'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

Alterações químicas, bioquímicas e da qualidade do café submetido a diferentes formas de processamento de secagem.

Devido ao elevado teor de umidade em que é colhido, o café requer secagem adequada a fim de preservar sua qualidade. Nesta etapa, o teor de umidade é reduzido de aproximadamente 60% (b.u.) para 11% (b.u.), sendo que o processo de secagem em terreiros, em secadores mecânicos ou a combinação destes são os métodos mais utilizados. Pesquisas recentes têm indicado várias alterações na integridade das membranas celulares, processo de germinação, conteúdo de ácidos e açúcares, devido ao estresse provocado aos grãos, ao longo do processamento e secagem. A elevação da temperatura de secagem promove danos aos grãos, o que reduz sensivelmente a qualidade da bebida. Este trabalho teve como objetivo verificar a influência da secagem lenta e secagem rápida sobre alguns parâmetros físicoquímicos do grão e sobre a qualidade do café. Os cafés utilizados neste experimento foram da cultivar Catuaí Vermelho IAC 44 produzidos na Fazenda Experimental de Machado-FEMA, da EPAMIG. Foram avaliadas três formas de preparo: café natural, desmucilado e despolpado. Após a obtenção destas três formas de preparo os cafés foram então submetidos à secagem lenta, sendo secados em telados suspensos à sombra ou secados por meio de secagem rápida em secadores de camada fixa com controle de temperatura de secagem de 35ºC, até atingirem cerca de 11% de umidade (b.u.). Depois do processo de secagem (lenta ou rápida), os cafés foram beneficiados e submetidos às seguintes análises: condutividade elétrica, lixiviação de potássio, atividade enzimática da polifenoloxidase, acidez total titulável e análise sensorial. Por meio dos resultados observados, verificam-se menores valores de condutividade elétrica, lixiviação de potássio, acidez total titulável, maior atividade enzimática da polifenoloxidase e melhor qualidade nos cafés submetidos à secagem lenta, ou seja, secagem à sombra, independente da forma de preparo utilizada. Em relação ao tipo de preparo, observa-se que os cafés naturais apresentaram maiores valores de condutividade elétrica e lixiviação de potássio quando submetidos à secagem rápida, ou seja, em secadores mecânicos, o que denota uma maior probabilidade desses cafés de perderem qualidade

Structural and Luminescence Properties of Silica-Based Hybrids Containing New Silylated-Diketonato Europium(III) Complex

A new betadiketonate ligand displaying a trimethoxysilyl group as grafting function and a diketone moiety as complexing site (TTA-Si = 4,4,4-trifluoro-2-(3-trimethoxysilyl)propyl)-1-3-butanedione (C4H3S)COCH[(CH2)3Si(OCH3)3]COCF3) and its highly luminescent europium(III) complex [Eu(TTA-Si)3] have been synthesized and fully characterized. Luminescent silica-based hybrids have been prepared as well with this new complex grafted on the surface of dense silica nanoparticles (28 (+/-3 nm) or on mesoporous silica particles. The covalent bonding of Eu(TTA-Si)3 inside the core of uniform silica nanoparticles (40 (+/- 5 nm) was also achieved. Luminescence properties are discussed in relation to the europium chemical environment involved in each of the three hybrids. The general methodology proposed allowed high grafting ratios and overcame chelate release and tendency to agglomeration, and it could be applied to any silica matrix (in the core or at the surface, nanosized or not, dense or mesoporous) and therefore numerous applications such as luminescent markers and luminophors could be foreseen

Correlação entre características químicas e sensoriais do Café rábica.

