Evaluation of an intervention program for assisting family caregivers with placement decisions

The emotional aspect of caregiving is extremely complex and caregivers face tremendous emotional challenges as they react to the reality of their loved one\u27s increasing disability. When it comes to making the placement decision, caregivers have frequently reached a burnout point in making decisions

The Impact of Mount Washington on the Height of the Boundary Layer and the Vertical Structure of Temperature and Moisture

Discrimination of the type of air mass along mountain slopes can be a challenge and is not commonly performed, but is critical for identifying factors responsible for influencing montane weather, climate, and air quality. A field campaign to measure air mass type and transitions on the summit of Mount Washington, New Hampshire, USA was performed on 19 August 2016. Meteorological observations were taken at the summit and at several sites along the east and west slopes. Ozone concentrations were measured at the summit and on the valley floor. Additionally, water vapor stable isotopes were measured from a truck that drove up and down the Mount Washington Auto Road concurrent with radiosonde launches that profiled the free atmosphere. This multivariate perspective revealed thermal, moisture, and air mass height differences among the free atmosphere, leeward, and windward mountain slopes. Both thermally and mechanically forced upslope flows helped shape these differences by altering the height of the boundary layer with respect to the mountain surface. Recommendations for measurement strategies hoping to develop accurate observational climatologies of air mass exposure in complex terrain are discussed and will be important for evaluating elevation-dependent warming and improving forecasting for weather and air quality

"It's very saddening, you keep on wondering when the symptoms will be over":A qualitative study exploring the long-term chikungunya disease impact on daily life and well-being, 6 years after disease onset

BACKGROUND: Long-term chikungunya is a mosquito-borne disease, characterized by disabling rheumatic symptoms persisting for years, after infection with the chikungunya virus. Previous studies focused on assessing the well-being of affected individuals from a quantitative perspective using generic instruments, and have reported physical and psychological impairment. However, a common critique is that generic instrument's structured responses and pre-defined health domains selected by health professionals, may not capture the full extent of well-being impairment experienced by patients. This study aimed to explore in-depth to which extent long-term chikungunya disease impacts daily living and the physical, psychological, and social well-being from the experiences and perspective of affected individuals. METHODOLOGY/PRINCIPAL FINDINGS: Using open-ended questions, in-depth interviews were conducted with 20 purposively selected individuals with long-term chikungunya disease, in Curaçao. Interview audio-recordings were transcribed verbatim. The data were thematically analyzed. Living with persistent rheumatic symptoms affected the participant's daily living and well-being in several ways: experience of physical impact (restricted physical functioning and limitations in activities of daily life); experience of psychological impact (altered emotional state, fear of walking and running, psychosocial aspects of footwear adaptations, and uncertainty about disease progression and future health); and experience of social impact (social isolation and impaired relational maintenance, social dependency, challenges of social support, at-work productivity loss, and giving up leisure activities after work). CONCLUSIONS/SIGNIFICANCE: This study, the first of its kind, indicated that the adverse impact of long-term chikungunya disease is currently underreported. The persistent rheumatic symptoms had a negative effect on functional ability, which in turn impacted broad aspects of daily life and well-being, beyond what is captured by generic instruments. In the view of the findings, physical exercise programs including manual therapy, aerobics, resistance and stretching exercises, and orthopaedic footwear interventions in a multidisciplinary patient-centred approach may improve physical function and subsequently overall well-being.</p

"It's very saddening, you keep on wondering when the symptoms will be over":A qualitative study exploring the long-term chikungunya disease impact on daily life and well-being, 6 years after disease onset

BACKGROUND: Long-term chikungunya is a mosquito-borne disease, characterized by disabling rheumatic symptoms persisting for years, after infection with the chikungunya virus. Previous studies focused on assessing the well-being of affected individuals from a quantitative perspective using generic instruments, and have reported physical and psychological impairment. However, a common critique is that generic instrument's structured responses and pre-defined health domains selected by health professionals, may not capture the full extent of well-being impairment experienced by patients. This study aimed to explore in-depth to which extent long-term chikungunya disease impacts daily living and the physical, psychological, and social well-being from the experiences and perspective of affected individuals. METHODOLOGY/PRINCIPAL FINDINGS: Using open-ended questions, in-depth interviews were conducted with 20 purposively selected individuals with long-term chikungunya disease, in Curaçao. Interview audio-recordings were transcribed verbatim. The data were thematically analyzed. Living with persistent rheumatic symptoms affected the participant's daily living and well-being in several ways: experience of physical impact (restricted physical functioning and limitations in activities of daily life); experience of psychological impact (altered emotional state, fear of walking and running, psychosocial aspects of footwear adaptations, and uncertainty about disease progression and future health); and experience of social impact (social isolation and impaired relational maintenance, social dependency, challenges of social support, at-work productivity loss, and giving up leisure activities after work). CONCLUSIONS/SIGNIFICANCE: This study, the first of its kind, indicated that the adverse impact of long-term chikungunya disease is currently underreported. The persistent rheumatic symptoms had a negative effect on functional ability, which in turn impacted broad aspects of daily life and well-being, beyond what is captured by generic instruments. In the view of the findings, physical exercise programs including manual therapy, aerobics, resistance and stretching exercises, and orthopaedic footwear interventions in a multidisciplinary patient-centred approach may improve physical function and subsequently overall well-being.</p