Videoconferencing and telementoring about dementia care: evaluation of a pilot model for sharing scarce old age psychiatry resources

While videoconferencing, telementoring, and peer support have been shown to enhance services in some instances, there has been no research investigating the use of these technologies in supporting professionals managing clients with dementia. The objective of this research was to evaluate expansion of an old age psychiatry consultation service and pilot test a model to improve medical supervision and clinical governance for staff within regional and remote areas using remote information technology. The design was a mixed methods (qualitative and quantitative) evaluation using before, mid-point and post-implementation semi-structured interviews and questionnaires to examine orientation, acceptance, and impact underpinned by theoretical approaches to evaluation. Education evaluations used a Likert style response template. Participants were 18 dementia service staff, including staff from linked services and old age psychiatrists. Qualitative interviews addressed the pilot implementation including: expectations, experiences, strategies for improving the pilot, and perceived impact on work practice and professional development opportunities. There was high satisfaction with the program. The case conference process contributed to perceived improved outcomes for clients, family, and staff. Clinicians perceived improvement in family carer and staff carer stress and their confidence in managing clients with behavioral and psychological symptoms of dementia (BPSD). Thematic analysis indicated that the pilot enhanced professional development, decreased travel time, and improved team cohesion. Given the increasing aging population in regional, rural, and remote areas, initiatives using videoconferencing and telementoring will help to develop a confident and skilled workforce. This pilot program was found to be acceptable and feasible. Potential benefits for clients and family carers should be examined in future resesarch

Entrepreneurial intention studies: A hybrid bibliometric method to identify new directions for theory and research

Fragmentation is the main obstacle to scientific progress on entrepreneurial intention. To address this issue, we systematise the current literature with a hybrid bibliometric method that combines co-citation and bibliographic coupling analysis for the first time in entrepreneurial intention studies to show the field's knowledge base and research fronts and to examine how divergent perspectives have challenged the core knowledge of the field. We highlight three recurring dimensions of entrepreneurial intention studies: (1) personal factors, (2) social factors and (3) investigational settings. In addition to introducing new constructs, divergent perspectives have emphasised the interplay between these components and challenged the mechanisms connecting them. Based on these findings, we extend previous classifications in the literature by providing a framework that integrates divergent perspectives with the field's knowledge base, helping establish future research avenues and improving the theorising process of entrepreneurial intention

Impact of Horse Grazing on Floristic Diversity in Mediterranean Small Standing-Water Ecosystems (SWEs)

Small standing-Water Ecosystems (SWEs), despite their pivotal ecological role due to their participation in hydrogeological processes and their richness in biodiversity, seem to be often overlooked by the scientific community. In this study, the vascular plant diversity in some representative SWEs, that host a peculiar assemblage of plant and animal species, was investigated in relation to the disturbance effects of a wild horse population. A total of 50 plots, equally distributed in small and large SWEs, were surveyed and a level of disturbance was attributed to each plot. We found greater species richness in small and undisturbed SWEs, which suggests the negative impact of horse grazing on the richness of plant species in this type of habitat. Significant differences in plant assemblage were found according to the disturbance level, whereas, contrary to what was observed for species richness, no differences were detected based on their size. The diversity indices, used to evaluate the richness and diversity in these areas, recorded the highest values for small and undisturbed areas. This result highlights that the disturbance of the horse grazing plays a pivotal role in affecting the diversity and richness of species in the SWEs. These findings suggest that SWE systems should be analyzed considering these areas as unique in order to allow the conservation of the plant richness and biodiversity of the SWE systems in conjunction with the protection of horses

New positive small vacuum region gravitational energy expressions

We construct an infinite number of new holonomic quasi-local gravitational energy-momentum density pseudotensors with good limits asymptotically and in small regions, both materially and in vacuum. For small vacuum regions they are all a positive multiple of the Bel-Robinson tensor and consequently have positive energy.Comment: 4 page

Discovering Plum, Watermelon and Grape Cultivars Founded in a Middle Age Site of Sassari (Sardinia, Italy) through a Computer Image Analysis Approach

