• w do baccalaureate degree nurses differ from diploma and associate degree nurses in ethical decision-making?

      King, Rebecca B.; School of Nursing (1987-04)
      The purpose of this ex post facto study was to test the hypothesis that baccalaureate degree nurses would make more ethical decisions at a higher moral reasoning level than diploma ·,. or associate degree nurses. A convenience sample of 86 registered nurses voluntarily participated in the study. The Judgement About Nursing Decisions (JAND) instrument, developed by Dr. Shake' Ketefian, was used to measure ethical judgements and decision-making. A demographic survey accompanied the JAND test. Results of the one-way analysis of variance test revealed no significant difference in the mean JAND scores of the baccalaureate degree, diploma and associate degree nurses. These findings resulted in the rejection of the study hypothesis. Results of the seven factor analysis revealed that one factor out of seven pupported that baccalaureate degree nurses make more ethical decisions ·at a higher· moral reasoning level than diploma or associate degree nurses. The findings of this investigation indicate the need to further study what factors play an active role in moral reasoning and ethical decision-making. The findings also support the need to revise and develop valid and reliable tools to measure moral reasoning and ethical behavior.
    • You Really Are Too Kind: Implications Regarding Friendly Submissiveness in Trainee Therapists

      Cain, Lylli; Department of Psychological Sciences; Augusta University (4/20/2018)
      To facilitate patient growth, therapists must immerse themselves in the patient’s world while also being able to see what is needed for change. This process requires finding a delicate balance between supporting and pushing patients. Therapists in training are additionally tasked with incorporating supervisors’ suggestions with their own views on what is needed to help their patients. Beginning therapists with tendencies to be overly accommodating may struggle to reconcile these competing demands. Thus, the aim of the present work is to explore how trainee friendly submissiveness (FS) interfaces with psychotherapy. Prior to training, clinical graduate trainee (n = 35) FS was assessed using the Inventory of Interpersonal Problems-32. Process and outcome data were then collected from each therapist’s first training case. Specifically, each trainee was assigned an undergraduate student volunteer with whom they had four non-manualized therapy sessions over the academic semester. After the third session, patients and trainees completed questionnaires assessing session impact and the working alliance, and two expert raters coded third session videotapes for techniques. Following termination, patients rated the overall helpfulness of the therapy. Trainee FS was significantly negatively associated with patient-rated depth, alliance, and overall helpfulness with moderate effects. Findings from a mediation analysis further suggested that trainees with high FS struggled to focus the therapy in a way that felt productive to patients. Implications for clinical training are discussed.
    • β-adrenergic receptor/β-arrestin-mediated microRNA maturation regulatory network: A new player in cardioprotective signaling

      Teoh, Jian Peng; Department of Biochemistry and Molecular Biology / Cancer Center (2017)
      Chronic treatment with the β-blocker carvedilol (Carv) has been shown to reduce established maladaptive left ventricle (LV) hypertrophy and to improve LV function in experimental heart failure. However, the detailed mechanisms by which carvedilol improves LV failure are poorly understood. We previously showed that carvedilol is a β-arrestin-biased β1-adrenergic receptor ligand, which activates cellular pathways through β-arrestins in the heart independent of G protein-mediated second messenger signaling, a concept known as biased signaling. Here, we sought to (i) identify the effects of Carv on LV gene expression on a genome-wide basis and (ii) investigate whether Carv could regulate novel miR expression/biogenesis, thereby providing a novel mechanism for its cardioprotective effects. Gene expression profiling analysis revealed that subsets of genes are differentially expressed after Carv treatment. Further analysis categorized these genes into pathways involved in tight junction, cardiac response to malaria, viral myocarditis, glycosaminoglycan biosynthesis, and arrhythmogenic right ventricular cardiomyopathy (ARVC). Genes encoding proteins in the tight junction, malaria, and viral myocarditis pathways were upregulated in the LV by Carv, while genes encoding proteins in the glycosaminoglycan biosynthesis and ARVC pathways were downregulated by Carv. In addition, our findings also revealed that Carv indeed upregulates 3 mature miRs, but not their pre-miRs and pri-miRs, in a β-arrestin1/2-dependent manner. Interestingly, Carv-mediated activation of miR-466g or miR-532-5p, and miR-674 is dependent on β2AR and β1AR, respectively. Mechanistically, β-arrestins regulate maturation of 3 newly identified βAR/β-arrestin-responsive miRs (β-miRs) by associating with the Dicer complex as well as two RNA binding proteins (hnRNPK and dyskerin) on three pre-miRs. Cardiac cell approaches uncover that β-miRs act as gatekeepers of cardiac cell function by repressing deleterious targets. Our findings indicate a novel role for βAR-mediated β-arrestin signaling activated by Carv in miR maturation, which may be linked to its protective mechanism. Altogether, our findings indicate that (i) the gene expression changes may reflect the molecular mechanisms that underlie the functional benefits of Carv therapy and (ii) the novel role for βAR-mediated β-arrestin signaling activated by Carv in miR maturation, which may be linked to its protective mechanism.