Microglia, the innate immune cells of the central nervous system, feature adaptive immune memory with implications for brain homeostasis and pathologies. However, factors involved in the emergence and regulation of these opposing responses in microglia have not been fully addressed. Recently, we showed that microglia from the newborn brain display features of trained immunity and immune tolerance after repeated contact with pathogens in a dose-dependent manner. Here, we evaluate the impact of developmental stage on adaptive immune responses of brain microglia after repeated challenge with ultra-low (1 fg/ml) and high (100 ng/ml) doses of the endotoxin LPS in vitro. We find that priming of naïve microglia derived from newborn but not mature and aged murine brain with ultra-low LPS significantly increased levels of pro-inflammatory mediators TNF-α, IL-6, IL-1β, MMP-9, and iNOS as well as neurotrophic factors indicating induction of trained immunity (p < 0.05). In contrast, stimulation with high doses of LPS led to a robust downregulation of pro-inflammatory cytokines and iNOS independent of the developmental state, indicating induced immune tolerance. Furthermore, high-dose priming with LPS upregulated anti-inflammatory mediators IL-10, Arg-1, TGF- β, MSR1, and IL-4 in newborn microglia (p < 0.05). Our data indicate pronounced plasticity of the immune response of neonate microglia compared with microglia derived from mature and aged mouse brain. Induced trained immunity after priming with ultra-low LPS doses may be responsible for enhanced neuro-inflammatory susceptibility of immature brain. In contrast, the immunosuppressed phenotype following high-dose LPS priming might be prone to attenuate excessive damage after recurrent systemic inflammation.

Induction of trained immunity (innate immune memory) is mediated by activation of immune and metabolic pathways that result in epigenetic rewiring of cellular functional programs. Through network-level integration of transcriptomics and metabolomics data, we identify glycolysis, glutaminolysis, and the cholesterol synthesis pathway as indispensable for the induction of trained immunity by β-glucan in monocytes. Accumulation of fumarate, due to glutamine replenishment of the TCA cycle, integrates immune and metabolic circuits to induce monocyte epigenetic reprogramming by inhibiting KDM5 histone demethylases. Furthermore, fumarate itself induced an epigenetic program similar to β-glucan-induced trained immunity. In line with this, inhibition of glutaminolysis and cholesterol synthesis in mice reduced the induction of trained immunity by β-glucan. Identification of the metabolic pathways leading to induction of trained immunity contributes to our understanding of innate immune memory and opens new therapeutic avenues.

Background: Correctional nurses make up a large part of the corrections workforce and have increasing responsibility for making decisions about patient care in the opioid dependent incarcerated patients. The National Commission on Correctional Health Care (NCCHC) has intoxication and withdrawal standards that advocate individuals entering a correctional facility under the influence or undergoing withdrawal from opioids have their therapy continued, or a plan for appropriate referral for treatment. The NCCHC standard that incarcerated opioid dependent inmates have their therapy continued or a plan for appropriate referral for treatment is not adhered to consistently, as the current process lacks organization. Purpose: The purpose of this quality improvement project was to develop an adult opioid dependence referral for treatment tool for opioid use dependent patients to be utilized by correctional nurses and providers working in the corrections intake medical facility with posttest evaluation. Theoretical Framework: Peplau’s nurse-patient relationship theory was used. Methods: A descriptive, exploratory design was utilized. Results: A majority of the nurses acknowledged the usefulness of the Nursing Opioid Referral for Treatment Algorithm (NORTA) in facilitating the adult opioid dependence referral process. In addition, of the 20 nurses surveyed, 18 nurses agreed that the NORTA tool was relevant to the adult opioid dependence referral process. Most claimed that the NORTA facilitated the opioid dependence referral process. Conclusion: The pain management algorithm is an effective referral method for opioid users as it contributes to patient safety through safe prescription and careful assessment of patient risk regarding opioid use. The findings from this project may impact nursing practice by identification of a new organized approach to enhance the current opioid dependence referral process.

