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Adult Third Culture Kids (ATCKs), with their mobile and cross-cultural childhood, bring into adulthood both benefits and challenges which impact their personal and professional lives. This research was conducted through narrative inquiry with 25 ATCK participants ranging in age from 18 to almost 80. These participants came from various backgrounds: military kids, diplomatic kids, missionary kids, and business expat kids. The research question that guided this study was “How can spiritual self-leadership foster identity development and sense of belonging in ATCKs in order for them to elevate their potential and value contribution in the workplace?” The four objectives for this study were to: (1) identify how ATCKs’ professional lives are impacted by their cross-cultural mobile life before the age of 18; (2) explore how the Spiritual Leadership model (Fry & Nisiewicz, 2020) can foster identity development (inner life) and sense of belonging (membership) for ATCKs within the workplace; (3) examine how ATCKs’ deconstruction and/or construction of faith impacts their inner life and, by extension, spiritual self-leadership; and, (4) propose recommendations for how ATCKs can cultivate spiritual self-leadership for themselves and leverage their value within their workplaces.Four emerging threads arose from the participants’ stories. The first emerging thread was professional mobility and restlessness, which were the most commonly cited impacts on ATCKs’ professional lives. Many ATCKs feel the need to change jobs, organizations, and geographical locations frequently, mirroring their mobile lives before the age of 18. The second emerging thread was spiritual leadership in the workplace. Although only a few of the ATCKs highlighted how organizational leaders who exercise spiritual leadership had helped them mitigate their challenges, those who did, spoke of how these leaders helped to foster a sense of belonging and provided outlets for purposeful living. The third emerging thread was the core spiritual beliefs questioning process. This process varied between ATCKs where some completely deconstructed the faith they followed before the age of 18 while others only sifted through their core spiritual beliefs. Some settled on their spirituality, while others still search for their path. Regardless of where this questioning process led them, the value was in the journey, not the destination. The fourth emerging thread was spiritual self-leadership principles. These principles were gleaned from examples from the lived experiences of the ATCKs, as well as their advice for other ATCKs. The ATCKs’ narratives clearly showed how they had used spiritual self-leadership to cultivate their inner life, mitigate their challenges, and engage with their community.The spiritual self-leadership principles from the fourth emerging thread informed the creation of the Spiritual Self-Leadership model, a signature contribution of this study. The model includes six principles which are housed under two headings: Focus on Self and Taking Self into Community. The four principles under Focus on Self are know yourself, develop your spirituality, seek professional help, and commit to a lifelong, continual journey. The two principles under Taking Self into Community are build your community and live your purpose. This model was developed as a tool for ATCKs to lead themselves towards fostering identity creation and sense of belonging; however, it has implications for a much wider audience. For organizational leaders, this model provides a pathway towards greater understanding of ATCKs and their challenges, as well as awareness of the need to provide space for ATCKs to cultivate their spiritual self-leadership. As well, leaders can use this model as a guideline on how to cultivate their own inner life and spiritual self-leadership, and, using this knowledge, to encourage their followers to do the same. If organizational leaders provide space for all organizational actors to cultivate and practice spiritual self-leadership, a climate of spiritual well-being can be created and encouraged for everyone within the organization.The Spiritual Self-Leadership model has implications for both the academic and non-academic world. This model is the first of its kind to marry spiritual leadership and self-leadership into one model. This overlap can inform literature in both subject areas in the organizational leadership discipline, as well as set itself apart in its own subject area. In addition, the model can fill a gap in the mainstream leadership literature for the same reason. For the ATCK academic literature, the model contributes knowledge on how to mitigate ATCK challenges of identity and belonging in order to elevate their potential and value contribution in the workplace. Very little has been written about ATCK professional challenges and nothing on solutions. The model’s practicality can be attractive to both academic and practitioner audiences.The recommendations for practice are centered around the Spiritual Self-Leadership model and how it can be made available and usable to the greatest number of people. First, training materials should be developed for ATCKs, ATCK practitioners, and organizations with target audiences such as those who dispatch expatriates, those for whom ATCKs work, organizational leaders, HR practitioners, and academic institutions. Second, a published book should be written to widen the access for ATCKs and organizational leaders. Third, a website should be developed to further widen access and provide videos and resources for all interested in the model. Although the Spiritual Self-Leadership model was birthed from ATCKs’ narratives and was designed to help ATCKs mitigate their belonging and identity challenges, this model will also help leaders who desire to cultivate their inner life in order to become a more effective spiritual leader.

Background: Adult Changes in Thought (ACT), a prospective cohort study, enrolls older adult members of Kaiser Permanente Washington. We describe an ambitious project to abstract medical records facilitating epidemiological investigation. Methods: Abstracted data include medications; laboratory results; women’s health; blood pressure; physical injuries; cardiovascular, neurological, psychiatric and other medical conditions. Results: Of 1419 of 5763 participants with completed abstractions, 1387 (97.7%) were deceased; 602 (42.4%) were diagnosed with Alzheimer’s Disease and Related Dementias; 985 (69.4%) had a brain autopsy. Each participant had an average of 34.3 (SD = 13.4) years of data abstracted. Over 64% had pharmacy data preceding 1977; 87.5% had laboratory data preceding 1988. Stroke, anxiety, depression and confusion during hospitalization were common among participants diagnosed with dementia. Conclusions: Medical records are transformed into data for analyses with outcomes derived from other ACT data. We provide detailed, unparalleled longitudinal clinical data to support a variety of epidemiological research on clinical-pathological correlations.

To establish standards for pulmonary artery and branch pulmonary artery (PA and BPA) effective diameter (ED) and cross-sectional area (CSA) by using computed tomography (CT) data in children of a wide range of sizes and investigate the roundness of arteries. The ED (average of short and long axes) and CSA for the PA and BPA were measured using 1-mm collimation double-oblique reconstructions. Ordinary least squares regression was used to investigate models with various functional forms that related ED and CSA to patient size. Aspect ratio (AR), the short axis divided by long axis, was measured to evaluate roundness. The ideal diameter derived from CSA measurements was compared to ED, short axis, and long axis measurements. 108 CT examinations were analyzed in children without reason for abnormal PA size who ranged in age from 0 to 18 years (mean, 10.9 years; SD, 5.9 years). Interrater reliability was excellent. Data were modeled using a natural log-transformed response variable and a linear term for height as the independent variable. AR for the PA, right pulmonary artery, and left pulmonary artery measured < 0.9 for 38, 55, and 37%, respectively, indicating that many arteries are not round. Ideal diameter was not significantly different than ED but was for short- and long-axis diameter measurements. Normal ED and CSA for PA and BPA were determined for children of different sizes. Measurements outside of the normal range are consistent with dilatation or stenosis. Single diameter techniques are likely to introduce error.

SYNAPTOBREVIN-LIKE membrane proteins that reside on transport vesicles, called the vesicle SNARE (v-SNARE), play a key role in ensuring that a vesicle targets and fuses with its correct acceptor compartment 1–3 . Here we show that Boslp, the v-SNARE of yeast endoplasmic reticulum-to-Golgi transport vesicles, pairs with another integral membrane protein of similar topology (Sec22p) on vesicles. This pairing, which appears to require functional Yptlp (Rab in mammalian cells), may aid the activity of Boslp on this compartment. These findings suggest that Rabs regulate the specificity of membrane fusion by selectively activating the v-SNARE on carrier vesicles. Because the v-SNARE resides on more than one membrane, such a regulated activation step may be necessary to prevent the premature fusion of donor and acceptor compartments 4 .