Creating a library, museum and citizen service centre for people with dementia. A project on participation and learning through transdisciplinary and interdisciplinary networking in Wiener Neustadt

Im partizipativen Gesundheitsforschungsprojekt "Eine Bibliothek für ALLE. Demenzfreundliche Bibliothek Wiener Neustadt" standen Menschen mit Demenz und betreuende Angehörige im Zentrum. Ziel war es, die Kompetenz der Mitarbeiter*innen in öffentlichen Einrichtungen (Bibliothek, Museum, Bürgerservice) im Umgang mit Menschen mit Vergesslichkeit zu erweitern und die Einrichtungen - im Sinne von Organisationslernen - demenzfreundlicher zu gestalten. Von Anfang an waren betroffene Menschen und ihre Angehörigen in das Projekt eingebunden wie auch soziale Einrichtungen und Selbsthilfegruppen. Erreicht wurde so nicht nur ein individueller Wissenszuwachs über Demenz und den Umgang mit Menschen mit Demenz, sondern die Themen wurden durch die Begegnung mit betroffenen Personen greifbar und erfahrbar. So konnte ein ressourcenorientiertes Bild geschaffen werden, das zur Entstigmatisierung von Menschen mit Demenz beiträgt. Auch für die beteiligten Betroffenen öffneten sich durch das Projekt (wieder) Türen mit neuen Handlungsmöglichkeiten für ihre soziale Teilhabe. Schließlich zeigte das Projekt auf: Es reicht nicht aus, Angebote für Menschen mit Demenz und deren Umfeld über die gewohnten Kanäle zu verbreiten. Vielmehr bedarf es der Vernetzung bzw. Zusammenarbeit mit Organisationen, die mit Menschen mit Demenz in Kontakt sind. (DIPF/Orig.)People with dementia and their caregivers are at the heart of the participatory health research project "A library for EVERYONE. Dementia-friendly Wiener Neustadt library". The goal was to increase the competence of employees of public institutions (library, museum, citizen service centre) in how to deal with people with memory issues and to make the institutions more dementia friendly - in the sense of organizational learning. From the start, people with dementia and their caregivers as well as social institutions and self-help groups were integrated into the project. Not only did individuals increase their knowledge of dementia and how to accommodate people with dementia but they also were able to better understand and experience the topics through encounters with individuals who are affected. This creates a perception of the disease that is oriented to human potential, which helps reduce the stigma of having dementia. For the participating individuals, the project (re)opened doors with new opportunities for social inclusion. The project ultimately demonstrated that it is not enough to communicate opportunities for people with dementia and their caregivers via the usual channels. Instead, it requires networking and cooperation with organizations that have contact with people with dementia. (DIPF/Orig.

Innovative Non-Pharmacological Management of Delirium in Persons with Dementia: New Frontiers for Physiotherapy and Occupational Therapy?

Delirium; Dementia; Occupational therapyDelirio; Demencia; Terapia ocupacionalDeliri; Demència; Teràpia ocupacionalBackground: Delirium and dementia are two of the most common geriatric syndromes, which requires innovative rehabilitation approaches. Aim: We aimed at determining which occupational therapy and physiotherapy interventions are applied with older people with delirium and dementia in different care settings. We also identified the assessment tools that were used. Materials and methods: We conducted a literature search for scientific articles published from 2012 to 2022 (PubMed, MEDLINE, AMED and CINAHL) with adults aged >65 years including experimental study designs with randomized or non-randomized intervention, exploratory studies, pilot studies, quasi-experimental studies, case series and/or clinical cases. Studies that did not use interventions that could be classified as occupational therapy or physiotherapy were excluded. Results: After applying the exclusion criteria, 9 articles were selected. The most widely used assessment to define dementia was the MMSE (N = 5; 55.5%), whereas the CAM (N = 2; 22.2%), CAM-ICU (N = 2; 22.2%) and RASS (N = 3; 33.3%) were the most widely used to define delirium. The rehabilitation interventions that were most frequently performed were early mobilization, inclusion of the caregiver during treatment, modification of the environment to encourage orientation and autonomy, the interprofessional systemic approach and engaging persons in meaningful activities. Conclusions: Despite the growing evidence on its effectiveness, the role of physiotherapy and occupational therapy interventions in the prevention and treatment of people with dementia and delirium is still emerging. More research is needed to investigate if effective occupational therapy programs known to reduce the behavioral and psychological symptoms in people with dementia are also useful for treating delirium and specifically delirium superimposed on dementia. Regarding physiotherapy, it is crucial to know about the amount and timing of intervention required. Further studies are needed including older adults with delirium superimposed on dementia to define the role of the interprofessional geriatric rehabilitation team

