Outcome measures in brain injury rehabilitation : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

Brain injury rehabilitation services require competent measures of outcome to monitor the progress made by individuals in their care. The FIM + FAM is the measure most widely used for this purpose. However, research suggests that this measure contains a number of limitations and does not adequately assess the activity limitations and participation restrictions experienced by individuals who have suffered brain injuries. The current study examined five outcome measures (BICRO-39, MPAI-4, R-CHART, CIQ, and DRS) for their suitability as possible replacement measures at Cavit ABI in Wellington and Auckland. Ten participants with brain injuries (eight males, two females; seven with TBI, three with injuries due to stroke) were administered six different outcome measures by therapists at Cavit ABI centres in Wellington and Auckland on admission and again at six weeks into the rehabilitation programme. Outcome measures were examined in relation to a set of specified criteria, and feedback regarding the performance of each outcome measure was collected from each therapist using a staff questionnaire. The results of the study show that there does not seem to be one adequate outcome measure currently available for use within post-acute brain injury rehabilitation settings Although the FIM + FAM was found to contain a number of strengths particularly in assessing physical independence, the MPAI-4 was found to be more useful in identifying goals related to activity limitations and participation restrictions, which was the key area of focus

Characterising primitive chondrite components

Primitive chondrite components in six carbonaceous chondrites, Bencubbin, HaH 237, Gujba, Isheyevo, Acfer 209 and Acfer 094 were studied to examine the complex thermal histories of individual particles. Significant information about the origin and evolution of the solar nebula is contained within primitive chondrite components including FeNi metals, sulphides, matrix material and calcium aluminium inclusions, allowing conclusions to be drawn about the conditions which prevailed in the early nebula. This thesis describes the analysis of meteoritic metal and other components in carbonaceous chondrites using a suite of complementary techniques including secondary electron microscopy (SEM), transmission electron microscopy (TEM), electron backscatter diffraction (EBSD), secondary ion mass spectrometry (nanoSIMS), grain-size frequency distribution (GSFD) and computed tomography. Metal is chosen as the primary comparative component as it is a common feature in carbonaceous chondrites and is an indication of the extent to which a sample has been exposed to thermal, metamorphic and alteration processes. EBSD results reveal a variation between chondrule-associated metal and matrix metal in CR chondrite Acfer 209 and the ungrouped chondrite Acfer 094 indicating a difference in formation and subsequent processing. TEM results demonstrated that evidence for aqueous alteration occurs on a sub-μm scale on the rims of FeNi metal grains in Acfer 094. FeNi metallic rims displayed regions of pitting corrosion and an enrichment in O and Ni accompanied by depletion in Fe. These features indicate interaction with an aqueous fluid. Grain-size frequency distribution analyses revealed a strong and common mode in the metal grain aspect ratios of three samples from the CB group of chondrites indicating a common deformational event. The presence of adjacent primitive components with varying chemical and crystallographic textures reveals that these samples were subject to a complex thermal history. Fine-grained matrix material in HaH 237 is heavily hydrated and shows no complementarity to chondrules which escaped aqueous alteration consistent with the X-wind model. In contrast, matrix material does show compositional complementarity to chondrules in Acfer 094 and Acfer 209. This suggests material for both components formed in the same region of a nebula conforming to the shock model where material formed on the disk

A qualitative study of 4-H state and field faculty use of social media to communicate with youth, volunteers, and stakeholders

The purpose of this study is to explore the type of social media technology utilized by 4-H field and state faculty to communicate with 4-H members, volunteers, and advisory board members. As youth increase their use of technology for communications it is critical for youth development agents to adapt to new communication methods Qualitative research methods were used to explore this topic. Guiding questions were developed from the empirical literature. Responsive interviewing technique was used to gather data. A purposeful sample was chosen for this study. The sample consisted of field and state 4-H Cooperative Extension Service faculty located in a southeastern state in United States. Personal interviews were conducted with individuals who utilized various forms of social media to communicate with their youth, volunteers, and stakeholder. The results of the study found that all the respondents communicate using social media and e-mail. All of the respondents communicate with youth by text-messaging and Facebook. Youth choose to use social media to communicate with youth development agents and volunteer. Youth will use phone calls as a last resort to communicate. Volunteers communicate with respondents mostly by e-mails and phone calls. Over half of the respondents communicate with their advisory board members through mail-outs and e-mails. All state and field faculty respondents continue to send newsletters, mail-outs and meet face to face with all of their cliental. This research indicates that faculty use various types of technology to communicate with youth, volunteer, and stakeholders.. Most of the information necessary for youth to participate in various events are available in several different formats in order to reach all youth. Facebook was used to inform and recruit new volunteers and advisory board members. Twitter and Facebook were also used state and field faculty to keep parents abreast of their children’s welfare during field trips and summer camp. If Cooperative Extension is going to have an impact on the youth they must adopt the new technology and communication styles utilized by youth. All Cooperative Extension employees should be mandated to take professional development courses on utilizing technology in order to communicate with their stakeholders

