Addressing the Spiritual Needs of People Aging with Dementia and/or Lifelong Disabilities

Educational Objectives 1. Present the need for spiritual care as part of holistic care for people living with dementia and/or lifelong disabilities. 2. Distinguish the difference between spirituality and religion. 3. Discuss how to assess the spiritual needs of people living with dementia and/or lifelong disabilities. 4. Show through case study examples specific ways to address the spiritual needs of people living with dementia and/or lifelong disabilities

Spirituality and the Cognitively Impaired

Educational Objectives 1. Discuss the need to acknowledge and nurture the spirituality of older adults with cognitive impainnent to enhance their health and well-being. 2. Provide tools and suggestions for use in nurturing the spirituality of older adults with cognitive impainnent. 3. Review the response of one resident with cognitive impainnent to spiritually-based programming and suppor

Simulated learning: Assessing student perceptions of skill development and employability in a criminology course

Internationally, there is an increasing focus on enhancing student employability as an outcome of successful university study (Pavlin and Svetlik 2014). While definitions of employability remain contested, the marketisation of universities in the UK and globally, (Wilton, 2014) has proliferated managerial approaches and metrics to assess student outcomes. The emergent Teaching Excellence Framework in the UK (Office for Students, 2018) intends to include graduate 'employment' within their metrics to assess teaching excellence. Thus, universities have implemented a range of approaches to developing the employability of their students, whether curricular, extra-curricular, or co-curricular. This paper will outline a rationale for developing a simulation module for criminology undergraduate students, along with a description of how the module was operationalised adopting experiential learning approaches and utilising models of reflection (Schon, 1983, Gibbs, 1988). The module was developed in partnership with practitioners, and adopted six active learning techniques to deliver student centred learning (O'Neill and McMahon 2005): outside speakers - visiting criminal justice professionals; criminal justice agency student visits; the provision of a reflective student work book; service learning in the form of opportunities for student placements; assessments designed to facilitate student reflection on their own career pathways, and an imaginary case study approach framework for the teaching delivery. Using summative assessments as a data set, a thematic analysis highlighted from students' own perspective, how their employability and skills have been developed as a consequence of undertaking the module. These include articulating transferable skills (Monks et al, 2009, Pollard et al 2015; Jackson 2016), personal growth through developing empathy and compassion and the identification of new opportunities. Finally, pragmatic

Management-intensive grazing impacts on total \u3ci\u3eEscherichia coli, E. coli\u3c/i\u3e O157: H7, and antibiotic resistance genes in a riparian stream

The impacts of management-intensive grazing (MIG) of cattle on concentrations of total Escherichia coli, total suspended solids (TSS), and nitrate-nitrite nitrogen (NO3+NO2-N), and occurrence of E. coli O157:H7 and selected antibiotic resistance genes (ARGs) in stream water and/or sediments were evaluated. Cattle were grazed for twoweek periods in May in each of three years. Overall, grazing increased total E. coli in downstream water by 0.89 log10 MPN/100 mL (p \u3c 0.0001), and downstream total E. coli concentrations were higher than upstream over all sampling intervals. Downstream TSS levels also increased (p ≤ 0.0294) during grazing. In contrast, there was a main effect of treatment for downstream NO3 + NO2-N to be lower than upstream (3.59 versus 3.70 mg/L; p = 0.0323). Overwintering mallard ducks increased total E. coli and TSS concentrations in January and February (p \u3c 0.05). For precipitation events during the 24 h before sampling, each increase of 1.00 cm of rainfall increased total E. coli by 0.49 log10 MPN/100 mL (p=0.0005). In contrast, there was no association of previous 24 h precipitation volume on TSS (p=0.1540), and there was a negative linear effect on NO3+NO2-N (p=0.0002). E. coli O157: H7 prevalence was low, but the pathogen was detected downstream up to 2½ months after grazing. Examination of ARGs sul1, ermB, blactx-m-32, and intI1 identified the need for additional research to understand the impact of grazing on the ecology of these resistance determinants in pasture-based cattle production. While E. coli remained higher in downstream water compared to upstream, MIG may reduce the magnitude of the downstream E. coli concentrations. Likewise, the MIG strategy may prevent large increases in TSS and NO3+NO2-N concentrations during heavy rain events. Results indicate that MIG can limit the negative effects of cattle grazing on stream water quality

