Does Preoperative Ostomy Education Decrease Anxiety in the New Ostomy Patient?

Background: There are approximately 100,000 patients with new ileostomies and colostomies created in the United States each year. These patients have specialized needs that include acceptance of altered body image, psychological stress, learning of difficult tasks, and occasionally an ominous diagnosis leading to the need for surgery. In addition to pre-surgical stoma site marking on the abdomen, ostomy nurses have identified early education to be an important factor in long-term success and management of the patient . Early education and stoma site marking may assist with a better-situated stoma leading to fewer complications related to appliance adherence and leakage. New ostomy patients that are well prepared may be able to adapt to the new body image and are more successful in management following ostomy surgery. Problem: Psychologists and sociologists have identified a link between anxiety levels and memory. Anxiety can affect learning by interfering with the attention process of the brain. This interference can hinder the ability of ostomy patients to effectively listen, learn, and perform ostomy care for themselves which places an increased demand on family, caregivers, and home health nurses. Pre-surgical education may offer reduced anxiety levels in post-operative patients, which may provide an improved environment for learning. Methods: Participants considered for study inclusion were those scheduled for ostomy surgery. Patients in Group 1 were provided with pre-surgical ostomy education and routine pre-surgical education, whereas patients in Group 2 were provided with routine pre-operative education only. The Hospital Anxiety and Depression Scoring tool (HADS) was administered during the post- operative period. The surveys were administered by a certified wound, ostomy, continence nurse practitioner. Analysis of Variance (ANOVA) was used to compare changes in anxiety scores between the two groups. Results: Of the 30 participants in the study, 22 were male (73.3%) and 8 were female (26.7%). The mean age was 65.27 ± 9.97 for Group 1 and 61.87 ± 17.56 for group 2. This difference was not statistically significant (p\u3e0.05). Both groups had an equal number of males (n=11) and females (n=4). Group 1 consisted of 9 colostomy patients, 4 ileostomy patients, and 2 urostomy patients. Group 2 consisted of 10 colostomy patients, 4 ileostomy patients and 1 urostomy patient. Patients who had pre-surgical ostomy education had statistically significant lower post surgical anxiety scores than patients who had standard education (p\u3c0.001). Conclusions: The findings of this study suggest that offering pre-operative ostomy education in addition to routine pre-operative education, significantly lowers anxiety when compared with patients who do not receive the pre-operative ostomy education

The Prediction of Violent Recidivism Amongst Individuals with Mental Disorders: Situational vs. Dispositional Factors

The objective of this study is to evaluate why some individuals with mental illness are more inclined to violently recidivate. There appears to be two perspectives that may explain recidivism: one that emphasizes situational factors and one that emphasizes dispositional factors. Situational factors are those that are constantly changing within one’s life, whereas dispositional factors are those that remain relatively stable over time. Therefore, dispositional factors would theoretically put individuals with mental illness at stable risk for recidivism because these factors remain relatively stable over time. In fact, perhaps individuals with mental illness repeatedly engage in violence because they have a dispositional trait (like low self-control, for example) that puts them at stable risk for recidivism. Conversely, situational factors would theoretically explain why individuals do not engage in recidivism because they are transient and constantly changing. Therefore, perhaps one desists from violence because some situational factor changed in that individual’s life. Using data from the MacArthur Violence Risk Assessment study (i.e. MacRisk), a longitudinal study of people with serious mental illness, violent recidivism will be evaluated across waves. Specifically, the objective is to determine if situational or dispositional factors influence violent recidivism

Victimization Amongst People with Mental Disorders: What Factors Influence Resiliency?

