. Study design: Using human cervical tissue obtained from pregnant and non-pregnant patients, the ECM was analyzed for its biochemical constituents and histologic morphology. The ECM was assayed for hydration, collagen concentration, collagen solubility, total sulfated glycosaminoglycan concentration, and individual disaccharide concentration. The ECM morphology was visualized using conventional histological techniques (Masson's trichrome stain, polarized light microscopy) as well as second harmonic generation (SHG) imaging. Results: When comparing pregnant to non-pregnant tissue, significant increases were measured for total sulfated glycosaminoglycans, hyaluronic acid, and collagen solubility. The microscopy studies confirmed that the collagenous network of the cervical stroma was anisotropic and pregnancy was associated with a discernable decrease in collagen organization. Conclusion: Significant changes were seen in the concentration and organization of cervical ECM constituents during normal pregnancy