Bridging the gaps in palliative care bereavement support: An international perspective

A review of palliative care policies and bereavement support practices in the United States, Canada, United Kingdom, Australia, and Japan demonstrated 4 challenges: questions over providing universal versus targeted support; a lack of clear evidence driving service delivery; informal or no risk assessment; and limited or no evaluation of services. Bridging the gaps between the policy and practice of palliative care bereavement support requires acknowledging the challenges of medical and public health models, improving bereavement need assessment processes, enhancing the role of primary care providers, and extending research to provide an evidence-base for interventions

Construction site communication study using the RAM management system for BIM adaptation

The UK’s construction industry is witnessing an annual increase in costs due to a lack of communication between the different organizational operators on the construction site that often leads to construction defects. Meanwhile, a cost-reduction strategy plan using BIM has become a fundamental requirement for the government, aiming to keep costs under control. To facilitate BIM adoption in the industry, the BIM strategy was introduced in four phases, with each stage entailing a number of criteria. The industry has seen a global reaction to the Level 2 BIM program and a significant cost saving of 840M in 2013/14 in Europe. However, the industry is unable to match the level 3 BIM, where a collaborative model file server is required as a common sharable platform to achieve efficient communication. This study contributes toward formulating a communication framework in the UK industry to understand communication issues and manage defects. A survey was targeted at construction industry practitioners and academics, with a total number of 328 participants

A 10-year literature review of family caregiving for motor neurone disease: Moving from caregiver burden studies to palliative care interventions

Background: There is growing awareness that different terminal diseases translate into different family caregiver experiences, and the palliative and supportive care needs of these families are both similar and unique. Family members caring for people with motor neurone disease may experience exceptional strain due to the usually rapid and progressive nature of this terminal illness. Aim: The purpose of this review is to synthesize contemporary research and provide a comprehensive summary of findings relevant to motor neurone disease family caregivers, as well as highlight some of the suggested interventions to alleviate burden and improve quality of life for this group. Design: We conducted a comprehensive review of empirical research on family caregiving for people with motor neurone disease in peer-reviewed journals published in English, January 2000–April 2011. Fifty-nine studies met the inclusion criteria. Results: This comprehensive literature review was consistent with previous research documenting the substantial burden and distress experienced by motor neurone disease family caregivers and revealed important points in the trajectory of care that have the potential for negative effects. The diagnosis experience, assisted ventilation, cognitive changes and end-of-life decision making create challenges within a short time. This review has also implicated the need for improvements in access to palliative care services and highlighted the absence of interventions to improve care. Conclusions: Caregiver burden and quality-of-life studies on motor neurone disease family caregivers have so far dominated the research landscape .The focus needs to be on developing interventions that provide direct practical and psychosocial supports for motor neurone disease family caregivers

IMPACT DES REJETS URBAINS ET INDUSTRIELS SUR L'EAU SUPERFICIELLE ET SOUTERRAINE DANS LA PLAINE D’ANNABA (ALGERIE) IMPACT OF URBAN AND INDUSTRIAL WASTES ON SUPERFICIAL AND GROUNDWATER IN THE PLAIN OF ANNABA (ALGERIA)

Les rejets urbains au niveau de l’oued Meboudja, un des affluents de la Seybouse posent l’épineuse question de leur impact surles eaux superficielles et souterraines de la plaine de d’Annaba. Dans cette recherche, plusieurs campagnes de prélèvement àpas mensuel des eaux superficielles de l’oued et les eaux souterraines sur deux points témoins dont un en pompage ont étéréalisées pendant le cycle hydrologique annuel. La comparaison entre la composition chimique des eaux de l’oued et celles deseaux souterraines captées montre qu’au niveau de l’oued, on observe l’existence de deux polluants : le phosphate etl’ammonium, par contre, au niveau de la nappe on observe seulement les ions phosphate qui ont pu se déplacer sous la mêmeforme chimique entre l’oued et les deux puits.La diminution de la concentration des phosphates entre l’oued et les captages est due à l’effet de la dilution des concentrationspar les eaux de la nappe, la précipitation des phosphates sous la forme des phosphates de calcium et enfin l’adsorption par lesargiles. En revanche l’absence de l’ammonium dans les captages est due au changement de la forme azotée en nitrate au coursdu trajet entre les deux milieux sous l’effet des conditions oxydantes. Urban wastes in wadi of Meboudja, a tributary of the Seybouse raise the difficult question of their impact on surface andgroundwater in conjunction with the plain of Annaba. In this research, several sampling campaigns at no monthly surfacewater of the river and groundwater on two witnesses in which a pump were conducted during the annual hydrological cycle.The comparison between the chemical composition of the river’s water and those of groundwater collected shows that, weobserve the existence of two pollutants: phosphate and ammonium, for against, at the water there is only the phosphate ionsthat have been moving in the same chemical form between the river and the two wells.The decrease in the concentration of phosphate between river and catchments is due to the dilution effect by the groundwaterlevels, the precipitation of phosphate in the form of calcium phosphate and finally by the clays adsorption. Nonetheless, theabsence of ammonium in the catchments is due to the change in the form of nitrate nitrogen during the journey between thetwo communities as a result of oxidizing conditions

