A Call for the Study of Irish Rhetoric

This thesis examines the existing scholarship in Irish rhetoric and the narrative that has been built thus far. Current knowledge of Irish rhetoric examines minute periods in the literature and communication rather than a coherent overview of its rhetorical development. This thesis identifies and analyzes three periods of rhetorical significance using the stipulative characterization of Irish rhetoric being narrative based relying on recursive elements from Irish history. It then posits a new perspective and language to typify Irish rhetoric using the metaphor of a Celtic braid. Through the composition of a braid, I classify three strands of rhetoric and trace them through the identified rhetorical periods to demonstrate the continuous nature of Irish rhetoric. Furthermore, I propose research questions for other scholars to use as entry points into the conversation. These questions also propose strategies for teaching the Irish rhetorical braid in classrooms

Factors Associated with Influenza & Tdap Vaccine Uptake in Pregnant Patients at the UT Family Medicine Clinic in Memphis

INTRODUCTION: Given the increased risk for infections among pregnant patients and newborns, vaccination against influenza (\u3e50,000,000 annual US cases affecting all ages) and pertussis (\u3e15,000 annual US cases disproportionately affecting newborns) are recommended among pregnant patients in order to protect them and their babies via passive immunity to cover a newborn’s window of vaccine ineligibility. Though flu and Tdap vaccination rates among pregnant patients have been trending upwards nationally, there is still room for improvement to achieve optimal rates. OBJECTIVES: The primary objectives were to study factors that affect the vaccination rates at the University of Tennessee Family Medicine Clinic at Memphis (UTFMC-M), compare those rates with national pregnancy flu/Tdap vaccination rates, and to generate recommendations based off observed factors associated with vaccine uptake to improve flu/Tdap vaccination rates in UTFMC-M pregnant patients. METHODS: This was a retrospective chart review of UTFMC-M patients who were pregnant from September 1, 2019-April 24, 2020 (included 2019-2020 flu season) (n=465). Variables studied included demographic data (race, age, insurance), immunization history (vaccine status, history of physician encouragement), and prenatal history (parity, number of prenatal visits, trimester at first visit, high risk clinic (HRC) admittance status). Vaccination status was based on ACIP recommendations (Flu shot eligible = any gestational age; Tdap eligible = ≥27 weeks). Positive HRC admittance was noted for patients with ≥2 visits to the UTFMC-M HRC, a clinic that specializes in high risk pregnant patient care. RESULTS: The patient sample was predominantly black (84.3%) and insured by Medicaid programs (88%). Among eligible UTFMC-M pregnant patients, 50.1% were flu-vaccinated (n=465); 73.8% were Tdap-vaccinated (n=317); and 52.1% were Flu+Tdap-vaccinated (n=317). No significant associations were found between vaccine uptake and HRC status, parity, and age. However, statistically significant relationships were found between vaccine uptake and physician encouragement (positive relationship with flu shot: X2(1, N = 465) =131, p \u3c 0.001, Tdap: X2 (6, N = 465) =476, p \u3c 0.001), number of prenatal visits (flu shot group median 8 visits, Tdap group median 9 visits vs. unvaccinated group median 4 visits; p \u3c 0.001), and early trimester age at first prenatal visit (X2(6, N = 465) =47.635 , p CONCLUSION: 2019-2020 UTFMC-M vaccination rates were on par with 2018-2019 US flu vaccine rates and higher than 2018-2019 US Tdap and Flu+Tdap rates. There were statistically significant relationships between vaccine uptake at UTFMC-M and physician encouragement, number of prenatal visits, and early trimester age at first prenatal visit but no significant relationships with UTFMC-M HRC admittance, parity, or age. Recommendations following from our observations to address further vaccine rate improvement include: continue vaccine encouragement, continue booking multiple visits (8 for flu, 9 for Tdap), prioritize Tdap vaccine higher for late trimester intake patients, and focus on flu vaccine encouragement and education

Comparing Fixed-amount and Progressive-amount DRO Schedules for Tic Suppression in Youth with Chronic Tic Disorders

Chronic tic disorders (CTDs) involve motor and/or vocal tics that often cause substantial distress and impairment. Differential reinforcement of other behavior (DRO) schedules of reinforcement produce robust, but incomplete, reductions in tic frequency in youth with CTDs; however, a more robust reduction may be needed to affect durable clinical change. Standard, fixed‐amount DRO schedules have not commonly yielded such reductions, so we evaluated a novel, progressive‐amount DRO schedule, based on its ability to facilitate sustained abstinence from functionally similar behaviors. Five youth with CTDs were exposed to periods of baseline, fixed‐amount DRO (DRO‐F), and progressive‐amount DRO (DRO‐P). Both DRO schedules produced decreases in tic rate and increases in intertic interval duration, but no systematic differences were seen between the two schedules on any dimension of tic occurrence. The DRO‐F schedule was generally preferred to the DRO‐P schedule. Possible procedural improvements and other future directions are discussed

Depression, Relationship Quality, and Couples’ Demand/Withdraw and Demand/Submit Sequential Interactions

