Addressing barriers to CRPD compatibility for advance planning provisions: an empirical study

This thesis identifies and addresses main barriers to compatibility with the Convention on the Rights of Persons with Disabilities (hereafter referred to as the CRPD) for advance planning provisions in England and Wales. The CRPD reimagines current mental capacity and mental health law, focusing on supporting the individual and respecting individual will and preference. Advance planning is one such explicit form of support. There are two potential uses for advance plans under the CRPD. These are to provide documented will and preference to be used when an individual has lost the ability to communicate, and to self-bind some decisions to overrule future will and preference during a mental health experience. The latter is by far the most contested. Despite ratification in 2009, we are yet to see meaningful legislative attempts at CRPD-compatible advance planning in England and Wales. Attempts are stifled by the retention of mental capacity assessments, their reliance on true self conceptions, and the tension between safeguarding vulnerable adults and the CRPD’s right to take risks and make mistakes. This thesis outlines these barriers to CRPD-compatibility and asks whether and how these barriers resonate with people who have experience of mental health difference. It also considers how identified barriers may be overcome to achieve greater compatibility while achieving the desired support. People with various mental health differences were invited to provide responses to these questions. 6 focus groups and 6 individual interviews were conducted, involving a total of 25 participants. Participants had a range of first and second-hand mental health experiences, including psychosis, PTSD, bipolar, schizophrenia, personality disorder, OCD, anxiety, depression, memory loss, dementia and Alzheimer’s. Main findings provide insight into self with mental health and how this offers a challenge to the true self conception often used to justify advance planning and restrictions to legal capacity. It supports existing research findings demonstrating a desire for self-binding by individuals who experience drastic changes in self and decision making during a mental health experience. Findings also indicate that the nature of mental health and how it impacts self influence participant opinions on self-binding, specifically whether self-binding should be available to all individuals and the scope of decisions an individual could be permitted to self-bind. Currently advance planning works the same for everyone, however these findings suggest a divergent approach may be more appropriate. Findings also indicate support for a non-absolutist adherence to will and preference when this adherence would lead to serious, direct self-harm leading to loss of life. New thinking is explored in relation to advance planning as a potential user-led alternative to mental capacity assessments and a way to opt into state intervention

Integrative Review: The Eat, Sleep, Console Model for Treating Neonatal Abstinence Syndrome

The opioid epidemic in the United States has led to an increase in infants with Neonatal Abstinence Syndrome (NAS). Traditionally, NAS is treated with morphine but there is a lack of a standardized treatment protocol for NAS across institutions (Patrick et al., 2020). Eat, Sleep, Console (ESC) is a new approach to NAS treatment which focuses on the infant’s normal functioning by evaluating feeding, ability to sleep uninterrupted, and ability to be consoled. ESC emphasizes non-pharmacologic therapies and consistent caregiver presence. Many hospitals, including UNC Medical Center have adopted ESC as the standard of care for NAS. The aim of this project was to evaluate the evidence for the safety and efficacy of ESC in managing NAS and to use this information to develop an educational brochure for prenatal clients at the UNC Horizons Clinic in Carrboro, NC. An integrative review of the evidence related to ESC was conducted and found that current evidence supports the quality of the Eat, Sleep, Console approach for treating Neonatal Abstinence Syndrome. ESC was associated with decreases in hospital length of stay and pharmacologic therapy, although there is a need for more rigorous studies including randomized controlled trials.Bachelor of Scienc

Silage- and forage-based diets compared to commercial diets in Ugandan pig growth

Introduction: Smallholder pig farmers in east Africa report that lack of feed, seasonal feed shortages, quality and cost of feed are key constraints to pig rearing. Commercially prepared pig diets are too expensive and there is competition for food between pigs and people. Smallholder farmers typically feed nutritionally unbalanced diets. This results in low average daily gain (ADG) and poor farmer profits. The objective was to compare the ADG of Ugandan pigs fed forage- or silage-based or commercial diets. Materials and Methods: Local and crossbred Ugandan weaner-grower pigs were randomly assigned to commercial or forage- or silage-based diets. The forage-based diet, on an as-fed basis included specific amounts (%) of the following ingredients; avocado (25.5 kg), banana leaf (1.7), cottonseed meal (1.8), jackfruit (21.9), maize bran (9.5), sun-dried fish (3.1), sweet potato vine (36.1), limestone (0.14), salt (0.14) and vitamin/mineral premix (0.07). Silage-based diet included similar amounts of cottonseed meal, jackfruit, minerals and vitamins, but more maize bran (12.4), sun-dried fish (2.7), and ensiled sweet potato vine and tubers (60.8). Pigs were individually weighed every 3 weeks from 9 to 32 weeks of age. Pen-level ADG was compared across diets controlling for breed and starting weight using multiple linear regression. Results: ADG of pigs fed commercial diet was higher than those fed forage- or silage-based diets between 9 and 24 weeks of age (p<0.03). Between 28 and 32 weeks, pigs fed forage-based diets had a lower ADG than those on other diets (P<0.001). Least squares mean ADG (g/pig/day) for pigs fed commercial, forage- and silage-based diets were 294, 36 and 52, respectively at 9–15 weeks; 329, 163, 212 at 15–19 weeks; 574, 112, 362 at 20-24 weeks and 1233, 694, and 994 at 28 to 32 weeks of age. Conclusion: Forage-and silage-based diets were unsuitable for newly-weaned pigs, which may be attributed to higher than anticipated diet ash and fiber contents. However, pigs on forage- and silage-based diets grew better than those on smallholder farms once they reached 20–24 weeks and 15–19 weeks, respectively. This was when pigs were approximately 12 kg body weight. Well-balanced cost-effective diets are needed to improve pig performance in east Africa. Fresh and ensiled locally available feedstuffs can be used in diets that meet the nutrient requirements of pigs. Low-cost forage- and silage-based diets containing some zero-cost feedstuffs are needed to improve the potential for profitability of smallholder pig farming. Efficient use of these feedstuffs is required to promote sustainable smallholder pig rearing enterprises

