The Remembered Experience of Adoption: Factors Supporting Healthy Adjustment

This qualitative research study is designed to explore ideas, customs, and practices related to adoption from the perspective of adult adoptees. While many studies seek to explain the negative impact of adoption, minimal literature exists with regard to a phenomenological exploration of adoption practices that successfully promote healthy adjustment and a sense of resilience and well-being in adopted children. Existing research on adoption has largely been conducted quantitatively, which can fail to capture the personal, lived experience of a positive adoption experience that leads to healthy adjustment. Specifically, little is known about which factors of the adoption experience adoptees perceive as contributing to healthy adjustment and a sense of well-being. The proposed study located themes and patterns that became apparent through narrative inquiry concerning factors in the adoption experience that contributed to adjustment. Narrative research honors the knowledge held in stories that are retrieved from memory (Fry, 2002). By interviewing adults who were adopted as children, it is hoped that their personal stories can augment clinical conceptualizations of adoption and shed light on positive meaning-making experiences in the context of adoption. These conceptualizations will be of use to persons and professionals who work closely with those involved in adoption, including mental health professionals and paraprofessionals working closely with adoptees and their families. This information is of value for those involved in family dependency treatment courts, child welfare services, and other agencies who wish to promote positive experiences for children and families who become involved in the adoption process. The electronic version of the dissertation is accessible at the Ohiolink ETD center http://www.ohiolink.edu/etd

Depression And Health Among American Indian and Alaska Native Elders

There is evidence of an association between depression, chronic disease, health status, and functionality among the elderly population. Research examining these relationships among American Indian elders is limited. This paper used data from the Identifying Our Needs: A Survey of Elders II to examine the relationships between target health variables and depression in a national sample of 10,743 American Indian elders. The data suggests that depression is significantly related to self-rated health, overnight hospital stays, spiritual activities, vigorous exercise, activity limitations, chronic disease, and community service usage. Additionally, self-rated health, limitations, binge drinking, and chronic disease were predictive of which American Indian elders had depression

Inclusive Language Matters: Recommendations for Health Care Providers to Address Implicit Bias and Equitable Health Care

Problem Statement: Stigmatizing language—written and verbal—can fuel implicit bias among health care professionals, leading to unintentional negative effects in how they care for patients. To provide equitable care, health care professionals and systems must become aware of the language they use and learn to replace biased language with inclusive language. Background: The medical field strives to treat all patients equally, yet disparities in health care persist. These disparities are due, in part, to implicit bias that affects how health care professionals and systems care for patients. Although reports recommend developing education programs that address implicit bias, these programs fail to address an important contributor: stigmatizing language used among health care professionals. With guidance, health care professionals and institutions can recognize and replace their biased language to foster more inclusive communication that promotes equitable health care. Application: The AMA Manual of Style outlines standardized inclusive language that health care professionals can use to address bias in their writing, as well as in their clinical practice, teaching, and research. The guide recommends using person-first language, avoiding generalizations and labeling, describing specific details, and being sensitive to the preferences of individuals or groups. The guide also provides detailed recommendations for using inclusive language regarding race/ethnicity, physical or mental condition, sex or gender, sexual orientation, age, and socioeconomic status. With these guidelines, health care providers can replace stigmatizing language to reduce implicit bias and comprehensively address disparities in health care

The Relationship Between Stressors and Intent to Leave Nursing Homes Among Directors of Nursing

According to the Centers for Medicare and Medicaid Services, some nursing homes have been ranked worst in the nation when rating the quality of resident care. The purpose of this study was to determine the relative strength of workplace stress, job satisfaction, organizational support, and personal data (number of years employed, age, highest education level) in predicting director of nursing (DON) intentions to leave the position. This information contributes to social change because it is important to know that DONs need to experience general satisfaction in order to maintain stable leadership that positively contributes to the quality of care in Tennessee nursing homes and ensures that the factors decreasing the stability in the DON position in nursing homes can be addressed

