Delirium in aged-care facilities : a major challenge for health professionals

RESEARCH QUESTION: What are the success and barriers in aged-care nurses assessing and managing of delirium cases? • A mixed method approach was utilised comprising of a survey over one year in one of Auckland’s emergency department (ED) and focus groups • Subsequently 10 focus groups with ARC nurses from standardised presentations of the top 5 (highest rate) and the bottom 5 (lowest rate) admissions to ED

Delirium assessment and management : a qualitative study on aged-care nurses’ experiences

Aged residential care (ARC) residents with morbid health conditions frequently experience delirium. This condition is associated with diminished quality of life, preventable morbidity and untimely death. It is challenging and costly to manage delirium because of the complex interplay of physical and psychiatric symp­toms associated with this condition in both primary and secondary services. With awareness of risk factors and knowledge about delirium, ARC nurses can play a vital role in early identification, assessment and treatment, but most importantly in preventing de­lirium in aged-care residents as well as improving health outcome

Facteurs de risques microbiologiques et transplantation pulmonaire dans la mucoviscidose

AIX-MARSEILLE2-BU Pharmacie (130552105) / SudocSudocFranceF

Connectivity dynamics and cognitive variability during aging

International audienceAging is associated with cognitive changes, with strong variations across individuals. One way to characterize this individual variability is to use techniques such as magnetoencephalography (MEG) to measure the dynamics of neural synchronization between brain regions, and the variability of this connectivity over time. Indeed, few studies have focused on fluctuations in the dynamics of brain networks over time and their evolution with age. We therefore characterize aging effects on MEG phase synchrony in healthy young and older adults from the Cam-CAN database. Age-related changes were observed, with an increase in the variability of brain synchronization, as well as a reversal of the direction of information transfer in the default mode network (DMN), in the delta frequency band. These changes in functional connectivity were associated with cognitive decline. Results suggest that advancing age is accompanied by a functional disorganization of dynamic networks, with a loss of communication stability and a decrease in the information transmitted

An infeasible interior-point technique to generate the nondominated set for multiobjective optimization problems

In this paper, an infeasible interior-point technique is proposed to generate the nondominated set of nonlinear multi-objective optimization problems with the help of the direction-based cone method. We derive the proposed method for both convex and nonconvex problems. In order to solve the parametric optimization problems of the cone method, the infeasible interior-point method starts with an initial iterate outside the feasible region, and then gradually reduces the primal and dual infeasibility measures and the objective function value across the iterations with the help of a merit function. Estimates of the reduction of primal and dual infeasibility parameters per iteration are given. The convergence analysis of the method and an estimate of the number of iterations to reach an  ϵ -precise solution are also provided. We provide the performance of the proposed methods on a variety of convex and nonconvex multi-objective test problems. Performance comparison between the proposed method and popular existing solvers is provided with respect to two performance measures and the corresponding relative efficiency measures. The reduction of a combined infeasibility measure, as the iterations progress, on the test problems is also shown graphically

MoodRush : designing a language-free mobile app for mood self-assessment

Depression affects a large percentage of young adults across the globe. The delivery of mental health information and the provision of tools for the self-assessment of mood are important means in addressing this problem. While self-assessment of mood is becoming more common through web resources and mobile applications, existing resources are limited in multiple ways. First, they typically include a significant language component and are therefore not suitable to youth with limited literacy/speakers of other languages. Second, existing tools are not visually engaging, usually constituting questionnaires presented on monochromatic background. Third, existing tools are limited in their clinical validity. This paper presents the background to the creation of a prototype mood self-assessment tool delivered via a mobile app. Based on a clinically validated mood self-assessment measure, the prototype guides the user through 21 pictorial questions and provides overall feedback. The user’s level of engagement is assessed using data provided by GoogleAnalytics and compared to their engagement with, and response to, the standard written selfassessment questionnair

