Exploring psychosocial interventions for people with dementia that enhance personhood and relate to legacy- an integrative review

Background: Epidemiological predictions suggest that dementia will continue to rise and that this will have social and economic ramifications. Effective interventions, beyond pharmacological management are needed. Psychosocial interventions have largely been investigated in relation to carers of people with dementia, or with regards to their ability to manage dementia symptoms, improve cognition, and reduce challenging behaviour. However, since dementia is a life-limiting illness and people with dementia are at risk of having their personhood compromised, psychosocial interventions should seek to enhance personhood, and offer the potential for the person to leave a legacy. Methods: An integrative review was carried out to identify, assess, appraise and synthesise studies featuring interventions, which relate to both personhood and legacy. Search strategies were developed in key databases: MEDLINE; PsycINFO; Embase; Joanna Briggs Institute; CINAHL; Cochrane Database of Systematic Reviews; ASSIA. Grey literature was also identified through free-text searches. Results: Thirty six articles were included in the final review, these were tabulated and were assessed based on how the intervention related to personhood and legacy. Classification resulted in three themes being identified: Offering aspects of legacy; Acknowledging the person behind the patient; Facilitating meaningful engagement. Generally, personhood aspects of interventions were well reported, but further research is required to explore legacy potential of psychosocial interventions for people with dementia. Conclusion: The integrative review provides an overview and exploration of an under-researched area, and provides directions for future research, which will help expand the evidence base and ultimately help improve patient care for people with dementia and their families

An end-of-life care nurse service for people with COPD and heart failure: stakeholders' experiences

Background: End-of-life care (EOLC) has historically been associated with cancer care. However, demographic changes indicate that future provision must also cater for other long term conditions (LTC). An EOLC-LTC service, delivered by palliative care nurses, is currently being piloted in one area in the East Midlands with patients with cardiac and respiratory disease. In order to inform future commissioning, it is important to gain the views and experiences of those involved with the service. Aims: This study aimed to explore patients, and their partners, views and experiences of the EOLC-LTC service. Methods: Semi-structured interviews were used as part of a case study design, involving six cases. Each case consisted of the patient, their nominated family member/carer and key healthcare professionals involved in their care as identified by the patient. This paper reports on the findings from the interviews conducted with the six patients and their family member/carers. Data were analysed thematically. Results: From the interviews, the following themes were identified: experiences managing a long term cardio-respiratory condition, the nurse service, building a close/therapeutic relationship and fragmentation and integration. Conclusions: This study has shown that the EOLC-LTC service is welcomed and highly regarded by patients and their family members/carers. Further studies are required to explore the views and experiences of other key stakeholders and to evaluate how well the pilot operates within the wider care pathway

Conducted EMI Mitigation in Power Converters using Active EMI Filters

Wide bandgap devices enable high power density power converters. Despite the advantages of increased switching frequency, the passive components are still a major bottleneck towards enabling high power density. Among the passive components in the converter, the passive EMI filters are unavoidable to ensure compliance with conducted EMI standards. Active EMI filters help reduce the volume of the passive components and have been around for three decades now. Firstly, this work presents a summary of all the different active EMI filters based on the type of noise-sensing, noise-processing, the type of active circuits used and the type of control methods. This is followed by modeling, design and stability analysis of three different active EMI filters for DM noise attenuation. The first active EMI filter is a conventional active EMI filter. The key bottlenecks to improving performance of the conventional active EMI filter are identified while still achieving volume reduction of passive components. Following this two novel active EMI filters are presented that overcome the bottlenecks of conventional active EMI filter. The second active EMI filter is based on a analog twin-circuit. This novel filter uses a twin-circuit which enables the use of low-voltage surface-mount components for compensation. The third active EMI filter uses zero-phase filtering implemented in an FPGA. While all the filters are demonstrated for differential-mode noise, their use can be extended for common-mode noise attenuation

Degradation of Alizarin Yellow R Using Ultraviolet/Hydrogen Peroxide (UV/H202) Advanced Oxidation Process

The homogeneous advanced oxidation process of Ultraviolet (UV) radiation in presence of Hydrogen Peroxide (H2O2) was utilized to degrade Alizarin Yellow R, one of the most used azo dyes in the textile industry. The UV/H2O2 oxidation process is a feasible and efficient alternative for wastewater treatment from recalcitrant compounds such as azo dyes. In this study, the effects ofinitial hydrogen peroxide concentration, imtial dye concentration, initial pH and temperature were examined to determine the optimum operating conditions that give the maximum rate of degradation. Complete decolourization was achieved in the relatively short time of 60-80 minutes of irradiation. The degradation efficiency increased with increasing initial concentration of H2O2 up to an optimum value. Faster decolourization was achieved at medium acidic and neutral pH environment ranging from p 5-7 and at high temperature. The degradation reaction was found to follow the first order kinetics with respect to the dye concentration. The Box-Behnken response surface methodology (RSM) was utilized for mathematical modelling for degradation rate and used to optimize the operating condition of this degradation process. The optimum operating conditions were imtial H2O2 concentration of0.25M, initial pH of 4.59 and temperature of 50°C. Under such conditions, the proposed model of Box- Behnken fitted very well with the experimental data with R =0.989. In general, the result indicates that the UV/H2O2 technology proved to have good potential for removing dyestuff from wastewater but further treatment might be necessary to achieve complete mineralization ofthe organic intermediates

Differential Subordination And Superordination For Analytic And Meromorphic Functions Defined By Linear Operators [QA331. N219 2007 f rb].

