The Vehicle, Fall 2007

Table of Contents Is This Thing On?Nichole D\u27Antoniopage 1 Death Came KnockingJacob Dawsonpage 5 Awaiting DecemberRebecca Griffithpage 9 ginamarieElizabeth Hoodpage 11 She LongsJennifer O\u27Neilpage 12 ForgottenStephanie Drozdpage 13 Art House WomanGreg Harrellpage 14 Young Woman OlderAmanda Vealepage 15 FirstRebecca Griffithpage 17 FlowJacob Dawsonpage 19 Am Animal AwareDanielle Meyerpage 20 Geneva 04\u27Stephanie Guyerpage 21 Poland, 1942.Jennifer O\u27Neilpage 22 Witness to the Atrophy of ForestsDanielle Meyerpage 23 Helvellyn IJacob Fosterpage 24 Three Out of Five Ain\u27t BadThomas McElweepage 25 FarceAmanda Vealepage 31 Strength of EmotionJennifer O\u27Neilpage 32 About the Authors Art Submissions Prerequisite for a RequiemJenna Smithcover Girl 3Jenna Smithpage 14 ManJenna Smithpage 16 Give Peace a ChanceMegan Mathypage 16 GraceJennifer O\u27Neilpage 20 Oh, the Places You\u27ll Go!Megan Mathypage 23https://thekeep.eiu.edu/vehicle/1086/thumbnail.jp

The Vehicle, Fall 2007

Table of Contents Is This Thing On?Nichole D\u27Antoniopage 1 Death Came KnockingJacob Dawsonpage 5 Awaiting DecemberRebecca Griffithpage 9 ginamarieElizabeth Hoodpage 11 She LongsJennifer O\u27Neilpage 12 ForgottenStephanie Drozdpage 13 Art House WomanGreg Harrellpage 14 Young Woman OlderAmanda Vealepage 15 FirstRebecca Griffithpage 17 FlowJacob Dawsonpage 19 Am Animal AwareDanielle Meyerpage 20 Geneva 04\u27Stephanie Guyerpage 21 Poland, 1942.Jennifer O\u27Neilpage 22 Witness to the Atrophy of ForestsDanielle Meyerpage 23 Helvellyn IJacob Fosterpage 24 Three Out of Five Ain\u27t BadThomas McElweepage 25 FarceAmanda Vealepage 31 Strength of EmotionJennifer O\u27Neilpage 32 About the Authors Art Submissions Prerequisite for a RequiemJenna Smithcover Girl 3Jenna Smithpage 14 ManJenna Smithpage 16 Give Peace a ChanceMegan Mathypage 16 GraceJennifer O\u27Neilpage 20 Oh, the Places You\u27ll Go!Megan Mathypage 23https://thekeep.eiu.edu/vehicle/1086/thumbnail.jp

The Vehicle, Fall 2006

Table of Contents Ferris WheelEmily Daviscover HerStephen Jefferiespage 1 UntitledBob Freyderpage 2 Writing at O\u27BrienWillie Joseph Morrispage 3 Blanks and HabitsRebecca M. Griffithpage 4 Soldier\u27s NightmareCraig A. Dennispage 5 UntitledLindsey Durbinpage 6 A Slow, Painless DeathJacob Fosterpage 7 ThoughtAmanda Yealepage 8 The SociopathBob Freyderpage 9 EasyRebecca M. Griffithpage 10 My PartnerDiedre Mapespage 11 BarriersSuzanne Krahnpage 12 The mind is a prisonJordan Hohespage 13 We Were Shirtless When Thousands DiedMitch Jamespage 14 ComplaintAmanda Yealepage 15 UntitledBob Freyderpage 16 MarkedAmanda Yealepage 17 She Wears Red Lipstick, He, Heartsick EyesRebecca M. Griffithpage 18 PrayerAmanda Yealepage 19 HomeDeej Rolewskipage 20 Your DreamDiedre Mapespage 21 Even Fingers Get LonelySuzanne Krahnpage 22 AggressivityMitch Jamespage 23 FallenMitch Jamespage 24 CollapseMario Podeschipage 36 The Italian CrisisAndy Masterspage 41 About the Authorshttps://thekeep.eiu.edu/vehicle/1084/thumbnail.jp

