A Family Affair: Competing Sponsors of Literacy in Appalachian Students’ Lives

This article explores the literacy lives of students enrolled in English Composition courses at two open-admission universities in Central Appalachia and the complex role of immediate and extended family members as sponsors of literacy. Some relatives emerge as both sponsors and inhibitors—or perhaps more accurately, sponsors of competing meanings of literacy—and illustrate the larger social forces surrounding literacy in students’ lives

Abdominal palpation to determine fetal position at the onset of labour: an accuracy study

Since the late 19th Century, abdominal palpation of the gravid uterus has been routine, worldwide obstetric practice to determine fetal position. A systematic review showed a dearth of research on the accuracy of this ubiquitous test. A test accuracy study was carried out prospectively to assess accuracy of abdominal palpation (index test) to identify the Left-Occipito-Anterior (LOA) fetal position at the onset of labour, in nulliparous women over 37 weeks’ gestation, with ultrasound as the reference standard. Trained observers blind to the index test results performed the ultrasound independently. Midwives palpation data on the position of 629 women were obtained and 61 (9%) fetuses were verified as LOA by ultrasound. The sensitivity, specificity and likelihood ratio of abdominal palpation to detect LOA position were 34% (23-46), 71% (67-74) and 1.2 (0.83-1.74) respectively. Higher accuracy was achieved by midwives with experience > 5 years (OR 4.02; 1.2-12.9) and those who worked in the community (OR 0.15; 0.03-0.9). Accuracy of abdominal palpation to determine LOA fetal position at the onset of labour is poor. If future research demonstrates that the optimal fetal position of LOA exists, midwives will need to confirm fetal position at the onset of labour by ultrasound to prognosticate

F.I.T. Our Challenge, Our Purpose, and What We Can Do For You

Our group was given the task of creating a wellness program for Biss Enterprises. The launch of the FIT program for Biss Enterprises will be a great benefit to the company as well as its employees. These types of programs have been shown to reduce health care costs and employee absenteeism while increasing employee productivity. Not only is wellness meant to improve the employee\u27s physical health, but also their mental health and social health outside of work

Outdoor Recreation in the Regional Copper-Nickel Study Area

Saint Paul: Minnesota Legislative Reference Library.This 35-year old study primarily discusses non-Indian recreational use of public and private lands in the Cu-Ni region of Minnesota’s Iron Range. This recreation-oriented study does not specifically note Native American use of study area lands except for very indirect references to gill-netting and wild ricing. It has a strong focus on human use of water resources in the region, but does not investigate potential impacts of increased recreational use, mining, or other anthropogenic activities with potential to affect condition of these resources. The study abstract and key segments are extracted and reproduced below. Abstract: “Geographic patters of outdoor recreational use in the Copper-Nickel Study Area were investigated as part of a study of potential impacts of copper-nickel mining in Northeastern Minnesota. With the objective of characterizing patterns of recreational use of facilities, water bodies and public lands, interviews were held with thirteen land use managers and others familiar with the study area. Findings from this interview program together with past recreation research provide a data base on existing recreational use necessary for to impact analysis. Numerous public and private recreation facilities are located along Study Area lakes and streams. Outside facilities, public and some private lands are used for diverse land-based activities when afforded road, trail, or surrogate trail access; old logging roads serve this function in the most heavily-used areas, although some activities such as and winter camping rarely occur in recently logged zones. Dense settlement and lowland bogs restrict access by most land-oriented recreationists. Water-based recreation is concentrated on large, deep lakes in the Study Area's northern half. Part of the Boundary Waters Canoe Area (BWCA), a national wilderness area, lies within the Study Area's north boundary. Canoeists and fishermen use BWCA lakes heavily. Dozens of smaller lakes throughout the Study Area serve Iess diverse but sometimes more intensive recreation functions. Only a few lakes lack any recreational use; most are quite small and lack access or recreation resources. Most Study Area streams have limited recreational use because of low water levels, with the exception of two rivers, the Kawishiwi and the St. Louis River. Three general types of outdoor recreation can be distinguished: facility -based recreation), dispersed land-based recreation, and water-based recreation. To spare the time and expense of primary field surveys, a program of interviews with thirteen land managers such as conservation officers and foresters was designed, using Spradley's interview method. Key points: ‘Outdoor recreation in all forms is dependent upon access: roads, trails, and public lands. The region is covered with an extensive network of land management units at various levels. Land-based recreation use relates closely to the area's logging history and logging roads. Lake, stream, road and facility use must be carefully evaluated before siting decisions about mining and recreational use are finalized.

An investigation of subsequent birth after obstetric anal sphincter injury

Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth with a reported average worldwide incidence of 4%-6%. They are a recognised major risk factor for anal incontinence resulting in concern amongst women who sustain such injuries when considering the most suitable mode of birth in a subsequent pregnancy. This thesis contains three studies; a systematic review and meta-analysis of the published literature exploring the impact of a subsequent birth and it’s mode on bowel function and/or QoL for women with previous OASIS, a follow-up study on the long-term effects of OASIS on bowel function and QoL and finally a prospective cohort study of women with previous OASIS to assess the impact of subsequent birth and its mode on change in bowel function. The work in this thesis demonstrated an increase in incidence of bowel symptoms in women with previous OASIS over time and that short-term bowel symptoms were significantly associated with bowel symptoms and QoL. This thesis also showed that the mode of subsequent birth was not significantly associated with bowel symptoms or QoL and for women with previous OASIS who have normal bowel function and no anal sphincter disruption a subsequent vaginal birth is a suitable option

Cardiovascular disease biomarkers are associated with declining renal function in type 2 diabetes

Aims/hypothesis: We investigated whether biochemical cardiovascular risk factors and/or markers of subclinical cardiovascular disease were associated with the development of reduced renal function in people with type 2 diabetes. Methods: A cohort of 1066 Scottish men and women aged 60–74 years with type 2 diabetes from the Edinburgh Type 2 Diabetes Study were followed up for a median of 6.7 years. New-onset reduced renal function was defined as two eGFRs <60 ml−1 min−1 (1.73 m)−2 at least 3 months apart with a > 25% decline from baseline eGFR. Ankle brachial pressure index (ABI), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hsTnT) were measured at baseline. Pulse wave velocity (PWV) and carotid intima media thickness were measured 1 year into follow-up. Data were analysed using Cox proportional hazards models. Results: A total of 119 participants developed reduced renal function during follow-up. ABI, PWV, NT-proBNP and hsTnT were all associated with onset of decline in renal function following adjustment for age and sex. These associations were attenuated after adjustment for additional diabetes renal disease risk factors (systolic BP, baseline eGFR, albumin:creatinine ratio and smoking pack-years), with the exception of hsTnT which remained independently associated (HR 1.51 [95% CI 1.22, 1.87]). Inclusion of hsTnT in a predictive model improved the continuous net reclassification index by 0.165 (0.008, 0.286). Conclusions/interpretation: Our findings demonstrate an association between hsTnT, a marker of subclinical cardiac ischaemia, and subsequent renal function decline. Further research is required to establish the predictive value of hsTnT and response to intervention