Training health care providers as first responders to victims of intimate partner violence

Plunkett, Sarah Elizabeth Indiana University 2009 해외박사(DDOD)

Intimate partner violence (IPV) has been declared a public health epidemic. Initial and annual training of healthcare providers regarding guidelines for identification and response to intimate partner violence has been mandated by the Joint Commission and endorsed by the Institute of Medicine. However, many providers/institutions lack the preparation necessary to implement such guidelines. The purpose of the feasibility study was to test the efficacy of an existing IPV training curriculum on participants, perception of knowledge, cultural competence, confidence (self-efficacy), and attitudes related to identifying and responding to victims of IPV. A sample of convenience including twenty-three registered nurse home-visitors and one social work intern participated in the mandatory one-day training program. However, consent to enroll in the study was voluntary and indicated by completing the study instruments. Participants were asked to complete three evaluative measures: The 11-item Plunkett Demographic Questionnaire (pre-training), a 15-item Training Program Evaluation (post-training), and the 21-item Instructional Measurement Subscales across three time points (pre-Training, post-Training, and six weeks follow-up). All items were numerically coded so the higher the score, the more favorable the response. Data were analyzed using descriptive and inferential statistics (percentages; minimum-maximum, mean, and composite scores; standard deviations; repeated measures analysis of variance; and, paired samples dependent t tests). Four hypothesis statements were made regarding participation in the training program on IPV: "There will be an overall increase in healthcare providers, perceived level of knowledge and cultural competence," (hypothesis 1); "There will be an overall increase in healthcare providers, perceived level of confidence in implementing routine enquiry," (hypothesis 2); "There will be an overall positive change in healthcare providers, attitudes towards routine enquiry," (hypothesis 3); and, "There will be an overall positive change in healthcare providers. attitudes towards victims of abuse following participation in Improving the Health Care Response to Domestic Violence," (hypothesis 4). Findings supported previous research outcomes that presently recognized barriers to routine screening/assessment for IPV can be overcome and positive changes can persist over time as a result of participation in a standard IPV training program. Future research involving larger, random sample populations, are needed to confirm these results.

Genetic influences on preterm birth

Plunkett, Jevon Anastasia Washington University in St. Louis 2010 해외박사(DDOD)

Preterm birth (PTB) is a leading cause of mortality and disease burden globally; however, determinants of human parturition remain largely uncharacterized, making prediction and prevention of difficult. Genetic studies are one way in which we can attempt to better understand this disorder. We first sought to develop a model for the genetic influences on PTB to facilitate gene discovery. Study of standard measures of familial aggregation, the sibling risk ratio and the sibling-sibling odds ratio, and segregation analyses of gestational age, a quantitative proxy for preterm birth, lend support to a genetic component contributing to birth timing, since preterm deliveries cluster in families and models in which environmental factors alone contribute to gestational age are strongly rejected. Analyses of gestational age attributed to the infant support a model in which mother's genome and/or maternally-inherited genes acting in the fetus are largely responsible for birth timing. We also aimed to discover specific genes associated with PTB by screening genes selected based on an evolutionary-motivated filter, rather than known parturition physiology. Because humans are born developmentally less mature than other mammals, birth timing mechanisms may differ between humans and model organisms that have been typically studied; as a result, we screened 150 genes, selected because of their rapid evolution along the human lineage. A screen of over 8000 SNPs in 165 Finnish preterm and 163 control mothers identified an enrichment of variants in FSHR associated with PTB and prompted further study of the gene. Additionally, PLA2G4C, identified as the gene with the most statistically significant evidence for rapid evolution that was also included in a list of preterm birth candidate genes, was examined further. Three SNPs in PLA2G4C and one SNP in FSHR were statistically significant across populations after multiple testing corrections. Additional work to identify variants in these genes with functional effects was also initiated, including comparisons of prostaglandin metabolite levels among genotype classes for significantly associated SNPs in PLA2G4C and sequencing of FSHR to identify functional coding variants. Together, these experiments better characterize the nature of genetic influences on PTB and support the role of PLA2G4C and FSHR in PTB.

