Involking silvern voices in healthcare : transforming practice by engaging older adults in collaborative partnerships

Canada's population is aging. This growing trend will ultimately have an impact on nursing practice as older individuals continue to seek healthcare services. Nurses must be able to work in collaboration with the older population to provide quality care. This action research study explored participative healthcare from an older adult's perspective. This study revealed that older adults prefer to be active participants in their care. The major theme that emerged was true partnership. Three sub-themes that emerged were communication, respect, and trust. These three sub-themes work in unity to contribute to a healthcare experience that exemplifies true partnerships. This study proposes a definition of true partnership as being open to and inviting mutual communication in an atmosphere that encourages equity sharing of information contributing to respect and the development of trust that results in confident collaboration in care

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Securing identity assignment using implicit certificates in P2P overlays

The security of the Peer-to-Peer (P2P) overlays networks has been questioned for years. Many works have been proposed to provide secure routing, anonymity, reputation systems, confidentiality, etc. However, the identity assignment has been less considered. These networks are designed so that each user has a unique identifier (nodeID), but the most of identity assignment systems allow malicious users to obtain a set of nodeIDs or even select certain identifiers. Thus, these users can disrupt the proper operation of a P2P overlay. In this paper, we propose a nodeID assignment protocol based on the issue of implicit certificates. Our purpose is to provide security services to struggle against the most of security threats in these networks with special attention to the identity assignment. This approach is based on the use of certificates and the joint generation of nodeIDs between a Certification Authority (CA) and the user. In addition, the use of implicit certificates presents certain advantages over the use of traditional certificates (explicit certificates).Peer ReviewedPostprint (published version

Transport at interfaces in lipid membranes and enantiomer separation

We study the dynamics and formation of differently ordered lateral phases of interfacial lipid layers for two types of lipid systems, a vesicle-supported bilayer and a Langmuir–Blodgett monolayer, both in experiment and by simulation. Similarly, we investigate the dynamics of objects embedded in a simpler interface given by an air–water surface and demonstrate the surface-acoustic-wave-actuated separation of enantiomers (chiral objects) on the surface of the carrier fluid. It turns out that the dynamics and the separation of the phases do not only depend on parameters such as temperature, mobilities and line tension but also on the mechanics of the lipid layers subjected to exterior forces as, for instance, compression, extensional and shear forces in film-balance experiments. Since the mechanical behavior of lipid layers is viscoelastic, we use a modeling approach based on the incompressible Navier–Stokes equations with a viscoelastic stress term and a capillary term, a convective Jeffrey (Oldroyd) equation of viscoelasticity, and the Cahn–Hilliard equation with a transport term. The numerical simulations are based on C0-interior-penalty discontinuous-Galerkin methods for the Cahn– Hilliard equation. Model-validation results and the verification of the simulation results by experimental data are presented. The feasibility of enantiomer separation by surface-acoustic-wave-generated vorticity patterns is shown both experimentally and through numerical simulations. This technique is cost-effective and provides an extremely high time resolution of the dynamics of the separation process compared to more traditional approaches. The experimental setup is an enhanced Langmuir–Blodgett film balance with a surface-acoustic-wave-generated vorticity pattern of the fluid, where model enantiomers (custom-made photoresist particles) float on the surface of the carrier fluid. For the simulations, we propose a finite element immersed boundary method (FEIBM) for deformable enantiomers and a fictitious-domain approach based on a distributed Lagrangian multiplier finite element immersed boundary method (DLM-FEIBM) for rigid chiral objects, both of which lead to simulation results consistent with experiments

Curr Diabetes Rev

BACKGROUND: Type 2 diabetes represents an increasing health burden world-wide and its prevalence in particularly higher in elderly population. Consistent epidemiological evidence suggests an increased risk of dementia associated to type 2 diabetes; the mechanisms underlying these associations, however, remain unclear. OBJECTIVE: The study aims to review epidemiological, clinical and pre-clinical data that weigh on pathophysiological links, mechanisms of disease and associations between type 2 diabetes and dementia to identify areas of opportunity for future research. METHODS: We searched the following electronic bibliographic databases: PUBMED, EMBASE, SCIELO, MEDLINE and OVID for clinical, translational and epidemiological research literature that summarize diabetes-related risk factors for dementia, metabolic and neurological changes associated to T2D, evidence of therapeutic approaches in type 2 diabetes and its pathophysiological implications for dementia. RESULTS: Type 2 diabetes mellitus increases risk for all-cause dementia, vascular dementia and Alzheimer's disease. The most evaluated mechanisms linking both disorders in pre-clinical studies include an increase in neuronal insulin resistance, impaired insulin signaling, pro-inflammatory state, mitochondrial dysfunction and vascular damage which increase deposition of beta-amyloid, tau proteins and GSK3beta, leading to an earlier onset of dementia in individuals with impairment in the glucose metabolism. Neuroimaging and neuropathology evidence linking cerebrovascular lesions, neurodegeneration and particularly small-vessel disease in the onset of dementia is consistent with the increased risk of incident dementia in type 2 diabetes, but consistent evidence of AD-related pathology is scarce. Epidemiological data shows increased risk of dementia related to hypoglycemic episodes, glycemic control, metabolic syndrome, insulin resistance and genetic predisposition, but the evidence is not consistent and statistical analysis might be affected by inconsistent covariate controlling. Therapeutic approaches for T2D have shown inconsistent result in relation to dementia prevention and delay of cognitive decline; lifestyle intervention, particularly physical activity, is a promising alternative to ameliorate the impact of disability and frailty on T2D-related dementia. CONCLUSION: Vascular disease, inflammation and impaired brain insulin signaling might occur in T2D and contribute to dementia risk. Evidence from epidemiological studies has not consistently reported associations that could integrate a unified mechanism of disease in humans. Evaluation of the effect of antidiabetic medications and non-pharmacological interventions in dementia prevention in type 2 diabetes is promising but has thus far offered inconsistent results

Evolution of π0\pi^0 suppression in Au+Au collisions from sNN=39\sqrt{s_{NN}} = 39 to 200 GeV

International audienceNeutral-pion, pi^0, spectra were measured at midrapidity (|y|<0.35) in Au+Au collisions at sqrt(s_NN) = 39 and 62.4 GeV and compared to earlier measurements at 200 GeV in the 1<p_T<10 GeV/c transverse-momentum (p_T) range. The high-p_T tail is well described by a power law in all cases and the powers decrease significantly with decreasing center-of-mass energy. The change of powers is very similar to that observed in the corresponding p+p-collision spectra. The nuclear-modification factors (R_AA) show significant suppression and a distinct energy dependence at moderate p_T in central collisions. At high p_T, R_AA is similar for 62.4 and 200 GeV at all centralities. Perturbative-quantum-chromodynamics calculations that describe R_AA well at 200 GeV, fail to describe the 39 GeV data, raising the possibility that the relative importance of initial-state effects and soft processes increases at lower energies. A conclusion that the region where hard processes are dominant is reached only at higher p_T, is also supported by the x_T dependence of the x_T-scaling power-law exponent