Community Physiotherapy and Chronic Disease Self-Management for Rural Community-Dwelling Older Adults

Research problem: The majority of older Canadians live with at least one chronic disease. Exercise has been shown to be an effective means to reducing symptoms, and to improving physical dysfunction in chronically ill populations; and self-management is a nationally advocated approach to dealing with the growing health care issue of chronic disease. Physiotherapists are experts in prescribing therapeutic exercise and promoting chronic disease self-management. Methods: This two-study dissertation explored older adults’ perceptions of exercise as a self-care activity within a chronic disease self-management strategy using focused ethnography; and physiotherapists’ experiences in promoting exercise as a means to chronic disease self-management using hermeneutic phenomenology. Findings: Older adults defined exercise generally, as movement, but did not demonstrate an understanding of the relevance or importance of exercise intensity or specificity to gain health benefits specific to their chronic disease(s). Older adults preferred to participate in exercise they enjoyed doing and was familiar to them. Older adults may not value exercise as a self-care activity in the same way that physiotherapists do. The client’s values with respect to exercise and the structure of the service model significantly impacted the physiotherapists’ ability to promote chronic disease self-management. Physiotherapists described facilitating chronic disease self-management as an important practice role, but physiotherapists were not referred to promote chronic disease self-management. This meant physiotherapists felt constrained by time, as they attempted to both promote chronic disease self-management and address the primary reason for referral. Physiotherapists took on a consultative role described as making connections with the client to build rapport, to help the client understand their chronic disease, and to connect the client with additional community programs, and/or health care practitioners to meet their goals or care needs. Conclusions: Physiotherapists could improve efficiency of their practice by gaining skills to help them understand client’s perceptions about exercise as a means to self-care, and or tailoring interventions to include opportunities to participate in enjoyable and familiar activities. Changes to service model with respect to acknowledging the role of physiotherapists in promoting chronic disease self-management could also facilitate physiotherapists’ efforts to enact this role in community settings

Gifts at work: spark wonder campaign

Support from alumni and donors allows the Linfield community to shin

Prepared for Launch

Hannah Waterman ’21 fondly remembers walking into a general chemistry class her first day at Linfield, and the inspiration and purpose she felt

Impact of imperfect test sensitivity on determining risk factors : the case of bovine tuberculosis

Background Imperfect diagnostic testing reduces the power to detect significant predictors in classical cross-sectional studies. Assuming that the misclassification in diagnosis is random this can be dealt with by increasing the sample size of a study. However, the effects of imperfect tests in longitudinal data analyses are not as straightforward to anticipate, especially if the outcome of the test influences behaviour. The aim of this paper is to investigate the impact of imperfect test sensitivity on the determination of predictor variables in a longitudinal study. Methodology/Principal Findings To deal with imperfect test sensitivity affecting the response variable, we transformed the observed response variable into a set of possible temporal patterns of true disease status, whose prior probability was a function of the test sensitivity. We fitted a Bayesian discrete time survival model using an MCMC algorithm that treats the true response patterns as unknown parameters in the model. We applied our approach to epidemiological data of bovine tuberculosis outbreaks in England and investigated the effect of reduced test sensitivity in the determination of risk factors for the disease. We found that reduced test sensitivity led to changes to the collection of risk factors associated with the probability of an outbreak that were chosen in the ‘best’ model and to an increase in the uncertainty surrounding the parameter estimates for a model with a fixed set of risk factors that were associated with the response variable. Conclusions/Significance We propose a novel algorithm to fit discrete survival models for longitudinal data where values of the response variable are uncertain. When analysing longitudinal data, uncertainty surrounding the response variable will affect the significance of the predictors and should therefore be accounted for either at the design stage by increasing the sample size or at the post analysis stage by conducting appropriate sensitivity analyses

Modelling the dynamics of intramammary E. coli infections in dairy cows: understanding mechanisms that distinguish transient from persistent infections

The majority of intramammary infections with Escherichia coli in dairy cows result in transient infections with duration of about 10 days or less, although more persistent infections (2 months or longer) have been identified. We apply a mathematical model to explore the role of an intracellular mammary epithelial cell reservoir in the dynamics of infection. We included biological knowledge of the bovine immune response and known characteristics of the bacterial population in both transient and persistent infections. The results indicate that varying the survival duration of the intracellular reservoir reproduces the data for both transient and persistent infections. Survival in an intracellular reservoir is the most likely mechanism that ensures persistence of E. coli infections in mammary glands. Knowledge of the pathogenesis of persistent infections is essential to develop preventive and treatment programmes for these important infections in dairy cows

Teasing apart fine- and coarse-scale effects of environmental heterogeneity on tree species richness in Europe

The environmental heterogeneity–biodiversity relationship is generally hypothesised to be positive, with greater heterogeneity leading to greater biodiversity. However, the generality of positive environmental heterogeneity–species richness relationships is often debated, with some studies finding non-significant or even negative relationships. Negative relationships have primarily been found at fine spatial scales. Both negative and positive relationships have a basis in ecological theory. Environmental heterogeneity at coarse scales opens up niche space to allow more species to coexist; whereas high local heterogeneity, for instance in topography, may lead to increased local extinction due to micro-fragmentation, or dominance of species suited to heterogeneous conditions. However, it is difficult to attribute how much of the variance is explained at different scales within the same modelling framework.Here, we use a new data-aggregation method which enables us to include both fine- and coarse-scale environmental heterogeneity within the same analysis. Using this method, we were able to tease apart the fine- and coarse-grain effects of topographic heterogeneity on European tree species richness. At the coarse scale (0.5 degrees), we found a positive effect of range in elevation on tree species richness. However, when measuring range in elevation using a fine-scale moving window of radius 500 m, we found a negative relationship with tree species richness. This supports existing research that has shown negative relationships between environmental heterogeneity and species richness at finer spatial grains. Because we were able to include a measure of both local and landscape-scale topographic heterogeneity in the same model, for the first time we could fully capture the effects of both scales on coarse-grain species richness while accounting for the effect of the other scale

Gifts at Work

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Accounting for among-sampler variability improves confidence in fuel moisture content field measurements

Background: Direct fuel moisture content measurements are critical for characterising spatio-temporal variations in fuel flammability and for informing fire danger assessments. However, among-sampler variability (systematic differences in measurements between samplers) likely contributes to fuel moisture measurement variability in most field campaigns. Aims: We assessed the magnitude of among-sampler variability in plot-scale Calluna vulgaris fuel moisture measurements. Methods: Seventeen individuals collected samples from six fuel layers hourly from 10:00 hours to 18:00 hours. We developed mixed effects models to estimate the among-sampler variability. Key results: Fuel moisture measurements were highly variable between individuals sampling within the same plot, fuel layer, and time of day. The importance of among-sampler variability in explaining total measured fuel moisture variance was fuel layer dependent. Among-sampler variability explained the greatest amount of measurement variation in litter (58%) and moss (45%) and was more important for live (19%) than dead (4%) Calluna. Conclusions: Both consideration of samplers within the experimental design and incorporation of sampler metadata during statistical analysis will improve understanding of spatio-temporal fuel moisture dynamics obtained from field-based studies. Implications: Accounting for among-sampler variability in fuel moisture campaigns opens opportunities to utilise sampling teams and citizen science research to examine fuel moisture dynamics over large spatio-temporal scales.</p

The Mystery Club: On Track with Tractor Safety

Farm safety newsletter and activities for youth, focusing on tractor safety, brought to you by Captain Overalls, the safety crusader.https://lib.dr.iastate.edu/extension_ag_pubs/1070/thumbnail.jp