The discovery of several waterlogged plant remains in a Middle Ages context (1330–1360 AD) in Sassari (NS, Sardinia, Italy) enabled the characterisation of archaeological plum fruit stones and watermelon and grape seeds through computer image analysis. Digital seed/endocarp images were acquired by a flatbed scanner and processed and analysed by applying computerised image analysis techniques. The morphometric data were statistically elaborated using stepwise linear discriminant analysis (LDA), allowing comparisons among archaeological remains, wild populations and autochthonous cultivars. Archaeological samples of plum were compared with 21 autochthonous cultivars of Prunus domestica from Sardinia, while archaeological watermelon seeds were compared with 36 seed lots of Citrullus from Europe, Africa and Asia. Moreover, archaeological grape seeds were compared with 51 autochthonous traditional cultivars of Vitis vinifera subsp. vinifera from Sardinia, 16 cultivars from Tuscany, six cultivars from Liguria, and eight cultivars from Catalonia (Spain). Archaeological plum remains showed morphological affinity with five cultivars of Sardinia. Seed features of the archaeological watermelon remains demonstrated affiliation with a proper sweet dessert watermelon, Citrullus lanatus, and similarity with some Sardinian cultivars. Regarding the archaeological remains of grape, morphometric comparisons showed a high similarity with autochthonous cultivars from Catalonia and Liguria. This study provides new information about ancient fruit cultivated and consumed during the Middle Ages in Sardinia

On the energy of homogeneous cosmologies

An energy for the homogeneous cosmological models is presented. More specifically, using an appropriate natural prescription, we find the energy within any region with any gravitational source for a large class of gravity theories--namely those with a tetrad description--for all 9 Bianchi types. Our energy is given by the value of the Hamiltonian with homogeneous boundary conditions; this value vanishes for all regions in all Bianchi class A models, and it does not vanish for any class B model. This is so not only for Einstein's general relativity but, moreover, for the whole 3-parameter class of tetrad-teleparallel theories. For the physically favored one parameter subclass, which includes the teleparallel equivalent of Einstein's theory as an important special case, the energy for all class B models is, contrary to expectation, negative.Comment: 11 pages, reformated with minor change

Parentage Influence On Gene Expression Under Acidification Revealed Through Single-Embryo Sequencing

The dissolution of anthropogenic carbon dioxide (CO2) in seawater has altered its carbonate chemistry in the process of ocean acidification (OA). OA affects the viability of marine species. In particular, calcifying organisms and their early planktonic larval stages are considered vulnerable. These organisms often utilize energy reserves for metabolism rather than growth and calcification as supported by bulk RNA-sequencing (RNA-seq) experiments. Yet, transcriptomic profiling of a bulk sample reflects the average gene expression of the population, neglecting the variations between individuals, which forms the basis for natural selection. Here, we used single-embryo RNA-seq on larval sea urchin Heliocidaris crassispina, which is a commercially and ecologically valuable species in East Asia, to document gene expression changes to OA at an individual and family level. Three paternal half-sibs groups were fertilized and exposed to 3 pH conditions (ambient pH 8.0, 7.7 and 7.4) for 12 h prior to sequencing and oxygen consumption assay. The resulting transcriptomic profile of all embryos can be distinguished into four clusters, with differences in gene expressions that govern biomineralization, cell differentiation and patterning, as well as metabolism. While these responses were influenced by pH conditions, the male identities also had an effect. Specifically, a regression model and goodness of fit tests indicated a significant interaction between sire and pH on the probability of embryo membership in different clusters of gene expression. The single-embryo RNA-seq approach is promising in climate stressor research because not only does it highlight potential impacts before phenotypic changes were observed, but it also highlights variations between individuals and lineages, thus enabling a better determination of evolutionary potential

'I know they are not trained in dementia': Addressing the need for specialist dementia training for home care workers

Global population ageing has meant a rapid increase in the numbers of older people with dementia, most of whom live in their own homes. Staying at home is an important determinant of health and well‐being. As care needs increase, the quality of community support which older people receive directly influences their capacity to remain in their own homes. While many are supported informally by family carers, formal support provided by home care workers often enables them to remain at home for longer period. However, providing community‐based care for people with dementia can be challenging. Workers often lack training in dementia‐specific care for clients with increasingly complex needs, and typically work without direct supervision. As the demand for person‐centred home care for people with dementia increases, specialist dementia training for home care workers is urgently needed. In this qualitative study, we used in‐depth interviews of a purposive sample, comprising 15 family carers and four older people with dementia, to understand the experience of receiving community care. Data analysis was guided by Braun and Clarke's approach to thematic analysis and revealed the following five overlapping themes, relating to home care workers’ understanding of dementia, person‐centred care, communication and rapport, mutual collaboration, and the influence of organisational constraints on continuity of care. Although participants acknowledged that service providers operated under challenging circumstances, they were frustrated with home care workers’ lack of dementia knowledge and inconsistent staff rostering. Conversely, an understanding of the lived experience of dementia, effective communication and rapport, and continuity of care contributed significantly to a positive experience of receiving care. The findings of this study will be used to inform the essential elements of a training program aimed at enabling and empowering a skilled, specialist home care workforce to support older people with dementia to live well at home for as long as possible

