A Follow-Up Study of the Secretarial Science Graduates of Morehead State University from June, 1960 to May, 1967

An abstract of a thesis presented to the faculty of the School of Applied Sciences and Technology at Morehead State University in partial fulfillment of the requirements for the Degree of Masters of Business Education by Ada Lee Salisbury in May of 1969

IgH Diversity In an Individual With Only One Million B Lymphocytes

Immunoglobulin sequences from an individual Xenopus laevis froglet were analyzed for combinatorial and junctional diversity. In an animal with about 106 B lymphocytes, at least 26 out of the 56 VH1 genes available in a diploid genome were expressed, as were all JH segments. Junctional diversity was similar to that observed in Xenopus tadpole sequences, that is, little or no N diversification was found and the recombination site sometimes occurred in a region of V/D or D/J homology. The froglet IgH diversity is further restricted by the elimination of D-gene participation through direct V to J joining. Of the six complementary-determining regions (CDR) contributing to the structure of the antigen-combining site, CDR3 is the most variable in sequence and structure. Froglet IgH CDR3 are restricted to both aspects. Compared to IgH sequences isolated from a 5-month-old adult, froglet CDR3 were, on the average, two codons shorter; overall, 58% of the froglet Ig sequences isolated carried CDR3 of ≤ 7 codons, compared to 30% of the adult sequences. In addition to being shorter, the tadpole/froglet CDR3 are less variable in sequence, as the absence of N regions also results in the V/D and D/J junctions being derived from germline elements. We therefore suggest that latent anti-adult specificities are not eliminated in situ, in the tadpole, but rather that such germline gene segments, singly or in their combinations thereof, that can potentially react to adult self-epitopes after metamorphosis have been counterselected during the course of evolution

Port productivity analysis by using DEA: A case study in Malaysia

Recent trends in containerized trade have led to the importance of measuring the performance of container ports. In Malaysia, container ports are mostly situated along the Straits of Malacca, one of the most important shipping lanes in the world. Two of its ports, Port Klang and Port of Tanjung Pelepas (PTP) are ranked amongst the top 20 container ports in the world. In particular, PTP is ranked 16 in 2004, even though it is just a young port which started its operations in October 1999. This paper aims to quantitatively measure the productivity of Malaysian container ports. A cross-sectional performance measurement is carried out, using a DEA approach. To further assess the productivity of the ports over time, a set of panel data is analyzed. In order to compare the productivity of the Malaysian ports with world standards, Port of Singapore is added as a reference

Three decades of the Human Genome Organization.

The Human Genome Organization (HUGO) was initially established in 1988 to help integrate international scientific genomic activity and to accelerate the diffusion of knowledge from the efforts of the human genome project. Its founding President was Victor McKusick. During the late 1980s and 1990s, HUGO organized lively gene mapping meetings to accurately place genes on the genome as chromosomes were being sequenced. With the completion of the Human Genome Project, HUGO went through some transitions and self-reflection. In 2020, HUGO (which hosts a large annual scientific meeting and comprises the renowned HUGO Gene Nomenclature Committee [HGNC], responsible for naming genes, and an outstanding Ethics Committee) was merged with the Human Genome Variation Society (HGVS; which defines the correct nomenclature for variation description) and the Human Variome Project (HVP; championed by the late Richard Cotton) into a single organization that is committed to assembling human genomic variation from all over the world. This consolidated effort, under a new Executive Board and seven focused committees, will facilitate efficient and effective communication and action to bring the benefits of increasing knowledge of genome diversity and biology to people all over the world

Size-selective Circulating Tumor Cell Isolation on a Centrifugal Microfluidic Device

