Healing Institute

Abstract This chapter explores the past, present, and future of design-based education. First, we look at the historical backdrop of design-based education and the literature’s current definitions and understandings of design-based learning. Next, we look at the philosophical underpinnings of narrative inquiry, experience, and design by exploring key philosophers and researchers that bridge the critical intersection of these fields: Dewey, Schwab, Craig, Schön, and Cross. This look to the past philosophers and researchers helps us broaden the understanding of curriculum to curriculum-making, broaden the knowledge of empathy interviewing and sensemaking to the tenets of narrative inquiry, and create an intersection across disciplines to more fully understand what design-based inquiry could be. Finally, we end the chapter by situating the future value of design-based inquiry as a vehicle for building the capabilities of individuals to design to thrive while navigating the critical tensions between the best-loved self and the best-loved society.

Abstract BackgroundLiquid biopsy (LBx) assays are transforming precision oncology by the screening of genomic alterations in cfDNA. These assays provide a less invasive alternative to tissue biopsies, which are not always feasible. Molecular pathology laboratories require LBx assays that detect variants at low allele frequencies using standardized methods.MethodsThis study evaluated the Hedera Profiling 2 ctDNA test panel (HP2) (Hedera Dx, Epalinges, Switzerland), a hybrid capture-based NGS assay for the detection of somatic alterations from cfDNA. Covering 32 genes, HP2 enables the detection of SNVs, Indels, Fusions, CNVs, and MSI status from a single DNA-only workflow. The analytical performance was assessed using reference standards and a diverse cohort of 137 clinical samples pre-characterized by orthogonal methods.ResultsIn reference standards at 0.5% VAF, detection sensitivity and specificity for SNVs/Indels were 96.92% and 99.67%, respectively, and 100% each for Fusions. For MSI with VAFs of ≥1% and CNVs with VAFs of ≥ 2% both achieved 100% sensitivity.ConclusionThis international, multicenter analytical performance evaluation study across a large number of hospital laboratories demonstrated high concordance of HP2 assay with orthogonal methods, confirming its significant potential as a highly sensitive, and efficient Pan-Cancer test for future decentralized LBx testing.

Background. There is substantial literature supporting the use of cellular and/or tissue-based product (CTP) in managing Wagner grade 1 and 2 diabetic foot ulcers (DFUs) and, to a lesser extent, venous leg ulcers (VLUs). Several studies advocate CTP therapy as an effective method for promoting healing in chronic DFUs and VLUs. Objective. To evaluate how the number of CTP applications affect healing and wound area reduction (WAR) rates of DFUs and VLUs. Methods. A multicenter private wound care practice, electronic health record, and database were used to analyze Medicare patients receiving CTPs between January 1, 2018, and December 31, 2023. Wound treatments occurred in the nursing home, private office, and home settings, not in hospital outpatient department settings. This privately funded, non–vendor-sponsored, real-world retrospective analysis included wound closure and WAR rates after each CTP application. Analysis includes current (2024) aspects of proposed local coverage determination changes that limit the number of CTP applications to 4. A paired t test was used to compare mean wound area before CTP applications and after completing CTP applications over a 16-week period. Effect sizes were analyzed using Cohen d, and correlations between the number of CTP applications and WAR were determined using the Pearson correlation coefficient. Results. A total of 257 wounds were reviewed for analysis, of which 123 were DFUs and 134 were VLUs. For both DFUs and VLUs, there was a significant difference in the average initial wound areas (cm2) compared with the average wound areas after the CTP application series (P < .001). Conclusion. This comprehensive retrospective real-world analysis of Medicare patients receiving CTP therapy in conjunction with standard of care treatment of DFUs and VLUs demonstrated significant reduction in the average wound area after completing a CTP application series. The results of this study could be used as a guide for the average number of CTP applications required for the effective treatment of DFUs and VLUs.