This study investigated the associations among depression, relationship quality, and demand/withdraw and demand/submit behavior in couples’ conflict interactions. Two 10-min conflict interactions were coded for each couple (N = 97) using Structural Analysis of Social Behavior (SASB; Benjamin, 1979a, 1987, 2000a). Depression was assessed categorically (via the presence of depressive disorders) and dimensionally (via symptom reports). Results revealed that relationship quality was negatively associated with demanding behavior, as well as receiving submissive or withdrawing behavior from one’s partner. Relationship quality was positively associated with withdrawal. Demanding behavior was positively associated with women’s depression symptoms but negatively associated with men’s depression symptoms. Sequential analysis revealed couples’ behavior was highly stable across time. Initiation of demand/withdraw and demand/submit sequences were negatively associated with partners’ relationship adjustment. Female demand/male withdraw was positively associated with men’s depression diagnosis. Results underscore the importance of sequential analysis when investigating associations among depression, relationship quality, and couples’ interpersonal behavior

Finding qualitative research: an evaluation of search strategies

BACKGROUND: Qualitative research makes an important contribution to our understanding of health and healthcare. However, qualitative evidence can be difficult to search for and identify, and the effectiveness of different types of search strategies is unknown. METHODS: Three search strategies for qualitative research in the example area of support for breast-feeding were evaluated using six electronic bibliographic databases. The strategies were based on using thesaurus terms, free-text terms and broad-based terms. These strategies were combined with recognised search terms for support for breast-feeding previously used in a Cochrane review. For each strategy, we evaluated the recall (potentially relevant records found) and precision (actually relevant records found). RESULTS: A total yield of 7420 potentially relevant records was retrieved by the three strategies combined. Of these, 262 were judged relevant. Using one strategy alone would miss relevant records. The broad-based strategy had the highest recall and the thesaurus strategy the highest precision. Precision was generally poor: 96% of records initially identified as potentially relevant were deemed irrelevant. Searching for qualitative research involves trade-offs between recall and precision. CONCLUSIONS: These findings confirm that strategies that attempt to maximise the number of potentially relevant records found are likely to result in a large number of false positives. The findings also suggest that a range of search terms is required to optimise searching for qualitative evidence. This underlines the problems of current methods for indexing qualitative research in bibliographic databases and indicates where improvements need to be made

The influence of maternal diet during lactation on milk fatty acid profile and offspring’s adipose tissue thermogenic capacity

Over the last two decades, obesity has become a major public health concern. Evidence suggests that obesity can be programmed by nutrition in early life. A way to treat/prevent obesity would be a major breakthrough for public health and brown adipose tissue (BAT) has been identified as a potential target for this, due to its propensity to utilise stored energy to produce heat, a process mediated by the uncoupling protein (UCP) 1 gene. In humans and sheep, UCP1 decreases with age. Diet during lactation and subsequent alterations in milk fatty acid profile have not been studied in relation to effects on offspring BAT function. There is evidence from in vitro and rodent studies to suggest the potential for some fatty acids, such as conjugated linoleic acid (CLA), to increase UCP1 expression. The aim of this thesis is to use sheep as a model to investigate the potential to alter the milk fatty acid profile by supplementing ewes’ diet with canola or sunflower oil, as previous research has found these to be effective in increasing milk CLA. I then investigated the effects on offspring in early life, with a particular focus on their BAT and its UCP1 abundance. The perirenal adipose depot was studied due to it being the largest depot in young sheep, which is known to transition from brown to white adipose tissue in the first month of life. In addition to this, I set out to investigate the CLA concentrations of infant formula milk and how they compare to those reported for human breast milk. From the day of delivery, ewes raising two lambs each were supplemented with 3% canola or sunflower oil or fed a control diet. Milk samples and ewe and lamb weights were taken at 7 and 28 days and offspring were tissue and blood sampled at either 7 or 28 days. The mRNA expression several of genes associated with thermogenesis was measured. Results showed that supplementation of ewe’s diet with canola, and to a lesser extent, sunflower oil, resulted in decreases in milk medium-chain saturated fatty acids (SFAs). Both supplements increased milk monounsaturated fatty acids (MUFAs) by ~50%, and total and cis-9, trans-11 CLA by ~80%. In addition, sunflower supplementation increased omega-6 PUFAs by 25% and the trans-10, cis-12 CLA isomer by 177% at 28 days of lactation compared to controls. Female lambs fed by sunflower oil supplemented ewes showed a 50% increase in adipose tissue weights compared with controls. Male and, to a lesser extent, female lambs fed by canola oil supplemented ewes showed increased UCP1 abundance at 28 days of age compared with controls. There was an increase in mRNA expression of other thermogenic genes in the canola females at 7 but not 28 days, however, not in males, so this unlikely to be the main cause of the increases seen in UCP1. Results from my investigation into infant formula showed that CLA was present in 67% of the infant formula milks tested but at lower concentrations to those reported in human breast milk. In conclusion, it is possible to induce changes in ewes’ milk fatty acid profile with dietary supplementation and I have shown that the fatty acid profile of milk received in early life has the potential to affect adipose tissue development and UCP1 gene expression. If in the prevention of the normal decline in UCP1 were to be maintained into adulthood it could improve long-term health by helping to maintain body weight. Further research is now necessary to establish whether this increase in UCP1 is maintained beyond the sampling time points of my investigation