The Role of Models and Formulations in the Management of Behaviors that Challenge in Dementia

The British Psychological Society’s Briefing Paper for Behaviors that Challenge (BtC) in dementia states that psychological formulation helps in the development of effective and well targeted treatments [1]. While not explicitly using the term psychological formulation, the 2018 NICE UK Dementia Guidelines support the use of systematic problem-solving approaches in the management of BtC. The current paper gives an overview of the content of a number of formulation models developed in this area and contrasts two established models. This article looks at two different ways of understanding people’s agitation – one which emphasizes the reasons for their behaviour in terms of the person with dementia [2] and the other called DICE [3] which puts equal emphasis on the roles of both caregivers and the environment in explaining behaviors. We suggest that, while the Newcastle Model tacitly suggests a role for caregivers and the environment in BtC, the explicit emphasis in DICE encourages a more holistic understanding of agitation

Program Update: Multi-State Extension Conference Addresses Food Diversity from Farm to Table

In 2005 and 2006, The Ohio State University Extension, University of Kentucky, Kentucky State University, and Purdue University Cooperative Extension Services developed and coordinated two conferences addressing food diversity from farm to table. The overall goal of the conferences was to foster a tri-state network of multi-disciplinary approaches to meet the needs of diverse audiences related to food. Self-reported email evaluation surveys suggested that conference goals and objectives were achieved. Future diversity trainings should continue to be multidisciplinary and should seek to attract others working in non-extension roles

Making waves in education

Making Waves in Education is a book of a collaborative nature, being a collection of chapters written by undergraduates studying B.A. Hons in Education at the Universities of Plymouth and York. Thirteen chapters, each from a different student, cover topics from learning theories to sex education, home education and autism. The chapters are well-organised and written, and they cover key topics in an accessible and thoughtful way. The chapters are generally well - referenced and present critical and balanced arguments. Many use hard statistics in an effective way to back up their points and all include bibliographies as indeed one expects from a serious publication. The collection therefore addresses itself to a wide readership of anyone interested in education, and students and teachers/trainers in HE in particula

An Investigation Of The Effect Of Network Latency On Pedagogic Efficacy: A Comparison Of Disciplines

E-learning has become a mainstream educational opportunity, as noted in U.S. News & World Report.  Further, differences among college students have been documented in various disciplines.  An experiment was conducted to determine the effects of network latency on pedagogical efficacy based on the students who were classified as in either humanities programs or engineering and science programs.  The findings indicate that tolerances to screen update latencies are discipline-dependent and that students in engineering and science have a lower tolerance for screen update latency than students in the humanities

Stromal microenvironment processes unveiled by biological component analysis of gene expression in xenograft tumor models

<p>Abstract</p> <p>Background</p> <p>Mouse xenograft models, in which human cancer cells are implanted in immune-suppressed mice, have been popular for studying the mechanisms of novel therapeutic targets, tumor progression and metastasis. We hypothesized that we could exploit the interspecies genetic differences in these experiments. Our purpose is to elucidate stromal microenvironment signals from probes on human arrays unintentionally cross-hybridizing with mouse homologous genes in xenograft tumor models.</p> <p>Results</p> <p>By identifying cross-species hybridizing probes from sequence alignment and cross-species hybridization experiment for the human whole-genome arrays, deregulated stromal genes can be identified and then their biological significance were predicted from enrichment studies. Comparing these results with those found by the laser capture microdissection of stromal cells from tumor specimens resulted in the discovery of significantly enriched stromal biological processes.</p> <p>Conclusions</p> <p>Using this method, in addition to their primary endpoints, researchers can leverage xenograft experiments to better characterize the tumor microenvironment without additional costs. The Xhyb probes and R script are available at <url>http://www.lussierlab.org/publications/Stroma</url></p

Secular changes in functional disability, pain, fatigue and mental well-being in early rheumatoid arthritis.:A longitudinal meta-analysis

Objectives: To conduct a systematic review and longitudinal meta-analysis of early rheumatoid arthritis (RA) cohorts with long-term data on pain, fatigue or mental well-being. Methods: Searches using PUBMED, EMBASE and PyscInfo were performed to identify all early RA cohorts with longitudinal measures of pain, fatigue or mental well-being, along with clinical measures. Using longitudinal meta-analyses, the progression of each outcome over the first 60-months was estimated. Cohorts were stratified based on the median recruitment year to investigate secular trends in disease progression. Results: Of 7,319 papers identified, 75 met the inclusion criteria and 46 cohorts from 41 publications provided sufficient data on 18,046 patients for meta-analysis. The Disease Activity Scores (DAS28) and the Short-Form 36 (SF-36) Physical Component Score (PCS) indicated that post-2002 cohorts had statistically significant improvements over the first 60-months compared to pre-2002 cohorts, with standardised mean differences (SMD) of 0.86 (95% Confidence Intervals 0.34 to 1.37) and 0.76 (95% CI 0.25 to 1.27) respectively at month-60. However, post-2002 cohorts indicated statistically non-significant improvements in pain, fatigue, functional disability and SF-36 Mental Component Score (MCS) compared to pre-2002 cohorts, with SMD of 0.24 (95% CI -0.25 to 0.74), 0.38 (95% CI -0.11 to 0.88), 0.34 (95% CI -0.15-0.84) and -0.08 (95% CI -0.41 to 0.58) at month-60 respectively. Conclusions: Recent cohorts indicate improved levels of disease activity and physical quality of life, however this has not translated into similar improvements in levels of pain, fatigue and functional disability by 60-months

Diagnosis and management of UTI in primary care settings—A qualitative study to inform a diagnostic quick reference tool for women under 65 years

Background: To inform interventions to improve antimicrobial use in urinary tract infections (UTIs) and contribute to a reduction in Escherichia coli bloodstream infection, we explored factors influencing the diagnosis and management of UTIs in primary care. Design: Semi-structured focus groups informed by the Theoretical Domains Framework. Setting: General practice (GP) surgeries in two English clinical commissioning groups (CCGs), June 2017 to March 2018. Participants: A total of 57 GP staff within 8 focus groups. Results: Staff were very aware of common UTI symptoms and nitrofurantoin as first-line treatment, but some were less aware about when to send a urine culture, second-line and non-antibiotic management, and did not probe for signs and symptoms to specifically exclude vaginal causes or pyelonephritis before prescribing. Many consultations were undertaken over the phone, many by nurse practitioners, and followed established protocols that often included urine dipsticks and receptionists. Patient expectations increased use of urine dipsticks, and immediate and 5 days courses of antibiotics. Management decisions were also influenced by patient co-morbidities. No participants had undertaken recent UTI audits. Patient discussions around antibiotic resistance and back-up antibiotics were uncommon compared to consultations for respiratory infections. Conclusions: Knowledge and skill gaps could be addressed with education and clear, accessible, UTI diagnostic and management guidance and protocols that are also appropriate for phone consultations. Public antibiotic campaigns and patient-facing information should cover UTIs, non-pharmaceutical recommendations for "self-care", prevention and rationale for 3 days antibiotic courses. Practices should be encouraged to audit UTI management

Development of the digital assessment of precise physical activity (DAPPA) tool for older adults

Physical activity (PA) is central to maintaining health and wellbeing as we age. Valid, reliable measurement tools are vital for understanding, and evaluating PA. There are limited options for comprehensively, accurately and affordably measuring older adults’ PA at scale at present. We aimed to develop a digital PA measurement tool specifically for adults aged 65+ using a person-based approach. We collated evidence from target users, field experts and the relevant literature to learn how older adults comprehend PA and would accept a digital tool. Findings suggest that older adults’ PA is often integrated into their daily life activities and that commonly applied terminology (e.g., moderate and vigorous) can be difficult to interpret. We also found that there is increasing familiarity with digital platforms amongst older adults, and that technological simplicity is valued. These findings informed the development of a digital tool that asks users to report their activities across key PA domains and dimensions from the previous 7-days. Users found the tool easy to navigate and comprehensive in terms of activity reporting. However, real-world usability testing revealed that users struggled with seven-day recall. Further work will address the identified issues, including creating a single-day reporting option, before commencing work to validate this new tool