Is the POLST Model Desirable for Florida?

Florida has one ofthe largest and most rapidly growing elderly populations in the nation. Although advances in medicine are allowing physicians to extend the lives of elderly patients, advances must simultaneously be made in the end-of-life care arena to ensure that the comfort and quality of life of elderly patients is maintained. This paper argues that use of a Physician Orders for Life Sustaining Treatment (POLST) form in Florida would be effective in increasing the accuracy oftranslating patients’ end-of-life wishes into treatment orders, in ensuring the consistency of treatment across settings, and in improving health care provider compliance with patient preferences. It will be demonstrated that present concerns in Florida are essentially the same as those which previously existed in other states that have successfully implemented POLST programs

The Impact Of A Group Counseling Intervention On Lesbian, Gay, Bisexual, Transgender, And Queer Older Adolescents\u27 Levels Of Hope, Coping, And Suicidality

This investigation examined the impact of an eight-week group counseling intervention on lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adolescents’ (aged 18-20) levels of hopefulness, coping skills, and suicidality. An experimental, randomized-controlledtrial research design was employed to identify differences between the intervention group and waitlist control group participants’ hopefulness, coping skills, and suicidality scores. In addition, the relationship between the LGBTQ+ participants’ outcome variables (hopefulness, coping skills, and suicidality) scores was examined. Furthermore, the impact of group therapeutic factors experienced by the LGBTQ+ participants in intervention group for the variables of hopefulness, coping skills, and suicidality was examined. Key findings included a significant interaction between time and group placement, indicating that the intervention group participants experienced significant improvements on measures of hopefulness, coping behaviors, and suicidality when compared to participants in the waitlist control group. In addition, hope was demonstrated to be a strong and significant predictor of suicidality. Furthermore, it was found that group therapeutic factors had a positive effect on intervention group participants’ Adaptive Coping scores, but did not have an effect on Hopefulness, Maladaptive Coping, or Suicidality as hypothesized. Lastly, there was no significant differences between the demographic variables perceptions of parental/guardian support, perceptions of peer support, gender identity, or ethnicity on their hopefulness, coping behaviors, or suicidality. There was, however, a significant difference between bisexual’s and lesbian’s post-test scores on Suicidality, with bisexuals scoring significantly lower. No other significant differences were observed between sexual orientation and the other key constructs

Real bad grammar: realistic grammatical description with grammaticality

Sampson (this issue) argues for a concept of “realistic grammatical description” in which the distinction between grammatical and ungrammatical sentences is irrelevant. In this article I also argue for a concept of “realistic grammatical description” but one in which a binary distinction between grammatical and ungrammatical sentences is maintained. In distinguishing between the grammatical and ungrammatical, this kind of grammar differs from that proposed by Sampson, but it does share the important property that invented sentences have no role to play, either as positive or negative evidence

Physiotherapy rehabilitation for osteoporotic vertebral fracture (PROVE) : study protocol for a randomised controlled trial

Background: Osteoporosis and vertebral fracture can have a considerable impact on an individual’s quality of life. There is increasing evidence that physiotherapy including manual techniques and exercise interventions may have an important treatment role. This pragmatic randomised controlled trial will investigate the clinical and cost-effectiveness of two different physiotherapy approaches for people with osteoporosis and vertebral fracture, in comparison to usual care. Methods/Design: Six hundred people with osteoporosis and a clinically diagnosed vertebral fracture will be recruited and randomly allocated to one of three management strategies, usual care (control - A), an exercise-based physiotherapy intervention (B) or a manual therapy-based physiotherapy intervention (C). Those in the usual care arm will receive a single session of education and advice, those in the active treatment arms (B + C) will be offered seven individual physiotherapy sessions over 12 weeks. The trial is designed as a prospective, adaptive single-blinded randomised controlled trial. An interim analysis will be completed and if one intervention is clearly superior the trial will be adapted at this point to continue with just one intervention and the control. The primary outcomes are quality of life measured by the disease specific QUALLEFO 41 and the Timed Loaded Standing test measured at 1 year. Discussion: There are a variety of different physiotherapy packages used to treat patients with osteoporotic vertebral fracture. At present, the indication for each different therapy is not well defined, and the effectiveness of different modalities is unknown

