Storm event impact on organic matter flux, composition and reactivity in Taskinas Creek, VA

Carbon export from the land to the ocean are an important part of the global carbon cycle, linking terrestrial watersheds and the global carbon cycle. Burial of terrestrial organic carbon represents a long term sink for atmospheric CO2. Approximately 0.4 Pg Cy-1 is delivered to the global ocean from rivers, equally divided between POC and DOC. However, the amount of carbon entering the ocean is a small portion of the total amount entering rivers from the terrestrial environment, suggesting a large amount of processing in inland waters and estuaries. Most monitoring efforts have focused the processing of organic matter on baseflow conditions. However, recent studies have shown that POC and DOC exported during storm events, a small time period during a hydrologic year, can account for the majority of the annual carbon exported from small watersheds. This dissertation identifies the impact different magnitudes of storm events have on the source, composition and reactivity of organic carbon released to downstream waters from the terrestrial environment at Taskinas Creek, Virginia. The proximity of the Creek to the York River estuary, the changes in water table at the site, along with the small size of the watershed allowing opportunity to examine the connectivity between the watershed processes and delivery of organic matter made the site ideal for identifying how hydrology and environment alter POM and DOM export and reactivity. The sources, composition and flux of DOM and POM were measured during four storm events of different magnitudes to determine how events impacted the sources and fluxes of organic matter and the % reactive DOC exported. Events of different magnitudes with varying sources of DOC and POC had similar % reactive DOC that was not predicted using excitation emission spectroscopy. The events resulted in DOC fluxes 1.5-490 fold higher than baseflow. POC fluxes for storm were 6.7-55 times higher than DOC fluxes. Although the % reactive DOC did not increase during storm event conditions, coupled with the overall flux, storm events represent a considerable pulse of % reactive DOC to downstream waters, well above baseflow levels. When considered with increases in storm intensity due to climate change, storm event fluxes of reactive OM may have broad impacts on estuaries and the global carbon cycle through changes in carbon storage

Negotiating culturally incongruent healthcare systems : the process of accessing dementia care in northern Saskatchewan

This study is an exploration of the process of accessing dementia care for Aboriginal Older Adults living in Northern Saskatchewan. The research question for this project was, “What is the process of accessing formal healthcare for dementia from the perspective of Northern Saskatchewan Aboriginal communities, and what factors specifically impede or encourage accessing formal care?” Grounded theory methodology informed the research process. Theoretical sampling resulted in a sample of thirty participants. Data were generated through eighteen in-person, semi-structured interviews; two in-person, semi-structured group interviews; and three focus group discussions including a directed activity led by participants. Analysis of data using the grounded theory constant comparison method led to an emergent theory that was verified by research participants.The theory that emerged explains the basic social process at the heart of the research question. The grounded theory, “The process of negotiating culturally incongruent healthcare systems” explains the access to and use of formal healthcare from the perspective of those living in Northern Saskatchewan. Specific attention to the social context of healthcare access helped to illuminate the challenges faced by Aboriginal Older Adults when accessing healthcare services. The findings indicate a need for enhancing the cultural competence of healthcare provision to Older Adults with dementia in Northern Saskatchewan while providing formal support for those persons with dementia as well as for their informal caregivers

NUTRITION CARE FOR LONG-TERM CARE RESIDENTS WITH DEMENTIA IN URBAN AND RURAL CONTEXTS: AN EVIDENCE BASED PRACTICE EXAMINATION OF THE ROLE OF CARE AIDES AND REGISTERED DIETITIANS

This doctoral dissertation contributes to the body of knowledge pertaining to nutrition care for persons with dementia. The aging population adds to the increased risk for and prevalence of dementia globally. Alongside this is a recognition of the need for care strategies for persons with dementia, and preventive strategies to delay onset of dementia or to delay secondary or tertiary comorbidity associated with dementia. Of strong interest is the field of nutrition, in terms of dietary strategies for primary prevention of dementia, for secondary and tertiary prevention of comorbidities, and for medical nutrition therapies to treat those with dementia, across the spectrum of dementing illnesses and degree of severity. Over the course of three related studies, nutrition care for long-term care (LTC residents was addressed using an evidence-based practice lens. Study 1 investigated care aides’ perception of nutrition care for urban and rural LTC residents with dementia. Key findings included the complexity of operationalizing person centered care into nutrition care activities, the mechanistic focus on feeding, and many organizational factors that direct nutrition care for care aides and residents with dementia. Study 2 examined the role of registered dietitians (RDs) in providing nutrition care for residents with dementia in urban and rural LTC. The key finding in this study was the downstream role of RDs in dementia care. As opposed to a more upstream preventive model of care, RDs were consulted or involved only at late stages or when comorbid decline had occurred, limiting their abilities to use their specialized nutrition knowledge and skills effectively. The 3rd study was an umbrella review of the peer-reviewed body of systematic reviews on nutrition care for residents with dementia in LTC. The major findings of this study include the lack of consistency in terms of nutritional outcomes considered and intervention tested, as well as a considerable gap in the published literature regarding both care aides and RDs. Taken together, these studies make a valuable contribution to the growing body of research on nutrition care and dementia. There is a need to continue to work with RDs and care aides in developing and testing interventions that can enhance both the physical health and quality of life for LTC residents with dementia