Occupational Therapy Caregiver\u27s Guide to Spinal Cord Injury

In 2006, it was estimated that there were 253,000 Americans living with spinal cord injuries (SCI) (Spinal Cord Injury Information Network, 2003, p. 1). Current literature suggests that individuals are transitioning into the community earlier with the majority of care being provided by informal caregivers (Boschen, Tonack, & Gargaro, 2005). These caregivers are often unprepared for the major role they will be assuming in the care of their loved one and often their health and well-being is compromised due to the overwhelming nature of caregiving. A comprehensive literature review was conducted to explore and identify the needs of caregivers. Topics researched included spinal cord injury (SCI), treatments, caregiving, caregiver needs and interventions, and caregiver resources. In addition, the literature was reviewed regarding best practice strategies to deal with the changing needs and lifestyles the family may experience. The literature review revealed that there were few resources examining caregivers of individuals with SCI, many of the needs of the caregiver were identified and shown to be underserved. Based upon the literature review, the Occupational Therapy Caregiver\u27s Guide to Spinal Cord Injll1Y has been developed to assist caregivers in performing their new role of primary caregiver. It provides them with information on basic patient care guidelines as well as information on the caregiver\u27s physical and psychosocial wellbeing. The guide also provides the caregiver with information on the importance of continuing their prior occupations along with their new occupations. Lastly, the guide will provide the caregiver with a list of resources that may be useful in trying times such as the benefits of respite care. The authors hope that the guide will begin to bridge the gap faced by caregivers of individuals with spinal cord injury. It is hoped that unifying the resources and strategies in the guide will decrease the caregivers stress so he or she can be in a more healthy and supportive role during the recovery process

Staff engagement for practice change in long-term care: evaluating the Feasible and Sustainable Culture Change Initiative (FASCCI) model

Context: Interventions aimed at increasing the provision of person-centred care in long-term care (LTC) homes, that do not address contextual and system issues, most often fail. Promoting positive change in LTC homes requires requires a multilevel, systems approach. Objectives: Evaluate the effectiveness of the Feasible and Sustainable Culture Change Initiative (FASCCI) model for improving the provision of person-centred mealtime practices in a LTC home. Methods: A single-group, time series design was used to assess the impact of the FASCCI model for change on outcome measures across four time periods (pre-intervention, 2-month, 4-month and 6-month follow-up). Differences in scores from baseline were assessed utilizing Wilcoxon signed-rank tests. Interviews (n = 21) were also conducted to examine treatment fidelity and to ascertain the study participants’ perceptions of the process for making improvements using the FASCCI model. Findings: We observed increases in care staff’s capacity to consistently provide relational and person-centred care during mealtimes. Mealtime environment scores started increasing immediately following the intervention, with statistically significant improvements in all mealtime environment scales by six-months, including: the physical environment (W = 55.00, p = 0.008); social environment (W = 55.00, p = 0.008); relationship-centred care (W = 45.00, p = 0.014); and overall quality of dining environment (W = 55.00, p = 0.010). Analysis of data from qualitative interviews demonstrated that use of the FASCCI model resulted in improved team leadership, communication, and collaborative decision-making. Limitations: Generalizability is limited due to the small sample size and use of convenience sampling methods. Implications: Outcomes indicate that the FASCCI model seems promising in its ability to improve PCC mealtime practices in LTC homes and is worthy of a larger scale study. The results further demonstrate the value of supportive team environments in quality dementia care

Using Artificial Intelligence Technology for Social Determinants and Risk Factors Surveillance

Session topic area Data science methods: machine learning in risk factor surveillance Overall objectives or goal Background Decades of research have shown that factors such as living conditions, and not just medical treatments and lifestyles, are strongly associated with the health of individuals and populations. These distal factors (social, economic, cultural and environmental) are collectively called the social determinants of health (SDOH), and affect health inequities (i.e. differences in health outcomes that are avoidable, unfair and unjust). Gathering data on both risk factors (biomedical/clinical) and SDOH is of the utmost importance to quantify their contribution in disease causation at individual and population levels. Social determinants of health and biomedical/clinical risk factors surveillance (collectively termed as “risk factor surveillance”) refers to the monitoring of distal and proximal factors that impact the health of individuals and populations and health equity. It offers the opportunity to “forecast” population health, potential disease incidence, and guide intervention programs to prevent disease manifestation. However, current risk factor surveillance data is limited in geographical representation, completion, and content and time. Identifying novel methods of collecting risk factors and SDOH data can allow for opportunities for population health and disease forecasting using high quality, nationally-representative, real-time data. Recent breakthroughs in artificial intelligence (AI), such as speech and image recognition, offers new opportunities to develop novel methods to collect risk factor information at individual levels. Meanwhile, we can use intelligent computer systems to process vast amount of data and turn those data into actionable information and knowledge for improving population health. Collaborative Session Objective Through a CIHR-funded project, we are assembling a team of national and international experts including stakeholders, public health officers/physicians, and researchers, who will identify key gaps in risk factor surveillance and data collection technologies. Resulting projects will focus on using AI for risk factor surveillance, for the ultimate purpose of monitoring population health, guiding intervention programs, and preventing disease. Our projects will focus on discovering and refining innovative methods in data collection, management, as well as assessment of data quality (i.e. selection bias). We will engage scientists and knowledge users from the inception of the ideas to ensure the relevancy of the final projects. This project aims to link medical records, clinical information, and SDOH data, to alter the way we conduct surveillance and work with big data. Facilitators involved; home institutions Dr. Vineet Saini, University of Calgary; Alberta Health Services Dr. Mingkai Peng, University of Calgary Dr. Hude Quan, University of Calgary; World Health Organization Collaborating Centre for Classification, Measurement and Standardization Intended output or outcome • Identify AI technologies for use in risk factor surveillance; innovative methods in data collection, management, as well as assessment of data quality (i.e. selection bias); uses for new data sources in improving health equity. • Create partnerships between national and international experts in risk factor surveillanc

