Impact of Family Presence in the Healthcare Setting

Family presence at the patient’s bed side is promoted and encouraged within the healthcare arena. Healthcare staff strive for reports of satisfaction from patients and families. Positive and negative outcomes of family presence on units within the hospital have been assessed, with suggestions for visitation practices and solutions for common concerns. Positive patient outcomes, including accelerated recovery time, increased reports of comfort, and decreased duration of hospital stay are the ultimate goals of hospital care. Research shows that patient outcomes are impacted greatly by family presence. Patient- and family-centered care represent the future model of healthcare. Knowledge of these policies and potential consequences of their implementation will guide the practice of nurses and other healthcare professionals

Characterization of 1-ACBP B-ACBP and PBR in oesophageal cancer

Faculty of Science; School of molecular and Cell Biology; MSC DissertationBackground: Cancer of the oesophagus ranks as the ninth most common malignancy in the world, and recent evidence shows that its incidence is increasing. Apoptosis is a process of programmed cell death, which is as essential as cell growth, for the maintenance of homeostasis. When these processes lose integration, such as cancer, then uncontrolled cell growth occurs. There are at least five ACBP subgroups and the two being focused on in this study is B-ACBP (brain specific) and 1-ACBP (found in nearly all tissues). ACBPs act as intracellular carrier-proteins for medium to long chain acyl-coA, mediating fatty acid transport to the mitochondrion for ß-oxidation. ACBPs are also believed to be putative ligands of PBR (Peripheral Benzodiazepine Receptor), and bound to this receptor facilitates mitochondrial membrane permeabilization giving the notion that it favours apoptosis. Aim: To establish the expression patterns of 1-ACBP, B-ACBP, and PBR in oesophageal cancer, and to characterize their roles in this disease. Methodology: Paraffin-embedded sections of normal and malignant oesophageal tissues were utilized for localization studies. RNA probes was synthesized and labelled using Digoxigenin for colorimetric and fluorescent detection during the in situ hybridization (ISH) technique for localization. Real time quantitative RT-PCR was performed to determine the expression levels of the three genes in oesophageal cancer RNA using the Roche Lightcylcer .Results: All three genes showed substantial upregulation within the malignant tissue sections compared to normal oesophageal sections, all three transcripts localized specifically to plasma cells and lymphocytes in diseased and normal tissue section. In the diseased tissue B-ACBP and 1-ACBP mRNA localized to endothelial cells of blood vessels in the submucosa. B-ACBP also localized to the nucleus of squamous epithelium cells. PBR localization occurred in tumour islands in invasive tissue sections. Quantitative RT-PCR also illustrated PBR expression level was the highest compared to the ACBP genes expression in tumours. Conclusion: These results show that 1-ACBP, B-ACBP and PBR play a role in the pathogenesis of oesophageal cancer as well as immunology. Further experiments are still required to determine the function of these genes and the role they play in apoptosis and oesophageal cancer

Shallow landsliding and catchment connectivity within the Houpoto Forest, New Zealand.

Active landslides and their contribution to catchment connectivity have been investigated within the Houpoto Forest, North Island, New Zealand. The aim was to quantify the proportion of buffered versus coupled landslides and explore how specific physical conditions influenced differences in landslide connectivity. Landsliding and land use changes between 2007 and 2010 were identified and mapped from aerial photography, and the preliminary analyses and interpretations of these data are presented here. The data indicate that forest harvesting made some slopes more susceptible to failure, and consequently many landslides were triggered during subsequent heavy rainfall events. Failures were particularly widespread during two high magnitude (> 200 mm/day) rainfall events, as recorded in 2010 imagery. Connectivity was analysed by quantifying the relative areal extents of coupled and buffered landslides identified in the different images. Approximately 10 % of the landslides were identified as being coupled to the local stream network, and thus directly contributing to the sediment budget. Following liberation of landslides during high-magnitude events, low-magnitude events are thought to be capable of transferring more of this sediment to the channel. Subsequent re-planting of the slopes appears to have helped recovery by increasing the thresholds for failure, thus reducing the number of landslides during subsequent high-magnitude rainfall events. Associated with this is a reduction in slope-channel connectivity. These preliminary results highlight how site specific preconditioning, preparatory and triggering factors contribute to landslide distribution and connectivity, in addition to how efficient re-afforestation improves the rate of slope recovery