Feeding decisions for the newly weaned pigs in East Africa are weight dependent

Introduction: Smallholder pig farmers in east Africa typically wean pigs at 6 to 8 weeks. Farmers report that commercially prepared pig diets are too expensive and therefore typically feed forage and food waste. This results in low average daily gain (ADG), especially for the newly weaned pig. The objective was to describe the weaning weights of local and crossbred Ugandan pigs purchased from smallholder farmers and to compare the growth rate of the pigs fed forage- or silage-based or commercial diets by their starting weights. Materials and Methods: Littermate local (n = 45) and crossbred (n = 45) Ugandan pigs were purchased from 14 smallholder farmers and individually weighed at 9 weeks of age. Pigs were randomly assigned to forage- or silage-based or commercial diets, housed in pens of 3 pigs and weighed every 3 weeks. Pigs on each diet were categorized into the lightest, middle, or heaviest tertile. Pig-level ADG was compared within diet and across diet by weight tertile multiple linear regression. Results: Average (SD) and range of body weight for 9-week-old pigs was 5.7 (1.6) and 2.8–10.2 kg for local and 8.0 (1.8) and 3.9 to 11.4 kg for crossbred pigs. From 9 to 20 weeks of age, 19 pigs gained less than 5 kg. All were fed either forage- or silage-based diets. Most pigs on these diets gained less than the smallest pigs fed commercial diet. For pigs fed forage-based, silage-based or commercial diets, the ADG of the lightest tertile of pigs was 18, -8 and 154 gm/d from 9–12 weeks and 115, 142 and 268 gm/d for 18–20 week old pigs fed forage-based, silage-based and commercial diets, respectively. Similarly, for these 3 diets, the ADG for the heaviest tertile of pigs was 32, 44, and 247 gm/d from 9–12 weeks, and 221, 332, and 319 gm/d for 18- to 20-week-old pigs. The ash levels ranged from 9–12, 12–20, and 9–11 % DM for forage-based, silage-based, and commercial diets. The high ash levels may in part explain the low ADG in the study. The highest ash levels were found in the first diets fed to the 9-week-old pigs because we included animal-grade dried fish dust rather than human-grade whole dried fish. The ash levels decreased when this change was made. Conclusion: At 9 weeks of age, there was a wide range of weaning weights for local and crossbred Ugandan pigs purchased from smallholder farms. Farmers should be encouraged to feed commercial diet until the pigs reach 11 kg of body weight. Older and heavier pigs grow well on less expensive forage-based and silage-based diets. ADG will likely be further improved when the ash content of diets can be reduced from both farmer made and commercial diets

Addressing barriers to CRPD compatibility for advance planning provisions: an empirical study

This thesis identifies and addresses main barriers to compatibility with the Convention on the Rights of Persons with Disabilities (hereafter referred to as the CRPD) for advance planning provisions in England and Wales. The CRPD reimagines current mental capacity and mental health law, focusing on supporting the individual and respecting individual will and preference. Advance planning is one such explicit form of support. There are two potential uses for advance plans under the CRPD. These are to provide documented will and preference to be used when an individual has lost the ability to communicate, and to self-bind some decisions to overrule future will and preference during a mental health experience. The latter is by far the most contested. Despite ratification in 2009, we are yet to see meaningful legislative attempts at CRPD-compatible advance planning in England and Wales. Attempts are stifled by the retention of mental capacity assessments, their reliance on true self conceptions, and the tension between safeguarding vulnerable adults and the CRPD’s right to take risks and make mistakes. This thesis outlines these barriers to CRPD-compatibility and asks whether and how these barriers resonate with people who have experience of mental health difference. It also considers how identified barriers may be overcome to achieve greater compatibility while achieving the desired support. People with various mental health differences were invited to provide responses to these questions. 6 focus groups and 6 individual interviews were conducted, involving a total of 25 participants. Participants had a range of first and second-hand mental health experiences, including psychosis, PTSD, bipolar, schizophrenia, personality disorder, OCD, anxiety, depression, memory loss, dementia and Alzheimer’s. Main findings provide insight into self with mental health and how this offers a challenge to the true self conception often used to justify advance planning and restrictions to legal capacity. It supports existing research findings demonstrating a desire for self-binding by individuals who experience drastic changes in self and decision making during a mental health experience. Findings also indicate that the nature of mental health and how it impacts self influence participant opinions on self-binding, specifically whether self-binding should be available to all individuals and the scope of decisions an individual could be permitted to self-bind. Currently advance planning works the same for everyone, however these findings suggest a divergent approach may be more appropriate. Findings also indicate support for a non-absolutist adherence to will and preference when this adherence would lead to serious, direct self-harm leading to loss of life. New thinking is explored in relation to advance planning as a potential user-led alternative to mental capacity assessments and a way to opt into state intervention