What is the lived experience of older migrants with mild cognitive impairment

RESEARCH QUESTION: What are the experiences of older migrants with mild cognitive impairment in New Zealand? BACKGROUND: Mild cognitive impairment (MCI) is a complex intermediate state of memory decline, which is widely acknowledged as a precursor to Alzheimer’s disease (AD). However, not all those diagnosed with MCI progress to AD, because many of those remains the same for life, but many recovers completely from it. MCI is an emerging primary target of aging research. MCI may have a significant impact on older migrants’ in relation to engagement from social activities, isolation, social disconnection, poor quality of life, and early retirement which can results in considerable socio-economic burden. Older migrants, are ethnically, culturally, linguistically diverse and are they are predisposed to psycho-social distress, loneliness, and trauma as well as physical health complications. Cultural factors, language barriers, and the resettlement process may all contribute to reduced cognition. AIM: As little is known on the experience of older migrants with MCI, this research will provide valuable information to better understand their lived experiences on this phenomenon. Research will help to better understand this condition, support shaping up strategies to sustain longer and better-quality life for older migrants. Method: Purposively sampled community-dwelling older migrants with MCI, aged 55 years old and over, will be recruited in Auckland’s region, to participate in semistructured interviews. Data will be inductively interpreted through a phenomenological lens that looks deeper and deeper into the reality of the world as it is experienced by older migrants. DISCUSSION: This research will provide a wealth of knowledge on the lived experience of older migrants’ with MCI. It is anticipated that learning from this research will help reduce a gap in knowledge, help to enhance professional practice and offer a culture-speci fic outcomes on improving quality health services for older migrants

MoodRush : engaging, language-free, mobile self-asssessment of mood

DIGITAL HEALTH ERA New Zealand: 91% of the 18-34 own a smartphone (Gibson et al., 2013) Youth spend a significant amount of time on their devices (The Common Sense Census, 2015). Feeling normal & autonomous and being connected, are crucial factors for young people affected by mental health problems (Wisdom, Clarke, & Green, 2006). 69% of contacts to telehealth providers originate from < 24yr olds (Coleman, 2017) Mobile health interventions have significant positive effect on health outcomes in young populations (Fedele et al., 2017). Self-assessment is therapeutically beneficial due to the individual being involved in the process (Bec

What is the lived experience of older migrants with mild cognitive impairment? A proposed phenomenological study

RESEARCH QUESTION: What are the experiences of older migrants with mild cognitive impairment in New Zealand? BACKGROUND: Mild cognitive impairment (MCI) is a complex intermediate state of memory decline, which is widely acknowledged as a precursor to Alzheimer’s disease (AD). However, not all those diagnosed with MCI progress to AD, because many of those remains the same for life, but many recovers completely from it. MCI is an emerging primary target of aging research. MCI may have a significant impact on older migrants’ in relation to engagement from social activities, isolation, social disconnection, poor quality of life, and early retirement which can results in considerable socio-economic burden. Older migrants, are ethnically, culturally, linguistically diverse and are they are predisposed to psycho-social distress, loneliness, and trauma as well as physical health complications. Cultural factors, language barriers, and the resettlement process may all contribute to reduced cognition. AIM: As little is known on the experience of older migrants with MCI, this research will provide valuable information to better understand their lived experiences on this phenomenon. Research will help to better understand this condition, support shaping up strategies to sustain longer and better-quality life for older migrants. Method: Purposively sampled community-dwelling older migrants with MCI, aged 55 years old and over, will be recruited in Auckland’s region, to participate in semistructured interviews. Data will be inductively interpreted through a phenomenological lens that looks deeper and deeper into the reality of the world as it is experienced by older migrants. DISCUSSION: This research will provide a wealth of knowledge on the lived experience of older migrants’ with MCI. It is anticipated that learning from this research will help reduce a gap in knowledge, help to enhance professional practice and offer a culture-speci fic outcomes on improving quality health services for older migrants

M/EEG Dynamics Underlying Reserve, Resilience, and Maintenance in Aging: A Review

International audienceCognitive reserve and resilience refer to the set of processes allowing the preservation of cognitive performance in the presence of structural and functional brain changes. Investigations of these concepts have provided unique insights into the heterogeneity of cognitive and brain changes associated with aging. Previous work mainly relied on methods benefiting from a high spatial precision but a low temporal resolution, and thus the temporal brain dynamics underlying these concepts remains poorly known. Moreover, while spontaneous fluctuations of neural activity have long been considered as noise, recent work highlights its critical contribution to brain functions. In this study, we synthesized the current state of knowledge from magnetoencephalography (MEG) and electroencephalography (EEG) studies that investigated the contribution of maintenance of neural synchrony, and variability of brain dynamics, to cognitive changes associated with healthy aging and the progression of neurodegenerative disease (such as Alzheimer's disease). The reviewed findings highlight that compensations could be associated with increased synchrony of higher (&gt;10 Hz) frequency bands. Maintenance of young-like synchrony patterns was also observed in healthy older individuals. Both maintenance and compensation appear to be highly related to preserved structural integrity (brain reserve). However, increased synchrony was also found to be deleterious in some cases and reflects neurodegenerative processes. These results provide major elements on the stability or variability of functional networks as well as maintenance of neural synchrony over time, and their association with individual cognitive changes with aging. These findings could provide new and interesting considerations about cognitive reserve, maintenance, and resilience of brain functions and cognition