Not just a simple dressing: A practitioner inquiry exploring the complexity within residential care homes and the district nursing response

People living in residential care homes are older, frailer and sicker than ever before. Levels of dependency and co-morbidity are increasing, with neurodegenerative diseases, and dementia in particular, having a significant impact. Previous research has reported high levels of unmet needs, including healthcare needs, amongst the resident population, yet has given a limited understanding of why staff may struggle to meet these healthcare needs. This qualitative study used a practitioner research approach to answer the following questions. Firstly, what challenges do care staff face in meeting the healthcare needs of residents, in particular those living with dementia, and secondly, what are the challenges faced by the district nursing service in supporting care staff to meet the healthcare needs of residents. Data were initially generated from an in-depth case study involving one residential care home, specialising in the provision of dementia care. Data were collected from individual (n= 7) and group interviews (n=1) with care staff and interviews with members of the district nursing team supporting this care home (n=4), together with documentation and contextual data. The practitioner researcher used herself as a research instrument to reflect on the findings from the case study, in relation to her own knowledge and experience of working as a district nurse with care homes, focusing in particular on those aspects of the work that were familiar and those that surprised. Data were analysed using thematic data analysis (Braun and Clarke 2006). To add strength to these findings, the experiences and challenges faced by staff (n=14) from other residential care homes were also sought, as well as from community nurses (n=12), community matrons (n=4) and specialist nurses (n=2) attached to these care homes. These data were compared to the findings from the original case study and reflections of the practitioner researcher, to identify findings that resonated, as well as identifying any perceived gaps. Findings suggested that staff could struggle to manage the healthcare needs of residents, as a result of the complexity present in today’s residential care homes, complexity that was not always recognised or acknowledged, especially by those supporting care homes, including community nurses. This thesis makes a unique contribution by drawing on complexity thinking, suggesting that residential care homes are diverse, embedded systems, which are constantly adapting and are governed by simple rules, which are interpreted and applied differently by agents, according to context and individual interpretation. These are characteristics, which others, including community nurses, may be unaware of, or fail to respond to. It identifies ‘simple rules’ which could explain the response of community nurses to this complexity and suggests certain contextual and behavioural issues that may need to be addressed if the relationship between the two services is to improve and the healthcare needs of residents are to be better met

Pembuatan Briket Arang Daun Kelapa Sawit (Elaeis Guineensis Jacq.) Dengan Perekat Pati Sagu (Metroxylon Sago Rott.)

Increasing need of energy and decreasing of fuel supply requires human to discover alternative energy resources. Consequently, there should be a research to discover a new renewable energy source such as palm leaves waste. Oil palm\u27s leaves (Elaeis guineensis Jacq.) are mostly the least used waste from oil palm plantation as an alternative energy resources. This research aims to discover the precise adhesive consentration rate in sago\u27s starch (Metroxylon sago Rott.) to make oil palm\u27s kernel, which are 97%:3%, 96%:4%, 95%:5%, 94%:6%, and 93%:7%. Based on analitycal result of oil palm\u27s leaves charcoal briquet research, the best quality briquet is the P1 composition which composed rate is 97%:3%, has 3,21% water content, 30,18% ashes content, 0,0022 g/s combustion rate, 20,73% evaporated substance rate, 54,46% carbon rate, and 5.114 cal/g heat value

Tick-transmitted co-infections among erythema migrans patients in a general practice setting in Norway:a clinical and laboratory follow-up study

Background Erythema migrans (EM) is the most common manifestation of Lyme borreliosis. Here, we examined EM patients in Norwegian general practice to find the proportion exposed to tick-transmitted microorganisms other than Borrelia, and the impact of co-infection on the clinical manifestations and disease duration. Methods Skin biopsies from 139/188 EM patients were analyzed using PCR for Neoehrlichia mikurensis, Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Follow-up sera from 135/188 patients were analyzed for spotted fever group (SFG) Rickettsia, A. phagocytophilum and Babesia microti antibodies, and tested with PCR if positive. Day 0 sera from patients with fever (8/188) or EM duration of ≥ 21 days (69/188) were analyzed, using PCR, for A. phagocytophilum, Rickettsia spp., Babesia spp. and N. mikurensis. Day 14 sera were tested for TBEV IgG. Results We detected no microorganisms in the skin biopsies nor in the sera of patients with fever or prolonged EM duration. Serological signs of exposure against SFG Rickettsia and A. phagocytophilum were detected in 11/135 and 8/135, respectively. Three patients exhibited both SFG Rickettsia and A. phagocytophilum antibodies, albeit negative PCR. No antibodies were detected against B. microti. 2/187 had TBEV antibodies without prior immunization. There was no significant increase in clinical symptoms or disease duration in patients with possible co-infection. Conclusions Co-infection with N. mikurensis, A. phagocytophilum, SFG Rickettsia, Babesia spp. and TBEV is uncommon in Norwegian EM patients. Despite detecting antibodies against SFG Rickettsia and A. phagocytophilum in some patients, no clinical implications could be demonstrated

Protection of cells from salinity stress by extracellular polymeric substances in diatom biofilms.

Diatom biofilms are abundant in the marine environment. It is assumed (but untested) that extracellular polymeric substances (EPS), produced by diatoms, enable cells to cope with fluctuating salinity. To determine the protective role of EPS, Cylindrotheca closterium was grown in xanthan gum at salinities of 35, 50, 70 and 90 ppt. A xanthan matrix significantly increased cell viability (determined by SYTOX-Green), growth rate and population density by up to 300, 2,300 and 200%, respectively. Diatoms grown in 0.75% w/v xanthan, subjected to acute salinity shock treatments (at salinities 17.5, 50, 70 and 90 ppt) maintained photosynthetic capacity, Fq'/Fm', within 4% of pre-shock values, whereas Fq'/Fm' in cells grown without xanthan declined by up to 64% with hypersaline shock. Biofilms that developed in xanthan at standard salinity helped cells to maintain function during salinity shock. These results provide evidence of the benefits of living in an EPS matrix for biofilm diatoms

Neuropixels 2.0: A miniaturized high-density probe for stable, long-term brain recordings

Measuring the dynamics of neural processing across time scales requires following the spiking of thousands of individual neurons over milliseconds and months. To address this need, we introduce the Neuropixels 2.0 probe together with newly designed analysis algorithms. The probe has more than 5000 sites and is miniaturized to facilitate chronic implants in small mammals and recording during unrestrained behavior. High-quality recordings over long time scales were reliably obtained in mice and rats in six laboratories. Improved site density and arrangement combined with newly created data processing methods enable automatic post hoc correction for brain movements, allowing recording from the same neurons for more than 2 months. These probes and algorithms enable stable recordings from thousands of sites during free behavior, even in small animals such as mice

Displaced Voices: A Journal of Archives, Migration and Cultural Heritage Volume 2, Issue 1 (Summer 2021)

Twentieth Century Histories of Civic Society’s Responses to Crises of Displacement: A Special Issue to mark the 70th Anniversary of Refugee Council Displaced Voices is a biannual digital magazine produced twice a year by the Living Refugee Archive team at the University of East London. Displaced Voices aims to provide a digital platform for activists, archivists, researchers, practitioners and academics to contribute to issues pertaining to refugee and migration history; refugee and migrant rights; social justice; cultural heritage and archives. We welcome a range of contributions to the magazine including articles of between 1000-2000 words; reports on fieldwork in archival collections; book recommendations and reviews; and more creative pieces including (but not limited too) cartoons; photography; and poetry. We would also welcome news on activities; publication of reports, projects; letters and news from your own networks. We welcome submissions from all writers whether you are a student, practitioner, activist or established academic. The Displaced Voices online magazine is born out of the collaborative and intersectional work that we have been undertaking through our work with the refugee and migration archives housed at the University of East London. Our work to date has explored the intersections of refugee and migration studies with narrative and life history research linked to oral history methods and archival approaches to the preservation, documentation and accessibility of archival resources recording the refugee experience. This magazine is a collaborative project between the Living Refugee Archive at the University of East London; the Oral History Society Migration Special Interest Group and the International Association for the Study of Forced Migration Working Group on the History of Forced Migration and Refugees. Thematically we are looking to engage with articles that explore the intersection of refugee and forced migration studies; history and cultural heritage studies; narrative research; oral history and archival science

Status of the FETS Project

The Front End Test Stand (FETS) under construction at RAL is a demonstrator for front end systems of a future high power proton linac. Possible applications include a linac upgrade for the ISIS spallation neutron source, new future neutron sources, accelerator driven sub-critical systems, high energy physics proton drivers etc. Designed to deliver a 60mA H-minus beam at 3MeV with a 10% duty factor, FETS consists of a high brightness ion source, magnetic low energy beam transport (LEBT), 4-vane 324MHz radio frequency quadrupole, medium energy beam transport (MEBT) containing a high speed beam chopper and non-destructive laser diagnostics. This paper describes the current status of the project and future plans

A five-year perspective on the situation of haemorrhagic fever with renal syndrome and status of the hantavirus reservoirs in Europe, 2005-2010

Hantavirus infections are reported from many countries in Europe and with highly variable annual case numbers. In 2010, more than 2,000 human cases were reported in Germany, and numbers above the baseline have also been registered in other European countries. Depending on the virus type human infections are characterised by mild to severe forms of haemorrhagic fever with renal syndrome. The member laboratories of the European Network for diagnostics of Imported Viral Diseases present here an overview of the progression of human cases in the period from 2005 to 2010. Further we provide an update on the available diagnostic methods and endemic regions in their countries, with an emphasis on occurring virus types and reservoirs