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Oscillating glucose levels can increase oxidative stress and may contribute to β-cell dysfunction. We tested the hypothesis that increased glycemic variability contributes to β-cell dysfunction by experimentally altering glucose variability with controlled diets varying in glycemic index (GI). Fifty-two adults with prediabetes received a 2-week moderate GI (GI = 55–58) control diet followed by randomization to a four-week low GI (LGI: GI < 35) or high GI (HGI HI > 70) diet. Those on the HGI diet were randomized to placebo or the antioxidant N-acetylcysteine (NAC). Participants underwent blinded CGMS, fasting oxidative stress markers and an intravenous glucose tolerance test to estimate β-cell function (disposition index: DI). On the control diet, DI was inversely correlated with SD glucose (r = −0.314, p = 0.03), but neither DI nor glucose variability were associated with oxidative stress markers. The LGI diet decreased SD glucose (Control 0.96 ± 0.08 vs. LGI 0.79 ± 0.06, p = 0.02) while the HGI diet increased it (Control 0.88 ± 0.06 vs. HGI 1.06 ± 0.07, p = 0.03). Neither DI nor oxidative stress markers changed after the LGI or HGI diets. NAC had no effect on DI, glucose variability or oxidative stress markers. We conclude small changes in glucose variability induced by dietary GI in adults with pre-diabetes are unlikely to contribute to β-cell dysfunction. •Low glycemic index diets decrease glucose variability in pre-diabetes.•Glucose variability change had no impact on β-cell function or oxidative stress.•The antioxidant N-acetylcysteine didn't change β-cell function or oxidative stress.

Premise of the study: Microsatellites were developed for Astragalus bibullatus (Fabaceae), a federally endangered narrow endemic, to investigate reproductive ecology and species boundaries among closely related taxa. Methods and Results: Next-generation sequencing was used to develop 12 nuclear microsatellite loci that amplify in A. bibullatus, as well as in A. crassicarpus var. trichocalyx, A. gypsodes, and A. tennesseensis. Identified loci were di- and trinucleotide repeats, with 1–15 alleles per locus. Observed and expected heterozygosities ranged from 0.000–0.938 and 0.000–0.860, respectively. Cross-amplification of three loci previously published in A. michauxii was also confirmed for the taxa included here. Conclusions: These data indicate the utility of novel microsatellite loci for conservation genetics and reproductive ecology in closely related Astragalus species.

Background: The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant. Using an evidence-based approach and building on the competencies identified by the IOM and QSEN, a team of experts at an academic health system developed eight competency domains and 186 related knowledge, skills, and attitudes (KSAs) for professional nursing practice. Purpose: The aim of our study was to validate the eight identified competencies and 186 related KSAs and determine their developmental progression within a clinical advancement program. Methods: Using the Delphi technique, nursing leadership validated the newly identified competency domains and KSAs as essential to practice. Clinical experts from 13 Magnet-designated hospitals with clinical advancement programs then participated in Delphi rounds aimed at reaching consensus on the developmental progression of the 186 KSAs through four levels of clinical advancement. Results: Two Delphi rounds resulted in consensus by the expert participants. All eight competency domains were determined to be essential at all four levels of clinical practice. At the novice level of practice, the experts identified a greater number of KSAs in the domains of safety and patient- and family-centered care. At more advanced practice levels, the experts identified a greater number of KSAs in the domains of professionalism, teamwork, technology and informatics, and continuous quality improvement. Conclusion: Incorporating the eight competency domains and the 186 KSAs into a framework for clinical advancement programs will likely result in more clearly defined role expectations; enhance accountability; and elevate and promote nursing practice, thereby improving clinical outcomes and quality of care. With their emphasis on quality and safety, the eight competency domains also offer a framework for enhancing position descriptions, performance evaluations, clinical recognition, initial and ongoing competency assessment programs, and orientation and residency programs.

BackgroundThe Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant. Using an evidence-based approach and building on the competencies identified by the IOM and QSEN, a team of experts at an academic health system developed eight competency domains and 186 related knowledge, skills, and attitudes (KSAs) for professional nursing practice.PurposeThe aim of our study was to validate the eight identified competencies and 186 related KSAs and determine their developmental progression within a clinical advancement program.MethodsUsing the Delphi technique, nursing leadership validated the newly identified competency domains and KSAs as essential to practice. Clinical experts from 13 Magnet-designated hospitals with clinical advancement programs then participated in Delphi rounds aimed at reaching consensus on the developmental progression of the 186 KSAs through four levels of clinical advancement.ResultsTwo Delphi rounds resulted in consensus by the expert participants. All eight competency domains were determined to be essential at all four levels of clinical practice. At the novice level of practice, the experts identified a greater number of KSAs in the domains of safety and patient- and family-centered care. At more advanced practice levels, the experts identified a greater number of KSAs in the domains of professionalism, teamwork, technology and informatics, and continuous quality improvement.ConclusionIncorporating the eight competency domains and the 186 KSAs into a framework for clinical advancement programs will likely result in more clearly defined role expectations; enhance accountability; and elevate and promote nursing practice, thereby improving clinical outcomes and quality of care. With their emphasis on quality and safety, the eight competency domains also offer a framework for enhancing position descriptions, performance evaluations, clinical recognition, initial and ongoing competency assessment programs, and orientation and residency programs.

The overarching purpose of this study is to mobilize Black feminism in order to deconstruct how She’s Gotta Have It’s story line paradoxically challenges and/or reinforces misogynistic and stereotypical understandings of Black women. Continuing to analyze and critique the portrayals of women of color in the media is vital because shows and films starring African-American actors and actresses are very popular amongst Black viewers (Abrams, 2012). These negative depictions of Black women in media continue to affect the way Black people, as well as American society, values, identifies and idealizes Black women in general (Francois, 2012).This study begins with a review of literature of concepts and theories regarding the representation of Black women in the media. By approaching these issues with a feminist perspective, this thesis explores the societal constructions of Black women’s experiences and sexualities in a White male dominated culture. Through a comparative analysis of the evolution between the 1986 film She’s Gotta Have It and the 2017 Netflix series She’s Gotta Have It, this study assesses the representation of women of color in the Black community. Lastly, it examines the public delivery of images and messages that challenge and/or reinforce the prevailing stereotypes of African American women in film and television.

Researchers have documented that integrating technology into mathematics instruction can help students improve their mathematical thinking. However, at the study site, Grade 5 students were not passing state tests and were not meeting adequate yearly progress (AYP). The purpose of this case study was to examine the experiences of Grade 5 math teachers with integrating technology into the curriculum in order to help their students improve their proficiency in math. The conceptual framework was based on social learning theory. A purposive sampling technique was used to select 6 Grade 5 math teachers who had integrated technology into the curriculum. Data were collected through face-to-face audio taped interviews, and then analyzed using line-by-line analysis for emergent themes. All participants reported having positive experiences regarding helping students learn math by integrating technology into the curriculum daily. Participants reported the need for professional development opportunities on teaching strategies and technology integration. Implications for positive social change include professional development for math teachers in integrating technology into instruction, which may help students meet AYP, graduate from high school, and be prepared to enter higher education or the work force. .

Evidence supports bedside report as a mechanism to improve communication, patient safety, quality of report, and nurse and patient satisfaction when implemented in a closed unit. The purpose of this project was to examine the impact of implementing a bedside report process to transition patients from the emergency department to a medical-surgical unit. Specifically, the goal was to analyze the impact of a bedside- reporting process on patient progression and on nurse and patient satisfaction. Lewin's change model provided the theoretical framework for this quasi-experimental study. Patient progression data consisted of 706 patient transitions from the emergency department to the medical-surgical unit. Pre and post implementation survey responses from 87 patients and 61 nurses comprised the patient and nurse satisfaction data. The data were evaluated through multiple t test analyses. Patient progression times improved significantly post implementation of the bedside report process (p < .05). Nursing satisfaction, quality of report, and safety information were gathered using the Transfer Report Communication Survey. There was statistically significant improvement in survey scores for perceived openness and ease of communication, nurses' perception of the accuracy of information exchanged, and the ability to understand the reported patient information after bedside report was implemented ( p < .05). Assessment of patient satisfaction via the Hospital Consumer Assessment of Healthcare Providers and Systems survey noted no improvement in patient satisfaction during the project timeframe (p < .05). These findings may promote positive social change by improving patient care transitions and improving safety in acute care patient transfers.

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This thesis investigated Fort Hampton, an American military installation established in 1809 near the Elk River, in present-day Limestone County, Alabama. Fort Hampton was constructed to remove settlers from Chickasaw lands prior to the cession of 1816. This was a short-lived, but significant era of Anglo and Native American habitation in northern Alabama: one in which the American government seemingly protected the Native American cause. This thesis is the first combination of historical sources and archaeological data in the documentation of Fort Hampton. Fort Hampton's location was formally identified, and Fort Hampton was compared with other forts to better understand its place in the history of settlement in the Southeast. Interpretation of Fort Hampton's material and spatial data from an interregional interaction perspective revealed that it had a focused military objective, limited interaction with the Chickasaw, and was a representation of American power in the frontier where the government hoped to gain control. Artifact patterning confirmed the fit of Fort Hampton's material culture with other frontier sites. Important recommendations were identified for the use of artifact patterning. Specifically, knowledge of site condition, site formation, and the identification of previous recoveries are crucial to the proper use of artifact patterns.