Does Preoperative Ostomy Education Decrease Anxiety in the New Ostomy Patient?

Background: There are approximately 100,000 patients with new ileostomies and colostomies created in the United States each year. These patients have specialized needs that include acceptance of altered body image, psychological stress, learning of difficult tasks, and occasionally an ominous diagnosis leading to the need for surgery. In addition to pre-surgical stoma site marking on the abdomen, ostomy nurses have identified early education to be an important factor in long-term success and management of the patient . Early education and stoma site marking may assist with a better-situated stoma leading to fewer complications related to appliance adherence and leakage. New ostomy patients that are well prepared may be able to adapt to the new body image and are more successful in management following ostomy surgery. Problem: Psychologists and sociologists have identified a link between anxiety levels and memory. Anxiety can affect learning by interfering with the attention process of the brain. This interference can hinder the ability of ostomy patients to effectively listen, learn, and perform ostomy care for themselves which places an increased demand on family, caregivers, and home health nurses. Pre-surgical education may offer reduced anxiety levels in post-operative patients, which may provide an improved environment for learning. Methods: Participants considered for study inclusion were those scheduled for ostomy surgery. Patients in Group 1 were provided with pre-surgical ostomy education and routine pre-surgical education, whereas patients in Group 2 were provided with routine pre-operative education only. The Hospital Anxiety and Depression Scoring tool (HADS) was administered during the post- operative period. The surveys were administered by a certified wound, ostomy, continence nurse practitioner. Analysis of Variance (ANOVA) was used to compare changes in anxiety scores between the two groups. Results: Of the 30 participants in the study, 22 were male (73.3%) and 8 were female (26.7%). The mean age was 65.27 ± 9.97 for Group 1 and 61.87 ± 17.56 for group 2. This difference was not statistically significant (p\u3e0.05). Both groups had an equal number of males (n=11) and females (n=4). Group 1 consisted of 9 colostomy patients, 4 ileostomy patients, and 2 urostomy patients. Group 2 consisted of 10 colostomy patients, 4 ileostomy patients and 1 urostomy patient. Patients who had pre-surgical ostomy education had statistically significant lower post surgical anxiety scores than patients who had standard education (p\u3c0.001). Conclusions: The findings of this study suggest that offering pre-operative ostomy education in addition to routine pre-operative education, significantly lowers anxiety when compared with patients who do not receive the pre-operative ostomy education

Leading Turnaround and Improvement in Low Performing Schools in Malaysia and Indonesia

Improving the fortunes of low-performing schools, often in the most challenging circumstances, remains a persistent and pervasive challenge in many education systems (Meyers & Darwin, 2017). This working paper outlines the findings from a small, qualitative comparative research project funded by the Head Foundation. The working paper commences with some explanation and contextualization of the idea of ‘turnaround schools’ from the literature. It presents the research methodology and subsequently outlines the main findings from the research project

A Modular Low-clearance Wrist Orthosis for Improving Wrist Motion in Children with Cerebral Palsy

Children with Cerebral Palsy (CP) often exhibit impairments in the coordination of the grip and lift phases of arm movements that directly impact their ability to perform activities of daily living (ADLs). The application of assistive robotic therapy to children with spastic hemiplegic CP has shown that augmented movement training can lead to improved functional outcomes and improved arm kinematics. Assistive robotic therapy of the wrist has been shown to help improve motor skills in stroke patients, but the devices employed are often large and obtrusive, focusing on a repeated motion rather than a task-based itinerary. Here, we propose a lightweight low clearance wrist orthosis for use in children with Cerebral Palsy that actuates pronation/supination and flexion/extension of the wrist

Reconnecting whānau: Pathways to recovery for Māori with bipolar disorder

While Māori are known to experience a higher burden of mental health and addiction problems compared to non-Māori (Baxter, 2008), little exploratory research has been conducted into Māori experiences of bipolar affective disorder. Bipolar disorder is at times regarded as a “life sentence”, with little hope of recovery. The recovery- focused mental health literature, however, argues wellness is achievable for even the most intractable conditions (Lapsley, Nikora, & Black, 2002; Mental Health Commission, 2001). The aim of this research was to gather information about the experiences of Māori who were diagnosed with bipolar affective disorder. Interviews were conducted with 22 Māori wāhine (women) and tāne (men), and using thematic analyses, themes relevant to their life stories were uncovered. This research sought to contribute to the realisation of Māori potential by explicitly shifting from deficit- focused frameworks to a focus on systemic factors that influenced Māori wellbeing. Highlights were that whānau (participants) who were connected with friends, partners and family were motivated to achieve wellness and to stay well

