Living with an acquired brain injury. Barriers and facilitators to developing community supports as a basis for independent living: the experiences and perceptions of people with acquired brain injury

This study found that natural community supports were comprised of two distinct groupings; firstly immediate families, friends and peer support groups; secondly neighbours and local community groups such as sporting and activity- based organisations and groups. The findings of this study indicate that living with acquired brain injury involves a process where the person moves from acute high intensity health services onto rehabilitative services and then onto re-establishing independent lives. It is evident that smooth transitions and interconnectivity of services are essential in facilitating this recovery process. Instrumental to the recovery is the support of immediate family and close friends, who form people’s immediate natural support network and go a long way towards facilitating individuals in rebuilding their lives. A key finding of this study is that broader natural community supports do not appear to play as central a role in supporting individuals to live independent lives when compared to the role of family and friends. The lack of involvement of broader community groups, in many ways, prompted individuals to contact formal support services. For the majority of participants, independence is facilitated through the combination of immediate natural community supports and formal services. The role of formal support services is key to developing broader community support networks. This study found a blurred division between formal services and broader community support networks. The authors recommended that the role of formal supports services in acting as a bridge between the needs of the individual and the development of meaningful community networks, be formally recognised and further developed. Additionally, they argued that the importance of the role of broader natural community, supports such as those provided by community and sporting groups must be enhanced. Greater awareness of the issues faced by people living with acquired brain injury and its often invisible nature is necessary in this endeavour. The authors stated it is important to recognise that there are multiple issues impacting on independent living and these issues intersect, for instance with age, gender, employment, qualifications and so on. A lack of public awareness of acquired brain injury was found to be a key barrier to independent living, along with issues relating to socialising, access to employment and finances. The findings of this study reflect the complexities of living with acquired brain injury and the need for holistic support that is cognisant of the factors which impact on integration. It is vital that flexible, personalised services are developed which are fit for purpose and meet the needs of not only people with acquired brain injury but also their immediate natural community support network. Recognition of the intersection between immediate/ broader natural community supports and formal services is also key to developing the comprehensive and practical supports required to achieve an independent life. This was a qualitative study and all participants were sourced through Headway, a community based service provider for people with ABI. Data collection was divided into two stages: firstly focus groups, followed by individual interviews. Four focus groups were convened in Cork (2), Dublin (1) and Limerick (1). Each focus group was facilitated by at least two members of the research team and a total of twenty-six individuals participated in the focus groups. Thematic analysis of the data was undertaken to guide and inform the second stage of the study; the individual interviews. Ten interviews were undertaken with individuals who presented with ABI in the Cork and Limerick regions

Transmission and lineage displacement drive rapid population genomic flux in cystic fibrosis airway infections of a Pseudomonas aeruginosa epidemic strain

Pseudomonas aeruginosa chronic infections of cystic fibrosis (CF) airways are a paradigm for within-host evolution with abundant evidence for rapid evolutionary adaptation and diversification. Recently emerged transmissible strains have spread globally, with the Liverpool Epidemic Strain (LES) the most common strain infecting the UK CF population. Previously we have shown that highly divergent lineages of LES can be found within a single infection, consistent with super-infection among a cross-sectional cohort of patients. However, despite its clinical importance, little is known about the impact of transmission on the genetic structure of these infections over time. To characterize this, we longitudinally sampled a meta-population of 15 genetic lineages within the LES over 13 months among seven chronically infected CF patients by genome sequencing. Comparative genome analyses of P. aeruginosa populations revealed that the presence of coexisting lineages contributed more to genetic diversity within an infection than diversification in situ. We observed rapid and substantial shifts in the relative abundance of lineages and replacement of dominant lineages, likely to represent super-infection by repeated transmissions. Lineage dynamics within patients led to rapid changes in the frequencies of mutations across suites of linked loci carried by each lineage. Many loci were associated with important infection phenotypes such as antibiotic resistance, mucoidy and quorum sensing, and were repeatedly mutated in different lineages. These findings suggest that transmission leads to rapid shifts in the genetic structure of CF infections, including in clinically important phenotypes such as antimicrobial resistance, and is likely to impede accurate diagnosis and treatment