Xeroderma Pigmentosum Group C Deficiency Alters Cigarette Smoke DNA Damage Cell Fate and Accelerates Emphysema Development

Cigarette smoke (CS) exposure is a major risk factor for the development of emphysema, a common disease characterized by loss of cells comprising the lung parenchyma. The mechanisms of cell injury leading to emphysema are not completely understood but are thought to involve persistent cytotoxic or mutagenic DNA damage induced by CS. Using complementary cell culture and mouse models of CS exposure, we investigated the role of the DNA repair protein, xeroderma pigmentosum group C (XPC), on CS-induced DNA damage repair and emphysema. Expression of XPC was decreased in mouse lungs after chronic CS exposure and XPC knockdown in cultured human lung epithelial cells decreased their survival after CS exposure due to activation of the intrinsic apoptosis pathway. Similarly, cell autophagy and apoptosis were increased in XPC-deficient mouse lungs and were further increased by CS exposure. XPC deficiency was associated with structural and functional changes characteristic of emphysema, which were worsened by age, similar to levels observed with chronic CS exposure. Taken together, these findings suggest that repair of DNA damage by XPC plays an important and previously unrecognized role in the maintenance of alveolar structures. These findings support that loss of XPC, possibly due to chronic CS exposure, promotes emphysema development and further supports a link between DNA damage, impaired DNA repair, and development of emphysema

Researchers Experience Multiple Embodiments in a Cross-Cultural, Intergenerational Event to Support Girls Challenging Gender-Based Violence

Many challenges exist to conducting participatory research and consultation with young people, especially with those considered vulnerable or at risk. Beyond respecting the safety and wellbeing of young research participants, researchers must be aware of barriers to youth engagement and be attuned to the many forms of youth resistance. As young people are seeking more control over their lives, traditional knowledge hierarchies between adults and youth are shifting. In July 2018, an event entitled Circles Within Circles brought together Indigenous and non-Indigenous girls and young women from South Africa, Canada, Russia, Sweden, and Kenya to learn from each other’s participatory art-making and create a network for challenging gender-based violence (GBV). This article provides insight into the often-invisible experience of the “supporting cast” in events like Circles Within Circles. The co-authors are doctoral and postdoctoral researchers who contributed to organization and acted as facilitators, notetakers, and participants. The co-authors conduct participatory analyses of journal entries they wrote throughout the event, and jointly reflect on the activities and their feelings about their roles. Reflecting, for example, on gut feelings about young participants’ use of voice and silence during adult-led activities, the co-authors discuss their reading of girls’ demonstrations of resistance. This embodied knowledge, further cultivated by attuning to shared experience, is explored in this collaborative auto-ethnography. Examining the complexities of this cross-cultural and intergenerational event, the co-authors contend that when supporting girls and young people subverting dominant narratives of GBV, researchers’ embodied reflexivity is crucial for positively contributing to girl-led change

Inelastic neutron scattering due to acoustic vibrations confined in nanoparticles: theory and experiment

The inelastic scattering of neutrons by nanoparticles due to acoustic vibrational modes (energy below 10 meV) confined in nanoparticles is calculated using the Zemach-Glauber formalism. Such vibrational modes are commonly observed by light scattering techniques (Brillouin or low-frequency Raman scattering). We also report high resolution inelastic neutron scattering measurements for anatase TiO2 nanoparticles in a loose powder. Factors enabling the observation of such vibrations are discussed. These include a narrow nanoparticle size distribution which minimizes inhomogeneous broadening of the spectrum and the presence of hydrogen atoms oscillating with the nanoparticle surfaces which enhances the number of scattered neutrons.Comment: 3 figures, 1 tabl

Canadian Postsecondary Students With Disabilities: Where Are They?

