A systematic literature review on nurses' and health care support workers' experiences of caring for people with dementia on orthopaedic wards

Aims and objectives To review literature on nurses’ and health care workers’ experiences of caring for people with dementia on orthopaedic wards. Background Dementia is a condition that affects a large number of the older population worldwide. It is estimated that there are 47·5 million people worldwide living with dementia with 4·6 million new cases being diagnosed annually. This number is said to increase to 75·6 million by 2030 and triple by 2050. It is also acknowledged that older people are at a greater risk of falls that are a devastating problem causing a tremendous amount of morbidity, mortality and use of health care services (Rubestein, Age and Ageing, 35, 2006, 37). Falls usually result from identified risk factors such as weakness, unsteady gait, confusion and certain medication. Therefore, it is reasonable to assume that a large population of older people suffering from dementia may be admitted to orthopaedic wards with various injuries. Nurse and support health workers may experience a range of difficulties when caring for this population of patients. Design A systematic review. Methods An extensive literature search using; CINAHL, MEDLINE, Academic Search Complete, National Health Service Evidence, websites like Department of Health, Dementia and Alzheimer's Society. Results The search generated several articles on dementia in general, however, only 14 articles dealing with care of these people in an acute hospital setting were found. No studies dealing with the care of people with dementia on orthopaedic wards were found; therefore, this review has taken a generalist nature and applies the findings to orthopaedic wards. The main themes identified from the review were: challenging behaviour and unsuitable care environment; lack of education on dementia; strain from nursing patients with dementia; and ethical dilemmas arising from care of people with dementia. Conclusion It would be an over-simplification to say that the care of people with dementia on medical wards is the same as the care of trauma patients with dementia. Therefore, there is a need for a study to explore nurses’ and health care worker's experiences of caring for trauma patients with dementia on orthopaedic wards. Relevance to clinical practice The results of this study could provide guidance on the effective care of people with dementia on orthopaedic wards

The Status of Civil Society in Zambia: Challenges and Future Prospects

This report analyses this multi-faceted nature of CSOs, whether formal or informal in nature, in order to gain a greater understanding of the characteristics that make them a valued partner in the development process, the challenges they encounter, and the capabilities most needed to play their expected roles

Integrated Multiple-tactic Management of the Redbanded Stink Bug on Soybeans in Louisiana

Stink bugs (Hemiptera: Pentatomidae) are major pests of soybeans in Louisiana and heavy infestations often lead to economic losses. The stink bug species complex has changed in the past decade with the prevalence of the invasive redbanded stink bug, Piezodorus guildinii (Westwood), which causes greater damage than other stink bug species. Moreover, control of the redbanded stink bug has been faced with challenges because it is less sensitive to recommended insecticides. Therefore, studies were conducted to evaluate different control options for P. guildinii. Among the studies conducted was the current status of egg parasitoids of stink bugs in Louisiana. Telenomus podisi Ashmead (Hymenoptera: Platygastridae) was the predominant egg parasitoid of stink bugs. Field studies were also conducted to determine the combined effects of host plant resistance and insecticide application, on the abundance of stink bugs and their natural enemies. The soybean cultivar Pioneer 95Y20 had the least pest pressure, seed damage, and yields were higher from these plants. Insecticide application of thiamethoxam provided some control of stink bugs, although it did not impact yield. The combination of cultivar and insecticide application did not have a significant effect on natural enemies of stink bugs. Lastly, a study was also performed to demonstrate the effect of synthetic plant volatiles on natural enemies of stink bugs in the field. Results from this study showed that methyl jasmonate had a significant impact on the number of fire ants collected during a 5-minute time interval. Overall, results from this research provide important information on the integrated pest management (IPM) of P. guildinii and other stink bugs in Louisiana

Civic Education Teaching Resources and Teacher Preparedness for Secondary School Competency-Based Curriculum in Lusaka, Zambia

This study sought to investigate on Civic Education Teaching Resources and Teacher Preparedness for Secondary School Competency-Based Curriculum in Lusaka, Zambia. The study employed the mixed methods approach, particularly the embedded research design in which 120 secondary school learners and 40 teachers were sampled using stratified random sampling. In addition, 10 Heads of Departments, 10 Head teachers, 2 Education Standards Officers and 1 Civic Education Curriculum Development Specialist were purposively sampled and semi-structured interview guides were used to obtain qualitative data from teachers and school leaders while the questionnaire was used to obtain information from learners. The findings revealed that despite teachers of civic education having being in-serviced on CBC, they were not using recommended teaching methods. It was also revealed that teaching resources were inadequate and teachers lacked an in- depth understanding of how to use teaching resources for effective implementation of the CBC. The study therefore recommended that the Ministry of Education should seriously consider retraining teachers with skills required for competency-based learning. Moreover, during the in-service and pre-service training, teachers should be upskilled in learner centered approachers that are most likely to promote learners acquisition of appropriate civic skills, knowledge and attitudes. Additionally, the Ministry of Education should facilitate and provide adequate teaching and learning resources in secondary schools so as to address the 21st century competencies deficiencies among learners

Numerical analysis of the cold gas dynamic spray surface coating process

Abstract: In Cold Spray, bonding is formed between substrate and the particles and between particles by impact which causes material deformation and temperature rise. During impact process, plastic deformation and frictional interaction of materials generate heat and strains/stresses. In this paper, a numerical study on multiple particles deposition process show that the plastic equivalent strain (von misses stress) and the temperature values, compare to a single particle impact under same conditions, are higher in multiple particles compared to a single particle impact. Based on this observation, there is a possibility of the bonding mechanism for the whole film coating better explained using the multiple particles modeling than is predicted using single particle analysis However the actual impacting mechanism in the multiple particle interaction is not yet fully understood and still requires further investigation

