Student Perspectives of the Occupational Therapy Doctoral Experience in an Academic Setting

The purpose of this study was to gather student perspectives of the 16-week doctoral experiential component (DEC) of the entry-level doctor of occupational therapy educational curriculum from students who completed the DEC in an academic setting. A retrospective qualitative study of a focus group of five students who completed the DEC in an occupational therapy (OT) academic setting was conducted using semi-structured interview questions. Codes were grouped into themes and the findings were summarized. Four major themes emerged: 1) learning experiences; 2) purposeful ambiguity; 3) knowledge and skill development; and 4) newfound appreciation. Learning experiences included both the academic and other experiences during the DEC. Purposeful ambiguity encompassed opportunities the students had navigating experiences that do not have one solution. Knowledge and skill development included both the skills needed for the DEC and skills gained after the DEC. The final theme of newfound appreciation described how the DEC students expressed their new view of academia and their appreciation of having strong mentorship during this experience to help guide them into becoming a better academician. This study adds to the body of knowledge in OT education by providing a general framework of experiences that can be included in a doctoral experience in an academic setting and displays the benefits of the DEC as one method of preparing future OT educators

Paradox and the Consumption of Authenticity through Reality Television

We position reality television within the broader category of consumer practices of authenticity seeking in a postmodern cultural context. The study draws on relevant perspectives from consumer research, literary criticism, sociology, and anthropology to argue that viewers of reality television encounter three elements of paradox in the process of constructing authenticity. The negotiation of each paradox exceeds the process of coping with or resolving their inherent contradictions to encompass the creation of new values. We argue that consumers blend fantastic elements of programming with indexical elements connected to their lived experiences to create a form of self-referential hyperauthenticity

"We Care About the Internet; We Care About Everything" Understanding Social Media Content Moderators' Mental Models and Support Needs

Despite the growing prevalence of ML algorithms, NLP, algorithmically-driven content recommender systems and other computational mechanisms on social media platforms, some of their core and mission-critical gatekeeping functions are nonetheless deeply reliant on the persistence of humans-in-the-loop to both validate computational models in use, and to intervene when those models fail. Perhaps nowhere is this human interaction with/on behalf of computation more key than in social media content moderation, where human capacities for discretion, discernment and the holding of complex mental models of decision-trees and changing policy are called upon hundreds, if not thousands, of times per day. This paper presents the results of a qualitative, interview-based study of an in-house content moderation team (Trust & Safety, or T&S) at a mid-size, erstwhile niche social platform we call FanClique. Findings indicate that while the FanClique T&S team is treated well in terms of support from managers, respect and support from the wider company, and mental health services provided (particularly in comparison to other social media companies), the work of content moderation remains an extremely taxing form of labor that is not adequately compensated or supported

Regulation of adrenal corticosteroidogenesis: the role of microRNAs in the control of aldosterone synthase and 11β-hydroxylase expression

