The transition to technology-enriched supported accommodation (TESA) for people living with dementia: the experience of formal carers

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905This paper presents the experiences of formal carers working in technology-enriched supported accommodation for people living with dementia, examining their care-giving role from a person-centred care perspective. Within a qualitative study, 21 semi-structured interviews were conducted with formal carers and data were analysed following a thematic approach. Four main themes were identified that mapped to the attributes of the person-centred practice framework (PCPF): promoting choice and autonomy, staffing model, using assistive technology and feeling that ‘you're doing a good job’. Central to person-centred practice in these settings was the promotion of choice, autonomy and independence. The dichotomy between safety and independence was evident, curtailing the opportunities within the environmental enablers and associated embedded assistive technologies. Formal carers reported considerable job satisfaction working in these settings. The small-scale, home-like facilities seemed to have a positive effect on job satisfaction. These findings are relevant to policy makers, commissioners and service providers, highlighting the facilitators of person-centred care in community dwellings for people living with dementia and the role of formal carers in promoting this approach.This project was funded by the Health and Social Care (HSC) Research & Development Division of the Public Health Agency in Northern Ireland (Reference COM/4955/14) in conjunction with the Atlantic Philanthropies, an international grant-awarding body. The project is part of the HSC research strand into the ‘Care of People with Dementia in Northern Ireland’. None of the awarding bodies have participated in any of the activities related to the research.https://doi.org/10.1017/S0144686X1900058840pubpub1

A rigorous benchmarking of methods for SARS-CoV-2 lineage abundance estimation in wastewater

In light of the continuous transmission and evolution of SARS-CoV-2 coupled with a significant decline in clinical testing, there is a pressing need for scalable, cost-effective, long-term, passive surveillance tools to effectively monitor viral variants circulating in the population. Wastewater genomic surveillance of SARS-CoV-2 has arrived as an alternative to clinical genomic surveillance, allowing to continuously monitor the prevalence of viral lineages in communities of various size at a fraction of the time, cost, and logistic effort and serving as an early warning system for emerging variants, critical for developed communities and especially for underserved ones. Importantly, lineage prevalence estimates obtained with this approach aren't distorted by biases related to clinical testing accessibility and participation. However, the relative performance of bioinformatics methods used to measure relative lineage abundances from wastewater sequencing data is unknown, preventing both the research community and public health authorities from making informed decisions regarding computational tool selection. Here, we perform comprehensive benchmarking of 18 bioinformatics methods for estimating the relative abundance of SARS-CoV-2 (sub)lineages in wastewater by using data from 36 in vitro mixtures of synthetic lineage and sublineage genomes. In addition, we use simulated data from 78 mixtures of lineages and sublineages co-occurring in the clinical setting with proportions mirroring their prevalence ratios observed in real data. Importantly, we investigate how the accuracy of the evaluated methods is impacted by the sequencing technology used, the associated error rate, the read length, read depth, but also by the exposure of the synthetic RNA mixtures to wastewater, with the goal of capturing the effects induced by the wastewater matrix, including RNA fragmentation and degradation.Comment: For correspondence: [email protected]

SARS-CoV-2 Wastewater Genomic Surveillance: Approaches, Challenges, and Opportunities

During the SARS-CoV-2 pandemic, wastewater-based genomic surveillance (WWGS) emerged as an efficient viral surveillance tool that takes into account asymptomatic cases and can identify known and novel mutations and offers the opportunity to assign known virus lineages based on the detected mutations profiles. WWGS can also hint towards novel or cryptic lineages, but it is difficult to clearly identify and define novel lineages from wastewater (WW) alone. While WWGS has significant advantages in monitoring SARS-CoV-2 viral spread, technical challenges remain, including poor sequencing coverage and quality due to viral RNA degradation. As a result, the viral RNAs in wastewater have low concentrations and are often fragmented, making sequencing difficult. WWGS analysis requires advanced computational tools that are yet to be developed and benchmarked. The existing bioinformatics tools used to analyze wastewater sequencing data are often based on previously developed methods for quantifying the expression of transcripts or viral diversity. Those methods were not developed for wastewater sequencing data specifically, and are not optimized to address unique challenges associated with wastewater. While specialized tools for analysis of wastewater sequencing data have also been developed recently, it remains to be seen how they will perform given the ongoing evolution of SARS-CoV-2 and the decline in testing and patient-based genomic surveillance. Here, we discuss opportunities and challenges associated with WWGS, including sample preparation, sequencing technology, and bioinformatics methods.Comment: V Munteanu and M Saldana contributed equally to this work A Smith and S Mangul jointly supervised this work For correspondence: [email protected]

Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM)

Background Dementia has an enormous impact on the lives of individuals and families, and on health and social services, and this will increase as the population ages. The needs of people with dementia and their carers for information and support are inadequately addressed at all key points in the illness trajectory. Methods The Unit is working specifically on an evaluation of the impact of the Mental Capacity Act 2005, and will develop practice guidance to enhance concordance with the Act. Phase One of the study has involved baseline interviews with practitioners across a wide range of services to establish knowledge and expectations of the Act, and to consider change processes when new policy and legislation are implemented. Findings Phase 1, involving baseline interviews with 115 practitioners, identified variable knowledge and understanding about the principles of the Act. Phase 2 is exploring everyday decision-making by people with memory problems and their carers

Lorcaserin, a novel selective human 5-hydroxytryptamine2C agonist: in vitro and in vivo pharmacological characterization.

ABSTRACT 5-Hydroxytryptamine (5-HT) 2C receptor agonists hold promise for the treatment of obesity. In this study, we describe the in vitro and in vivo characteristics of lorcaserin [(1R)-8-chloro-2,3,4,5-tetrahydro-1-methyl-1H-3 benzazepine], a selective, high affinity 5-HT 2C full agonist. Lorcaserin bound to human and rat 5-HT 2C receptors with high affinity (K i ϭ 15 Ϯ 1 nM, 29 Ϯ 7 nM, respectively), and it was a full agonist for the human 5-HT 2C receptor in a functional inositol phosphate accumulation assay, with 18-and 104-fold selectivity over 5-HT 2A and 5-HT 2B receptors, respectively. Lorcaserin was also highly selective for human 5-HT 2C over other human 5-HT receptors (5-HT 1A , 5-HT 3 , 5-HT 4C , 5-HT5 5A , 5-HT 6 , and 5-HT 7 ), in addition to a panel of 67 other G protein-coupled receptors and ion channels. Lorcaserin did not compete for binding of ligands to serotonin, dopamine, and norepinephrine transporters, and it did not alter their function in vitro. Behavioral observations indicated that unlike the 5-HT 2A agonist (Ϯ)-1-(2,5-dimethoxy-4-phenyl)-2-aminopropane, lorcaserin did not induce behavioral changes indicative of functional 5-HT 2A agonist activity. Acutely, lorcaserin reduced food intake in rats, an effect that was reversed by pretreatment with the 5-HT 2C -selective antagonist 6-chloro-5-methyl-1-[6-(2-methylpyridin-3-yloxy)pyridin-3-yl-carbamoyl]indoline (SB242,084) but not the 5-HT 2A antagonist (R)-(ϩ)-␣-(2,3-dimethoxyphenyl)-1-[2-(4-fluorophenylethyl)]-4-piperidinemethanol (MDL 100,907), demonstrating mediation by the 5-HT 2C receptor. Chronic daily treatment with lorcaserin to rats maintained on a high fat diet produced dose-dependent reductions in food intake and body weight gain that were maintained during the 4-week study. Upon discontinuation, body weight returned to control levels. These data demonstrate lorcaserin to be a potent, selective, and efficacious agonist of the 5-HT 2C receptor, with potential for the treatment of obesity. Serotonin mediates its physiological effects through at least 14 different receptors. The serotonin 5-HT 2 receptor subfamily contains three distinct receptor subtypes, 5-HT 2A , 5-HT 2B , and 5-HT 2C , all of which share considerable sequence homology (Ͼ80% in transmembrane spanning regions) and activate common signaling pathways, including G q ␣-mediated stimulation of phospholipase-C␤, elevation of intracellular inositol phosphates, and elevation of intracellular calciu

TRY plant trait database - enhanced coverage and open access

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Prisoners co-infected with tuberculosis and HIV: a systematic review.