Residual stress characterization from numerical analysis of the multi-particle impact behavior in cold spray

Abstract: In cold spray, bonding is created between a substrate and the particles and between particles through impact deformation at high strain rates. A prominent feature of the cold spray process is the compressive residual stress that arises during the deposition process. Compressive residual stress on the surface can be beneficial for fatigue resistance. As a post processing technique several applications require surface treatment processes that produce this state of stress on component surfaces such as shot peening, laser shock peening, ultrasonic impact treatment, low plasticity burnishing, etc. In all of these methods the compressive stress is produced through plastic deformation of the surface region. In a similar manner, the cold spray process induces compressive stress by high speed impact of the sprayed particles on the surface, causing a peening effect. The effects of these variations in the properties of the coatings are rarely reported. Moreover there are some applications which require minimal residual stresses in the components such as in optics. In this study, we have investigated the residual stress using numerical analysis of the multi-particle impact behavior in cold spray

Film surface characterization in cold spray using advanced numerical modeling and simulation techniques

Abstract: In cold spray, even when the initial properties are within the critical values for deposition, the multi-impact process is much more complex to ensure a 100% deposition. In inelastic impact, part of the initial kinetic energy of the particles at impact is lost through plastic deformation. After impact and subsequent restitution, unbounded particles will be ejected through rebound forces or material jetting at erosion. Observation of the final kinetic energies achieved in the particles after impact was used as criteria for a rough estimate of the coating process. The surface roughness increased with reduced deposition efficiency. The interface roughness was less affected by this process. Qualitative comparison to experimental results shows some closer correlations with some of the surfaces of experimentally obtained surfaces in cold spray. This could provide some of the answers to the underlying mechanisms in which the cold spray surfaces are generated

Impact of night travel ban on road traffic crashes and fatalities in Zambia: an interrupted time series analysis

Background The burden of road traffic crashes (RTCs) and road traffic fatalities (RTFs) has been increasing in low-income and middle-income countries (LMICs). Most RTCs and RTFs happen at night. Although few countries, including Zambia, have implemented night travel bans, there is no evidence on the extent to which such policies may reduce crashes and fatalities. Methods We exploit the quasi-experimental set up afforded by the banning of night travel of public service vehicles in Zambia in 2016 and interrupted time series analysis to assess whether the ban had an impact on both levels and trends in RTCs and RTFs. We use annual administrative data for the period 2006—2020, with 10 pre-intervention and 4 post-intervention data points. In an alternative specification, we restrict the analysis to the period 2012—2020 so that the number of data points are the same pre-interventions and post-interventions. We also carry out robustness checks to rule out other possible explanation of the results including COVID-19. Results The night travel ban was associated with a reduction in the level of RTCs by 4131.3 (annual average RTCs before the policy=17 668) and a reduction in the annual trend in RTCs by 2485.5. These effects were significant at below 1%, and they amount to an overall reduction in RTCs by 24%. The policy was also associated with a 57.5% reduction in RTFs. In absolute terms, the trend in RTFs reduced by 477.5 (Annual average RTFs before the policy=1124.7), which is significant at below 1% level. Our results were broadly unchanged in alternative specifications. Conclusion We conclude that a night travel ban may be an effective way of reducing the burden of RTCs and RTFs in Zambia and other LMICs. However, complementary policies are needed to achieve more gains.publishedVersio

In vivo dissection of the role of the ubiquitin proteasome system in the pathogenesis of prion disease

Prion diseases comprise a group of fatal neurodegenerative disorders caused by the conformational re-arrangement of a normal host-encoded prion protein, PrPC, to an abnormal infectious isoform, PrPSc. Currently, the precise cellular mechanism(s) of prion-mediated neurodegeneration remain unclear. However, increasing evidence suggests a role for the ubiquitin proteasome system (UPS) in prion disease pathogenesis, with a direct functional impairment of the 26S proteasome leading to the accumulation of UPS substrates in the brains of prion-infected mice. The UPS functions to regulate the targeted degradation of intracellular proteins and maintain cellular proteostasis. Alterations in proteasome proteolysis have been shown to contribute to the build up of proteins associated with aging and dysregulation of the UPS has been linked to several neurodegenerative diseases. The principal aim of this thesis was to characterise the progression of UPS dysfunction in vivo in the brains of prion-infected mice using a ubiquitin-GFP reporter mouse model. Using the UbG76V-GFP transgenic mouse model, UPS dysfunction was observed in the brain early in the prion disease incubation period, before key hallmarks of disease pathology were observed. The accumulation of Ub-GFP reporter coincided with markers of prion disease neuropathology, such as PrPSc deposition and extensive astrogliosis. The majority of cells in which the Ub-GFP reporter was observed in the thalamus appeared to be astrocytes, suggesting that altered proteolysis and reactive astrocyte pathology may be linked. Ubiquitin levels were increased significantly in the brains of prion infected mice, while 26S proteasome peptidase activity was reduced. Behavioural abnormalities and motor skills deficits were also observed in prion-infected UbG76V-GFP mice, which may correlate to neuronal loss and/or synaptic dysfunction associated with impairment of the UPS machinery. Collectively, the data presented in this thesis provide evidence of an early and potentially important role for UPS dysfunction in prion disease pathogenesis