Implementing State Health Reform: Lessons for Policymakers

Drawing on five states' experiences, discusses questions and considerations, including the need to coordinate state agencies' work and share data, simplify eligibility and enrollment procedures, and involve community groups and businesses in outreach

Can TILT Be Used to Teach Study Tactics? A Case Study in a Biology Classroom

Recently, there has been a movement encouraging instructors in higher education to use the Transparency in Teaching and Learning (TILT) framework when designing assignments. This framework helps instructors clarify their expectations and evaluation criteria. Making assignments more transparent may result in greater student success. However, it is less clear how this framework can be applied to classes that use exams as a main method of assessing student learning. One option might be to use a TILTed assignment to introduce students to learning tools to improve their studying. I did this by giving students in an introductory biology class an assignment to construct a concept map prior to their first exam. This intervention did not result in students performing better on the exam when compared to the performance of prior classes without the intervention. One assignment may not have been enough to train students in concept mapping or to convince them of the utility of concept mapping as a learning technique

Fluorinated boranes in dehydrocoupling and hydroboration

This thesis describes the chemistry of the Lewis adducts of mono- and bis-(pentafluorophenyl)borane (LB·BHn(C6F5)3−n; n = 1, 2; LB = SMe2, NH3) as it applies to the development of novel perfluoroarylboranes. Chapter 2 details the use of Me2S·BHn(C6F5)3−n in the preparation of the pentafluorophenyl substituted amine borane adducts, LB·BHn(C6F5)3−n (LB = NR3, NHR2, NH2R, py). Their solid state structures feature N—H···H—B and N—H···F—C hydrogen bonding interactions, important structural motifs for further application of these materials. The related pentafluorophenyl substituted amine boranes H3N·BHn(C6F5)3−n may be used as ligand precursors for the synthesis of group 4 metallocene amidoborane complexes. Chapter 3 desribes the divergent chemistry observed for each of the group 4 metals in the presence of the pentafluorophenyl substituted amidoborane ligands, including N—H activation with hafnium, B—H activation in the case of zirconium and single electron reduction of titanium. In all but one instance, the crystal structures of isolated group 4 metallocene amidoboranes display a β-B-agostic interaction. This structural feature is proposed to play a significant role in catalytic dehydrocoupling of amine boranes by early transition metal catalysts. Chapter 4 describes the preparation of novel pentafluorophenyl substituted organoboranes RnB(C6F5)3−n (n = 1, 2) through facile hydroboration of alkenes using Me2S·BHn(C6F5)3−n. In particular, the double hydroboration of 1,5-cyclooctadiene with Me2S·BH2(C6F5) resulted in isolation and crystallographic characterization of pentafluorophenyl-9-borobicyclo[3.3.1]nonane dimethylsulfide adduct, the –C6F5 substituted analog of the popular hydroboration reagent 9-BBN (9-borabicyclo[3.3.1]nonane)

Living with Manic Experiences: An Interpretative Phenomenological Analysis

Although psychological research into manic experiences is increasing, it remains an underresearched phenomenon. In particular, there is a dearth of qualitative research exploring these experiences in a clinical sample of people diagnosed with Bipolar Disorder. This study examined six participants’ experiences of mania using Interpretative Phenomenological Analysis. Through semi-structured interviews, the participants provided detailed accounts of how they made sense of and experienced their manic states. Three master themes were described: “A mixed relationship with mania,” “A separate and controlled self”, and “The struggle to be different.” The first master theme explored the participants’ mixed and ambivalent relationship with their manic experiences. These were viewed as both alluring and dangerous, but overall the perceived costs had outweighed the benefits, for all but one of the participants. Most participants described losses in relation to giving up their manic experiences, as well as losses related to the destructive consequences of their episodes. The second master theme examined perceptions of mania as a separate, uncontrollable phenomenon, over which they had little influence. It was hypothesised that these explanations served to relieve these participants from underlying negative emotions, such as guilt, regret, shame and selfstigma. The third master theme described how manic experiences had represented struggles to be different. These included a struggle against society; a struggle to experience a preferred self; and a struggle to access very unique experiences or abilities. A number of issues were discussed in relation to the above themes. These included positive and conflicting appraisals of high moods; loss; entrapment and helplessness; ambivalence; negative moral emotions and a preferred manic identity. A range of therapeutic approaches were suggested as potentially helpful for some of these issues. These included Motivational Interviewing, Narrative, Constructivist and Compassion therapies. Additionally, the findings of the study provided support for existing therapies for Bipolar Disorder; particularly Cognitive-Behavioural Therapy (CBT) and Interpersonal & Social Rhythm Therapy (IPSRT)

Spirituality: History and contemporary developments – An evaluation

Spirituality is increasingly becoming a popular concept both in the media and in academic literature. However, there is a vast difference between the original concepts of spirituality, which were largely based on a Biblical view, and many contemporary perceptions thereof. Spirituality is generally seen as being divorced from any specific religion and specific truth claims. Nevertheless, it can be stated that spirituality is now seen as a universal human phenomenon. An evaluation of these trends is attempted by studying the concept in its original Biblical context, and by understanding the development of the dichotomy between religion and spirituality.Spiritualiteit: Geskiedenis en hedendaagse ontwikkelinge: ’n Evaluering. Spiritualiteit word ’n toenemend populêre konsep, beide in die media en in akademiese literatuur. Dit is belangrik om op te merk dat daar ’n groot verskil is tussen die oorspronklike konsep van spiritualiteit, wat op ’n Bybelse siening gegrond was, en baie van die hedendaagse persepsies daarvan. In die meeste gevalle word spiritualiteit tans beskou as iets wat van enige spesifieke godsdiens asook spesifieke aansprake op waarheid geskei is. Daar kan wel gestel word dat spiritualiteit vandag as ’n universele menslike eienskap beskou kan word. Hierdie tendense word geëvalueer deur die konsep in die oorspronklike Bybelse konteks te bestudeer en deur die ontwikkeling van die skeiding tussen godsdiens en spiritualiteit te verstaan