Results of a Canada-wide and a Quebec based study of students with a variety of disabilities in Canadian postsecondary education are presented. Study 1 involved 156 professionals. They represent 80% of the population of professionals who provide on-campus disability support services. Results indicate that (1) 8% of postsecondary institutions reported not having any students with disabilities, (2) overall, 2% of students are registered to receive disability related services from their post- secondary institutions, and (3) this varies from 1/2% to 6% across the country. Junior/community colleges had a higher percentage of students with disabilities registered to receive disability related services (3 3/4%) than universities (1 2/3%). (4) Distance education had 3%. (5) Quebec has a smaller proportion of both college (2/3% vs 6%) and university (1/2%) vs 2 1/2%) students with disabilities than the rest of Canada. A targeted study involving 46 professionals who provide disability related services in Quebec's public junior/community colleges, the CEGEPs, revealed that lack of recognition of learning disabilities for postsecondary funding by the Quebec government is an important contributor to the small percentages, although it cannot explain the huge discrepancies between Quebec and the rest of Canada. Extrapolation suggests that there are over 100,000 students with disabilities currently enrolled in Canadian postsecondary education, although only 1/4 to 1/2 of them register to receive disability related services.Les résultats d'une étude pancanadienne basée au Québec portant sur des étudiants ayant diverses incapacités dans des institutions postsecondaires canadiennes sont présentés. L'étude 1 impliquait 156 professionnels. Ils représentent 80% de la population des intervenants qui fournissent de l'appui, sur les campus, aux étudiants ayant des incapacités. Les résultats révèlent que (1) 8% des institutions postsecondaires rapportent qu'elles n'ont pas d'étudiants ayant des incapacités, (2) globalement, 2 % des étudiants sont inscrits aux services offerts aux étudiants ayant des incapacités de leur institution postsecondaire, et (3) cette donnée varie de 1/2% à 6% à travers le pays. Les collèges communautaires ont un pourcentage plus élevé d'étudiants ayant des incapacités inscrits aux services d'appui (3 3/4%) par rapport aux universités (1 2/3%). (4) La formation à distance a 3% d'étudiants nécessitant des services de cette nature. (5) Le Québec a le pourcentage le plus faible au Canada d'étudiants ayant des incapacités aux niveaux collégial (2/3%) contre 6%) et universitaire (1/2% contre 2 1/2%). Une étude cible impliquant 46 intervenants qui fournissent des services aux étudiants ayant des incapacités dans les collèges au Québec, les CEGEPs, révèle qu'un des facteurs contribuant aux faibles pourcentages est le fait que le gouvernement du Québec ne tient pas compte des difficultés d'apprentissage lors du financement. Cependant, ceci ne peut expliquer les différences énormes entre le Québec et le reste du Canada. Par extrapolation, il est possible d'avancer qu'il y a plus de 100 000 étudiants ayant des incapacités présentement inscrits dans des institutions postsecondaires canadiennes, quoique seulement 25 à 50 % de ceux-ci soient inscrits aux services offerts aux étudiants ayant des incapacités

Fatherhood in the Twenty-First Century

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65867/1/1467-8624.00126.pd

Non-oxidative modification of low density lipoprotein by ruptured myocytes

AbstractIn this study, the interaction of ruptured cardiac myocytes with low density lipoprotein (LDL) has been investigated and the consequent extent of uptake by macrophages. The results show that lysate released from ruptured myocytes is capable of inducing LDL oxidation and that the resulting modified form is recognised and degraded by macrophages. Peroxyl radical scavengers inhibit the LDL oxidation but not the macrophage uptake suggesting that LDL can be modified by mechanisms that are independent of oxidative processes by intracellular constituents of cardiac myocytes