From ocean to ocean, or, The Salvation Army\u27s march from Atlantic to the Pacific

https://place.asburyseminary.edu/ecommonsatsdigitalresources/1519/thumbnail.jp

\u3cem\u3eVaccinium corymbodendron\u3c/em\u3e Dunal as a bridge between taxonomic sections and ploidies in \u3cem\u3eVaccinium\u3c/em\u3e: A work in progress

The species V. corymbodendron of section Pyxothamnus has shown value as a potential bridge between taxonomic sections and ploidies in Vaccinium when involved as either a first generation or second generation parent. Tetraploid V. corymbodendron has hybridized successfully with 2x and 4x section Cyanococcus species and with 2x section Vitis-idaea. Hybridizations with other sections are currently being tested. Second generation allotetraploid V. corymbodendron - V. vitis-idaea hybrids have hybridized successfully with 4x section Oxycoccus (cranberry), 4x section Cyanococcus (blueberry), and 2x section Vitis-idaea (lingonberry). It appears that these allotetraploid hybrids may allow gene movement among these diverse sections at the 4x level. Further test-crosses are being made to evaluate the range of crossability of 4x V. corymbodendron and the V. corymbodendron allotetraploids with other taxonomic sections of Ericaceae

To establish the effect of task oriented group circuit training for people affected by stroke in the public healthcare sector in RSA

Stroke remains a serious public health problem in low, middle and high income countries worldwide. In low and middle income countries there has been a greater than 100% increase in stroke incidence. The impact of HIV associated vasculopathy is recognized as contributing to the increased prevalence of stroke in younger patients (Tipping et al., 2007) and is an independent risk factor for stroke (Cole et al., 2004). The impact of this increased stroke incidence has not only resulted in an increase in death rates in the developing world, but has also resulted in increases noted in long term disability as a result of stroke. The available resources for stroke care and rehabilitation are lacking in developing countries including Africa, particularly in rural areas. It has also been noted that 80% of the population live in areas where factors such as limited resources and cultural practices limit access to stroke services (Poungvarin 1998). Currently patients with stroke are discharged from hospitals in the public healthcare sector within six to 14 days of having a stroke, because of the pressure for beds (Mudzi, 2009; Reid et al., 2005; Hale, 2000). As a result patients are not benefitting from rehabilitation services and this leads to suboptimal recovery post stroke and to a large number of persons living with disabilities in under resourced communities. Because the patients with stroke are discharged so acutely after their stroke, carers become a necessity to cope with the burden of care. These conditions result in increased stroke survivor dependence in South Africa compared to the USA or New Zealand. While 80% of stroke survivors who are initially unable to walk achieve independent walking (Jorgensen et al., 1995), at three months post stroke 25%-33% still require assistance or supervision when walking (Jorgenson et al., 1995; Duncan et al., 1994; Richards et al., 1993). Unfortunately these independent walkers seldom achieve walking speeds that are sufficient for community ambulation (Schmid et al., 2007; Lord and Rochester, 2005; Lord et al., 2004). Walking competency is a term used to describe a certain level of walking ability allowing an individual to participate in the community safely and efficiently (Salbach et al., 2004). It should also be noted that even those with mild and moderate strokes experience limitations with higher physical functioning which impacts on their quality of life and ability to return to work (Duncan and Lai, 1997). The cerebral cortex has the ability to undergo functional and structural reorganization for several weeks and even months in more severe cases post stroke. Rehabilitation post stroke facilitates this process and can shape the reorganization of the adjacent intact cortex (Green, 2003). Further, it has been concluded that to facilitate the best possible functional outcome for people post stroke, engagement in intensive task oriented therapy is necessary (Kwakkel et al., 2004; Van Peppen et al., 2004). Considering these findings it is extremely concerning that there is little or no rehabilitation provided to stroke survivors in the public healthcare sector in South Africa (Mudzi, 2009; Rhoda and Hendry 2003; Hale and Wallner, 1996; Stewart et al., 1994). With this in mind, the aim of this study was to determine if an out -patient based task oriented group training programme would promote improved walking competency more than the current progressive resistance strength group training programmes that are common practice in persons who have had an acute stroke in the public healthcare system in South Africa. The specific objectives of this study were to establish the effect of a low intensity, namely once a week (for six weeks), out- patient based task programme on: walking competency, walking endurance, gait speed and health status in terms of physical functioning in persons with sub-acute stroke. Due to the high incidence of post stroke survivors with HIV it was important to establish if the training programme produced comparable effects in HIV positive and HIV negative subjects. This study used a stratified blocked randomised controlled trial design. Where group allocation was concealed. In addition assessor blinded evaluations were conducted at baseline, post intervention and at six months after the intervention had ceased. A total of 144 persons who had a stroke were stratified according to their walking speed – mild (able to walk at a gait speed > 0.8m/s), moderate (able to walk at a speed of 0.4-0.8 m/s) or severe (able to walk at a speed < 0.4m/s) – and randomly assiged to one of three training groups. One group received task oriented group circuit training (task group), the second group received progressive resistance strength training (strength group), and the third group participated in one multidisciplinary education group training session (control group). The task and strength interventions included 6 sessions, of 60 minutes each for six to 12 weeks. While the control intervention group participated in one three hour education session, which included advice on the importance of exercise and a 20-minute exercise session. All subjects had been discharged from the public healthcare sector and were less than six months post stroke at inclusion into the study. The primary objective was walking competency, which included the measurement of walking endurance, gait speed, functional balance and mobility (Salbach et al., 2004). The task group showed an improvement that was significantly greater than that achieved by the strength and control groups in walking endurance, gait speed, functional mobility and balance at the follow-up. These findings demonstrate that the provision of as little as six sessions of task training (in a developing country, where persons with sub-acute stroke have had no previous rehabilitation) improves walking competency to a significantly greater extent than either a strength intervention of equal intensity, or a control intervention programme consisting of one three hour education visit in the sub -acute phase post stroke. While the strength group received a more frequent and intensive training compared with the control group, there were no significant differences in terms of walking competency between these two groups over the study period. The task group showed significantly greater improvements in walking endurance, comfortable and maximum gait speed than the strength and control groups immediately post intervention. While post intervention, the task training led to superior gains in functional mobility and balance compared to the control group, it was not superior to the strength group. For subjects, with a moderate gait disability at baseline, the improvements in walking endurance and in comfortable and maximum walking speed in the task group were significantly more than the strength and control groups. For subjects with a severe gait deficit at baseline, the task group improved significantly more than the control group on all measures of walking competency but not significantly more than the strength group. There were no significant differences among the groups for subjects with a mild gait deficit at baseline. All three treatment intervention groups improved their score on the stroke impact scale 16 (SIS 16) over the course of the study period. The task group improved significantly more than the control group’s health status in terms of physical functioning measured by the SIS16. There were no significant differences among the groups in the change scores for the measures of walking competency between the HIV positive and HIV negative subjects throughout the study period. The results of this study demonstrate that an extremely limited number of task training sessions resulted in significantly greater improvements in walking competency than progressive strength training or a multidisciplinary education training approach. However, these results must be interpreted with caution, remembering the context of the sample population who had not received a period of inpatient rehabilitation prior to their inclusion into the study and were 10-15 years younger than subjects in numerous other studies. This appears to be the first study conducted with such a limited rehabilitative intervention post stroke. As a result, further research to evaluate the effectiveness of limited intensity task oriented training interventions for non -ambulant stroke survivors in the developing world where resources are limited, needs to be conducted. It is important to explore the benefits of different group based rehabilitative interventions for stroke survivors to alleviate the burden as a result of disability as much as possible. Key words: Stroke, Task Oriented, Rehabilitation, Walking, Walking Competenc