A Qualitative Case Study About Online Reflection for Elementary Mathematics Teachers

Many teachers report that they rarely engage in reflection. Asynchronous forums have been used to foster reflection among prospective teachers, but there is limited research about the allocation of time for reflection in an asynchronous forum for practicing teachers. The purpose of this qualitative case study was to (a) determine teachers\u27 perceptions about the benefits and drawbacks of the use of an online forum to allocate time for reflection and (b) to classify the levels of the teachers\u27 reflections in the forum. A conceptual framework based on select writings by Dewey, Hatton and Smith, and van Manen was used to guide this study. The research questions addressed teachers\u27 perceptions of the benefits, drawbacks, and use of a forum to allocate time to reflect as well as the levels of reflection achieved by the teachers in the forum. Ten online discussions and 2 sets of questionnaires were analyzed and coded using constant comparative data analysis. Seven elementary mathematics teachers completed the study and 52% and 56% of the discussion postings were coded as critical reflections using Hatton and Smith\u27s framework and a summary of van Manen\u27s framework, respectively. The themes pertaining to the benefits of reflecting online were convenience, sharing, and learning. Peer-to-peer interactions, however, were infrequent, and the teachers indicated that time was a factor that limited participation. This study may effect positive social change by advancing knowledge about using online forums to provide teachers with time earmarked for reflection focused on improving mathematics teaching and learning. Furthermore, educators can use information from this study to design online professional development experiences that include opportunities for reflection and reflective practice

Behavioural characteristics of rapists

A substantial proportion of past research on rapists has focused on their motives. This paper reports on two studies that investigated the behavioural characteristics of rapists. The first study gathered behavioural data from police rape files to determine the types of behaviours exhibited by 130 men charged with rape. The second study was designed to validate the behavioural clusters found in study 1, using the transcripts of court cases from a sample of 50 accused rapists. The results demonstrated a high level of consistency in the behaviours of the accused rapists in the two studies. Rapists were most frequently a stranger, the rape occurred frequently in the victim\u27s home, and the rapist used a range of different ways to communicate verbally with his victim. Five behavioural themes were identified in both studies: vaginal, kissing/fondling, oral, anal and brutal/physical themes. This analysis of the behavioural aspects of rape provides an understanding of the types of behaviours exhibited by men who reach the stage of court proceedings for the crime of rape. The difference between the current behavioural profile and that reported by members of the general community who have experienced rape is discussed

Factors Impacting Perceived Safety Among Staff Working on Mental Health Wards

Background: Safety at work is a core issue for mental health staff working on in-patient units. At present, there is a limited theoretical base regarding which factors may affect staff perceptions of safety. Aims: This study attempted to identify which factors affect perceived staff safety working on in-patient mental health wards. Method: A cross-sectional design was employed across 101 forensic and non-forensic mental health wards, over seven National Health Service trusts nationally. Measures included an online staff survey, Ward Features Checklist and recorded incident data. Data were analysed using categorical principal components analysis and ordinal regression. Results: Perceptions of staff safety were increased by ward brightness, higher number of patient beds, lower staff to patient ratios, less dayroom space and more urban views. Conclusions: The findings from this study do not represent common-sense assumptions. Results are discussed in the context of the literature and may have implications for current initiatives aimed at managing in-patient violence and aggression

Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke

Background. Effective treatment methods are needed for moderate/severely impairment chronic stroke. Objective. The questions were the following: (1) Is there need for long-dose therapy or is there a mid-treatment plateau? (2) Are the observed gains from the prior-studied protocol retained after treatment? Methods. Single-blind, stratified/randomized design, with 3 applied technology treatment groups, combined with motor learning, for long-duration treatment (300 hours of treatment). Measures were Arm Motor Ability Test time and coordination-function (AMAT-T, AMAT-F, respectively), acquired pre-/posttreatment and 3-month follow-up (3moF/U); Fugl-Meyer (FM), acquired similarly with addition of mid-treatment. Findings. There was no group difference in treatment response (P ≥ .16), therefore data were combined for remaining analyses (n = 31; except for FM pre/mid/post, n = 36). Pre-to-Mid-treatment and Mid-to-Posttreatment gains of FM were statistically and clinically significant (P \u3c .0001; 4.7 points and P \u3c .001; 5.1 points, respectively), indicating no plateau at 150 hours and benefit of second half of treatment. From baseline to 3moF/U: (1) FM gains were twice the clinically significant benchmark, (2) AMAT-F gains were greater than clinically significant benchmark, and (3) there was statistically significant improvement in FM (P \u3c .0001); AMAT-F (P \u3c .0001); AMAT-T (P \u3c .0001). These gains indicate retained clinically and statistically significant gains at 3moFU. From posttreatment to 3moF/U, gains on FM were maintained. There were statistically significant gains in AMAT-F (P = .0379) and AMAT-T P = .003

