Many interventions designed to meet physical activity guideline recommendations focus on a single component (e.g., walking), to the detriment of other elements of a healthy lifestyle, such as reducing prolonged sitting and doing balance and strength exercises (i.e., bundled multiple behaviors). Adopting these multiple health behaviors within daily life routines may facilitate uptake and support longer-term behavior change. We tested feasibility for a three-part lifestyle intervention to support older women to sit less, move more, and complete balance and strength exercises.We used a convergent parallel mixed-methods, single-arm study design to test feasibility for a 6-week lifestyle intervention: Return to Everyday Activities in the Community and Home (REACH). We collected information at baseline, 3 and 6 weeks (final), and 6 months (follow-up) using questionnaires, semi-structured interviews, and performance-based measures. We describe three key elements: (1) implementation factors such as recruitment, retention, program delivery, and adherence; (2) participants' acceptability and experience with the program; and (3) health outcomes, including participants' global mobility, activity, and perceptions of their physical activity identity, and habit strength for (i) physical activity, (ii) breaking up sitting time, and (iii) balance and strength exercises.We were able to recruit enough participants in the allotted time to conduct one cycle of the REACH group-based program. There were 10 community-dwelling women, median (p25, p75) age 61 (57.5, 71) years, who completed the study. The program was feasible to deliver, with high attendance (mean 5/6 sessions) and positive overall ratings (8/10). Participants rated session content and length high, and educational materials as highly acceptable and understandable. Although participants were active walkers at baseline, few were breaking up prolonged sitting or participating in any balance and strength exercises. At final and follow-up assessments, participants reported developing habits for all three health behaviors, without diminishing physical activity.These results show acceptability of the program and its materials, and feasibility for bundling multiple health behaviors within the REACH program. It also provides confirmation to advance to testing feasibility of this three-part lifestyle intervention with older, less active, adults.ClinicalTrials.gov Identifier, NCT02786394; May 18, 2016.
To discuss the unmet needs of patients living with advanced cancer and their caregivers and to review strategies, including collaborating with community and non-profit organizations, to help improve the experience of living with, and beyond, advanced cancer.Published articles, first person experience (SB), community organization input, and survey data (Canadian Cancer Society).People living with advanced cancer face significant challenges, including persistent physical symptoms and psychosocial concerns, difficulties with coordination of care, and possible lack of available resources and supports if the person is no longer being followed by cancer health care professionals. More research is required to better understand the needs of patients and their caregivers living with advanced cancer. Existing resources and supports may be inadequate for this population, and delineation of the unique needs of this population may lead to tailored care plans and, ultimately, an improved experience for patients and caregivers alike.Oncology nurses are ideally suited to care for this population to help elucidate their unique unmet needs and collaborate with patients and other clinicians to develop interventions to address such unmet needs. Oncology nurses can liaise with community organizations to identify sources of support and resources for patients and their loved ones and advocate for improved care for patients affected by advanced cancer.
ABSTRACT More than 100 steeply dipping or vertical Mesozoic fault zones, which cut across Paleozoic igneous and metamorphic rocks, have been reported in the Piedmont and Appalachians of the Carolinas. The present investigation deals with the hydrological problems encountered in exploring for ground water in the Pax Mountain Fault zone. This is the largest known Mesozoic fault in the Carolinas, having a length of more than 75 km and attaining a width of 1 km in places. Subsurface studies of seven wells, which were drilled along the axis of Pax Mountain, South Carolina, show that the composition of the fault rocks is much more complicated than was known heretofore. These rocks consist of angular particles of quartz and feldspar fault breccia enclosed in a kaolinitic clay gouge. They vary greatly in degrees of consolidation and permeability, and these variations were the cause of some serious ground‐water problems. Two wells were dry holes because the intergranular spaces of the breccia were clogged with clay and also because most of the joints were filled with secondary minerals. Three wells, which were drilled in more permeable, but poorly consolidated fault rocks, caved in at a depth of about 80 m just when they had encountered large volumes of water. Two of the seven wells produce potable water, but chemical analyses of the ground water showed that their turbidity values were 6.0 t.u. and 2.0 t.u., which exceed the limit of 1.0 recommended by the South Carolina Department of Health and Environmental Control.
Environmental factors associated with deep chlorophyll maximum (DCM) layers were examined in five lakes of the McMurdo Dry Valleys, Antarctica, to test the hypothesis that DCM are more closely associated with resource limitations than water density. Because data could not be transformed to meet the assumption of normal distribution, distance matrices were constructed from vectors of observed chlorophyll-a (CHL), photosynthetic active radiation intensity (PAR), soluble reactive phosphorous (SRP), dissolved inorganic nitrogen (DIN), dissolved oxygen (DO), water density (DEN), and incremental change in water density/depth (DEL). Multiple regression analyses then were based on permutation evaluations of the relationships between distance matrices (partial Mantel analyses). Results indicated that resource availability (PAR and DIN) was most frequently related to chlorophyll-a, although DEN and DEL often were significant within individual lakes. Hence, resource relationships were strongest across lakes and seasons whereas density relationships also were important within individual lakes. Moreover, DCM appeared sensitive to threshold levels of DEN and PAR, suggesting that controls may exist as both discrete (threshold) and continuous functions of both resource availability and water density.
Young adults (YAs), defined as individuals between the ages of 18 and 39 years, experience unique challenges when diagnosed with advanced cancer. Using the social constructivist grounded theory approach, we aimed to develop a theoretical understanding of how YAs live day to day with their diagnosis. A sample of 25 YAs (aged 22–39 years) with advanced cancer from across Canada participated in semi-structured interviews. Findings illustrate that the YAs described day-to-day life as an oscillating experience swinging between two opposing disease outcomes: (1) hoping for a cure and (2) facing the possibility of premature death. Oscillating between these potential outcomes was characterized as living in a liminal space wherein participants were unsure how to live from one day to the next. The participants oscillated at various rates, with different factors influencing the rate of oscillation, including inconsistent and poor messaging from their oncologists or treatment team, progression or regression of their cancer, and changes in their physical functioning and mental health. These findings provide a theoretical framework for designing interventions to help YAs adapt to their circumstance.
This is the story of how communications changed drink driving behaviour over the course of thirty years from 1979 to 2009. Four successive periods of communication tackled drink driving attitudes, acceptability, denial and decisions. This relentless pursuit of potential drink drivers saved almost 2,000 lives and prevented over 10,000 serious injuries. The value of this to society is £3bn. We estimate that for periods two, three and four of the campaign, every £1 spent on communications saved society £154, £12 and £38 respectively. The campaign offers powerful learning for all who seek to change behaviour over the long term.
A follow-up study has been conducted on 27 patients who had infantile spasms and normal electroencephalograms before the age of 1 year, and who did not have hypsarhythmia, the electroencephalographic abnormality which is usual in this condition. The purpose of the study was to determine whether the absence of electroencephalographic abnormality alters the prognosis. Less than half of the patients were found to be physically or mentally retarded and only one quarter still had seizures, which is somewhat better than was previously reported for cases with hypsarhythmia. However, the difference in prognosis is most evident as regards mental development: The present data indicate that there is a 55% chance that a child with infantile spasms and a normal electroencephalogram will develop normal mentality; the chance is only 15% with hypsarhythmia.