Implementing Affirmative Action: Global Trends

This scoping article gives a global picture of dynamics, trends, policies and mechanisms for engaging with women's representation in political office. It discusses the kind of affirmative action introduced, and where it features vis?à?vis electoral cycles. It describes and compares candidate and reserved seats quotas and shows how electoral systems influence the possibilities of challenging power hierarchies in politics. The second part of the article reflects on the extent to which implementing quotas have been effective in engendering political representation and the conditions that allow or inhibit this

The carry-over effect of an aquatic-based intervention in children with cerebral palsy

Background: Cerebral palsy (CP) is the most common motor disability in childhood. Children with CP are more likely to have lower levels of physical activity than their peers, which has negative implications for their health. However, aquatic exercise can be used to improve levels of fitness among children with CP. Objective: To determine the carry-over effect of an aquatic-based programme (postural control and balance) on land (walking, running and jumping) in children with CP, post aquatic intervention. Method: The study used a pretest-post-test, randomised group, cross-over design. Children aged 8–12 years (n = 10) were divided into intervention (n = 5) and control (n = 5) groups. The intervention group participated in two 30-min sessions a week, while the control group continued with normal activities. Pre- and post-intervention testing was conducted using gross motor function measurement. The 10-point programme of the Halliwick Concept was used. Results: Results demonstrated that the aquatic therapy had a significant effect on gross motor function scores. The aquatic programme-based group showed increased motor function following the intervention, compared to the control group (z = -2.803, p = 0.005). Furthermore, the aquatic-based therapy improved the average score for gross motor function measurement, post-intervention. Conclusion: Together with conventional modes of therapy, aquatic-based programmes should be integrated and considered as an essential, ongoing mode of treatment for children with CP, in order to ensure long-term gross motor function improvements

Religious Coping and Types and Sources of Information Used in Making Prostate Cancer Treatment Decisions.