Effects of deep sedation or general anesthesia on cardiac function in mice undergoing cardiovascular magnetic resonance

<p>Abstract</p> <p>Background</p> <p>Genetically engineered mouse models of human cardiovascular disease provide an opportunity to understand critical pathophysiological mechanisms. Cardiovascular magnetic resonance (CMR) provides precise reproducible assessment of cardiac structure and function, but, in contrast to echocardiography, requires that the animal be immobilized during image acquisition. General anesthetic regimens yield satisfactory images, but have the potential to significantly perturb cardiac function. The purpose of this study was to assess the effects of general anesthesia and a new deep sedation regimen, respectively, on cardiac function in mice as determined by CMR, and to compare them to results obtained in mildly sedated conscious mice by echocardiography.</p> <p>Results</p> <p>In 6 mildly sedated normal conscious mice assessed by echo, heart rate was 615 ± 25 min^-1(mean ± SE) and left ventricular ejection fraction (LVEF) was 0.94 ± 0.01. In the CMR studies of normal mice, heart rate was slightly lower during deep sedation with morphine/midazolam (583 ± 30 min^-1), but the difference was not statistically significant. General anesthesia with 1% inhaled isoflurane significantly depressed heart rate (468 ± 7 min^-1, p < 0.05 vs. conscious sedation). In 6 additional mice with ischemic LV failure, trends in heart rate were similar, but not statistically significant. In normal mice, deep sedation depressed LVEF (0.79 ± 0.04, p < 0.05 compared to light sedation), but to a significantly lesser extent than general anesthesia (0.60 ± 0.04, p < 0.05 vs. deep sedation).</p> <p>In mice with ischemic LV failure, ejection fraction measurements were comparable when performed during light sedation, deep sedation, and general anesthesia, respectively. Contrast-to-noise ratios were similar during deep sedation and during general anesthesia, indicating comparable image quality. Left ventricular mass measurements made by CMR during deep sedation were nearly identical to those made during general anesthesia (r²= 0.99, mean absolute difference < 4%), indicating equivalent quantitative accuracy obtained with the two methods. The imaging procedures were well-tolerated in all mice.</p> <p>Conclusion</p> <p>In mice with normal cardiac function, CMR during deep sedation causes significantly less depression of heart rate and ejection fraction than imaging during general anesthesia with isoflurane. In mice with heart failure, the sedation/anesthesia regimen had no clear impact on cardiac function. Deep sedation and general anesthesia produced CMR with comparable image quality and quantitative accuracy.</p

Hypersaline “wet patches” in Taylor Valley, Antarctica

Spatially isolated patches of soil located in Taylor Valley, McMurdo Dry Valleys, Antarctica, are sites of elevated salt content and soil moisture. During Antarctic spring, in the absence of snow melt, visibly wet (reduced albedo) patches of soil are present at the surface. The soil pore fluids are hypersaline and have average water activity of 0.74 (the water activity of a solution determines the equilibrium vapor pressure of that solution), and are an order of magnitude more saline than average soils in the Dry Valleys. These salty soils are 3–5 times more water rich than average soils. Geochemical and meteorological analyses show that these wet patches are sites of direct vapor emplacement into soil pore fluids that may ultimately be sourced by the deliquescence of soil salts. These wet patches represent a non-precipitation, non-groundwater source for water into Antarctic permafrost

In vivo visualization of age-related differences in the locus coeruleus.

