'Wet' care homes for older people with refractory alcohol problems: a qualitative study

Background This study describes a registered care home in England and a registered nursing home in Norway which provide permanent care for alcohol-dependent older people who are unable or unwilling to stop drinking and cannot maintain an adequate standard of self-care and/or live independently. Prior to admission, most residents have been living unsafely in their own home or were homeless. They have high levels of contact with health, social and criminal justice services and complex needs as a result of mental illness, poor physical health and physical disabilities. Most have lost contact with their families. The aim is to stabilise drinking, physical and mental health and improve quality of life. The homes are based on a harm reduction philosophy, that is, they focus on strategies to reduce harm from high-risk alcohol use, rather than insisting on abstinence. Residents can drink as much alcohol as they want on the premises but staff encourage them to drink less and in a less harmful way (e.g. spreading drinking throughout the day and having ‘dry’ days). Method We carried out interviews and focus groups with staff and residents, observed verbal exchanges, experiences and routines in communal areas, took field notes during staff rounds and analysed documents such as care plans for individual residents. Key findings • Most residents’ drinking, physical and mental health stabilises and their use of health, social and criminal justice services reduces following admission. • This is achieved by encouraging less harmful drinking, providing on-site health care, assistance with medication and self-care and provision of nutritious meals and social activities. • Wet care homes are viewed by some residents as a safe refuge which has improved their quality of life. • Other residents are frustrated by a lack of personal autonomy. • Suitable outcomes include improved hygiene and nutrition, increased self-esteem, better compliance with healthcare, healthier living which is not entirely alcohol focused and more hope for the future. • Homes should have processes in place to collect quantitative measures which provide clear evidence of impact.        

Welcome to My World

My work revolves around two dimensional drawings on small 9”x12” smooth Bristol Paper. In a sense I’m more of a traditional artist; I prefer to use Prismacolor Pencils, Watercolors, Copic Markers, Micron Pens, and White Gel Pens in my art. Not only have I created lots of drawings, but I have also painted a bit; about a year ago I had a piece put up on display at an Art Center in my hometown called the Glema Mahr Center for the Arts. Quite recently I have been into Digital art; I like to use the free software known as GIMP to color over drawings I have scanned onto my computer. My thought process before I put my pencil to paper usually revolves around what I’ve recently watched, it’s pretty weird but when I watch a show my inspiration to draw starts to shine. I really want people to recognize my work, by noticing my style and knowing that I like to draw a lot of Fan Art. My personal Art Philosophy is to draw whatever you want, don’t let people tell you what to draw during this day in age. Art is Art, and with a lot of hard work it’s beautiful no matter what it is, because it’s yours. A couple of people who have inspired me are Katy Lipscomb, Aaron Blaise, and an artist on the Website DeviantArt known as WildSpiritWolf. WildSpiritWolf was the first artist who got me interested into drawing animals, and mainly wolves. Her FAQ (frequently asked questions) came in handy when I didn’t know where to start with my art, I was introduced to shading, micron pens, and prismacolor pencils from her. Katy Lipscomb was another artist on DeviantArt that I met a while back and is a friend of mine, her art is so vibrant and colorful, she introduced to me the idea of using watercolors as a base before coloring an entire drawing with Prismacolor Pencils. And Aaron Blaise gave me the push to draw more human figures and to add cartoon characteristics to them along with animals, and also to start drawing digitally.https://digitalcommons.murraystate.edu/art399/1048/thumbnail.jp

Scattered

I have been dealing with loneliness my whole life. I was given up for adoption at birth and brought from Paraguay to the United States. I feel a kind of loneliness for someone I have never met: my birth mother. In grade school I didn’t have many friends who would spend time with me outside of class. My brother was usually busy with homework and my mother and father were busy with work, leaving me a lot of time spent on my own. My main emphasis in college has been drawing. I wanted to refine my skills that I’ve been developing since I was a kid, so it made sense to focus there. The most influential experience though was being able to draw the figure from a model. I had been drawing character and caricatures of people for a long time, but I didn’t really understand the human anatomy. Being able to draw from life has changed my understanding of what the body can do and what kind of poses are possible and now my figures are more expressive. I didn’t think that my work had any kind of theme or concept behind it. I have realized though that everything I do, from my personal work drawing television characters to everything I have made in college that I have made has been a tool. Either a tool for me to deal with my loneliness and anxiety, or as a tool that has use for others. My work serves a purpose; that is to improve the world it’s in.https://digitalcommons.murraystate.edu/art499/1027/thumbnail.jp

An Evaluation of Relationships Among Streamflow and Selected Water Quality Parameters in a Forested High-Altitude Watershed