Treatment experiences for prostate cancer survivors can be challenging and dependent on many clinical and psychosocial factors. One area that is less understood is the information needs and sources men utilize. Among these is the influence of religion as a valid typology and the value it may have on treatment decisions. The objective of this study was to assess the relationship between race, religion, and cancer treatment decisions in African American men compared with White men. Data were from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 877 African American and White men. The main dependent variables sought respondents’ use of resources or advisors when making treatment decisions. Questions also assessed men perceptions of prostate cancer from the perspective of religious coping. After adjusting for age, marital status, education, and insurance status, race differences in the number of sources utilized were partially mediated by cancer was a punishment from God (β = −0.46, SE = 0.012, p \u3c .001), cancer was a test of faith (β = −0.49, SE = 0.013, p \u3c .001), and cancer can be cured with enough prayer (β = −0.47, SE = 0.013, p \u3c .001). Similarly, race differences in the number of advisors utilized in making the treatment decision were partially mediated by cancer was a punishment from God (β = −0.39, SE = 0.014, p = .006), and cancer was a test of faith (β = −0.39, SE = 0.014, p = .006). Religious views on prostate cancer may play an important role in explaining race differences in information used and the number of advisors utilized for treatment decision making for prostate cancer

Beyond Tinkering with the System: Rethinking Gender, Power and Politics

This article offers some reflections on how the 1995 Beijing Platform for Action (BPfA) theme of women and decision?making power came to be translated into a set of policy directions, and what their implementation suggests in terms of their potential to challenge power hierarchies. The article draws on work from the Pathways of Women's Empowerment programme on voice and constituency building. The article argues that the policy focus of the BPfA, after the introduction of MDG 3 in particular, became one of redressing gender disparities in representation in legislatures. Twenty years later, we are at a critical juncture at which we need to ask ourselves whether we need to go beyond numbers in parliament as a proxy for political empowerment, and probe into: what kind of politics, through which pathways, in relation to whom, to achieve what

Minimal access surgery for congenital diaphragmatic hernia: surgical tricks to facilitate anchoring the patches to the ribs

Objective: Minimal Access Surgery (MAS) for Congenital Diaphragmatic Hernia (CDH) repair is well described, yet only a minority of surgeons report this as their preferred operative approach. Some surgeons find it particularly difficult to repair the defect using MAS and convert to laparotomy when a patch is required. We present in this study our institutional experience in using an easy and relatively cheap methodology to anchor the patch around the ribs using Endo Close™. This device has an application in MAS for tissue approximation using percutaneous suturing. Methods and technique: We retrospectively reviewed our database for patients undergoing MAS repair of CDH between 2009 and 2021. Outcome measures included length of surgery and recurrence rates after patch repair. Endo Close™ was used in all patients who required patch repair. We declare no conflict of interest and to not having received any funding from Medtronic (UK). The technique is as follows: (1) The edges of the diaphragm are delineated by dissection. When primary suture repair of the diaphragmatic hernia was unfeasible without tension, a patch was used. (2) The patch is anchored in place by two corner stitches at the medial and lateral borders. (3) The posterior border of the patch is fixed to the diaphragmatic edge by running or interrupted stitches. (4) For securing the anterior border, a non-absorbable suture is passed through the anterior chest wall and the patch border is taken with intracorporeal instruments. (5) Without making another stab incision, the Endo Close™ is tunnelled subcutaneously through the anterior chest wall. (6) The suture end is pulled through the Endo Close™ and the knot is tied around the rib. This procedure can be performed as many times as required to secure the patch. Results: 58 patients underwent MAS surgery for repair of CDH between 2009 and 2021. 48 (82%) presented with a left defect. 34 (58%) had a patch repair. The length of patch repair surgery for CDH ranged from 100–343 min (median 197). There was only one patient (3%) in the patch repair cohort that had a recurrent hernia, diagnosed 12 months after the initial surgery. Conclusions: In our experience, MAS repair of CDH is feasible. We adopted a low threshold in using a patch to achieve a tension-free repair. We believe that the Endo Close™ is a cheap and safe method to help securing the patch around the ribs

A systematic review on the effects of group singing on persistent pain in people with long‐term health conditions

Singing can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long‐term health conditions. We searched for published peer‐reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31 July 2018). After screening 123 full texts, 13 studies met the inclusion criteria: five randomized controlled trials (RCTs), seven non‐RCTs and one qualitative study. Included studies were appraised using Downs and Black and the Critical Appraisals Skills Programme quality assessments. Included studies reported differences in the type of singing intervention, long‐term condition and pain measures. Due to the high heterogeneity, we conducted a narrative review. Singing interventions were found to reduce pain intensity in most studies, but there was more equivocal support for reducing pain interference and depression. Additionally, qualitative data synthesis identified three key linked and complementary themes: physical, psychological and social benefits. Group singing appears to have the potential to reduce pain intensity, pain interference and depression; however, we conclude that there is only partial support for singing on some pain outcomes based on the limited available evidence of varied quality. Given the positive findings of qualitative studies, this review recommends that practitioners are encouraged to continue this work. More studies of better quality are needed. Future studies should adopt more robust methodology and report their singing intervention in details. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long‐term health conditions.Health and Social Care Research Centr