Identifying and managing constipation in older people

Constipation is a major problem in residential care. It is a condition which, if left untreated, can result in major distress and health problems for sufferers. If the condition is not detected early, then resultant interventions become increasingly complex and costly, meaning staff spend time and resources managing what could have been, a simple problem. This paper seeks to define and identify the main causes of constipation in residential care settings. It evaluates lifestyle approaches to prevention which are relevant to residential care and provides information on early detection and strategies to manage the condition. Finally, a ‘red flag’ table is identified which will support carers and nurses to identify how constipation may be an early warning sign for more complex health conditions

Measures of narrative performance in Spanish-speaking children on the test of narrative language-Spanish

textIn the field of speech-language pathology, there is an increasing need for valid and appropriate assessment measures for Spanish-speaking students that can reliably be given by examiners with a wide range of Spanish knowledge and scoring experience. In order to determine the level of detail needed to reliably score a standardized measure of Spanish narrative ability, 15 participants, ranging in Spanish proficiency and experience levels, scored six samples of the experimental version of the Test of Narrative Language-Spanish (TNL-Spanish). Consistency and accuracy of scores were compared with Spanish proficiency levels, comfort levels, and presentation method (written transcript and audio-recorded samples). Results indicated no significant effect for any factor, indicating that examiners of varying levels of Spanish proficiency and experience level can reliably and efficiently score an assessment in Spanish when provided with clear and specific scoring procedures and information regarding the kinds of errors present in language disorders in Spanish.Communication Sciences and Disorder

The Clean Air Act Amendments and Firm Investment in Pollution Abatement Equipment

The command-and-control approach to environmental regulation requires that firms install prescribed technologies to meet specified goals. However, environmental regulations change frequently; in addition, the enforcement agency cannot perfectly monitor firm compliance. We examine the impact of uncertainties surrounding the enactment and the enforcement of the Clean Air Act Amendments of 1990 on firm investment in air pollution abatement equipment. We find that our measures of the likelihood of CAAA passage clearly affect a firm's investment in pollution equipment. Enforcement actions also affect a firm's investment, but these effects are weaker and are statistically significant only after enactment

Which interval is most crucial to presentation and survival in gastroesophageal cancer: a systematic review

Aim: The aim of this study was to identify the most crucial interval to encourage earlier diagnosis in with gastroesophageal cancer and to identify potential factors effecting this interval. Background: Gastroesophageal malignancy is the eighth most commonly presenting cancer with one of the worst survival rates. Identifying the most crucial period for intervention to inform earlier diagnosis is an important step towards improving survival. Design: Mixed methods literature review. Data Sources: CINAHL, MEDLINE and Academic search primer online databases were searched using keywords and inclusion/exclusion criteria. Empirical evidence published between 2000–2016 with a focus on gastroesophageal cancer presentation and survival was reviewed to inform this study. Review methods: Twelve studies were extracted for further review. Selected studies were appraised and presented through Olensen's “delay interval” framework to inform the most crucial interval to survival in gastroesophageal cancer. Results: The findings identify the patient interval as the most critical period for encouraging earlier presentation and reducing advanced stage presentation in gastroesophageal cancer. The article also highlighted some methodological limitations to cancer research, such as a lack of consensus in definitions which prevent statistical meta-analysis of cancer data, survivor bias in gastroesophageal cancer studies and a significant lack of qualitative evidence to reveal patient experience in presenting with this cancer. Conclusion: Further research into the patient interval is required to elicit information on how and why patients present with their cancer symptoms

The Tone of Life on Social Networking Sites

Presents survey findings about American adults' views of the social and emotional climate of social networking sites, including experiences of kind or unkind behavior, those that boosted or ended a friendship, and reactions to problems

The Digital Disconnect: The Widening Gap Between Internet Savvy Students and Their Schools

Presents findings from a survey of public middle and high school students from thirty schools across the U.S. Looks at how students rely on the Internet to help them do their schoolwork, in addition to dozens of other education related tasks

Indigenous voices in climate change adaptation

AbstractThis project investigated how the deep knowledge of the Yorta Yorta people can be used to strengthen their participation and influence in the complex national and regional processes that determine how their traditional lands, which are in the highly-contested Murray-Darling Basin, are managed, leading to improved adaptation decisions both for the Yorta Yorta and the wider community.Through discussions with the Yorta Yorta over several years, the approach developed for the project was the creation of a Geographical Information System (GIS) mapping framework containing both Yorta Yorta knowledge and more conventional knowledge. GIS allows for mapping and layering of different types of data, allowing the Yorta Yorta to access and present their knowledge in ways that relate to Western decision-making processes. To do this, the project had four components:1. Development and testing of protocols and methodology for the collection and protection of Yorta Yorta knowledge. This was carried out through an intergenerational process, whereby Yorta Yorta youth were trained in cultural data collection techniques, and they interviewed Elders to capture the knowledge.2. Building of a GIS framework to integrate both the Yorta Yorta knowledge and more conventional data about the climate, hydrology and biodiversity of the Yorta Yorta area. For the first time this pulled together all of the conventional information normally used as a basis for natural resource management decisions. In addition, because the GIS database has been created and is owned by the Yorta Yorta means that they have something of value to bring to the discussions, so that they are able to participate in those discussions on equal terms.3. Exploration of the views of the broader community in the region regarding management of the region and adaptation alternatives through a stakeholder consultation process. The consultation identified the potential for greater use of science as a neutral arbiter in issues such as management of the Murray-Darling Basin, but even more important is the need for genuine, deep, open-minded dialogue with the community at all stages of decision-making, particularly at an early stage before proposals are put forward and views become entrenched.4. Identification of broader lessons for improving adaptation of First Nations communities in Australia from the experience of the Yorta Yorta and other communities around the country, through a national workshop. The key conclusion of the workshop was the urgent need to empower First Nation communities to make their own assessments and decisions on the best ways for them to respond to climate change.The project raised community awareness and knowledge and energised the Yorta Yorta youth to take an interest in their history and culture, and in the climate challenges facing their community. Overall the project has been a successful pilot demonstration of the utility of a GIS database to integrate Indigenous and conventional knowledge for better natural resource management outcomes and the project has increased the knowledge and capacity of the Yorta Yorta to engage in effective natural resource management and decision-making.Please cite this report as:Griggs, D, Lynch, A, Joachim, L, Zhu, X, Adler, C, Bischoff-Mattson, Z, Wang, P, Kestin, T 2013  Indigenous voices in climate change adaptation: Addressing the challenges of diverse knowledge systems in the Barmah-Millewa, National Climate Change Adaptation Research Facility, Gold Coast, pp.71AbstractThis project investigated how the deep knowledge of the Yorta Yorta people can be used to strengthen their participation and influence in the complex national and regional processes that determine how their traditional lands, which are in the highly-contested Murray-Darling Basin, are managed, leading to improved adaptation decisions both for the Yorta Yorta and the wider community.Through discussions with the Yorta Yorta over several years, the approach developed for the project was the creation of a Geographical Information System (GIS) mapping framework containing both Yorta Yorta knowledge and more conventional knowledge. GIS allows for mapping and layering of different types of data, allowing the Yorta Yorta to access and present their knowledge in ways that relate to Western decision-making processes. To do this, the project had four components:Development and testing of protocols and methodology for the collection and protection of Yorta Yorta knowledge. This was carried out through an intergenerational process, whereby Yorta Yorta youth were trained in cultural data collection techniques, and they interviewed Elders to capture the knowledge.Building of a GIS framework to integrate both the Yorta Yorta knowledge and more conventional data about the climate, hydrology and biodiversity of the Yorta Yorta area. For the first time this pulled together all of the conventional information normally used as a basis for natural resource management decisions. In addition, because the GIS database has been created and is owned by the Yorta Yorta means that they have something of value to bring to the discussions, so that they are able to participate in those discussions on equal terms.Exploration of the views of the broader community in the region regarding management of the region and adaptation alternatives through a stakeholder consultation process. The consultation identified the potential for greater use of science as a neutral arbiter in issues such as management of the Murray-Darling Basin, but even more important is the need for genuine, deep, open-minded dialogue with the community at all stages of decision-making, particularly at an early stage before proposals are put forward and views become entrenched.Identification of broader lessons for improving adaptation of First Nations communities in Australia from the experience of the Yorta Yorta and other communities around the country, through a national workshop. The key conclusion of the workshop was the urgent need to empower First Nation communities to make their own assessments and decisions on the best ways for them to respond to climate change.The project raised community awareness and knowledge and energised the Yorta Yorta youth to take an interest in their history and culture, and in the climate challenges facing their community. Overall the project has been a successful pilot demonstration of the utility of a GIS database to integrate Indigenous and conventional knowledge for better natural resource management outcomes and the project has increased the knowledge and capacity of the Yorta Yorta to engage in effective natural resource management and decision-making

A case study of survival and presentation of gastroesophageal cancer in local neighbourhoods

This thesis presents a quantitative case study on incidence, survival and presentation of patients diagnosed with gastroesophageal cancer to evaluate whether where people live affects how they present and survive with a gastroesophageal cancer diagnosis. The focus research evolved from studies on gastroesophageal cancer’s ‘geographic affiliation’ and a desire to review whether patient and population attributes could be harnessed to reveal potential ‘hotspots’ to inform targeted health intervention strategies. As the most crucial stage for intervention was associated with patients detecting symptoms early enough for intervention, the focus of this case study was narrowed to survival and presentation.This research analysed data from 2785 patients who presented to a regional referral specialist cancer treatment centre between the years 2000 and 2013. Cohort analysis revealed common attributes and survival, and data were merged with demographic information in a geographic information system to present findings in mapped format.Descriptive analysis revealed an association between later stage presentation and reduced survival outcome. Emergency presentations tended to have worse outcomes. Survival deteriorated with advancing age. Gastroesophageal cancer diagnoses in the under 54 age group was more common in lower socioeconomic groups and survival outcomes were marginally lower than in those patients from the least deprived areas. Spatial analysis revealed variation in incidence, presentation and survival across the region. Though this case study revealed several new findings on gastroesophageal cancer presentation and survival, there remains no single solution to informing and encouraging earlier diagnosis interventions. Though presenting data at finer scales of resolution is more clinically relevant, it threatens patient confidentiality