Improving continence services for older people from the service-providers' perspective: a qualitative interview study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.Objective To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting 3 acute and 13 primary care National Health Service Trusts in England. Participants 16 continence service leads in England actively treating and managing older people with UI. Results In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.Funding was received from the New Dynamics of Ageing Programme, led by the Economic & Social Research Council, UK (grantnumber RES-353-25-0010)

Intertwining caring science, caring practice and caring education from a lifeworld perspective—two contextual examples

This article describes how caring science can be a helpful foundation for caring practice and what kind of learning support that can enable the transformation of caring science into practice. The lifeworld approach is fundamental for both caring and learning. This will be illustrated in two examples from research that show the potential for promoting health and well-being as well as the learning process. One example is from a caring context and the other is from a learning context. In this article, learning and caring are understood as parallel processes. We emphasize that learning cannot be separated from life and thus caring and education is intertwined with caring science and life. The examples illustrate how an understanding of the intertwining can be fruitful in different contexts. The challenge is to implant a lifeworld-based approach on caring and learning that can lead to strategies that in a more profound way have the potential to strengthen the person's health and learning processes

Older persons’ experiences of Reflective STRENGTH‐Giving Dialogues – ‘It\u27s a push to move forward’

Rationale: Experiences of the innovative method Reflective STRENGTH‐Giving Dialogue (STRENGTH), which is grounded in a lifeworld perspective and developed to improve quality of care, is described in this study. Innovative thinking in developing health and social care, which may include digital solutions, is required to ensure a meaningful and dignified life in old age. Aim: The aim of this study was to describe experiences of the intervention Reflective STRENGTH‐Giving Dialogue from the perspective of older persons living with long‐term health problems. Method: Individual qualitative interviews were conducted with 27 older persons who participated in the intervention. The older persons wrote notes from each dialogue in booklets, and the booklets became part of the study data, analysed with a Reflective Lifeworld Research approach. Results: STRENGTH is experienced as an opportunity to reflect upon life and identify small and large life projects. Dialogues that lead to change in thoughts and actions influence the older persons\u27 well‐being, sense of balance, joy and meaning in life. There is an experience of STRENGTH as a starting point and a push to move forward in an effort to experience joy and meaning in life when living with long‐term health problems. Conclusions: STRENGTH has the potential to contribute to quality improvement in person‐centred care and enhance meaning in life for older persons living with long‐term health problems. However, the use of a digital tool in this particular context poses challenges that must be considered

MAC OS X Forensics: Password Discovery

OS X provides a password-rich environment in which passwords protect OS X resources and perhaps many other resources accessed through OS X. Every password an investigator discovers in an OS X environment has the potential for use in discovering other such passwords, and any discovered passwords may also be useful in other aspects of an investigation, not directly related to the OS X environment. This research advises the use of multiple attack vectors in approaching the password problem in an OS X system, including the more generally applicable non-OS X-specific techniques such as social engineering or well-known password cracking techniques such as John the Ripper or other versions of dictionary attacks and Rainbow table attacks. In some successful approaches the components of the attack vector will use more OS X specific techniques such as those described here: application-provided password revealing functions, a Javascript attack, an “Evil Website” attack, system file scavenging, exploitation of the keychain, and an OS X install disk attack. Keywords: OS X, password, password discovery, social engineering, sleepimage, keychai

E5501: phase II study of topotecan sequenced with etoposide/cisplatin, and irinotecan/cisplatin sequenced with etoposide for extensive-stage small-cell lung cancer.

PURPOSE: Sequence-dependent improved efficacy of topoisomerase I followed by topoisomerase 2 inhibitors was assessed in a randomized phase II study in extensive-stage small-cell lung cancer (SCLC). METHODS: Patients with previously untreated extensive-stage SCLC with measurable disease, ECOG performance status of 0-3 and stable brain metastases were eligible. Arm A consisted of topotecan (0.75 mg/m(2)) on days 1, 2 and 3, etoposide (70 mg/m(2)) and cisplatin (20 mg/m(2)) (PET) on days 8, 9 and 10 in a 3-week cycle. Arm B consisted of irinotecan (50 mg/m(2)) and cisplatin (20 mg/m(2)) on days 1 and 8 followed by etoposide (85 mg/m(2) PO bid) on days 3 and 10 (PIE) in a 3-week cycle. RESULTS: We enrolled 140 patients and randomized 66 eligible patients to each arm. Only 54.5 % of all patients completed the planned maximum 6 cycles. There were grade ≥3 treatment-related adverse events in approximately 70 % of the patients on both arms including 6 treatment-related grade 5 events. The overall response rates (CR + PR) were 69.7 % (90 % CI 59.1-78.9, 95 % CI 57.1-80.4 %) for arm A and 57.6 % (90 % CI 46.7-67.9, 95 % CI 44.8-69.7 %) for arm B. The median progression-free survival and overall survival were 6.4 months (95 % CI 5.4-7.5 months) and 11.9 months (95 % CI 9.6-13.7 months) for arm A and 6.0 months (95 % CI 5.4-7.0 months) and 11.0 months (95 % CI 8.6-13.1 months) for arm B. CONCLUSION: Sequential administration of topoisomerase inhibitors did not improve on the historical efficacy of standard platinum-doublet chemotherapy for extensive-stage SCLC