A long-term water quality program has been established at the Noland Divide Watershed (NDW) in the Great Smoky Mountains National Park. The Noland Divide Watershed is a spruce-fir forested catchment which has been shown in previous research to receive some of the largest fluxes of atmospherically-deposited nitrogen and sulfur compounds in the world. Streamwater chemistry data from November 1991 through August 1998 for two streams, the northeast (NE) and southwest (SW) stream, were examined to note results of this deposition on water quality. Automatic monitoring equipment on both streams measure and record pH, conductivity, and temperature readings every 15 minutes, and Stevens recorders in 3-foot H-flumes record stage height which corresponds to a flow rate every 15 minutes. In addition, grab samples were collected weekly and analyzed for pH, conductivity, acid neutralizing capacity (ANC), major anions and cations, aluminum, and silica. Experimental analysis was conducted to describe conditions, detect long-term and/or seasonal trends in water quality, and to relate water quality constituents with the watershed hydrology. In addition, parametric regression models were formed to note influence of several variables such as flow, time, seasonality, pH, and conductivity on analyte loads and concentrations and to test several sampling scenarios that may more-efficiently represent the water quality at NDW. It was determined from the analysis that high flow events are not well represented by the weekly grab samples and therefore water quality during these flow conditions is not fully understood. The SW stream is controlled more by groundwater inputs than is the NE stream, and the water quality characteristics of the two streams are statistically different (p\u3c 0.05) with respect to all analyte concentrations except ammonium. Increased sulfate concentrations (+1.08 μeq/L in SW, +1.32 μeq/L in NE) were observed in the streams for each 1-inch increase of precipitation that occurs since the previous sampling visit. Decreased sulfate concentrations (-0.65 μeq/L in SW and -0.67 μeq/L in NE) were observed in the streams for each 1-day increase in consecutive dry days prior to sampling. Nitrate concentrations observed in the streams were not significantly influenced by precipitation prior to sampling, but decreased concentrations (-0.05 μeq/L in SW and -0.54 μeq/L in NE) were observed for each 1-day increase in consecutive dry days prior to sampling. Parametric regression models show that chloride, sodium, aluminum, and ammonium loads and concentrations are increasing over time, nitrate and silica loads and concentrations are decreasing over time, and sulfate, potassium, and hydrogen ion loads and concentrations are not changing over time. All analyte loads and concentrations except silica are significantly (p\u3c0.10) influenced by seasonality. Parametric regression models also show that grab samples collected on a bi-weekly or tri-weekly frequency would be as statistically adequate for characterizing water quality concentrations and loads as are samples collected on a weekly basis

The role and regulation of nitric oxide and oxidative stress in cardiometabolic disease : focus on preeclampsia

Cardiovascular (CVD) and metabolic diseases account for significant morbidity and mortality. Over the last decades, despite significant research and clinical effort, their global prevalence is estimated to further increase. This trend is similarly observed in the pregnant population, which increases the risk of cardiometabolic complications of pregnancy, such as preeclampsia (PE), which in turn, predisposes both the mother and offspring to increased future cardiovascular and metabolic risk. Disruption of the delicate balance between nitric oxide (NO) and reactive oxygen species (ROS) leads to a vicious pathogenic cycle which results in oxidative stress and systemic vascular dysfunction, key features of numerous CVD and metabolic diseases. In the vasculature, NO is predominantly synthesised via endothelial nitric oxide synthase (eNOS), although the nitrate-nitrite-NO pathway can serve as an additional source. The latter can be stimulated by dietary inorganic nitrate, found in leafy green vegetables and beetroot. The present thesis aimed to further explore the role of NO deficiency and oxidative stress in the pathogenesis of cardiometabolic disease, with focus on PE. We sought to dissect the mechanisms underlying the beneficial metabolic effects of dietary nitrate, investigate the role and mechanisms underlying erythrocrine function on endothelial homeostasis, assess the feasibility of conducting a clinical dietary nitrate intervention RCT in PE women and finally, examine how monocyte-derived factors perpetuate endothelial oxidative stress in PE. In study I, models of diet-induced metabolic syndrome and liver steatosis demonstrated a novel therapeutic role of dietary nitrate, mediated via modulation of AMPK signalling and NADPH oxidase-derived oxidative stress. In studies II, III, and IV, ex vivo incubations of red blood cells (RBCs) and healthy murine aortas were utilised to specifically evaluate functional RBCendothelial interactions. In study II, a lack of RBC eNOS induced endothelial dysfunction (ED), in part mediated via vascular arginase, elevated endothelial oxidative stress, and reduced NO bioavailability. In studies III and IV, RBCs isolated from PE patients, but not healthy pregnant women, induced ED, mediated via elevated arginase activity, reduced NO bioavailability, and elevated oxidative stress, in a contact-dependent manner. Study IV demonstrated that short term (7-day) dietary nitrate supplementation was well accepted and not associated with any adverse events. No significant differences in blood pressure changes were observed. Beneficial nitrate-independent effects on RBC-endothelial communication were observed ex vivo. In Study V an in vitro approach demonstrated that peripheral blood mononuclear cells (PBMCs) isolated from PE women increase oxidative stress and reduce NO bioavailability in the endothelium, which was prevented by antioxidant treatment (Silibinin). The balance between NO bioavailability and oxidative stress governs endothelial homeostasis. Beneficially targeting this delicate balance can be achieved via dietary inorganic nitrate, which holds safe, therapeutic promise for cardiometabolic disease. The RBC is a central player in mediating this balance in the vascular microenvironment, dysregulated erythrocrine function results in ED. Further investigation regarding RBC-endothelial signalling may provide insight into previously discarded therapeutic approaches for cardiometabolic diseases