On the Eve of Destruction : Courts Confronting the Climate Emergency

In the dim and smokey twilight, with only bare necessities in tow, a family rushes to escape the wildfire racing toward them. Elsewhere, a household evacuates just ahead of a category five hurricane, perhaps not for the first time. Along the coastlines, countless others are resigned to looking on as their homesites erode into the inexorably rising surf. At this moment, millions of Americans are forced to reckon with the horrors of the climate catastrophe, and the number of such people who now viscerally grasp our grim climate reality grows every day. Even the judges of this nation prove no exception to this trend. Enveloped by smoke from a recent wildfire, a Washington appellate court judge remarked to a government attorney in an atmospheric trust litigation case: “I can’t go outside. If I go outside, I’m threatening my life. I have asthma, so I have to stay inside with the windows shut—I don’t have an air conditioner. Why isn’t that affecting my life and my liberty?” Amidst a full-blown climate emergency in which the fate of Humanity rests, this Article argues that our judiciary system is equipped—and is Constitutionally duty-bound—to provide the people of our nation a remedy for the extraordinary governmental malfeasance that has brought our nation, and indeed the world, this climate calamity

Nature\u27s Trust: A Legal, Political and Moral Frame for Global Warming

This essay portrays the urgency of global warming and discusses the role of environmental law in bringing about this crisis. It explains why our regulatory system ignored this problem for too long and offers a property-based perspective to frame government’s responsibility in confronting climate crisis

A Comparison: Lessons from the Columbia Basin and the Upper Colorado Basin Fish Recovery Efforts

47 pages. Contains 5 pages of references

Help-Seeking among People with Symptoms of Lung or Colorectal Cancer: Experience and social context

The UK has some of the poorest cancer outcomes in Europe, commonly attributed to diagnostic delays. The patient interval appears to be a substantial contributor to these, with awareness raising campaigns a key strategy for encouraging earlier presentation. However, research has identified a number of barriers to help-seeking beyond awareness, such as fear, concerns about wasting the doctor’s time, personal commitments and access. This research sought to explore social context and help-seeking for people with symptoms of lung or colorectal cancer, comparing the experiences of prompt consulters with those who prolonged presentation. 164 people with symptoms of lung or colorectal cancer completed a questionnaire on symptom experience and social context and 26 of these took part in follow-up semi-structured interviews. People with symptoms of bleeding or pain had shorter patient intervals than those experiencing other symptoms. Those with symptoms which were perceived of as severe body state deviations decided to seek help much quicker than those with general or systemic symptoms, who instead reappraised symptoms over time. Symptom appraisal and help-seeking processes were informed by numerous contributory elements, which were drawn from four contextual domains of a person's life; individual experience, interpersonal relationships, health care system interactions and social and temporal context. They included micro-level elements, such as exposure to carcinogens as well as macro-level factors, like social discourses on morality, calling into question the centrality of awareness-raising campaigns to encourage earlier presentation among the symptomatic population. A novel model The Contextual Model of the Patient Interval, is presented to illustrate this part of the diagnostic pathway. The concept of risk is used to explain how people assess the necessity of help-seeking and the threshold of tolerability is introduced as a means of explaining the timing of help-seeking decision making, based on contextual contributory elements and symptom burden. The assessment of cancer risk is one contributory element which is explored in detail and its incorporation into calculations of the threshold of tolerability is considered. The idea of 'critical incidents' is used to explain the assessment of cancer risk among people who consulted quickly about symptoms, with 'cancer candidacy' being used to explain the cancer risk assessments undertaken by those with prolonged patient intervals. In line with a societal focus on risk generally, public health developments have now resulted in a shift away from contagion and treatment, towards prediction and prevention, under the 'new public health' approach. The focus on risk and prevention has created an environment in which discourses of 'early presentation' and the 'good patient' have emerged. These discourses place moral obligations on people in relation to acceptable responses to symptoms and the need to present oneself as a 'good patient', which are explored through the examples of 'time wasting', the Be Clear on Cancer campaign, and discrepant reports of patient interval length from this study