The authors pay homage to Black feminists and Black feminism as they reflect on the impact of Black feminism on their lives. The authors challenge readers to examine the ways that anti-Black racism (ABR) persists within the field of psychology and introduce ten strategies from their experiences and research on Black feminism-informed interventions that facilitate resistance and prevention through radical healing. In addition to the strategies offered, readers are provided with next steps and recommendations for addressing ABR in psychology and facilitating radical healing through Black feminism.

Objective: This study determined if diosmin, a flavone glycoside of diosmetin, can repair damaged extracellular endothelial glycocalyx (GCX) (readouts: GCX labels including wheat germ agglutinin (WGA), hyaluronic acid (HA) binding protein, and core protein syndecan-1 (SDC1) antibody). Additionally, the study wanted to identify if diosmin can reverse endothelial dysfunction by improving vascular tone (readouts: endothelial nitric oxide synthase expression (eNOS), vessel wall thickness, and vessel lumen diameter) and vascular permeability (readouts: inflammatory cell uptake). Methods: In a mouse, acute disturbed blood flow pattern was induced by ligating three of the four left carotid artery (LCA) branches. This partial LCA ligation mouse model has shown to induce rapid endothelial dysfunction and loss of endothelial GCX. The right carotid artery (RCA) was the designated control for each mouse, as no surgical intervention occurred. Diosmin (50 mg/kg) was administered daily either orally or intraperitoneally for 7 days, 72 hours after the ligation surgery. One week after the first treatment dose, mice were sacrificed via exsanguination, and tissue was collected and fixed for further processing. Results: Diosmin enhanced endothelial GCX coverage and thickness after one week of treatment, as demonstrated by increased fluorescence of WGA, HA binding protein, and SDC1 antibody label on the diosmin-treated ligated LCA wall, compared to untreated tissue. Furthermore, diosmin also appeared to improve vascular tone as demonstrated by the increase in percent of total eNOS that is activated (p-eNOS/total eNOS) in diosmin-treated ligated LCA, compared to the untreated LCA. Interestingly, diosmin had limited effect on vessel wall thickness and vessel diameter. Finally, diosmin demonstrated attenuation of vessel inflammation by impeding macrophage (CD68 + ) uptake within ligated LCA walls. Conclusion: The novelty of our findings is that diosmin enhances endothelial GCX integrity. This study also demonstrated that diosmin can improve endothelium functionality after injury by decreasing inflammation and improving vascular tone. This work can lead to a new option for endothelial GCX restoration and endothelial-dependent aspects of vascular disease.

There are currently over 80 biomaterials derived from autologous, allogeneic, synthetic and xenogeneic sources, or a combination of any or all these types of materials, available for soft-tissue coverage to effect wound closure. Often generically referred to as cellular and/or tissue-based products (CTPs), they are manufactured under various trade names and marketed for a variety of indications.

There is a large body of research on the importance of addressing culture in psychotherapy. However, less is known about providing critically conscious and racially affirmative therapy for Black, Indigenous, and People of Color (BIPOC) clients in the context of ongoing systemic racism and racism-related stress and trauma, especially in the sociopolitical context of the United States. This article introduces and illustrates the Keeping Radical Healing in Mind Therapeutic Approach using a sample therapy session. To contextualize the therapeutic approach, we outline the need for antiracist and liberatory approaches to psychotherapy and describe in detail the Psychology of Radical Healing theoretical framework. The clinical stance that underpins the Keeping Radical Healing in Mind Therapeutic Approach includes helping clients develop, internalize, and nurture (a) Critical Consciousness, (b) Cultural Authenticity and Self-Knowledge, (c) Radical Hope and Envisioning Possibilities, (d) Collectivism, and (e) Strength and Resistance. To better meet the needs of BIPOC clients, the stance requires clinicians to develop their critical consciousness of systemic racism and interlocking forms of oppression. The clinical case of "Brenda," a Black woman experiencing the effects of racism-related stress while raising a young Black boy, is presented. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent. The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT). This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions' preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ 2 test, 1-way analysis of variance, and repeated-measures analysis of variance. There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency ( P = .002) and spiritual care therapeutics ( P = .038), whereas no significant difference was found for compassion fatigue ( P = .716). The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training. The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.