Video visits for home health patients with Chronic Obstructive Pulmonary Disease

Purpose. Patients with Chronic Obstructive Pulmonary Disease (COPD) tend to face frequent emergency department visits and hospitalizations. The purpose of this project was to assist a home health agency in the process of building a video visit program to provide additional support to their COPD patient population. Methods. A literature review was conducted to explore evidence for the use of video visits in home health care. Existing telehealth resources, a chart review, and interviews with stakeholders were utilized to create video visit guidelines. An online education module for staff was developed based off of the administration-approved guidelines. A post-module survey was used to assess module effectiveness. Results. Research supports the complimentary use of video visits for home health patients. The chart review revealed areas where video visits could help the agency improve patient care. Clinicians and patients had a mixed response to the idea of video visits and offered important input toward the guidelines and education module. The video visit guidelines were drafted and accepted by the agency’s administration. Initial feedback regarding the education module suggests effectiveness at increasing participant awareness of the potential benefits of a video visit program and the basic guidelines to follow when conducting video visits. Budgetary concerns remain a roadblock for the initiation of a video visit program. Conclusion. Research suggests that home health patients with COPD may benefit from home health video visits to avoid rehospitalizations and improve their disease self-management skills. Initiating a video visit program takes significant planning and resources. The guidelines and education module may serve as a foundation for program development. A small pilot project led by one or two clinical staff members could act as a stepping-stone to launching a larger program. There is potential for the growth of a video visit program beyond the COPD patient population

Second Topological Moment < m^2 > of Two Closed Entangled Polymers

We calculate the second topological moment of entanglement of two closed polymers $P_1$ and $P_2$ in a solution. The result holds approximately for a closed polymer linked to many others, which may be considered as a single very long effective polymer.Comment: Author Information under http://www.physik.fu-berlin.de/~kleinert/institution.html Latest update of paper also at http://www.physik.fu-berlin.de/~kleinert/30

Documentary realism and fundamentalist religion in Ireland: a case study of power in the blood together with The Rocky Road to Dublin and The Road to God Knows Where

Introduction: According to many critics documentary helps to interpret history and promote human understanding while dramatising and bending reality. In general it does not draw conclusions, but rather consists of statements and assertions so that conclusions can be drawn. All the ‘creative’ documentaries discussed in this paper attempt to address the power and influence of religion in Ireland and to encourage audiences to reflect on such issues using a range of conventional strategies from direct address to cinema verite techniques, drawing upon the powerful influence of Robert Flaherty's poetic exposé of Man of Aran from the 1930s, together with more recent documentary techniques using more dialogical and reflexive formats. Peter Lennon, John T. Davis and Alan Gilsenan's documentaries under discussion in this paper present a relatively raw yet somber aesthetic, combining many of these techniques in their varying attempts to understand and appreciate the historical power and legacy of religion for contemporary Ireland

Climate change adaptation in industry and business

This report delivers a best practice framework to integrate financial risk assessment, governance and disclosure with existing governance principles around climate change adaptation.AbstractThe Australian business community has long been aware of the risks and opportunities associated with greenhouse gas mitigation and climate change policies. Some businesses have taken initial steps to adapt to the expected effects of climate change; however, most enterprises are only vaguely aware of the breadth of adaptation that may be required. Associated with strategic adaptation are the principles of financial/operational risk management and governance, as well as financial impact disclosure to investors and regulators. We develop a consolidated framework in which boards and executive managers can develop a robust approach to climate change adaptation governance, climate change risk assessment and financial disclosure. The project outlines a matrix of disclosures required for investors to enable them to evaluate corporate exposure to climate change risk.The project initially comprised a&nbsp;set of workshops with members of the Australian business community, industry representatives, regulatory authorities and academics with expertise in business risk and disclosure effects. Each workshop focused on a separate theme that built upon the work of previous workshops. A set of follow-up discussions was held with some of the key members who contributed to the project, including the Australian Stock Exchange (ASX) Investor Group on Climate Change (IGCC), the Australian Accounting Standards Board (AASB) and the Australian Institute of Company Directors. This discussion permitted each body to comment on the final report, advise on the mechanics of the costing, reporting and disclosure approaches of climate change adaptation, and lend their expertise to the formulation of an appropriate framework.The scope of the research is constrained to firm behaviour and the requirements for investor disclosure and governance of adaptation activities. The project therefore focuses on financial analyses – including real options – undertaken by firms with regard to investing in climate change adaptation activities and projects. While the economic costs and benefits are important to organisational adaptation activities, they represent a secondary level of analysis that may need to be carried out on either an independent or cumulative scale by governments or other bodies to measure the wider effects.As the degree of sophistication in climate change adaptation activities, modelling and cost estimation increases, along with the anticipated growth in interest of both company boards and managers, it is expected that accounting standards, ASX listing rules and disclosures required under the&nbsp;Corporations Act&nbsp;would need to explicitly reflect these corporate actions. The asset allocation of banks, mutual funds, superannuation funds and other investments is also likely to adapt as companies quantify their exposure to climate change. The makeup of assets in investment portfolios may therefore markedly shift, and thus indirectly adjust to the climate change adaptation activities of companies in the broader market

