Community Engagement for Health and Wellness in Aging Populations: Institute for Inclusion, Inquiry, and Innovation (iCubed)

The Virginia Commonwealth University (VCU) Institute for Inclusion, Inquiry and Innovation (iCubed) is a cutting-edge institute focused on creating collaborative connections between the university and Richmond through innovative academic and research programs. iCubed consists of six transdisciplinary cores which unite faculty members and students to work with key community members to develop holistic solutions to 21st century urban challenges. One of these cores, the Health and Wellness in Aging Populations (HWAP) core, was designed to educate and assist low-income older adults in becoming self-sufficient in navigating healthcare services. The HWAP core is centered within the Richmond Health and Wellness Program, an interprofessional care coordination and wellness service that serves Richmond’s low-income senior housing communities. As part of its inaugural mentorship program, iCubed created the Commonwealth Scholars Program (CSP) to pair academically talented undergraduate students with faculty members in the HWAP core to conduct research on aging populations in Richmond. As part of their responsibilities, the students were tasked with interviewing HWAP core faculty members to assess their perceptions of the core’s mission and progress. As such, the current study summarizes the findings from these interviews and offers guidelines for future directions. CSP conducted interviews with HWAP core faculty members (N=10) to establish a multiperspective vision of HWAP core objectives. Interviewed members come from the following VCU Departments: Family and Community Health Nursing/School of Nursing, Pharmacotherapy and Outcomes Science/School of Pharmacy, Family Medicine and Population Health/School of Medicine, Gerontology/School of Allied Health Professions, Adult Health and Nursing Systems, and Urban and Regional Studies, Planning/L. Douglas Wilder School of Government and Public Affairs. Each interview lasted approximately 10 minutes and was recorded into an electronic document. Themes from the interviews were identified and main themes are described. Coded themes indicated that the HWAP core aims to deliver care, offer education, and help aging clients navigate the healthcare system. Faculty members noted that HWAP core’s engagement with the community aims to build trust with community members and create lifelong partnerships. Findings indicated that the HWAP core has the potential to improve the quality of life for older adults and empower community members to maintain their independence and age in place. Future opportunities for the HWAP core include training older adults to become community health workers to be truly vested within the mission and actions of the core. In conclusion, the HWAP core aims to improve the lives of low-income older adults in Richmond and does so by connecting VCU researchers and students with community members.https://scholarscompass.vcu.edu/uresposters/1279/thumbnail.jp

Attitudes towards Complementary Medicine in Patients with Musculoskeletal Pain

The epidemic of opiate use-related deaths has become a public health crisis and has highlighted the potentially lethal effects of opiates. Vermont has adopted new laws to address the prescription of opiates, which has reduced the number of prescriptions by 41% between 2013 and 2017. However, there has been sparse research how the decrease in prescriptions has influenced the use of non-pharmacologic and/or complementary methods of pain management, such as acupuncture, chiropractic manipulation, yoga, massage, meditation, and psychotherapy. In October and November 2018, patients with musculoskeletal pain were surveyed about current methods of pain management, experience with complementary medicine, likelihood of using complementary methods in the future, and potential barriers to use. Interviews were conducted at the Community Health Centers of Burlington - Riverside. Nine patients completed the survey, 5 of 9 had chronic pain (\u3e3 months). Most patients had used either medications or physical therapy for musculoskeletal pain in the past. Participants expressed most interest in using chiropractic manipulation, massage, and acupuncture for future pain management. Barriers included cost, lack of time and/or scheduling, and lack of knowledge about the benefits of complementary therapy. Future interventions should address these barriers, and should also focus on educating providers about the efficacy and local availability of complementary medical services.https://scholarworks.uvm.edu/fmclerk/1471/thumbnail.jp

Scattering of two spinning black holes in post-Minkowskian gravity, to all orders in spin, and effective-one-body mappings

