Lipscomb University

The wellbeing of astronauts on long-duration space missions is critical to current and future mission success. It is equally important that those who support astronauts, pre-mission, during the mission, and post-mission, are thriving as well. Therefore, this interpretative phenomenological analysis study examines how a selection of NASA leaders perceive a phenomenon, awe, along with related resilience practices, as supporting their wellbeing in both their professional work and personal lives. The results reveal that awe-narrative interviews can support them professionally while also enhancing their overall wellbeing. Awe narratives have the ability to serve as a gateway to other resilience practices, including cognitive reappraisal, finding meaning and purpose in life, gratitude, hope and optimism, and social connectedness. These results suggest the awe narrative-based interventions can offer both an evidence-based and practical way to benefit NASA personnel, as well as other professionals working in high-pressure and stressful environments.

Honors classes in secondary schools are designed to provide advanced learning opportunities for both identified gifted students and high-potential students. They also serve as a bridge to AP/IB classes or other advanced coursework. Beyond preparing students for future courses, honors classes can play a role in talent development by supporting students in engaging in disciplinary thinking and progressing towards expertise in specific domains. Distinguishing between honors and standards courses is essential for district leaders, curriculum specialists, and teachers to design differentiated advanced learning experiences. Without a structured framework, the rigor and expectations for honors courses may vary significantly, limiting the effectiveness and value of honors classes. This article introduces the 4C Honors framework that includes advanced content, complexity, critical and creative reasoning, and context/transfer with student inquiry driving all components. The article includes considerations for intentional program design, implementation, and evaluation of secondary honors courses.

Abstract This exploratory paper examines how the practical application of narrative medicine (NM) has the capability to support police hostage/crisis negotiators. Narrative medicine ensures that the humanity and dignity of both medical professional and patients are constantly addressed while the patient is being treated for their illness. While the medical professional purposefully involves the patient’s story as a crucial part of the process, it is suggested that negotiators can adapt a similar approach when assisting a person in crisis. This paper explores the foundation of NM and important terms through the lens of its application and potential contribution in police-related crisis work. In conclusion, synthesizing narrative practices and skills with police crisis incidents can benefit negotiators professionally while also contributing to enhancing their personal resilience and overall wellbeing.

Virtue theory has occupied a place of relative prominence within the Christian intellectual tradition. But there is a problem facing it: how one contemplates the virtues and vices will ultimately depend upon deeper accounts of the good and the right. Accordingly, virtue theory is incomplete, at least when taken by itself. Our task in this paper is to show that neither of the standard approaches to explaining the metaphysical foundations of morality within the Christian tradition—natural law theory and divine command theory—are sufficient to fix this incompleteness. We thus propose a combination of natural law theory and divine command theory to remedy the matter. The upshot of our argument, then, is this: what counts as a virtue ultimately depends upon the natural law and divine commands.

Abstract Background Congestion in acute heart failure (AHF) is treated with furosemide, mainly in continuous infusion (furosemide continuous, FC) or iv boluses, and combination of different diuretics. Randomized controlled trials (RCTs) only compared the efficacy and safety of some diuretic strategies with discordant results. Purpose To provide a comprehensive synthesis of the effects of diuretic regimens in AHF. Methods The PubMed, EMBASE, SCOPUS and Cochrane databases were searched for phase III RCTs until July 31st, 2023, evaluating diuretics without any other intervention in patients admitted for AHF, with randomization within 48 hours, no run-in period and/or need of clinical stabilization. The arms assigned to iv boluses or undefined schemas of furosemide/loop diuretic (LD) were grouped together as "furosemide bolus" (FB). The endpoints were weight loss over 24 hours (WL), worsening renal function (WRF), total urine output (tUO) and net urine output (nUO) over 24 hours, hypokalemia (hypoK), and hyponatremia (hypoNa). Heterogeneity was estimated by Thompsons’ I2 statistics, and odds ratios (OR) with 95% confidence intervals were calculated by means of a random-effects model with inverse variance weighting. A leave-one-out analysis, an analysis limited to studies with specified mode of furosemide/LD administration, and an analysis of measures of congestion/decongestion were also carried out. Results Twenty-five RCTs were selected, for a total of 7,095 patients with mean age 69.2±11.1 years and mean LVEF 38.1±12.7%. In subjects treated with furosemide/LD, the mean furosemide equivalent dose was 154.7±53.0 mg/24 hours. Heterogeneity was moderate-to-high (37.3%-66.0% across the study endpoints). FC, FB plus tolvaptan, FB plus sodium-glucose cotransporter inhibitor (SGLT2i), and FB plus thiazide were associated with greater WL than FB (Figure 1A). The combination of FB and thiazide or SGLT2i also portended higher odds of WRF than FB alone, as did the combination of FB and acetazolamide (Figure 1B). tUO was greater with FC (OR 2.77 [1.98-3.88]), FB plus tolvaptan (OR 1.69 [1.22-2.35]), and FB plus SGLT2i (OR 1.95 [1.16-3.28]) than with FB, and nUO was greater with FC (OR 1.50 [1.06-2.13]) and FB plus tolvaptan (OR 1.76 [1.06-2.92]) than with FB. Compared with FB, hypoK was more frequent with FB and thiazide (OR 1.68 [1.29-2.19]), while there was a trend for less hypoK events with FB plus tolvaptan (OR 0.86 [0.69-1.08]). No differences in hypoNa rates were found. Sensitivity analyses were consistent with the main one. Thirteen (52%) and 14 (56%) studies had published information about symptoms and signs of congestion, respectively, and 6 (24%) adopted pre-specified scoring systems. Conclusions FC and most combination diuretic regimens have greater efficacy than FB in promoting WL and diuresis, but at the cost of WRF and hyoK, especially when thiazide is used. Congestion has inconsistently been evaluated in RCTs of diuretic therapy in AHF.

