Gaining perspective: incidents that damage the therapeutic alliance as described by male mental health clients

This study investigated what incidents male clients found to be most detrimental to the formation or strengthening of the alliance with their mental health care providers, using an abbreviated version of the qualitative critical incident technique (a written form focusing on hindering incidents). Participants were 86 adult (M = 36.87 years old) male outpatients. Most (90.7%) were receiving individual counseling or psychotherapy at the time of the study. A total of 76 critical incident statements were extracted. After redundant statements were eliminated, 56 statements remained. The statements were sorted into categories by three participants and two researchers, according to what each sorter understood as the commonalities between the incidents in relation to what male clients saw as hindering or weakening the alliance. The consensus structure, based on the individual sort structures, contains 12 categories: Not the Right Fit, Unexpected Actions/Personality of Counselor/Psychotherapist, Communication Problems, Unprofessional, Client Needs to Build Trust, No Choice, Unsure of Therapist/Therapy, Client Not Putting in Work, Counselor/Psychotherapist Didn\u27t Work Hard Enough on Client\u27s Issues, Acting on Assumptions About Client, Pushy Counselor/Psychotherapist, and Time Problems. These categories can serve researchers in developing measures to better represent the male client\u27s perspective on the alliance and can aid practitioners in providing gender-sensitive care by helping them become alert to the ways in which strains in the alliance may manifest with male clients

A Crack in the Glass Ceiling: How TRIO Programs in Maine are Narrowing the Gender Gap

Although women have increased their presence within the workforce, higher education, and politics, they are still underrepresented in top leadership positions. Men outnumber women in the Senate, House of Representatives, Congress, and at the CEO level. Even in the nonprofit sector where women have historically outnumbered men, the top leadership positions are primarily held by men. However, there is a predominance of women directors in Maine’s TRIO programs. TRIO programs are federally funded non-profit organizations designed to encourage access to higher education for economically disadvantaged and first-generation students (Council for Opportunity in Education, n.d.). There are 23 TRIO programs in Maine and 20 of those are led by women. Existing research has been focused on the barriers women face such as male-dominated leadership, second-generation gender bias, gender stereotypes, lack of support, and cultural or structural norms. Little has been explored regarding how to support and empower women to practice leadership. In this qualitative study, a phenomenological approach is used in interviewing current women directors of Maine TRIO programs to gain insight into their experiences and understand how they have been supported and empowered to practice leadership. Findings reveal that these directors do face barriers, however, they have found and created sources of support and empowerment for themselves. The directors benefit greatly from relationships with other directors in the field providing support and guidance for each other. Having a positive relationship with a female leader as a mentor or role model was also a source of empowerment. Traits described stem from servant to transformational leadership styles

Student Integration into STEM Careers and Culture: A Longitudinal Examination of Summer Faculty Mentors and Project Ownership

It is widely recognized that the United States needs to attract and retain more people in science, technology, engineering, and mathematics (STEM) careers. Intensive undergraduate research experiences (UREs) are one of the few strategies shown to improve longitudinal student interest and persistence in STEM-related career pathways; however, less is known about the underlying process linking activities to positive outcomes. The tripartite integration model of social influences (TIMSI) provides a framework for understanding the social influence processes by which students integrate into STEM careers and culture. The current study used a longitudinal design and latent growth curve modeling to examine and predict the development of scientific research career persistence intentions over the course of an intensive summer URE. The latent growth curve analysis showed that student persistence intentions declined and rebounded over the course of the summer. Furthermore, the positive impact of faculty mentor role modeling on growth trajectories was mediated through internalization of science community values. In addition, project ownership was found to buffer students from the typical trend of declining and rebounding persistence intentions. The TIMSI framework illuminates the contextual features and underlying psychological processes that link UREs to student integration into STEM careers and culture

Valence-Band Electronic Structure of MoS2 and Cs/MoS2(0002) Studied by Angle-Resolved X-ray Photoemission Spectroscopy

The angle dependence of the valence-band photoemission from the trigonal prismatic layered MoS2shows both the forward-scattering features normally observed in core-level photoelectron diffraction and, in addition, the initial-state orbital character associated with partially occupied, nonbonding MoIV(4dz2+4dx2−y2 +4dxy) orbitals near the top of the valence band. The difference in forward scattering between the Mo and S emitters is also used to assess relative contributions from the Mo and S atomic orbitals at specific binding energies within the valence band. Deposition of cesium (0.23 ML Cs with 1 ML equal to the Cs saturation coverage) onto the basal plane of MoS2 introduces a density of states at 1.25 eV above the top of the valence-band maximum. The intensity anisotropy for this Cs-induced valence level is interpreted via the angle dependence of the electric dipole matrix element as due to the initial-state orbital character at the bottom of the conduction band of the Cs/MoS2 heterostructure

Pills, Public Nuisance, and Parens Patriae: Questioning the Propriety of the Posture of the Opioid Litigation