Biomedical EngineeringDetection of circulating tumor cells (CTCs) has gained increasing attention as scientists and physicians learn more about the roles these malignant cells play in metastatic cancer and disease progression. Quantification and molecular analysis of CTCs are considered very important because they can function as potential indicators of early diagnosis and prognosis of cancer metastasis. Therefore, many efforts have been made to develop a reliable method to detect the CTCs. However, one major drawback of CTC detection using a conventional microfluidic approach is that it generally requires a long and complicated processing time due to its small scale and slow fluid velocity. In addition, commonly used immunoaffinity-based positive selection method has a limitation that its recovery rate heavily relies on EpCAM expression of target CTCs, which is known to be heterogeneous among different cell types. In this thesis, a size-selective lab-on-a-disc platform is introduced for a rapid and label-free isolation of CTCs from whole blood. The polycarbonate track-etch (PCTE) membrane was utilized to isolate CTCs based on the size difference between the target cell and other blood cells. Validation of the device was performed using the MCF7 breast cancer cell line spiked into PBS buffer solution as well as healthy donor blood. The capture efficiency of approximately 50~65 % was achieved with the devised CTC isolation system. The purity of the captured cells varied, ranging from 15 % to 30 %. For the clinical studies, patient blood samples from gastric cancer and breast cancer patients were tested and analyzed. The number of CTCs ranging from 5 to 29 CTCs was captured. Overall, the CTC detection rate for the lung cancer patient was 50 %, and the detection rate for the gastric cancer patients was 38.4 %.ope

Impact of a Dyadic Intervention on Family Supporter Involvement in Helping Adults Manage Type 2 Diabetes

Background: Family support for adults’ diabetes care is associated with improved self-management and outcomes, but healthcare providers lack structured ways to engage those supporters. Objective: Assess the impact of a patient-supporter diabetes management intervention on supporters’ engagement in patients’ diabetes care, support techniques, and caregiving experience. Design: Multivariate regression models examined between-group differences in support-related measures observed as part of a larger trial randomizing participants to a dyadic intervention versus usual care. Participants: A total of 239 adults with type 2 diabetes and either A1c \u3e8% or systolic blood pressure \u3e160mmHg enrolled with a family supporter. Intervention: Health coaches provided training on positive support techniques and facilitated self-management information sharing and goal-setting. Main Measures: Patient and supporter reports at baseline and 12 months of supporter roles in diabetes care and caregiving experience. Results: At 12 months, intervention-assigned patients had higher odds of reporting increased supporter involvement in remembering medical appointments (AOR 2.74, 95% CI 1.44, 5.21), performing home testing (AOR 2.40, 95% CI 1.29, 4.46), accessing online portals (AOR 2.34, 95% CI 1.29, 4.30), deciding when to contact healthcare providers (AOR 2.12, 95% CI 1.15, 3.91), and refilling medications (AOR 2.10, 95% CI 1.14, 3.89), but not with attending medical appointments or with healthy eating and exercise. Intervention-assigned patients reported increased supporter use of autonomy supportive communication (+0.27 points on a 7-point scale, p=0.02) and goal-setting techniques (+0.30 points on a 5-point scale, p=0.01). There were no differences at 12 months in change scores measuring supporter distress about patients’ diabetes or caregiving burden. Intervention-assigned supporters had significantly larger increases in satisfaction with health system support for their role (+0.88 points on a 10-point scale, p=0.01). Conclusions: A dyadic patient-supporter intervention led to increased family supporter involvement in diabetes self-management and increased use of positive support techniques, without increasing caregiver stress

Measuring quality of life for an economic evaluation of aphasia: First steps

Health economists typically use the Quality Adjusted Life Year (QALY) when conducting economic evaluations of healthcare investments. We have begun investigating methods to obtain QALYs for aphasia by developing a pictographic version of the Time Trade-Off methodology (picTTO) in an attempt to circumvent language barriers. A convenience sample of 50 adults with aphasia participated in reliability and validity testing of the picTTO. Analysis suggests that while the picTTO itself has face validity, results demonstrated poor to moderate test-retest reliability which we plan to improve by optimizing the study design