A análise sensorial atesta a qualidade do café, discriminando suas propriedades sensoriais, assim como a intensidade em que elas são percebidas por quem a realiza. Ainda existe a necessidade de provadores especializados, que dependendo do treinamento, ou da frequência que provam determinados tipos de café ou também da região geográfica em que atuam, podem desenvolver habilidades sensoriais distintas. Estas situações acarretam distorções, fazendo com que frequentemente haja discordância entre amostras analisadas por diferentes provadores. A classificação da bebida, por prova de xícara, poderia ser complementada com a adoção de métodos químicos, que facilitariam a avaliação, tornando-a menos subjetiva. Nesse contexto, o objetivo do presente trabalho foi analisar a correlação simples entre características químicas dos grãos de café cru e sensoriais da bebida. Foram avaliados 51 genótipos de Coffea arabica, em fase adulta de produção. A análise sensorial da bebida foi realizada utilizando a metodologia do Cup off Excellence aprimorada. Em sua maioria, as estimativas dos coeficientes de correlação entre as características químicas dos grãos de café foram baixas, indicando baixa associação entre os caracteres . Entretanto a correlação entre açúcares totais e açúcares não redutores teve o valor muito alto (0,99**) e a correlação entre condutividade elétrica e lixiviação de potássio apresentou valor moderado (0,66**). Todas as características sensoriais da bebida tiveram correlações positivas significativas, embora algumas apresentar em baixos valores. A maior correlação entre as características sensoriais foi observada entre sabor e total (0,92**). A correlação entre características químicas dos grãos do café e sensoriais da bebida apresentou valor baixo a nulo. Os resultados sugerem que para cafés de alta qualidade são poucas as correlações significativas entre características sensoriais e químicas avaliadas nos grãos crus. Por conseguinte, outras características químicas, possivelmente após a torra dos grãos, devem ser consideradas em novos estudos visando correlacionar análises físico-química e análises sensoriais

What constitutes 'good' home care for people with dementia? An investigation of the views of home care service recipients and providers

BACKGROUND: Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia. METHODS: We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach. RESULTS: Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. CONCLUSIONS: It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. TRIAL REGISTRATION: ACTRN 12619000251123

What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

BACKGROUND: Our objective was to explore what people receiving and providing care consider to be 'good' in-home care for people living with dementia. METHODS: We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke's six-step approach. RESULTS: Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers' understanding of dementia and its impact; 2) Home care workers' demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers' knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. CONCLUSIONS: It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. TRIAL REGISTRATION: ACTRN 12619000251123

Effects of external nutrient sources and extreme weather events on the nutrient budget of a Southern European coastal lagoon

The seasonal and annual nitrogen (N), phosphorus (P), and carbon (C) budgets of the mesotidal Ria Formosa lagoon, southern Portugal, were estimated to reveal the main inputs and outputs, the seasonal patterns, and how they may influence the ecological functioning of the system. The effects of extreme weather events such as long-lasting strong winds causing upwelling and strong rainfall were assessed. External nutrient inputs were quantified; ocean exchange was assessed in 24-h sampling campaigns, and final calculations were made using a hydrodynamic model of the lagoon. Rain and stream inputs were the main freshwater sources to the lagoon. However, wastewater treatment plant and groundwater discharges dominated nutrient input, together accounting for 98, 96, and 88 % of total C, N, and P input, respectively. Organic matter and nutrients were continuously exported to the ocean. This pattern was reversed following extreme events, such as strong winds in early summer that caused upwelling and after a period of heavy rainfall in late autumn. A principal component analysis (PCA) revealed that ammonium and organic N and C exchange were positively associated with temperature as opposed to pH and nitrate. These variables reflected mostly the benthic lagoon metabolism, whereas particulate P exchange was correlated to Chl a, indicating that this was more related to phytoplankton dynamics. The increase of stochastic events, as expected in climate change scenarios, may have strong effects on the ecological functioning of coastal lagoons, altering the C and nutrient budgets.Portuguese Science and Technology Foundation (FCT) [POCI/MAR/58427/2004, PPCDT/MAR/58427/2004]; Portuguese Science and Technology Foundation (FCT

Nanoencapsulation of luminescent 3-hydroxypicolinate lanthanide complexes

We have synthesized luminescent nanoparticles comprising a core of lanthanide complexes and shells of amorphous silica using reverse micelles as nanoreactors. 3-Hydroxypicolinate complexes of Eu(III), Tb(III), and the corresponding heteronuclear complexes have been investigated as the photoactive cores. The size of the silica particles is within the nanometer scale, which, together with the ability for surface biofunctionalization, opens up perspectives for their use in bioapplications. Optical studies of the as-prepared nanoparticles reveal that the luminescence properties of the 3-hydroxypicolinate complexes in the matrices are markedly different from their original features