536 research outputs found
The disconnect between evidence and practice: A systematic review of person-centred interventions and training manuals for care home staff working with people with dementia
This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordObjective The overall objective is to determine the availability of person-centred intervention and training manuals for dementia care staff with clinical trial evidence of efficacy. Design Interventions were identified using a search of electronic databases, augmented by mainstream search engines, reference lists, hand searching for resources and consultation with an expert panel. The specific search for published manuals was complemented by a search for randomised control trials focussing on training and activity-based interventions for people with dementia in care homes. Manuals were screened for eligibility and rated to assess their quality, relevance and feasibility. Results A meta-analysis of randomised control trials indicated that person-centred training interventions conferred significant benefit in improving agitation and reducing the use of antipsychotics. Each of the efficacious packages included a sustained period of joint working and supervision with a trained mental health professional in addition to an educational element. However, of the 170 manuals that were identified, 30 met the quality criteria and only four had been evaluated in clinical trials. Conclusions Despite the availability of a small number of evidence-based training manuals, there is a widespread use of person-centred intervention and training manuals that are not evidence-based. Clearer guidance is needed to ensure that commissioned training and interventions are based on robust evidence. Copyright © 2014 John Wiley & Sons, Ltd.National Institute for Health Research (NIHR
Practitionersâ understanding of barriers to accessing specialist support by family carers of people with dementia in distress
Distressing symptoms in dementia are hard to manage for many family carers. This article explores practitioners' perceptions of the barriers to accessing skilled behaviour management support encountered by carers. A survey of cases referred to the English National Health Service (n = 5,360) was followed by in-depth group discussions and practitioner interviews. Data revealed that practitioners focused on care home residents or older people with mental health problems other than dementia, rather than community-dwelling people with dementia and families. Barriers to access included misperceptions about the nature of distressing behaviour affecting carers and structural limitations in the capacity of specialist services to respond to carers
Water in HD 209458b's atmosphere from 3.6 - 8 microns IRAC photometric observations in primary transit
The hot Jupiter HD 209458b was observed during primary transit at 3.6, 4.5,
5.8 and 8.0 microns using the Infrared Array Camera (IRAC) on the Spitzer Space
Telescope. We detail here the procedures we adopted to correct for the
systematic trends present in the IRAC data. The light curves were fitted
including limb darkening effects and fitted using Markov Chain Monte Carlo and
prayer-bead Monte Carlo techniques, finding almost identical results. The final
depth measurements obtained by a combined Markov Chain Monte Carlo fit are at
3.6 microns, 1.469 +- 0.013 % and 1.448 +- 0.013 %; at 4.5 microns, 1.478 +-
0.017 % ; at 5.8 microns, 1.549 +- 0.015 % and at 8.0 microns 1.535 +- 0.011 %.
Our results clearly indicate the presence of water in the planetary atmosphere.
Our broad band photometric measurements with IRAC prevent us from determining
the additional presence of other other molecules such as CO, CO2 and methane
for which spectroscopy is needed. While water vapour with a mixing ratio of
10^-4-10^-3 combined with thermal profiles retrieved from the day-side may
provide a very good fit to our observations, this data set alone is unable to
resolve completely the degeneracy between water abundance and atmospheric
thermal profile.Comment: 14 pages, 6 tables, 10 figures, Accepted for publication in MNRA
Association between longer hospitalization and development of de novo donor specific antibodies in simultaneous liverâkidney transplant recipients
© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background:De novo Donor Specific Antibodies (DSA) are considered as a risk factor for the kidney allograft outcomes in recipients after simultaneous liverâkidney transplantation (SLKT). We hypothesized that length of hospital stay (LOS) might be associated with de novo DSA development of due to the increased likelihood of receiving blood transfusions with reduced immunosuppressive regimens. Methods: This study is a single-center, retrospective cohort study consisting of 85 recipients who underwent SLKT from 2009 to 2018 in our hospital. We divided the patients into two groups according to LOS [long hospital stay (L) group (LOS \u3e14 days) and short hospital stay (S) group (LOS â€14 days)]. Propensity score (PS) has been created using logistic regression to predict LOS greater than median of 14 days. The association between the presence of de novo DSA and LOS was assessed by logistic regression models adjusted for PS. Results: The mean age at transplantation of the entire cohort was 55.5 ± 10.1 years. Sixty percent of the recipients were male and Caucasian. Median LOS in (L) group was three-fold longer than (S) group [L: median 30 days (IQR: 21â52), S: median 8.5 days (IQR: 7â11)]. Eight patients developed de novo DSA after SLKT (9.4%), all of them were in (L) group. Longer LOS was significantly associated with higher risk of development of de novo DSA in unadjusted (OR+ each 5 days: 1.09, 95% CI:1.02â1.16) and PS adjusted (OR+ each 5 days: 1.11, 95% CI:1.02â1.21) analysis. Conclusion: Longer hospitalization is significantly associated with the development of de novo DSA in SLKT
An ingress and a complete transit of HD 80606 b
We have used four telescopes at different longitudes to obtain
near-continuous lightcurve coverage of the star HD 80606 as it was transited by
its \sim 4-MJup planet. The observations were performed during the predicted
transit windows around the 25th of October 2008 and the 14th of February 2009.
Our data set is unique in that it simultaneously constrains the duration of the
transit and the planet's period. Our Markov-Chain Monte Carlo analysis of the
light curves, combined with constraints from radial-velocity data, yields
system parameters consistent with previously reported values. We find a
planet-to-star radius ratio marginally smaller than previously reported,
corresponding to a planet radius of Rp = 0.921 \pm 0.036RJup .Comment: 6 pages, 2 figures, MNRAS accepte
Methane in the atmosphere of the transiting hot Neptune GJ436b?
We present an analysis of seven primary transit observations of the hot
Neptune GJ436b at 3.6, 4.5 and m obtained with the Infrared Array Camera
(IRAC) on the Spitzer Space Telescope. After correcting for systematic effects,
we fitted the light curves using the Markov Chain Monte Carlo technique.
Combining these new data with the EPOXI, HST and ground-based and
published observations, the range m can be covered. Due to
the low level of activity of GJ436, the effect of starspots on the combination
of transits at different epochs is negligible at the accuracy of the dataset.
Representative climate models were calculated by using a three-dimensional,
pseudo-spectral general circulation model with idealised thermal forcing.
Simulated transit spectra of GJ436b were generated using line-by-line radiative
transfer models including the opacities of the molecular species expected to be
present in such a planetary atmosphere. A new, ab-initio calculated, linelist
for hot ammonia has been used for the first time. The photometric data observed
at multiple wavelengths can be interpreted with methane being the dominant
absorption after molecular hydrogen, possibly with minor contributions from
ammonia, water and other molecules. No clear evidence of carbon monoxide and
dioxide is found from transit photometry. We discuss this result in the light
of a recent paper where photochemical disequilibrium is hypothesised to
interpret secondary transit photometric data. We show that the emission
photometric data are not incompatible with the presence of abundant methane,
but further spectroscopic data are desirable to confirm this scenario.Comment: 19 pages, 10 figures, 1 table, Astrophysical Journal in pres
Line-profile tomography of exoplanet transits -- II. A gas-giant planet transiting a rapidly-rotating A5 star
Most of our knowledge of extrasolar planets rests on precise radial-velocity
measurements, either for direct detection or for confirmation of the planetary
origin of photometric transit signals. This has limited our exploration of the
parameter space of exoplanet hosts to solar- and later-type, sharp-lined stars.
Here we extend the realm of stars with known planetary companions to include
hot, fast-rotating stars. Planet-like transits have previously been reported in
the lightcurve obtained by the SuperWASP survey of the A5 star HD15082
(WASP-33; V=8.3, v sin i = 86 km/sec). Here we report further photometry and
time-series spectroscopy through three separate transits, which we use to
confirm the existence of a gas giant planet with an orbital period of 1.22d in
orbit around HD15082. From the photometry and the properties of the planet
signal travelling through the spectral line profiles during the transit we
directly derive the size of the planet, the inclination and obliquity of its
orbital plane, and its retrograde orbital motion relative to the spin of the
star. This kind of analysis opens the way to studying the formation of planets
around a whole new class of young, early-type stars, hence under different
physical conditions and generally in an earlier stage of formation than in
sharp-lined late-type stars. The reflex orbital motion of the star caused by
the transiting planet is small, yielding an upper mass limit of 4.1 Jupiter
masses on the planet. We also find evidence of a third body of sub-stellar mass
in the system, which may explain the unusual orbit of the transiting planet. In
HD 15082, the stellar line profiles also show evidence of non-radial
pulsations, clearly distinct from the planetary transit signal. This raises the
intriguing possibility that tides raised by the close-in planet may excite or
amplify the pulsations in such stars.Comment: 9 pages, 6 figures, accepted for publication in MNRA
Electronic communication of cells with a surface mediated by boronic acid saccharide interactions
The fabrication of a molecularly tailored surface functionalised with a saccharide binding motif, a phenyl boronic acid derivative is reported.The functionalised surface facilitated the transfer of electrons, via unique electronic interactions mediated by the presence of the boronic acid, from a macrophage cell line. This is the first example of eukaryotic cellular-electrical communication mediated by the binding of cells via their cellâsurface saccharide units
Effects of mountain gorilla foraging activities on the productivity of their food plant species
Mountain gorillas subsist principally on foliage from the dense herbaceous understorey that is found throughout most of their habitat in the Virunga Volcanoes region. Their foraging activities cause considerable structural damage to this vegetation. Those plant species that are quantitatively most important in the gorillas' diet respond to this damage by increasing primary productivity. At a sample of spots at which gorillas had fed, these species showed significantly higher growth rates over a 6-month interval than they did at nearby spots that had not been touched by the gorillas. Stem densities of herbaceous food species at feeding spots increased markedly both in comparison to their original values and to values for the same species at untouched spots. As a result, spots at which gorillas have fed are likely to become very attractive as future feeding spots. It is unlikely that gorillas âmanageâ their habitat in any specific fashion, largely because they do not have exclusive use of their home ranges. Their activities appear to maintain habitat productivity over the short term, on a time scale relevant to patterns of area revisits by social groups, and may contribute to long term beneficial alterations of regularly used areas, however. Effects of the type reported here may have been an important aspect of the adaptation by gorillas to terrestrial folivory. RĂSUMEĂ Les gorilles de montagne s'alimentent principalement de feuillages dans le sous-bois herbacĂ dense prĂsent presque partout dans leur habitat de la rĂgion des volcans Virunga. Leurs activitĂs alimentaires causent des dommages structurels considĂrables Ă cette vĂgĂtation. Les plantes des espĂces qui sont quantitativement les plus importants dans le rĂgime du gorille rĂagissent Ă ces dĂgats en augmentant leur productivitĂ primaire. Aux postes Ăchantillons oĂ les gorilles se sont nourris, ces espĂces prĂsentent des taux de croissance significantivement supĂrieurs sur un intervalle de six mois, par rapport aux postes voisins qui n'ont pas ĂtĂ touchĂs par les gorilles. Les densitĂs de tiges des espĂces herbacĂes appĂtĂes aux postes de nourrissage augmentent nettement aussi bien en comparaison avec leurs valeurs antĂrieures qu'avec celles de ces mÄmes espĂces dans des stations non touchĂes. En consĂquence, les postes oĂ les gorilles se sont nourris ont plus de chance de devenir des futurs postes de nourrissage trĂs attractifs. Il est peu probable que les gorilles âgĂrentâ leur habitat d'une quelconque faĂon, surtout parce qu'ils n'ont pas l'utilisation exclusive de leur domaine vital. Leurs activitĂs semblent maintenir Ă court terme la productivitĂ de leur habitat, sur une Ăchelle de temps comprenant les visites successives de groupes sociaux, et peuvent contribuer Ă long terme Ă des altĂrations bĂnĂfiques pour ces zones rĂguliĂrement frĂquentĂes. Des effets du type rapportĂ ici peuvent avoir ĂtĂ un ĂlĂment important de l'adaptation des gorilles Ă la folivorie terrestre.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75171/1/j.1365-2028.1987.tb01102.x.pd
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