Chiming Bells : Meditation

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The Minimum Clinically Important Difference on the Sleep Disorders Inventory for People with Dementia

Objectives: Sleep disturbances in dementia causes distress to people with dementia and their family carers and are associated with care home admission. The Sleep Disorders Inventory (SDI) is a validated questionnaire of sleep disturbances in dementia often used to measure treatment effectiveness, but the minimum clinically important difference (MCID) is unknown. Methods: We triangulated three investigative methods to determine the MCID of the SDI. Using data on SDI from a randomised controlled trial (RCT) with 62 participants in an intervention for sleep disorders in dementia, we (1) calculated distribution‐based values where MCID = 0.33 of a SD (SD) (2) an anchor based approach using quality of life (measured using DEMQOL‐Proxy) as an anchor. We also employed a Delphi consensus process asking 12 clinicians, sleep researchers and family carers to rate which changes on vignettes were equivalent to a MCID. Results: We found that 0.33 SD in the SDI = 4.86. Reduction in SDI total score was not significantly correlated with improvement in DEMQOL‐Proxy (Pearson's correlation = −0.01; P = 0.96) score. The Delphi consensus required two rounds to reach a consensus and concluded that changes equivalent to three points on the SDI equated to the MCID. Conclusions: Taking into account both the distribution‐based values and the Delphi process we used a whole number at the midpoint and judged the minimum clinically important difference MCID to be equal to four points. We note the clinicians and carers opinions from the Delphi process determined the MCID to be lower at three points

Isolation and characterisation of 17 microsatellite loci for the red-billed chough (Pyrrhocorax pyrrhocorax)

Peer reviewedPostprin

The impact of sleep disturbances on care home residents with dementia: the SIESTA qualitative study

OBJECTIVES: Nearly 40% of care home residents who are living with dementia also have symptoms of disturbed sleep. However, the impact of these disturbances is relatively unknown and is needed to indicate whether interventions are warranted; therefore, we aimed to investigate the impact. DESIGN: One-to-one semi-structured interviews. SETTINGS: Four UK care homes. PARTICIPANTS: We interviewed 18 nurses and care assistants about residents with sleep disturbances. MEASUREMENTS: We used a topic guide to explore staff experience of sleep disturbance in residents with dementia. The interviews were audio recorded and transcribed and then analyzed thematically by two researchers independently. RESULTS: Staff described that sleep disturbances in most, but not all, residents impacted negatively on the resident, other residents, staff, and relatives. Residents became more irritable or agitated if they had slept badly. They slept in the daytime after a bad night, which then increased their chances of being awake the following night. For some, being sleepy in the day led to falls, missing medication, drinks, and meals. Staff perceived hypnotics as having low efficacy, but increasing the risk of falls and drowsiness. Other residents were disturbed by noise, and staff described stress when several residents had sleep disturbance. Some of the strategies reported by staff to deal with sleep disturbances such as feeding or providing caffeinated tea at night might be counterproductive. CONCLUSIONS: Sleep disturbances in care home residents living with dementia negatively affect their physical and psychological well-being. These disturbances also disturb other residents and increase stress in staff

Ultrareliable, fault-tolerant control systems: A conceptual description

An Ultrareliable, Fault-Tolerant, Control-System (UFTCS) concept is described using a systems design philosophy which allows development of system structures containing virtually no common elements. Common elements limit achievable system reliability and can cause catastrophic loss of fault-tolerant system function. The UFTCS concept provides the means for removing common system elements by permitting the elements of the system to operate as independent, uncoupled entities. Multiple versions of the application program are run on dissimilar hardware. Fault tolerance is achieved through the use of static redundancy management

Spirituality in the work of Theodore Roszak : implications for contemporary ecopsychology

Despite the recent flourishing of ecopsychology research, risks may be involved if ecopsychology remains a loosely defined paradigm. We suggest that drawing from some of the central themes of Theodore Roszak’s The Voice of the Earth (1992), a seminal text of ecopsychology, may help to elucidate the unique contribution of ecopsychology and its sustained relevance for environmentally focused psychologies. To provide a comprehensive review, we consider The Voice of the Earth by placing this text in the context of Roszak’s broader body of literature, discussing his earlier and more recent works. We particularly focus on the theme of spiritual experience throughout Roszak’s literature, as we believe that this is one of the more unique and important aspects of his work that has implications for the future development of ecopsychology as a paradigm and social movement. In conclusion, we suggest that Roszak’s emphasis on the value of a spiritual or animistic experience of nature, as a means of fostering empathy toward the natural world, may assist in providing meaningful focus to contemporary ecopsychology