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

Weighted maximal regularity estimates and solvability of non-smooth elliptic systems II

We continue the development, by reduction to a first order system for the conormal gradient, of $L^2$ \textit{a priori} estimates and solvability for boundary value problems of Dirichlet, regularity, Neumann type for divergence form second order, complex, elliptic systems. We work here on the unit ball and more generally its bi-Lipschitz images, assuming a Carleson condition as introduced by Dahlberg which measures the discrepancy of the coefficients to their boundary trace near the boundary. We sharpen our estimates by proving a general result concerning \textit{a priori} almost everywhere non-tangential convergence at the boundary. Also, compactness of the boundary yields more solvability results using Fredholm theory. Comparison between classes of solutions and uniqueness issues are discussed. As a consequence, we are able to solve a long standing regularity problem for real equations, which may not be true on the upper half-space, justifying \textit{a posteriori} a separate work on bounded domains.Comment: 76 pages, new abstract and few typos corrected. The second author has changed nam

Inclusive Education and UDL Professional Development for Teachers in Sweden and India

In education, the factors involved in a successful inclusive education classroom are diverse and multidimensional, with a growing research base. Universal design for learning (UDL) can help educators address the varied needs of students through diversification of the design of instructional methods, materials, and assessments. Global interest in UDL has driven the need for more teacher training opportunities. This chapter contributes to the literature base on professional development in UDL cases by presenting two examples from two national contexts, Sweden and India. The authors ground the two cases in the literature on teacher training, inclusive education, and UDL, concluding with a discussion on the contextual impact and insights stemming from the cases

Resolvent Estimates in L^p for the Stokes Operator in Lipschitz Domains

We establish the $L^p$ resolvent estimates for the Stokes operator in Lipschitz domains in $R^d$, $d\ge 3$ for $|\frac{1}{p}-1/2|< \frac{1}{2d} +\epsilon$. The result, in particular, implies that the Stokes operator in a three-dimensional Lipschitz domain generates a bounded analytic semigroup in $L^p$ for (3/2)-\varep < p< 3+\epsilon. This gives an affirmative answer to a conjecture of M. Taylor.Comment: 28 page. Minor revision was made regarding the definition of the Stokes operator in Lipschitz domain

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

Magnetothermodynamics of the Ising Antiferromagnet Dy2Ge2O7

We report systematic low temperature measurements of the DC magnetization, AC susceptibility, and heat capacity of dysprosium pyrogermanate (Dy2Ge2O7) single crystal and powder samples. Our results confirm that Dy2Ge2O7 is an anisotropic antiferromagnet. The isothermal field dependent magnetization and the integrated magnetic entropy both indicate that the Dy3+ ions behave as Ising-like spins, analogous to those in the pyrochlore spin ice materials. Both single-spin and collective spin relaxation phenomena appear to lead to spin freezing in this material, again in analogy to observations in the spin ice materials, suggesting that such phenomena may be generic to a broader class of magnetic materials.Comment: Phys. Rev. B, in press (2008

On thin plate spline interpolation

We present a simple, PDE-based proof of the result [M. Johnson, 2001] that the error estimates of [J. Duchon, 1978] for thin plate spline interpolation can be improved by $h^{1/2}$. We illustrate that ${\mathcal H}$-matrix techniques can successfully be employed to solve very large thin plate spline interpolation problem

Spin ice behavior in Dy2Sn2-xSbxO7+x/2 and Dy2NbScO7

We report the magnetic and thermal properties of Dy2Sn2-xSbxO7+x/2, x = 0, 0.25, and 0.5, and Dy2NbScO7. We find evidence for Ising-like single ion ground states in the Dy2Sn2-xSbxO7+x/2 materials. These materials possess nearly the same zero point entropy as the canonical spin ices Ho2Ti2O7 and Dy2Ti2O7, strongly suggesting that they have spin ice states at low temperatures. We also observe a somewhat reduced zero point entropy in Dy2NbScO7, which is possibly associated with the higher level of cation disorder. The ice-like states in these materials with cation disorder on the B-sites of the pyrochlore lattice provide new evidence for the robust nature of spin ice behavior in the presence of disorder

Bethe-Sommerfeld conjecture for periodic operators with strong perturbations

We consider a periodic self-adjoint pseudo-differential operator $H=(-\Delta)^m+B$, $m>0$, in $\R^d$ which satisfies the following conditions: (i) the symbol of $B$ is smooth in \bx, and (ii) the perturbation $B$ has order less than $2m$. Under these assumptions, we prove that the spectrum of $H$ contains a half-line. This, in particular implies the Bethe-Sommerfeld Conjecture for the Schr\"odinger operator with a periodic magnetic potential in all dimensions.Comment: 61 page