Management of Agitation in Individuals with Dementia: an Animal-assisted Therapy Approach

Dementia is not a natural and normal part of aging, but rather a symptom of a disease process. Most individuals with dementia experience emotional distress or behavioral problems best summed up by the term agitation. Approximately 90% of individuals with dementing illnesses demonstrate problem behaviors ranging from repetitive verbalizations and wandering to verbal and physical aggression toward self or others. Each evening thousands of older adults in the community and in institutions become agitated, restless, and confused and begin to wander about or scream. This phenomenon is referred to as sundown syndrome, since it occurs in the evening hours after sunset. Sundown syndrome is not a psychiatric diagnosis, but it is a common and recognizable phenomenon for those who provide care for individuals with dementia (Burney-Puckett, 1996; Churchill, Safaoui, McCabe, & Baun, 1999). There is an enormous amount of pressure on nursing facility staff to manage agitation in individuals with dementia without resorting to the use of chemical and physical restraints. The federal government became involved in the oversight of nursing home care with the passage of the Omnibus Budget Reconciliation Act (OBRA, 1990). One of the goals of these regulations was to improve the quality of nursing home care by reducing the use of chemical and physical restraints in the management of agitation. The Omnibus Budget Reconciliation Act regulations recommend that an environmental and/or behavioral management strategy be the first line of treatment for agitated residents. Environmental and/or behavioral management strategies need to be devised to reduce the level of agitation in individuals with dementia, as well as provide feasibility for nursing facility staff to implement and incorporate these interventions into individual plans of care. Animal-assisted therapy is an environmental intervention that can be implemented by nursing facility staff as a nonpharmacologic treatment approach to managing agitation in individuals with dementia. This study was designed to investigate whether or not an animal-assisted therapy approach would be effective in managing agitation associated with sundown syndrome in individuals with dementia, thereby reducing the need to use chemical and/or physical restraints

Simulation of the Elastic Properties of Reinforced Kevlar-Graphene Composites

The compressive strength of unidirectional fiber composites in the form of Kevlar yarn with a thin outer layer of graphene was investigated and modeled. Such fiber structure may be fabricated by using a strong chemical bond between Kevlar yarn and graphene sheets. Chemical functionalization of graphene and Kevlar may achieved by modification of appropriate surface-bound functional (e.g., carboxylic acid) groups on their surfaces. In this report we studied elastic response to unidirectional in-plane applied load with load peaks along the diameter. The 2D linear elasticity model predicts that significant strengthening occurs when graphene outer layer radius is about 4 % of kevlar yarn radius. The polymer chains of Kevlar are linked into locally planar structure by hydrogen bonds across the chains, with transversal strength considerably weaker than longitudinal one. This suggests that introducing outer enveloping layer of graphene, linked to polymer chains by strong chemical bonds may significantly strengthen Kevlar fiber with respect to transversal deformations

The impact of an insecticide treated bednet campaign on all-cause child mortality: A geospatial impact evaluation from the Democratic Republic of Congo

Objective To test the impact of a nationwide Long-Lasting Insecticidal Nets [LLINs] distribution program in the Democratic Republic of Congo [DRC] on all-cause under-five child mortality exploiting subnational variation in malaria endemicity and the timing in the scale-up of the program across provinces. Design Geospatial Impact Evaluation using a difference-in-differences approach. Setting Democratic Republic of the Congo. Participants 52,656 children sampled in the 2007 and 2013/2014 DRC Demographic and Health Surveys. Interventions The analysis provides plausibly causal estimates of both average treatment effects of the LLIN distribution campaign and geospatial heterogeneity in these effects based on malaria endemicity. It compares the under-five, all-cause mortality for children pre- and post-LLIN campaign relative to children in those areas that had not yet been exposed to the campaign using a difference-in-differences model and controlling for year- and province-fixed effects, and province-level trends in mortality. Results We find that the campaign led to a 41% decline [3.7 percentage points, 95% CI 1.3 to 6.0] in under-5 mortality risk among children living in rural areas with malaria ecology above the sample median. Results were robust to controlling for household assets and the presence of other health aid programs. No effect was detected in children living in areas with malaria ecology below the median. Conclusion The findings of this paper make important contributions to the evidence base for the effectiveness of large scale-national LLIN campaigns against malaria. We found that the program was effective in areas of the DRC with the highest underlying risk of malaria. Targeting bednets to areas with greatest underlying risk for malaria may help to increase the efficiency of increasingly limited malaria resources but should be balanced against other malaria control concerns

Consideration of Technology Transfer in Tenure and Promotion

Universities face increasing expectations from both the public and elected officials to contribute to the economic development of their respective states, geographical regions, and the country. Technology transfer activities have proven to be a key way to meet these new imperatives. Despite the university’s expanded mission and the growing role of tech transfer, the academic community has yet to produce a consistent framework for evaluating faculty activities in technology transfer and their societal benefits. In response to this situation, the authors, working as the APLU Task Force on Tenure, Promotion, and Technology Transfer, surveyed US and Canadian universities to ascertain current approaches for defining technology transfer activities and recognizing them in assessing faculty performance. Building on the results of that survey, the authors offered the following five recommendations: 1) university policy statements should acknowledge the merit of technology transfer as part of the university’s work, while including safeguards against conflicts of interest or commitment; 2) technology transfer activities should be explicitly included among the criteria relevant for promotion and tenure at the university, college, and department levels, as appropriate to the respective disciplines; 3) technology transfer activities should be an optional component of the review process, one that will be rewarded when present but not seen as a requirement for everyone; 4) recognizing the unique character of technology transfer, the criteria should be flexible enough to encompass high-quality work in many forms of creative expression; and 5) technology transfer activities should be evaluated for intellectual contribution and expected social benefit consistent with the accepted process of peer review and without reliance on artificial metrics

Polarized spectroscopy of aligned single-wall carbon nanotubes

Polarized resonant Raman and optical spectroscopy of aligned single-wall carbon nanotubes show that the optical transitions are strongly polarized along the nanotubes axis. This behavior is consistent with recent electronic structure calculations

What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response

Efforts have been made to adapt the delivery of mental health care and support services to the demands of COVID-19. Here we detail the perspectives and experiences of mental health workers (MHWs), in relation to what they found helpful when adapting mental health services during the COVID-19 pandemic and responding to its demands. We were interested in exploring what has helped to support MHWs' own health and wellbeing given that staff wellbeing is central to sustaining the delivery of quality mental health services moving forward. Individual interviews were conducted with MHWs (n = 30) during the third COVID-19 lockdown. Interviews were audio-recorded, transcribed and managed using NVIVO. Qualitative data was analyzed using an inductive thematic approach. Three major themes were created, which emphasized the importance of: (1) 'self-care and peer support (checking in with each other)', (2) 'team cohesion and collaboration' and (3) 'visible and supportive management and leadership (new ways of working)'. Our findings emphasize the importance of individual, team and systems-based support in helping MHWs maintain their own wellbeing, whilst adapting and responding to the challenges in providing mental health care and support during this pandemic. Guidance and direction from management, with adaptive leadership in providing sustained, efficient, and equitable delivery of mental healthcare, is essential. Our findings support future policy, research and mental health practice developments through sharing important salutogenic lessons learned and transferable insights which may help with preparedness for future pandemic

Frontline experiences of delivering remote mental health supports during the COVID-19 pandemic in Scotland : innovations, insights and lessons learned from mental health workers

COVID-19 restrictions drove rapid adaptations to service delivery and new ways of working within Scotland’s mental health sector. This study explores mental health workers’ (MHWs’) experiences of delivering their services remotely. Twenty participants, who had worked in mental health professions in the National Health Service (NHS) in Scotland throughout the COVID-19 pandemic, took part in online semi-structured interviews. Data was transcribed then analysed using an inductive thematic analysis. Two major themes are reported: (1) ‘Improved Flexibility for both MHWs and Service Users’ and (2) ‘Teletherapies Challenge Therapeutic Boundaries’. In relation to (1) virtual platforms were seen as vital in maintaining patient care throughout the COVID-19 pandemic and a valuable resource for service users (SUs) who had previously struggled with mobility or social anxieties when accessing face-to-face services. Some MHWs’ also noted benefits for their productivity and comfort. Regarding (2) MHWs highlighted that whilst conducting teletherapies from home, work-life boundaries became blurred and, in some instances, typically comforting spaces became associated with the traumatic content discussed by SUs. These stressors seemed to be compounded by MHWs’ isolation, as they were less able to draw upon their colleagues for support. Further, confidentiality could not be assured, as MHWs and SUs alike had to accommodate their family members. These findings highlight important insights from MHWs in adapting to rapid changes in mental health working practices, particularly in relation to the challenges of delivering quality, safe and equitable services and the increased use of teletherapies. Such insights are vital in informing service developments and supporting future pandemic preparedness across a range of healthcare contexts and countries seeking to adopt hybrid models of mental health service delivery

Disaster Risk Reduction, Climate Change Adaptation and Human Security: A Commissioned Report for the Norwegian Ministry of Foreign Affairs by the Global Environmental Change and Human Security (GECHS) Project

The Norwegian Nobel Committee awarded the 2007 Nobel Peace Prize to the Intergovernmental Panel on Climate Change and Al Gore, in an effort to ‘contribute to a sharper focus on the processes and decisions that appear to be necessary to protect the world’s future climate and thereby to reduce the threat to the security of mankind’. In the wake of the 2007 award, the relationship between climate change and security has surfaced as a key concern among national governments and international institutions

Structural basis of DNA gyrase inhibition by antibacterial QPT-1, anticancer drug etoposide and moxifloxacin

New antibacterials are needed to tackle antibiotic-resistant bacteria. Type IIA topoisomerases (topo2As), the targets of fluoroquinolones, regulate DNA topology by creating transient double-strand DNA breaks. Here we report the first co-crystal structures of the antibacterial QPT-1 and the anticancer drug etoposide with Staphylococcus aureus DNA gyrase, showing binding at the same sites in the cleaved DNA as the fluoroquinolone moxifloxacin. Unlike moxifloxacin, QPT-1 and etoposide interact with conserved GyrB TOPRIM residues rationalizing why QPT-1 can overcome fluoroquinolone resistance. Our data show etoposide’s antibacterial activity is due to DNA gyrase inhibition and suggests other anticancer agents act similarly. Analysis of multiple DNA gyrase co-crystal structures, including asymmetric cleavage complexes, led to a ‘pair of swing-doors’ hypothesis in which the movement of one DNA segment regulates cleavage and religation of the second DNA duplex. This mechanism can explain QPT-1’s bacterial specificity. Structure-based strategies for developing topo2A antibacterials are suggested