Examining the impact of Media Content, Emotions, and Mental Imagery Visualization on Pre-Trip Place Attachment

Plunkett, Daniel Arizona State University 2013 해외박사(DDOD)

Numerous studies have examined the attachments individuals have to the places they visit, and that those attachments are formed through experiencing a place in person. This study is unique in that it examines pre-trip place attachment formation via the use of mobile technology and social media. It proposes that media experienced through the use of a participant's smartphone can foster the development of positive emotions, which in turn, facilitates greater mental imagery processing that ultimately influences pre-trip place attachment formation. An experimental design was constructed to examine how text and video on a destination's Facebook page influences an individual's emotions, mental imagery, and subsequently attachment to that destination. Specifically, a 2 (narrative text vs. descriptive text) x 2 (short, fast-paced video vs. long, slow-paced video) between-subjects design was used. A total of 343 usable participant responses were included in the analysis. The data was then analyzed through a two-step process using structural equation modeling. Results revealed no significant influence of textual or video media on emotions although the choice in text has a greater influence on emotions than choice in video. Additionally, emotions had a significant impact on mental imagery. Finally, mental imagery processing had a significant impact on only the social bonding dimension of place attachment. In conclusion, while media had no significant impact on emotions, the effect of previous traveler's retelling of personal accounts on the emotions of potential travelers researching a destination should be examined more closely. Further, the study participants had no prior experience with the destination, yet emotions influenced mental imagery, which also influenced social bonding. Thus further research should be conducted to better understand how potential traveler's image of a destination can be affected by the stories or others.

The Neural Representation of Structured Complex Ideas in Different Formats

Plunkett, Dillon Sterling Harvard University ProQuest Dissertations & Theses 2022 해외박사(DDOD)

Darth Vader has waded knee-deep into the Black Sea and is filtering some of the water with a Brita pitcher. Even though you’d never read that sentence before, you immediately understood its specific, improbable meaning. Moreover, you can imagine that scene, even though you’ve never seen it before. How is it that humans are able to understand and imagine novel, complex ideas when we first encounter or conceive them? This example highlights the intersection of two defining features of human cognition. First, thought is compositional. We can combine familiar conceptual components in precise ways to build novel composite thoughts. Second, we can represent ideas in different formats—including both symbolic, language-like representations and depictive mental images—and the brain can translate complex ideas between representational formats.In this dissertation, I describe three neuroimaging experiments directed at advancing our understanding of how the brain implements compositional representation and translates composite ideas from one representational format to another. Experiment 1 investigated where and how the brain represents composite ideas that are defined by spatial structure. Participants undergoing fMRI read descriptions of arrangements of shapes and imagined those arrangements. Structure-dependent information was found bilaterally in the supramarginal gyrus and superior parietal lobule, along the left intraparietal sulcus, and in left anterior middle frontal gyrus. Experiment 2 took a similar approach for ideas with temporal structure, using sequences of described and imagined sounds. Experiment 3 used an individual-focused approach to investigate the translation of composite ideas between formats. We collected over 25 hours of fMRI data from each of three individuals as they compared the meaning of ideas conveyed in images and sentences. We identified a number of regions—most notably the left lateral posterior temporal cortex—that were preferentially engaged in all three participants when comparing ideas expressed in different representational formats.

An examination of the impact of an assistive technology device on the quality of adult/young child interactions

Plunkett, Diane M University of Kansas 2013 해외박사(DDOD)

The purpose of this study was to gain greater understanding of the potential benefits of assistive technology (AT) devices on young children's social development. Specifically, changes to the quality of the adult/young child social interactions as a function of the child's access to and use of his/her personal AT device was examined. Using a multielement single-case design, the quality of adult/young child social interactions were examined during snack time when the child used his personal AT device; and the adult/young child social interactions were examined when the personal AT device was not available to the child. Results indicate that the quality of caregiver/young child interactions were significantly enhanced when the AT device was utilized by the child. Implications for practice and future research are discussed.

