Using a taxonomy of behaviour change techniques to define key components of Stop Delirium! a complex intervention to prevent delirium in care homes

Objective: This paper aims to describe Behaviour Change Techniques (BCTs) used within a multi-component intervention to prevent delirium in older people living in care homes, called Stop Delirium! Methods: The Behaviour Change Technique Taxonomy version 1 (BCTTv1) was used to code and characterise the ‘key ingredients’ within Stop Delirium!. Four sources of information were examined to identify BCTs used: intervention manual and toolkit; the delirium resource box; and contemporaneous written logs recorded by staff delivering the intervention in two feasibility studies. Details of BCTs used in each part of the intervention and whom they were targeting were recorded, as well as the frequency of each identified BCT. Results: 31.2% of all BCTs described in the BCTTv1 were used in the Stop Delirium! intervention. The majority of BCTs focused on changing care home staff behaviour through enhanced education, training and empowerment. ‘Social support (practical)’ was the most frequently occurring BCT. Conclusion: The large number of different BCTs identified within the Stop Delirium! intervention reflects the complexities of multicomponent interventions. The prominence of social support and empowerment further emphasises the group and organisational effort required to improve delirium care. By explicitly identifying and describing the BCTs used in Stop Delirium!, can enhance standardisation and replicability, and promote intervention fidelity for future trial evaluation and implementation of a multicomponent intervention to prevent delirium in long-term care

Stationary Josephson effect in a weak-link between nonunitary triplet superconductors

A stationary Josephson effect in a weak-link between misorientated nonunitary triplet superconductors is investigated theoretically. The non-self-consistent quasiclassical Eilenberger equation for this system has been solved analytically. As an application of this analytical calculation, the current-phase diagrams are plotted for the junction between two nonunitary bipolar $f-$wave superconducting banks. A spontaneous current parallel to the interface between superconductors has been observed. Also, the effect of misorientation between crystals on the Josephson and spontaneous currents is studied. Such experimental investigations of the current-phase diagrams can be used to test the pairing symmetry in the above-mentioned superconductors.Comment: 6 pages and 6 figure

Causal role of a neural system for separating and selecting multidimensional social cognitive information

People are multi-faceted, typically good at some things but bad at others, and a critical aspect of social judgement is the ability to focus on those traits relevant for the task at hand. However, it remains unknown how the brain supports such context-dependent social judgement. Here, we examine how people represent multidimensional individuals, and how the brain extracts relevant information and filters out irrelevant information when comparing individuals within a specific dimension. Using human fMRI, we identify distinct neural representations in dorsomedial prefrontal cortex (dmPFC) and anterior insula (AI) supporting separation and selection of information for context-dependent social judgement. Causal evaluation using non-invasive brain stimulation shows that AI disruption alters the impact of relevant information on social comparison, whereas dmPFC disruption only affects the impact of irrelevant information. This neural circuit is distinct from the one supporting integration across, as opposed to separation of, different features of a multidimensional cognitive space

Exploring shared decision making in breast cancer care: A case-based conversation analytic approach

Shared decision making (SDM) is acknowledged as the gold standard of healthcare communication, particularly relevant to preference-sensitive care such as breast cancer treatment. However, research on patients’ experiences shows a misalignment between clinicians’ goals and the rhetoric regarding patients’ empowerment during SDM for this treatment. This warrants detailed examination on the conversational dynamics of SDM, and this study aims to identify interactional features and social practices through which SDM is achieved. Fifteen audio recordings from adjuvant treatment breast cancer consultations were examined using the methodology of conversation analysis (CA), and recurrent patterns relevant for understanding SDM were identified. Boundary markers, rhetorical questioning and epistemic markers discouraged a shared orientation to patient participation, reinforcing perceived imbalanced doctor–patient power relations. Cues for SDM such as multi-turn utterances and spaces for transition were presented but not recognised by patients, resulting in sub-optimal two-way discussions about decision making. The findings also reveal that interactional practices were deployed that theoretically should have enabled patients to contribute to SDM. However, in reality these did not result in extended sequences of reciprocated contributions from practitioner and service user. SDM did not happen with the ease implied by current models, and the resultant interactions bore more similarity to expert-led, rather than collaborative, decision makin

Morphological Effects of Combined Systemic Administration of Fluoxetine and Sildenafil in the Murine Hippocampus