ABSTRACT The diet during pregnancy, or antenatal diet, influences the offspring’s intestinal health. We previously showed that antenatal butyrate supplementation reduces injury in adult murine offspring with dextran sulfate sodium (DSS)-induced colitis. Potential modulators of butyrate levels in the intestine include a high fiber diet or dietary supplementation with probiotics. To test this, we supplemented the diet of pregnant mice with high fiber, or with the probiotic bacteria Lactococcus lactis subspecies cremoris or Lactobacillus rhamnosus GG. We then induced chronic colitis with DSS in their adult offspring. We demonstrate that a high fiber antenatal diet, or supplementation with Lactococcus lactis subspecies cremoris during pregnancy diminished the injury from DSS-induced colitis in offspring. These data are evidence that antenatal dietary interventions impact offspring gut health and define the antenatal diet as a therapeutic modality to enhance offspring intestinal health.

This paper builds on continuing research to study the impact of humanitarian engineering projects on student professional formation and views of diversity, equity, and inclusion. It is well-known that engineering lacks diversity and attempts to increase representation of women and racial minorities has not been as fruitful as hoped. The goals of this research study aim to create a more inclusive and equitable workplace environment through student involvement in humanitarian engineering projects. Thus far, the project has shown positive results through qualitative analysis of two open-ended questions from a survey The survey also employed two existing Likert-scaled instruments: the Engineering Professional Responsibility Assessment and the Valuing Diversity and Enacting Inclusion in Engineering instrument. This paper will focus on the quantitative results from these instruments in the survey from three participant groups: current engineering students at Lipscomb University, alumni of the engineering program at Lipscomb, and engineering professionals who are not affiliated with Lipscomb University. The results are compared to data from the existing instruments with a focus on connectedness and inclusive behaviors. Additionally, comparisons were made across sub-groups separated by involvement or non-involvement in humanitarian engineering projects. Interestingly, the quantitative results show significant difference from the existing instruments for the dimensions examined but little significance across the sub-groups. Data from two students who participated in the questionnaire before and after participating in a humanitarian engineering project is also presented. From these results, the authors conclude that the sampling methods may have had an impact on the mixed significance and that further qualitative methods may be appropriate for deeper study. For future work, the project team will conduct interviews with selected participants toward building a model for creating inclusive engineers through humanitarian engineering projects.

Guidelines provide varying recommendations for the prophylactic antimicrobial treatment of open fractures. This single-center, retrospective cohort study was conducted to determine how well an institutional prophylactic antibiotic protocol covered pathogens associated with open fractures. The authors included adult trauma patients with one or more open fractures and a positive culture from the site of the open fracture, and compared outcomes between patients who were covered by prophylactic antibiotics with patients not covered by prophylactic antibiotics. Of 957 patients evaluated, 75 were included, with 40 patients (53%) covered by the prophylactic antibiotics received. Multidrug-resistant pathogens were isolated in 23 (58%) patients covered versus 26 (74%) patients not covered (p = 0.128). The median time to positive culture was less in patients not covered by initial antibiotics compared with those who were covered (30.2 vs. 102.1 days; p = 0.003). Over half of the patients developed cultures with pathogens that were covered by their initial antibiotic prophylaxis. (Journal of Surgical Orthopaedic Advances 33(2):084-087, 2024).