Brain Reserve in Multiple Sclerosis: The Impact of Maximal Lifetime Brain Growth on Fine Motor Functioning

Plunkett, Lindsay G Columbia University 2016 해외박사(DDOD)

Multiple sclerosis (MS) is a prevalent and progressive autoimmune inflammatory disease affecting both white and gray matter and resulting in lesions and atrophy within the central nervous system (CNS) (Bermel & Bakshi, 2006; Confavreux & Vukusic, 2006; Cree, 2012; Friese, Schattling, & Fugger, 2014). Fine motor impairment, including manual motor speed and fine motor dexterity deficits, is common in MS patients (e.g., Benedict et al., 2011; Chipchase, Lincoln, & Radford, 2003). However, impairment does not progress uniformly across patients (Confavreux, Vukusic, Moreau, & Adeleine, 2000; Filippi & Rocca, 2011; Scalfari, Neuhaus, Daumer, DeLuca, & Muraro, 2013) and the association between disease burden and physical disability is moderate at best (Bermel & Bakshi, 2006; Filippi et al., 2013). Though the brain reserve hypothesis has helped to explain the clinico-pathologic dissociation between cognitive functioning and disease burden in MS patients (Sumowski et al., 2013; Sumowski et al., 2014a), there is no published literature on brain reserve and motor functioning in MS. Instead, only preliminary data have been presented on brain reserve and general physical disability (Sumowski et al., 2014b). As such, the purpose of this dissertation was to examine the protective effect of brain reserve, estimated via intracranial volume (ICV), on fine motor functioning in relapse-onset MS patients. A sample of 178 relapse-onset, right-handed MS patients underwent neuropsychological testing along with neurological examination, including magnetic resonance imaging (MRI). As part of the evaluation, patients were administered the Nine Hole Peg Test (NHPT; a measure of fine motor speed and dexterity) and the Finger Tapping Test (FTT; a measure of manual motor speed), which served as this study's outcomes (i.e., dependent variables). Predictors (i.e., independent variables) included demographic variables (age, sex), disease variables (disease duration and disease phenotype, including relapsing-remitting MS (RRMS) or secondary-progressive MS (SPMS)), MRI estimates of disease burden (T2 lesion volume [T2LV], normalized brain volumes as measures of cerebral atrophy), and MRI-derived measures of ICV as an estimate of brain reserve. Results revealed that phenotype (r = .56, p < .001) significantly predicted performance on the NHPT, such that patients with SPMS did worse than patients with RRMS. Regarding disease burden, T2LV (r = .24, p = .001) and normalized gray matter volume (r = -.18, p = .019) predicted NHPT, with less disease burden associated with better performance. Greater ICV (r = -.21, p =.006) was also significantly associated with better performance on the NHPT. Next, phenotype (r = -.45, p < .001) predicted FTT with SPMS patients again performing worse than RRMS patients. Sex (r = .40, p < .001) was a significant predictor of FTT with men outperforming women, on average. For FTT, normalized gray matter volume (r = .36, p < .001) was the only measure of disease burden that predicted performance, with greater volume (i.e., less atrophy) associated with better performance. Similarly, greater ICV ( r = .31, p < .001) significantly predicted better performance on the FTT. For both NHPT and FTT, interactions between measures of disease burden and ICV were not significant. As such, some evidence from this study was not consistent with the reserve hypothesis; however, this finding may be due to differences in the way brain reserve impacts motor outcomes (relative to cognitive outcomes). Nonetheless, as ICV was associated with better performance for both outcome measures, these findings provide partial support for the brain reserve hypothesis in fine motor functioning in MS. Therefore, findings from this study have real-life applications with regard to improved understanding of fine motor disability in MS and identification of patients at risk for upper extremity dysfunction, leading to the possibility of early intervention. Findings also have implications for informing clinical research in MS. Future research should examine the protective effect of brain reserve on fine motor functioning within larger cross-sectional samples (i.e., RRMS vs. SPMS), within primary-progressive MS (PPMS) patients, and when using additional measures of upper extremity disability (e.g., Grip Strength Test). Longitudinal research would also help to determine whether there is a moderating effect of brain reserve on fine motor disability progression as well as allow patients to serve as their own baseline, which would control for individual differences in motor functioning. Next, examining reserve in patients experiencing lesions and atrophy in specific brain regions underlying motor function (e.g., cerebellum and precentral gyrus) may help explain why interactions between disease burden and ICV were not significant within the present study. Finally, by testing the brain reserve hypothesis as it relates to fine motor functioning in non-clinical, healthy controls, it would be possible to determine whether the protective effect of reserve is present premorbidly.