Employment and Life-Satisfaction: Insights from Ireland

Mainstream neoclassical economics takes it as given that the consumption of goods and services (output) is positively related to well-being. Work (labour-input) is assumed to be negatively related to well-being at the margin and so is only undertaken in exchange for payment. This view has been challenged for decades in the psychology and sociology literature and results suggests that employment status (especially unemployment) has profound effects on well-being, even at the margin. It is surprising then that several labour force status categories have been under researched in the literature to date. In this paper, using a sample of Irish adults carried out in 2001, we extend the current literature to examine the impacts of additional labour force status categories on life-satisfaction based on International Labour Organisation (ILO) classifications. These include part-time employment, disconnection from the labour force and being disabled, unable to work. Additionally, we expand the analysis of unemployment in the happiness literature and examine if the effects of unemployment and part-time employment on life satisfaction are conditioned by gender. Insights show that being part-time employed has a significant negative effect on life satisfaction, particularly for males. Being unemployed is found to have a significant negative effect on well-being, independent of gender and income, but no such effect is found for the local unemployment rate.

Religion and Irish cinema in studies

In classics like The Quiet Man and Ryan’s Daughter representations of the clergy and religion in Irish cinema has to some extent reflected perceptions of the church in the wider Irish society. These representations were certainly favourable, validating the great reverence in which the people then held their church. An apparent anti-Catholic agenda was given voice more recently, which was precipitated by the numerous church scandals of the 1990s. However, it still took a long time for representations of institutional violence by the clergy to be documented as exemplified recently in The Magdalene Sisters (2002) and Song for a Raggy Boy (2003). This paper will concentrate on close narrative readings of these films to illustrate how cinematic representations of Catholic authority figures involved in such abuse can be read as endorsing an anti-clerical and broadly secular humanist discourse. I suggest however, that these provocative texts nonetheless remain foregrounded within religious discourses and the traumatic evocation expressed in these narratives is necessary for the therapeutic process of healing within Irish society

SRC willow development, biomass composition and biofuel potential

The aims of this PhD were to examine nitrogen allocation and partitioning in Short Rotation Coppice (SRC) willow in regard to tree development and to investigate biomass composition and cell wall structure for the purpose of assessing and understanding biofuel potential. To address these topics four major experiments were performed and are presented in the thesis. An investigation of SRC willow development and nitrogen dynamics was conducted as a pot trial comprising 14 different genotypes from a willow mapping population. The genotypes were selected on the extremity and consistency of their field biomass yields. Fertiliser enriched with the stable isotope nitrogen 15 was applied as a means of nitrogen surveillance. One of the findings was that higher biomass yielding varieties of SRC willow had increased nitrogen-use-efficiency yet less (or later) nitrogen remobilisation in the autumn. The recalcitrance of the cell wall to enzymatic saccharification was assessed across 138 field-grown genotypes of the same willow mapping population. The aim was to identify any relationships between glucose yield and several biomass yield traits and to identify any quantitative trait loci (QTL) associated with enzymatic saccharification. Four QTL associated to enzymatic saccharification were identified and no relationship was found between glucose and biomass yield traits. A third experiment aimed to modify cell wall composition and structure of a single cultivar of willow grown in a pot trial. Tension wood, fibre cells containing an extra cell wall layer unique to angiosperms, and cellulose synthesis inhibited phenotypes were both induced. These modifications were accomplished through chemical and environmental treatments during development and their impact on composition and cell wall recalcitrance was assessed. Tension wood formation was found to increase glucose yields. The final main experiment used 35 of the UK’s leading biomass yielding willow varieties, grown in the field, to assess not only the variation in composition and enzymatic saccharification but also to identify any relationships between these two traits and a variety of morphological traits. The final part of the experiment investigated how variation in these traits interacted with dilute acid pretreatment. Surprisingly lignin content did not significantly correlate with cell wall recalcitrance to enzymatic saccharification. Another important finding was that enzymatic saccharification without the pretreatment correlated with enzymatic saccharification after the pretreatment. General introduction and general materials and methods chapters are included. A final summary discussion chapter is also included in order to address the overall impact of these findings on biofuel potential