We demonstrate equivalences, under simple mappings, between the dynamics of three distinct systems---(i) an arbitrary-mass-ratio two-spinning-black-hole system, (ii) a spinning test black hole in a background Kerr spacetime, and (iii) geodesic motion in Kerr---when each is considered in the first post-Minkowskian (1PM) approximation to general relativity, i.e. to linear order $G$ but to all orders in $1/c$, and to all orders in the black holes' spins, with all orders in the multipole expansions of their linearized gravitational fields. This is accomplished via computations of the net results of weak gravitational scattering encounters between two spinning black holes, namely the net $O(G)$ changes in the holes' momenta and spins as functions of the incoming state. The results are given in remarkably simple closed forms, found by solving effective Mathisson-Papapetrou-Dixon-type equations of motion for a spinning black hole in conjunction with the linearized Einstein equation, with appropriate matching to the Kerr solution. The scattering results fully encode the gauge-invariant content of a canonical Hamiltonian governing binary-black-hole dynamics at 1PM order, for generic (unbound and bound) orbits and spin orientations. We deduce one such Hamiltonian, which reproduces and resums the 1PM parts of all such previous post-Newtonian results, and which directly manifests the equivalences with the test-body limits via simple effective-one-body mappings.Comment: 26 pages, 2 figures. v2: added references; corrected typos in Appendix A; added missing link in Eq. (B11

Properties of an affine transport equation and its holonomy

An affine transport equation was used recently to study properties of angular momentum and gravitational-wave memory effects in general relativity. In this paper, we investigate local properties of this transport equation in greater detail. Associated with this transport equation is a map between the tangent spaces at two points on a curve. This map consists of a homogeneous (linear) part given by the parallel transport map along the curve plus an inhomogeneous part, which is related to the development of a curve in a manifold into an affine tangent space. For closed curves, the affine transport equation defines a "generalized holonomy" that takes the form of an affine map on the tangent space. We explore the local properties of this generalized holonomy by using covariant bitensor methods to compute the generalized holonomy around geodesic polygon loops. We focus on triangles and "parallelogramoids" with sides formed from geodesic segments. For small loops, we recover the well-known result for the leading-order linear holonomy ($\sim$ Riemann $\times$ area), and we derive the leading-order inhomogeneous part of the generalized holonomy ($\sim$ Riemann $\times$ area$^{3/2}$). Our bitensor methods let us naturally compute higher-order corrections to these leading results. These corrections reveal the form of the finite-size effects that enter into the holonomy for larger loops; they could also provide quantitative errors on the leading-order results for finite loops.Comment: 18 pages, 4 figures, new short section (Sec. 5) in v3; updated to match article published in GR

Scattering of Spinning Black Holes from Exponentiated Soft Factors

We provide evidence that the classical scattering of two spinning black holes is controlled by the soft expansion of exchanged gravitons. We show how an exponentiation of Cachazo-Strominger soft factors, acting on massive higher-spin amplitudes, can be used to find spin contributions to the aligned-spin scattering angle, conjecturally extending previously known results to higher orders in spin at one-loop order. The extraction of the classical limit is accomplished via the on-shell leading-singularity method and using massive spinor-helicity variables. The three-point amplitude for arbitrary-spin massive particles minimally coupled to gravity is expressed in an exponential form, and in the infinite-spin limit it matches the effective stress-energy tensor of the linearized Kerr solution. A four-point gravitational Compton amplitude is obtained from an extrapolated soft theorem, equivalent to gluing two exponential three-point amplitudes, and becomes itself an exponential operator. The construction uses these amplitudes to: 1) recover the known tree-level scattering angle at all orders in spin, 2) recover the known one-loop linear-in-spin interaction, 3) match a previous conjectural expression for the one-loop scattering angle at quadratic order in spin, 4) propose new one-loop results through quartic order in spin. These connections link the computation of higher-multipole interactions to the study of deeper orders in the soft expansion.Comment: 29 pages + appendices + refs, 3 figures; v3 minor corrections, journal versio

Fiscal Policy, intercountry adjustment and the real exchange rate within Europe

In EMU, a country may have difficulty ensuring stability in the face of asymmetric shocks; the response may be unstable, or, even if not, the real exchange rate might overshoot. Fiscal policy may help to stabilise inflation and also to target the real exchange rate. The paper argues that an improved fiscal policy process might result in improved macroeconomic performance within Europe. Within EMU, a country may have difficulty ensuring stability in the face of asymmetric shocks; the response may be unstable, or, even if not, the real exchange rate might overshoot. In this context, the rules of the SGP may interfere with the control of inflation control, with the short-run stabilisation of demand, and also with the longer term adjustment of intra-European real exchange rates. We recommend using fiscal policy to stabilise inflation and also to target the real exchange rate rather than deficits or debt. Such a policy would require a more active use of fiscal policy.adjustment, macroeconomic stability, fiscal policy, EMU, "Fiscal policy, intercountry adjustment and the real exchange rate within Europe", Allsopp , Vines