Specialist nursing and community support for the carers of people with dementia living at home: an evidence synthesis.

Specialist nurses are one way of providing support for family carers of people with dementia, but relatively little is known about what these roles achieve, or if they are more effective than roles that do not require a clinical qualification. The aim of this review was to synthesise the literature on the scope and effectiveness of specialist nurses, known as Admiral Nurses, and set this evidence in the context of other community-based initiatives to support family carers of people with dementia. We undertook a systematic review of the literature relating to the scope and effectiveness of Admiral Nurses and a review of reviews of interventions to support the family carers of people with dementia. To identify studies, we searched electronic databases, undertook lateral searches and contacted experts. Searches were undertaken in November 2012. Results are reported narratively with key themes relating to Admiral Nurses identified using thematic synthesis. We included 33 items relating to Admiral Nurses (10 classified as research) and 11 reviews evaluating community-based support for carers of people with dementia. There has been little work to evaluate specific interventions provided by Admiral Nurses, but three overarching thematic categories were identified: (i) relational support, (ii) co-ordinating and personalising support and (iii) challenges and threats to the provision of services by Admiral Nurses. There was an absence of clearly articulated goals and service delivery was subject to needs of the host organisation and the local area. The reviews of community-based support for carers of people with dementia included 155 studies but, in general, evidence that interventions reduced caregiver depression or burden was weak, although psychosocial and educational interventions may reduce depression in carers. Community support for carers of people with dementia, such as that provided by Admiral Nurses, is valued by family carers, but the impact of such initiatives is not clearly established

Back To The Future: Using Traditional Knowledge to Strengthen Biodiversity Conservation in Pohnpei, Federated States of Micronesia

Pohnpei's traditional belief system strongly supports conservation, but years of foreign rule and influence, population growth, excessive US aid, shift to a cash economy and other factors have combined to weaken the islanders' conservation ethic. The result has been a rapid decline in biodiversity health, which has in turn led to a decrease in quality of life and increased dependence on outside assistance. Conventional government-led western style approaches to resource management were clearly failing, and in 1990, The Nature Conservancy, the local government, and other partners embarked on a program to involve the island's traditional leaders and other cultural experts in the protection of the island's upland forest watershed. After a difficult start, the program has focused on combining Pohnpei culture and traditional knowledge with modern conservation planning and management practices with some success. The result has been a unique community-based management approach that establishes local control over spatially discreet resources that are legitimately considered to belong to the community and the return of resource management and use to an autonomous, consensus-based decision-making process. In a sense, the approach is an act of reconciliation, reconfirming those aspects of both political systems that are considered legitimate. For the participants, it has been a valuable learning experience through which a uniquely "Pohnpei-style" approach - suited specifically to the island's social and political conditions - is being developed

TacSat-4: Military Utility in a Small Communication Satellite

TacSat-4 is a Navy-led joint mission to augment existing Satellite Communication (SATCOM) capabilities and to advance the state of Operationally Responsive Space (ORS) capabilities. In September 2011 TacSat-4 launched from Kodiak Launch Complex in Alaska into a low Highly Elliptical Orbit (HEO). During the following 12 months, experimentation and formal utility assessment were performed. This operational testing allowed users from across the Department of Defense and other governmental agencies to use the capability. The spacecraft and operations were sponsor by Office of Naval Research and Office of Secretary of Defense with Naval Research Lab leading the execution. The ORS Office funded launch and was tasked by the Commander of United States Strategic Command to conduct a Joint Military Utility Assessment (JMUA) to support a transition to operations decision as well as future acquisition decisions. This paper provides a description of the TacSat-4 system and a summary of the testing performed including the results. A primary objective of the TacSat-4 JMUA was to assess the use of small satellites to provide UHF SATCOM to support disadvantaged users in the tactical community. The TacSat-4 experimentation and JMUA activities performed to-date have shown TacSat-4’s ability to provide SATCOM for a wide range of users and applications, using standard SATCOM equipment. Voice, chat, file transfers and other network applications were successfully performed. In addition to providing new SATCOM, the TacSat-4 program also advanced many elements of the ORS concept such as maturing the ORS bus standards, developing an enhanced Minotaur-IV+ launch vehicle capability, demonstrating the first long dwell orbit and mission for a small satellite, and developing highly automated command and control and mission planning systems

Traditional lifestyles, transition, and implications for healthy aging: An Example from the remote island of Pohnpei, Micronesia.

Lifestyle-related, non-communicable diseases, such as diabetes, hypertension, and obesity have become critical concerns in the Pacific islands of Micronesia. We investigated the relationship between the diminution of traditional lifestyle practices and the decline in the health of the population in the State of Pohnpei, Federated States of Micronesia. To assess this, our interdisciplinary team developed two scales, one to rank individuals on how traditional their lifestyles were and one to rank individuals on the healthiness of their lifestyles. Participants' locations were categorized as living on a remote atoll, living on the main island, or as a transitional population. Pohnpeians living in transitional communities (e.g. recently moved from a remote atoll to the main island, or the reverse) ranked lowest on both the tradition and health scales, rather than ranking intermediate between the remote and main island groups as we had hypothesized. As predicted, individuals residing on the remote atolls were living the most traditional lifestyles and also had the healthiest lifestyles, based on our rating system. The higher an individual scored on the tradition scale, e.g. the more traditional life they lived, the higher they scored on the health scale, suggesting the importance of traditional lifestyle practices for maintaining health. These findings have significant implications for promoting health and longevity of Micronesians and other Pacific Island peoples. We suggest the process of transition be recognized as a significant lifestyle and health risk and be given the attention we give to other risk factors that negatively influence our health. Based on our findings, we discuss and recommend the revitalization of particular traditional lifestyle practices, which may advance healthy aging among Pohnpeians

TacSat-4 Early Flight Operations Including Lessons From Integration, Test, And Launch Processing

TacSat-4 is an experimental Ultra High Frequency (UHF) communications satellite that launched on a Minotaur IV+ from Kodiak, Alaska on September 27, 2011. The spacecraft and ground capabilities are briefly described for context. The integration, testing, launch processing, early flight operations, and initial end user results are then discussed. Unique approaches and lessons learned are highlighted. For example, the “launch powered off” approach used to test new Operationally Responsive Space (ORS) bus standards worked particularly well, and had several benefits during launch processing. The ORS Office is leading the Joint Military Utility Assessment of the TacSat-4 mission