Locating practical normativity

Plunkett, David J University of Michigan 2010 해외박사(DDOD)

A central feature of ethical thought is that it appears to involve not only descriptive belief, belief about what is the case, but also normative belief about what should be done. Suppose we take this at face value and understand normative thought in ethics to consist of attitudes that, at the most basic explanatory level, are genuine beliefs. What then should we say about the basic nature of the normative properties that such beliefs are about? I argue that normative properties are complex naturalistic properties of psychology. In the first chapter, I consider the non-naturalistic realist position, according to which our world contains the instantiation of irreducibly normative, metaphysically sui generis properties. I argue that proponents of non-naturalistic realism have not successfully shown that this view is compatible with confidence in the claims and methodologies of the natural sciences. This gives us powerful (if ultimately defeasible) reason to reject this view. In the second chapter, I consider metaethical ideal attitude theory, exemplified in the work of Michael Smith, according to which normative properties about what an agent A should do concern what an ideal version of A would desire that non-ideal A do. In order (a) to maintain a naturalistic account of normative properties, (b) to avoid radical skepticism about ethical knowledge, and (c) to explain the motivational force of normative judgment, I argue that ideal attitude theorists should hold that what it is for an agent A to be ideal is derived from A's own evaluative attitudes. I call this a fully agent-attitude-dependent version of ideal attitude theory. In the third chapter, I consider Sharon Street's recent arguments in favor of metaethical constructivism, according to which normative properties concern what is entailed by an agent's practical standpoint. I argue that Street's metaethical constructivism is best developed as a version of agent-attitude-dependent ideal attitude theory.

Actions, reasons and self-expression: A defense of subjectivist-internalism about reasons

Plunkett, Carolyn City University of New York 2016 해외박사(DDOD)

The central question of my dissertation is: what makes it the case that certain considerations are reasons for acting? This is a question about the truth-makers of claims about reasons, that is, what makes it the case that one has a reason to phi rather than Psi. There are two leading camps in the philosophical debate devoted to answering this question: subjectivism and objectivism. Subjectivist theories hold that one has a reason to do something when one has a non-truth evaluable favoring attitude towards that thing, e.g. desiring it. Objectivist theories insist that one's desires are irrelevant to establishing the existence of reasons; that some action or desire is morally good or valuable is equally and universally reason-providing, whatever else individual agents happen to desire. I argue that all reasons for action are subjective; that, conversely, there are no objective reasons. After rejecting objectivism and providing a general defense of subjectivist views, I defend a more nuanced subjectivist-internalist position called Expressive Reasons. Subjectivist-internalism is the view that reasons are not only rooted in agent's desires, but also that it must be possible for a reason to serve as the basis for an individual's action if it is to be a reason in the first place. Expressive Reasons is the particular view that R is a reason for A to &phis; when &phis;-ing is an expression of soundly deliberating A's self; and A, under ordinary conditions, would act on the basis of R. I argue that Expressive Reasons has unique philosophical advantages over competing views of reasons, and that it has compelling practical advantages in how it directs us to respond to different others.

