Pain Intervention for people with Dementia in nursing homes (PID) : study protocol for a quasi-experimental nurse intervention

Background: It is estimated that 19 to 83% of people with dementia suffer from pain that is inadequately treated in the last months of life. A large number of healthcare workers who care for these people in nursing homes lack appropriate expertise and may therefore not always recognise, assess and treat pain in those with dementia who have complex problems on time, properly and efficiently. The aim of this intervention trial is to identify care needs of people with dementia suffering from pain living in a nursing home. Methods: A quasi-experimental nurse-led intervention trial based on a convenience sample of four nursing homes in the Swiss Canton of Zurich examines the effects on dementia patients (n = 411), the healthcare institution and the qualification level of the healthcare workers compared to historical controls, using an event analysis and a multilevel analysis. Healthcare workers will be individually trained how to assess, intervene and evaluate acute and chronic pain. There are three data-monitoring cycles (T0, T1, T2) and two intervention cycles (I1, I2) with a total study duration of 425 days. There is also a process evaluation based on Dobbins analyses that analyze in particular the potentials for change in clinical practice of change agents. Discussion: The aim of the intervention trial is to improve pain management strategies in older people with dementia in nursing homes. Clinically significant findings will be expected that will help reduce suffering in the sense of “total pain” for people with dementia. The joint intra- and interdisciplinary collaboration between practice and supply-oriented (nursing) research will have both a lasting effect on the efficiency measurement and provide scientifically sound results. Nursing homes can integrate the findings from the intervention trial into their internal quality control process. The potential for improvements can be directly influenced by the nursing home itself

Pain Interventions for people with dementia: a quasi-experimental study

Abstract Background Due to the complexity of the provision of care for people with dementia, pain assessment and management is still considered to be lacking. An optimal way to support frontline staff in providing pain assessment and management for people with dementia living in nursing homes has not yet been identified. The success of supporting interventions seems dependent on contextual factors in the nursing homes. This study, therefore, analyzes the feasibility of a nurse-led training intervention, using repeated on-site case studies, in modifying pain intensity and frequency in people with dementia. Methods Using a quasi-experimental design, we undertook a multi-center study of nurse-led training in pain management, with subsequent on-site case studies. Healthcare workers from 3 nursing homes assessed pain in 164 residents with dementia over 147 days. We used mixed-effect growth curve models with spline regression to analyze the data. Results We found that on-site case studies support frontline staff with pain management and assessment. Repeated reflection in case studies led to significantly longer pain free intervals (from 4.7 at baseline to 37.1 days at second follow-up) and decreased frequency of pain events (OR 0.54 at first follow-up and 0.43 at second follow-up). However no trends regarding pain intensity could be found. Therefore, on-site case studies may be valuable for improving pain frequency and pain-free intervals over time. Conclusion This feasibility study shows the potential of on-site support for frontline nursing home staff. On-site case studies may also affect health outcomes in people with dementia. However, the complexity of dementia care necessitates the management of a broader range of needs. Trial registration The study was retrospectively registered on the tenth of January 2017 with the German registry of clinical trials (DRKS00009726)

COMPLIS experiments : COllaboration for spectroscopy Measurements using a Pulsed Laser Ion Source

Laser spectroscopy measurements have been carried out on very neutron-deficient isotopes of Au, Pt and Ir, produced as daughter elements from a Hg ISOLDE beam. For these transitional region nuclides, the hyperfine structure (HFS) and isotope shift (IS) were measured by Resonance Ionization Spectroscopy (RIS). Magnetic moments μ, spectroscopic quadrupole moments Qs and changes of the nuclear mean square charge radius δ〈rc 2〉along isotopic series have been extracted. For some results, a detailed comparison with theoretical predictions is presented. (Springer

Etude génétique de Vintégration temporelle de lettres en mots

Summary Temporal and visual integration of successively presented letters into words of 4, 5 and 6 letters and of two degrees of familiarity was studied in children aged 7, 9 and 11 years. The children had to pronounce the word which corresponded to the sequence of letters. The verbal response was given either immediately or after a delay of 10 sec during which a colour naming task was interpolated. Performance improved with age, and at 11 years, children easily completed the task both with and without delay. The performance of children aged 7 and 9 years, however, was affected by the delay. Success in this task may be related to reading ability.Résumé Etude génétique (7, 9 et 11 ans) de l'intégration temporelle visuelle des lettres en mots (4, 5 et 6 lettres) en utilisant deux degrés de familiarité ; l'enfant doit énoncer le mot qui correspond à la synthèse des lettres présentées l'une après l'autre. Les réponses d'intégration sont données soit immédiatement soit après un délai de 10 s. On constate une amélioration de la réussite avec l'âge. A 11 ans, les enfants réussissent sans difficulté la tâche. Par contre, on constate la fragilité des réponses élaborées à 7 et à 9 ans car elles résistent mal à l'interférence de la tâche effectuée pendant le délai de 10 s (dénomination de pastilles colorées). Les enfants de 11 ans réussissent aussi bien avec et sans délai. L'analyse des mécanismes impliqués dans cette tâche permet d'envisager une relation avec la maîtrise de la lecture.Oléron Geneviève, Blanc Jean-Jacques. Etude génétique de Vintégration temporelle de lettres en mots. In: L'année psychologique. 1976 vol. 76, n°2. pp. 417-427

Pain Intervention for people with Dementia in nursing homes (PID): study protocol for a quasi-experimental nurse intervention

BACKGROUND: It is estimated that 19 to 83% of people with dementia suffer from pain that is inadequately treated in the last months of life. A large number of healthcare workers who care for these people in nursing homes lack appropriate expertise and may therefore not always recognise, assess and treat pain in those with dementia who have complex problems on time, properly and efficiently. The aim of this intervention trial is to identify care needs of people with dementia suffering from pain living in a nursing home. METHODS: A quasi-experimental nurse-led intervention trial based on a convenience sample of four nursing homes in the Swiss Canton of Zurich examines the effects on dementia patients (n = 411), the healthcare institution and the qualification level of the healthcare workers compared to historical controls, using an event analysis and a multilevel analysis. Healthcare workers will be individually trained how to assess, intervene and evaluate acute and chronic pain. There are three data-monitoring cycles (T0, T1, T2) and two intervention cycles (I1, I2) with a total study duration of 425 days. There is also a process evaluation based on Dobbins analyses that analyse in particular the potentials for change in clinical practice of change agents. DISCUSSION: The aim of the intervention trial is to improve pain management strategies in older people with dementia in nursing homes. Clinically significant findings will be expected that will help reduce suffering in the sense of "total pain" for people with dementia. The joint intra- and interdisciplinary collaboration between practice and supply-oriented (nursing) research will have both a lasting effect on the efficiency measurement and provide scientifically sound results. Nursing homes can integrate the findings from the intervention trial into their internal quality control process. The potential for improvements can be directly influenced by the nursing home itself. TRIAL REGISTRATION: Registration trial number: DRKS00009726 on DRKS, registered 10 January 2017, retrorespectively registered. Clearance certificate is available of the ethics committees of the canton of Thurgau, Switzerland, number: TG K201-02, and Zurich, Switzerland, number: ZH 01-2016. KEYWORDS: Dementia; Intervention; Nursing home; Pai

Le nouveau capitalisme agricole. De la ferme à la firme

En rupture avec l'exploitation familiale traditionnelle, des firmes agricoles se profilent dans de nombreuses régions du globe. Avec elles, s’amorce une recomposition agraire dont les contours restent largement invisibles.À l’exception de quelques cas médiatisés de « mégafermes » et autres « fermes des 1 000 vaches », la majorité de ces firmes ont jusqu’à présent échappé à l’analyse tant leurs visages sont multiples et flous.Leurs performances économiques et financières tout comme leurs incidences environnementales et sociales interrogent aussi bien les milieux politiques, professionnels que scientifiques.Comment sont-elles organisées ? Quels sont leurs logiques et modes d’action ? Dans quels espaces s’inscrivent-elles ? Comment une ferme familiale devient-elle une firme agricole ? Quels types d’acteurs sont impliqués ? Quels rapports au politique entretiennent-elles ? Quels conflits provoquent-elles ?Le premier ouvrage sur un phénomène mondial en pleine émergence

Tackling social inequalities in health: acceptability and feasibility of a systematic approach toward health impact assessment of urban projects

International audienceIntroduction: The general objective of this research project was to explore the feasibility and acceptability of an original method intended to systematically identify urban planning projects whose potential impacts on health and social inequalities in health (SIH) would be most damaging. An approach based on a short meeting and a tool would help to discuss whether or not to engage in a more comprehensive health impact assessment. Methods: A tool was developed by the research team based on various tools reported in the literature and modified with urban planners. Meetings were organized for each development project with the volunteer planners, who were working on the projects selected. Reviews of six projects at different stages of design made it possible to assess the acceptability and feasibility of this approach to identify public health and social equity issues in health. Results: The process and the use of the tool were found to be feasible. The tool was easily understandable, adapted to the practices of planners and usable without real training other than a quick introduction to tool usage. It was also found to be acceptable. Despite an interest in the inclusion of SIH, the integration of the relationship between SIH and urban development was not easy for most of the urban planners. Conclusion: This exploratory work suggests that a systematic approach to assessing the impact of urban projects on health and SIH is feasible and acceptable. Dealing with SIH was not found to be easy by the urban planners

On the use of hot-wire anemometry in pulsating flows. A comment on 'A critical review on advanced velocity measurement techniques in pulsating flows'

International audienceIn their recent topical review, Nabavi and Siddiqui (Meas. Sci. Technol. 2010 21 042002) recommended the use of hot-wire anemometry for velocity measurements in pulsating flows, especially at high frequency. This recommendation is misleading. The procedures invoked by these authors are valid only for small-amplitude fluctuations, which are of little interest for pulsating flows. When large-amplitude velocity changes occur without flow reversal, new procedures for the correction of the nonlinearities of the hot wire are required. This case was thoroughly investigated for a constant-voltage anemometer by Berson et al (Rev. Sci. Instrum. 2009 80 045102). In addition, we show that when flow reversal occurs--a case most relevant to pulsating flows--accurate hot-wire velocity measurements are not possible because heat transfer is not well defined when velocity passes through zero and changes direction

A strategy to eliminate all nonlinear effects in constant-voltage hot-wire anemometry

International audienc