Arts on prescription for community‐dwelling older people with a range of health and wellness needs

Published evidence for the role of participatory art in supporting health and well‐being is growing. The Arts on Prescription model is one vehicle by which participatory art can be delivered. Much of the focus of Arts on Prescription has been on the provision of creative activities for people with mental health needs. This Arts on Prescription program, however, targeted community‐dwelling older people with a wide range of health and wellness needs. Older people were referred to the program by their healthcare practitioner. Professional artists led courses in visual arts, photography, dance and movement, drama, singing, or music. Classes were held weekly for 8–10 weeks, with six to eight participants per class, and culminated with a showing of work or a performance. Program evaluation involved pre‐ and postcourse questionnaires, and focus groups and individual interviews. Evaluation data on 127 participants aged 65 years and older were available for analysis. We found that Arts on Prescription had a positive impact on participants. Quantitative findings revealed a statistically significant improvement in the Warwick–Edinburgh Mental Well‐being Scale(WEMWBS) as well as a statistically significant increase in the level of self‐reported creativity and frequency of creative activities. Qualitative findings indicated that the program provided challenging artistic activities which created a sense of purpose and direction, enabled personal growth and achievement, and empowered participants, in a setting which fostered the development of meaningful relationships with others. This evaluation adds to the evidence base in support of Arts on Prescription by expanding the application of the model to older people with a diverse range of health and wellness needs

Towards enhancing national capacity for evidence informed policy and practice in falls management: a role for a "Translation Task Group"?

There has been a growing interest over recent years, both within Australia and overseas, in enhancing the translation of research into policy and practice. As one mechanism to improve the dissemination and uptake of falls research into policy and practice and to foster the development of policy-appropriate research, a Falls Translation Task Group has formed to facilitate linkage and exchange. There has been a growing interest over recent years, both within Australia and overseas, in enhancing the translation of research into policy and practice. As one mechanism to improve the dissemination and uptake of falls research into policy and practice and to foster the development of policy-appropriate research, a Falls Translation Task Group was formed as part of an NHMRC Population Health Capacity Building grant. This paper reports on the group\u27s first initiative to address issues around the research to policy and practice interface, and identifies a continuing role for such a group. MethodA one day forum brought together falls researchers and decision-makers from across the nation to facilitate linkage and exchange. Observations of the day\u27s proceedings were made by the authors. Participants were asked to complete a questionnaire at the commencement of the forum (to ascertain expectations) and at its completion (to evaluate the event). Observer notes and the questionnaire responses form the basis of analysis. Results: Both researchers and decision-makers have a desire to bridge the gap between research and policy and practice. Significant barriers to research uptake were highlighted and included both health system barriers (for example, a lack of financial and human resources) as well as evidence barriers (such as insufficient economic data and implementation research). Solutions to some of these barriers included the identification of clinical champions within the health sector to enhance evidence uptake, and the sourcing of alternative funding to support implementation research and encourage partnerships between researchers, decision-makers and other stakeholders. Conclusion: Participants sought opportunities for ongoing networking and collaboration. Two activities have been identified as priorities: establishing a policy-sensitive research agenda and partnering researchers and decision-makers in the process; and establishing a National Translation Task Group with a broad membership

A boundary element analysis on the influence of Krc and e/d on the performance of cyclically loaded single pile in clay

The environment prevalent in oceans necessitates the piles supporting offshore structures to be designed against lateral cyclic loading initiated by wave action. Such quasi-static load reversal induces deterioration in the strength and stiffness of the soil-pile system, introducing progressive reduction in the bearing capacity associated with increased settlement of the pile foundation. To understand the effect of lateral cyclic load on axial response of single piles in soft clay, a numerical model was previously developed and validated by the author. Using the methodology, further analysis has been carried out to investigate how the variation in relative pilesoil stiffness and eccentricity effects the degradation of axial pile capacity due to the effect of lateral cyclic load. This paper presents a brief description of the methodology, analysis and interpretations of the theoretical results obtained from the further analysis and the relevant conclusions drawn there from

