How Do Health Care Providers Identify and Address Lifestyle Factors with Community Dwelling Adults Who Have Chronic Wounds?

Wound prevention and management best practice guidelines and literature contain recommendations that treatment plans need to consider the client’s lifestyle but offer little guidance about the specific lifestyle factors to be considered, nor how to address these. A post positivist constructivist grounded theory study was used to explore this gap Participants were health care providers with at least 5 years of experience working with community dwelling adults with chronic wounds. Data were transcripts of two semi structured individual interviews, a reflective journal, relevant documents identified by participants and transcripts of focus groups. A common understanding of lifestyle factors was not found; however, a substantive theory was co-constructed. This work builds on a concept described by Schon (1987, pg 3)where best practices and research studies are described as occupying a high ground overlooking a swamp, where complex clients are managed with limited resources. In this study, three major themes emerged – the high ground, the swamp and co-occupation. The high ground included how the health care provider entered wound prevention and management, and that their initial task was local wound care. Health care providers expected wounds to heal with specific treatments within specific time frames. Practice, however, happens in the “swamp”. Participants described the context of the swamp to include ideas such as; the practicality of treatment, client characteristics, the client’s vocation, etc. Co-occupation occurs when the clinician and client are both engaged, working together on the common goal of identifying and addressing lifestyle factors within the context of the swamp

Elementary School Age Children's Perceptions of Teachers Nonverbal Behavior

Elementary Educatio

Ophyiulus in Victoria: results of millipede surveys from south-eastern Australia

The composition and ecology of the millipede fauna of Victoria remain poorly understood. We collected millipedes as part of a series of ecological arthropod surveys across south-eastern Australia, focusing mainly on Victoria. These samples almost exclusively contained millipedes from the introduced order Julida. We pursued species identification of the julids when it became apparent there were species other than the well-recorded Ommatoiulus moreleti (Lucas, 1860) (Portuguese millipede) in the samples. The majority of specimens were O. moreleti, but we also detected at least one species of Cylindroiulus Verhoeff, 1894, as well as an Ophyiulus Berlese, 1884, species, specimens of which have been identified as Ophyiulus cf. targionii. These are the first Ophyiulus records for Victoria to our knowledge. We present preliminary data on the abundance through the year of Ophyiulus. This is the first study to examine this species in Victoria and little is currently known about its likely impact on agriculture or on native species. Monitoring and research of the species in the future is therefore warranted

[I] The Challenge of Cloud Mass Transport in Antarctica

The Tenth Symposium on Polar Science/Ordinary sessions: [OM] Polar Meteorology and Glaciology, Wed. 4 Dec. / 2F Auditorium, National Institute of Polar Researc

Variables associated with performance of an active limb movement following within-session instruction in people with and people without low back pain

Modification of a movement pattern can be beneficial in decreasing low back pain (LBP) symptoms. There is variability, however, in how well people are able to modify performance of a movement. What has not been identified is the factors that may affect a person’s ability to modify performance of a movement. We examined factors related to performance of active hip lateral rotation (HLR) following standardized instructions in people with and people without LBP. Data were collected during performance of HLR under 3 conditions: passive, active, and active instructed. In people with LBP, motion demonstrated during the passive condition (r=0.873, P<0.001), motion demonstrated during the active condition (r=0.654, P=0.008), and gender (r=0.570, P=0.027) were related to motion demonstrated during the active-instructed condition. Motion demonstrated during the passive condition explained 76% (P<0.001) of the variance in motion demonstrated during the active-instructed condition. A similar relationship did not exist in people without LBP. The findings of the study suggest that it may be important to assess motion demonstrated during passive HLR to determine how difficult it will be for someone with LBP to modify the performance of HLR. Prognosis should be worst for those who display similar movement patterns during passive HLR and active-instructed HLR

SCOR/IODE/MBLWHOI Library collaboration on data publication [poster] 

Author Posting. © The Author(s), 2011. This is the author's version of the work. Accepted by the ACM/IEEE Joint Conference on Digital Libraries, June 13-17, 2011, Ottawa, CanadaThis poster describes the development of international standards to publish oceanographic datasets. Research areas include the assignment of persistent identifiers, tracking provenance, linking datasets to publications, attributing credit to data providers, and best practices for the physical composition and semantic description of the content.Funding provided by the George Frederick Jewett Foundation

