'Timely' diagnosis of dementia: what does it mean? A narrative analysis of GPs' accounts

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors

ASUHAN KEPERAWATAN PADA Tn. S DENGAN GANGGUAN SISTEM PERKEMIHAN: BENIGNA PROSTAT HIPERPLASIA POST OPERASI PROSTATEKTOMY DI RUANG MAWAR II RS Dr. MOEWARDI SURAKARTA

Tinjauan teori yang di dapat dari karya tulis ini adalah Benigna Prostat Hiperplasia adalah pembesaran progresif dari kelenjar prostat, secara umum pada pria berumur lebih dari 50 tahun, dan menyebabkan berbagai derajat obstruksi uretral dan pembatasan aliran urinarius. Tujuan umum dari karya tulis ilmiah ini adalah memberikan pengalaman yang nyata kepada penulis dalam melakukan asuhan keperawatan pada pasien BPH. Sedangkan tujuan khusus dari karya tulis ilmiah ini adalah melakukan pengkajian pada pasien BPH, merumuskan diagnosa keperawatan yang muncul pada pasien BPH merumuskan intervensi keperawatan pada pasien BPH, melakukan implementasi keperawatan dan evaluasi keperawatan pada pasien BPH. Metode yang digunakan dalam penyusunan karya tulis ilmia ini adalah dengan observasi di rumah sakit dan wawancara langsung dengan pasien dan keluarga pasien. Kesimpulan dari penulisan karya tulis ilmiah ini, yaitu masalah yang lazim pada pasien dengan BPH adalah gangguan rasa nyaman nyeri, gangguan eliminasi urin dan resiko infeksi

Karakteristik Serat Kulit Waru yang Disusun Laminasi Bermatrik Polyester dengan Orientasi Serat (450,500,550) terhadap Sifat Fisis dan Mekanis

Research hibiscus bark fiber composite rod is intended to describe the physical and mechanical properties of skin stem hibiscus fiber composites due to variation of the angle and macro photographs describe fiber composite skin stem hibiscus after testing the tensile and impact testing due to variations in the angle. The method to do that is to alkalization hibiscus fiber skin by soaking KMnO4 5% per 1 liter of distilled water for 2 hours. The test object is made by Hand Lay-up method, the ratio of 30% fiber, fiber orientation [-450 / 450]; [- 500/500]; [- 550/550]. using polyester resin series BQTN 157. The mechanical properties obtained are of a tensile testing using standard ASTM D3039-07 and ASTM impact testing using standard D256-03 with the variation of the angle of 450, 500, 550, as well as describe the tensile strength, impact the price and composite macro photo polyester fiber trunk hibiscus skin due to variation of the angle. The results of the tensile test composites prepared symmetry [-450 / 450], [- 500/500], [- 550/550] contained in the maximum tensile strength of composite with 450 test corner, where the strength of its increase in the amount of 42.340 N / mm2 more greater than the composite with a test corner 500, and 550. While the Izod impact testing of composites prepared symmetry [-450 / 450], [- 500/500], [- 550/550] where the smaller the angle, the greater the test 450 energy is absorbed and the price impact. At the macro image tensile test specimens fault structure composite bumpy and irregular. At an angle of 550 trials going on the enlargement process void and broken fiber is very dominating. While the macro image Izod impact testing results of composite fault structure at 450 test specimens seen that the pull-out of fiber

What next? Experiences of social support and signposting after a diagnosis of dementia

The experience of being diagnosed with dementia can be shocking. This may be compounded if individuals feel that there is a lack of signposting onto further avenues of support following diagnosis. This study, then, examines how social support is promoted in the diagnostic process. Using purposive sampling and a grounded theory approach, semi-structured interviews were conducted with 13 members of a dementia empowerment group in Northern Ireland, discussing both their experience of diagnosis and also their subsequent group membership. Respondents reported both positive and negative experiences of diagnosis. Feelings of shock and bewilderment accompanied this process. Only one was able to identify a direct link between a medical professional and referral to the empowerment group, others being referred by other health professionals or dementia navigators. The study indicates that, due to disorienting feelings, one diagnostic consultation is insufficient to explain both the diagnosis and offer follow-up support. Therefore, more explicit links to navigators or other services need to be made at the point of diagnosis to prioritise information regarding opportunities for social engagement for those being diagnosed.

Family involvement in timely detection of changes in health of nursing homes residents: a qualitative exploratory study

YesThis article aims to explore family perspectives on their involvement in the timely detection of changes in their relatives' health in UK nursing homes. Increasingly, policy attention is being paid to the need to reduce hospitalisations for conditions that, if detected and treated in time, could be managed in the community. We know that family continue to be involved in the care of their family members once they have moved into a nursing home. Little is known, however, about family involvement in the timely detection of changes in health in nursing home residents. This was a qualitative exploratory study with thematic analysis. A purposive sampling strategy was applied. 14 semi-structured one-to-one telephone interviews with family members of people living in 13 different UK nursing homes. Data were collected from November 2015 to March 2016. Families were involved in the timely detection of changes in health in three key ways: noticing signs of changes in health, informing care staff about what they noticed, and educating care staff about their family members' changes in health. Families suggested they could be supported to detect timely changes in health by developing effective working practices with care staff. Families can provide a special contribution to the process of timely detection in nursing homes. Their involvement needs to be negotiated, better supported, as well as given more legitimacy and structure within the nursing home. Families could provide much needed support to nursing home nurses, care assistants, and managers in timely detection of changes in health. This may be achieved through communication about their preferred involvement on a case-by-case basis as well as providing appropriate support or services.NIH Research Programme Grant for Applied Research (RP-PG-0612-20010

Family involvement in timely detection of changes in health of nursing homes residents:a qualitative exploratory study

Aims and objectives To explore family perspectives on their involvement in the timely detection of changes in their relatives’ health in UK nursing homes. Background Increasingly, policy attention is being paid to the need to reduce hospitalisations for conditions that, if detected and treated in time, could be managed in the community. We know that family continue to be involved in the care of their family members once they have moved into a nursing home. Little is known, however, about family involvement in the timely detection of changes in health in nursing home residents. Design Qualitative exploratory study with thematic analysis. Methods A purposive sampling strategy was applied. 14 semi-structured one-to-one telephone interviews with family members of people living in 13 different UK nursing homes. Data were collected from November 2015 to March 2016. Results Families were involved in the timely detection of changes in health in three key ways: noticing signs of changes in health, informing care staff about what they noticed, and educating care staff about their family members’ changes in health. Families suggested they could be supported to detect timely changes in health by developing effective working practices with care staff. Conclusion Families can provide a special contribution to the process of timely detection in nursing homes. Their involvement needs to be negotiated, better supported, as well as given more legitimacy and structure within the nursing home. Relevance to clinical practice Families could provide much needed support to nursing home nurses, care assistants, and managers in timely detection of changes in health. This may be achieved through communication about their preferred involvement on a case-by-case basis as well as providing appropriate support or services

What works for whom in the management of diabetes in people living with dementia: a realist review

Background Dementia and diabetes mellitus are common long-term conditions and co-exist in a large number of older people. People living with dementia (PLWD) may be less able to manage their diabetes, putting them at increased risk of complications such as hypoglycaemia. The aim of this review was to identify key mechanisms within different interventions that are likely to improve diabetes outcomes in PLWD. Methods This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories and their validation with a purposive sample of stakeholders. Twenty-six stakeholders — user/patient representatives, dementia care providers, clinicians specialising in diabetes or dementia and researchers — took part in interviews, and 24 participated in a consensus conference. Results We included 89 papers. Ten focused on PLWD and diabetes, and the remainder related to people with either dementia, diabetes or other long-term conditions. We identified six context-mechanism-outcome configurations which provide an explanatory account of how interventions might work to improve the management of diabetes in PLWD. This includes embedding positive attitudes towards PLWD, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. An overarching contingency emerged concerning the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. Conclusions Evidence highlighted the need for personalised care, continuity and family-centred approaches, although there was limited evidence that this happens routinely. This review suggests there is a need for a flexible service model that prioritises quality of life, independence and patient and carer priorities. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to their needs. Trial registration PROSPERO, CRD42015020625. Registered on 18 May 2015

An early diagnosis is not the same as a timely diagnosis of Parkinson's disease

referee-status: Indexed referee-response-35490: 10.5256/f1000research.15815.r35490, Matthew J. Farrer, Djavad Mowafhagian Centre for Brain, University of British Columbia, Vancouver, British Columbia, Canada, 18 Jul 2018, version 1, indexed referee-response-35489: 10.5256/f1000research.15815.r35489, Mayela Rodriguez-Violante, Movement Disorders Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico, 18 Jul 2018, version 1, indexed grant-information: This review was supported by grants from: Parkinson’s UK (G-1606), National Institute for Health Research University College Hospitals Biomedical Research Centre and Bart’s Charity (Preventative Neurology Grant). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. copyright-info: This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This review was supported by grants from: Parkinson’s UK (G-1606), National Institute for Health Research University College Hospitals Biomedical Research Centre and Bart’s Charity (Preventative Neurology Grant)