Nurses' pain management practices in Ontario long-term care homes

Pain is the most prevalent medical problem that elderly persons experience in a long-term care home. Nurses play an essential role in managing their pain. The purpose of this study was to explore nurses’ pain management practices in Ontario long-term care homes facilities. The ultimate aim was to recommend measures for effective pain management in aged people. The setting for this study was a selected long-term care home in Ontario, Canada, a 160-bed nursing home for aged people offering various medical care services. Semi-structured focus group interviews, averaging approximately one hour, were conducted. The population of this study was 45 nurses. The researcher used a purposive sampling method to select a sample of 25 nurses. Open-ended questions were used to explore pain management practices and to find barriers to effective pain management. Qualitative data analysis was used to review the data to identify common issues that recurred, and they were summarised in a narrative form. This study demonstrated the importance of recognising and overcoming barriers to the effective management of pain and reinforcing good practices in long-term care homes. Therefore, improved pain management practices are required to manage pain in a long-term care home effectively.Health StudiesM.A. (Nursing Sciences

Using Superatomic Clusters and Charge Transfer Ligands to Control Electronic Characteristics of Phosphorene Nanoribbons and Phosphorene Monolayer

Phosphorene is a two-dimensional electron poor p-type semiconductor with high carrier mobility and great promise for applications in electronics and optoelectronics. As the main theme in this dissertation, the following work represents different investigations of various electronic properties associated with phosphorene. Most notable are the findings on charge transfer doping with metal-chalcogenide superatoms which displays novel control of the two most important properties of a semiconductor – the band gap energy and the nature of carriers. By tuning the width of the gap and p-/n-type character of conduction, we gain control over a material’s capacity to play a certain role upon incorporation into a device setting. For example, control of bandgap characteristics on the nanometer and sub-nanometer scale is an integral next step for scientists and engineers to move beyond the current size limit of logic transistors. Additionally, improving the function of optoelectronics leading to a variety of positive enhancements in sensing devices spanning a wide array of fields from specialized medical devices to ubiquitous consumer electronics. Another possibility is fine-tuning photovoltaic devices to increase efficiency or expand the energy range which a solar panel may harvest light, subsequently increasing overall output – a vital component to our transition and continued improvement of renewable energy technologies

Innovation in Agile and Waterfall project management: a qualitative analysis.

Viene sviluppato un esperimento comportamentale per confrontare gli approcci al PM. Lo scopo è analizzare se le persone si comportano diversamente e come questo influenzi i risultati. Si dimostra che l'approccio Agile è più efficiente e meno rischioso, e consente di arrivare a un picco di performance più alto. Nell'approccio Waterfall i risultati sono più bassi a causa di livelli di motivazione e sfida insufficienti

Decolonizing Psychotherapy

This project aims to increase the use and inclusivity of mental health services within marginalized communities by providing education and training tools on the use and application of integrative mental health approaches. It is an offering of guidance, providing a culturally responsive framework for integrating yoga into psychotherapy. The manual aims to reduce systemic, colonialist, barriers to mental health services. This project is founded on the basis that mono-cultural foundations in traditional psychotherapeutic treatments negatively impact the attitudes and beliefs of service seekers, typically within excluded groups. Systems Theory and Critical Race Theory and Social Justice principles inform the application framework, reinforcing why this focus is critically significant. The project includes a somatic protocol and treatment manual. The Mind-Body Manual (MBM) is designed to support mental health and wellness professionals with implementing the Mind-Body Protocol as a yoga-psychotherapy treatment plan intervention informed by the cultural nuances and needs of people of color. While the Mind-Body Protocol can be used with all ethnicities, races, groups, and identities, it may be particularly helpful when used with marginalized, silenced, and overlooked groups. These groups include racial minorities, women, LGBTQ+, individuals with disabilities, refugees, economically disadvantaged people, and first-generation families. The MBM includes four components: Intention- the foundation and history of the intervention, Implementation- guidance on implementing the Mind-Body Protocol: a yoga psychotherapy approach, Introspection- reflective yoga-psychotherapy prompts, and Instruments- treatment plan supports and learning resource

