Appalachian Caregivers of Persons with Dementia Non Use of Services

Abstract Background: The purpose of this current study was to explain factors most strongly associated with Caregiver (CG) of Person with Dementia (PWD) non-use of formal and informal services in Appalachia. Methods: A correlational explanatory design using validated self-report surveys was used to explain the association of the substructed Andersen’s Behavioral Model for Health Services Use in Appalachian CG non-use of formal and informal services. Data were analyzed using descriptive statistics and ANOVA tests considering eight independent variables in total from each research question, using a sample of 43 CG/CR dyads. Results: The analyses of four research questions suggested: 1) Data supported the Social Provisions Scale (SPS) explained 8.3% of variance for the Non-Use of Services (Adjusted R2 0.83 - 8.3%); 2) Data supported Caregiving Service Availability explained 11.7% of the variance for Non-Use of Services (Adjusted R2 0.117 - 11.7%); 3) Evaluated Need, a calculated variable that included the health care provider recommending services for the PWD explained 7.9% of the variance for Non-Use of Services (Adjusted R2 0.079 - 7.9%); 4) Non-use of services final regression analysis entering the three significant variables of the SPS, Caregiving Service Availability, and Evaluated Need explained 40% of non-use of services. A theory-based forced-entry logistic regression on a dichotomous variable found the same variables significant, although linear regression offered more explanatory strength. Implications: To reduce non-use of services, more caregiving support services need to be available and health care providers’ recommendation to use support services would be helpful for CGs of PWD

Scale, ecological fallacy, and the river continuum concept

Concern over scale is not new, and it is not restricted to geographers. Spatial and temporal scaling is a conceptual and methodological problem for all sciences using geographic information. This paper teases out issues of scale and ecological fallacy from the literature and discusses how these issues influence the applicability of an influential theoretical framework in stream ecology, the River Continuum Concept (RCC). Investigators are faced with decisions regarding scale during sampling location selection, field data capture, and subsequent data interpretation. A thorough understanding of the heterogeneity of stream habitats and the life histories of the organisms being studied could enable investigators to make appropriate methodological choices with regard to sampling resolution and extent. It is crucial that investigators improve their ability to understand the consequences of aggregating and extrapolating data collected point samples in order to adequately evaluate ecological hypotheses operating over relatively broad spatial and temporal scales

Synthesis of the Literature: Variables Influencing Caregiver Use or Nonuse of Supportive Services

Two out of three caregivers (CGs) of persons with dementia (PWD) living in the community do not use supportive services or resources, and three out of four underutilize available support. These findings are troubling because CGs report many unmet needs in providing support to PWD. What predisposing, enabling, and need variables influence CGs to use or not use support services are poorly understood. This article reviews the literature on CG of PWD to find characteristic variables that are related to CG\u27s decisions to use or not use support services. Instruments used in research studies were named to determine recommendations for future studies. The article organizes the variables following Anderson\u27s model of predisposing, enabling, and need characteristics. It also supports future research to examine CG use or nonuse of resources that could inform practice, funding of programs, and policy

A Simple Suturing Technique for Laparoscopic Ligation of Vascular Pedicles

We report on the performance of 348 adnexectomies and 35 uterine artery ligations for both benign and malignant disease using a simple laparoscopic suturing technique. Only 5-mm ports are required, and there was no morbidity directly associated with this approach. The procedure can be performed quickly, is relatively inexpensive, and allows hysterectomy and oophorectomy to be performed without bipolar electrocautery

Laparoscopy in the Treatment of Early Cervical Carcinoma

Recent investigators have used several indications to incorporate laparoscopy in the management of patients with cervical cancer. This manuscript reviews the current literature on the role of modern operative laparoscopy in early cervical cancer and recommends a simple approach for its use in these patients

Transdisciplinary Research in Practice: Lessons from Participatory, Folklore and Community-Supported Approaches in the Greater American West

Rapid social and ecological changes on global rangelands amplify the challenges to achieving biodiversity conservation, rural economic viability and social well-being, and rangeland sustainability. These dynamics create a need for transdisciplinary science that is inclusive of ecological, sociological, and participatory approaches in order to rebuild meaningful working relationships between scientists, ranchers and managers, and other rangeland stakeholders. In real application, however, transdisciplinary science faces numerous social, ethical, and logistical challenges, including the question of how the work might benefit rangeland stakeholders. Our objective is to advance rangeland researchers’ toolbox for meaningful engaged research by describing three lessons from transdisciplinary projects in the rangeland contexts of the United States. These include the need for 1) ranch-scale, long-term participatory management experiments; 2) folklore and oral history methods and 3) community-supported social-ecological research that creates credible science that can be communicated out to non-ranching decision-makers. These examples illustrate the nuances of transdisciplinary research, reciprocity, and useable knowledge creation in complex rangeland social-ecological contexts

Sense Yo Soles

The Sense Yo Soles project is a system that is embedded into a shoe insert; the plantar pressure distribution is measured by calculating the ratio of pressure on 6 individual pressure sensors located on the lateral, medial, and heel areas of both the left and right foot to the total pressure distributed across both feet. The alpha prototype created by our client and her Biomedical Engineering senior project team at San Jose State University, measured and analyzed data using the above method while connected to power and a computer. In CPE 350, we made the system stand alone and wireless allowing for the product to be more usable, and reduced the overall cost of the system. We achieved 2 this by using an ATtiny84 microcontroller to control these peripherals and to send data wirelessly using Bluetooth to an external device for processing. In CPE 450, we ported the Java application to an Android application, implemented sleep cycles with interrupts for power management, and implemented a dual sensor communication, allowing 2 sensors to send data to a single Android device. Our main goals for CPE 461/462 were to use Bluetooth Low Energy for power management, to display standing and stride data in a user friendly way on an iOS application, and to package hardware into the insole

INTER-TRIAL VARIABILITY IN KINEMATIC DESCRIPTORS OF GAIT

The purpose of this study was to determine the inter-trial variability of kinematic descriptors of human gait. A case study subject with spastic hemiplegic gait following traumatic event was analyzed for kinematic differences pertreatment, 1-week post-treatment and 4-weeks post-treatment. The treatment protocol included a focal dennervation of the spastic gastrocnemius muscle on the affected side of the body. Data was collected via three 60 Hz S-VHS camcorders set at a shutter speed of 11100 second. Each camera was placed at approximately a 30 degree angle with respect to the optical axis of the other two cameras. Ten trials of walking gait at a self-selected pace were recorded for both the affected and unaffected sides for two complete strides. Kinetic data was recorded during a single stance phase simultaneous with the kinematic data. The three views were synchronized using a single pulse from a standard flash unit. The three planer views were transformed to three-dimensional coordinates using a Direct Linear Transformation (DLT) as part of the Ariel Performance Analysis System (APAS). Each joint center location as smoothed individually by selecting the proper cutoff frequency of a double-pass recursive Butterworth filter via an inspection of the joint center's power spectrum. Joint angular displacements of the ankle, knee and hip were compared across the ten trials for each leg individually using a univariate analysis of variance (ANOVA). The pre-treatment and two post-treatment conditions were analyzed separately. Non-significant inter-trial differences were found for each variable and each leg across the data collection periods. Given the proliferation and gait analysis as a clinical tool, as well as a research device for exercise and sport, demonstration of the efficacy and reliability of this analysis is essential