Population genetic analysis of Chadian Guinea worms reveals that human and non-human hosts share common parasite populations

Following almost 10 years of no reported cases, Guinea worm disease (GWD or dracunculiasis) reemerged in Chad in 2010 with peculiar epidemiological patterns and unprecedented prevalence of infection among non-human hosts, particularly domestic dogs. Since 2014, animal infections with Guinea worms have also been observed in the other three countries with endemic transmission (Ethiopia, Mali, and South Sudan), causing concern and generating interest in the parasites’ true taxonomic identity and population genetics. We present the first extensive population genetic data for Guinea worm, investigating mitochondrial and microsatellite variation in adult female worms from both human and non-human hosts in the four endemic countries to elucidate the origins of Chad’s current outbreak and possible host-specific differences between parasites. Genetic diversity of Chadian Guinea worms was considerably higher than that of the other three countries, even after controlling for sample size through rarefaction, and demographic analyses are consistent with a large, stable parasite population. Genealogical analyses eliminate the other three countries as possible sources of parasite reintroduction into Chad, and sequence divergence and distribution of genetic variation provide no evidence that parasites in human and non-human hosts are separate species or maintain isolated transmission cycles. Both among and within countries, geographic origin appears to have more influence on parasite population structure than host species. Guinea worm infection in non-human hosts has been occasionally reported throughout the history of the disease, particularly when elimination programs appear to be reaching their end goals. However, no previous reports have evaluated molecular support of the parasite species identity. Our data confirm that Guinea worms collected from non-human hosts in the remaining endemic countries of Africa are Dracunculus medinensis and that the same population of worms infects both humans and dogs in Chad. Our genetic data and the epidemiological evidence suggest that transmission in the Chadian context is currently being maintained by canine hosts

Investigation of the deposition and emission of mercury in arctic snow during an atmospheric mercury depletion event

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94701/1/jgrd14741.pd

Hypertension persisting after pre-eclampsia: a prospective cohort study at Mulago Hospital, Uganda.

BACKGROUND: Pre-eclampsia/eclampsia usually resolves after delivery but sometimes hypertension persists and cardiovascular disease develops later. Our objective was to determine the incidence and maternal socio-demographic and obstetric risk factors for persistence of hypertension in women with pre-eclampsia/eclampsia. METHODS: This was a prospective cohort study conducted from July 2009 to June 2011 at Mulago Hospital labour ward and postnatal clinics. We followed up 188 women admitted with pre-eclampsia/eclampsia until 3 months after delivery. Data was collected using interviewer-administered questionnaires, examination of participants and review of medical records. Stata (version12) software was used for data analysis. Univariable analysis was used to compute the relative risk of persistent hypertension at the 95% confidence level. This was followed by multivariable logistic regression analysis to determine factors independently associated with persistence of hypertension. RESULTS: 64 (34%) out of the 188 women analysed had persistent hypertension three months after delivery. Maternal age, gestational age at delivery and parity were predictors of persistent hypertension. CONCLUSION: The proportion of women with pre-eclampsia/eclampsia at risk of persistent hypertension at three months after delivery was high, with nearly one of three mothers remaining hypertensive. Follow up of mothers who develop pre-eclampsia is important so that early diagnosis and management of chronic hypertension can be made to avoid long term morbidity and mortality

The association of polymorphisms in hormone metabolism pathway genes, menopausal hormone therapy, and breast cancer risk: a nested case-control study in the California Teachers Study cohort

Abstract Introduction The female sex steroids estrogen and progesterone are important in breast cancer etiology. It therefore seems plausible that variation in genes involved in metabolism of these hormones may affect breast cancer risk, and that these associations may vary depending on menopausal status and use of hormone therapy. Methods We conducted a nested case-control study of breast cancer in the California Teachers Study cohort. We analyzed 317 tagging single nucleotide polymorphisms (SNPs) in 24 hormone pathway genes in 2746 non-Hispanic white women: 1351 cases and 1395 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by fitting conditional logistic regression models using all women or subgroups of women defined by menopausal status and hormone therapy use. P values were adjusted for multiple correlated tests (P ACT). Results The strongest associations were observed for SNPs in SLCO1B1, a solute carrier organic anion transporter gene, which transports estradiol-17β-glucuronide and estrone-3-sulfate from the blood into hepatocytes. Ten of 38 tagging SNPs of SLCO1B1 showed significant associations with postmenopausal breast cancer risk; 5 SNPs (rs11045777, rs11045773, rs16923519, rs4149057, rs11045884) remained statistically significant after adjusting for multiple testing within this gene (P ACT = 0.019-0.046). In postmenopausal women who were using combined estrogen-progestin therapy (EPT) at cohort enrollment, the OR of breast cancer was 2.31 (95% CI = 1.47-3.62) per minor allele of rs4149013 in SLCO1B1 (P = 0.0003; within-gene P ACT = 0.002; overall P ACT = 0.023). SNPs in other hormone pathway genes evaluated in this study were not associated with breast cancer risk in premenopausal or postmenopausal women. Conclusions We found evidence that genetic variation in SLCO1B1 is associated with breast cancer risk in postmenopausal women, particularly among those using EPT