How people with dementia and their families decide about moving to a care home and support their needs: development of a decision aid, a qualitative study

yesBackground: People with dementia and their relatives find decisions about the person with dementia living in a care home difficult. Methods: We interviewed 20 people with dementia or family carers around the time of this decision in order to design a decision-aid. Results: Decision-makers balanced the competing priorities of remaining somewhere familiar, family’s wish they remain at home, reduction of risk and effects on carer’s and person with dementia’s physical health. The person with dementia frequently resented their lack of autonomy as decisions about care home moves were made after insight and judgment were impaired. Family consultation usually helped carers but sometimes exacerbated tensions. Direct professional support was appreciated where it was available. There is a need for healthcare professionals to facilitate these conversations around decision-making and to include more than signposting to other organisations. Conclusions: There is a need for a healthcare professional facilitated decision-aid. This should detail what might change for the person with dementia and their carer, possible resources and alternatives and assist in facilitating discussion with the wider family; further research will develop and test a tool to facilitate decision making about place of care needs

A mixed-methods evaluation of the Association of Anaesthetists of Great Britain and Ireland Uganda Fellowship Scheme

The Association of Anaesthetists of Great Britain and Ireland and the then Uganda Society of Anaesthesia established the Uganda Fellowship Scheme in 2006, to provide scholarships to encourage doctors to train in anaesthesia in Uganda. We conducted an evaluation of this programme using online questionnaires and face‐to‐face semi‐structured interviews with trainees who received scholarships, as well as with senior surgeons and anaesthetists. Focus group discussions were held to assess changes in attitudes towards anaesthesia over the last 10 years. Interviews were recorded, transcribed and analysed using the constant comparative method. A total of 54 Ugandan doctors have received anaesthesia scholarships since 2006 (median funding per trainee (IQR [range]) £5520 (£5520–£6750 [£765–£9000]). There has been a four‐fold increase in the number of physician anaesthetists in Uganda during this time. All those who received funding remain in the region. The speciality of anaesthesia is undergoing a dramatic transformation led by this group of motivated young anaesthetists. There is increased access to intensive care, and this has allowed surgical specialities to develop. There is greater understanding and visibility of anaesthesia, and the quality of education in anaesthesia throughout the country has improved. The Uganda Fellowship Scheme provided a relatively small financial incentive to encourage doctors to train as anaesthetists. Evaluation of the project shows a wide‐ranging impact that extends beyond the initial goal of simply improving human resource capacity. Financial incentives combined with strong ‘north‐south’ links between professional organisations can play an important role in tackling the shortage of anaesthesia providers in a low‐income country and in improving access to safe surgery and anaesthesia

Narratives of family transition during the first year post-head injury: perspectives of the non-injured members.

To explore the narratives created by non-injured family members in relation to themselves and their family in the first year after head injury

Insulin Resistance and Body Fat Distribution in South Asian Men Compared to Caucasian Men

South Asians are susceptible to insulin resistance even without obesity. We examined the characteristics of body fat content, distribution and function in South Asian men and their relationships to insulin resistance compared to Caucasians.Twenty-nine South Asian and 18 Caucasian non-diabetic men (age 27+/-3 and 27+/-3 years, respectively) underwent euglycemic-hyperinsulinemic clamp for insulin sensitivity, underwater weighing for total body fat, MRI of entire abdomen for intraperitoneal (IP) and subcutaneous abdominal (SA) fat and biopsy of SA fat for adipocyte size.Compared to Caucasians, in spite of similar BMI, South Asians had higher total body fat (22+/-6 and 15+/-4% of body weight; p-value<0.0001), higher SA fat (3.5+/-1.9 and 2.2+/-1.3 kg, respectively; p-value = 0.004), but no differences in IP fat (1.0+/-0.5 and 1.0+/-0.7 kg, respectively; p-value = 0.4). SA adipocyte cell size was significantly higher in South Asians (3491+/-1393 and 1648+/-864 microm2; p-value = 0.0001) and was inversely correlated with both glucose disposal rate (r-value = -0.57; p-value = 0.0008) and plasma adiponectin concentrations (r-value = -0.71; p-value<0.0001). Adipocyte size differences persisted even when SA was matched between South Asians and Caucasians.Insulin resistance in young South Asian men can be observed even without increase in IP fat mass and is related to large SA adipocytes size. Hence ethnic excess in insulin resistance in South Asians appears to be related more to excess truncal fat and dysfunctional adipose tissue than to excess visceral fat