The Effects of Incubation Humidity on Broiler Chicks

Leg health issues are a welfare problem in commercial broiler chickens and an economic issue for the broiler industry. Broilers exhibiting leg abnormalities show altered gait, reduced ability to access resources, and increased lameness incidence. These leg health issues can result from many animal and environmental factors during incubation and post-hatch. Incubation strategies may contribute to the development of leg health issues, and recent research has increased focus on incubation factors affecting embryonic development and health and welfare post-hatch. Thus, the objective of this study was to evaluate the effect of high (80%), low (55%), and ideal (65%) humidity on broilers behavior and leg health. From day 7 on, males had a greater (p£0.03) body weight than females for the entire population of birds. Yet no sex differences were found for birds tested for fear behavior in the emergence and isolation tests and bone morphology. While there were no significant differences between treatment or sexes for the emergence test, it was interesting to see that of the 30 focal chicks, 15 did emerge, and 15 did not. Females were more successful (57%) at escaping the bucket than males (13%) in the isolation test (p=0.01). Regarding the bone morphology, tibial volume was greater (

The Effects of Incubation Humidity on Broiler Chicks

Leg health issues are a welfare problem in commercial broiler chickens and an economic issue for the broiler industry. Broilers exhibiting leg abnormalities show altered gait, reduced ability to access resources, and increased lameness incidence. These leg health issues can result from many animal and environmental factors during incubation and post-hatch. Incubation strategies may contribute to the development of leg health issues, and recent research has increased focus on incubation factors affecting embryonic development and health and welfare post-hatch. Thus, the objective of this study was to evaluate the effect of high (80%), low (55%), and ideal (65%) humidity on broilers behavior and leg health. From day 7 on, males had a greater (p£0.03) body weight than females for the entire population of birds. Yet no sex differences were found for birds tested for fear behavior in the emergence and isolation tests and bone morphology. While there were no significant differences between treatment or sexes for the emergence test, it was interesting to see that of the 30 focal chicks, 15 did emerge, and 15 did not. Females were more successful (57%) at escaping the bucket than males (13%) in the isolation test (p=0.01). Regarding the bone morphology, tibial volume was greater (

Implementing theory of planned behavior in health profession education in Ghana

The process of clinical knowledge translation contributes to clinical decision-making along with interactions with other healthcare professionals, their patients, and the communities they serve. Clinical practice guidelines, patient care experience, and continuing medical education are some of the components that contribute to clinical knowledge translation. The knowledge and interactions help inform a physician’s salient beliefs. Thus, the use of the Theory of Planned Behavior (TPB) facilitates research into how background factors which include knowledge and interactions influence behavioral, normative, and control beliefs and in turn, how those beliefs influence intention and ultimately, physician clinical practice behavior

An Investigation into Ghanaian Primary Care Physicians’ Beliefs and Their Influence on Clinical Knowledge Translation

ABSTRACT AN INVESTIGATION INTO GHANAIAN PRIMARY CARE PHYSICIANS’ BELIEFS AND THEIR INFLUENCE ON CLINICAL KNOWLEDGE TRANSLATION by Linda D. Caples The University of Wisconsin-Milwaukee, 2019 Under the Supervision of Professor Barbara Daley, PhD There is a disconnect between the use of evidence-based clinical practice guidelines and the medical practice of Ghanaian primary care physicians in the care of hypertensive patients. This study sought to answer the question of how the formal and informal beliefs of Ghanaian primary care physicians influence clinical knowledge translation in the management of hypertension in adults. The process of clinical knowledge translation helps physicians construct knowledge along with interactions with other healthcare professionals, their patients, and the communities they serve. These interactions help inform a physician’s salient beliefs. Thus, the use of the Theory of Planned Behavior (TPB) facilitated research into how background factors influenced behavioral, normative, and control beliefs and in turn, how those beliefs influenced intentions and ultimately, physician behavior. Findings in the form of six themes illustrate the importance of culture and context in shaping the beliefs of how primary care physicians saw their patients and how they translated clinical knowledge into medical practice. The background factors such as a physician’s gender, medical school training, clinical setting, health sector, specialty, and years in practice had some influence on beliefs. However, the patient population significantly influenced their beliefs particularly their interactions with patients within the culture and context of Ghana. Additionally, clinical knowledge translation is supported using continuing medication education (CME) as a primary channel of knowledge translation and as a means to educate physicians and other health care professionals about clinical practice guidelines. Incorporating culture and context into the development of CME content is important for effective clinical knowledge translation and improved patient care. This is particularly important in medically pluralistic societies such as Ghana, where primary care physicians are few and traditional medical practitioners are prevalent. Implications of this research may shape policy, future CME content development, and CME research

An Interdisciplinary, Teaming Approach to History and English Instruction at the Secondary Level

The relationship of integrating history and English objectives to enhance student achievement was studied. A model curriculum has been developed to connect U.S. History and American Literature content. Research has been obtained that indicates improved student learning when subjects are integrated in a relevant fashion. Secondary schools using interdisciplinary curriculum are showing improved GPA\u27s, attendance and standardized test scores. Secondary teachers must align their daily lesson plans and assessments with the state essential learning\u27s in both the history and language arts area