Proliferation and estrogen signaling can distinguish patients at risk for early versus late relapse among estrogen receptor positive breast cancers

Introduction: We examined if a combination of proliferation markers and estrogen receptor (ER) activity could predict early versus late relapses in ER-positive breast cancer and inform the choice and length of adjuvant endocrine therapy. Methods: Baseline affymetrix gene-expression profiles from ER-positive patients who received no systemic therapy (n = 559), adjuvant tamoxifen for 5 years (cohort-1: n = 683, cohort-2: n = 282) and from 58 patients treated with neoadjuvant letrozole for 3 months (gene-expression available at baseline, 14 and 90 days) were analyzed. A proliferation score based on the expression of mitotic kinases (MKS) and an ER-related score (ERS) adopted from Oncotype DX® were calculated. The same analysis was performed using the Genomic Grade Index as proliferation marker and the luminal gene score from the PAM50 classifier as measure of estrogen-related genes. Median values were used to define low and high marker groups and four combinations were created. Relapses were grouped into time cohorts of 0-2.5, 0-5, 5-10 years. Results: In the overall 10 years period, the proportional hazards assumption was violated for several biomarker groups indicating time-dependent effects. In tamoxifen-treated patients Low-MKS/Low-ERS cancers had continuously increasing risk of relapse that was higher after 5 years than Low-MKS/High-ERS cancers [0 to 10 year, HR 3.36; p = 0.013]. High-MKS/High-ERS cancers had low risk of early relapse [0-2.5 years HR 0.13; p = 0.0006], but high risk of late relapse which was higher than in the High-MKS/Low-ERS group [after 5 years HR 3.86; p = 0.007]. The High-MKS/Low-ERS subset had most of the early relapses [0 to 2.5 years, HR 6.53; p < 0.0001] especially in node negative tumors and showed minimal response to neoadjuvant letrozole. These findings were qualitatively confirmed in a smaller independent cohort of tamoxifen-treated patients. Using different biomarkers provided similar results. Conclusions: Early relapses are highest in highly proliferative/low-ERS cancers, in particular in node negative tumors. Relapses occurring after 5 years of adjuvant tamoxifen are highest among the highly-proliferative/high-ERS tumors although their risk of recurrence is modest in the first 5 years on tamoxifen. These tumors could be the best candidates for extended endocrine therapy

Imaging of SNR IC443 and W44 with the Sardinia Radio Telescope at 1.5 GHz and 7 GHz

Observations of supernova remnants (SNRs) are a powerful tool for investigating the later stages of stellar evolution, the properties of the ambient interstellar medium, and the physics of particle acceleration and shocks. For a fraction of SNRs, multi-wavelength coverage from radio to ultra high-energies has been provided, constraining their contributions to the production of Galactic cosmic rays. Although radio emission is the most common identifier of SNRs and a prime probe for refining models, high-resolution images at frequencies above 5 GHz are surprisingly lacking, even for bright and well-known SNRs such as IC443 and W44. In the frameworks of the Astronomical Validation and Early Science Program with the 64-m single-dish Sardinia Radio Telescope, we provided, for the first time, single-dish deep imaging at 7 GHz of the IC443 and W44 complexes coupled with spatially-resolved spectra in the 1.5-7 GHz frequency range. Our images were obtained through on-the-fly mapping techniques, providing antenna beam oversampling and resulting in accurate continuum flux density measurements. The integrated flux densities associated with IC443 are S_1.5GHz = 134 +/- 4 Jy and S_7GHz = 67 +/- 3 Jy. For W44, we measured total flux densities of S_1.5GHz = 214 +/- 6 Jy and S_7GHz = 94 +/- 4 Jy. Spectral index maps provide evidence of a wide physical parameter scatter among different SNR regions: a flat spectrum is observed from the brightest SNR regions at the shock, while steeper spectral indices (up to 0.7) are observed in fainter cooling regions, disentangling in this way different populations and spectra of radio/gamma-ray-emitting electrons in these SNRs.Comment: 13 pages, 9 figures, accepted for publication to MNRAS on 18 May 201