Estimating the population size of the Sanje mangabey (Cercocebus sanjei) using acoustic distance sampling

The Sanje mangabey (Cercocebus sanjei) is endemic to the Udzungwa Mountains, Tanzania, and is classified as Endangered due to its putatively declining population size, habitat degradation and fragmentation. Previous population size estimates have ranged from 1,350 to 3,500 individuals, with the last direct survey being conducted 15 years before the present study. Previous estimates are now thought to have underestimated the population due to a limited knowledge of group and habitat size, nonsystematic approaches and the use of visual methods that are not suitable for surveying the Sanje mangabey with its semi‐terrestrial and elusive behaviors. We used an acoustic survey method with observers recording the distinctive “whoop‐gobble” vocalization produced by mangabeys and point transect distance sampling to model a detection function and estimate abundance. Twenty‐eight surveys were conducted throughout the two forests where Sanje mangabeys are found: Mwanihana forest in the Udzungwa Mountains National Park (n = 13), and the Uzungwa Scarp Nature Reserve (n = 15). Group density was found to be significantly lower in the relatively unprotected Uzungwa Scarp forest (0.15 groups/km2; 95% CI: 0.08–0.27) compared to the well‐protected Mwanihana forest (0.29 groups/km2; 95% CI: 0.19–0.43; p = .03). We estimate that there are 1,712 (95% CI: 1,141–2,567) individuals in Mwanihana and 1,455 (95% CI: 783–2,702) in the Uzungwa Scarp, resulting in a total population size of 3,167 (95% CI: 2,181–4,596) individuals. The difference in group density between sites is likely a result of the differing protection status and levels of enforcement between the forests, suggesting that protection of the Uzungwa Scarp should be increased to encourage recovery of the population, and reduce the threat of degradation and hunting. Our results contribute to the reassessment of the species' IUCN Red List status and informing management and conservation action planning

Adiposity, Cardiometabolic Risk, and Vitamin D Status: The Framingham Heart Study

OBJECTIVE: Because vitamin D deficiency is associated with a variety of chronic diseases, understanding the characteristics that promote vitamin D deficiency in otherwise healthy adults could have important clinical implications. Few studies relating vitamin D deficiency to obesity have included direct measures of adiposity. Furthermore, the degree to which vitamin D is associated with metabolic traits after adjusting for adiposity measures is unclear. RESEARCH DESIGN AND METHODS: We investigated the relations of serum 25-hydroxyvitamin D (25[OH]D) concentrations with indexes of cardiometabolic risk in 3,890 nondiabetic individuals; 1,882 had subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes measured by multidetector computed tomography (CT). RESULTS: In multivariable-adjusted regression models, 25(OH)D was inversely associated with winter season, waist circumference, and serum insulin (P < 0.005 for all). In models further adjusted for CT measures, 25(OH)D was inversely related to SAT (−1.1 ng/ml per SD increment in SAT, P = 0.016) and VAT (−2.3 ng/ml per SD, P < 0.0001). The association of 25(OH)D with insulin resistance measures became nonsignificant after adjustment for VAT. Higher adiposity volumes were correlated with lower 25(OH)D across different categories of BMI, including in lean individuals (BMI <25 kg/m2). The prevalence of vitamin D deficiency (25[OH]D <20 ng/ml) was threefold higher in those with high SAT and high VAT than in those with low SAT and low VAT (P < 0.0001). CONCLUSIONS: Vitamin D status is strongly associated with variation in subcutaneous and especially visceral adiposity. The mechanisms by which adiposity promotes vitamin D deficiency warrant further study.National Institutes of Health's National Heart, Lung, and Blood Institute (N01-HC-25195, R01-DK-80739): American Heart Associatio

Association of treatment satisfaction and psychopathological sub-syndromes among involuntary patients with psychotic disorders

Publisher's version: http://www.springerlink.com/content/rx24036274667t10