Étude sur Les Perceptions et les Attentes des Professionnels de Santé, des Bénévoles et des Familles des Malades dans le Cadre de la Prise en Charge des Soins Palliatifs

This qualitative study, conducted in three metropolitan areas, Champagne Ardenne, Ile-de-France, and Languedoc-Roussillon explores current palliative care practices in 37 facilities, both for dependent elderly (nursing homes) and for adults and children with severe disabilities (MAS and IME). The study confronts the viewpoints of the different actors that revolve around a patient: doctors, nurses and other health professionals (physiotherapists, occupational therapists, psychologists, etc.), relatives, volunteers and patients themselves. 40 cases of sick children and adults were observed. From the analysis of the interviews, it appears that the palliative approach is still not fully adopted by teams that are reluctant to deal with the end of life and postpone the most difficult cases. Among the priorities to be developed are: the harmonization of the initial training of caregivers and ongoing training and the mobilization of specialist palliative care that could better support and assist caregivers in this sector

“Levi Coffin on Trial”

Grade Level(s): 4 (5 or 6)To introduce students to Quaker beliefs about slavery. To introduce students to actual statements of conviction about slavery by Levi Coffin. To introduce students to the federal laws about returning escaped slaves, specifically the Fugitive Slave Act of 1850. To compare the religious and legal issues involved with helping slaves to escape. To use both primary and secondary sources for gathering information. To write a persuasive piece. To make an oral presentation.Crooked Creek Elementary Indianapolis, I

Increasing stability and interpretability of gene expression signatures

Motivation : Molecular signatures for diagnosis or prognosis estimated from large-scale gene expression data often lack robustness and stability, rendering their biological interpretation challenging. Increasing the signature's interpretability and stability across perturbations of a given dataset and, if possible, across datasets, is urgently needed to ease the discovery of important biological processes and, eventually, new drug targets. Results : We propose a new method to construct signatures with increased stability and easier interpretability. The method uses a gene network as side interpretation and enforces a large connectivity among the genes in the signature, leading to signatures typically made of genes clustered in a few subnetworks. It combines the recently proposed graph Lasso procedure with a stability selection procedure. We evaluate its relevance for the estimation of a prognostic signature in breast cancer, and highlight in particular the increase in interpretability and stability of the signature

To Honor Our Elders: Exploration of Elder Abuse in Long-Term Settings

Older adults living in long-term care settings seek support as they age. Due to their health concerns, they may be vulnerable to elder abuse and neglect. As older adults continue to live longer and the Baby Boomer generation reaches older adulthood, elder abuse will only continue to increase and adversely affect older adults living in both long-term care and home settings. This thesis explores the causes, instances, and interventions of elder abuse in long term settings. Understanding elder abuse and neglect is paramount towards effectively addressing it and creating innovative interventions and preventative strategies. Those who experience elder abuse have many negative health- related outcomes. An examination of the types of abuse and neglect occurring in long term care settings in addition to the risk factors, training practices of employees, and suggested interventions provide a better understanding as well as a foundation for potential interventions supporting older adults as they age with health needs. This exploratory qualitative research study included interviews with five professionals working in settings that have equipped them with an understanding and expertise of elder abuse and neglect in these settings. Results suggest that agency efforts, workplace culture, and resident risk factors greatly affect the occurrence of elder abuse in long-term care settings. These findings revealed areas of improvement and potential pathways towards tackling elder abuse and neglect

An Exploratory Qualitative Study of Elder Abuse and Neglect in Long-Term Settings

Older adults living in long-term care settings seek support as they age. Due to health concerns, they may be vulnerable to elder abuse and neglect. As older adults continue to reach older adulthood at later ages, elder abuse will continue to increase and adversely affect older adults living in both long-term care and home settings. Those who experience elder abuse have many negative health- related outcomes. Understanding elder abuse and neglect is critical in both addressing it and creating innovative prevention strategies. This exploratory qualitative research study included interviews with five professionals working in settings that have equipped them with an understanding and expertise of elder abuse and neglect in these settings. Results suggest that agency efforts, workplace culture, and resident risk factors greatly affect the occurrence of elder abuse in long-term care settings. These findings revealed areas of improvement and potential pathways towards addressing elder abuse and neglect

Variations écologiques et chorologiques de la végétation macrophytique des rivières acides du Massif armoricain et des Vosges du Nord (France)

La végétation macrophytique des rivières acides d'Europe occidentale présente une grande unité, marquée par la constance d'un ensemble floristique de base, dont certaines espèces (Callitriche hamulata, Myriophyllum alterniflorum, Potamogeton polygonifolius, P. alpinus, etc) sont propres à ces eaux acides, d'autres (Callitriche platycarpa, Sparganium emersum, Elodea canadensis, Potamogeton crispus, etc) étant communes avec les eaux calcaires.Cet ensemble subit des variations écologiques et chorologiques :L'augmentation du niveau trophique des eaux conduit d'une végétation oligotrophe (différenciée par P. polygonifolius, Juncus bulbosus, etc) à un groupement mésoeutrophe (caractérisé par Callitriche obtusangula, Nasturtium officinale, etc). Ainsi, quatre types de phytocénoses ont pu étre distingués dans les Vosges du Nord en fonction de ce paramètre. D'autre part, une pollution organique localisée, par exemple par une pisciculture en Bretagne, provoque une augmentation des espèces eutrophes (C. obtusangula) et une régression des taxons plus oligotrophes (Scapania undulata).L'alternance de biotopes courants et lents se traduit par un remplacement de phytocénoses : ainsi, en Bretagne, Oenanthe crocata et Ranunculus penicillafus sont associées sur les radiers, alors que Nuphar lutea et S. emersum caractérisent les mouilles. De plus, une diminution de l'éclairement permet la présence de groupements bryophytiques spécifiques.Les principales variations chorologiques entre les deux territoires correspondent à un enrichissement des zones atlantiques en macrophytes euatlantiques ou méditerranéoatiantiques, comme O. crocata ou Apium inundatum, qui manquent dans les régions médioeuropéennes. En outre, selon les territoires biogéographiques, l'écologie de certaines espèces peut varier (par exempte S. emersum, R. peltatus, P. polygonifolius).Les macrophytes permettent donc, à l'instar des invertébrés benthiques, l'élaboration de biodiagnostics des eaux courantes.For the study of the vegetation of acid rivers in France, two areas have been investigated by the authors : Armorican Massif and Northern Vosges (fig. 1).This paper has two aims :- assessing the general trends of macrophytic vegetation : floristic composition and plant communities, with special reference to the influence of physical and water quality parameters,- pointing out and interpreting the variations observed between the two regions (chorological differences), and in the watercourses (ecological variations).Floristic data and phytosociological surveys (from bryophytes to angiosperm macrophytes) were collected along 50 m. stretches (at least) by the stratified sampling method in the case of large watercourses, and by systematic surveys for smaller ones. Consecutive 50 m. long sketches were used to measure the effect of localized pollution. (The inventory is as precise as possible). A distinction was made between the aquatic communities and river-bankside ones. At the same time, physical parameters were measured or observed (depth, light conditions, width,...), certain water-quality parameters were measured (pH, conductivity,...) and water samples were collected for further analysis.The data collected are gathered and compared in a table (table 1) showing differences between aquatic and subaquatic species, and between sunlit and shaded stretches. Trophic tendencies of most species are given according to either our observations or the literature.The main ecological feature is the streaking longitudinal variation of aquatic species, which agrees with the zones described by ILLIES and BOTOSANEANU : crenon, rhitron and potamon. In sunlit areas the succession is dominated by the following species :Potamogeton polygonifolius, Juncus bulbosus, Glyceria fluitans,...-> Ranunculus spp., Callitriche hamulata, Myriophyllum alterniflorum,...     ->Potamogeton crispus, Elodea canadensis,...Areas in the shade are characterized by bryophyta; the succession is : Scapania ondulata->Rhynchostegim riparioïdes, Fontinalis antipyreticaAs for the aquatic species, a longitudinal succession of bankside species exists :Sparganium erectum, Carex paniculata, Carex rostrata->Phalaris arundinacea      ->Phalaris arundinacea, Typha latifoliaThe macrophytic vegetation in acid rivers of Western Europe shows a great homogeneity, marked by the constancy of a floristic list, in which some species (Callitriche hamulata, Myriophyllum alterniflorum, Potamogeton polygonifolius, Potamogeton alpinus, Scapania undulata, etc.) only grow into acid waters, while others species (Callitriche platycarpa, Sparganium emersum, Elodea canadensis, Potamogeton crispus, etc.) grow also in calcareous waters.This basic unit is submitted to ecological and chorological variations.Ecological variations are due mainly to changes of the water quality. They are illustrated by two examples :- two river systems in the Northern Vosges where a general survey shows longitudinal variations of communities without pollution or assessing different kinds of pollution,- a pisciculture pollution with observations of species distribution on consecutive sketches.An increase of water trophic level leads progressively from an oligotrophic vegetation (marked by Potamogeton polygonifolius, Juncus bulbosus, etc.) to a meso-eutrophic community (characterized by Callitfriche obtusangula, Nasturtium officinale, etc.). Four communities are distinguished in Northern Vosges (table 2) and characterize water quality (both pollution and trophic level) :A : Potamogeton polygonifolius, Juncus bulbosus, Sphagnum spp. community, with the following main water-quality parameters : conductivity : 40-80 µS, phosphates : 500 ppb N).Two vegetation maps show the distribution of these communities (fig. 2). The succession of communities is related to water quality and fastened sequences are compared to normal ones. Without any pollution, A and B communities caver more than 5 km along the upper streams; under these conditions, the entire sequence A to D develops to 15 km, while with much anthropic pollution, it may occur within less than 3 km. A heavy pollution leads to the leads of communities as observed with the change tram A to C (without any B) due to a camping-site.A localized organic pollution by a Breton pisciculture is responsible for water-quality changes (table 3): ammonia, nitrites, phosphates and conductivity increase. The succession of mineral nitrogen forms is assessed (fig. 3). In the N-NH4+ and N-NO2- peak areas, the eutrophic species increase (Callitriche spp., specially Callitriche obtusangula, Amblystegium riparium) and the oligotrophic ones decrease (Scapania undulata) (fig. 3). Tissue analysis of Ranunculus penicillatus and of Callitriche spp. does not show any enrichment in nitrogen in polluted areas: the ecological response is mainly an increase of nitrophilous macrophytes (Callitriche spp.).The influence of water quality is more obvious in the Northern Vosges for most of the oligotrophic communities grow in forested sketches, white in Brittany these conditions are rare and eutrophication occurs in all the streams, even in the source areas. Floristically, neutrophilous or ubiquitous species are numerous. Some of them indicate either eutrophication or pollution : Amblystegium riparium and perhaps Octodiceras fontanum for bryophyta, Callitriche obtusangula, Potamageton perfoliatus and Sparganium. emersum (long leaves form), for aquatic species, Nasturtium officinale, Glyceria maxima for helophytes.Physical parameters also lead to variations. The succession of swift and slow areas leads to changes in the communities. Thus, in Brittany, Oenanthe crocata and Ranunculus penicillatus are associated on the riffles, while Nuphar lutes and Sparganium emersum characterize the pools, even in the upper parts of the streams where there are watermill ponds.The relationships between local hydrodynamic features and species distribution are discussed with regards to the stretches around the pisciculture area.Main chorological variation is an enrichment of atlantic areas with numerous eu-atlantic or mediterraneo-atlantic species : Porella pinnata and Amblystegium fluviatile as bryophyla, Oenanthe crocata, Apium inundatum, Ranunculus omiophyllus as spermaphyta. As there are few or no species restricted to medio-european areas, Atlantic communities are often richer than eastern ones. But some invading species as Elodea nuttallii are spreading all over the country from North-Eastern France.Ecological trends of certain species (Sparganium emersum, Ranunculus peltatus, Potamogeton polygonifolius) can change between the two biogeographical areas. So, Sparganium emersum grows in the upper oligotrophic zones in Northern Vosges while it characterizes lower meso-eutrophic zones in Brittany. In Brittany, Ranunculus peltatus un exist in eutrophic areas when the stretches are far from the sea. Potamogeton polygonifolius is very rare in swift streams in Brittany.Therefore, macrophytes permit, as benthic invertebrates do, to get a river biodiagnosis. They are easily observed and mapped so they can be used for a general survey

Building Jobs in Iowa: New Deal Dams of the Wapsipinicon River Watershed in Northeast Iowa

https://ir.uiowa.edu/osa_pubs/1013/thumbnail.jp