Scholars have consistently shown that people with mental illness are at an elevated risk for victimization experiences when compared to their non-disordered counterparts (Goodman et al., 2001; Hiday et al. 1999; Hiday et al., 2002; Silver, 2002; Teplin et al., 2005; Walsh et al., 2003). Researchers have identified numerous risk factors that elevate the risk of victimization experiences amongst people with mental illness; yet, little is known about what factors may protect this group of people from victimization That is, what is currently missing in the literature is the assessment of why, despite elevated risk, some persons with mental illness are notvictimized – known as resiliency. Utilizing multiple datasets, factors that are associated with resiliency from victimization amongst those with mental illness are investigated using multiple measure strategies for resiliency. Further, subsequent analyses examining group differences based on biological sex within the resiliency process are explored. Additional analyses examining how protective factors may differ within diagnostic categories are also examined. The applicability of resiliency models for people with mental illness are also explored. Results suggest that two domains of protective factors are important in the resiliency process from victimization amongst this population including those related to social support and those related to institutions such as the school. Results also suggest there are differences in protective factors that influence resiliency based on biological sex and protective factors within different diagnostic categories are identified. Finally, the compensatory resilience model appears to be the most applicable for people with mental illness. Future research and prevention implications are discussed

Documenting Magnatic Processes at Filicudi Island, Aeolian Arc, Italy: Integrating Quantitative Modeling and Plagioclase Textural and in situ Compositional Data

Documenting the physiochemical processes that influence magma composition is critical for forecasting eruption styles and managing volcanic hazards. Compositional diversity of magmas develops through recharge, assimilation, and fractional crystallization (RAFC) within subvolcanic magma reservoirs. Integration of MELTS modeling, whole rock, plagioclase textural and in situ elemental and isotopic data from Filicudi Island, Italy allow documentation of the roles and relative chronology that RAFC played in the magmatic evolution and elucidates aspects of the magma plumbing system structure. Results indicate a polybaric magma plumbing system with deeper (3.5-4 kilobars) and shallower (0.5-1.2 kilobars) storage regions. Within the deeper system, FC acted to differentiate magma, while water contents acted to suppress plagioclase growth. Differentiated magma intruded to shallower levels, where plagioclase crystallized rapidly resulting in monotonous textures and high anorthite contents. Within the shallower system, recharge from the deeper system and continued FC contributed to the compositional diversity observed on Filicudi Island

A Modular Low-clearance Wrist Orthosis for Improving Wrist Motion in Children with Cerebral Palsy

Children with Cerebral Palsy (CP) often exhibit impairments in the coordination of the grip and lift phases of arm movements that directly impact their ability to perform activities of daily living (ADLs). The application of assistive robotic therapy to children with spastic hemiplegic CP has shown that augmented movement training can lead to improved functional outcomes and improved arm kinematics. Assistive robotic therapy of the wrist has been shown to help improve motor skills in stroke patients, but the devices employed are often large and obtrusive, focusing on a repeated motion rather than a task-based itinerary. Here, we propose a lightweight low clearance wrist orthosis for use in children with Cerebral Palsy that actuates pronation/supination and flexion/extension of the wrist

Leading Turnaround and Improvement in Low Performing Schools in Malaysia and Indonesia

Improving the fortunes of low-performing schools, often in the most challenging circumstances, remains a persistent and pervasive challenge in many education systems (Meyers & Darwin, 2017). This working paper outlines the findings from a small, qualitative comparative research project funded by the Head Foundation. The working paper commences with some explanation and contextualization of the idea of ‘turnaround schools’ from the literature. It presents the research methodology and subsequently outlines the main findings from the research project

Role of the Human Cytomegalovirus IE2 Protein on Transcriptional Regulation of Viral Promoters

Human cytomegalovirus (HCMV) is a ubiquitous pathogen able to cause severe mortality and morbidity in immuno-compromised individuals. Successful infection by HCMV is dependent on expression of viral genes essential for replication. Immediate early (IE) gene products are the first subset of viral genes to be expressed during infection and function as key transcriptional regulators. IE2 is one the most predominantly expressed IE proteins and is essential for HCMV infection. IE2 transactivates several viral promoters, including those of the essential viral DNA polymerase (UL54) and UL112-113 gene regions. IE2 is also able to autoregulate is own expression and repress expression of the major IE gene products. This study aims to investigate the role of IE2 and cellular proteins in regulation of viral promoters in order to gain a better understanding of early events required for HCMV replication. Through the use of both transient assays and complementing assays in recombinant HCMV clones, we show that single amino acid mutations in the C-terminus of IE2 impair both IE2-mediated transactivation of early gene promoters and autorepression of the major IE promoter. These mutations in IE2 also result in nonviable recombinant viruses, emphasizing the importance of IE2 in HCMV replication. GST pulldown assays demonstrate that mutagenesis of Tyrosine 544 in IE2 reduces IE2 interactions with TATA binding protein (TBP) when compared to the wildtype IE2 protein. Using ChIP assays, we demonstrate that wildtype IE2 is recruited to the UL54 promoter in transiently transfected cells. However, mutagenesis in the IE2 protein at Proline 535 and Tyrosine 544 significantly decrease recruitment of IE2 to the UL54 promoter. Interestingly, these functional defects in mutated IE2 protein had no effect on RNA polymerase II recruitment, suggesting that IE2 may function in transcriptional regulation alter formation of the transcriptional pre-initiation complex. In this dissertation, we have further characterized regions and functional properties of IE2 essential for UL54 activation and HCMV replication. Our studies are significant in understanding the regulation of viral genes essential for replication of HCMV and in the development of novel HCMV therapies

Evacuating the Womb: Abortion and Contraception in the High Middle Ages, circa 1050-1300

This thesis examines contraception and abortion in high medieval legal, ecclesiastical, and medical rhetoric, focusing specifically on the negative perception of women detailed in these treatises and the suspicions their sexual bodies aroused in contemporary narratives. Gynaecological literature flourished during the high medieval period. Impacted by the influx of Arabic and Hebrew translations and the emergence of formalised university centres, medical knowledge represented a unique relationship between the religious and the secular. As most medical volumes were housed and disseminated in monastic libraries across Western Europe, the literate sections of medieval society were exposed to different perceptions of anatomy: female physiology was just one of these areas. However, these medical texts were overwhelmingly written by celibate men, creating methodological questions concerning the audience, purpose, and remedial expertise of these treatises. This thesis examines several perceptions of reproductive control, emphasising the fluid definitions ascribed to these terms. Firstly, this thesis examines sterility and infertility, discussing how both men and women who suffered from these ailments were perceived in medieval society and the inherent value placed on reproductive capabilities (Chapter I). In addition, some chose to deny their sexual functions in lieu of a life of abstinence, often portraying pregnancy and childbirth as undesirable, disgusting, and possibly hazardous (Chapter II). Those that did engage in sex were not always portrayed in procreative pursuits, as contraceptive techniques like coitus interruptus or penile barriers were prescribed in contemporary medical manuals, showing men to be as equally desirous of controlled reproduction as women (Chapter III). In addition, abortive methods were also prescribed in medical texts and these actions were usually associated with promiscuity and lascivious sexuality (Chapter IV). Finally, this thesis examines how these texts were disseminated and whether the female voice may be extrapolated from these male dominated manuals (Chapter V)

Application of Confocal Microscopy To Study the Neural Mechanisms Underlying Insect and Rodent Behavior

Posture and walking require support of the body weight, which is thought to be detected by sensory receptors in the legs. Specificity in sensory encoding occurs through the morphological properties of the sense organs (numerical distribution, receptor size) and their physiological response characteristics. These studies focus upon campaniform sensilla, receptors that detect forces as strains in the insect exoskeleton. To study the morphology of campaniform sensilla, the sites of mechanotransduction (cuticular caps) were imaged by light and confocal microscopy in four species (stick insects, cockroaches, blow flies and Drosophila). These data indicate that the gradient (range) of cap sizes may most closely correlate with the body weight. These studies support the idea that morphological properties of force-detecting sensory receptors in the legs may be tuned to reflect the body weight. Overall, this study indicates that the morphological properties of the sense organs are specifically tuned to provide information needed for postural stability and successful locomotion