Assessing Unmet Needs of Caregivers after Stroke: Occupational Therapist Practices and Perspectives

Background: Family caregivers of stroke survivors often feel unprepared and overwhelmed post discharge with numerous unmet needs. Occupational therapists can play an integral role in addressing family caregivers’ needs. Limited research exists on assessment practices of occupational therapists in identifying caregivers’ needs poststroke. This study explores the practices and perspectives of occupational therapists in assessing unmet caregivers’ needs. Method: A cross-sectional, mixed methods research design was used to electronically survey 15 occupational therapists. Part 1 of the survey explored participant methods for identifying caregivers’ needs and their views on using formal caregiver assessment tools. Part 2 gathered participant perspectives on three selected caregiver assessments. Descriptive statistics and thematic analysis were used to interpret the data. Results: The participants perceive formal assessments as beneficial. However, they use informal strategies to assess the unmet needs of caregivers rather than formal assessment. Reimbursement challenges, productivity pressure, and questionable necessity are barriers to conducting formal assessments. Advantages and disadvantages of each assessment are discussed. Conclusion: Occupational therapists face barriers to conducting formal assessment across settings. Implementation of recent policies is needed to further support occupational therapy’s role in addressing caregivers’ needs. This study can inform future development of assessment tools tailored to occupational therapy

Decolonising Aboriginal and Torres Strait Islander Research

There is an important but unwieldy research policy infrastructure designed to engage with Aboriginal and Torres Strait Islander research and researchers. This framework links the key performance indicators and policies of funders and institutions to researchers and communities. In this article, we explain the relevant policies and targets, with a view to showing how sector regulation interconnects in practice and identifying ways to strengthen institutional commitments to meaningful engagement with, and implementation of, Aboriginal and Torres Strait Islander research policy. We suggest next steps that are needed to help researchers comply with funder and institution-mandated obligations and to empower Indigenous Peoples to make informed decisions about the benefits of research collaboration with universities

Legislature’s Planning Committee 2015 Report

A message from Senator Tanya Cook, Chair of the Legislature’s Planning Committee 2015-2016 The Legislature’s Planning Committee serves a vital role in the Nebraska Unicameral. In an era of term limits, the Planning Committee provides future-focused, data-driven research for senators to use in crafting smart, effective policies. The 2015 Database Update continues to highlight nine key benchmarks – Economy, Agriculture, Natural Resources, State and Local Government, Education, Health and Human Services, Public Safety, Transportation, and Telecommunications – that give a well-rounded picture of the state’s strengths, struggles, and opportunities. The Planning Committee owes a debt of gratitude to Dr. John Bartle and Jerry Deichert, who have worked tirelessly since the Committee’s founding to ensure the best, most accurate data is provided to Nebraska’s policymakers. Thanks are also in order for the staffers and students at the University of Nebraska-Omaha’s College of Public Affairs and Community Service, as well as the other professors and researchers who have worked with the Committee over the years. I hope the data in this update will inform and inspire ever better policy decisions and discussions in Nebraska. The Planning Committee’s collection of studies and data resources will only continue to grow, and I trust that Nebraska’s policymakers will continue to utilize the information wisely. Sincerely,Senator Tanya CookLegislative District 1

Lynch syndrome: barriers to and facilitators of screening and disease management

Background Lynch syndrome is a hereditary cancer with confirmed carriers at high risk for colorectal (CRC) and extracolonic cancers. The purpose of the current study was to develop a greater understanding of the factors influencing decisions about disease management post-genetic testing. Methods The study used a grounded theory approach to data collection and analysis as part of a multiphase project examining the psychosocial and behavioral impact of predictive DNA testing for Lynch syndrome. Individual and small group interviews were conducted with individuals from 10 families with the MSH2 intron 5 splice site mutation or exon 8 deletion. The data from confirmed carriers (n = 23) were subjected to re-analysis to identify key barriers to and/or facilitators of screening and disease management. Results Thematic analysis identified personal, health care provider and health care system factors as dominant barriers to and/or facilitators of managing Lynch syndrome. Person-centered factors reflect risk perceptions and decision-making, and enduring screening/disease management. The perceived knowledge and clinical management skills of health care providers also influenced participation in recommended protocols. The health care system barriers/facilitators are defined in terms of continuity of care and coordination of services among providers. Conclusions Individuals with Lynch syndrome often encounter multiple barriers to and facilitators of disease management that go beyond the individual to the provider and health care system levels. The current organization and implementation of health care services are inadequate. A coordinated system of local services capable of providing integrated, efficient health care and follow-up, populated by providers with knowledge of hereditary cancer, is necessary to maintain optimal health

