Living with Hypertension: Experiences of Black Men Related to Their Perceptions of the Clinical Encounter at Diagnosis

Introduction: In the U.S., hypertension (HTN) is the most common primary diagnosis and HTN related illnesses are the number one cause of death. Being a member of the Black population increases the risk for developing HTN. Black males are reported to develop HTN earlier in life and have a high incidence of undiagnosed, untreated, and uncontrolled HTN. Sociocultural and gender barriers influence this population’s perceptions of medical experiences, which affects their participation in health-promoting behaviors such as eating a healthy diet, engaging in regular physical activity, avoiding tobacco, limiting alcohol consumption, and decreasing stress. Purpose: The purpose of this study was to increase nursing and interdisciplinary knowledge about the clinical encounter at the time of diagnosis from the perspective of Black males, aged 18 to 44, including how their life experiences at and after diagnosis were influenced by that encounter. The overall aim was to generate knowledge useful in the development of practice interventions that improve outcomes, reduce costs, and decrease health disparities for Black men with HTN. Method: An interpretive description qualitative method, as developed by Thorne, was used for this study. Semi-structured questions guided data collection during private one-on-one interviews with participants. Data analysis was an inductive process informed by constant comparative analysis. Findings: The consensus of the 17 participants was that, while healthcare providers were polite and professional the information provided at diagnosis did not meet their needs for managing HTN. Themes identified were denial, fear, and frustration. Most participants believed HTN happens to older people, an assumption that promoted denial of their condition. Knowing loved ones who suffered from HTN related illnesses led to fear when acknowledging their own diagnosis. Participants reported engaging in some health promoting behaviors. However, limited education, support, and motivation often resulted in unmanaged blood pressure and feelings of frustration. Conclusion: While it is evident that educational opportunities exist during and after diagnosis, the men received little more than confirmation of their condition. As the focus on disease prevention increases, the provision of adequate resources to help Black men manage HTN should become a research priority

How does localism for standards work in practice? The practitioner’s view of local standards post Localism Act 2011

This thesis examines the new regime brought in by the Localism Act 2011 for promoting and maintaining standards of conduct of members of English local government. It asks how practitioners can improve their practice in the implementation of new legislation addressing the issue of standards of behaviour of locally elected politicians. The legislation was highly controversial in reversing the approach taken by the previous Labour government of a national oversight regime and addresses the issue of public confidence in local elected representatives by leaving decisions to take action regarding standards to local authorities. This is a form of localism. The thesis adopts the methodology of action research combining two specific elements of insider action research and participative action research. This is achieved through reflective consideration of own practice and working with a regional partnership of public sector professionals charged with the responsibility of administering and applying the legislation to deal with complaints. The participants are at the most senior level of their professions and they contribute through rigorous semi structured interviews supported by public sector performance indicators. This provides robust qualitative and quantitative data which enables an original assessment of the implementation of a controversial piece of legislation. The thesis provides evidence to support the finding that the Localism Act’s duty on local authorities to promote and maintain standards of conduct of members is subject to local culture and by the removal of the national oversight of the former Standards Board, Standards for England and the Audit Commission, standards can only be maintained and improved by close regard to the Committee for Standards in Public life guidance and practitioners working together as in the sample partnership applying best practice Critical Success Factors and actions to promote the raising of standards of elected members. This thesis identifies such Critical Success Factors and provides a narrative of the author’s improvements in practice as the research proceeds. As action research is used as the method, it is intended that the findings of the research will be fed into further action research cycles

An Investigation of Textile Fibers by means of RGB analysis of Birefringence

Fiber analysis using birefringence has been around for years but has only recently been looked at more closely under a microscope. Recent scientists have proposed methods to correct issues found with fiber analysis using birefringence, yet there has not be a defined perfect method. This research will focus on correcting previously found issues with works by Michel-Lévy and Sorensen\u27s, as well as other scientists involved and perfecting the analysis of fiber through birefringence. The goal will be to take this research one step further into the analysis of textile fibers by RGB value analysis and birefringence. The RGB values will be analyzed in a color analysis program to compare HEX values. The cross section of the fiber will be done to receive an accurate diameter measurement of the fiber. Those RGB values and cross section diameter will then be matched to the Michel-Lévy chart and the birefringence will be determined

Preparing to Dewater a CCR Pond

PREPARING TO DEWATER A CCR POND: WAYS TO BETTER UNDERSTAND YOUR POND CHARACTERISTICS AND PLAN FOR A SUCCESSFUL DEWATERING EFFORT Authors Mr. Ron Hager - United States - Burns & McDonnell Dr. James Feild - United States - Burns & McDonnell Abstract Prior to dewatering a CCR pond, Owners and Operators should make the financially responsible decision to invest in the data gathering process to better understand the conditions of the surface impoundment, the properties of the CCR materials contained in the impoundment, and the potential approaches to remove the separable pore water from the ash materials prior to closure. This proactive approach includes a review of historical data, a field investigation, and a pilot study prior to moving to a full-scale dewatering approach. Prior to conducting a field investigation on the emplaced ash materials, the results of previous investigations were gathered to create a repository of data and analyzed to construct an initial conceptual site model. A field investigation was implemented that included piezometers, cone penetrometer tests, hydraulic profiling tool, and in-situ vane shear testing to create a more robust set of data regarding the response of ponded CCR during dewatering. This data was used to measure hydraulic conductivity, collect soil samples for grain size analysis, and verify the lithology. In-situ vane shear testing was also performed to measure the material\u27s shear strength to better understand the risk for instability during unwatering. This field investigation provided the key data to identify the proposed dewatering methods to be implemented in the pilot study. A dewatering pilot study has been proposed for implementation at the site in the summer of 2024. The objectives of the pilot study will be to implement multiple dewatering techniques that were identified as being compatible with site conditions based on data gathered during the field investigation. The key to a successful dewatering program is to do the necessary upfront research to understand the characteristics of your pond, the CCR materials, and what techniques will help to dewater your pond in the most effective and cost-efficient manner