Philosophies of adult education as practiced by agricultural education teachers in Pennsylvania, West Virginia, and Virginia

The purpose of this study was to increase understanding of adult education philosophies as practiced by Pennsylvania, West Virginia, and Virginia secondary school agriculture teachers.;A Philosophy of Adult Education Inventory (PAEI) and researcher-created demographic sheet was sent to a sample of agriculture teachers in the tri-state area (n = 314). Descriptive data were analyzed using the Statistical Package for Social Sciences for Windows (SPSS). Frequencies, means, and correlational and multivariate analyses were used to describe and analyze the research results.;It was shown that there is a slight relationship between adult education preparation and the five philosophies. The Humanist philosophy is statistically significant when comparing the states of Pennsylvania and West Virginia. Educator\u27s payment for teaching adult classes is significant when compared to the Progressive orientation. The Liberal and Behaviorist philosophies were shown to have a very strong association as do the Progressive and Behaviorist philosophies

Metabolism of Arachidonate-containing Phospholipid Molecular Species in the Murine Macrophage-like Cell Line, P388d1

Glycerophospholipids of mammalian cells exist as chemically diverse structures with various fatty acids at the sn-1 and sn-2 positions. Arachidonic acid, a polyunsaturated fatty acid, which may be converted to biologically active eicosanoids such as prostaglandins, thromboxanes, and leukotrienes, is found predominantly in the sn-2 position of glycerophospholipids. The purpose of this study was to examine, at the level of the individual molecular species, the incorporation of arachidonate into phospholipids and its release from phospholipids during stimulation. In this way, the specificity of the enzymes controlling arachidonate metabolism could be examined in order to clarify the processes that control the metabolism of this precursor of potent biological mediators. An investigation of the deacylation-reacylation mechanisms for the incorporation of arachidonic acid into the cellular phospholipids revealed that both the CoA-independent transacylation and CoA-dependent acylation mechanisms are active in the P388D1 macrophages. The CoA-independent transacylase preferentially acylated the alkyllysoglycero-phosphatidylcholine substrate with the polyunsaturates, arachidonate, and docosahexaenoate. The CoA-dependent pathways exhibited less selectively and acylated the alkyl-substrate with more saturated fatty acids. Supplementation of the P388D1 macrophages with the n-3 marine oil fatty acids, eicosapentaenoate and docosahexaenoate resulted in the enrichment of the cellular phospholipids with these polyunsaturates at the expense of arachidonate-containing molecular species. Using methodology, which permits the measure of both mass and specific radioactivity changes in the molecular species of phospholipids, it was determined that the arachidonate-containing species are preferentially degraded during stimulation with the calcium ionophore, A23187. Stimulation with calcium ionophore results in the activation of a calcium dependent phospholipase specific for the arachidonate-containing species. Together, these results demonstrate that the incorporation and release of arachidonic acid is regulated by enzymes that bear distinct substrate specificities. The specificities of these enzymes can be directly related to the trafficking of arachidonate and its various esterified forms in cell phospholipids

Service Standards in Higher Education: Lasswell\u27s Communication Model as a Training Tool

This paper examines a service standards training process established during the 2016/2017 academic year for Prairie State College (PSC), a two-year community college located in Chicago Heights Illinois. The goal of examining and revising the service training process was to enhance the quality of service after the college received poor service reviews from a recent satisfaction survey. Lasswell\u27s Communication Model was used to create content and structure for a training manual and workshop as part of the overall service training process at PSC. The service standards and training manual was successfully developed and is currently being tailored to accommodate the needs of the college. PSC plans to facilitate its first customer service training session in summer 2017 and a second session in the fall

Structural and Functional Consequences of HIV-1 Viral Protein Tat and Morphine Co-Exposure at the Blood-Brain Barrier

