Home and Exile: Some General Themes

This paper will discuss the creative potential of liminality. This idea will be developed through a discussion of the experience of the liminal position of the exiled individual and the examination of some personalities whose lives have been shaped by exile. This will encompass the dislocation of the individual from a ‘home’ space into a situation of homelessness, the reworking of the individual’s identity in the unfamiliar environment and the resulting consequences of this shift. It will be argued that the exilic position is characterised by almost permanent liminality, as many situations will not result in a return to normality, i.e. return to the home. It will also be argued that the particular experience of dislocation/exile affords a certain perspective which could not have been gained from remaining at home, and that homelessness therefore breeds innovation and creativity

Adaptation to Cesarean Birth: Implementation of an International Multisite Study

The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women’s perceptions of and responses to cesarean birth. The need for the study arose from the concern that women’s childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of study sites revealed opportunities for examination of the influence of the contextual stimuli of culture and geographic region on the women’s adaptation to cesarean birth. Strategies used to foster integration of teaching, practice, and research are discussed

Program proposal : guided self-help bulimia nervosa program delivered in primary care [research project]

Bulimia nervosa is a complex emotional and physical illness that presents challenges for primary care providers in identifying and supporting individuals with this eating disorder. Many patients experience difficulties in accessing specialist psychological treatments. In particular, mature patients and those in rural settings may find significant barriers to cognitive behavioural therapy delivered in specialist settings. Guided self-help administered in primary care can be an effective first step in the treatment of less severe bulimic patients. This project provides a literature review on the efficacy of self-help treatments for bulimia nervosa, outlines a conceptual framework for more intervention at the primary care level, and proposes a program to develop and Implement a guided self-help tool for the treatment of bulimia nervosa in primary care

A Framework for the Evaluation of Large-Scale Regional Conservation and Management Strategies

The success of complex, regional strategies depends on the ability to evaluate the process of implementation as well as progress toward achieving intended outcomes. The Southeast Cohesive Wildland Fire Management Strategy and the Comprehensive Strategy for Prescribed Fire to Restore Longleaf Pine in the Southeast United States are examples of regional strategies that require extensive efforts across a large landscape. This article presents a framework developed by North Carolina State University Extension Forestry for evaluating these types of regional strategies so that informed recommendations for resource allocation, new program development, and strategic collaboration can be made

Tools for Quickly Adapting During Pandemics, Disasters, and Other Unique Events

Amid the current COVID-19 pandemic, Cooperative Extension personnel across the nation are quickly adapting to daily changes while continuing to respond to the needs of clients. This article provides examples of how we in North Carolina State Extension Forestry have responded to the challenges we have faced thus far. The solutions and tools described can be used in the current situation and for future pandemics, disasters, and other unique events that require alternative arrangements. The needs of landowners, farmers, youths, and the public at large will not diminish during this unprecedented time; therefore, we should continue to innovate to ensure that our impact is not diminished

Women’s Perceptions of Caesarean Birth: A Roy International Study

The purpose of this Roy adaptation model-based multi-site international mixed method study was to examine the relations of type of caesarean birth (unplanned/planned), number of caesarean births (primary/repeat), and preparation for caesarean birth to women’s perceptions of and responses to caesarean birth. The sample included 488 women from the United States (n = 253), Finland (n = 213), and Australia (n = 22). Path analysis revealed direct effects for type of and preparation for caesarean birth on responses to caesarean birth, and an indirect effect for preparation on responses to caesarean birth through perception of birth the experience

Weight based tacrolimus trough concentrations post liver transplant

Tacrolimus is one of the most widely used liver transplant medications. With the increasing number of obese patients requiring liver transplants, knowledge of the effect of body size affecting post-transplant outcomes e.g. drug exposure is increasingly required.1) To investigate whether patient body size (i.e. total body weight) affect trough plasma concentrations of tacrolimus when a standard mg/kg dosing regimen is used; 2) To investigate whether obese patients have different number of plasma concentrations outside the therapeutic range compared to the non-obese patients in the first months after liver transplant.Using a transplant database, data tacrolimus concentrations were available for 69 patients. Tacrolimus was initially dosed at a standard 0.1mg/kg/day after liver transplant, and adjusted to maintain a target trough concentration. Trough blood samples, phenotypic and outcome variables were analysed.Trough concentrations were similar between the obese and non-obese patients (p>0.05) at each sampling day. At day-7 post-transplant, 85.7% and 79.5% of the observed plasma concentrations were outside the recommended therapeutic range for the obese and the non-obese patients respectively; at day-30, 52.9% and 57.4% and at 6 months, 18.7% and 27.5%.In the first week post-transplant, tacrolimus trough concentrations after standard mg/kg dosing post liver transplant appear to be corrected by total body weight. Obese patients have similar number of trough plasma concentrations outside the therapeutic range compared to the non-obese patients. This article is protected by copyright. All rights reserved

Injured adult motor and sensory axons regenerate into appropriate organotypic domains of neural progenitor grafts.

Neural progenitor cell (NPC) transplantation has high therapeutic potential in neurological disorders. Functional restoration may depend on the formation of reciprocal connections between host and graft. While it has been reported that axons extending out of neural grafts in the brain form contacts onto phenotypically appropriate host target regions, it is not known whether adult, injured host axons regenerating into NPC grafts also form appropriate connections. We report that spinal cord NPCs grafted into the injured adult rat spinal cord self-assemble organotypic, dorsal horn-like domains. These clusters are extensively innervated by regenerating adult host sensory axons and are avoided by corticospinal axons. Moreover, host axon regeneration into grafts increases significantly after enrichment with appropriate neuronal targets. Together, these findings demonstrate that injured adult axons retain the ability to recognize appropriate targets and avoid inappropriate targets within neural progenitor grafts, suggesting that restoration of complex circuitry after SCI may be achievable