Understanding the training and education needs of homecare workers supporting people with dementia and cancer: a systematic review of reviews

Many people with dementia, supported by family carers, prefer to live at home and may rely on homecare support services. People with dementia are also often living with multimorbidities, including cancer. The main risk factor for both cancer and dementia is age and the number of people living with dementia and cancer likely to rise. Upskilling the social care workforce to facilitate more complex care is central to national workforce strategies and challenges. Training and education development must also respond to the key requirements of a homecare workforce experiencing financial, recruitment and retention difficulties. This systematic review of reviews provides an overview of dementia and cancer training and education accessible to the homecare workforce. Findings reveal there is a diverse range of training and education available, with mixed evidence of effectiveness. Key barriers and facilitators to effective training and education are identified in order to inform future training, education and learning development for the homecare workforce supporting people with dementia and cancer

Privacy as an Operating System Service

The issue of electronic privacy has of late attracted considerable attention. The proliferation of Internet services and, perhaps unavoidably, Internet crime, in conjunction with expanded government monitoring of communications has caused irreparable damage to the basic definition of privacy (the state or condition of being free from unwanted surveillance). Implementing privacy in personal computer systems has traditionally been the domain of the paranoid computer specialist. In order for basic privacy to become pervasive among the non-technical user base, we believe that it must imitate the usage of other successful security (and other) services. Services like filesystem encryption, email and web security are successful because they are invisible to the user. Other services (not related to security) such as backups, networking, file searching, etc., also gain traction by being well integrated with the user's operating environment. In most cases, this means embedding such services in the OS. In this work, we propose a new paradigm for implementing privacy, as an operating system service. We believe that privacy, similarly to other security services, is a service that has cross-application appeal and must therefore be centrally positioned

Success and Survival of Various Types of All-Ceramic Single Crowns: A Critical Review and Analysis of Studies with a Mean Follow-Up of 5 Years or Longer

Purpose: The aim of this critical review was to assess the survival and success rates of all-ceramic single crowns manufactured using different ceramic materials with a mean follow-up time of 5 years or longer. Materials and Methods: An electronic search of studies published between 1980 and 2014 complemented by manual searching was conducted in Medline and Scopus. The terms ceramic, crown, survival, success, longevity, and complications were selected as keywords. Predetermined inclusion and exclusion criteria guided the search. Data were extracted and assessed by two independent reviewers. The results were statistically analyzed according to the type of material, and survival/success rate was calculated by assuming a Poisson-distributed number of events. Results: The initial search yielded 972 articles. After subsequent filtering, 14 studies were selected. The inter-reviewer agreement was rated as good (κ = 0.65) and very high agreement (κ = 0.93) during the identification and screening phases, respectively. No studies on densely sintered zirconia or feldspathic crowns satisfied the minimum follow-up time. Only one study of each of the following materials satisfied the inclusion criteria: lithium disilicate, leucite reinforced, pressed Al2O3, and sintered Al2O3. Meta-analysis of the included studies on other materials resulted in the following estimated survival and success rates: for densely sintered alumina crowns, 93.8% and 92.75%, respectively; for fluoromica reinforced, 87.7% and 87.7%, respectively; and for glass-infiltrated alumina core, 94.4% and 92%, respectively. Crown fracture was considered the most frequent complication. Conclusion: Based on the present critical review, there was no evidence to support the superior application of a single ceramic system or material. Further long-term prospective studies are required

New insights into the role of motion and form vision in neurodevelopmental disorders

A selective deficit in processing the global (overall) motion, but not form, of spatially extensive objects in the visual scene is frequently associated with several neurodevelopmental disorders, including preterm birth. Existing theories that proposed to explain the origin of this visual impairment are, however, challenged by recent research. In this review, we explore alternative hypotheses for why deficits in the processing of global motion, relative to global form, might arise. We describe recent evidence that has utilised novel tasks of global motion and global form to elucidate the underlying nature of the visual deficit reported in different neurodevelopmental disorders. We also examine the role of IQ and how the sex of an individual can influence performance on these tasks, as these are factors that are associated with performance on global motion tasks, but have not been systematically controlled for in previous studies exploring visual processing in clinical populations. Finally, we suggest that a new theoretical framework is needed for visual processing in neurodevelopmental disorders and present recommendations for future research

A meta-analysis of the prevalence of Different functions of non-suicidal self-injury.