Plastic anisotropy of hexagonal closed packed metals

Plunkett, Brian W University of Florida 2005 해외박사(DDOD)

Due to the effects of twinning and texture evolution, the yield surface for hexagonal closed packed (hcp) metals displays an asymmetry between the yield in tension and compression, and significantly changes its shape with accumulated plastic deformation. Traditional initial yield criteria or hardening assumptions such as isotropic or kinematic hardening cannot accurately model these phenomena. In this dissertation, a macroscopic anisotropic model that can describe both the initial yielding and influence of evolving texture on the plastic response of hexagonal metals is proposed. Initial yielding is described by a newly developed macroscopic yield criterion that accounts for both anisotropy and asymmetry between yielding in tension and compression. The coefficients involved in this proposed yield criterion as well as the size of the elastic domain are then considered to be functions of the accumulated plastic strain. Viscoplastic self-consistent polycrystal simulations and a newly developed interpolation technique are then used to determine the evolution laws. The proposed model was implemented into the implicit finite element code ABAQUS and used to simulate the three-dimensional deformation of a pure zirconium beam subjected to four-point bend tests along different directions with respect to the texture orientation. Comparison between predicted and measured macroscopic strain fields and beam sections shows that the proposed model describes very well the contribution of twinning to deformation. The proposed model is then extended to include the effects of strain rate and the temperate increase within the material due to mechanical work. The proposed rate and temperature dependent model was implemented into ABAQUS/EXPLICIT and used to simulate the three-dimensional Taylor impact experiment for specimens made from pure zirconium and from a tantalum alloy. The post experiment data and simulation results are shown to be in very good agreement.

Multi-wavelength, Multi-scale Observations of Outflows in Star-Forming Regions

Plunkett, Adele Laurie Dennis Yale University 2015 해외박사(DDOD)

During the early stages of star formation, an embedded protostar accretes mass and simultaneously expels mass and angular momentum in the form of a bipolar outflow. In the common case of clustered star formation, outflows likely impact their surrounding environment and influence subsequent star formation. Numerical simulations have shown that outflows can sustain turbulence and maintain a cluster in quasi-equilibrium; alternatively, it was proposed that outflows may trigger rather than regulate or inhibit star formation. Observations of outflows and their impact on clusters are challenging because they must probe spatial scales over several orders of magnitude --- from the size of a core (a few hundred AU, or N ~ 10-3 pc) to a cluster (a few pc) --- and previous works generally focused on one scale or the other. This thesis incorporates high-resolution, high-sensitivity interferometry observations (with millimeter/sub-millimeter wavelengths) complemented by observations obtained using single dish telescopes in order to assess molecular outflow properties and their cumulative impact in two young protostellar clusters: Serpens South and NGC 1333. Based on these case studies, I develop an evolutionary scenario for clustered star formation spanning the ages of the two clusters, about 0.1 - 1 Myr. Within this scenario, outflows in both Serpens South and NGC 1333 provide sufficient energy to sustain turbulence early in the protocluster formation process. In neither cluster do outflows provide enough energy to counter the gravitational potential energy and disrupt the entire cluster. However, most of the mass in outflows in both clusters have velocities greater than the escape velocity, and therefore the relative importance of outflow-driven turbulence compared with gravitational potential likely changes with time as ambient gas escapes. We estimate that enough gas mass will escape via outflows in Serpens South so that it will come to resemble NGC 1333 in terms of its ratio of outflow energy to gravitational binding energy; further, if gas escapes from NGC 1333, then outflow energy and gravitational energy may become comparable within the next N ~ 0.5 Myr, possibly disrupting the cluster. Finally, we investigate the properties of a particular Class 0 molecular outflow in Serpens South, providing evidence for episodic outflow events and corresponding accretion at a very early stage. This remarkable outflow remains intact even within the active, central hub region of Serpens South.