Executive Summary of Survey Among Temporarily Homeless Families

Executive Summary of Survey Project Among Temporarily Homeless Families The agency we were assigned is a non-profit organization centered around providing housing and resources for houseless families in the Seattle region. The agency consists of five housing locations along with additional day centers. The housing locations are Burien, Northshore, The Regrade, Bellevue, and the Family Diversion Center. They all offer family housing services, healthcare, education, and employment. The goal of our project was to gather information from guests on the healthcare services that they have utilized. It was also used to gather requests for additional services at each site to improve quality of care. With the information collected, the health services at the agency will be improved and provide additional awareness to better meet the guests\u27 specific needs. Background The families within the agency are described as two-parent families (pregnant or with children), single parents of all genders (pregnant or with children), extended families, and families with pets. The guest population varies from people coming from Seattle to those who have arrived from across the world, resulting in a variety of languages spoken at each site. These factors also provide a truly diverse population, each culture being accompanied by their own specific needs. In 2021, 76% of the families served identified as Black, Indigenous, or People of Color (Mary’s Place, 2021). Out of all the guests at the agency, 40% of these families considered themselves African American or of African Descent. The agency commits to “create a workplace and service structure that advances equity, diversity, and inclusion as a priority” (p.7). In 2021, the agency served 592 families, had 138,644 overnight stays, served 415,932 meals, served 1,204 children and 592 families, and had 100+ women visit the day center on average each day. Across the multiple locations, the organization commits to address barriers such as social determinants of health, and empower parents to build family stability, secure housing, and prepare for employment. Some of the healthcare services offered are dental, optical, mental health services, pediatric healthcare, and substance use aid. The agency also offers housing, assistance, and support to families with children with life threatening illnesses within their Popsicle Program (Mary’s Place, n.d.). The organization’s Housing Services and Housing Specialist utilize a problem-solving approach along with light flexible funding to support their guests in finding permanent housing. Often, these families have a challenging time finding housing due to the Americans with Disabilities Act (ADA), size of the unit or family, language barriers, or other barriers. In 2021, the agency helped 549 families find permanent housing (Mary’s Place, 2021). A main priority among the guests and the organization is employment. The agency has partnered with 35+ different companies to provide a variety of employment options for the guests (Mary’s Place, n.d.). In addition, the Employer Engagement team offers training for specific careers, readiness skills, access to referrals, and preparations for long-term employment (Mary’s Place, n.d.). To accompany employment services, the organization also values education and encourages to maintain education for families by providing program resources for enhanced learning, language classes, GED classes, region-based school systems, and tutoring services (Mary’s Place, n.d.). These resources are provided for guests and for houseless families not currently sheltered (Mary’s Place, n.d.). Activities and Methods The foundation of our project was centered around the agency’s willingness to improve guest utilization of health services through survey conduction. We began our project by conducting a windshield survey of each shelter site. By doing this, we were able to get a sense of the community and understand the conditions that affect the health of the population. Moving forward, we collected data about the physical environment, social, economics, and services available (Rector, 2021). Using these observations, we developed a nursing diagnosis for the population. The nursing diagnosis is readiness for enhanced knowledge related to guest utilization of agency’s health services. The agency requested that we facilitate a previously designed survey, created by preceding SPU nursing students. Next, we researched the best method of conducting a high-quality survey in an ethical manner. An emphasis was placed on the importance of voluntary participation; therefore, we did not directly ask guests to fill out the surveys in order to avoid skewing data (Kelley et al., 2003). Our literature review revealed several different approaches to how to best conduct the surveys. We used incentives like baked goods and coloring pages for a greater participation outcome. We took into consideration the population of families at the agency and included an activity for children to do while parents took the surveys. We offered surveys to the guests to complete and made them aware of our intentions with the results (Kelley et al., 2003). We addressed the language barrier by using site-provided interpreter services. Our team conducted surveys at each agency location twice and input the data in an Excel document. We created graphs to display the data to the organization. Outcomes/Limitations We succeeded in collecting data from guests regarding the services they are utilizing and their additional needs from the organization. Visiting each site twice provided a greater opportunity to collect surveys resulting in more data. The results consisted of anonymous, voluntary responses which we compiled and analyzed. Since participation was voluntary, the results were limited based on how many guests decided to engage in the survey. We attempted to address this limitation by visiting each site twice to collect the most data possible for each location and offering incentives to encourage participation. Another limitation we came across was a language barrier between us and some of the guests. This was addressed by having nine translations of the survey available to expand participation. We also utilized interpreter phone services when needed to communicate with guests. Conclusion Overall, the project’s purpose was to conduct surveys at the agency locations and gather information about health services being used and current health concerns to improve care quality. We accomplished the organization’s goal by implementing the surveys amongst the guests. By doing this, we hope to have achieved the desired outcomes of increasing awareness of resources by guests, accessibility of resources, and guest satisfaction. With our project, the health services team can set annual goals for guests and the organization. We encourage the continuation of survey use within the agency. References Abdelazeem, B., Abbas, K.S., Amin, M.A., El-Shahat, N.A., Malik, B., Kalantary, A., & Eltobgy, M. (2022) The effectiveness of incentives for research participation: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 17(4): e0267534. https://doi.org/10.1371/journal.pone.0267534 Kelley, K., Clark, B., Brown, V., & Sitzia, J. (2003). Good practice in the conduct and reporting of survey research. International Journal for Quality in Health Care, 15(3), 261-266. https://doi.org/10.1093/intqhc/mzg031 Orcher, L. T. (2007). Conducting a survey: Technique for a term project, (1st ed.). Routledge. https://doi.org/10.4324/9781315267937 Rector, C., & Stanley, M. J. (2021). Lippincott CoursePoint Enhanced for Rector\u27s Community and Public Health Nursing. Wolters Kluwer. vbk://9781975178284 Who we serve. (n.d.). Mary’s Place. Retrieved February 22, 2023, from https://www.marysplaceseattle.org/who-we-serve 2021 gratitude report. (2021). Mary’s Place. https://static1.squarespace.com/static/5b8989d231d4df1bccd7bcc7/t/6282aaeac941950e930ace53/1652730603879/2021+Gratitude+Report.pd

