Identity Development and Reconstruction Among Caregivers

The goal of the current study was to assess possible changes in identity upon becoming a caregiver to another adult. Caregivers of adults (N= 9) completed an online, anonymous survey. A significant change in Identity Commitment was found from pre to post caregiving. Three participants went from a Foreclosed Identity Status pre caregiving to a Diffused Identity Status post caregiving, and one participant went from an Achieved Identity Status to a Moratorium Identity Status. However, no consistent trends in responses were found among these participants, suggesting further research with a larger sample size is needed

Dare to care : why being care aware matters in further and higher education

This article will explore outcomes for care experienced young people in education and will examine and dissect the current statistics for care experienced students. Furthermore, this article will identify various support mechanisms which could be implemented and embedded within further and higher education settings and will discuss how staff members can gain an awareness and understanding of supporting our care experienced population

Effects of a Falls Prevention Program for Individuals Post-Stroke in Guyana: An International Collaboration Protocol

Background. Falls related to stroke have a negative impact on physical mobility, overall health, quality of life, and fear of falls. In Guyana, falls are accepted as a normal part of life and there is little to no research on the impact of a falls prevention program on decreasing both falls and fear of falling in the post-stroke population in this country. Objectives. This international collaboration protocol will determine the ability of a falls prevention program to decrease falls and fear of falling in individuals post-stroke in Guyana. Design. This is a within subjects design, with exercises based on the individuals’ walking abilities. Setting. The study will be conducted at the Palms Rehabilitation Department in Georgetown, Guyana. Physical therapists in Guyana will perform all data collection and interventions. The data analysis will be performed at Misericordia University in Dallas, Pennsylvania by physical therapy students. Participants. Twenty individuals who have a history of stroke and who score less than 45/50 on the Berg Balance Scale. Intervention. The multifactorial exercise intervention program will focus on common post-stroke impairments such as static and dynamic balance and strength. These exercise interventions will be delivered by trained physical therapists 1 time a week for 8 weeks. Participants will report any falls throughout the program to the physical therapists. Participants will also be asked to perform a home exercise program (HEP) to increase frequency of exercises. Measurements. The primary outcome measures to assess the effectiveness of the interventions will be the Berg Balance Scale, 5 Times Sit to Stand and the Short FES-I. Limitations. The short time frame of the interventions and the frequency of sessions (once a week), as well as the participants’ ability to attend sessions due to travel limitations including cost of travel. Participant adherence to HEP between treatment sessions could also potentially impact the results of the study.https://digitalcommons.misericordia.edu/research_posters2022/1038/thumbnail.jp

"Sit Less at Work": exploring the contextual factors which influence intervention development, implementation and evaluation

Introduction Prolonged periods of sitting, a common feature of sedentary jobs, are associated with increased morbidity and mortality. Evaluation of interventions to reduce workplace sitting have shown mixed results, suggesting impact also depends on context. This research, therefore, aimed to explore contextual factors that influence the development, implementation and evaluation of interventions to reduce workplace sitting time. Methods An integrative systematic review assessed effectiveness of interventions to reduce workplace sitting and explored key considerations for intervention development and implementation. Phase 1 involved a qualitative study to explore how barriers and facilitators to reducing workplace sitting time differed in four organisations of varying size and sector. Phase 2 developed and planned the implementation of organisation-specific interventions using ecological approaches and co-production. Phase 3 comprised a mixed-methods “before and after” study to assess the feasibility of implementation and evaluation and explored contextual barriers and enablers in three of the participating organisations. Results The review produced an operational framework which was tested during the three phases and then refined. Phase 1 highlighted barriers and enablers that differed across organisations including: organisational culture, the idea of presenteeism and wider political and economic influences. Phase 2 produced four “Sit Less at Work” interventions which targeted multiple levels of influence. Phase 3 identified no change in workplace sitting time, however, process evaluation determined that interventions were not implemented as intended. Key contextual barriers to implementation included: organisational culture, social norms of sitting, and lack of management buy-in. Conclusion Successful development, implementation and evaluation of interventions to reduce workplace sitting time requires careful consideration of contextual factors, particularly organisational culture and ingrained social practices. The evidence-based operational framework developed in this thesis can be used to ensure consideration is given to these factors to develop and deliver more effective interventions

Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases.

BACKGROUND As global mobile phone penetration increases, direct health information communication from hard-to-reach communities is becoming commonplace. Mobile health (mHealth) tools that enable disease control programs to benefit from this information, while simultaneously empowering community members to take control of their own health, are vital to the goal of universal health care. OBJECTIVE Our aim was to highlight the development of the Liverpool mHealth Suite (LMS), which has been designed to address this need and improve health services for neglected tropical diseases being targeted for global elimination, such as lymphatic filariasis. METHODS The LMS has two main communication approaches-short message service and mobile phone apps-to facilitate real-time mass drug administration (MDA) coverage, reporting patient numbers, managing stock levels of treatment supplies, and exchanging health information to improve the quality of care of those affected. RESULTS The LMS includes the MeasureSMS-MDA tool to improve drug supplies and MDA coverage rates in real-time (currently being trialed in urban Tanzania); the MeasureSMS-Morbidity tool to map morbidity, including lymphedema and hydrocele cases (initially piloted in rural Malawi and Ghana, then extended to Ethiopia, and scaled up to large urban areas in Bangladesh and Tanzania); the LyMSS-lymphedema management supply system app to improve distribution of treatments (trialed for 6 months in Malawi with positive impacts on health workers and patients); and the HealthFront app to improve education and training (in development with field trials planned). CONCLUSIONS The current success and scale-up of the LMS by many community health workers in rural and urban settings across Africa and Asia highlights the value of this simple and practical suite of tools that empowers local health care workers to contribute to local, national, and global elimination of disease