Intra-articular Injection of HB-IGF-1 Sustains Delivery of IGF-1 to Cartilage through Binding to Chondroitin Sulfate

Objective: Insulin-like growth factor 1 (IGF-1) stimulates cartilage repair but is not a practical therapy due to its short half-life. We have previously modified IGF-1 by adding a heparin-binding domain and have shown that this fusion protein (HB-IGF-1) stimulates sustained proteoglycan synthesis in cartilage. This study was undertaken to examine the mechanism by which HB-IGF-1 is retained in cartilage and to test whether HB-IGF-1 provides sustained growth factor delivery to cartilage in vivo and to human cartilage explants. Methods: Retention of HB-IGF-1 and IGF-1 was analyzed by Western blotting. The necessity of heparan sulfate (HS) or chondroitin sulfate (CS) glycosaminoglycans (GAGs) for binding was tested using enzymatic removal and cells with genetic deficiency of HS. Binding affinities of HB-IGF-1 and IGF-1 proteins for isolated GAGs were examined by surface plasmon resonance and enzyme-linked immunosorbent assay. Results: In cartilage explants, chondroitinase treatment decreased binding of HB-IGF-1, whereas heparitinase had no effect. Furthermore, HS was not necessary for HB-IGF-1 retention on cell monolayers. Binding assays showed that HB-IGF-1 bound both CS and HS, whereas IGF-1 did not bind either. After intraarticular injection in rat knees, HB-IGF-1 was retained in articular and meniscal cartilage, but not in tendon, consistent with enhanced delivery to CS-rich cartilage. Finally, HB-IGF-1 was retained in human cartilage explants but IGF-1 was not. Conclusion: Our findings indicate that after intraarticular injection in rats, HB-IGF-1 is specifically retained in cartilage through its high abundance of CS. Modification of growth factors with heparin-binding domains may be a new strategy for sustained and specific local delivery to cartilage.National Institute of Biomedical Imaging and Bioengineering (U.S.) (Grant EB-003805)National Institute of Arthritis and Musculoskeletal and Skin Diseases (U.S.) (Grant AR-045779

Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training

Introduction. Web-based learning (WBL) is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre-and postmodule test scores and survey Likert scores were analysed using the paired test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice

Lee County, North Carolina : a community diagnosis including secondary data analysis and qualitative data collection

This document describes the most salient issues that exist for the residents of Lee County, North Carolina as determined through both primary and secondary data collected for a research project. This research project is called a ‘community diagnosis’ and aims to provide a thorough understanding of a community area by elucidating the assets, challenges, and future directions of the community, as defined by the community. This community diagnosis was conducted by six first-year masters students in the Department of Health Behavior and Health Education of the School of Public Health at the University of North Carolina at Chapel Hill. It was conducted at the request of the Lee County Health Department, and as a requirement of the HBHE 240/241 course at the University of North Carolina. The collection and analysis of the data occurred between September, 1999 through April, 2000, culminating with the production of this document. The document is meant to serve as an aid to community members, the health department, and service providers to address the needs of the community by drawing on the identified strengths and challenges of the community. The Lee County community diagnosis commenced with informal talks with residents of the area, and by taking car tours of the area. Concurrently, we began gathering pre-existing or secondary data. We gathered statistics related to demographics, health status of the residents, economic conditions, as well as other social variables [such as housing] of the area. Much of these data came from sources such as LINC (Logging Into North Carolina), U.S. Census, the State Center for Health Statistics, and the Chamber of Commerce. We also researched the history of the area to provide us with a richer context in which to understand this data. All of this information combined comprises the first section of our document (Community Description, Community Profile and Health). The following is a brief summary of this first section. Lee County is found in the geographical center of North Carolina, and spans 259.3 square miles. Lee County is comprised of eight townships: Deep River, West Sanford, East Sanford, Sanford, Pocket, Cape Fear, Jonesboro, and Greenwood. The only incorporated towns, Sanford and Broadway, are found within the townships of Sanford and Cape Fear, respectively. Lee County was officially incorporated in 1907, building on a strong history of economic growth stemming from natural resources and natural deposits. These natural resources and natural deposits allowed people in the area to develop the mining industry, and in more recent history, agricultural development, and manufacturing. The county grew quickly as people were attracted to the new tobacco farming as well as brick production, which later put Lee on the map as the Brick Capital. Throughout the next few decades, the area continued to grow despite some trouble during the depression. Once World War II had ended, industry prospered. This trend has more or less continued to the present day. Today Lee is a burgeoning industrial and economic center. The economy has shifted from a largely agricultural base to largely a manufacturing base. The manufacturing industry in Lee is currently very strong, accounting for 45% of the county’s total employment. Manufacturing holds five of the ten positions in the Lee County’s top ten employers' list (Chamber of Commerce, 1998). It is largely a result of Lee’s prosperity in that so many people are attracted to and continue to move to Lee County. The largest populated area in Lee County is Sanford, containing over one half (21,100) of the entire county population (48,813) (Chamber of Commerce, 1998). As mentioned above, Lee County has experienced tremendous growth throughout its history, which continues to the present day, much like the rest of North Carolina. There was a 59% increase in the population from 1970-1997, and it is projected that Lee will reach 51,182 in 2000. A good portion of the population growth can be attributed to the influx of Latino/a immigrants, which has shifted the racial composition of the county. In 1990 the racial breakdown of Lee County was 75% White, 21.9% Black, 1.2 % Latino/a, 1.3% other (U.S. Census, 1990). Estimates suggest the Latino/as now make up over 10% of Lee County, with much of this growth occurring over the last decade. Additionally, many people are moving to the area from Research Triangle Park (RTP) to take advantage of Lee’s growing economy. All of this growth, both with respect to population and economy, can be characterized as assets and challenges for the community. After we completed analyzing the data from secondary sources, we went to the community members and service providers themselves to try and get a myriad of perspectives on all of the assets, challenges, and future directions of Lee County. We created three different interview guides, one for community members, one for service providers, and one for focus groups. We selected the people we interviewed based on a list provided by the health department, referrals by other interviewees and our subjective opinion about who might best represent the voices of Lee County. One of our main goals was to hear voices not generally heard. We conducted a total of 26 interviews and four focus groups, which included between five and eleven participants each. What follows is a summary of our findings from these interviews and focus groups, which we refer to as our primary data. They are presented within six major themes: growth in population, jobs/economy, growth as it impacts infrastructure and the environment, health, youth, and recreation. The fact that Lee County is experiencing greater than average population growth surfaced in almost every interview as either or both an asset and a challenge for the community. Some were excited to see Lee evolve and change, while others feared a loss of the ‘small town feel.’ While Lee was considered “a great place to raise a family,” concerns were raised that crime and drug activity were on the rise. Also, there is a perception of division among racial/ethnic groups in Lee County, and that division was generally regarded as disturbing. On the same note, several people spoke of churches playing a seminal role in bringing various groups of people together. Lack of representation of various ethnic groups, as well as women and younger people, was mentioned with regard to city and county governments. The two groups that comprise the large numbers of people migrating into the county are people from Raleigh/Cary/RTP, and Latino/as. Despite the potential of bringing greater wealth into Lee County, there are major concerns regarding the growth of the Raleigh/Cary/RTP population. First, it was feared that the new housing being built for these generally wealthier people would lead to an increase in property values, which in turn would lead to a lack of affordable homes for those with middle or low incomes. Another concern was that Lee was becoming a ‘bedroom community’ to RTP. A third concern was that Lee might grow too quickly and become ‘the next Cary.’ A further concern was heard from communities who wanted to grow with Sanford and not be left behind while other neighborhoods grew. Others concerns surfaced regarding the resulting effects on the infrastructure due to this growth including the need for emergency and transitional housing, lack of public transportation, environmental issues as they relate to both the physical and natural environment, as well as an increase in traffic. The burgeoning Latino/a population in Lee was also viewed as both an asset and a challenge. Some spoke excitedly about a rich, new culture. They also mentioned that Latino/as help keep the economy growing with their hard work and willingness to take jobs others might not want. Some people, however, spoke about Latino/as as a strain on local services. Others spoke of the challenges that Latino/as face with regard to their quality of life in Lee County such as a lack of cultural awareness on the part of the Blacks and Whites, lack of bilingual services, and discrimination. Other challenges include poor housing, lack of representation in the government, and transportation barriers. With regard to jobs and economy, people stated that Lee had a strong and vibrant economy, a diverse industrial base, and a low rate of unemployment. Some challenges facing Lee County residents are the increasing cost of living, and the sentiment that the wages are too low. Finally, the influx of Latino/as was linked to employment in factories in the county. With regard to health, the interviewees’ greatest concerns were diabetes, cancer and HIV/AIDS. Community members were cognizant and generally pleased with the variety of health services. They spoke relatively highly of the Lee County Health Department, the Helping Hands Clinic, and the Central Carolina Hospital. However, they were quick to mention numerous barriers regarding accessing these services. The primary barriers were transportation, lack of bilingual services and cultural sensitivity, and lack of insurance coverage. Special mention was made of the need for increased services for the elderly, expecting mothers and their infants, and for people with substance addictions. With regard to youth, our findings suggest that many community members are concerned about older teens in the community. Many community members and providers expressed concern with the burgeoning high school in Lee. Additionally, drug and alcohol misuse and teenage pregnancy were identified as challenges to older teens. As far as assets were concerned, community members were proud of the programs and resources developed for younger youth, and expressed responsibility of attention to youth issues. In terms of recreation, the majority of the people interviewed felt that Lee County had good, organized youth sports opportunities, but lacked a variety of places to go for entertainment and exercise. Some identified barriers to recreation included lack of space available and a lack of free or inexpensive opportunities. The final component of the Lee County community diagnosis process was the Community Forum, which was held on March 4, 2000 at the Lee County Senior High School cafeteria (see Appendix E). The ultimate goal of the Forum was to share all of the findings from both the primary and secondary data with the community. It was our hope that the community members who came would then prioritize the issues most important to them and create solutions and mobilize around them. Although our turnout was lower than expected, there was vibrant discussion around the issues of health and growth, as well as additional themes born out of the discussion. The issues discussed were recreation, substance abuse, environmental issues, representative government, accurate count for the 2000 U.S. Census, and racial/ethnic barriers. It is our hope that the issues discussed at the Forum and the information presented in this document will be a helpful tool for community development in Lee County. In our interviews and focus groups we heard perspectives on the many assets and challenges of Lee County. What follows is a brief overview of recommendations and potential ways to target some of the issues that emerged in our data. These suggestions by no means imply that these are the sole actions that the community could take to address the issues. It is important to point out that above all, we found many caring, concerned individuals in Lee County, which is what makes Lee County a strong community. One way people in Lee could begin to address some of the challenges they face is to have each existing group, organization, or task force create assets maps, which are ostensibly a list of all the strengths each offers [such as services]. An assets map of the individual strengths of each member of each group or organization could be created as well. All of the groups could combine their assets maps to form a collective map of all of the strengths in Lee County. This collective map could provide a very useful tool to assist the community in addressing issues. More general suggestions are as follows: include youth in planning and discussions of the future of Lee County, address the increasing diversity in a proactive and positive way, utilize the sense of community pride to address issues of growth, and tap the already existing community organizing capabilities to further create change. Ultimately, Lee County is perceived to be a great place to live. It is our hope that our community diagnosis served to further create dialogue about what is important to the people of Lee.Master of Public Healt