Hypertension is a major risk factor for all cardiovascular disease, which is the largest known cause of global mortality. Essential hypertension-that is hypertension of unknown cause-is thought to have genetic and environmental risk factors. The best studied genetic system is that concerning corticosteroid biosynthesis. In humans, the principal glucocorticoid is cortisol, the main function of which is the control of intermediary metabolism; the major mineralocorticoid is aldosterone, which affects electrolyte and acid-base homeostasis. These steroid hormones are produced in the adrenal cortex through a series of biosynthetic reactions and under the influence of multiple regulatory factors. The final step in cortisol and aldosterone production involves, respectively, the cytochrome p450 enzymes, 11β-hydroxylase and aldosterone synthase. These are encoded by the CYP11B1 and CYP11B2 genes which have a similar sequence and are highly polymorphic and lie, in tandem, on human chromosome 8. Regulation of CYP11B1 and CYP11B2 mRNA abundance and of aldosterone and cortisol production have been extensively investigated. These studies have identified that there are several polymorphisms located across the locus which are associated with an increased aldosterone to renin ratio (ARR; used as an indicator of aldosterone regulation), inefficient 11β-hydroxylation and essential hypertension. However, to date, no underlying mechanism for these associations has been established. Regulation of expression by transcription factors has been widely studied but, in this thesis, it is the role of a novel regulator, microRNA (miRNA) that is central. miRNAs are short, non-coding RNAs which negatively regulate mRNA abundance They are transcribed from endogenous loci, then undergo a series of enzymatic maturation reactions that result in the production of a single-stranded molecule of approximately 20 nucleotides. They function by associating with a group of proteins known as the RNA-induced silencing complex (RISC) and targeting the 3’ untranslated region (3’UTR) of specific target mRNAs which they bind with imperfect complementarity. There are approximately 1100 human miRNAs, which have been implicated in the regulation of a range of target mRNAs and in several pathologies including cancer and cardiovascular disease. The aim of this project was to investigate what role, if any, miRNAs have in the regulation of CYP11B1 and CYP11B2 expression and in corticosteroid production. The studies in Chapter 3 investigated miRNA regulation of corticosteroidogenesis in the adrenal cell line H295R. miRNA levels were universally reduced by targeting Dicer mRNA, a key component of the miRNA synthetic pathway, with short interfering RNA (siRNA). This study identified all of the CYP450 enzymes of the corticosteroidogenic pathway (CYP11A1, CYP17A1, CYP21A1, CYP11B1 and CYP11B2) as likely candidates for miR-mediated regulation based on mRNA and steroid analysis. The study also suggested that StAR, 3βHSDII and 11βHSDII are not modulated by miRNAs. To determine whether apparent miRNA regulation of CYP11B1 and CYP11B2 expression occurs by direct action at their 3’UTRs, reporter constructs were generated and tested. Under both basal and stimulated (AngII) conditions, these studies support a regulatory mechanism involving the 3’UTR of CYP11B1 and CYP11B2. This chapter therefore provides evidence for miRNA-mediated regulation of corticosteroidogenesis. In Chapter 4, putative miRNA target sites in the CYP11B1 and CYP11B2 3’UTR were identified using bioinformatic prediction algorithms and the miRNA expression profile of the normal human adrenal, as determined by microarray analysis. Based on miRNA target site prediction and analyses of the 3’UTR sequences (including such parameters as relative length, predicted sequence conservation and RNA secondary structure), in silico methods indicated the possibility that miRNAs can target CYP11B1 and CYP11B2 mRNA. Furthermore, the expression of 107 miRNAs in the normal adrenal gland was confirmed. Cross-referencing of microarray expression and bioinformatic data identified 16 adrenal miRNAs predicted to bind putative sites in CYP11B1 and 16 predicted to bind CYP11B2; 12 of these miRNAs were common to both genes. These formed the basis of the miRNA target validation studies in Chapter 5. Sixteen adrenal miRNAs identified by bioinformatic analysis were tested individually in vitro. This was achieved by measuring mRNA expression, steroid production and 3’UTR reporter construct activity following artificially induced increases or reductions in the levels of specific miRNAs. These studies identified some miRNAs as being false positive predictions, while certain others were validated. The miRNA that gave the most striking and consistent results, for targeting both CYP11B1 and CYP11B2, was miR-24, which significantly decreased mRNA levels and steroid production. Analysis of adrenal miRNAs predicted only to target the CYP11B2 3’UTR confirmed miR-125a-5p and miR-125b as novel regulators, although effects on steroid secretion remain to be assessed. The studies in this chapter are the first to report of miRNA-mediated regulation of CYP11B1 and CYP11B2 expression. Finally, in Chapter 6, the miRNA expression profiles of four aldosterone producing adenoma (APA) samples were generated and compared to those of normal adrenal gland. Analysis identified 67 miRNAs expressed within the APAs; 54 were also present in the normal tissue. The levels of several miRNAs, including miR-24 and miR-125a-5p, were shown to be differentially expressed between the tissue types. This chapter also describes polymorphisms within the 3’UTR of the CYP11B1 gene, generated from 26 normotensive patients. No novel SNPs were identified, but three are located in putative miRNA-binding sites. Previously, sequence analysis of the CYP11B2 3’UTR had been used to map miRNA binding sites, this identified two miRNA-binding sites which mapped to a known SNP. Taken together, the studies in this chapter provide a foundation for exploring altered miRNA function and/or expression within the adrenal gland. In summary, the results presented in this thesis support a role for miRNA mediated regulation of corticosteroidogenesis through actions on CYP11B1 and CYP11B2 expression. It demonstrates that miRNA are present in the adrenal gland, that miRNA-binding sites are present on the 3’UTR of relevant mRNAs, and that miRNAs are capable of post-transcriptional regulation that significantly alters mRNA abundance and steroid production. My findings describe a novel regulatory mechanism of corticosteroidogenesis. Whether this mechanism is altered in diseases such as essential hypertension remains to be elucidated. If so, miRNAs could, in the longer term, be used as targets for novel therapies or as biomarkers to classify more precisely specific pathologies

Information/Control – Control in the Age of Post-Truth: An Introduction

Guest editors Stacy E. Wood, James Lowry, and Andrew J Lau introduce the issue on Information/Control – Control in the Age of Post-Truth