Background A broad variety of different functions can underlie acts of Non-suicidal self-injury (NSSI). Whilst research so far has identified many of the commonly reported functions, no reliable estimates of prevalence currently exist for these different NSSI functions. Understanding the prevalence of NSSI functions represents a key to better understanding the phenomenology of NSSI and addressing the differing needs of the NSSI population. We conducted a systematic review and meta-analysis of the prevalence of NSSI functions in community and clinical samples. Method A literature search of electronic databases PsycINFO, Medline, and Web of Science from date of inception to March 2017 was undertaken. A pre-specified framework for categorising different functions of NSSI was used to collate data from across studies. A random-effects meta-analysis of prevalence was then undertaken on these data. Results Intrapersonal functions (66–81%), and especially those concerning emotion regulation were most commonly reported by individuals who engage in NSSI (63–78%). Interpersonal functions (e.g., expressing distress) were less common (33–56%). Limitations The review was limited to English-language articles. Reviewed articles were inconsistent in their measurement of NSSI. Inconsistency within pooled prevalence estimates was high when moderators were not accounted for. Conclusions Findings indicate that intrapersonal functions of NSSI are most common and are present for the majority of participants. This finding supports dominant emotion-regulation models of NSSI, and the use of interventions that work to improve emotion-regulation ability. However, interpersonal functions remain endorsed by a substantial portion of participants

Understanding and Measuring the Wellbeing of Carers of People With Dementia

Background and Objectives  To determine how the wellbeing of carers of people with dementia is understood and measured in contemporary health research.  Research Design and Methods  A systematic review of reviews was designed, registered with PROSPERO, and then conducted. This focused on systematic reviews of research literature published from 2010 onwards; with the wellbeing of carers of people with dementia being a primary focus. N = 19 studies met the inclusion criteria. Quality appraisal was conducted using the AMSTAR tool (2015). A narrative synthesis was conducted to explore how wellbeing is currently being understood and measured.  Results  Contemporary health research most frequently conceptualizes wellbeing in the context of a loss–deficit model. Current healthcare research has not kept pace with wider discussions surrounding wellbeing which have become both more complex and more sophisticated. Relying on the loss–deficit model limits current research in understanding and measuring the lived experience of carers of people with dementia. There remains need for a clear and consistent measurement of wellbeing.  Discussion and Implications  Without clear consensus, health professionals must be careful when using the term “wellbeing”. To help inform healthcare policy and practice, we offer a starting point for a richer concept of wellbeing in the context of dementia that is multi-faceted to include positive dimensions of caregiving in addition to recognized aspects of burden. Standardized and robust measurements are needed to enhance research and there may be benefit from developing a more mixed, blended approach to measurement

Assessing the quality of reports of randomized trials in pediatric complementary and alternative medicine

OBJECTIVE: To evaluate the quality of reports of complementary and alternative medicine (CAM) randomized controlled trials (RCTs) in the pediatric population. We also examined whether there was a change in the quality of reporting over time. METHODS: We used a systematic sample of 251 reports of RCTs that used a CAM intervention. The quality of each report was assessed using the number of CONSORT checklist items included, the frequency of unclear allocation concealment, and a 5-point quality assessment instrument. RESULTS: Nearly half (40%) of the CONSORT checklist items were included in the reports, with an increase in the number of items included. The majority (81.3%) of RCTs reported unclear allocation concealment with no significant change over time. The quality of reports achieved approximately 40% of their maximum possible total score as assessed with the Jadad scale with no change over time. Information regarding adverse events was reported in less than one quarter of the RCTs (22%) and information regarding costs was mentioned in only a minority of reports (4%). CONCLUSIONS: RCTs are an important tool for evidence based health care decisions. If these studies are to be relevant in the evaluation of CAM interventions it is important that they are conducted and reported with the highest possible standards. There is a need to redouble efforts to ensure that children and their families are participating in RCTs that are conducted and reported with minimal bias. Such studies will increase their usefulness to a board spectrum of interested stakeholders

Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD):Explanation and Elaboration. Translation into Russian

The TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis) Statement includes a 22-item checklist, which aims to improve the reporting of studies developing, validating, or updating a prediction model, whether for diagnostic or prognostic purposes. The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used. This explanation and elaboration document describes the rationale; clarifies the meaning of each item; and discusses why transparent reporting is important, with a view to assessing risk of bias and clinical usefulness of the prediction model. Each checklist item of the TRIPOD Statement is explained in detail and accompanied by published examples of good reporting. The document also provides a valuable reference of issues to consider when designing, conducting, and analyzing prediction model studies. To aid the editorial process and help peer reviewers and, ultimately, readers and systematic reviewers of prediction model studies, it is recommended that authors include a completed checklist in their submission. The TRIPOD checklist can also be downloaded from www.tripod-statement.org.</p

The unrestricted global efort to complete the COOL trial

Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option may be open abdomen (OA) management with negative peritoneal pressure therapy (NPPT) to remove inflammatory ascites and attenuate the systemic damage from SCIAS, although there are definite risks of leaving the abdomen open whenever it might possibly be closed. This potential therapeutic paradigm is the rationale being assessed in the Closed Or Open after Laparotomy (COOL trial) (https://clinicaltrials.gov/ct2/show/NCT03163095). Initially, the COOL trial received Industry sponsorship; however, this funding mandated the use of a specific trademarked and expensive NPPT device in half of the patients allocated to the intervention (open) arm. In August 2022, the 3 M/Acelity Corporation without consultation but within the terms of the contract canceled the financial support of the trial. Although creating financial difficulty, there is now no restriction on specific NPPT devices and removing a cost-prohibitive intervention creates an opportunity to expand the COOL trial to a truly global basis. This document describes the evolution of the COOL trial, with a focus on future opportunities for global growth of the study