One Step at a Time: A Journey of Hope, Inspiration, and Determination

Approximately three million persons in the United States face the challenge of living with Parkinson\u27s Disease (PD). In spite of medical and surgical interventions, the disease progresses, resulting in bradykinesia, rigidity and postural instability that impair functional ability and quality of life. The purpose of this case study is to illuminate the impact an exercise program may have on an individual with PD. A single case study design was used to explore the effect of exercise on the quality of life of a 73-year old gentleman with advanced PD. Interviews and field observations of the client, wife, and staff at a community based exercise facility were conducted. Analyses were based on coding of verbatim transcripts and field notes. Three themes emerged from the study: hope, inspiration, and determination. This case study is an exemplar of the impact exercise conducted in a supportive environment may have on improving the functional ability and quality of life for persons with PD

Engaging Older Adults With Parkinson’s Disease in Physical Activity Using Technology: A Feasibility Study

Parkinson’s disease (PD), a progressive neurodegenerative disorder, presents unique and daily challenges. Living with PD may limit one’s physical activity and negatively affect quality of life (QOL). No studies were identified that utilized online technology to promote health in this population. The purposes of this study were to (a) assess the feasibility of an intervention that requires wearing a physical activity tracker and participating in an online support group, and (b) examine the effect of this intervention on the self-efficacy for physical activity and QOL of older adults with PD. A 12-week longitudinal pretest/posttest design was used to assess physical activity, engagement in an online support group, self-efficacy, and QOL. A postintervention questionnaire was used to capture the participants’ (n = 5) experience using the physical activity tracker and an electronic tablet to engage in an online support group. The sample size of this feasibility study precluded robust quantitative analysis of QOL or self-efficacy. Findings from the open-ended questionnaire suggest technology was challenging for most participants, yet it did provide social support. Teaching effective interventions to promote self-management for increasing physical activity, and consequently improving QOL, is recommended. While technology can assist, older persons with PD may experience technological challenges

Student reflections of psychiatric/mental health: Using journals and creative expressions

Second semester undergraduate nursing students in their psychiatric/mental health clinical rotation express an array of emotions as they frequently view the setting as foreign. Two assignments, reflective journaling and a form of expression were incorporated into clinical to provide students an opportunity to reflect and convey their thoughts and feelings concerning their clinical experiences. Thematic analysis was used to analyze 10 journals and 10 art forms with a written description. Two content themes emerged: A Change in Perspective and Insight. Exemplars of the students’ perspectives are provided. As evidenced by students’ submissions, reflective journaling and creative expression can be an effective and beneficial assignment for students grappling with the complexities of psychiatric/mental health nursing

Student reflections of psychiatric/mental health: Using journals and creative expressions

Second semester undergraduate nursing students in their psychiatric/mental health clinical rotation express an array of emotions as they frequently view the setting as foreign. Two assignments, reflective journaling and a form of expression were incorporated into clinical to provide students an opportunity to reflect and convey their thoughts and feelings concerning their clinical experiences. Thematic analysis was used to analyze 10 journals and 10 art forms with a written description. Two content themes emerged: A Change in Perspective and Insight. Exemplars of the students’ perspectives are provided. As evidenced by students’ submissions, reflective journaling and creative expression can be an effective and beneficial assignment for students grappling with the complexities of psychiatric/mental health nursing

Military nurses caring for the enemy

Purpose: This phenomenological study described the lived experience and aftermath of U.S. military nurses assigned enemy detainees during Operation Iraqi Freedom/Operation Enduring Freedom. Two themes emerged: Insurgent Assignments (subthemes included identification of and interactions with insurgents; training, precautions, and ethical issues, thoughts and feelings, coping, and meanings of insurgent care) and The Aftermath (subthemes were mental, emotional, personal, professional, and positive). Conclusions: Insurgent assignments caused ethical dilemmas and challenged theoretical constructs related to caring. Formal training is needed to prepare nurses for the practicalities of and responses to insurgent assignments. This work is the dissertation manuscript of Sharon Thompson, completed by faculty members in the School of Nursing at The University of Texas at Tyler. A final, published version of this article can be viewed at: https://doi.org/10.20467/1091-5710-18.2.6

Impact of Tai Chi on Peripheral Neuropathy Revisited: A Mixed-Methods Study

Exercise may be beneficial to older persons living with peripheral neuropathy (PN), but maintaining an exercise program is challenging. After participating in a 12-week tai chi (TC) study, 12 participants requested classes continue. A mixed-methods design was used to explore long-term engagement of older persons with bilateral PN enrolled in a TC class for 18 months beyond the original 3-month study. Pre- and posttest measures of functional status and quality of life (QOL) were conducted. Focus groups were held after 18 months of twice-weekly classes. Psychosocial support was critical to participants’ long-term commitment to exercise. Participants reported, and objective assessments confirmed, increased strength, balance, and stamina beyond that experienced in the original 12-week study. Changes in QOL scores were nonsignificant; however, qualitative data supported clinical significance across QOL domains. Results from this study support psychosocial and physical benefits of TC to older persons

Tai Chi Exercise on Muscle Strength and Physical Function in Peripheral Neuropathy Patients

This poster was presented at the American College of Sports Medicine\u27s (ACSM) 63rd Annual Meeting and World Congresses, Boston, MA.https://scholarworks.uttyler.edu/fac_posters/1016/thumbnail.jp