INTRODUCTION: Almost from the beginning of the HIV epidemic in 1981, an association with tuberculosis (TB) was recognized. This association between HIV and TB co-infection has been particularly evident amongst prisoners. However, despite this, few studies of TB in prisons have stratified results by HIV status. Given the high prevalence of HIV-positive persons and TB-infected persons in prisons and the documented risk of TB in those infected with HIV, it is of interest to determine how co-infection varies amongst prison populations worldwide. For this reason we have undertaken a systematic review of studies of co-infected prisoners to determine the incidence and/or prevalence of HIV/TB co-infection in prisons, as well as outcomes in this group, measured as treatment success or death. METHODS: A literature search was undertaken using the online databases PubMed, Embase, IBSS, Scopus, Web of Science, Global Health and CINAHL Plus. No restrictions were set on language or publication date for article retrieval, with articles included if indexed up to 18 October 2015. A total of 1975 non-duplicate papers were identified. For treatment and outcome data all eligible papers were appraised for inclusion; for incidence/prevalence estimates papers published prior to 2000 were excluded from full text review. After full text appraisal, 46 papers were selected for inclusion in the review, 41 for incidence/prevalence estimates and nine for outcomes data, with four papers providing evidence for both outcomes and prevalence/incidence. RESULTS: Very few studies estimated the incidence of TB in HIV positive prisoners, with most simply reporting prevalence of co-infection. Co-infection is rarely explicitly measured, with studies simply reporting HIV status in prisoners with TB, or a cross-sectional survey of TB prevalence amongst prisoners with HIV. Estimates of co-infection prevalence ranged from 2.4 to 73.1% and relative risks for one, given the other, ranged from 2.0 to 10.75, although some studies reported no significant association between HIV and TB. Few studies provided a comparison with the risk of co-infection in the general population. CONCLUSIONS: Prisoners infected with HIV are at high risk of developing TB. However, the magnitude of risk varies between different prisons and countries. There is little evidence on treatment outcomes in co-infected prisoners, and the existing evidence is conflicting in regards to HIV status influence on prisoner treatment outcomes.PROSPERO Number: CRD42016034068

Effects of the cannabinoid CB1 agonist ACEA on salicylate ototoxicity, hyperacusis and tinnitus in guinea pigs

Cannabinoids have been suggested as a therapeutic target for a variety of brain disorders. Despite the presence of their receptors throughout the auditory system, little is known about how cannabinoids affect auditory function. We sought to determine whether administration of arachidonyl-2′-chloroethylamide (ACEA), a highly-selective CB1 agonist, could attenuate a variety of auditory effects caused by prior administration of salicylate, and potentially treat tinnitus. We recorded cortical resting-state activity, auditory-evoked cortical activity and auditory brainstem responses (ABRs), from chronically-implanted awake guinea pigs, before and after salicylate + ACEA. Salicylate-induced reductions in click-evoked ABR amplitudes were smaller in the presence of ACEA, suggesting that the ototoxic effects of salicylate were less severe. ACEA also abolished salicylate-induced changes in cortical alpha band (6-10 Hz) oscillatory activity. However, salicylate-induced increases in cortical evoked activity (suggestive of the presence of hyperacusis) were still present with salicylate + ACEA. ACEA administered alone did not induce significant changes in either ABR amplitudes or oscillatory activity, but did increase cortical evoked potentials. Furthermore, in two separate groups of non-implanted animals, we found no evidence that ACEA could reverse behavioural identification of salicylate- or noise-induced tinnitus. Together, these data suggest that while ACEA may be potentially otoprotective, selective CB1 agonists are not effective in diminishing the presence of tinnitus or hyperacusis