Critical Feminism in the Archives

Through the use of feminist historiography this article examines some of the myriad ways in which feminist praxis has pushed against, challenged, enriched, dismantled, assimilated or otherwise affected archival theory and practice. We contend that archival theory and practice have yet to fully engage with a feminist praxis that is aimed at more than attaining better representation of women in archives. We begin this piece by tracing the ways in which archives became embedded in feminist social movements and can be understood as critical tools and modes of self-representation and self-historicization. In the second section, we consider the explicit presence of feminist theory in archival studies literature and contemporary practice, the key focal points and arguments that have challenged traditional understandings of archival work around gender. We then address, in the third section, the expansive figure of the archives in humanities and social science literature. This piece contributes significantly to thinking on the ways in which these conversations in the archival turn can, at their best, expose blind spots within the archival literature and provide us with theoretical tools to tackle what we take for granted. Finally, we offer ways in which we see critical and intersectional feminist theory can contribute to existing archival discourse and practice, critiquing concepts that have remained unquestioned such as community and organization. This piece exposes the transformational potential of feminism for archives and of archives for dismantling the heteronormative, capitalist and racist patriarchy

The First Stars: Mass Growth Under Protostellar Feedback

We perform three-dimensional cosmological simulations to examine the growth of metal-free, Population III (Pop III) stars under radiative feedback. We begin our simulation at z=100 and trace the evolution of gas and dark matter until the formation of the first minihalo. We then follow the collapse of the gas within the minihalo up to densities of n = 10^12 cm^-3, at which point we replace the high-density particles with a sink particle to represent the growing protostar. We model the effect of Lyman-Werner (LW) radiation emitted by the protostar, and employ a ray-tracing scheme to follow the growth of the surrounding H II region over the next 5000 yr. We find that a disk assembles around the first protostar, and that radiative feedback will not prevent further fragmentation of the disk to form multiple Pop III stars. Ionization of neutral hydrogen and photodissociation of H_2 by LW radiation leads to heating of the dense gas to several thousand Kelvin, and this warm region expands outward at the gas sound speed. Once the extent of this warm region becomes equivalent to the size of the disk, the disk mass declines while the accretion rate onto the protostars is reduced by an order of magnitude. This occurs when the largest sink has grown to ~ 20 M_sol while the second sink has grown to 7 M_sol, and we estimate the main sink will approach an asymptotic value of ~ 30 M_sol by the time it reaches the main sequence. Our simulation thus indicates that the most likely outcome is a massive Pop III binary. However, we simulate only one minihalo, and the statistical variation between minihaloes may be substantial. If Pop III stars were typically unable to grow to more than a few tens of solar masses, this would have important consequences for the occurence of pair-instability supernovae in the early Universe as well as the Pop III chemical signature in the oldest stars observable today.Comment: 21 pages, 11 figures, to appear in MNRA

A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence

BACKGROUND: Patient misunderstanding of prescription drug label instructions is a common cause of unintentional misuse of medication and adverse health outcomes. Those with limited literacy and English proficiency are at greater risk. OBJECTIVE: To test the effectiveness of a patient-centered drug label strategy, including a Universal Medication Schedule (UMS), to improve proper regimen use and adherence compared to a current standard. DESIGN: Two-arm, multi-site patient-randomized pragmatic trial. PARTICIPANTS: English- and Spanish-speaking patients from eight community health centers in northern Virginia who received prescriptions from a central-fill pharmacy and who were 1) ≥30 years of age, 2) diagnosed with type 2 diabetes and/or hypertension, and 3) taking ≥2 oral medications. INTERVENTION: A patient-centered label (PCL) strategy that incorporated evidence-based practices for format and content, including prioritized information, larger font size, and increased white space. Most notably, instructions were conveyed with the UMS, which uses standard intervals for expressing when to take medicine (morning, noon, evening, bedtime). MAIN MEASURES: Demonstrated proper use of a multi-drug regimen; medication adherence measured by self-report and pill count at 3 and 9 months. KEY RESULTS: A total of 845 patients participated in the study (85.6 % cooperation rate). Patients receiving the PCL demonstrated slightly better proper use of their drug regimens at first exposure (76.9 % vs. 70.1 %, p = 0.06) and at 9 months (85.9 % vs. 77.4 %, p = 0.03). The effect of the PCL was significant for English-speaking patients (OR 2.21, 95 % CI 1.13-4.31) but not for Spanish speakers (OR 1.19, 95 % CI 0.63-2.24). Overall, the intervention did not improve medication adherence. However, significant benefits from the PCL were found among patients with limited literacy (OR 5.08, 95 % CI 1.15-22.37) and for those with medications to be taken ≥2 times a day (OR 2.77, 95 % CI 1.17-6.53). CONCLUSIONS: A simple modification to pharmacy-generated labeling, with minimal investment required, can offer modest improvements to regimen use and adherence, mostly among patients with limited literacy and more complex regimens. Trial Registration (ClinicalTrials.gov): NCT00973180, NCT01200849