Effect of Tai Chi on Vascular Function Among Patients with Peripheral Neuropathy

Foot pain due to Peripheral Neuropathy (PN) is one of the factors affecting walking ability. It has been reported that diminished vascular function contributes to a decrease in physical function in individuals with PN. Microvascular disturbances have been reported in humans with neuropathic pain. Tai Chi, a Chinese conditioning exercise, has been associated with enhanced endothelial function. However, the effect of Tai Chi training on microvascular function in patients with PN has not been studied. This study aimed to assess the effects of Tai Chi on vascular function (i.e., vascular reactivity) and functional exercise capacity among patients with PN. Thirty-seven participants (men = 21, women = 16) were randomly assigned to either Tai Chi exercise (Ex, n = 20, age: 71 ± 9.50 years) or control group (Con, n = 17, age: 75 ± 9.02 years). Exercise training consisted of 12-week progressive Tai Chi (i.e., Yang Style), offered 3 times per week, 60 minutes sessions. The Con group did not participate in any exercise activity. Before and after training, vascular function [finger tip digital thermal monitoring of vascular reactivity] and functional exercise capacity [Six-Minute Walk test (6MW)] were evaluated. The Ex group experienced a significant 25% increase in vascular reactivity index from baseline [1.93 ± 0.43 to 2.41 ± 0.47, (P \u3c 0.05)]. In addition, the 6MW test increased significantly in the Ex group by 28% [pre = 392 ± 93; post = 503 ± 105 m, (P \u3c 0.05)]. In the control group no significant changes were observed in either vascular function [1.83 ± 0.43 to 1.81 ± 0.37] or in the 6MW test [393 ± 142 to 398 ± 149 m]. Participants experienced no complications and/or falls as a result of the intervention. These findings demonstrated that in patients with PN, a 12-week progressive Tai Chi exercise program was capable of increasing not only vascular function, specifically vascular reactivity index, but also of increasing the distance covered during the 6MW test. Clearly, this study underlies the importance of Tai Chi as an effective and safe exercise intervention suitable for patients with PN

A patient with glycogen storage disease type Ib presenting with acute myeloid leukemia (AML) bearing monosomy 7 and translocation t(3;8)(q26;q24) after 14 years of treatment with granulocyte colony-stimulating factor (G-CSF): A case report

<p>Abstract</p> <p>Introduction</p> <p>Glycogen storage disease type Ib is an autosomal recessive transmitted disorder of glycogen metabolism caused by mutations in the glucose-6-phosphate translocase gene on chromosome 11q23 and leads to disturbed glycogenolysis as well as gluconeogenesis. Besides hepatomegaly, growth retardation, hypoglycemia, hyperlactatemia, hyperuricemia and hyperlipidemia, patients suffer from neutropenia associated with functional defects predisposing for severe infections. In order to attenuate these complications, long-term treatment with granulocyte colony-stimulating factor is common but this is associated with an increased risk for acute myeloid leukemia or myelodysplastic syndromes in patients with inherited bone marrow failures such as severe congenital neutropenia. Onset of these myeloid malignancies is linked to cytogenetic aberrations involving chromosome 7. In addition, granulocyte colony-stimulating factor is known to stimulate proliferation of monosomy 7 cells <it>in vitro</it>. To our knowledge, we report for the first time a case report of a patient with glycogen storage disease type Ib, who developed acute myeloid leukemia with a classical monosomy 7 and acute myeloid leukemia-associated translocation t(3;8)(q26;q24) after 14 years of continuous treatment with granulocyte colony-stimulating factor.</p> <p>Case presentation</p> <p>A 28-year-old Turkish man with glycogen storage disease type Ib was admitted to our department because of dyspnea and increasing fatigue. He also presented with gum bleeding, bone pain in his legs, night sweats, recurrent episodes of fever with temperatures up to 39°C and hepatosplenomegaly.</p> <p>A blood count taken on the day of admission showed pancytopenia and a differential count displayed 30% blasts. A bone marrow biopsy was taken which showed a hypercellular marrow with dysplastic features of all three cell lines, while blast count was 20%. Classical cytogenetic analyses as well as fluorescence in situ hybridization showed a monosomy 7 with a translocation t(3;8)(q26;q24). Based on these findings, the diagnosis of acute myeloid leukemia was made.</p> <p>Conclusion</p> <p>Our observations suggest that bone marrow examinations including cytogenetic analysis should be carried out on a regular basis in patients with glycogen storage disease type Ib who are on long-term treatment with granulocyte colony-stimulating factor for severe neutropenia, since this treatment might also contribute to an increased risk for acute myeloid leukemia or myelodysplastic syndromes.</p

The Far-Infrared Spectral Energy Distributions of X-ray-selected Active Galaxies

[Abridged] We present ISO far-infrared (IR) observations of 21 hard X-ray selected AGN from the HEAO-1 A2 sample. We compare the far-IR to X-ray spectral energy distributions (SEDs) of this sample with various radio and optically selected AGN samples. The hard-X-ray selected sample shows a wider range of optical/UV shapes extending to redder near-IR colors. The bluer objects are Seyfert 1s, while the redder AGN are mostly intermediate or type 2 Seyferts. This is consistent with a modified unification model in which the amount of obscuring material increases with viewing angle and may be clumpy. Such a scenario, already suggested by differing optical/near-IR spectroscopic and X-ray AGN classifications, allows for different amounts of obscuration of the continuum emission in different wavebands and of the broad emission line region which results in a mixture of behaviors for AGN with similar optical emission line classifications. The resulting limits on the column density of obscuring material through which we are viewing the redder AGN are 100 times lower than for the standard optically thick torus models. The resulting decrease in optical depth of the obscuring material allows the AGN to heat more dust at larger radial distances. We show that an AGN-heated, flared, dusty disk with mass 10^9 solar and size of few hundred pc is able to generate optical-far-IR SEDs which reproduce the wide range of SEDs present in our sample with no need for an additional starburst component to generate the long-wavelength, cooler part of the IR continuum.Comment: 40 pages, 14 figures, accepted for publication in Astrophysical Journal, V. 590, June 10, 200