The opioid crisis has been in litigation for almost twenty years on various fronts, including criminal prosecutions of pharmaceutical executives, civil lawsuits by individuals against drug manufacturers and physicians, class actions by those affected by opioid abuse, and criminal actions filed by the Drug Enforcement Administration (“DEA”). In the early 2000s, opioid litigation began with individual plaintiffs filing suit against manufacturers and others for damages allegedly related to opioid use. The litigation has since expanded significantly in terms of the type of plaintiffs and defendants, the nature of the claims being asserted, and the damages attributable to the crisis. The most current and active litigation is that which is pursued by state attorneys general in both federal and state courts to recover monies expended in their respective jurisdictions in response to the opioid epidemic. Additionally, and to a greater extent, individual municipalities, including cities and counties and even tribes like the Cherokee Nation, have filed similar independent actions against drug manufacturers, distributors, and pharmacies. In 2018, more than 400 of the cases filed in courts throughout the United States by individual states, local governments, individuals, and other nongovernmental entities against drug manufacturers, distributors, and pharmacies were consolidated and transferred for pre-trial coordination to the Northern District of Ohio by the Judicial Panel on Multidistrict Litigation under the multi-district litigation (“MDL”) process set forth in 28 U.S.C. § 1407. Since that time, an additional 1500 parties have been added to this consolidated litigation, and there are approximately 330 opioid-related cases pending in various state courts, including fifty-five lawsuits filed by state attorneys general. In fact, in April 2019, plaintiffs’ expert witnesses provided reports that estimated it will cost more than $480 billion to “fix” the crisis. One clear conclusion that can be drawn from even a cursory review of the nature of the litigation that has arisen over the last twenty years is that nearly every facet of the community, from individuals and families to government entities and corporations, has been affected by the opioid crisis. Another point that cannot be denied is that the prescription drug industry, including manufacturers, distributors, and pharmacies, played a significantly culpable role in allowing the crisis to develop into its current magnitude. However, what is also clear is that many, many others played supporting roles in this regard, including, but not limited to, individuals, friends; families; governments, both federal and state; licensing boards; and physicians

Archaeological Approaches for Understanding the Marquesan Stone Pounder ke’a tuki popoi

Stone pounders known as ke’a tuki popoi, ke’a tu’i kioe, or k’ea tuki kóna, were and are still used on certain Polynesian Islands to mash food, usually fruit, especially breadfruit, to make a paste known as poi, and some were used to produce medicine and pigments. They were the second most frequently collected stone objects in Polynesia after adzes in the colonial period and are numerous in global museum collections. Yet, pounders have not received as much archaeological attention. Stone pounders provide a way of studying the colonial period and the impacts of colonialism on the production and circulation of traditional Polynesian objects by comparing them with adzes from earlier and more recent (pre-Contact to early colonial) periods. This study combines an object itineraries and portable X-ray fluorescence (pXRF) geochemical study to an assemblage of Marquesan pounders in museum collections to (1) identify stylistic change through time, (2) identify volcanic rock type and match geological sources used to make these artifacts, and (3) consider the impacts of Western colonialism on Marquesan cultural practices. The results of these analyses identified that the distinct Tiki-headed ke’a tuki popoi were produced from a localized region in the Marquesas and that pounders were not produced from the same basalt quarries as adzes. The patterns of stone pounder production and distribution identified in this geochemical study contrast somewhat with the historical accounts from the 19th and 20th centuries and therefore provide a new perspective into Marquesan stone carving practices just prior to and during the early Western colonial period

Laser speckle contrast imaging for intraoperative monitoring of cerebral blood flow

Ensuring adequate blood flow during surgical procedures is crucial, as prolonged ischemia can result in tissue death and lead to poor clinical outcomes. This is especially important during neurosurgery, since the brain relies on a constant supply of cerebral blood flow (CBF) to maintain normal function. Intraoperative blood flow monitoring tools are essential to detect ischemia in a timely manner, and allow surgical correction before the onset of irreversible brain injury. Laser speckle contrast imaging (LSCI) is an optical imaging method that provides blood flow maps with high spatiotemporal resolution, and overcomes many of the limitations of current intraoperative monitoring technologies. The objective of this dissertation is to demonstrate that LSCI is an effective tool for blood flow monitoring during neurosurgery, and to optimize and improve LSCI technology for clinical use. This research has two primary elements: assessing the LSCI instrumentation components in a controlled laboratory setting, and evaluating the clinical performance of LSCI during neurosurgery. The laboratory study aims to determine the optimal specifications for the clinical instrument design, using controlled static and microfluidic flow experiments. Two of the main components of the LSCI instrument are the camera used for recording, and the laser used for coherent illumination of the tissue. Thus, a broad camera and laser comparison was performed spanning a wide array of available hardware options to determine which specifications are the most important for reliable and highly sensitive flow measurements. The two-phase clinical study aims to demonstrate the performance and utility of LSCI in a neurosurgical setting as a potential tool for real-time, continuous, and noninvasive image guidance. These studies demonstrate that LSCI can produce blood flow maps consistent with expected physiological trends, and show the impact of instrument design and image acquisition techniques on image quality and quantitative flow assessment. The results from both the laboratory and clinical studies can be used to design a more sensitive and robust LSCI system, which increases its value as an intraoperative tool for monitoring blood flow. LSCI has the potential to be the next generation of neurosurgical image guidance for blood flow visualization, and the work presented in this dissertation can accelerate its clinical adoption.Biomedical Engineerin

12 Angry Men v. The Agency: Why Preemption Should Resolve this Conflict in Drug Labeling Litigation

The Supreme Court has found in favor of preemption in tort liability cases involving matters of heavy federal regulation in which Congress has delegated implementation of a statute involving technical subject matter to the agency. It has not been the case, however, in matters concerning the labeling of prescription drugs, despite the fact that the FDA has exclusively regulated drug labeling for more than a century. In fact, the current state of affairs now allows a jury to substitute the judgment of the FDA in approving a label on a name-brand drug for their own in state law failure to warn claims, allowing for preemption on the same question when a generic drug manufacturer is involved, and a proposed rule by the FDA set to be released in April of 2017 could remove the protection of preemption for generic manufacturers, in contravention of the purpose and goals of the Hatch-Waxman Amendments to the FDCA. To support the delegation of power given to FDA to regulate drug labeling, prevent juries from second-guessing the propriety of an FDA-approved drug label, and encourage generic manufacturers to remain in the market and provide consumers access to drugs at a lower cost, Congress should provide for express preemption to both name-brand and generic manufacturers in failure to warn cases