Identification of citrullinated α-enolase as a candidate autoantigen in rheumatoid arthritis

Antibodies against citrullinated proteins are highly specific for rheumatoid arthritis (RA), but little is understood about their citrullinated target antigens. We have detected a candidate citrullinated protein by immunoblotting lysates of monocytic and granulocytic HL-60 cells treated with peptidylarginine deiminase. In an initial screen of serum samples from four patients with RA and one control, a protein of molecular mass 47 kDa from monocytic HL-60s reacted with sera from the patients, but not with the serum from the control. Only the citrullinated form of the protein was recognised. The antigen was identified by tandem mass spectrometry as α-enolase, and the positions of nine citrulline residues in the sequence were determined. Serum samples from 52 patients with RA and 40 healthy controls were tested for presence of antibodies against citrullinated and non-citrullinated α-enolase by immunoblotting of the purified antigens. Twenty-four sera from patients with RA (46%) reacted with citrullinated α-enolase, of which seven (13%) also recognised the non-citrullinated protein. Six samples from the controls (15%) reacted with both forms. α-Enolase was detected in the RA joint, where it co-localised with citrullinated proteins. The presence of antibody together with expression of antigen within the joint implicates citrullinated α-enolase as a candidate autoantigen that could drive the chronic inflammatory response in RA

An interdisciplinary statement of scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT)

BACKGROUND: Delirium is a geriatric syndrome that presents in 1 out of 5 hospitalized older patients. It is also common in the community, in hospices, and in nursing homes. Delirium prevalence varies according to clinical setting, with rates of under 5% in minor elective surgery but up to 80% in intensive care unit patients. Delirium has severe adverse consequences, but despite this and its high prevalence, it remains undetected in the majority of cases. Optimal delirium care requires an interdisciplinary, multi-dimensional diagnostic and therapeutic approach involving doctors, nurses, physiotherapists, and occupational therapists. However, there are still important gaps in the knowledge and management of this syndrome. MAIN BODY: The objective of this paper is to promote the interdisciplinary approach in the prevention and management of delirium as endorsed by a delirium society (European Delirium Association, EDA), a geriatrics society (European Geriatric Medicine Society, EuGMS), a nursing society (European Academy of Nursing Science, EANS), an occupational therapy society (Council of Occupational Therapists for European Countries, COTEC), and a physiotherapy society (International Association of Physical Therapists working with Older People of the World Confederation for Physical Therapy, IPTOP/WCPT). SHORT CONCLUSION: In this paper we have strongly promoted and supported interdisciplinary collaboration underlying the necessity of increasing communication among scientific societies. We have also provided suggestions on how to fill the current gaps via improvements in undergraduate and postgraduate delirium education among European Countries.status: publishe

Metabolism and Regulation of Glycerolipids in the Yeast Saccharomyces cerevisiae

Due to its genetic tractability and increasing wealth of accessible data, the yeast Saccharomyces cerevisiae is a model system of choice for the study of the genetics, biochemistry, and cell biology of eukaryotic lipid metabolism. Glycerolipids (e.g., phospholipids and triacylglycerol) and their precursors are synthesized and metabolized by enzymes associated with the cytosol and membranous organelles, including endoplasmic reticulum, mitochondria, and lipid droplets. Genetic and biochemical analyses have revealed that glycerolipids play important roles in cell signaling, membrane trafficking, and anchoring of membrane proteins in addition to membrane structure. The expression of glycerolipid enzymes is controlled by a variety of conditions including growth stage and nutrient availability. Much of this regulation occurs at the transcriptional level and involves the Ino2–Ino4 activation complex and the Opi1 repressor, which interacts with Ino2 to attenuate transcriptional activation of UASINO-containing glycerolipid biosynthetic genes. Cellular levels of phosphatidic acid, precursor to all membrane phospholipids and the storage lipid triacylglycerol, regulates transcription of UASINO-containing genes by tethering Opi1 to the nuclear/endoplasmic reticulum membrane and controlling its translocation into the nucleus, a mechanism largely controlled by inositol availability. The transcriptional activator Zap1 controls the expression of some phospholipid synthesis genes in response to zinc availability. Regulatory mechanisms also include control of catalytic activity of glycerolipid enzymes by water-soluble precursors, products and lipids, and covalent modification of phosphorylation, while in vivo function of some enzymes is governed by their subcellular location. Genome-wide genetic analysis indicates coordinate regulation between glycerolipid metabolism and a broad spectrum of metabolic pathways

“Take me to the back, or they'll think I am not normal” - Ethical reflections on narrative research with people with dementia living in long-term care institutions

Background: Over 80% of older adults in long-term care institutions live with cognitive impairment/dementia. They represent a particularly vulnerable group, yet the perspective of people with advanced dementia has still not been sufficiently explored. These people are often excluded from research, also because of ethical and methodical issues and legal barriers. Design: In this paper we discuss ethical considerations und challenges which arise in qualitative research with people living with advanced dementia. We present ethical issues in research using a design inspired by ethnography with the aim to encourage future research in this field. Methods applied were observations, interviews and informal talks with people diagnosed with moderate and severe dementia. Two different long-term care institutions were researched: a specialized dementia-care unit and an institution based on a community- oriented household-model. Participants were older adults with dementia, and data were collected within a period of two years. Staff and next of kin were included in data collection. A thematic and narrative analysis was performed.Challenges linked to ethical and methodological issues were experienced throughout the whole research process. These included getting approval from a local ethical committee, gaining access to the field, dealing with process consent and complex qualitative analysis, representing the participant's stories in a respectful way, enabling reciprocity as well as dealing with difficult situations in long-term care and questions of the vulnerability of both the participants and the researcher. Conclusion: It is possible to include vulnerable adults living with advanced dementia in qualitative research. This should be done more extensively in order to make the experience of a group that is growing in numbers visible. Strategies of reflexivity have to be carefully planned and organized in advance because methodological and ethical aspects are strongly intertwined. In contemporary qualitative narrative research, it is recommended to not only present the participant's stories, but also the researcher's own story that exerts influence on the research process. Approaches derived from care- and process ethics as well as appreciative inquiry can provide valuable support throughout the research process

Understanding the role of occupation in ageing: four life stories of older Viennese women

This article presents the life stories of four older women in Vienna in order to better understand the role of occupation in the course of ageing. A qualitative life-story method in the narrative tradition was used as a design of this multiple case study. The stories presented extend beyond an illness or deficit narrative and contribute to a more multifaceted narrative of the subjective experience of ageing in occupational terms in connection with identity. The women did not perceive themselves as old or sick despite problems in mobility, the presence of chronic disease and advanced age. This was associated with their engagement in occupation that was meaningful and linked to their identity. Engaging occupation is the means to continue, test, and adapt to the ageing self. Because occupation is like a litmus-test of one's identity and capacities, the women used it as a measure of change while ageing. Using Atchley's continuity theory, the attempt of the four older women to maintain a balance between adapting and struggling to continue their occupations is discussed in relation to their identity. The results expand Atchley's continuity theory by adding an occupational perspective