Atmospheric Influences on Cave Meteorology, Jinapsan Cave, Guam: A Drip Rate Analysis

Temperature, pressure, and relative humidity within Jinapsan Cave on Guam were compiled and analyzed over a five-month period to gain a better understanding of this environment. Temperatures within the cave hover around ~26°C with no apparent influences except the mean annual temperature, with humidity values over 90%. There is high fidelity between outside and internal air pressures indicating no pressure differential exists and pressure changes are a result of kinematic wave flow. A mild correlation exists between a cave speleothem’s drip rate and outside pressure. The cave’s tidal pool compared to oceanic tides show a lag of 1-2 hours and amplitude dampening. The tidal pool’s temperature is 25.7°C, signifying no mass transfer of water occurs. Tropical cave studies are rare, but are important for paleoclimate research using cave speleothems as proxies. This study determined cave meteorological factors that affect speleothem development to allow for more accurate paleoclimate studies

An After-School Wellness Program for Children in Low Socioeconomic Neighborhoods

The purpose of this scholarly project was to develop an interdisciplinary after-school program for fifth graders living in low socioeconomic neighborhoods. This program entitled Let’s Move, Cook, and Learn With Friends! is intended to reduce obesity through promoting healthy habits in children by increasing physical activity, consumption of healthy food, and positive interactions with peers. Childhood obesity is a worldwide epidemic that can result in lifelong health problems if not treated proactively (Vizcaino et al., 2008). Therefore, the goal of this scholarly project is to raise their knowledge about obesity and decrease the risk factors for childhood obesity. A literature review was conducted by the authors of this scholarly project to examine the problem of childhood obesity and obtain research about other after-school programs regarding what has worked and what has not worked at reducing childhood obesity. Researchers supported the need for this interdisciplinary after school program for children living in low socioeconomic neighborhoods. These children are at a higher risk of obesity than their peers. The researchers also provided evidence of effective health promotion strategies that was used to design Let’s Move, Cook, and Learn With Friends!. An after-school program manual was developed through multiple theoretical frameworks including pedagogy, self-efficacy theory, person-environment-occupation [PEO] model and Cole’s Seven Steps (Bastable & Dart, 2011; Cole, 2012; Law, Cooper, Strong, Stewart, Rigby, and Letts, 1996). This product has a strong focus on increasing children\u27s self-efficacy through their engagement in meaningful occupations. This manual includes an introduction section with background information for the program coordinator, three separate booklets for each session area addressed (i.e. physical activity, nutrition, and well-being) and a parent handout for implementing healthy habits into the home environment. Let’s Move, Cook, and Learn with Friends! program is intended to run 30-weeks, with three 90-minute sessions each week. This after-school program will provide professionals and children with knowledge about physical activity, healthy eating and implementing positive interactions with peers at school. It is unique to existing after-school program as it is interdisciplinary and focuses on children from low socioeconomic neighborhoods, while coordinated by an occupational therapist, who is trained in group process and occupation-based activities

THE ACUTE EFFECTS OF THE PREVENT INJURY ENHANCE PERFORMANCE PROGRAMME (PEP) ON ANTERIOR CRUCIATE LIGAMENT INJURY RISK FACTORS

The purpose of this study was to determine the immediate effects the prevent injury enhance performance programme (PEP) had on lower extremity biomechanics in relation to anterior cruciate ligament (ACL) risk factors compared to when it was not performed. 8 healthy males were required to perform a number of drop rebound jumps as a task that mimicked the sudden deceleration seen during ACL injuries. The PEP significantly (

Developing and Implementing a 100% Renewable Electricity Resolution: A Research-Based Framework

While it may seem that the efforts of local governments have only a marginal impact on the global issue of climate change, local action can spread to generate large-scale change. Local action can inspire other communities to adopt policies, creating the potential to expand and form regional action on climate change. Furthermore, local policies can influence state and federal policies. This guide will walk you through a five-step framework that was developed from the results of a qualitative research study that explored how three Utah cities, Salt Lake City, Park City, and Moab, successfully adopted 100% renewable electricity resolutions