The Physiological Mechanisms of Effect of Vitamins and Amino Acids on Tendon and Muscle Healing: A Systematic Review

© 2018 Human Kinetics, Inc.To evaluate the current literature via systematic review to ascertain whether amino acids/vitamins provide any influence on musculotendinous healing and if so, by which physiological mechanisms. Methods: EBSCO, PubMed, ScienceDirect, Embase Classic/Embase, and MEDLINE were searched using terms including "vitamins," "amino acids," "healing," "muscle," and "tendon." The primary search had 479 citations, of which 466 were excluded predominantly due to nonrandomized design. Randomized human and animal studies investigating all supplement types/forms of administration were included. Critical appraisal of internal validity was assessed using the Cochrane risk of Bias Tool or the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool for human and animal studies, respectively. Two reviewers performed duel data extraction. Results: Twelve studies met criteria for inclusion: eight examined tendon healing and four examined muscle healing. All studies used animal models, except two human trials using a combined integrator. Narrative synthesis was performed via content analysis of demonstrated statistically significant effects and thematic analysis of proposed physiological mechanisms of intervention. Vitamin C/taurine demonstrated indirect effects on tendon healing through antioxidant activity. Vitamin A/glycine showed direct effects on extracellular matrix tissue synthesis. Vitamin E shows an antiproliferative influence on collagen deposition. Leucine directly influences signaling pathways to promote muscle protein synthesis. Discussion: Preliminary evidence exists, demonstrating that vitamins and amino acids may facilitate multilevel changes in musculotendinous healing; however, recommendations on clinical utility should be made with caution. All animal studies and one human study showed high risk of bias with moderate interobserver agreement (k = 0.46). Currently, there is limited evidence to support the use of vitamins and amino acids for musculotendinous injury. Both high-quality animal experimentation of the proposed mechanisms confirming the physiological influence of supplementation and human studies evaluating effects on tissue morphology and biochemistry are required before practical application.Peer reviewe

Apple polyphenol extract improves insulin sensitivity in vitro and in vivo in animal models of insulin resistance