In vivo Detection of Hyperoxia-induced Pulmonary Endothelial Cell Death Using \u3csup\u3e99m\u3c/sup\u3eTc-Duramycin

Introduction 99mTc-duramycin, DU, is a SPECT biomarker of tissue injury identifying cell death. The objective of this study is to investigate the potential of DU imaging to quantify capillary endothelial cell death in rat lung injury resulting from hyperoxia exposure as a model of acute lung injury. Methods Rats were exposed to room air (normoxic) or \u3e 98% O2 for 48 or 60 hours. DU was injected i.v. in anesthetized rats, scintigraphy images were acquired at steady-state, and lung DU uptake was quantified from the images. Post-mortem, the lungs were removed for histological studies. Sequential lung sections were immunostained for caspase activation and endothelial and epithelial cells. Results Lung DU uptake increased significantly (p \u3c 0.001) by 39% and 146% in 48-hr and 60-hr exposed rats, respectively, compared to normoxic rats. There was strong correlation (r2 = 0.82, p = 0.005) between lung DU uptake and the number of cleaved caspase 3 (CC3) positive cells, and endothelial cells accounted for more than 50% of CC3 positive cells in the hyperoxic lungs. Histology revealed preserved lung morphology through 48 hours. By 60 hours there was evidence of edema, and modest neutrophilic infiltrate. Conclusions Rat lung DU uptake in vivo increased after just 48 hours of \u3e 98% O2 exposure, prior to the onset of any substantial evidence of lung injury. These results suggest that apoptotic endothelial cells are the primary contributors to the enhanced DU lung uptake, and support the utility of DU imaging for detecting early endothelial cell death in vivo

Protection by 20-5,14-HEDGE Against Surgically-Induced Ischemia Reperfusion Lung Injury in Rats

Background We previously reported that the cytochrome P450 product 20-hydroxyeicosatetraenoic acid has prosurvival effects in pulmonary artery endothelial cells and ex vivo pulmonary arteries. We tested the potential of a 20-hydroxyeicosatetraenoic acid analog N-[20-hydroxyeicosa-5(Z),14(Z)-dienoyl]glycine (20-5,14-HEDGE) to protect against lung ischemic reperfusion injury in rats. Furthermore, we examined activation of innate immune system components, high mobility group box 1 (HMGB1) and toll-like receptor 4 (TLR4), in this model as well as the effect of 20-5,14-HEDGE on this signaling pathway. Methods Sprague-Dawley rats treated with 20-5,14-HEDGE or vehicle were subjected to surgically induced, unilateral lung ischemia for 60 minutes followed by reperfusion for 2 hours in vivo. Injury was assessed histologically by hematoxylin and eosin, and with identification of myeloperoxidase immunohistochemically. The HMGB1 and TLR4 proteins were identified by Western blot. Caspase 3 activity or 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, a yellow tetrazole, incorporation were used to measure apoptosis and cell survival. Results The ischemia reperfusion injury evoked atelectasis and hemorrhage, an influx of polymorphonuclear cells, and increased TLR4 and HMGB1 expression. Caspase 3 activity was increased, and 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide incorporation was decreased. The 20-5,14-HEDGE protected against each of these endpoints, including infiltration of polymorphonuclear cells, with no changes in caspase 3 activity in other organs. Conclusions Lung ischemia reperfusion produces apoptosis and activation of the innate immune system including HMGB1 and TLR4 within 2 hours of reperfusion. Treatment with 20-5,14-HEDGE decreases activation of this response system, and salvages lung tissue

Ethical Considerations and Change Recipients’ Reactions: ‘It’s Not All About Me’

An implicit assumption in most works on change recipient reactions is that employees are self-centred and driven by a utilitarian perspective. According to large parts of the organizational change literature, employees’ reactions to organizational change are mainly driven by observations around the question ‘what will happen to me?’ We analysed change recipients’ reactions to 26 large-scale planned change projects in a policing context on the basis of 23 in-depth interviews. Our data show that change recipients drew on observations with three foci (me, colleagues and organization) to assess change, making sense of change as multidimensional and mostly ambivalent in nature. In their assessment of organizational change, recipients care not only about their own personal outcomes, but go beyond self-interested concerns to show a genuine interest in the impact of change on their colleagues and organization. Meaningful engagement of employees in organizational change processes requires recognizing that reactions are not simply ‘all about me’. We add to the organizational change literature by introducing a behavioural ethics perspective on change recipients’ reactions highlighting an ethical orientation where moral motives that trigger change reactions get more attention than is common in the change management literature. Beyond the specifics of our study, we argue that the genuine concern of change recipients for the wellbeing of others, and the impact of the organizations’ activities on internal and external stakeholders, needs to be considered more systematically in research on organizational change