The Impact of Different Classification Criteria Sets on the Estimated Prevalence and Associated Risk Factors of Diastolic Dysfunction in Rheumatoid Arthritis

This study compared the estimated prevalence and potential determinants of left ventricular (LV) diastolic dysfunction upon applying different classification criteria in rheumatoid arthritis (RA). LV diastolic function was assessed echocardiographically by pulsed Doppler (E/A), tissue Doppler (E/e′, lateral and septal e′), and left atrial volume index in 176 RA patients. Relationships of traditional cardiovascular risk factors and RA characteristics with LV diastolic function and dysfunction according to previous and current criteria were determined in multivariate regression models. Waist-hip ratio was associated with E/A (standardised β (SE) = -0.28±0.09, p=0.0002) and lateral e′ (standardised β (SE) = 0.26±0.09, p=0.01); low diastolic blood pressure was related to E/e′ (standardised β (SE) = -0.16±0.08, p=0.04). Diastolic dysfunction prevalence differed upon applying previous (59%) compared to current (22%) criteria (p<0.0001). One SD increase in waist-hip ratio was associated with diastolic dysfunction when applying current criteria (OR = 2.61 (95% CI = 1.51–4.52), p=0.0006), whereas one SD increase in diastolic blood pressure was inversely related to diastolic dysfunction upon using previous criteria (OR = 0.57 (95% CI = 0.40–0.81), p=0.002). In conclusion, application of current and previous diastolic dysfunction criteria markedly alters the prevalence and risk factors associated with diastolic dysfunction in RA

Supported by The South African Medical Research Council (grant MRC2008_DES) and National Research Foundation

ABSTRACT. Objective. Depending on physiological context, the adipokine chemerin can reduce or enhance cardiovascular risk. We investigated whether chemerin concentrations represent cardiovascular disease risk in rheumatoid arthritis (RA). Methods. We assessed ELISA-determined chemerin concentrations and those of 4 early endothelial activation molecules as well as angiopoietin 2, which mediates angiogenesis and thereby contributes to advanced atherosclerosis, the common carotid artery intima-media thickness (cIMT), and carotid artery plaque by ultrasound in 236 patients (114 black and 122 white) with RA. Relationships were identified in potential confounder and mediator-adjusted mixed regression models. . The β (SE) for the chemerin-intima-media thickness relations in patients with overweight or generalized obesity and abdominal obesity were larger than in those without these characteristics (p &lt; 0.0001 and = 0.04, respectively). Conclusion. Chemerin is associated with endothelial activation and atherosclerosis in RA. Adiposity influences the chemerin-atherosclerotic phenotype relations i

Factors Associated with Potential Medication-Herb/Natural Product Interactions in a Rural Community

Context—Use of both conventional medicines and herbs/natural products are increasing in the United States (US). Consequently, individuals are more likely to be exposed to potentially harmful interactions between these products. Objective—To examine the use of both herbs/natural products and conventional medications in a rural community; examine the prevalence of potential interactions between herbs/natural products and conventional medications; and identify factors associated with exposure to such interactions. Design—Population-based epidemiological study. Setting—Data for this paper were collected between 1999 and 2004 as part of the Johnston County Osteoarthritis Project. Participants—Limited to civilian, non-institutionalized, Caucasian and African American residents, age 45 years or older, of Johnston County, North Carolina. Data used in this paper are from 2,523 individuals who completed face-to-face interviews. Main Outcome Measures—Prevalence of herb/natural product use and exposure to potential interactions between these products and conventional medications. Results—Nineteen percent (n=488) of participants used at least one herb/natural product. Among those who used both conventional medications and herbs/natural products, more than 1 in 5 (97 [21.9%]) were using a combination of products associated with a potential interaction. Odds of exposure to a potential interaction was lower among people who had health insurance and increased with the number of products used. Conclusions—Many people are exposed to potential interactions between herbs/natural products and conventional medications. Research is needed to better understand the effect such interactions may have on patient care