Abdominal aortic aneurysm is associated with a variant in low-density lipoprotein receptor-related protein 1

Abdominal aortic aneurysm (AAA) is a common cause of morbidity and mortality and has a significant heritability. We carried out a genome-wide association discovery study of 1866 patients with AAA and 5435 controls and replication of promising signals (lead SNP with a p value < 1 × 10-5) in 2871 additional cases and 32,687 controls and performed further follow-up in 1491 AAA and 11,060 controls. In the discovery study, nine loci demonstrated association with AAA (p < 1 × 10-5). In the replication sample, the lead SNP at one of these loci, rs1466535, located within intron 1 of low-density-lipoprotein receptor-related protein 1 (LRP1) demonstrated significant association (p = 0.0042). We confirmed the association of rs1466535 and AAA in our follow-up study (p = 0.035). In a combined analysis (6228 AAA and 49182 controls), rs1466535 had a consistent effect size and direction in all sample sets (combined p = 4.52 × 10-10, odds ratio 1.15 [1.10-1.21]). No associations were seen for either rs1466535 or the 12q13.3 locus in independent association studies of coronary artery disease, blood pressure, diabetes, or hyperlipidaemia, suggesting that this locus is specific to AAA. Gene-expression studies demonstrated a trend toward increased LRP1 expression for the rs1466535 CC genotype in arterial tissues; there was a significant (p = 0.029) 1.19-fold (1.04-1.36) increase in LRP1 expression in CC homozygotes compared to TT homozygotes in aortic adventitia. Functional studies demonstrated that rs1466535 might alter a SREBP-1 binding site and influence enhancer activity at the locus. In conclusion, this study has identified a biologically plausible genetic variant associated specifically with AAA, and we suggest that this variant has a possible functional role in LRP1 expression

Nine Decades Later: Idaho Women Reflect on the Meaning of the Nineteenth Amendment

Reflecting on the 90th anniversary of the Nineteenth Amendment (ratified August, 1920), this narrative inquiry explored its significance to women in leadership positions residing in Idaho. Idaho's status as a forerunner approving suffrage underscored the foundation for the study. The researchers also wanted to investigate whether women have reached equal citizenship in aspects other than the right to vote. Findings indicate that the Nineteenth Amendment was pivotal in not only giving women a voice in governmental decisions, but also paved the way for other political and social breakthroughs. However, few participants linked passage of the Amendment with their rise to leadership. In some instances, full equality has not been achieved and gender discrimination still occurs, primarily when seeking leadership position

Making Australian research free for everyone to read sounds ideal. But the Chief Scientist's open access plan isn't risk free.

Chief Scientist Cathy Foley is leading an open access strategy for Australia. Foley estimates the Australian government invests A$12 billion a year of public money in research and innovation only for most of the publications that eventuate to be locked behind a paywall, inaccessible to industry and the taxpayer. At the same time, Australian universities and others pay publishers an estimated$460 million to $1 billion a year to see this published work

Child participation and disaster risk reduction

It has been shown that child participation can have positive results in the rescue, relief and rehabilitation phases of a disaster. Currently child participation is achieving increased attention as a component of disaster risk reduction (DRR). This paper examines the ongoing dialogues on child participation and reviews pertinent literature describing effective DRR outcomes within diverse contexts. A myriad of factors such as gender, age, socio-economic status, caste, religion and geographic location play a role in socialising children into particular ways of being. These factors are considered in light of the ways in which they may influence opportunities for children to participate in DRR and other activities in meaningful ways. The roles of adults in facilitating or preventing child participation, with particular regard to complex power structures and attitudes towards children's rights, are also discussed. Drawing out the potential implications of these factors calls for analyses of attitudes and possible restructuring of societal systems at several levels to enhance child participation. Planning for DRR may represent a crucial sequeway for challenging social norms and promoting equity, inclusion and participation - for children and other groups. This paper explores the role of child participation in DRR plans and practices, and identifies directions for developing an evidence base to support this potentially significant connection.9 page(s