A deeper understanding of service users’ needs, self-management support and user involvement in Healthy Life Centres: A qualitative study on lifestyle change in persons with overweight or obesity

Background: Worldwide, including Norway, overweight and obesity present some of the greatest health challenges. Since the 1980s, the incidence has tripled, leading to a subsequent high prevalence of chronic lifestyle diseases or non-communicable diseases (NCDs), such as cardiovascular disorder, diabetes type 2, some types of cancer, muscle and skeleton disorders and mental health challenges. This has led to an increased focus on lifestyle interventions that emphasise self-management of the condition, as well as the need for users to be readily involved and participating. Therefore, self-management support (SMS) and user involvement have become two important concepts in health services in today’s society. The Norwegian Directorate of Health recommended the establishment of Healthy Life Centres (HLCs) in all municipalities to help facilitate and empower people to obtain a greater mastery of the health challenges they face. HLCs assist persons at risk of NCDs or those in need of support for health behaviour changes or weight management. Behaviour change refers to efforts to change people’s personal habits to prevent disease. The purpose of these self-management interventions is mainly to promote and improve people’s physical activity and diets. There is no clear way of addressing overweight and obesity in primary care; knowledge regarding lifestyle interventions in HLCs and what works is still sparse and needs further investigation. Aim: The overall aim of this PhD-study was to contribute to a deeper understanding of service users’ needs, beneficial SMS and user involvement in lifestyle interventions in Norwegian primary care HLCs. The study explored adult service users’ and healthcare professionals’ (HPs) experiences and perceptions of these phenomena. Three sub-studies were conducted. The aim of the first study was to explore HLC service users’ experiences of living with overweight or obesity and their perceptions of seeking help to change dietary and activity habits. The second study aimed to explore service users’ experiences of beneficial SMS and user involvement. The aim of the third study was to explore how HPs provide SMS and what user involvement implies for HPs in HLCs. Methods: This study involved a qualitative, explorative and interpretative design grounded in hermeneutic methodology and tradition. Semi-structured in-depth interviews with service users participating in lifestyle interventions in HLCs were conducted and analysed using qualitative content analysis. A total of 13 service users (five men and eight women), aged 30-69, from five different HLCs, participated (Papers I and II). Focus groups were used to collect data from healthcare professionals working in HLCs and this was analysed using thematic analysis. 10 healthcare professionals from eight different HLCs participated in two focus group interviews (Paper III). Results: The analysis of the first study (Paper I) resulted in one main theme: Searching for dignity, which could be split into two themes: 1) Needing to justify avoidance of personal responsibility and 2) A desire to change. In the second study (Paper II), one main theme was identified: Regaining self-esteem and dignity through active involvement and long-term self-worth support in partnership with others. This main theme comprised four themes: 1) Selfefficacy through active involvement and better perceived health, 2) Valued through HPs acknowledgement, equality and individualised support, 3) Increased motivation and self-belief through fellowship and peer support and 4) Maintenance of lifestyle change through accessibility and long-term support. The analysis in the third study (Paper III) resulted in one overall theme: A partnership based on ethical awareness, a non-judgemental attitude, dialogue and shared responsibility, comprising four interrelated themes: 1) Supporting self-efficacy, self-worth and dignity through an attitude of respect, acknowledgement and generosity, 2) Promoting self-belief and self-perceived health, 3) Collaborating and sharing responsibility and 4) Being flexible, adjusting and sharing time. Conclusion and implications for practice: A synthesis of the findings in the three papers can provide a deeper understanding of service users’ needs, beneficial SMS and user involvement by means of three new themes. The first theme, The dual face of responsibility in health – the burden and the value is based on the service user’s search for dignity and the emotional alternation between shame, guilt and pride. This duality can be understood as a burden of shame and weight stigma that influence the user’s capability to assume personal responsibility. The value can be understood as a perception of dignity, pride, active involvement and assuming responsibility. HPs need to address self-conscious feelings like guilt, shame and internalised stigma, as well as responsibility related to dilemmas about right and wrong lifestyles. The second theme, The art of acting ethically seems to be an integrated attitude of beneficence in HPs’ practice and is demonstrated by their capability to engage in a person-centred approach and to see the service users’ existential needs in a vulnerable situation. HPs’ self-worth support is based on ethical awareness, a non-judgemental attitude, dialogue and shared responsibility. This may help the service users to increase their self-efficacy and self-management and regain their integrity, self-respect and dignity. The last theme, The challenges and possibilities in sharing responsibility, is built on the findings related to HPs treating service users as equal partners in a collaborative partnership based on shared responsibility. The challenges are related to the need for long-term follow-up, emotional and social support, personal responsibility in an obesitypromoting environment and structural and political responsibility. An important therapeutic mechanism in beneficial SMS and user involvement may lie in the possibility of sharing responsibility, which may reduce the burden of personal responsibility, shame, guilt and weight stigma. This may also increase self-efficacy and help service users live a healthier life and experience a better quality of life and wellbeing. Accordingly, there is a possibility of sharing responsibility at a relational level and to highlight collective approaches from a socio-ecological perspective