The locus coeruleus (LC), the major origin of noradrenergic modulation of the central nervous system, may play an important role in neuropsychiatric disorders including Parkinson's disease and Alzheimer's disease. The pattern of age-related change of the LC across the life span is unclear. We obtained normalized, mean LC signal intensity values, that is, contrast ratios (CRs), from magnetization transfer-weighted images to investigate the relationship between LC CR and age in cognitively normal healthy adults (N = 605, age range 18-88 years). Study participants were part of the Cambridge Centre for Ageing and Neuroscience-an open-access, population-based data set. We found a quadratic relationship between LC CR and age, the peak occurring around 60 years, with no differences between males and females. Subregional analyses revealed that age-related decline in LC CR was confined to the rostral portion of the LC. Older adults showed greater variance in overall LC CR than younger adults, and the functional and clinical implications of these observed age-related differences require further investigation. Visualization of the LC in this study may inform how future scanning parameters can be optimized, and provides insight into how LC integrity changes across the life span

Garwood Valley, Antarctica: A new record of Last Glacial Maximum to Holocene glaciofluvial processes in the McMurdo Dry Valleys

We document the age and extent of late Quaternary glaciofluvial processes in Garwood Valley, McMurdo Dry Valleys, Antarctica, using mapping, stratigraphy, geochronology, and geochemical analysis of sedimentary and ice deposits. Geomorphic and stratigraphic evidence indicates damming of the valley at its Ross Sea outlet by the expanded Ross Sea ice sheet during the Last Glacial Maximum. Damming resulted in development of a proglacial lake in Garwood Valley that persisted from late Pleistocene to mid-Holocene time, and in the formation of a multilevel delta complex that overlies intact, supraglacial till and buried glacier ice detached from the Ross Sea ice sheet. Radiocarbon dating of delta deposits and inferred relationships between paleolake level and Ross Sea ice sheet grounding line positions indicate that the Ross Sea ice sheet advanced north of Garwood Valley at ca. 21.5 ka and retreated south of the valley between 7.3 and 5.5 ka. Buried ice remaining in Garwood Valley has a similar geochemical fingerprint to grounded Ross Sea ice sheet material elsewhere in the southern Dry Valleys. The sedimentary sequence in Garwood Valley preserves evidence of glaciofluvial interactions and climate-driven hydrological activity from the end of the Pleistocene through the mid-Holocene, making it an unusually complete record of climate activity and paleoenvironmental conditions from the terrestrial Antarctic

Multicenter Evaluation of the BIOFIRE Blood Culture Identification 2 Panel for Detection of Bacteria, Yeasts, and Antimicrobial Resistance Genes in Positive Blood Culture Samples

Diagnostic tools that can rapidly identify and characterize microbes growing in blood cultures are important components of clinical microbiology practice because they help to provide timely information that can be used to optimize patient management. This publication describes the bioMerieux BIOFIRE Blood Culture Identification 2 (BCID2) Panel clinical study that was submitted to the U.S. Food &amp; Drug Administration. Results obtained with the BIOFIRE BCID2 Panel were compared to standard-of-care (SoC) results, sequencing results, PCR results, and reference laboratory antimicrobial susceptibility testing results to evaluate the accuracy of its performance. Results for 1,093 retrospectively and prospectively collected positive blood culture samples were initially enrolled, and 1,074 samples met the study criteria and were included in the final analyses. The BIOFIRE BCID2 Panel demonstrated an overall sensitivity of 98.9% (1,712/1,731) and an overall specificity of 99.6% (33,592/33,711) for Gram-positive bacteria, Gram-negative bacteria and yeast targets which the panel is designed to detect. One hundred eighteen off-panel organisms, which the BIOFIRE BCID2 Panel is not designed to detect, were identified by SoC in 10.6% (114/1,074) of samples. The BIOFIRE BCID2 Panel also demonstrated an overall positive percent agreement (PPA) of 97.9% (325/332) and an overall negative percent agreement (NPA) of 99.9% (2,465/2,767) for antimicrobial resistance determinants which the panel is designed to detect. The presence or absence of resistance markers in Enterobacterales correlated closely with phenotypic susceptibility and resistance. We conclude that the BIOFIRE BCID2 Panel produced accurate results in this clinical trial