Nurse-Provided Foot Care for Populations with Severe Mental Illness: A Phenomenological and Swanson’s Theory of Caring Approach

Foot care is an essential element of health care for populations with, or at high risk for chronic diseases and foot abnormalities. However, nursing research regarding foot care specifically for patients with severe mental illness (a category which includes bipolar disorder, schizophrenia, and schizoaffective disorder) is sparse. This mixed methodology phenomenological study seeks to provide a further understanding of how nurse-provided foot care and its implicit “caring” ethos impact this patient population, and what might this imply about creating models and educational protocols for the delivery of future evidence-based care. Methodology: Participants at a low-barrier day center for populations who self-identified as female, unhoused, and diagnosed with severe mental illness were treated with nurse-provided foot care. Data was collected from a five-question semi-structured interview, focused on the participant’s experience of foot care and then thematically coded. Results: Six participants fulfilled eligibility requirements, provided informed consent, and completed the semi-structured interviews. Five main themes emerged from data analysis: 1) apprehension to enjoyment, 2) self-criticism, 3) importance of hygiene, 4) inclusion of anecdotal experience, and 5) attitude of the practitioner. Conclusion: This research project called attention to the need for increased access and provision of hygiene supplies and the relevance of incorporating relationship-based therapeutic foot care. The process of addressing these issues will require focusing on these needs in the development of models for hygiene access provision as well as incorporating the importance of a Swanson’s Theory of Caring derived education protocol

Perceived stress and emotional social support among women who are denied or receive abortions in the United States: a prospective cohort study.

BackgroundExamining women's stress and social support following denial and receipt of abortion furthers understanding of the effects of unwanted childbearing and abortion on women's well-being. This study investigated perceived stress and emotional social support over time among women who were denied wanted abortions and who received abortions, and compared outcomes between the groups.MethodsThe Turnaway Study is a prospective cohort study of women who sought abortions at 30 abortion facilities across the United States, and follows women via semiannual phone interviews for five years. Participants include 956 English or Spanish speaking women aged 15 and over who sought abortions between 2008 and 2010 and whose gestation in pregnancy fit one of three groups: women who presented up to three weeks beyond a facility's gestational age limit and were denied an abortion; women presenting within two weeks below the limit who received an abortion; and women who received a first trimester abortion. The outcomes were modified versions of the Perceived Stress Scale and the Multidimensional Scale of Perceived Social Support. Longitudinal mixed effects models were used to assess differences in outcomes between study groups over 30 months.ResultsWomen denied abortions initially had higher perceived stress than women receiving abortions near gestational age limits (1.0 unit difference on 0-16 scale, P = 0.003). Women receiving first-trimester abortions initially had lower perceived stress than women receiving abortions near gestational age limits (0.6 difference, P = 0.045). By six months, all groups' levels of perceived stress were similar, and levels remained similar through 30 months. Emotional social support scores did not differ among women receiving abortions near gestational limits versus women denied abortions or women having first trimester abortions initially or over time.ConclusionsSoon after being denied abortions, women experienced higher perceived stress than women who received abortions. The study found no longer-term differences in perceived stress or emotional social support between women who received versus were denied abortions

Risk of violence from the man involved in the pregnancy after receiving or being denied an abortion.

BackgroundIntimate partner violence is common among women having abortions, with between 6% and 22% reporting recent violence from an intimate partner. Concern about violence is a reason some pregnant women decide to terminate their pregnancies. Whether risk of violence decreases after having an abortion, remains unknown.MethodsData are from the Turnaway Study, a prospective cohort study of women seeking abortions at 30 facilities across the U.S. Participants included women who: presented just prior to a facility's gestational age limit and received abortions (Near Limit Abortion Group, n = 452), presented just beyond the gestational limit and were denied abortions (Turnaways, n = 231), and received first trimester abortions (First Trimester Abortion Group, n = 273). Mixed effects logistic regression was used to assess the relationship between receiving versus being denied abortion and subsequent violence from the man involved in the pregnancy over 2.5 years.ResultsPhysical violence decreased for Near Limits (adjusted odds ratios (aOR), 0.93 per month; 95% Confidence Interval (CI) 0.90, 0.96), but not Turnaways who gave birth (P < .05 versus Near Limits). The decrease for First Trimesters was similar to Near Limits (P = .324). Psychological violence decreased for all groups (aOR, 0.97; CI 0.94, 1.00), with no differential change across groups.ConclusionsPolicies restricting abortion provision may result in more women being unable to terminate unwanted pregnancies, potentially keeping them in contact with violent partners, and putting women and their children at risk

The thorny issue of choosing outcome measures for aphasia therapy trials: A comparison of discourse and aphasia battery outcomes following Multi-modality and Constraint Induced aphasia therapy

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Exploring the Relationship Between Fidelity of Implementation and Academic Achievement in a Third-Grade Gifted Curriculum: A Mixed-Methods Study

This study used sequential mixed-methods analyses to investigate the effectiveness of a research-based language arts curriculum for gifted third graders. Using analytic induction, researchers found that teachers’ beliefs and expectations (time, sense of autonomy, expectations for students, professional expertise) influenced the degree to which they implemented the research intervention with fidelity to its design. Next, maximum variation sampling and quantitative analysis of student outcomes determined that postassessment achievement test scores are higher for students in classrooms with teachers who show high fidelity or adherence to the intervention

Innate Immunity in the C. elegans Intestine Is Programmed by a Neuronal Regulator of AWC Olfactory Neuron Development

