June Balm

Parody of August Heat , by Carla Harri

Winter Song

Poem by Carla Harri

Sailing Sunday

Fiction by Carla Harri

Notion

Poem by Carla Harri

HB 828: TANF Eligibility; Drug-Related Felonies

House Bill 828 (HB828) was proposed in 2016 to remove the ban on Temporary Assistance for Needy Families (TANF) for individuals with felony-related drug convictions who are otherwise eligible to receive benefits. The TANF program is designed to help low income families achieve self-sufficiency. States receive block grants to design and operate programs that accomplish one of the purposes of the TANF program: 1) Provide assistance to needy families so children can be cared for in their own homes; 2) Reduce the dependency of parents by promoting job preparation, work, and marriage; 3) Prevent and reduce the incidence of out-of-wedlock pregnancies; 4) Encourage the formation and maintenance of two-parent families (Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Section 401). With nearly 700,000 people released from state and federal prison each year, access to TANF benefits is particularly critical for helping formerly incarcerated individuals transitioning back to their home communities. Significant disparities in convictions and incarceration coupled with variations in state population between Whites and Nonwhites translate into a disproportionate impact of the felony drug ban (The Sentencing Project, 2015). Virginia is one of 14 states with a full ban on TANF benefits for individuals with felony-related drug convictions. Adoption of HB828 proposes to eliminate this lifetime ban and provide an opportunity for low income families to meet their basic needs during the period in which they are in most need

Transition

Poem by Carla Harri

Pathways to a Lung Cancer Diagnosis

Purpose The purpose of this qualitative descriptive study was to identify and describe pathways to a lung cancer diagnosis based on narratives of persons diagnosed with the disease. Data sources Eleven adults with lung cancer were recruited from an academic thoracic oncology clinic in a large city in the southeastern United States. Moderately structured interviews were conducted by an experienced nurse practitioner (NP) to obtain information regarding the participants’ experiences leading to their diagnosis. Qualitative content analysis was used to develop a typology of pathways. Conclusions Findings revealed four distinct pathways: missing opportunities, waiting and seeing, being alarmed, and being blindsided. Implications for practice The Pathways to a Lung Cancer Diagnosis Typology has important implications for clinical practice and can be used to inform NPs and other healthcare providers who provide care for patients at risk for or diagnosed with lung cancer

Ultrasound estimates of muscle quality in older adults: reliability and comparison of Photoshop and ImageJ for the grayscale analysis of muscle echogenicity

Background. Quantitative diagnostic ultrasound imaging has been proposed as a method of estimating muscle quality using measures of echogenicity. The Rectangular Marquee Tool (RMT) and the Free Hand Tool (FHT) are two types of editing features used in Photoshop and ImageJ for determining a region of interest (ROI) within an ultrasound image. The primary objective of this study is to determine the intrarater and interrater reliability of Photoshop and ImageJ for the estimate of muscle tissue echogenicity in older adults via grayscale histogram analysis. The secondary objective is to compare the mean grayscale values obtained using both the RMT and FHT methods across both image analysis platforms. Methods. This cross-sectional observational study features 18 community-dwelling men (age = 61.5 ± 2.32 years). Longitudinal views of the rectus femoris were captured using B-mode ultrasound. The ROI for each scan was selected by 2 examiners using the RMT and FHT methods from each software program. Their reliability is assessed using intraclass correlation coefficients (ICCs) and the standard error of the measurement (SEM). Measurement agreement for these values is depicted using Bland-Altman plots. A paired t-test is used to determine mean differences in echogenicity expressed as grayscale values using the RMT and FHT methods to select the post-image acquisition ROI. The degree of association among ROI selection methods and image analysis platforms is analyzed using the coefficient of determination (R2). Results. The raters demonstrated excellent intrarater and interrater reliability using the RMT and FHT methods across both platforms (lower bound 95% CI ICC = .97–.99, p \u3c .001). Mean differences between the echogenicity estimates obtained with the RMT and FHT methods was .87 grayscale levels (95% CI [.54–1.21], p \u3c .0001) using data obtained with both programs. The SEM for Photoshop was .97 and 1.05 grayscale levels when using the RMT and FHT ROI selection methods, respectively. Comparatively, the SEM values were .72 and .81 grayscale levels, respectively, when using the RMT and FHT ROI selection methods in ImageJ. Uniform coefficients of determination (R2 = .96–.99, p \u3c .001) indicate strong positive associations among the grayscale histogram analysis measurement conditions independent of the ROI selection methods and imaging platform. Conclusion. Our method for evaluating muscle echogenicity demonstrated a high degree of intrarater and interrater reliability using both the RMT and FHT methods across 2 common image analysis platforms. The minimal measurement error exhibited by the examiners demonstrates that the ROI selection methods used with Photoshop and ImageJ are suitable for the post-acquisition image analysis of tissue echogenicity in older adults