Reaching perinatal women online: The healthy you, healthy baby website and app

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today\u27s Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff

Sampling methods for Acropora corals, other benthic coral reef organisms, and marine debris in the Florida Keys: Field protocol manual for 2011-2012 assessments

The 2011-2012 sampling of Acropora corals, other coral reef benthic invertebrates, and marine debris in the Florida Keys National Marine Sanctuary (FKNMS) is being undertaken as a spatially intensive effort to provide updated population distribution and abundance information. The particular focus of surveys in the Florida Keys, as well as in the U.S. Caribbean (Puerto Rico and the U.S.V.I.), concerns the habitat distribution, colony density, size, condition, and population abundance of Acropora corals. Surveys in the Florida Keys also include assessments of urchins, mollusks, anemones, corallimorpharians, and marine debris. These additional assessments are relatively fast and easy to perform. Annual surveys for Acropora corals began in 2006 in the Florida Keys in response to their listing on the Federal Endangered Species List, as well as the paucity of large-scale information on habitat distribution, abundance, and condition in the Florida Keys. Periodic surveys for Acropora corals as part of our long-term monitoring and assessment program date back to 1999. The purpose of this field protocol manual is to outline the Acropora sampling procedures used in the Florida Keys and to standardize survey methods for the Florida and U.S. Caribbean regional population assessments planned for 2012. A previous draft of this manual was prepared for Florida Keys National Marine Sanctuary personnel in June 2011 to help guide the field sampling in 2011

The assessment and treatment of sub-acute hand oedema after trauma or surgery

Background: Hand oedema (swelling) is a common consequence of hand trauma or surgery. However, there is no consensus on the best practice for assessment or management and a lack of high quality evidence. This programme of research aims to address this knowledge gap. Methods: Systematic reviews were conducted on methods of assessing and treating hand oedema. An online survey established current practice of UK-based hand therapists. A subsequent Delphi with eight hand therapy experts led to consensus on a standardised oedema management programme. The relative responsiveness of two clinical and two patient-rated outcome measures were evaluated in an observational study. Finally, an assessor-blind pilot randomised controlled trial of kinesiology tape for sub-acute hand oedema tested the feasibility of methods, recruitment, adherence and acceptability of interventions. Results: There was limited, low to moderate quality evidence to support the use of one of 16 oedema interventions described in the literature. The survey of current practice identified ‘standard care’ as comprising compression, elevation and massage. The Delphi established consensus on the dose, method and instructions for interventions. The volumeter was identified as the most responsive method of measuring hand oedema. Finally, the pilot RCT identified issues with recruitment and retention. Conclusion: There is wide variation in the type and application of oedema treatments, and actual practice does not concur with best evidence. Manual oedema mobilisation may be applied in addition to conventional therapies in problematic oedema. However, this technique requires more consistent description. The volumeter is the most responsive measure for hand oedema, but the figure-of-eight tape should be considered as an alternative where immersion in water is not practical. The pilot trial confirmed that a definitive trial is warranted. However, strategies to maximise recruitment and retention in a full study need to be considered

Effectiveness of edema management techniques for subacute hand edema: A systematic review

Study Design: Systematic review. Introduction: Prolonged hand edema can have detrimental effects on range of motion and function. There is no consensus on how best to manage traumatic subacute edema. This is the first systematic review which examines the clinical effectiveness of edema treatments on hand volume. Purpose of the Study: The purpose of this systematic review was to examine the evidence of effectiveness of treatments for sub-acute hand edema. Methods: A literature search of AMED, CINAHL, Embase, and OVID MEDLINE (from inception to August 2015) was undertaken. Studies were selected if they met the following inclusion criteria: randomized controlled or controlled trials in adults who have subacute swelling after a recent upper limb musculoskeletal trauma or cerebral vascular attack or after surgery. Two independent assessors rated study quality and risk of bias using the 24-point MacDermid Structured Effectiveness Quality Evaluation Scale (SEQES). Results: Ten studies met the inclusion criteria. Study quality ranged from 23 to 41 out of 48 points on the SEQES. A total of 16 edema interventions were evaluated across the studies. Due to heterogeneity of the patient characteristics, interventions, and outcomes assessed, it was not possible to pool the results from all studies. Therefore, a narrative best evidence synthesis was undertaken. There is low to moderate quality evidence with limited confidence in the effect estimate to support the use of manual edema mobilization methods in conjunction with standard therapy to reduce problematic hand edema. Conclusion: Manual edema mobilization techniques should be considered in conjunction with conventional therapies, in cases of excessive edema or when the edema has not responded to conventional treatment alone; however, manual edema mobilization is not advocated as a routine intervention

Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia

Background: Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequities. Cape York Kidney Care (CYKC) has been created as an unique service which provides specialist care that aims to centre the client within a multidisciplinary team that is integrated within the primary care setting of the remote health clinics in six communities in western Cape York, Australia. This research aims to describe the Cape York Kidney Care service delivery model, and baseline service data, including aggregated client health measures. Methods: The model of care is described in detail. Review of the first 12 months of service provision has been undertaken with client demographic and clinical profile baseline data collected including kidney health measures. Participants are adults (> 18 years if age) with CKD grades 1–5. This data has been de-identified and aggregated. Results: CYKC reviewed 204 individuals, with 182 not previously been reviewed by specialist kidney health services. Three quarters of clients identified as Aboriginal. The average age was 55 with a high level of comorbidity, with majority having a history of hypertension and Type 2 diabetes (average Hba1c 8.2%). Just under one third had cardiovascular disease. A large proportion of people had either Grade 2 CKD (32%) or Grade 3 CKD (~ 30%), and over half had severely increased albuminuria (A3), with Type 2 diabetes being the predominant presumed cause of CKD. Most clients did not meet evidence-based targets for diabetes, blood pressure or lipids and half were self-reported smokers. The proportion of clients reviewed represents 6.2% of the adult population in the participating First Nation communities. Conclusion: The CYKC model was able to target those clients at high risk of progression and increase the number of people with chronic kidney disease reviewed by specialist kidney services within community. Baseline data demonstrated a high burden of chronic disease that subsequently will increase risk of CKD progression and cardiovascular disease. People were seen to have more severe disease at younger ages, with a substantial number demonstrating risk factors for rapid progression of kidney disease including poorly controlled Type 2 diabetes and severely increased albuminuria. Further evaluation concerning implementation challenges, consumer and community satisfaction, and health outcomes is required

"I am an athlete": A multiple case study of Division I female athletes' post-sport transitions and influences on athletic identity

The purpose of this qualitative multiple case study was to explore how transitioning out of collegiate soccer influenced the athletic identities of Division I female collegiate athletes who were no longer pursuing competitive athletics. Because fewer than 2% of Division I student-athletes go on to a professional career in athletics (National Collegiate Athletic Association [NCAA], 2018a), the expiration of eligibility often signals the end to an athletic self the student-athlete may have identified with since youth (NCAA, 2016). This multiple case study focused on four female athletes' narrated experiences of their journeys 8-16 years after they exited their collegiate athlete roles. Each participants' experiences were examined through three in-depth interviews with artifact collection.This study applied a posteriori theories to the data collected. Four main findings and two sub-findings emerged from the data analysis. First, the initial operationalization of athletic identity was influenced by each individual's attributes, personality, preferences, opportunities, and life experiences. Second, athletes physically transitioned out of competitive sport but not out of their identities as athletes. The concept of "athletic identity" was too unidimensional to capture women's multidimensional experiences of exiting collegiate soccer, and new motherhood required reassessing identity, including recalibration of athletic identity. Third, the women's level of anticipation and preparation for the transition out of collegiate sport contributed to the ease of the transition experience participants described. Finally, each athlete's transition experience remained unique and did not align with an overall model or expectation. To better understand how transitioning out of collegiate athletics may influence female athletic identities, these findings have significant implications for the NCAA, athletic departments, and personnel who work with current and former student-athletes, particularly at Division I institutions

The Visceral Metaphor: a contemplation on the invaded self

This practice-led thesis explores the disruptive metaphor in relation to ideas of loss, irresolution and the photographic. It is centred around the researcher’s experience of a home invasion. Through the process of grief, the body is considered for its expressive, visceral and morphological properties. In photographic prints and moving image sequences, enigmatic metaphors operate as an extension of the corporeal. In the spatio-temporal dimension of the work, images are constructed (and deconstructed) through a series of instantaneous moments: repeating, multiplying and becoming

Isolation and Development of a Surrogate Bioagent for Analysis of Disease Transmission by Inanimate Objects

The phylogenetic nature within the Bacillus group allows Bacillus cereus to be used as a surrogate for Bacillus anthracis research. A total of 96 soil samples were collected in Oklahoma on a path that crossed the ecological dividing line. Pasteurization studies revealed a temperature of 70?C was ideal for treating the soil samples. This temperature eliminated extraneous microbes without inhibiting the germinating potential of B. cereus spores. Temperatures greater than 80?C were needed to inactivate spore germination. An ingestion transmission study utilizing coffee as a source showed the ease of B. cereus contamination and transmission by foodstuffs. An additional study utilized B. cereus contaminated toothbrushes for possible transmission of infection. A third study utilized doorknobs as a source of B. cereus transmission. These studies demonstrated the ease of obtaining a bioagent from an undocumented and untraceable source such as dirt and the subsequent transmission by inanimate objects.Department of Biochemistry and Molecular Biolog