Beam on Nonlinear Winkler Foundation and Modified Neutral Plane Solution for Calculating Downdrag Settlement

The neutral plane solution has been widely used to estimate downdrag settlements and drag loads mobilized in piles in consolidating soil profiles. Pile settlement is typically assumed equal to soil settlement at the neutral plane depth corresponding to effective stress conditions at the end of consolidation. This paper demonstrates that, in general, pile settlement is not equal to soil settlement at the neutral plane depth; rather, it is the relative velocity between the pile and soil that is zero at the neutral plane depth. A beam on nonlinear Winkler foundation (BNWF) solution, in which the shaft friction capacity is proportional to effective stress, is utilized to demonstrate that pile settlement is not equal to soil settlement at the neutral plane depth, because the neutral plane depth evolves as consolidation progresses. The BNWF solution also shows that pile settlement depends on drainage conditions, with more settlement occurring when consolidation occurs first near the top of the consolidating soil layer, and less settlement occurring when consolidation initiates at the bottom. A modified neutral plane solution that is amenable to hand calculation is formulated to account for the evolution of neutral plane depth on pile settlement. Finally, the proposed BNWF and modified neutral plane solutions are compared with measurements of downdrag settlement from a centrifuge test program. The proposed methods produced more accurate estimates of pile settlement than the traditional neutral plane solution. © 2013 American Society of Civil Engineers

Oxygen Activation and Radical Transformations in Heme Proteins and Metalloporphyrins

As a result of the adaptation of life to an aerobic environment, nature has evolved a panoply of metalloproteins for oxidative metabolism and protection against reactive oxygen species. Despite the diverse structures and functions of these proteins, they share common mechanistic grounds. An open-shell transition metal like iron or copper is employed to interact with O_2 and its derived intermediates such as hydrogen peroxide to afford a variety of metal–oxygen intermediates. These reactive intermediates, including metal-superoxo, -(hydro)peroxo, and high-valent metal–oxo species, are the basis for the various biological functions of O_2-utilizing metalloproteins. Collectively, these processes are called oxygen activation. Much of our understanding of the reactivity of these reactive intermediates has come from the study of heme-containing proteins and related metalloporphyrin compounds. These studies not only have deepened our understanding of various functions of heme proteins, such as O2 storage and transport, degradation of reactive oxygen species, redox signaling, and biological oxygenation, etc., but also have driven the development of bioinorganic chemistry and biomimetic catalysis. In this review, we survey the range of O_2 activation processes mediated by heme proteins and model compounds with a focus on recent progress in the characterization and reactivity of important iron–oxygen intermediates. Representative reactions initiated by these reactive intermediates as well as some context from prior decades will also be presented. We will discuss the fundamental mechanistic features of these transformations and delineate the underlying structural and electronic factors that contribute to the spectrum of reactivities that has been observed in nature as well as those that have been invented using these paradigms. Given the recent developments in biocatalysis for non-natural chemistries and the renaissance of radical chemistry in organic synthesis, we envision that new enzymatic and synthetic transformations will emerge based on the radical processes mediated by metalloproteins and their synthetic analogs

Practical mammography

‘Digital health’ is an overarching concept that currently lacks theoretical definition and common terminology. For instance, this broad and emerging field includes all of the following terms within its lexicon: mHealth, Wireless Health, Health 2.0, eHealth, e-Patient(s), Healthcare IT/Health IT, Big Data, Health Data, Cloud Computing, Quantified Self, Wearable Computing, Gamification, and Telehealth/Telemedicine [1]. However, whilst a definition is difficult to provide, in this overview it is considered that digital health is the use of digital media to transform the way healthcare provision is conceived and delivered. We consider it does this through three basic features

A qualitative examination of inappropriate hospital admissions and lengths of stay

<p>Abstract</p> <p>Background</p> <p>Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions). We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group.</p> <p>Methods</p> <p>Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach.</p> <p>Results</p> <p>The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS), including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations.</p> <p>Conclusion</p> <p>Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.</p