Exploring the Support Needs of Family Caregivers of Patients with Brain Cancer Using the CSNAT: A Comparative Study with Other Cancer Groups

A substantial burden is placed on family caregivers of patients diagnosed with brain cancers. Despite this, the support needs of the caregivers are often under-recognised and not addressed adequately in current routine and patient centred clinical care. The Care Support Needs Assessment Tool (CSNAT) is a validated instrument designed to systematically identify and address caregiver needs. It has been trialled in an Australian palliative care community setting using a stepped wedge cluster design involving 322 family carers of terminally ill patients. The current article reports on a subset from this trial, 29 caregivers of patients with primary brain cancer, and compares their profile and outcomes to those of other cancer groups. Caregiver strain was assessed using the Family Appraisal of Caregiving Questionnaire, caregiver physical and mental wellbeing using SF12 and caregiver workload using a questionnaire on support with activities of daily living (ADL). In comparison to caregivers of patients with all other cancers, the primary brain cancer group had significantly higher levels of caregiver strain, lower levels of mental wellbeing and a higher level of ADL workload. Their physical wellness also deteriorated significantly over time.An action plan approach led to practical solutions for addressing highlighted concerns. Four themes evolved from the family caregivers’ feedback interviews: The extremely challenging caregiver experience with brain cancer; the systematic and practical approach of the CSNAT during rapid changes; connection with health professionals, feeling acknowledged and empowered; and timely advice and assurance of support during the caregiving journey. This preliminary study has demonstrated that the CSNAT provides a practical and useful tool for assessing the support needs of family caregivers of patients with brain cancer and has provided the basis for a larger scale, longitudinal study that allows a more detailed characterisation of the evolving caregiver needs at different stages of the disease

Who cares for the bereaved? A national survey of family caregivers of people with motor neurone disease

Background: Although Motor Neurone Disease (MND) caregivers are most challenged physically and psychologically, there is a paucity of population-based research to investigate the impact of bereavement, unmet needs, range of supports, and their helpfulness as perceived by bereaved MND caregivers. Methods: An anonymous national population-based cross-sectional postal and online survey of bereavement experiences of family caregivers who lost a relative/friend to MND in 2016, 2017, and 2018. Recruitment was through all MND Associations in Australia. Results: 393 valid responses were received (31% response rate). Bereaved caregiver deterioration in physical (31%) and mental health (42%) were common. Approximately 40% did not feel their support needs were met. Perceived insufficiency of support was higher for caregivers at high bereavement risk (63%) and was associated with a significant worsening of their mental and physical health. The majority accessed support from family and friends followed by MND Associations, GPs, and funeral providers. Informal supports were reported to be the most helpful. Sources of professional help were the least used and they were perceived to be the least helpful. Conclusions: This study highlights the need for a new and enhanced approach to MND bereavement care involving a caregiver risk and needs assessment as a basis for a tailored “goodness of fit” support plan. This approach requires continuity of care, more resources, formal plans, and enhanced training for professionals, as well as optimizing community capacity. MND Associations are well-positioned to support affected families before and after bereavement but may require additional training and resources to fulfill this role

Monte Carlo validation of a mu-SPECT imaging system on the lightweight grid CiGri

à paraître dans Future Generation Computer SystemsMonte Carlo Simulations (MCS) are nowadays widely used in the field of nuclear medicine for system and algorithms designs. They are valuable for accurately reproducing experimental data, but at the expense of a long computing time. An efficient solution for shorter elapsed time has recently been proposed: grid computing. The aim of this work is to validate a small animal gamma camera MCS and to confirm the usefulness of grid computing for such a study. Good matches between measured and simulated data were achieved and a crunching factor up to 70 was attained on a lightweight campus grid

Who needs bereavement support? A population based survey of bereavement risk and support need

This study identifies and describes the profiles of bereavement risk and support needs of a community sample in Australia and tests the fit of the data with the three-tiered public health model for bereavement support. Family members who were bereaved 6-24 months prior to the survey and who were clients of four funeral providers participated (May-July 2013). A postal survey was used to collect information about bereaved people's experience of caring and perceived satisfaction with any bereavement support provided. The questionnaire included a validated risk assessment screening measure for Prolonged Grief Disorder (PG-13). A total of 678 bereaved people responded. The model predicted that 60% of the sample would be low risk, 30% moderate risk, and 10% high risk. Actual figures were very close at 58.4%, 35.2%and 6.4% respectively. The analysis of the demographic characteristics, experience and impact of caring and bereavement, and satisfaction with support received from a variety of sources revealed differential experiences and needs that align with the expectation of low, moderate, and high bereavement support need, as articulated in the public health model. This is the first empirical test of the public health model of bereavement support. As there is a lack of clear evidence to guide development and allocation of bereavement support programs, the findings have the potential to inform the ability of services, community organizations and informal networks to prioritize care according to each level of bereavement need. This is essential to achieve cost-effective and equitable resource allocation