Quenched crystal field disorder and magnetic liquid ground states in Tb2Sn2-xTixO7

Solid-solutions of the "soft" quantum spin ice pyrochlore magnets Tb2B2O7 with B=Ti and Sn display a novel magnetic ground state in the presence of strong B-site disorder, characterized by a low susceptibility and strong spin fluctuations to temperatures below 0.1 K. These materials have been studied using ac-susceptibility and muSR techniques to very low temperatures, and time-of-flight inelastic neutron scattering techniques to 1.5 K. Remarkably, neutron spectroscopy of the Tb3+ crystal field levels appropriate to at high B-site mixing (0.5 < x < 1.5 in Tb2Sn2-xTixO7) reveal that the doublet ground and first excited states present as continua in energy, while transitions to singlet excited states at higher energies simply interpolate between those of the end members of the solid solution. The resulting ground state suggests an extreme version of a random-anisotropy magnet, with many local moments and anisotropies, depending on the precise local configuration of the six B sites neighboring each magnetic Tb3+ ion.Comment: 6 pages, 6 figure

Exchange Field Induced Magnetoresistance in Colossal Magnetoresistance Manganites

The effect of an exchange field on electrical transport in thin films of metallic ferromagnetic manganites has been investigated. The exchange field was induced both by direct exchange coupling in a ferromagnet/antiferromagnet multilayer and by indirect exchange interaction in a ferromagnet/paramagnet superlattice. The electrical resistance of the manganite layers was found to be determined by the absolute value of the vector sum of the effective exchange field and the external magnetic field.Comment: 5 pages, 4 figure

Patient participation: A qualitative study of immigrant women and their experiences

Patient participation in healthcare is a neglected area of interest in the rather extensive amount of research on immigrant so-called Selma patients in Swedish health care as well as worldwide. The aim is to explore the phenomenon “patient participation” in the context of the Swedish health care from the perspective of immigrants non-fluent in Swedish. A phenomenological lifeworld approach was chosen. Data were collected from patients within a municipal home care setting in Sweden. Eight women agreed to participate. In seven interviews, an interpreter was necessary for the translation of the interview. Five authorized interpreters were used. Data were analysed in accordance to a descriptive phenomenological method for caring research. The analysis led to an essence of the phenomenon with three constituents, “to experience participation,” “to refrain from participation,” and “to be deprived of participation.” Patient participation from the perspective of immigrant women means that patients are involved and active in their own health and caring processes. For these women, it is particularly important to have the opportunity to express themselves. Patient participation presupposes professional caregivers who act in a way that increases the patients' opportunities to take part. A skilled interpreter is often necessary in order to enable the patient participation

An Innovative Partnership between National and Regional Partnerships: STARS Meets McPIE

The Students & Technology in Academia, Research, and Service (STARS) Computing Corps is a nationally-connected system of regional partnerships among higher education, K-12 schools, industry and the community, with a mission to broaden the participation of women, under-represented minorities and persons with disabilities in computing (BPC). With support from National Science Foundation funding, the University of North Carolina at Charlotte founded the STARS Alliance (now the STARS Computing Corps) which includes 44 universities, each with its own “constellation” of local and regional partnerships. McClintock Partners in Education (McPIE) is a partnership between a middle school, a church, and their surrounding community. This paper describes how a STARS-McPIE “partnership between partnerships” has impacted both the middle school students and their college student mentors

Deriving Telescope Mueller Matrices Using Daytime Sky Polarization Observations

Telescopes often modify the input polarization of a source so that the measured circular or linear output state of the optical signal can be signficantly different from the input. This mixing, or polarization "cross-talk", is defined by the optical system Mueller matrix. We describe here an efficient method for recovering the input polarization state of the light and the full 4 x 4 Mueller matrix of the telescope with an accuracy of a few percent without external masks or telescope hardware modification. Observations of the bright, highly polarized daytime sky using the Haleakala 3.7m AEOS telescope and a coude spectropolarimeter demonstrate the technique.Comment: Accepted for publication in PAS