We examined the effects of fluoxetine, a selective serotonin re-uptake inhibitor, of sildenafil, a phosphodiesterase-5 (PDE5) inhibitor, and of combined administration of these agents on morphometric characteristics of principal cells of the murine hippocampus. Fluoxetine (5 mg/kg), sildenafil (2 mg/kg), or a combination of these drugs in the above doses were administered i.p. daily for 2 weeks to male mice. Hippocampal sections (5 mm thick) were stained with hematoxylin/eosin. Both drugs and their combination evoked no considerable changes in the dimensions of pyramidal cells in the CA1 and CA2 areas and in the dentate gyrus (DG), except for a trend toward some decrease of this parameter after fluoxetine injections in the CA1 area. Combined administration of fluoxetine and sildenafil provided significant decreases in the density of pyramidal neurons (their mean number per 10 mm of the slice) in the CA1 area and DG. Isolated administration of fluoxetine resulted in significant but less intense decreases in the density of principal cells in the CA2 area and DG. Possible mechanisms of the effects of the mentioned drugs are discussed. Further studies of interaction between fluoxetine and sildenafil in their effects on morphological and physiological properties of cells in different subregions of the hippocampus are recommended.Ми досліджували вплив флуоксетину (селективного інгібітора зворотного захвату серотоніну), силденафілу (інгібітора фосфодіестерази-5, PDE5) та їх сукупного введення на морфометричні характеристики основних (пірамідних) клітин гіпокампа мишей. Флуоксетин (5 мг/кг), силденафіл (2 мг/кг) або комбінація цих агентів у зазначених дозах уводилися самцям мишей внутрішньоочеревинно щоденно протягом двох тижнів. Зрізи гіпокампа завтовшки 5 мкм забарвлювали гематоксиліном та еозином. Обидві речовини та їх комбінація не викликали значних змін розмірів пірамідний нейронів у зонах CA1, CA2 та зубчастої звивини (ЗЗ), певна тенденція до зменшення зазначеного параметра спостерігалася після ін’єкцій флуоксетину в зоні CA1. Сукупна дія флуоксетину та силденафілу призводила до істотного зменшення щільності пірамідних нейронів (їх середньої кількості з розрахунку на 10 мкм зрізу) у зоні CA1 та ЗЗ. Обговорюються можливі механізми ефектів згаданих агентів. Доцільними є подальші дослідження особливостей взаємодії флуоксетину та силденафілу на морфологічні та фізіологічні характеристики клітин у різних підрозділах гіпокампа

Morphological Effects of Combined Systemic Administration of Fluoxetine and Sildenafil in the Murine Hippocampus

We examined the effects of fluoxetine, a selective serotonin re-uptake inhibitor, of sildenafil, a phosphodiesterase-5 (PDE5) inhibitor, and of combined administration of these agents on morphometric characteristics of principal cells of the murine hippocampus. Fluoxetine (5 mg/kg), sildenafil (2 mg/kg), or a combination of these drugs in the above doses were administered i.p. daily for 2 weeks to male mice. Hippocampal sections (5 mm thick) were stained with hematoxylin/eosin. Both drugs and their combination evoked no considerable changes in the dimensions of pyramidal cells in the CA1 and CA2 areas and in the dentate gyrus (DG), except for a trend toward some decrease of this parameter after fluoxetine injections in the CA1 area. Combined administration of fluoxetine and sildenafil provided significant decreases in the density of pyramidal neurons (their mean number per 10 mm of the slice) in the CA1 area and DG. Isolated administration of fluoxetine resulted in significant but less intense decreases in the density of principal cells in the CA2 area and DG. Possible mechanisms of the effects of the mentioned drugs are discussed. Further studies of interaction between fluoxetine and sildenafil in their effects on morphological and physiological properties of cells in different subregions of the hippocampus are recommended.Ми досліджували вплив флуоксетину (селективного інгібітора зворотного захвату серотоніну), силденафілу (інгібітора фосфодіестерази-5, PDE5) та їх сукупного введення на морфометричні характеристики основних (пірамідних) клітин гіпокампа мишей. Флуоксетин (5 мг/кг), силденафіл (2 мг/кг) або комбінація цих агентів у зазначених дозах уводилися самцям мишей внутрішньоочеревинно щоденно протягом двох тижнів. Зрізи гіпокампа завтовшки 5 мкм забарвлювали гематоксиліном та еозином. Обидві речовини та їх комбінація не викликали значних змін розмірів пірамідний нейронів у зонах CA1, CA2 та зубчастої звивини (ЗЗ), певна тенденція до зменшення зазначеного параметра спостерігалася після ін’єкцій флуоксетину в зоні CA1. Сукупна дія флуоксетину та силденафілу призводила до істотного зменшення щільності пірамідних нейронів (їх середньої кількості з розрахунку на 10 мкм зрізу) у зоні CA1 та ЗЗ. Обговорюються можливі механізми ефектів згаданих агентів. Доцільними є подальші дослідження особливостей взаємодії флуоксетину та силденафілу на морфологічні та фізіологічні характеристики клітин у різних підрозділах гіпокампа

Josephson effect in point contacts between ''f-wave'' superconductors

A stationary Josephson effect in point contacts between triplet superconductors is analyzed theoretically for most probable models of the order parameter in UPt_{3} and Sr_{2}RuO_{4}. The consequence of misorientation of crystals in superconducting banks on this effect is considered. We show that different models for the order parameter lead to quite different current-phase dependences. For certain angles of misorientation a boundary between superconductors can generate the parallel to surface spontaneous current. In a number of cases the state with a zero Josephson current and minimum of the free energy corresponds to a spontaneous phase difference. This phase difference depends on the misorientation angle and may possess any value. We conclude that experimental investigations of the current-phase dependences of small junctions can be used for determination of the order parameter symmetry in the mentioned above superconductors.Comment: 11 pages, 8 figure

Self-similar disk packings as model spatial scale-free networks

The network of contacts in space-filling disk packings, such as the Apollonian packing, are examined. These networks provide an interesting example of spatial scale-free networks, where the topology reflects the broad distribution of disk areas. A wide variety of topological and spatial properties of these systems are characterized. Their potential as models for networks of connected minima on energy landscapes is discussed.Comment: 13 pages, 12 figures; some bugs fixed and further discussion of higher-dimensional packing

Correction to: The health-related quality of life in Iranian patients with COVID-19 (BMC Infectious Diseases, (2021), 21, 1, (459), 10.1186/s12879-021-06170-z)

After publication of the original article 1, an error was identified in two authors� names. The incorrect names are: Sima Pourteymour; Hassan Mahmoudi The correct names are: Sima Pourteimour; Hassan Mahmoodi The original article has been corrected. © The Author(s). 202