834 research outputs found
I'm a celebrity, get me into politics: the political celebrity and the celebrity politician
This chapter discusses the political celebrity and the celebrity politician
Caregiver Evaluation of the Quality of End-Of-Life Care (CEQUEL) Scale: The Caregiver's Perception of Patient Care Near Death
Purpose End-of-life (EOL) measures are limited in capturing caregiver assessment of the quality of EOL care. Because none include caregiver perception of patient suffering or prolongation of death, we sought to develop and validate the Caregiver Evaluation of Quality of End-of-Life Care (CEQUEL) scale to include these dimensions of caregiver-perceived quality of EOL care. Patients and Methods Data were derived from Coping with Cancer (CwC), a multisite, prospective, longitudinal study of advanced cancer patients and their caregivers (N = 275 dyads). Caregivers were assessed before and after patient deaths. CEQUEL's factor structure was examined; reliability was evaluated using Cronbach's α, and convergent validity by the strength of associations between CEQUEL scores and key EOL outcomes. Results: Factor analysis revealed four distinct factors: Prolongation of Death, Perceived Suffering, Shared Decision-Making, and Preparation for the Death. Each item loaded strongly on only a single factor. The 13-item CEQUEL and its subscales showed moderate to acceptable Cronbach's α (range: 0.52â0.78). 53% of caregivers reported patients suffering more than expected. Higher CEQUEL scores were positively associated with therapeutic alliance (Ï = .13; pâ€.05) and hospice enrollment (z = â2.09; pâ€.05), and negatively associated with bereaved caregiver regret (Ï = â.36, pâ€.001) and a diagnosis of Posttraumatic Stress Disorder (z = â2.06; pâ€.05). Conclusion: CEQUEL is a brief, valid measure of quality of EOL care from the caregiver's perspective. It is the first scale to include perceived suffering and prolongation of death. If validated in future work, it may prove a useful quality indicator for the delivery of EOL care and a risk indicator for poor bereavement adjustment
Cumulative harm and chronic child maltreatment
In this paper, cumulative harm is defined, past approaches that have contributed to conceptualising maltreatment as an isolated event are discussed. Possible indicators of chronic maltreatment are highlighted and the potential for chronic maltreatment to have a cumulative impact on children is demonstrated using a case example. The paper focuses on the Victorian context, but the issues of cumulative harm and chronic child maltreatment have relevance to policy-makers and practitioners in other jurisdictions
Is the Waiting the Hardest Part?: How Cancer Family Caregivers Experience Quality of Care at the End of Life
Thesis advisor: Kathleen McInnis-DittrichCancer caregivers are key stakeholders across the cancer trajectory, particularly in the final weeks of life and the bereavement period that follows. Current measures are limited in capturing caregiver assessment of the quality of end-of-life (EOL) care. Because none include caregiver perception of patient suffering or prolongation of death, the author sought to develop and validate a new measure of caregiver-perceived quality of EOL care that includes these dimensions. Data for this study comes from Coping with Cancer (CwC), a multisite, prospective, longitudinal study of advanced cancer patients and their caregivers (N=275 dyads). CwC investigators interviewed cancer patients and caregivers prior to the patient's death, and then caregivers again following the patient's death, on a range of psychosocial issues related to EOL care and bereavement. The present study represents a refinement of the author's previous work in developing and validating the Caregiver Evaluation of Quality of End-of-Life Care (CEQUEL) scale, a comprehensive measure of caregiver-perceived quality of EOL care. Factor analysis revealed four distinct factors: Prolongation of Death, Perceived Suffering, Shared Decision-Making, and Preparation for the Death. Each item loaded strongly on only a single factor. The author examined the new measure's factor structure, and evaluated its reliability (using Cronbach's α) and convergent validity (via associations between CEQUEL and key EOL outcomes). CEQUEL and its subscales showed moderate to acceptable Cronbach's α (range: 0.52-0.78). Higher scores (indicating better perceived quality of care) were positively associated with therapeutic alliance (Ï=.13; pâ€.05) and hospice enrollment (z=-2.09; â€;.05), and negatively associated with bereaved caregiver regret (Ï=-.36, pâ€.001) and a diagnosis of Posttraumatic Stress Disorder (z=-2.06; pâ€.05). Scores did not vary by caregiver characteristics other than religious affiliation, with Catholics scoring lower than non-Catholics, and those without religious affiliation scoring lower than those with an affiliation. Models predicting CEQUEL scores were compared using multiple regression analysis and AICc values. In unadjusted analyses, dying in a hospital, inpatient hospice length of stay (LOS) < 1 week, patients feeling seen as a whole person by their physician, and caregiver religiosity predicted CEQUEL scores. Only dying in a hospital (B=-1.65, SE=0.42, p=0.000) and inpatient hospice LOS < 1 week (B=-1.87, SE=-.69, p=0.008) remained significant in adjusted analysis. These findings suggest that CEQUEL is a brief, valid measure of quality of EOL care from the caregiver's perspective. This study also identifies key factors that can be modified to improve caregiver evaluation of quality of care and associated bereavement outcomes. CEQUEL is the first scale of its kind to include perceived suffering and prolongation of death. If validated in future work, it may prove a useful quality indicator for the delivery of EOL care and a risk indicator for poor bereavement adjustment. Implications for research, clinical practice and policy are discussed.Thesis (PhD) â Boston College, 2013.Submitted to: Boston College. Graduate School of Social Work.Discipline: Social Work
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Using genomic DNA-based probe-selection to improve the sensitivity of high-density oligonucleotide arrays when applied to heterologous species
High-density oligonucleotide (oligo) arrays are a powerful tool for transcript profiling. Arrays based on GeneChipÂź technology are amongst the most widely used, although GeneChipÂź arrays are currently available for only a small number of plant and animal species. Thus, we have developed a method to improve the sensitivity of high-density oligonucleotide arrays when applied to heterologous species and tested the method by analysing the transcriptome of Brassica oleracea L., a species for which no GeneChipÂź array is available, using a GeneChipÂź array designed for Arabidopsis thaliana (L.) Heynh. Genomic DNA from B. oleracea was labelled and hybridised to the ATH1-121501 GeneChipÂź array. Arabidopsis thaliana probe-pairs that hybridised to the B. oleracea genomic DNA on the basis of the perfect-match (PM) probe signal were then selected for subsequent B. oleracea transcriptome analysis using a .cel file parser script to generate probe mask files. The transcriptional response of B. oleracea to a mineral nutrient (phosphorus; P) stress was quantified using probe mask files generated for a wide range of gDNA hybridisation intensity thresholds. An example probe mask file generated with a gDNA hybridisation intensity threshold of 400 removed > 68 % of the available PM probes from the analysis but retained >96 % of available A. thaliana probe-sets. Ninety-nine of these genes were then identified as significantly regulated under P stress in B. oleracea, including the homologues of P stress responsive genes in A. thaliana. Increasing the gDNA hybridisation intensity thresholds up to 500 for probe-selection increased the sensitivity of the GeneChipÂź array to detect regulation of gene expression in B. oleracea under P stress by up to 13-fold. Our open-source software to create probe mask files is freely available http://affymetrix.arabidopsis.info/xspecies/ webcite and may be used to facilitate transcriptomic analyses of a wide range of plant and animal species in the absence of custom arrays
Population decline is linked to migration route in the Common Cuckoo
Migratory species are in rapid decline globally. Although most mortality in long-distance migrant birds is thought to occur during migration, evidence of conditions on migration affecting breeding population sizes has been completely lacking. We addressed this by tracking 42 male Common Cuckoos from the rapidly declining UK population during 56 autumn migrations in 2011â14. Uniquely, the birds use two distinct routes to reach the same wintering grounds, allowing assessment of survival during migration independently of origin and destination. Mortality up to completion of the Sahara crossing (the major ecological barrier encountered in both routes) is higher for birds using the shorter route. The proportion of birds using this route strongly correlates with population decline across nine local breeding populations. Knowledge of variability in migratory behaviour and performance linked to robust population change data may therefore be necessary to understand population declines of migratory species and efficiently target conservation resources
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