The morphology of lath martensite: a new perspective

A mathematical framework is proposed to predict the features of the (5 5 7) lath transformation in low-carbon steels based on energy minimisation. This theory generates a one-parameter family of possible habit plane normals and a selection mechanism then identifies the (5 5 7) normals as those arising from a deformation with small atomic movement and maximal compatibility. While the calculations bear some resemblance to those of double shear theories, the assumptions and conclusions are different. Interestingly, the predicted microstructure morphology resembles that of plate martensite, in the sense that a type of twinning mechanism is involved

Neuronal apoptosis-inhibitory protein does not interact with Smac and requires ATP to bind caspase-9.

The neuronal apoptosis-inhibitory protein (NAIP) is the founding member of the mammalian family of inhibitor of apoptosis (IAP) proteins (also known as BIRC proteins) and has been shown to be antiapoptotic both in vivo and in vitro. The 160-kDa NAIP contains three distinct regions: an amino-terminal cluster of three baculoviral inhibitory repeat (BIR) domains, a central nucleotide binding oligomerization domain (NOD), and a carboxyl-terminal leucine-rich repeat (LRR) domain. The presence of the NOD and LRR domains renders NAIP unique among the IAPs and suggests that NAIP activity is regulated in a manner distinct from that of other members of the family. In this report, we examined the interaction of various regions of NAIP with caspase-9 and Smac. Recombinant NAIPs with truncations of the carboxyl-terminal LRR or NOD-LRR regions bound to caspase-9. In contrast, the full-length protein did not, suggesting some form of structural autoregulation. However, the association of the wild type full-length protein with caspase-9 was observed when interaction analysis was performed in the presence of ATP. Furthermore, mutation of the NAIP ATP binding pocket allowed full-length protein to interact with caspase-9. Thus, we conclude that NAIP binds to caspase-9 with a structural requirement for ATP and that in the absence of ATP the LRR domain negatively regulates the caspase-9-inhibiting activity of the BIR domains. Interestingly, and in contrast to the X-chromosome-linked inhibitor of apoptosis protein (XIAP), NAIP-mediated inhibition of caspase-9 was not countered by a peptide containing an amino-terminal IAP binding motif (IBM). Consistent with this observation was the failure of Smac protein to interact with the NAIP BIR domains. These results demonstrate that NAIP is distinct from the other IAPs, both in demonstrating a ligand-dependent caspase-9 interaction and in demonstrating a distinct mechanism of inhibition

Peer-Facilitated Cognitive Dissonance versus Healthy Weight Eating Disorders Prevention: A Randomized Comparison

Research supports the efficacy of both cognitive dissonance (CD) and healthy weight (HW) eating disorders prevention, and indicates that CD can be delivered by peer-facilitators, which facilitates dissemination. This study investigated if peer-facilitators can deliver HW when it is modified for their use and extended follow-up of peer-facilitated CD as compared to previous trials. Based on pilot data, we modified HW (MHW) to facilitate peer delivery, elaborate benefits of the healthy-ideal, and place greater emphasis on consuming nutrient dense foods. Female sorority members (N=106) were randomized to either two 2-hour sessions of CD or MHW. Participants completed assessment pre- and post-intervention, and at 8-week, 8-month, and 14-month follow-up. Consistent with hypotheses, CD decreased negative affect, thin-ideal internalization, and bulimic pathology to a greater degree post-intervention. Both CD and MHW reduced negative affect, internalization, body dissatisfaction, dietary restraint, and bulimic pathology at 14 months

Insights from individuals with chronic conditions in the context of COVID-19

The objective of this prospective survey series was to evaluate knowledge and concerns related to the COVID-19 pandemic among individuals with one or more chronic conditions, including cardiometabolic, autoimmune, respiratory and cancer diagnoses. Two surveys were distributed consisting of up to 55 items (March; n=1069) and up to 71 items (April, n=1126), with 24 items repeated from the first survey. Questions focused on healthcare access, barriers and concerns related to the COVID-19 virus. Descriptive analysis evaluated central tendencies, spread, and frequencies of the demographic data, disease states, and survey results within and between the two survey timepoints. Results from 416 individuals (38.9%) on survey 1 and 425 (37.7%) on survey 2 were analyzed. Participants were predominantly female (85%) and white (67%) with 7% residing in rural areas and 69% employed. Respondents reported an average of 2 chronic conditions and 62% would be classified as “at risk” for COVID-19 complications by the CDC. Only 20% reported a conversation about COVID-19 with a healthcare provider, 9% reported anxiety, 35% indicated loneliness. Level of concern about COVID-19 contracting the disease, cost of treatment/complications, medical access, and process of being treated was associated with increased anxiety (p\u3c0.001) and wearing a facemask (p=0.01). Analysis suggests that analyzing concern and its association with health behaviors and anxiety should be a priority for innovative solutions. Insights into how the COVID-19 pandemic is impacting individuals with chronic conditions are imperative to inform tailored interventions to support individuals at higher risk of serious complications and death. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens