A qualitative evaluation of the effect of a longitudinal dementia education programme on healthcare student knowledge and attitudes

Background and objectives There is a need to ensure that the future healthcare workforce has the necessary knowledge and skills to deliver high quality compassionate care to the increasing number of people with dementia. Our programme has been set up to address this challenge. In the programme, undergraduate healthcare students (nursing, medical and paramedic) visit a family (person with dementia and their carer) in pairs over a 2-year period. This qualitative study sought to understand the student experience of the programme. Methods Participants were undergraduate healthcare students who were undertaking our programme at two universities. We sampled for variation in the student participants in order to generate a framework for understanding the student experience of the programme. Students were invited to take part in the qualitative study, and written consent was obtained. Interviews and focus group transcripts were analysed using thematic analysis. Results Thirty-nine (nursing, medical and paramedic) student participants took part in individual in-depth qualitative interviews and 38 took part in five focus groups. Four key themes were identified from the analysis; relational learning, insight and understanding, challenging attitudes and enhanced dementia practice. Discussion Student experience of our programme was shown to be positive. The relationship between the students and family was most impactful in supporting student learning, and the subsequent improvement in knowledge, attitudes and practice. Our model of undergraduate dementia education has applicability for other long-term conditions

Castleman's Disease with Cutaneous Involvement Manifestating as Multiple Violaceous Plaques on Entire Body

Castleman's disease (CD) is an uncommon B-cell lymphoproliferative disorder characterized by lymph node hyperplasia with vascular proliferation. Cutaneous involvement in CD is rare. A 65-year-old man presented with a 7-year history of gradually developing multiple reddish to violaceous indurated plaques on the scalp, trunk, and legs. On physical examination, there were palpable enlarged cervical, axillary, and inguinal lymph nodes. Laboratory examination revealed anemia, thrombocytosis, hyperproteinemia, hypoalbuminemia, and polyclonal hypergammaglobulinemia. An inguinal lymph node biopsy and a skin biopsy were performed and the patient was diagnosed with the plasma cell type of CD. Chemotherapy was started and the lesions have responded to treatment

Pedigree Reconstruction Sheds Light on the Mating System and Social Dynamics of Urban Bobcats (Lynx rufus)

Wildlife pedigrees are crucial to addressing a broad range of fundamental ecological and evolutionary questions related to population dynamics, mating systems, trait heritability, and inbreeding levels. Pedigree analyses also have important implications for the conservation and management of threatened species. In this study, we reconstructed a multigenerational pedigree for 196 urban bobcats (Lynx rufus) sampled from 1996–2015 in the Simi Hills of southern California using 21 microsatellite loci. We determined that both sexes exhibit moderate to high mate fidelity between breeding seasons, but did not detect multiple paternity among litters, which adds support to the long-standing hypothesis that bobcats are polygynous within breeding seasons. Our results shed light on the social dynamics and mating system of an elusive, solitary mesopredator and will provide an invaluable tool for future research related to spatial social organization, trait heritability, and mating patterns in this population

A competitive online algorithm for the paging problem with "shelf" memory

We consider an extension of the two-level paging problem. Besides a fast memory (the cache) and a slow memory, we postulate a third memory, called the \shelf", near the fast memory so that it is more cost-e cient to store or retrieve a page from the shelf than to retrieve a page from the slow memory. Unlike the standard two-level paging prob- lem, the extension is not a special case of the K-server problem as it is not embedded in a space with a symmetric metric. Our goal is to establish an upper bound on the competitive ratio of this \three-level" memory paging problem. We show that unless per page storage costs more than per page retrieval from the shelf, a simple extension of the well-known LRU algorithm has competitive ratio of 2k + l + 1, where k and l are, respectively, the capacities of the cache and the shelf. If, in addition, k l, then the same algorithm is k + l + 2-competitiveThe research is partially supported by Chung-Ang University Research Grant 96-106