Genetic elements and molecular mechanisms driving the evolution of the pathogenic marine bacterium Vibrio parahaemolyticus

Vibrio parahaemolyticus is an opportunistic human pathogen that occurs naturally in a non-pathogenic form in coastal estuarine and marine environments worldwide. Following the acquisition of virulence-associated genes, V. parahaemolyticus has emerged as a significant pathogen causing seafood-borne illnesses. The mechanisms and conditions that promote the emergence of disease causing V. parahaemolyticus strains are not well understood. In addition, V. parahaemolyticus clinical strains isolated from disease-associated samples and environmental strains from sediment, water, and marine organisms have been identified with considerable diversity; however, the evolutionary relationships of disease-causing strains and environmental strains are not known. In the following research, the evolutionary relationships of V. parahaemolyticus clinical and environmental strains are examined. In addition, the contribution of genetic elements and molecular mechanisms such as deficiency of DNA repair to the evolution of V. parahaemolyticus clinical and environmental strains is shown. Molecular analysis of the evolutionary relationships of V. parahaemolyticus clinical and environmental strains demonstrated separate lineages of pathogenic and non-pathogenic strains with the exception of several environmental strains that may represent a reservoir of disease-causing strains in the environment. Sequence characterization of plasmids isolated from diverse environmental Vibrios indicated a role of plasmids in strain evolution by horizontal transfer of housekeeping genes. In addition, analysis of plasmids from V. parahaemolyticus clinical and environmental strains indicated the existence of a plasmid family distributed among V. parahaemolyticus, V. campbellii, and V. harveyi environmental strains. Sequence characterization of a plasmid of this family from a V. parahaemolyticus environmental strain indicated the contribution of these plasmids to the emergence of the clonal pandemic strains. Investigation of the role of molecular mechanisms to the evolution of V. parahaemolyticus strains showed that inactivation of the DNA repair pathway methyl-directed mismatch repair (MMR) increased the accumulation of spontaneous mutations leading to increased nucleotide diversity in select genes. The research findings in the following chapters demonstrate a considerable contribution of genetic elements and molecular mechanisms to the evolution of genetic and phenotypic diversity.Ph.D.Committee Chair: Patricia Sobecky; Committee Member: Eric Stabb; Committee Member: Jim Spain; Committee Member: Roger Wartell; Committee Member: Thomas DiChristin

Evidencing atmospheres and narratives: measuring the immeasurable?

Most academic researchers conscious of metrics for the assessment of quality of research such as the Research Excellence Framework (REF) in the UK, will be seeking impact for their work. The evaluation of academic research now extends to relevance and impact beyond the academy (Gunn and Mintrom, 2017). Some may consider evidencing the impact of research into atmospheres and narratives somewhat challenging, particularly for those who adopt a creative, interpretive approach. Thus, if we are to evidence this in our practice and to a wider audience, we should consider whether or not it is measurable, how we would want it to be used and who may read or act upon it. The political systems in the UK, as in many other European countries, are situated in a positivist theoretical framework and capitalist paradigm built on accountability, performativity and measurability, and where scale is objectified. Policy and decision making for funding throughout Europe usually is based on evaluative evidence (E) that places the apparent fluidity and openness of research into atmospheres and narratives at an epistemological margin. Emphasis is placed on an outcome driven educational system (Prince and Exeter, 2016)

How Targeted Are Federal Expenditures on Children? A Kids' Share Analysis of Expenditures by Income in 2009

Analyzes the distribution of government spending on children by family income; category, such as health, social services, and education; and program, such as Medicaid; and the extent to which it is targeted to low-income children. Considers implications

What nursing knowledge is needed to develop nursing practice?

Years ago, a nurse I admired was kidding me about graduate school. What was a nursing diagnosis (ND), and why did we need them? Wasn’t it enough to know that the infant had respiratory distress syndrome? Why add in this other layer of nonsense? Why spend my time thinking about theory and other ridiculous things that had no context in clinical practice? I hear similar comments from nurses today. What, then, is the knowledge of nursing practice? Nurses generally do not question the need for medicine to research disease and its treatment – yet many cite as irrelevant research done on human responses and treatment of those responses to achieve nurse-sensitive outcomes. When we neglect to teach, read or implement critical research on nursing knowledge and how it impacts patients – it becomes an afterthought, information that is “nice to know if you have time”. Is this what nursing is – a nice to have but not necessary field of practice? Why do nursing students and nurses in practice often feel they must implement physician orders and then, if they have time, “do some nursing”? I believe that this clinical reality occurs primarily because we do not, as a collective whole, really educate nurses, our peers or our patients about the discipline of nursing. Nursing curricula heavily emphasize pathophysiology and pharmacology – is this nursing? These disciplines provide important content for nursing practice. But do they define nursing? I believe they do not – nurses need to understand these related fields, but we need to focus on human responses. What is pain? How is it manifested across lifespan, setting, etiology, gender, or culture? How do we differentiate acute pain, chronic pain and impaired comfort? How does a particular medical condition impact the human response of pain or comfort? What makes pain associated with a bone fracture different from pain experienced with diabetic neuro-pathy? Do we really understand the concepts – or do we merely rush to provide pharmacologic treatment of a symptom we are observing? Is that medication the best intervention – or is it simply the easiest? What do we do for the patient who cannot tolerate the medicine, or does not want it? How does the etiology of the pain, the patient’s coping mechanisms and history, impact his pain response? If we do not understand how acute pain and chronic pain differ, or how impaired comfort and chronic pain differ, how do we know what we are really treating? How can we best achieve a positive patient outcome? I believe we cannot. Imagine a curriculum designed around core concepts of nursing knowledge. Rather than modules based on physician diagnosis (MD) on congestive heart failure or bone fractures, we could have modules on pain, risk for contamination, decreased cardiac output, or acute confusion. Rather than clustering content around medical diagnoses, we could use ND - concepts of importance to nursing practice – and cluster content around them, including related medical diagnoses, psychosocial, cultural and physiological responses, pharmacological treatments and desired outcomes. This would require many nurses to reframe their concepts of ND. Some recent literature implies that ND were developed for documenting nursing in the electronic health record (EHR). The truth is that ND were (and are) developed to provide language that describes the knowledge and practice of nursing. Just as medical diagnoses are used within medicine – not as a documentation tool, but as a tool for describing what is being treated in a concise, internationally understood language to drive intervention and outcome - if correctly developed as concepts that can be defined, studied, taught and implemented in practice, ND can describe what nurses know, drive what we do and what outcomes we achieve. I doubt that anyone would suggest that a physician should be allowed to create a medical diagnosis at a patient’s bedside and begin to use it clinically; yet some advocate for this practice in nursing. Simply construct a label and you have ND. But what does it mean? What do we know about this concept? How do I teach it, research it, measure it or share it with other disciplines and patients? How can we be so disinterested in understanding the core knowledge of our discipline? How can we allow what works best in a computer system to drive nursing practice, to mandate how we, as a discipline, develop the science beneath the labels? Are ND just documentation tools? Unfortunately, that is what they become when we neglect to teach the concepts – really understand these phenomena of nursing practice and the content underlying them. Nursing diagnoses were never meant to be simple terms that could be created at random to describe a condition. Nursing diagnosis labels should describe a concept (including health promotion concepts, not just “problems”) that is clearly and uniformly defined and supported by nursing research and practice literature, identified by signs/symptoms that can be obtained during nursing assessment, review of patient/family history, diagnostic tests and completion of various screening tools. The concepts should be well researched, well developed, and internationally disseminated. What would have to change to enable students to learn about nursing practice, how it supplements and interrelates with the practice of other health disciplines? We would have to teach nursing – the science of diagnosing and treating human responses to actual or potential health problems or life processes – and we would have to completely restructure, in most cases, how we practice nursing. Are you ready for such a challenge? I believe we must make these changes quickly, before we lose what it truly means to be a nurse

Shared-story approaches in outdoor studies: the HEAR (Hermeneutics, Auto/Ethnography and Action Research) ‘listening’ methodological model

Capturing the voices of practitioners and participants in outdoor experiences as data in qualitative research, demands imaginative, creative and practical methodologies, embedded within sound ethical frameworks. In this chapter, we explore shared-story approaches as ways in which experiences can be considered, analysed critically and conceptualised to give ‘testimony’ - a recognisable way of constructing meaning and disseminating research findings. We illustrate HEAR (Hermeneutics, (Auto)Ethnographic Action Research) as a methodological ‘listening’ model and a form of praxiography, rooted in the use of fables and stories to convey findings. This transdisciplinary method has meaning and application within and out with outdoor contexts

Evidencing atmospheres and narratives: measuring the immeasurable?

As outdoor educators and researchers, we face many challenges. Not least of which is the need to evidence the impact of our work. How do we do this with something as ephemeral and tenuous as Hauntings or Aesthetics or Atmospheres – what about when we sense a presence that is not physically present?(i) Can we really claim that narratives and storytelling are valid forms of research? What about being robust?(ii) Whilst we welcome initiatives that highlight the importance of spending time outdoors, and seek to nurture young people’s connection with nature, we believe that many research projects are attempting to measure the immeasurable.(iii) It is one thing to co-construct a way of thinking about our outdoor practice so that new understandings of atmospheres and narratives engender curiosity, raise cultural sensitivity and enrich our outdoor practices. It is a very different thing to show how this is achieved. Given the increasing importance of ‘impact’ in relation to both academia and practice, we ask a number of questions, including: a) What does impact really mean, and who is ‘impacted’? b) How do we want our research to be used, and who do we want to read/act on it? We will explore the apparent need to measure, quantify and statistically signify concepts that are arguably better suited to interpretative practices. We will discuss the contentious nature of the word ‘impact’ and propose that ‘influence’ is preferable for concepts that change with each situation, individual and environment. Is this type of work truly measurable? (i) Loynes, C. (2015) Email to Tracy Hayes, 27 March. (ii) Bragg, R.; Wood, C.; Barton, J. and Pretty, J. (2013) Measuring connection to nature in children aged 8 -12: A robust methodology for the RSPB. Essex: Essex Sustainability Institute and University of Essex. (iii) Chia, J. Measuring the immeasurable? Diss. Bond University, 2006. Available from: http://www.pria.com.au/sitebuilder/resources/knowledge/asset/files/2/measuringtheimmeasurablejoychia.pdf Last Accessed: 17/01/2017. Goleman, D., ed. (2008) Measuring the Immeasurable: The Scientific Case for Spirituality. Boulder, USA: Sounds True Inc

Development of hydronephrosis secondary to poorly managed neurogenic bowel requiring surgical disimpaction in a patient with spinal cord injury: A case report

Case of an adult patient with paraplegia managing neurogenic bladder with intermittent catheterization who was not performing a standard bowel program for management of neurogenic bowel

Kids' Share 2011: Report on Federal Expenditures on Children Through 2010

Examines trends in federal, state, and local spending and tax expenditures on children in 2010 and during the recession, their share of federal outlays and the economy since 1960, and projected 2011-20 spending. Analyzes the impact of stimulus funding