Effects of Litter on Aquatic Macrophyte Germination and Growth

In Arkansas, during seasonal drought periods, lake water levels drop leaving exposed mudflats which are primary sites for seedling establishment. Commonly, these exposed mudflats are partially covered with decomposing litter from previous stands of aquatic plants. In this study, aqueous leachates from the litter of four macrophytes, Eleocharis quadrangulata, Justicia americana, Polygonum lapathifolium, and Potamogeton nodosus, were used to test for chemical interference with germination and seedling growth. Only Justicia americana leachate was found to affect the growth of several of the test species. The potential for chemical interference by Justicia litter was evaluated further using extracts of acidified leachate. Resulting bioassays demonstrated significant effects on growth but not on seed germination. Bioassays of chromatographically separated fractions again revealed significant effects on seedling growth. These results suggest that interference by Justicia americana leachate on growth of seedlings is in part allelochemic

Assessing the allelopathy of invasive Robina pseudoacacia in northern Michigan forests

Forest EcosystemsThe rapid spread of invasive species, facilitated by increasing globalization, can have negative impacts on native ecosystems. Our study focuses on Robinia pseudoacacia, an invasive tree species native to the southern Appalachian and Ozark mountains that has spread to multiple continents (Li et al. 2014). Previous studies have suggested that one adaptation that makes R. pseudoacacia successful is the secretion of allelopathic chemicals, which can affect surrounding vegetation (Nasir et al., 2005; Callaway et al., 2011; Dreiss and Volin., 2011; Benesperi et al.,2012; Cierjacks et al., 2013; Medina-Villar et al., 2017). We looked at the effect of age and size of R. pseudoacacia on concentration of allelopathic chemicals, as well as how these chemicals might affect surrounding species composition, diversity, and richness. We hypothesize the following: 1. Robinia pseudoacacia significantly affects species composition, diversity and richness of surrounding vegetation. 2. The concentration of allelopathic compounds within Robinia pseudoacacia is correlated with the age of the tree. 3. The concentration of allelopathic compounds within Robinia pseudoacacia is correlated with the size of the tree. We compared species composition surrounding 20 R. pseudoacacia against 12 control species, Quercus rubra and Acer saccharum. We also tested tree cores to see if age and size of R. pseudoacacia affect the concentration of allelopathic chemicals. We found no significant difference in species composition, diversity, and richness. However, we did find that age and size were significantly positively correlated with allelopathic concentration. The allelopathic effects of R. pseudoacacia on surrounding vegetation may vary depending on ecosystem type, stand density, and other variables. R. pseudoacacia in different life stages may have varying priorities for energy investment, explaining the effect of age and size on concentration of allelopathic compounds.https://deepblue.lib.umich.edu/bitstream/2027.42/143548/1/Carter_Ladd_Lough_Pamenan_Pernecky_2017.PD

Towards appropriate sanitary inspection tools for self supply systems in developing countries

The assessment criteria in many of the available examples of standard sanitary inspection tools are scored on a two-way ‘yes or no’ answer. The possibility of variations between the set out criteria in the forms and the observed sanitary faults are not provided for within the two-way answer system. The use of this type of scoring system may therefore either exaggerate or underplay particular risk factors. Onsite sanitary inspection of urban self supply wells was conducted in Abeokuta, Nigeria. The survey included the inspection of system operations and maintenance, to evaluate systems adequacy for safe water supply. This paper captures the inspection process. It explains the need for moderation of standard sanitary inspection forms to suit the peculiarities of urban self supply wells. The paper introduced a new scoring method and suggests appropriate sanitary survey format for self supply hand dug wells

Buying Bodies

Explores a variety of aspects that women in the sex-based work industry face. Provides insight on the history of these professions, and focuses on the health impacts it plays on women today. Discusses who is susceptible to this type of work and the criminalization of it. Spotlights the current forms of sex-work in society today.https://digitalcommons.butler.edu/spring_2023/1012/thumbnail.jp