Indian student concerns about violence : exploring student perceptions

While considerable attention has been given to the spate of attacks on Indian students in Australia in 2009 and 2010, less attention has been paid to how the students who were at the centre of the furore perceived the violence. In this paper we explore the perceptions of Indian postgraduate and undergraduate male students studying in Melbourne, Australia, based on data gathered in focus groups. Analysis revealed four broad themes in students\u27 explanations for the attacks: race hate versus opportunism, intercultural issues, systemic ineffectiveness, and media reporting. Students\u27 perceptions of the reasons for the attacks were divided in some areas and aligned in others. There was divergence among students about whether the attacks were race hate crime or opportunistic, and about intercultural issues. Students\u27 perceptions were aligned on issues of systemic ineffectiveness and media reporting. In the current context of decreased international enrolments from Indian students, in which we seek to better understand them, the findings provide implications for international student policy and planning priorities.<br /

Q^2 Dependence of the S_{11}(1535) Photocoupling and Evidence for a P-wave resonance in eta electroproduction

New cross sections for the reaction $ep \to e'\eta p$ are reported for total center of mass energy $W$=1.5--2.3 GeV and invariant squared momentum transfer $Q^2$=0.13--3.3 GeV$^2$. This large kinematic range allows extraction of new information about response functions, photocouplings, and $\eta N$ coupling strengths of baryon resonances. A sharp structure is seen at $W\sim$ 1.7 GeV. The shape of the differential cross section is indicative of the presence of a $P$-wave resonance that persists to high $Q^2$. Improved values are derived for the photon coupling amplitude for the $S_{11}$(1535) resonance. The new data greatly expands the $Q^2$ range covered and an interpretation of all data with a consistent parameterization is provided.Comment: 31 pages, 9 figure

The Kepler Science Data Processing Pipeline Source Code Road Map

We give an overview of the operational concepts and architecture of the Kepler Science Processing Pipeline. Designed, developed, operated, and maintained by the Kepler Science Operations Center (SOC) at NASA Ames Research Center, the Science Processing Pipeline is a central element of the Kepler Ground Data System. The SOC consists of an office at Ames Research Center, software development and operations departments, and a data center which hosts the computers required to perform data analysis. The SOC's charter is to analyze stellar photometric data from the Kepler spacecraft and report results to the Kepler Science Office for further analysis. We describe how this is accomplished via the Kepler Science Processing Pipeline, including, the software algorithms. We present the high-performance, parallel computing software modules of the pipeline that perform transit photometry, pixel-level calibration, systematic error correction, attitude determination, stellar target management, and instrument characterization

Immunogenicity and Efficacy of Single Antigen Gp63, Polytope and PolytopeHSP70 DNA Vaccines against Visceral Leishmaniasis in Experimental Mouse Model

Polytope approach of genetic immunization is a promising strategy for the prevention of infectious disease as it is capable of generating effective cell mediated immunity by delivering the T cell epitopes assembled in series. Leishmaniasis is a significant world wide health problem for which no vaccine exists. In this study we have compared immunogenicity and efficacy of three types of DNA vaccines: single antigen Gp63 (Gp63/pcDNA), polytope (Poly/pcDNA) and Polytope fused with hsp70 (Poly/hsp/pcDNA) against visceral leishmaniasis in susceptible BALB/c mice. Mice vaccinated with these plasmids generated strong Th1 immune response as seen by dominating IFN-γ over IL-10 cytokine. Interestingly, cytotoxic responses generated by polytope DNA plasmid fused with hsp70 of Leishmania donovani were significantly higher when compared to polytope and single antigen Gp63 vaccine. Challenge studies revealed that the parasite load in liver and spleen was significantly lower with Poly/hsp/pcDNA vaccination compared to other vaccines. Therefore, our study indicates that polytope DNA vaccine is a feasible, practical and effective approach for visceral leishmaniasis

Civil Society in Times of Crisis: Understanding Collective Action Dynamics in Digitally-Enabled Volunteer Networks

Social media play an important role in political mobilization. Voluntary engagement can especially benefit from new opportunities for organizing collective action. Although research has explored the use of Twitter by decentralized individuals for this, there has been little emphasis on its use for community engagement and the provision of public goods. Even less is known about its role in the emergence and offline expansion of spontaneous self-organized solidarity initiatives. This paper investigates how networked communication facilitates self-organization and the development of ties in a network of volunteers in Greece. To examine whether initiative-specific community feelings that can transcend online-offlsine divides evolve in such hybrid networks, the analysis is complemented with individual-level data drawn from a survey with the initiative's volunteers