Background: Apple polyphenols could represent a novel nutritional approach in the management and control of blood glucose, especially in type 2 diabetics. The aim of this study was to test the therapeutic potential of an apple polyphenol extract (APE) in an insulin-resistant rat model and to determine the molecular basis of insulin sensitivity action in skeletal muscle cells.Methods: Acute effect of APE on the postprandial hyperglycemic response was assayed in 15 week old obese Zucker rats (OZR), by using a meal tolerance test (MTT). The ability of APE to improve whole peripheral insulin sensitivity was also assayed in a chronic study by using the euglycemic-hyperinsulinemic clamp technique. To elucidate the molecular mechanisms, rat L6 myotubes were used. Glucose uptake was measured by using 2-[3H]-Deoxy-Glucose (2-DG) and specific inhibitors, as well as phosphorylation status of key kinases, were used to determine the implicated signaling pathway.Results: In vivo study showed that nutritional intervention with APE induced an increase of insulin sensitivity with an increase of glucose infusion rate (GIR) of 45 %. Additionally, in vitro results showed a synergistic effect between APE and insulin as well as increased glucose uptake through GLUT4 translocation in muscle cells. This translocation was mediated by phosphatydil inositol 3-kinase (PI3K) and peroxisome proliferator-activated receptor-gamma (PPARγ) signaling pathways.Conclusions: As a whole, this study describes the mechanisms involved in the insulin sensitizing effect of APE, which could be considered a promising ingredient for inclusion in nutritional products focused on the management of chronic diseases such as diabetes.This research was supported by funds from Abbott Laboratories S.A

Role of Mitochondrial Electron Transport Chain Complexes in Capsaicin Mediated Oxidative Stress Leading to Apoptosis in Pancreatic Cancer Cells

We evaluated the mechanism of capsaicin-mediated ROS generation in pancreatic cancer cells. The generation of ROS was about 4–6 fold more as compared to control and as early as 1 h after capsaicin treatment in BxPC-3 and AsPC-1 cells but not in normal HPDE-6 cells. The generation of ROS was inhibited by catalase and EUK-134. To delineate the mechanism of ROS generation, enzymatic activities of mitochondrial complex-I and complex-III were determined in the pure mitochondria. Our results shows that capsaicin inhibits about 2.5–9% and 5–20% of complex-I activity and 8–75% of complex-III activity in BxPC-3 and AsPC-1 cells respectively, which was attenuable by SOD, catalase and EUK-134. On the other hand, capsaicin treatment failed to inhibit complex-I or complex-III activities in normal HPDE-6 cells. The ATP levels were drastically suppressed by capsaicin treatment in both BxPC-3 and AsPC-1 cells and attenuated by catalase or EUK-134. Oxidation of mitochondria-specific cardiolipin was substantially higher in capsaicin treated cells. BxPC-3 derived ρ0 cells, which lack mitochondrial DNA, were completely resistant to capsaicin mediated ROS generation and apoptosis. Our results reveal that the release of cytochrome c and cleavage of both caspase-9 and caspase-3 due to disruption of mitochondrial membrane potential were significantly blocked by catalase and EUK-134 in BxPC-3 cells. Our results further demonstrate that capsaicin treatment not only inhibit the enzymatic activity and expression of SOD, catalase and glutathione peroxidase but also reduce glutathione level. Over-expression of catalase by transient transfection protected the cells from capsaicin-mediated ROS generation and apoptosis. Furthermore, tumors from mice orally fed with 2.5 mg/kg capsaicin show decreased SOD activity and an increase in GSSG/GSH levels as compared to controls. Taken together, our results suggest the involvement of mitochondrial complex-I and III in capsaicin-mediated ROS generation and decrease in antioxidant levels resulting in severe mitochondrial damage leading to apoptosis in pancreatic cancer cells

New Insight into the Antifibrotic Effects of Praziquantel on Mice in Infection with Schistosoma japonicum