Backtranslation of EEG biomarkers of Alzheimer's disease from patients to mouse model

The present Ph.D. thesis has been mainly developed on the data of the project with the short name PharmaCog (2010-2015), granted by the European Framework Programme 7 with about 28 millions of Euro (i.e. Innovative Medicine Initiative, IMI, grant agreement n°115009; www.pharmacog.org). This project involved 15 academic institutions, 12 global pharmaceutical companies, and 5 small and medium sized enterprises (SMEs). The PharmaCog project aimed at improving the pathway of drug discovery in Alzheimer’s disease (AD), based on a major interest of pharma companies, namely the validation of electrophysiological, neuroimaging, and blood biomarkers possibly sensitive to the effect of disease-modifying drugs reducing Ab42 in the brain in AD patients at the prodromal stage of amnesic mild cognitive impairment (aMCI). The core concept of the PharmaCog project was that the pathway of drug discovery in AD may be enhanced by (1) the validation of biomarkers derived from blood, EEG, magnetic resonance imaging (MRI), and positron emission tomography (PET) in patients with aMCI due to AD diagnosed by in-vivo measurement of Ab42 and phospho-tau in the brain and (2) the evaluation of the translational value of those human biomarkers in wild type (WT) mice and animal models of AD including transgenic mice with the mutation of PS1 and/or APP (i.e. PDAPP and TASTPM strains). Those genetic factors induce an abnormal accumulation of Ab42 in the brain and related cognitive deficits. The expected results may be (1) the identification of a matrix of biomarkers sensitive to the prodromal AD (aMCI cognitive status) and its progression in patients and (2) the selection of similar biomarkers related to AD neuropathology and cognitive deficits in PDAPP and TASTPM strains. These biomarkers were expected to be very useful in clinical trials testing the efficacy and neurobiological impact of new disease-modifying drugs against prodromal AD. For the development of this Ph.D. thesis, the access to the experiments and the data of the PharmaCog project was allowed by Prof. Claudio Babiloni, leader of an Italian Unit (University of Foggia in 2010-2012 and Sapienza University of Rome in 2013-2015) of the PharmaCog Consortium and coordinator of study activities relative to biomarkers derived from electroencephalographic (EEG) signals recorded from human subjects and animals in that project. Specifically, Prof. Claudio Babiloni was in charge for the centralized qualification and analysis of EEG data recorded from aMCI patients (Work Package 5, WP5) and transgenic mouse models of AD such as PDAPP and TASTPM strains (WP6). The data of the present Ph.D. thesis mostly derived from the WP5 and WP6. This document illustrating the Ph.D. thesis is structured in three main Sections: ▪ An Introductive part illustrating concisely the AD neuropathology, the mouse models of AD used in this thesis, and basic concepts of EEG techniques useful to understand the present study results; ▪ An Experimental part describing the result of the four research studies led in the framework of this Ph.D. project. Two of these studies were published in international journals registered in ISI/PubMed with impact factor, while the other two are being currently under minor revisions in those journals; ▪ A Conclusion section