Exploring the Effects of Caring for Congestive Heart Failure Patients on Caregiver Well-Being: A Descriptive Study

Background: As the incidence of heart failure (HF) quickly becomes the leading cause of disability among older adults, the need for non-professional, in-home caregivers increases as well. Many caregivers are family members who receive no compensation for their efforts, but all are an invaluable tool in the fight against a debilitating disease. Patients with caregivers experience an improved quality of life and lower mortality rates than patients with little social support. The caregiver of a patient with HF may be responsible for everyday activities such as housekeeping and shopping, as well as more complex disease-related necessities as managing medication regimens and fluid restrictions. The stresses associated with caring for a loved one with a progressive and life-altering disease can take a toll on the caregiver, contributing to a decrease in caregiver health and increase in mortality. Purpose: The purpose of this study was to explore how stress factors of caring for an individual with HF impact the emotional health, physical health, social activity, relationships, and lifestyle of the caregiver. Methodology: The study protocol was approved by the University of Arkansas and Washington Regional Medical Center Institutional Review Boards. Patients were accessed through a HF clinic in Northwest Arkansas, the Advanced Nurse Practitioner identifying patients that met the criteria of having an unpaid caregiver as defined in the study. The prospective cohort study was conducted September to December 2016 with 29 individuals identified as friends or family members of a patient with HF who provided care to the HF patient and received no financial compensation for their services. The Caregiver Burden Questionnaire – HF Version 3.0, consists of 26 questions regarding how the caregiver’s experience has been over the past four weeks of caregiving, and was used to measure four domains of physical, emotional/psychological, social, and lifestyle burdens. Results: Summary scores were created for all variables and descriptive statistics used. A Spearman’s rank-order correlation was used to determine the strength and direction of the association between variables. In agreement with previous research findings, physical health of the caregiver was positively correlated with emotional well-being. Discussion: Being a caregiver for a patient with HF can cause strain for the caregiver, but can also be rewarding. The benefits, such as feeling a sense of reward through helping someone else, can provide an emotional buffer that supports the caregiver through times of hospitalization or decline in the patient’s condition. Our findings suggest that interventions implemented to increase the caregiver’s perception of emotional support, perhaps through repeated contact by a healthcare professional, could improve caregiver, and therefore patient, outcomes

An investigation of geometry and noise corrections to San Marco-C neutral atmospheric composition experiment data

The problem of the calculation of ambient densities from San Marco-C neutral atmospheric composition experiment data is considered. A brief description is given of the data measurement method, followed by a description of both the theoretical and experimental data curves. Geometry, electrometer distortions, and noise effects are then studied in terms of their effects on the ideal data form. From these considerations two data reduction methods are evolved. The first is an iterative integration technique that exploits the symmetry of the experimental data about the minimum angle of attack. For the analysis of geometry effects, a second method using interval averaging was developed and studied

Effects of argon ion injections in the plasmasphere

In lifting massive space power system payloads from low Earth orbit to geosynchronous Earth orbit, Cargo Orbit Transfer (COTV) using ion propulsion will inject energetic beams of argon ions into the plasmasphere. The relationship of the beam velocity to Alfven and thermal velocities as a function of radial distance in the plasmasphere is given for positions near the Earth's equatorial plane. A beam sheath loss model is used which results in a deposition of argon ions and hence energy in the plasmasphere which is much less than that in models calling for clouds or plasma instabilities to rapidly stop the beam. A comparison is given of the cumulative fractional mass loss of an ion beam injected at 1.5 R for the ion cloud and the ion beam sheath loss process. The integrated difference of these two deposition models is shown for the construction of one SPS

Galactic cosmic ray heavy primary secondary doses

Results of a calculation which estimates the heavy primary secondary doses from cosmic ray interaction data are reported. The incident galactic cosmic ray heavy primary spectrum is represented as the sum of helium, nitrogen, magnesium, and iron components. The incident iron nuclei are allowed to fragment into lesser Z secondaries, which are assumed to travel in the same direction and start with the same energy per nucleon as the interacting primary. The total emergent particle energy spectra and dose are then presented for the galactic heavy primary spectrum incident on aluminum and tissue slabs. The importance of the fragmentation parameters assumed is also evaluated. The total dose from the heavy primaries and their secondaries is found to be reduced by only a factor of two in 20 g/sq cm of shielding

A study of radiation environment in space and its biological effects

Biological effects on man in space resulting from galactic and solar cosmic radiation are discussed. Importance of secondary ions which contribute to galactic cosmic radiation hazards is analyzed. Mathematical model to show rate of production of secondary ions of given atomic number at various points in absorber is presented

After Recess: Historical Practice, Textual Ambiguity, and Constitutional Adverse Possession

The Supreme Court’s interpretation of the Recess Appointments Clause in NLRB v. Noel Canning stands as one of the Supreme Court’s most significant endorsements of the relevance of “historical gloss” to the interpretation of the separation of powers. This Article uses the decision as a vehicle for examining the relationship between interpretive methodology and historical practice, and between historical practice and textual ambiguity. As the Article explains, Noel Canning exemplifies how the constitutional text, perceptions about clarity or ambiguity, and “extra-textual” considerations such as historical practice operate interactively rather than as separate elements of interpretation. The decision also provides a useful entry point into critically analyzing the concept of constitutional “liquidation,” which the majority in Noel Canning seemed to conflate with historical gloss but which seems more consistent with the approach to historical practice reflected in Justice Scalia’s concurrence in the judgment. Finally, this Article argues that the historical gloss approach, when applied cautiously and with sensitivity to the potential concerns raised by Justice Scalia and others, is not vulnerable to the charge of licensing executive aggrandizement by “adverse possession.

Constructed Constraint and the Constitutional Text

In recent years, constitutional theorists have attended to the unwritten aspects of American constitutionalism and, relatedly, to the ways in which the constitutional text can be “constructed” upon by various materials. This Article takes a different approach. Instead of considering how various materials can supplement or implement the constitutional text, it focuses on how the text itself is often partially constructed in American constitutional practice. Although interpreters typically regard clear text as controlling, this Article contends that whether the text is perceived to be clear is often affected by various “modalities” of constitutional interpretation that are normally thought to come into play only after the text is found to be vague or ambiguous: the purpose of a constitutional provision, structural inferences, understandings of the national ethos, consequentialist considerations, customary practice, and judicial and nonjudicial precedent. The constraining effect of clear text, in other words, is partially constructed by considerations that are commonly regarded as extratextual. This phenomenon of constructed constraint unsettles certain distinctions drawn by modern theorists: between interpretation and construction, between the written and the unwritten constitutions, and between the Constitution and the “Constitution outside the Constitution.” Although primarily descriptive, this Article also suggests that constructed constraint produces benefits for the constitutional system by helping interpreters negotiate tensions within democratic constitutionalism