Schistosomiasis is a parasitic disease infecting more than 200 million people in the world. Although chemotherapy targeting on killing schistosomes is one of the main strategies in the disease control, there are few effective ways of dealing with liver fibrosis caused by the parasite infection in the chronic and advanced stages of schistosomiasis. For this reason, new strategies and prospective drugs, which exert antifibrotic effects, are urgently required.-induced liver fibrosis was inhibited by PZQ treatment for 30 days. Furthermore, we analyzed the effects of praziquantel on mouse primary hepatic stellate cells (HSCs). It is indicated that mRNA expressions of Col1α1, Col3α1, α-SMA, TGF-β, MMP9 and TIMP1 of HSCs were all inhibited after praziquantel anti-parasite treatments.The significant amelioration of hepatic fibrosis by praziquantel treatment validates it as a promising drug of anti-fibrosis and offers potential of a new chemotherapy for hepatic fibrosis resulting from schistosomiasis

Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy.

PURPOSE: The medial patellofemoral ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. METHODS: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3 February 2016. All papers investigating the anatomy of the MPFL were eligible. Methodological quality was assessed using a modified CASP tool. A narrative analysis approach was adopted to synthesise the findings. RESULTS: After screening and review of 2045 papers, a total of 67 studies investigating the relevant anatomy were included. From this, the origin appears to be from an area rather than (as previously reported) a single point on the medial femoral condyle. The weighted average length was 56 mm with an 'hourglass' shape, fanning out at both ligament ends. CONCLUSION: The MPFL is an hourglass-shaped structure running from a triangular space between the adductor tubercle, medial femoral epicondyle and gastrocnemius tubercle and inserts onto the superomedial aspect of the patella. Awareness of anatomy is critical for assessment, anatomical repair and successful surgical patellar stabilisation. LEVEL OF EVIDENCE: Systematic review of anatomical dissections and imaging studies, Level IV

Ulnar-sided wrist pain. II. Clinical imaging and treatment

Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed

Perspectives and Integration in SOLAS Science

Why a chapter on Perspectives and Integration in SOLAS Science in this book? SOLAS science by its nature deals with interactions that occur: across a wide spectrum of time and space scales, involve gases and particles, between the ocean and the atmosphere, across many disciplines including chemistry, biology, optics, physics, mathematics, computing, socio-economics and consequently interactions between many different scientists and across scientific generations. This chapter provides a guide through the remarkable diversity of cross-cutting approaches and tools in the gigantic puzzle of the SOLAS realm. Here we overview the existing prime components of atmospheric and oceanic observing systems, with the acquisition of ocean–atmosphere observables either from in situ or from satellites, the rich hierarchy of models to test our knowledge of Earth System functioning, and the tremendous efforts accomplished over the last decade within the COST Action 735 and SOLAS Integration project frameworks to understand, as best we can, the current physical and biogeochemical state of the atmosphere and ocean commons. A few SOLAS integrative studies illustrate the full meaning of interactions, paving the way for even tighter connections between thematic fields. Ultimately, SOLAS research will also develop with an enhanced consideration of societal demand while preserving fundamental research coherency. The exchange of energy, gases and particles across the air-sea interface is controlled by a variety of biological, chemical and physical processes that operate across broad spatial and temporal scales. These processes influence the composition, biogeochemical and chemical properties of both the oceanic and atmospheric boundary layers and ultimately shape the Earth system response to climate and environmental change, as detailed in the previous four chapters. In this cross-cutting chapter we present some of the SOLAS achievements over the last decade in terms of integration, upscaling observational information from process-oriented studies and expeditionary research with key tools such as remote sensing and modelling. Here we do not pretend to encompass the entire legacy of SOLAS efforts but rather offer a selective view of some of the major integrative SOLAS studies that combined available pieces of the immense jigsaw puzzle. These include, for instance, COST efforts to build up global climatologies of SOLAS relevant parameters such as dimethyl sulphide, interconnection between volcanic ash and ecosystem response in the eastern subarctic North Pacific, optimal strategy to derive basin-scale CO2 uptake with good precision, or significant reduction of the uncertainties in sea-salt aerosol source functions. Predicting the future trajectory of Earth’s climate and habitability is the main task ahead. Some possible routes for the SOLAS scientific community to reach this overarching goal conclude the chapter

Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management

Objective: Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing. Method: A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts. Results: In the first round, 38/47 statements reached or exceeded the consensus threshold of 80% and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80% consensus. Conclusion: This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions