A preliminary evaluation of the Short Break Stay Program: respite care for people with dementia

Recognising the need for a respite service which provides real support and reassurance for carers of people with dementia, Brotherhood of St Laurence Aged Services devised the Short Break Stay program at the Banksia Community Respite Centre. There is clear evidence that the program, which provides a three-day stay for people with advanced dementia in a homelike living space staffed by experienced personnel, has been a resounding success even beyond what was anticipated by the managers, providers and carers who developed and delivered the program.Key findingsThis preliminary evaluation suggests that the Short Break Stay Program is highly successful in meeting the respite needs of carers and the high care needs of their care recipients. Carers have given the program whole- hearted endorsement for a range of reasons.•    The Short Break Stay program offers an innovative dementia-specific, respite care service enabling a three-day break for carers which is long enough for them to receive some tangible respite from their caring role but short enough to avoid unduly disrupting the care routines already established at home unlike the standard fortnight in residential aged care facilities.•    The program staffing ratio of 2:6 and the person- centred care approach enable close attention to each individual.•    Carers valued highly the availability of staff to spend time with them to learn about their care recipient’s preferences and needs, as well as the regular communication provided during the client’s stay.•    Carers appreciated the careful matching of clients with staff as well as with other clients to ensuresome commonality among the clients taking a short break at any particular time.•    Carers appreciated the efforts made to replicate the care that clients received at home and, especially, the attention paid to transitions into the Banksia Centre and back home, which for people with dementia or cognitive impairment can often cause great anxiety and distress.•    The Banksia Centre offers clients and carers a smooth and seamless transition between day and short-break respite.•    Carers were confident that the Short Break Stay program included access to specialist services if required

A shared journey: insights from the Banksia Younger Onset Dementia Support Group

The study of a pilot program to support people with younger onset dementia in the Frankston area of outer Melbourne has found that the participants valued being involved in initiating and organising activities that they find meaningful and enjoyable, and having the chance to share their experience with others. The report poses some questions for the further development of services

Valuing capabilities in later life

This research report examines, from the perspective of the Brotherhood’s aged service users, what they value in life, what enables them to live fulfilled and meaningful lives, and what Brotherhood aged services can contribute to this. With its accent on freedoms, opportunities and human rights, the capability approach provides a conceptual framework in which to consider a new model of aged services in which will enhance older adults’ human rights and capabilities, especially for those who have been disadvantaged, and ensure that their views continue to inform and shape ageing policies, services and models of practice. The central concern of the capability approach, first articulated by Amartya Sen (1979) and developed by Martha Nussbaum within a social justice and human rights framework, is the opportunities people have for being and doing what, for them, constitutes a good life. Taking this as the starting point, this research represents the first part of a larger study which will examine what users of Brotherhood aged services value in life, what capabilities they aspire to, how current services enhance capabilities and how the capability approach might be integrated into service provision. Image: Report Cove

Comparing the diagnostic and clinical utility of WGS and WES with standard genetic testing (SGT) in children with suspected genetic diseases: A systematic review and meta-analysis

Rare genetic diseases remain a significant cause of infant mortality worldwide. Despite the established use of classic newborn screening (NBS) methodologies, many genetic diseases escape detection, necessitating the exploration of alternative diagnostic approaches. Whole-genome sequencing (WGS) and whole-exome sequencing (WES) have emerged as promising techniques for diagnosing genetic diseases in children. This study aimed to systematically evaluate the diagnostic and clinical utility of WGS and WES compared to standard genetic testing (SGT) in children suspected of having genetic diseases and discuss their potential impact on the expansion of NBS. A thorough search of EMBASE, MEDLINE, PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and references of included full-text articles was conducted until October 21, 2021. Studies reporting the diagnostic yield or rate of change in management using WGS and/or WES were included for analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed for data extraction, and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess study quality. Meta-analysis was performed using a random-effects model to calculate pooled proportions and odds ratios. The main outcomes of interest were the diagnostic utility and clinical utility of WGS, WES, and SGT. Diagnostic utility was defined as the identification of pathogenic or likely pathogenic variants strongly or moderately associated with the patient's clinical phenotype, which were subsequently reported to the clinician. Clinical utility encompassed any changes observed in medical or surgical management, as assessed through clinician questionnaires or Electronic Health Record reviews. The analysis included 43 studies involving 6,168 children. The pooled diagnostic utility of WES (0.40, 95% CI 0.34-0.45, I2=90%) exhibited a qualitative superiority over WGS (0.34, 95% CI 0.29-0.39, I2=79%) and SGT (0.19, 95% CI 0.13-0.25, I2=64%). Regarding clinical utility, WGS (0.74, 95% CI 0.56-0.89, I2=93%) demonstrated a qualitative advantage over WES (0.72, 95% CI 0.61-0.81, I2=86%), while both outperformed SGT (0.69, 95% CI 0.38-0.94). In conclusion, our findings suggest that WGS and WES should be considered as primary diagnostic tools for identifying genetic diseases in children. Furthermore, the integration of WGS and WES into NBS holds promise; however, additional investigations are warranted to assess the cost-effectiveness of this approach. This study sheds light on the potential of advanced sequencing methods to revolutionize the diagnosis and management of genetic diseases, thus impacting the field of human genetics significantly

Six ways to help fix energy hardship in New Zealand

Energy hardship is caused by the interaction of factors including housing quality, appliance efficiency, energy source and price, and occupant needs and income. Multiple policy approaches are needed to address these varied causes of energy hardship, and the lack of an official definition and a measurement strategy in Aotearoa should not preclude policy action to address this critical social determinant of health. Here we outline six ways to help fix energy hardship in New Zealand

What goes in, must come out:combining scat-based molecular diet analysis and quantification of ingested microplastics in a marine top predator

Context: Microplastics (plastic particles &lt;5 mm in size) are highly available for ingestion by a wide range of organisms, either through direct consumption or indirectly, via trophic transfer, from prey to predator. The latter is a poorly understood, but potentially major, route of microplastic ingestion for marine top predators.Approach: We developed a novel and effective methodology pipeline to investigate dietary exposure of wild top predators (grey seals; Halichoerus grypus) to microplastics, by combining scat-based molecular techniques with a microplastic isolation method. We employed DNA metabarcoding, a rapid method of biodiversity assessment, to garner detailed information on prey composition from scats, and investigated the potential relationship between diet and microplastic burden.Results: Outcomes of the method development process and results of both diet composition from metabarcoding analysis and detection of microplastics are presented. Importantly, the pipeline performed well and initial results suggest the frequency of microplastics detected in seal scats may be related to the type of prey consumed. Conclusions: Our non-invasive, data rich approach maximises time and resource-efficiency, while minimising costs and sample volumes required for analysis. This pipeline could be used to underpin a much-needed increase in understanding of the relationship between diet composition and rates of microplastic ingestion in high trophic-level species.<br/

The Urolift System for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: a NICE medical technology guidance

As part of its Medical Technologies Evaluation Programme (MTEP), the National Institute for Health and Care Excellence (NICE) invited Neotract (manufacturer) to submit clinical and economic evidence for their prostatic urethral lift device, Urolift, for the relief of lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS BPH). The Urolift System uses implants to retract the prostatic lobe away from the urethral lumen. The clinical evidence used in the manufacturer’s submission shows that Urolift is effective for the treatment of BPH. Urolift delivers a weighted mean International Prostate Symptom Score (IPSS) improvement of between 9.22 and 11.82 points. These Urolift improvements are greater than a published ‘marked improvement’ in IPSS score of 8.80. Comparison with randomised controlled trials (RCTs) of TURP (Transurethral Resection of Prostate) and HoLEP (Holmium Laser Enucleation of Prostate) show that Urolift does not yield better clinical outcomes from baseline compared to TURP and HoLEP in terms of IPSS, QoL (Quality of Life) and Qmax (maximum urinary flow). However, Urolift appears to have the advantage in terms of minimal and mild complications, and this may be of interest to patients and urologists. The economic case for Urolift was made using a very detailed and thorough de novo cost model. The base case posed by the manufacturer placed Urolift at almost cost-neutral (£3 cost incurring, based on 2014 prices) compared to TURP, and £418 cost incurring compared to HoLEP. In an additional scenario comparing day-case Urolift with in-patient TURP, the estimated per-patient savings with Urolift were £286 compared with monopolar TURP (mTURP) and £159 compared with bipolar TURP (BiTURP). NICE guidance MTG26 recommends that the case for adoption of Urolift was supported by the evidence, when implemented in a day-case setting

An overview of the rare parotid gland cancer

Cancer of the parotid gland is relatively rare, but carries poor prognosis owing to its prevailing distant metastases. In addition to the disease's basic epidemiology and pathology, we review some current discoveries of its tumorigenesis molecular mechanism. Based on published salivary gland cancer clinical trial data, non-surgical antitumor efficacies amongst a range of chemotherapy, radiation, and concurrent therapy regimens are compared. We also present the current development status of novel radiation therapy and targeted therapeutics, focusing on intensity-modulated radiation therapy (IMRT), and epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) blockages, which are showing promise for improving parotid gland cancer management

Student perceptions of effective feedback in psychology

Receiving, interpreting and adopting feedback is a crucial component of higher education learning. Rubrics offer structured feedback and are widely used to increase marker consistency, increase feedback detail and increase student self-regulation. Despite widespread use, the empirical evidence for these claims across different forms of rubrics remains lacking. This cohort-controlled trial examined 491 psychology student perceptions of assessment task feedback using a detailed assessment rubric compared to a graded rating scale including a description of the highest level. Across two years, students completing two introduction to psychology units (one per semester) received feedback on the major assessment for each unit using an alternate assessment rubric or graded rating scale. The two introductory units were consecutive courses with the same cohort of students. Using a novel 9-itemed measure, students completed anonymous online questionnaires about both forms of feedback. There was a significant difference for one item, student understanding of the feedback, suggesting a preference for the graded rating scale. Across 8 other items there was no significant difference between feedback forms. These outcomes included other items measuring student comprehension, helpfulness for future similar tasks, usefulness when preparing the task, and whether feedback was read. Despite widespread academic preference for assessment rubrics, these results indicate no strong advantage for this form of feedback. This finding challenges traditional approaches to providing feedback and calls for further research to examine reasons why the rubric feedback was harder for students to understand, and identify characteristics of feedback that is preferred by both educators and students

Introduction: Policy Responses to Ageing and the Extension of Working Lives

Since the beginning of the twenty-first century, the relationship between work and ageing has become increasingly visible as a policy issue. It is both reflected in and influenced by changes in macro-economic policy, life-opportunities and social attitudes associated with growing older, as a combination of falling birth rates and increased longevity, and has put pressure on the traditional parameters of the working age. The idea of retiring at a fixed point in the life-course, to enjoy a period of rest or leisure at the end of a working life, emerged in many advanced economies during the 1900s and evolved into policies that encouraged early retirement as the baby-boomers entered the jobs market in the 1960s and 1970s (Phillipson and Smith, 2005). Early retirement, itself a relatively recent development, gave rise to the possibility of a ‘third age’ of leisure and active ageing (Laslett, 1987), but as demographic and economic changes make themselves felt, it is again becoming an uncertain prospect for many older workers (Biggs and McGann, 2015)