Lactobacillus ruminis strains cluster according to their mammalian gut source

peer-reviewedBackground Lactobacillus ruminis is a motile Lactobacillus that is autochthonous to the human gut, and which may also be isolated from other mammals. Detailed characterization of L. ruminis has previously been restricted to strains of human and bovine origin. We therefore sought to expand our bio-bank of strains to identify and characterise isolates of porcine and equine origin by comparative genomics. Results We isolated five strains from the faeces of horses and two strains from pigs, and compared their motility, biochemistry and genetic relatedness to six human isolates and three bovine isolates including the type strain 27780T. Multilocus sequence typing analysis based on concatenated sequence data for six individual loci separated the 16 L. ruminis strains into three clades concordant with human, bovine or porcine, and equine sources. Sequencing the genomes of four additional strains of human, bovine, equine and porcine origin revealed a high level of genome synteny, independent of the source animal. Analysis of carbohydrate utilization, stress survival and technological robustness in a combined panel of sixteen L. ruminis isolates identified strains with optimal survival characteristics suitable for future investigation as candidate probiotics. Under laboratory conditions, six human isolates of L. ruminis tested were aflagellate and non-motile, whereas all 10 strains of bovine, equine and porcine origin were motile. Interestingly the equine and porcine strains were hyper-flagellated compared to bovine isolates, and this hyper-flagellate phenotype correlated with the ability to swarm on solid medium containing up to 1.8% agar. Analysis by RNA sequencing and qRT-PCR identified genes for the biosynthesis of flagella, genes for carbohydrate metabolism and genes of unknown function that were differentially expressed in swarming cells of an equine isolate of L. ruminis. Conclusions We suggest that Lactobacillus ruminis isolates have potential to be used in the functional food industry. We have also identified a MLST scheme able to distinguish between strains of L. ruminis of different origin. Genes for non-digestible oligosaccharide metabolism were identified with a putative role in swarming behaviour.This work was supported by a Principal Investigator Award (07/IN.1/B1780) from Science Foundation Ireland to P.W. O’Toole

Correlations Between Internal and External Power Outputs During Weightlifting Exercise

Identifying loads that maximize mechanical power is important because training at such loads may optimize gains in dynamic athletic performance. The purpose of this study was to examine correlations between measures of external mechanical power output and internal mechanical joint power output across different loads during a weightlifting exercise. Ten subjects performed 3 sets of the clean exercise at 65, 75, and 85% of 1 repetition maximum (1RM). Peak external mechanical power output was calculated with 4 commonly used methods, whereas an inverse dynamics approach was used to calculate peak internal mechanical power output for the hip, knee, and ankle joints along with the peak of the sum of all internal joint powers. All peak mechanical power outputs were expressed as relative peak power by either ratio (watts per kilogram) or allometrically scaling to body mass (W·kg-0.67). Correlation coefficients were used to compare power output measures. The greatest numbers of significant correlations between internal and external power outputs were observed at 85% of 1RM, at this load hip and knee joint power outputs were correlated to external mechanical power output when calculated with the traditional work-energy method. In addition, the peak sum of all mechanical joint powers was correlated to mechanical power output when calculated with the impulse-momentum method at loads of 75 and 85% of the 1RM. Allometric scaling of power outputs yielded one more significant correlation than did the ratio scaled power outputs. These findings support the use of the work-energy method when making inferences about internal joint powers from external power outputs when loads equal to 85% of 1RM are being lifted. In addition, the impulse-momentum method may be used to make inferences about the sum of all internal joint powers from external power outputs when loads between 75 and 85% of 1RM are being lifted

Lower Extremity Biomechanics During Weightlifting Exercise Vary Across Joint and Load

The purpose of this study was to determine the effect of load on lower extremity biomechanics during the pull-phase of the clean. Kinematic and kinetic data of the three joints of the lower extremity were collected while participants performed multiple sets of cleans at three percentages: 65, 75, and 85% of 1-Reptition maximum (RM). General linear models with repeated measures were used to assess the influence of load on angular velocities, net torques, powers, and rates of torque development at the ankle, knee, and hip joint. The results suggest that the biomechanical demands required from the lower extremities change with the lifted load and to an extent depend on the respective joint. Most notably, the hip and knee extended significantly faster than the ankle independent of load, while the hip and ankle generally produced significantly higher torques than the knee. Torque, rate of torque development, and power at the ankle and knee joint were maximal at 85% and 75% of 1-RM, respectively, whereas torque and rate of torque development at the hip were maximal at loads above 75% and 85% of 1-RM, respectively. This study provides important novel information about the mechanical demands of a weightlifting exercise and should be heeded in the design of resistance training programs

The Prediction of Violent Recidivism Amongst Individuals with Mental Disorders: Situational vs. Dispositional Factors

The objective of this study is to evaluate why some individuals with mental illness are more inclined to violently recidivate. There appears to be two perspectives that may explain recidivism: one that emphasizes situational factors and one that emphasizes dispositional factors. Situational factors are those that are constantly changing within one’s life, whereas dispositional factors are those that remain relatively stable over time. Therefore, dispositional factors would theoretically put individuals with mental illness at stable risk for recidivism because these factors remain relatively stable over time. In fact, perhaps individuals with mental illness repeatedly engage in violence because they have a dispositional trait (like low self-control, for example) that puts them at stable risk for recidivism. Conversely, situational factors would theoretically explain why individuals do not engage in recidivism because they are transient and constantly changing. Therefore, perhaps one desists from violence because some situational factor changed in that individual’s life. Using data from the MacArthur Violence Risk Assessment study (i.e. MacRisk), a longitudinal study of people with serious mental illness, violent recidivism will be evaluated across waves. Specifically, the objective is to determine if situational or dispositional factors influence violent recidivism