Suatu fungsi f yang tertakrif pada cakera unit terbuka U dalam satah kompleks C disebut univalen jika fungsi tersebut memetakan titik berlainan dalam U ke titik berlainan dalam C. A function f defined on the open unit disk U of the complex plane C is univalent if it maps different points of U to different points of C

Decision making in mental health team meetings

Background: Single point of access meetings represent a critical juncture in the lives of mental health clients. The decision-making process undertaken by mental health professionals during this time is therefore crucial. Method: Glaserian grounded theory, with observations and interviews through theoretical sampling, was used to investigate the decision making of attendees. Findings: A basic social process named handling role boundaries emerged, consisting of four phases: recognising, positioning, weighing up and balancing. Conclusion: Handling role boundaries is an innovative, sociological theory that allows conceptual understanding to show how personality traits contribute to the discussions and decisions, as well as professional roles. These need to be managed effectively to make decisions in a limited time frame. Handling role boundaries explains how this is done in a local mental health trust

The challenges with problem=based learning: a case study of MUFY students studying economics and information and communication technology (ICT)

Problem-based learning (PBL) is a method that challenges students to learn through engagement in a real scenario. It helps to develop problem solving strategies and disciplinary knowledge bases and skills by engaging students in an active role of problem solvers (Hmelo-Silver, 2004). The PBL approach originated from the medical school and is currently used in many different schools. This research paper is focused on the challenges of problem-based learning faced by students enrolled in the Monash University Foundation Year (MUFY) program offered in Sunway College, Malaysia. In order to carry out the research, two subjects which are Economics and Information and Communication Technology (ICT), are used. In today’s learning, PBL is considered an ideal learning approach which incorporates teamwork, independent learning, critical thinking and problem solving. Thus, the purpose of this research is to employ PBL and examine the challenges encountered by students learning using this problem-based approach

Assessment of hematological and biochemical alterations as markers in an Indian major carp Catla catla exposed to various concentrations of zinc oxide nanoparticles

Fingerlings of Catla catla were exposed to 1, 5, and 25 mg/L of zinc oxide nanoparticles (ZnO NPs) for 15 days, and specific hematological and biochemical parameters were evaluated to assess the toxicity. During the exposure period, red blood cell (RBC) count was found to decrease (except at the end of the 5th day in 1 mg/L) whereas white blood cell (WBC) count was found to increase in ZnO NPs treated fishes. A significantly higher hematocrit (Hct) level was recorded in fish exposed to 1 mg/L when compared with control and a higher concentration of ZnO NPs (5 and 25 mg/L). Erythrocyte indices such as mean cellular volume (MCV) and mean cellular hemoglobin (MCH) values (except at the end of 5 and 10th day at 1 and 10 mg/L exposed groups) were significantly increased. Mean cellular hemoglobin concentration (MCHC) level was found to be increased at 1 and 25 mg/L treated groups compared to 10 mg/L. Compared to the control group, plasma glucose level was increased significantly in fish exposed to 5 and 25 mg/L concentrations of ZnO NPs, while the plasma glucose level was decreased at the end of the 15th day in all the concentrations. Plasma protein level was increased at the end of the 5th day while the level of plasma protein was decreased on the 10 and 15th day. A significant increase in glutamate oxaloacetate transaminase (GOT) (except at the end of 10th day) and glutamate pyruvate transaminase (GPT) activity in gill and liver (except at the end of 10 and 15th day in gill) were noted in all the concentrations tested when compared to control groups. The results of the present study indicate that ZnO NPs at 1, 5, and 25 mg/L can alter the hematological and biochemical parameters of fish and the toxicity data may provide the ecotoxicological impact of ZnO NPs on the aquatic environment.

Neuroprotection through flavonoid: Enhancement of the glyoxalase pathway.

The glyoxalase pathway functions to detoxify reactive dicarbonyl compounds, most importantly methylglyoxal. The glyoxalase pathway is an antioxidant defense mechanism that is essential for neuroprotection. Excessive concentrations of methylglyoxal have deleterious effects on cells, leading to increased levels of inflammation and oxidative stress. Neurodegenerative diseases - including Alzheimer\u27s, Parkinson\u27s, Aging and Autism Spectrum Disorder - are often induced or exacerbated by accumulation of methylglyoxal. Antioxidant compounds possess several distinct mechanisms that enhance the glyoxalase pathway and function as neuroprotectants. Flavonoids are well-researched secondary plant metabolites that appear to be effective in reducing levels of oxidative stress and inflammation in neural cells. Novel flavonoids could be designed, synthesized and tested to protect against neurodegenerative diseases through regulating the glyoxalase pathway

An Enhanced Security Model for Protecting Data Transmission and Communication in Recent IoT Integrated Healthcare Industry Using Machine Learning Algorithm

Different kinds of security need to be applied to various application-centric IoT networks. Safety is one of the most important aspects to be considered regarding user, device, and data. The healthcare industry is a special IoT network fully connected with medical/healthcare IoT devices. The data generated from the IoT devices are transmitted or shared from one hospital to another through the Internet. Healthcare data has more private, medical, and insurance information that intruders can use on the Internet. The intruders misbehave with the patient or the general public registered in the healthcare industry. Some intruders blackmail the patient based on their private/personal information. Healthcare industries and their research team are trying to create a security framework to safeguard the data to avoid these malicious activities. This paper aims to secure and analyze healthcare IoT data using the Support Vector Machine algorithm. It learns the entire dataset, classifies it, and calls the encryption-decryption algorithms (RSA) to secure private data. The proposed SVM and the RSA algorithm are implemented in Python, and the results are verified. The performance of the proposed SVM-RSA is evaluated by comparing its results with the other algorithms