The needs of people with dementia living at home from user, caregiver and professional perspectives: a cross-sectional survey

Few reports have been published about differences in perspectives on perceived needs among community-residing people with dementia, their family caregivers, and professionals. The aim of this study was to compare these perspectives

Improving continence services for older people from the service-providers' perspective: a qualitative interview study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.Objective To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting 3 acute and 13 primary care National Health Service Trusts in England. Participants 16 continence service leads in England actively treating and managing older people with UI. Results In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.Funding was received from the New Dynamics of Ageing Programme, led by the Economic & Social Research Council, UK (grantnumber RES-353-25-0010)

The art of HAART: a practical approach to antiretroviral therapy

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Reflective Practices in the Dance Studio: Implementing Deliberate Observation and Examination Methods into the Dance Technique Class for Youth to Encourage the Development of Self-awareness

The purpose of this study was to investigate the effects of a reflective pedagogy on younger students in the dance studio setting. Three research questions were designed to be answered by this study. Q1 In what ways are reflective practices effective in a dance studio setting? Q2 Are reflective practices effective for younger students? Q3 How can reflective practices be applied effectively in future dance classes? Five students participated in the study by completing weekly self-evaluation progress forms and reflective journal entries. The researcher at the same time completed an observation form of the participants’ progresses. These research instruments composed the quantitative and qualitative data of the study. Even with the researcher’s best efforts, there were some limitations to the study. These limitations were the small population size, lack of mirrors in the studio space, possible misunderstanding of the self-evaluation rating scale, and only one observer who was also the researcher. Analysis of the quantitative and qualitative data showed that each participant experienced and used the reflective practices differently. The study suggested that students of this age were better at identifying strengthens and weaknesses rather than critical thinking and problem-solving aspect of the reflective process. Despite this, the study demonstrated that students of a younger age were capable of participating in the reflective process to some degree

Life After Roe: Supporting Women and Families Facing Unexpected Pregnancies

Key PointsIn the post–Roe v. Wade world, state governments will revise laws and regulations about abortion access. All states, whether their elected officials favor abortion access or decide to restrict access to the procedure, should review laws and programs affecting women facing unexpected pregnancy.For many women, unexpected pregnancy is accompanied by financial hardship, health issues, substance use disorders, housing needs, and other challenges. To help these women, states should review benefit and service strategies to help ensure women have the support they need for healthy pregnancies and babies, whether they live in states that allow abortion or ones that seek to restrict it.The federal government can help by implementing a balanced, pro-family tax credit; increasing appropriations for existing maternal and child health safety-net programs; and creating a new maternity choice voucher program to provide immediate, supplemental support to women facing unexpected pregnancies

'I just like thinking about the moon and lighting candles': 21st Century Witches on Instagram

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Model Error and Predictability over Different Timescales in the Lorenz '96 Systems

Prediction problems have been described by Lorenz as falling into two categories. Problems which depend on the initial condition, such as short to medium range weather forecasting, are described as ‘predictions of the first kind’, while problems that depend on boundary rather than initial con-ditions, such as in many cases the longer term climatology, are referred to as predictions of the second kind. Both kinds of prediction will be af-fected by error in the model equations used to approximate the true sys-tem. In this paper, we examine predictability over different time scales for the medium-dimensional Lorenz ’96 systems. Models are constructed for the purposes of optimising both short-range prediction and climatological behavior, and studied over a range of forcings for which they show peri-odic, quasi-periodic, or chaotic behavior. It is shown that, for the models discussed here, there is a link between short and long-range predictability, which holds independently of the effects of chaos. The role of stochas-tic terms is considered, and the possible implications for atmospheric or oceanographic modelling are discussed. 2

A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being

Background: Behavioural and psychological symptoms in dementia (BPSD) are important predictors of institutionalisation as well as caregiver burden and depression. Previous reviews have tended to group BPSD as one category with little focus on the role of the individual symptoms. This review investigates the role of the individual symptoms of BPSD in relation to the impact on different measures of family caregiver wellbeing. Methods: Systematic review and meta-analysis of articles published in English between 1980 and December 2015 reporting which BPSD affect caregiver wellbeing. Article quality was appraised using the Downs and Black Checklist (1998). Results: 40 medium and high quality quantitative articles met the inclusion criteria, 16 were suitable to be included in a meta-analysis of mean distress scores. Depressive behaviours were the most distressing for caregivers followed by agitation/aggression and apathy. Euphoria was the least distressing. Correlation coefficients between mean total behaviour scores and mean distress scores were pooled for 4 studies. Irritability, aberrant motor behaviour and delusions were the most strongly correlated to distress, disinhibition was the least correlated. Conclusion: The evidence is not conclusive as to whether some BPSD impact caregiver wellbeing more than others. Studies which validly examined BPSD individually were limited, and the included studies used numerous measures of BPSD and numerous measures of caregiver wellbeing. Future research may benefit from a consistent measure of BPSD, examining BPSD individually, and by examining the causal mechanisms by which BPSD impact wellbeing by including caregiver variables so that interventions can be designed to target BPSD more effectively

Aspirin for vascular dementia

BACKGROUND: For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered: Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition, does the risk of cerebral or gastric haemorrhage outweigh any benefit? The aim of this review is to assess the evidence of effectiveness of aspirin in those with a diagnosis of vascular dementia. OBJECTIVES: To assess the evidence of effectiveness of the use of aspirin for vascular dementia. SEARCH STRATEGY: Computerised databases were searched independently by two reviewers. In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material and also any publications found were searched for additional references. SELECTION CRITERIA: All randomised controlled trials investigating the effect of aspirin for vascular dementia are included. Inclusion/exclusion of studies comprised systematic assessment of the quality of study design and the risk of bias. DATA COLLECTION AND ANALYSIS: Data were extracted independently by both reviewers, using a previously tested data extraction form and, where required, authors were contacted for data not provided in the papers. The aim was to evaluate data recorded via tools assessing cognitive and behavioural changes along with mortality, morbidity and institutionalisation data. MAIN RESULTS: One randomised controlled trial ( approximately approximately Meyer 1989 approximately approximately ) was included, and yielded data for analysis on a total of 70 patients. The only relevant outcome assessed in this trial was cognition. Change in cognitive outcome was towards being in favour of treatment. REVIEWER'S CONCLUSIONS: There is very limited evidence that aspirin is effective in treating patients with a diagnosis of vascular dementia. Further research is needed to assess the effect of aspirin on cognition, and also on additional outcomes such as behaviour, and quality of life. At present it is not possible to provide evidence for other queries regarding the use of aspirin for dementia (these are described in the Background section of this review)