Olfactory neurons allow animals to discriminate nutritious food sources from potential pathogens. From a forward genetic screen, we uncovered a surprising requirement for the olfactory neuron gene olrn-1 in the regulation of intestinal epithelial immunity in Caenorhabditis elegans. During nematode development, olrn-1 is required to program the expression of odorant receptors in the AWC olfactory neuron pair. Here, we show that olrn-1 also functions in AWC neurons in the cell non-autonomous suppression of the canonical p38 MAPK PMK-1 immune pathway in the intestine. Low activity of OLRN-1, which activates the p38 MAPK signaling cassette in AWC neurons during larval development, also de-represses the p38 MAPK PMK-1 pathway in the intestine to promote immune effector transcription, increased clearance of an intestinal pathogen, and resistance to bacterial infection. These data reveal an unexpected connection between olfactory receptor development and innate immunity and show that anti-pathogen defenses in the intestine are developmentally programmed

The perspectives of senior researchers in applied disciplines on the current state of developmental attachment research: an interview study

Based on interviews with leading researchers and researcher-clinicians in fields allied to attachment research, this paper describes participants’ perceptions of contemporary attachment research in the developmental tradition. Semi-structured qualitative interviews were conducted with 13 research leaders in applied disciplines cognate to attachment research. Participants perceived attachment research as having played a foundational role for developmental science, including highlighting the importance of a developmental perspective and attention to early caregiving experiences. They also identified important contemporary strengths in developmental attachment research, including the observational acuity and insightfulness of its measures, its attention to dyadic processes in contrast to much of biomedicine, the development of a number of attachment-based interventions with well-articulated mechanisms of action, and the capacity of developmental attachment concepts to resonate with clinical and popular audiences. However, participants suggested that the developmental tradition is also perceived as having a comparatively high “cost of entry,” and consequently they warned that it has become somewhat separated from wider developmental science, with its growing prominence of biological research, scalability of methods, and less reliance on theory. Participants perceived both strengths and weaknesses to contemporary developmental attachment research. However they felt that the classic concerns of developmental attachment research were placing the field potentially at odds with current trends in developmental science

Sleep in children with type 1 diabetes and their parents in the T1D Exchange

Objectives Sleep has physiological and behavioral impacts on diabetes outcomes, yet little is known about the impact of sleep disturbances in children with type 1 diabetes. The current study sought to characterize sleep in children with type 1 diabetes and in their parents and to examine the associations between child sleep, glycemic control and adherence, parent sleep and well-being, parental fear of hypoglycemia, and nocturnal caregiving behavior. Methods Surveys were emailed to parents of 2- to 12-year-old participants in the Type 1 Diabetes (T1D) Exchange clinic registry. Clinical data were obtained from the registry for the 515 respondents. Results In our sample, 67% of children met criteria for poor sleep quality. Child sleep quality was related to glycemic control (HbA1c of 7.9% [63 mmol/mol] in children with poor sleep quality vs 7.6% [60 mmol/mol] in children with non-poor sleep quality; P < 0.001) but not mean frequency of blood glucose monitoring (BGM) (7.6 times/day vs 7.4 in poor/non-poor quality; P = 0.56). Associations were similar for sleep duration. Children with poor sleep quality were more likely to experience severe hypoglycemia (4% in children with poor sleep quality vs 1% in children with non-poor sleep quality; P = 0.05) and more likely to experience DKA (7% vs 4%, respectively; P < 0.001). Poorer child sleep quality was associated with poorer parental sleep quality, parental well-being, and fear of hypoglycemia (P < 0.001 for all). Child sleep was not related to the use of diabetes-related technology (CGM, insulin pump). Conclusions Sleep may be a modifiable factor to improve glycemic control and reduce parental distress

The SAMI Galaxy Survey: gravitational potential and surface density drive stellar populations -- I. early-type galaxies

The well-established correlations between the mass of a galaxy and the properties of its stars are considered evidence for mass driving the evolution of the stellar population. However, for early-type galaxies (ETGs), we find that $g-i$ color and stellar metallicity [Z/H] correlate more strongly with gravitational potential $\Phi$ than with mass $M$, whereas stellar population age correlates best with surface density $\Sigma$. Specifically, for our sample of 625 ETGs with integral-field spectroscopy from the SAMI Galaxy Survey, compared to correlations with mass, the color--$\Phi$, [Z/H]--$\Phi$, and age--$\Sigma$ relations show both smaller scatter and less residual trend with galaxy size. For the star formation duration proxy [$\alpha$/Fe], we find comparable results for trends with $\Phi$ and $\Sigma$, with both being significantly stronger than the [$\alpha$/Fe]-$M$ relation. In determining the strength of a trend, we analyze both the overall scatter, and the observational uncertainty on the parameters, in order to compare the intrinsic scatter in each correlation. These results lead us to the following inferences and interpretations: (1) the color--$\Phi$ diagram is a more precise tool for determining the developmental stage of the stellar population than the conventional color--mass diagram; and (2) gravitational potential is the primary regulator of global stellar metallicity, via its relation to the gas escape velocity. Furthermore, we propose the following two mechanisms for the age and [$\alpha$/Fe] relations with $\Sigma$: (a) the age--$\Sigma$ and [$\alpha$/Fe]--$\Sigma$ correlations arise as results of compactness driven quenching mechanisms; and/or (b) as fossil records of the $\Sigma_{SFR}\propto\Sigma_{gas}$ relation in their disk-dominated progenitors.Comment: 9 pages, 4 figures, 1 table Accepted to Ap