Nurses' perceptions in caring for people with dementia in Dutch acute hospitals

AIMS AND OBJECTIVES: Overall, this study aimed to describe nursing care for patients with dementia in acute hospitals, with the objectives of describing the provided nursing care (a), nurses’ attitudes and perceptions in caring for patients with dementia (b), and exploring how nurses deal with challenging behaviour (c). Additionally, we determined background variables associated with caring for people with dementia. BACKGROUND: Due to comorbidities, people with dementia are frequently admitted to acute care hospitals. Here, they are at high risk of complications. Nurses strive for good care but regularly experience insufficient knowledge and skills regarding caring for people with dementia. DESIGN: A cross‐sectional survey study design. METHODS: Data were collected in seven Dutch acute hospitals and through social media. In total, 229 hospital nurses completed the questionnaire. We used the Geriatric In‐Hospital Nursing Care Questionnaire and two subscales of Hynninen on managing challenging behaviour. This report followed the STROBE checklist. RESULTS: Nurses express that they often apply general preventive interventions not explicitly related to dementia care. In general, nurses have mixed feelings about the nursing care provided in their department. For challenging behaviour, a variety of approaches, including restrictive measures and medication, is applied. The nurses’ attitudes and perceptions are influenced by the type of hospital where the nurses work, the level of education, the number of hours nurses work, and if the nurses completed a course on dementia in the last year. CONCLUSIONS: Despite a positive attitude, nurses do not have the specific knowledge and skills needed to provide proper care. Nurses who recently completed a course on dementia had more positive attitudes and perceptions towards caring for patients with dementia. RELEVANCE TO CLINICAL PRACTICE: The results of this research can be used to improve the quality of nursing care for patients with dementia in acute hospitals

Involvement, topics, and roles of nurses in shared decision-making with patients with dementia in acute hospitals:An integrative review

Aim: To describe nurses' roles, involvement, and topics in shared decision-making with older patients with dementia in acute hospitals. Design: An integrative review. Methods: A systematic search was performed until April 2022 in PubMed, PsychInfo, CINAHL, and Cochrane, followed by a manual search on the reference lists of relevant systematic reviews. Studies were independently screened, appraised using the Joanna Briggs Institute (JBI) methodology, and extracted by two reviewers. Results: Nine studies were included. Nurses were involved as treatment team members, intermediates, or patient supporters. Nurses' roles were most explicit in the preparatory phase of shared decision-making. The step of ‘developing tailor-made options’ was limitedly identified. ‘Deliberating and trying options to reach a decision’ were described from an outsider's perspective in which nurses attempted to influence the decision. In conclusion, nurses primarily have a role in decision-making by supplementing patient information. Patient and Public Contribution No Patient or Public Contribution.</p

Involvement, topics, and roles of nurses in shared decision-making with patients with dementia in acute hospitals:An integrative review

Aim: To describe nurses' roles, involvement, and topics in shared decision-making with older patients with dementia in acute hospitals. Design: An integrative review. Methods: A systematic search was performed until April 2022 in PubMed, PsychInfo, CINAHL, and Cochrane, followed by a manual search on the reference lists of relevant systematic reviews. Studies were independently screened, appraised using the Joanna Briggs Institute (JBI) methodology, and extracted by two reviewers. Results: Nine studies were included. Nurses were involved as treatment team members, intermediates, or patient supporters. Nurses' roles were most explicit in the preparatory phase of shared decision-making. The step of ‘developing tailor-made options’ was limitedly identified. ‘Deliberating and trying options to reach a decision’ were described from an outsider's perspective in which nurses attempted to influence the decision. In conclusion, nurses primarily have a role in decision-making by supplementing patient information. Patient and Public Contribution No Patient or Public Contribution.</p

Repositioning the Catalytic Triad Aspartic Acid of Haloalkane Dehalogenase: Effects on Stability, Kinetics, and Structure

Haloalkane dehalogenase (DhlA) catalyzes the hydrolysis of haloalkanes via an alkyl-enzyme intermediate. The covalent intermediate, which is formed by nucleophilic substitution with Asp124, is hydrolyzed by a water molecule that is activated by His289. The role of Asp260, which is the third member of the catalytic triad, was studied by site-directed mutagenesis. Mutation of Asp260 to asparagine resulted in a catalytically inactive D260N mutant, which demonstrates that the triad acid Asp260 is essential for dehalogenase activity. Furthermore, Asp260 has an important structural role, since the D260N enzyme accumulated mainly in inclusion bodies during expression, and neither substrate nor product could bind in the active-site cavity. Activity for brominated substrates was restored to D260N by replacing Asn148 with an aspartic or glutamic acid. Both double mutants D260N+N148D and D260N+N148E had a 10-fold reduced kcat and 40-fold higher Km values for 1,2-dibromoethane compared to the wild-type enzyme. Pre-steady-state kinetic analysis of the D260N+N148E double mutant showed that the decrease in kcat was mainly caused by a 220-fold reduction of the rate of carbon-bromine bond cleavage and a 10-fold decrease in the rate of hydrolysis of the alkyl-enzyme intermediate. On the other hand, bromide was released 12-fold faster and via a different pathway than in the wild-type enzyme. Molecular modeling of the mutant showed that Glu148 indeed could take over the interaction with His289 and that there was a change in charge distribution in the tunnel region that connects the active site with the solvent. On the basis of primary structure similarity between DhlA and other α/β-hydrolase fold dehalogenases, we propose that a conserved acidic residue at the equivalent position of Asn148 in DhlA is the third catalytic triad residue in the latter enzymes.

Spinaxinus (Bivalvia: Thyasiroidea) from sulfide biogenerators in the Gulf of Mexico and hydrothermal vents in the Fiji Back Arc: Chemosymbiosis and Taxonomy

Two new species of the thyasirid genus Spinaxinus (S. emicatus Oliver n. sp. and S. phrixicus Oliver n. sp.) are described from the Gulf of Mexico and the southwest Pacific, respectively. Both are compared with the type species of the genus, the eastern Atlantic S. sentosus Oliver and Holmes, 2006. Living specimens from the Gulf of Mexico were retrieved from artificial sulfide bio-generators on the upper Louisiana Slope. Gill morphology and molecular markers from the symbiotic bacteria confirm that Spinaxinus is chemosynthetic and that the chemoautotrophic bacteria are related to sulfide oxidizing Gammaproteobacteria. Living specimens from the southwest Pacific were retrieved from hydrothermal vent sites in the Fiji and Lau Back Arc Basins. In the Atlantic Spinaxinus is now recorded from two anthropogenic situations and appears to be generally absent from natural cold seep sites and not yet recorded at any hydrothermal sites. The primarily anthropogenic distribution of Spinaxinus in the Atlantic is discussed with reference to the natural hydrothermal vent habitat of the Pacific S. phrixicus.Spinaxinus (Bivalvia: Thyasiroidea) de bio-generadores artificiales de sulfuro situados en el Golfo de Méjico y en fuentes hidrotermales de las Islas Fiji: quimiosimbiosis y taxonomía. – En este trabajo se describen dos especies nuevas de tisárido del género Spinaxinus (S. emcatus Oliver n. sp. y S. phrixicus Oliver n. sp.) encontradas res- pectivamente en el Golfo de Méjico y en el sureste del Pacífico. Se comparan estas dos especies nuevas con la especie tipo del género, S. sentous Oliver y Holmes, 2006 descrita en el Este del Atlántico. Para describir estas dos especies, se observaron ejemplares vivos recolectados sobre bio-generadores artificiales de sulfuro situados en la parte alta de la plataforma conti- nental de Louisiana, en el Golfo de Méjico. Las observaciones realizadas de las branquias de Spinaxinus y la caracterización genética de las bacterias simbiontes en estos ejemplares confirmaron que Spinaxinus es un género quimiosintético que con- tiene bacterias quimioautótrofas cercanas a las Gammaproteobacterias responsables de la oxidación del sulfuro. También se recolectaron ejemplares vivos de fuentes hidrotermales situadas en las Islas Fiji y en ‘Lau Back Arc Basins’ ambas localiza- das en el Pacífico suroccidental. La especie atlántica de Spinaxinus se encontró en dos tipos de sustratos artificiales mientras que parece que esta especie no se encuentra en ambientes naturales equivalentes como serían las surgencias frías y las fuentes hidrotermales. La distribución aparentemente limitada de la especie atlántica se discute en relación con la distribución de S. phrixicus en las fuentes hidrotermales del Pacífico

Atomic layer deposition of high-k dielectric layers on Ge and III-V MOS channels

Ge and III-V semiconductors are potential high performance channel materials for future CMOS devices. In this work, we have studied At. Layer Deposition (ALD) of high-k dielec. layers on Ge and GaAs substrates. We focus at the effect of the oxidant (H2O, O3, O2, O2 plasma) during gate stack formation. GeO2, obtained by Ge oxidn. in O2 or O3, is a promising passivation layer. The germanium oxide thickness can be scaled down below 1 nm, but such thin layers contain Ge in oxidn. states lower than 4+. Still, elec. results indicate that small amts. of Ge in oxidn. states lower than 4+ are not detrimental for device performance. Partial intermixing was obsd. for high-k dielec. and GeO2 or GaAsOx, suggesting possible correlations in the ALD growth mechanisms on Ge and GaAs substrates. [on SciFinder (R)

Measuring the activity of European and African Countries using Social Accounting Matrices

Economic models at the micro, meso and macro levels presuppose the existence of consistent databases that make it possible to quantify the activity of enterprises, sectors, regions, countries or continents. Such models can also be important aids in the policy decision process, since they permit the construction of scenarios resulting from the adoption of policy measures and the consequent changes that they introduce. When consistent with the United Nations System of National Accounts (SNA), the Social Accounting Matrix (SAM) can include all the nominal flows of the measured part of the economy, at the level of both production and the institutions, and therefore satisfies these requirements. Thus, in its numerical version, a SAM constitutes a database and provides a snapshot of the measured reality at a certain moment, whereas its possible algebraic versions, i.e. models that are based upon it, permit the construction of the above-mentioned scenarios. The possibility and usefulness of constructing SAMs for African countries consistent with the SNA will be examined and experimented. The SAM’s basic structure and consistency within the whole system will be studied, as well as any possible disaggregations, extensions, aggregates, indicators and balances that can be calculated. Other aspects beyond that basic structure will also be examined in order to show to what extent the SAM is capable of covering parts of the economy that are not covered by the SNA.info:eu-repo/semantics/publishedVersio