The purpose of this study is to examine the phenomenon of institutional credential devaluation and the impacts on internationally-trained social workers in Canada. International social workers are recruited to immigrate to Canada based on their credentials and experience but some discover after immigrating that their qualifications are devalued which limits or prohibits their ability to engage in professional practice. This experience is recognized within the literature in other professions; however, there has been insufficient attention given to it within social work itself and to the various stakeholders involved. Using critical theory and interpretative phenomenological analysis, semi-structured interviews were conducted with internationally-trained social workers to gain insight into their experiences of devaluation and graduate degree repetition in Ontario universities. Extensive exploration of the institutional stakeholders in credential assessment, the field of social work and universities was also undertaken and provides systemic context to the experiences of international social workers. While internationally-trained social workers have high views of Canada prior to immigrating, these perspectives change upon encountering systemic devaluation and discrimination post-immigration. They describe confusion, frustration and powerlessness as they navigate through social work systems in seeking to gain recognition of their credentials in order to practice. When they eventually decide to return to Ontario universities to obtain the recognition they need/deserve, they experience continued devaluation. Instead of identifying different or better social work education in Ontario, they describe repetition of what they learned in their countries of origin, raising questions about the similarities and differences in international social work education. The personal costs and psychological impacts of these experiences are shared by the participants. The practices of social work and post-secondary institutions in creating systemic barriers to internationally-trained social workers are examined with recommendations for further research and policy and practice changes that will lead to greater justice and equity. / Thesis / Master of Social Work (MSW)

Ballistic movements have been shown to be controlled differently by the central nervous system than slow, ramp actions. It has been suggested that the cerebellum is involved primarily with ballistic actions, while the basal ganglia primarily control slower movements. These command and control differences have been shown to manifest in unique ways at the neuromuscular level. Ballistic actions evidence high firing rates, brief contraction times, and high rates of force development. A characteristic triphasic agonistantagonist-agonist burst pattern presents itself during ballistic movement, wherein the amount and intensity of antagonist co-activation is variable. In conditions of low-grade tonic muscular activity, a premovement depression (P:MD; or silent period, PMS) can occur in both agonist and antagonist muscles prior to ballistic contraction. The agonist P:MD period may serve to potentiate the force and velocity of the following contraction A selective activation of fast twitch motor units may occur in ballistic contractions under certain movement conditions. Finally, high velocity, ballistic training induces specific neuromuscular adaptations that are representative of the underlying neurophysiological mechanisms that sub serve ballistic movement. / Thesis / Master of Science (MS)

Innate immune memory has become an increasingly popular area of research in the last decade. However, much of the work done on innate immune memory using inflammatory agents such as BCG, C. albicans, and β-glucan has been pursued through systemic administration, which has been shown to induce training in circulating monocytes. In addition, little is known about whether microbial ligands can induce training. Here, we show that local mucosal exposure to an acute dose of LPS induces long-lasting phenotypic changes in airway macrophage populations. LPS-exposed macrophages display increased glycolytic metabolism and differential cytokine expression upon restimulation, whereas circulating monocytes are not affected. Finally, we show that LPS exposure provides long-lasting protection against Streptococcus pneumoniae in the lung, likely due to the higher acquisition of CD11b, which is indicative of macrophage activation and phagocytosis. As much of the work on innate immune memory has been done through systemic administration of training agents, this project aims to fill existing knowledge gaps in the induction of innate immune memory upon local mucosal exposure to inflammatory agents. / Thesis / Master of Science in Medical Sciences (MSMS) / The innate immune system is one of the first defenders in our bodies that fight against a variety of pathogens. In the last decade, the innate immune system was found to be capable of having memory, meaning it reacts faster or at a heightened magnitude in response to a wide range of subsequent pathogens after it is trained by an agent. This project explores the effect a bacteria wall component, LPS, has on the lung environment and examines if it will induce memory in the lung. Our findings show that intranasal exposure to LPS changes the cellular landscape in the lung. LPS-exposed airway innate immune cells become more activated and provide subsequent protection against bacterial infections. This work has implications for using LPS as a vaccine adjuvant in order to provide protection against a variety of pathogens in addition to specific protection brought by the vaccine.

Training can enable performers to express music in a personal and emotional way while communicating aesthetic impressions to an audience. Little research has been done on the emotive experiences of performing musicians listening to their own performances. The main goal of this study was to develop a reliable way to investigate emotive content of such experiences through a combination of listening profiles and continuous measurement. This empirical, methodological study used a mixed-method design. Responses from formally and informally trained musicians were tested. The methodology consists of two parts: listening profiles (Part I), and the continuous measurement of self-reported emotional response to music (Part II), supported by interviews. Part I consists of a demographic questionnaire, a listening test and a personality test. Part II consists of a computerised questionnaire with four questions: 1) word sorting, 2) word, colours, and facial expressions checklists, which participants use to indicate their emotional responses while the music plays, 3) free description, and 4) rating scales. Data was obtained during three test periods. Part I results revealed that personality, illness, preferences, and psychological factors influence the emotive content of listening experiences. Participants’ response time and manner of word sorting was also supportive of their profiles. Part II results revealed that listeners pay attention to both structural and performance elements as well as emotive content in both prescribed and personal musical tracks. Only a few participants were able to identify the predetermined emotion of the prescribed musical tracks. Participants’ experiences seemed to be influenced by training and personal preferences. Listening to their own recorded performances, informally trained participants were able to focus progressively less on performance elements and more on emotive content, while formally trained participants seemed to focus progressively more on performance elements, and less on emotive content. / Thesis (MMus)--North-West University, Potchefstroom Campus, 2012

Training can enable performers to express music in a personal and emotional way while communicating aesthetic impressions to an audience. Little research has been done on the emotive experiences of performing musicians listening to their own performances. The main goal of this study was to develop a reliable way to investigate emotive content of such experiences through a combination of listening profiles and continuous measurement. This empirical, methodological study used a mixed-method design. Responses from formally and informally trained musicians were tested. The methodology consists of two parts: listening profiles (Part I), and the continuous measurement of self-reported emotional response to music (Part II), supported by interviews. Part I consists of a demographic questionnaire, a listening test and a personality test. Part II consists of a computerised questionnaire with four questions: 1) word sorting, 2) word, colours, and facial expressions checklists, which participants use to indicate their emotional responses while the music plays, 3) free description, and 4) rating scales. Data was obtained during three test periods. Part I results revealed that personality, illness, preferences, and psychological factors influence the emotive content of listening experiences. Participants’ response time and manner of word sorting was also supportive of their profiles. Part II results revealed that listeners pay attention to both structural and performance elements as well as emotive content in both prescribed and personal musical tracks. Only a few participants were able to identify the predetermined emotion of the prescribed musical tracks. Participants’ experiences seemed to be influenced by training and personal preferences. Listening to their own recorded performances, informally trained participants were able to focus progressively less on performance elements and more on emotive content, while formally trained participants seemed to focus progressively more on performance elements, and less on emotive content. / Thesis (MMus)--North-West University, Potchefstroom Campus, 2012

Foreign-trained healthcare professionals consist of a sizable and important portion of the United States healthcare workforce (Chen et al., 2013; Farkas, 2003; Lowell, 2012). Foreign-trained healthcare workers often encounter various challenges in acclimating and integrating into the American society and workforce. Even though foreign-trained occupational therapists are considered essential, and their difficulties in adjusting are well-recognized, there are very limited bridging and training programs designated solely for this population that incorporate a comprehensive approach and meets their unique needs. Therefore, this doctoral project aimed to understand the barriers to integrating into the local workforce and proposed ways for supporting these highly- educated and experienced professionals in their new country. The resulting solution is A Bright Future Ahead, an online educational and vocational program designed for new foreign occupational therapists. The program’s content and structure are based on existing programs for adjacent health professionals while customizing the program’s layout and content to target occupational therapists. A Bright Future Ahead suggests a multi-layered solution that requires an enormous investment in the program’s development and implementation; however, this program can be expanded in the future to other professions that share similar professional credentialing processes and experience akin barriers.

A multiple baseline design was employed to evaluate the effectiveness of a sibling training package including modeling, role-play, and feedback on play and engagement between children with autism and their siblings. The results of two experiments suggest that, following training, siblings of children with autism correctly implemented all trained interaction components. Additionally, Experiment II assessed and programmed generalization to other materials and a non-training setting. The results showed that some unprogrammed generalization to non-trained toys occurred. Conversely, siblings engaged in trained skills in a non-training setting (home) only following the experimenter's instructions to generalize. In both experiments, the siblings' overall engagement and physical proximity of play in training sessions increased significantly above baseline. This study extends previous research in that it includes additional stimulus and response generalization measures.