According to UNAIDS 2016, over 37 million people worldwide were infected with human immunodeficiency virus (HIV) in 2016, with over 1.2 million people living with HIV in the United States. Of those, approximately one half will suffer from HIV-associated neurocognitive disorders (HAND), which is a spectrum of neurocognitive disorders ranging from asymptomatic neurocognitive impairment, to mild neurocognitive disorder, to HIV-associated dementia. While combination antiretroviral therapy (cART) has decreased the incidence of the most severe forms of HAND in patients with HIV, milder forms of HAND still persist. These defects can include decreased motor skills, cognitive abilities, memory, and attention. While patients with HIV are living longer thanks to cART, there are few to no long-term options for managing the neurocognitive defects caused by the chronic disease of HAND. Additionally, opiate abuse can increase both the incidence and severity of HAND. HAND may result due to poor antiretroviral drug (ARV) penetration across the blood-brain barrier (BBB). Thus, a better understanding of the effects of HIV and opiates on the BBB may result in improved therapies for HAND. The Tat transgenic model was used to evaluate the effects of the HIV-1 viral protein Tat and morphine on blood-brain barrier leakiness using varied-sized paracellular compounds. Secondly, antiretroviral drug accumulation in the brain of Tat transgenic mice under Tat and/or morphine co-exposure was measured. Specifically, the single tablet regimen of Triumeq® (abacavir/lamivudine/dolutegravir) was studied in these mice and antiretroviral drug measured in both striatum and hippocampus brain regions and plasma via LC-MS/MS. Additionally, morphine and its metabolites were also measured via LC-MS/MS. Lastly, macrophage turnover within the caudate/putamen and phagocytic macrophage/microglia accumulation in the brain was measured in Tat transgenic mice under Tat and/or morphine conditions. Perivascular and parenchymal spaces were distinguished within the caudate/putamen, while overall phagocytic activity was measured in all other brain regions, including the nucleus accumbens, anterior cingulate cortex, primary motor cortex, somatosensory cortex, agranular insular cortex, and piriform cortex

Magnetic Flux Sensor for Hearing and Application

A 3-D microelectronic inductor has been fabricated and characterized for use as a magnetic flux sensor, also known as a telecoil, for a hearing aid application. This telecoil was fabricated in a 0.5pm CMOS process with three metal layers. The 3-D structure is more space efficient than conventional spiral inductors and allows for an optimal number of turns for the space available. The telecoil has an inductance of 80pH, a resistance of 34kR, and a capacitance of 275pF. The integrated telecoil acts as a magnetic flux sensor by picking up the magnetic signal fiom the phone speaker. The integrated telecoil is smaller than commercially available telecoils, which may allow telecoils to be available in all types of hearing aids. The electrical response of the telecoil to a changing magnetic field is linear with respect to the input amplitude. Neglecting the noise associated with lower frequencies, it is shown that the telecoil response is not dependent on frequency, which agrees with theory. The magnitude of the telecoil signal is of the form of A + 5 where r is the distance between the speaker and telecoil, which differs from the theory. The increase in response due to the addition of a permeable core is much lower than expected. When the telecoil is combined with a high-gain low-noise amplifier, it can easily be integrated with existing microelectronic hearing aid designs. Therefore the Cherry Hooper amplifier and a single-ended amplifier were investigated. A single stage Cherry Hooper amplifier design was simulated at a gain of 29 dB, THD of -SO&, and equivalent input noise of 2.01%. A three stage Cherry Hooper design (identical stages) with a filter has a simulated gain of 84 dB, THD of -49dB, and equivalent input noise of 2.01%. The three stage amplifier also has a bandwidth of 3kHz and a driving capacity of 30pF external load capacitance. The complete single-ended amplifier design was simulated at a gain of 67dI3, THD of -48dB, equivalent input noise of 45.3%, and driving capacity of I n . external load capacitance. More research is needed to obtain conclusive experimental parameters of the amplifiers