The Vehicle, Spring 2007

Table of Contents She Might Just Take You for GrantedRebecca M. Griffithpage 1 ShwagDarius Juttipage 2 In LoveAmanda Vealepage 9 SubmissiveSarah Ellerpage 10 Wedding SongRebecca M. Griffithpage 11 Why No Ladies and Gentlemen, My Shit Never StinksJacob Fosterpage 13 Death of an English MajorLindsey Durbinpage 14 Summer\u27s PerfumeRebecca M. Griffithpage 15 Gigavolt and ChrisEric Schumacherpage 16 UntitledKris Jonespage 22 Ode to the MuseGreg Harrellpage 23 TenderAmanda Vealepage 24 When the Muses HeaveElizabeth Hoodpage 25 Depression LiftingAmanda Vealepage 26 Red SwordAndrew Deckerpage 27 Warring IdeologyMargaret B. Hamperpage 29 ConfessionGreg Harrellpage 34 A Glass PuzzleBrittany Morganpage 35 Hey MaJacob Fosterpage 36 As July Faded AwayRebecca M. Griffithpage 37 About the LeftoversGina LoBiancopage 38 Me, Myself & ILindsey Durbinpage 39 Iced Parking LotRebecca M. Griffithpage 41 About the Authors Art Submissions Mike\u27s Revelation and MikeSean Walkercovers UntitledChad Navelpage 9 Morning in Tintern AbbeyCarrie Muellerpage 12 WestminsterCarrie Muellerpage 21 A Fighting ChanceOsha Rudduckpage 22 Rooftop SunsetJennifer O\u27Neilpage 25 EIU IVCarrie Muellerpage 28 MandolinOsha Rudduckpage 38 EIU IIICarrie Muellerpage 42https://thekeep.eiu.edu/vehicle/1087/thumbnail.jp

The Vehicle, Fall 2008

Table of Contents DwIFoFErREINdTPhilip Gallagherpage 17 LeftoversAmanda Vealepage 18 the bogGrace Lawrencepage 19 Visitor\u27s Morning on EarthSteven T. Coxpage 20 The Moon Man Philip Gallagherpage 21 SearchingsAmanda Vealepage 23 Becoming WiseAmanda Vealepage 24 PerennialsAmanda Vealepage 26 SoldierMary Lieskepage 27 Desecration of a RelicAmanda Vealepage 29 New LifeJennifer O\u27Neilpage 30 GardenerKrystina Levyapage 43 The Reasons WhyMary Lieskepage 44 Dining at the MortuaryAmanda Vealepage 45 Poetry Hop Scotch BehopJake Dawsonpage 1 Empty RoomAmanda Vealepage 2 Mantis (from memory) Muddy ShoesGina Marie LoBiancopage 3 MEMOSamuel Clowardpage 5 MathMary Lieskepage 7 To a Little Black GirlJustin Sudkamppage 8 Government OfficeSamuel Clowardpage 9 FirstKellen Fasnachtpage 10 Seeing Artichoke, Call MeAmanda Vealepage 11 TrumpetSarah Fairchildpage 12 That\u27s the StuffJake Dawsonpage 13 Your Hair is ThinningAmanda Vealepage 15 UnableDonica Millerpage 16 Dance PartnersSamantha Sauerpage 32 I StillMegan Mathypage 33 IncandescenceSarah Fairchildpage 34 Stone CraneBrendan Hughespage 35 The Road TakenSamantha Sauerpage 36 YouMegan Mathypage 37 Zhangjiajie National Forest Park, Zhangjiajie, ChinaBrendan Hughespage 38 Spotlight on 2008 Chapbook LessonsGlen Davispage 62 Interview with Glen DavisRebecca Griffithpage 64 Contributorspage 69 Submission Guidelines/Reading Event Blues Mad FoolJake Dawsonpage 47 Good WomanJake Dawsonpage 49 Good ManJake Dawsonpage 51 And I Miss YouDonica Millerpage 53 Entropy of Your ShirtAmanda Vealepage 56 Mavericks Philip Gallagherpage 57 Untitled [It\u27s 10:15 p.m....]Philip Gallagherpage 59 Prose A Birdhouse for GrandpaLeslie Hancockpage 39 MotivationMary Lieskepage 55 Art Forgotten GardenBrendan Hughescovers BeMegan Mathypage 31https://thekeep.eiu.edu/vehicle/1088/thumbnail.jp

Attitudes, norms and controls influencing lifestyle risk factor management in general practice

<p>Abstract</p> <p>Background</p> <p>With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs) around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP). This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45–49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist.</p> <p>Methods</p> <p>A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework.</p> <p>Results</p> <p>GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the patient's motivation, and cost and accessibility of services to patients.</p> <p>Conclusion</p> <p>General practitioner attitudes, normative influences from both patients and the profession, and perceived external control factors (time, cost, availability and practice capacity) all influence management of behavioural risk factors. Provider education, community awareness raising, support and capacity building may improve the uptake of lifestyle modification interventions.</p

The Mental Health of Children and Young People

Children and young people were not a priority in the early stages of the pandemic. Whilst children and young people were considered to be at ‘low health risk’ but this did not account for the seriousness of mental health issues. Evidence of the psychological impact of Covid-19 on children and young people is fast emerging. A concerning number of studies and systemic reviews suggest the overwhelming negative impact on child and adolescent mental health. The Buttle UK survey (June 22 – 15 July 2021) revealed that the Covid-19 pandemic had exacerbated an ‘under the radar’ mental health crisis leaving a generation of children traumatised and unable to benefit from the Government’s educational recovery programmes. ‘We must listen to frontline professionals and prioritise mental health support’: https://buttleuk.org/news/news-list/state-of-child-poverty-202

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes