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Impact of COVID-19 on 'living well' with mild-to-moderate dementia in the community: findings from the IDEAL cohort
Get PDFYes.
Negative impacts of the COVID-19 pandemic on people with dementia have been widely-documented, but most studies have relied on carer reports and few have compared responses to information collected before the pandemic.
Objective.
We aimed to explore the impact of the pandemic on community-dwelling individuals with mild-to-moderate dementia and compare responses with pre-pandemic data.
Methods.
During the second wave of the pandemic we conducted structured telephone interviews with 173 people with dementia and 242 carers acting as informants, all of whom had previously participated in the IDEAL cohort. Where possible we benchmarked responses against pre-pandemic data.
Results.
Significant perceived negative impacts were identified in cognitive and functional skills and ability to engage in self-care and manage everyday activities, along with increased levels of loneliness and discontinuity in sense of self and a decline in perceived capability to ‘live well’. Compared to pre-pandemic data there were lower levels of pain, depression and anxiety, higher levels of optimism, and better satisfaction with family support. There was little impact on physical health, mood, social connections and relationships, or perceptions of neighbourhood characteristics.
Conclusion.
Efforts to mitigate negative impacts of pandemic-related restrictions and restore quality of life could focus on reablement to address the effects on participation in everyday activities, creating opportunities for social contact to reduce loneliness, and personalised planning to reconnect people with their pre-COVID selves. Such efforts may build on the resilience demonstrated by people with dementia and carers in coping with the pandemic.‘Identifying and mitigating the individual and dyadic impact of COVID-19 and life under physical distancing on people with dementia and carers (INCLUDE)’ was funded by the Economic and Social Research Council (ESRC) through grant ES/V004964/1. Investigators: Clare, L., Victor, C., Matthews, F., Quinn, C., Hillman, A., Burns, A., Allan, L., Litherland, R., Martyr, A., Collins, R., & Pentecost, C. ESRC is part of UK Research and Innovation (UKRI). ‘Improving the experience of Dementia and Enhancing Active Life: living well with dementia. The IDEAL study’ was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR) through grant ES/L001853/2. Investigators: L. Clare, I.R. Jones, C. Victor, J.V. Hindle, R.W. Jones, M. Knapp, M. Kopelman, R. Litherland, A. Martyr, F.E. Matthews, R.G. Morris, S.M. Nelis, J.A. Pickett, C. Quinn, J. Rusted, J. Thom. ESRC is part of UK Research and Innovation (UKRI). IDEAL data were deposited with the UK data archive in April 2020 and will be available to access from April 2023. Details of how the data can be accessed after that date can be found here: http://reshare.ukdataservice.ac.uk/854293/ ‘Improving the experience of Dementia and Enhancing Active Life: a longitudinal perspective on living well with dementia. The IDEAL-2 study’ is funded by Alzheimer’s Society, grant number 348, AS-PR2-16-001. Investigators: L. Clare, I.R. Jones, C. Victor, C. Ballard, A. Hillman, J.V. Hindle, J. Hughes, R.W. Jones, M. Knapp, R. Litherland, A. Martyr, F.E. Matthews, R.G. Morris, S.M. Nelis, C. Quinn, J. Rusted. L. Clare acknowledges support from the NIHR Applied Research Collaboration South-West Peninsula. The views expressed are those of the author(s) and not necessarily those of the ESRC, UKRI, NIHR, the Department of Health and Social Care, the National Health Service, or Alzheimer’s Society. The support of ESRC, NIHR and Alzheimer’s Society is gratefully acknowledged
Blockchain adoption in the maritime supply chain: Examining barriers and salient stakeholders in containerized international trade
Get PDFYesThis study aimed to investigate the relationships between blockchain adoption barriers and identified the salient stakeholders for blockchain adoption in containerized international trade. The interpretative structural modelling and Cross-Impact Matrix Multiplication Applied to Classification analyses indicated that the most impactful among the eight barriers are lack of support from influential stakeholders, lack of understanding regarding blockchain, and lack of government regulations. The stakeholder mapping analysis demonstrated that the high salient stakeholders among 11 legitimate stakeholders are container lines, ports, beneficial cargo owners, freight forwarders/third party logistics, and customs authorities. The study is original and contributes to theory and practice as it uncovers both impactful barriers and critical stakeholders by adopting a stakeholder theory perspective and offers significant implications to practice, policy, and theory by combining these two analyses
Mattering Mediates Between Fairness and Well-being
Get PDFYesResearch has suggested a fundamental connection between fairness and well-being at the individual, relational, and societal levels. Mattering is a multidimensional construct consisting of feeling valued by, and adding value to, self and others. Prior studies have attempted to connect mattering to both fairness and a variety of well-being outcomes. Based on these findings, we hypothesize that mattering acts as a mediator between fairness and well-being. This hypothesis was tested through Covariance-Based Structural Equation Modeling (CB-SEM) using multidimensional measures of fairness, mattering, and well-being. Results from a Latent Path Analysis conducted on a representative sample of 1,051U.S. adults provide support to our hypothesis by revealing a strong direct predictive effect of mattering onto well-being and a strong indirect effect of fairness onto well-being through mattering. Results also show that mattering is likely to fully mediate the relationship between fairness and multiple domains of well-being, except in one case, namely, economic well-being. These findings illustrate the value of a focus on mattering to understand the relationship between fairness and well-being and to provide future directions for theory, research, and practice. Theoretical implications for the experience of citizenship and participation, along with cross-cultural considerations, are also discussed.Erwin and Barbara Mautner Endowed Chair in Community Well-Being at the University of Miam
Research priority setting in obesity: a systematic review
Get PDFYesObesity research priority setting, if conducted to a high standard, can help promote policy-relevant and efficient research. Therefore, there is a need to identify existing research priority setting studies conducted in the topic area of obesity and to determine the extent to which they followed good practice principles for research priority setting.
Studies examining research priority setting in obesity were identified through searching the MEDLINE, PBSC, CINAHL, PsycINFO databases and the grey literature. The nine common themes of good practice in research priority setting were used as a methodological framework to evaluate the processes of the included studies. These were context, use of a comprehensive approach, inclusiveness, information gathering, planning for implementation, criteria, methods for deciding on priorities, evaluation and transparency.
Thirteen articles reporting research prioritisation exercises conducted in different areas of obesity research were included. All studies reported engaging with various stakeholders such as policy makers, researchers and healthcare professionals. Public involvement was included in six studies. Methods of research prioritisation commonly included both Delphi and nominal group techniques and surveys. None of the 13 studies fulfilled all nine of the good practice criteria for research priority setting, with the most common limitations including not using a comprehensive approach and lack of inclusivity and evaluating on their processes.
There is a need for research priority setting studies in obesity to involve the public and to evaluate their exercises to ensure they are of high quality.National Institute for Health Research (NIHR) under its Applied Research Collaboration (ARC) Yorkshire and Humber in the form of Ph.D. funding to HI [NIHR200166], the UK Prevention Research Partnership (UKPRP) in the form of funding to JW and RM [MR/S037527/1], the NIHR Clinical Research Network in the form of funding to JW, and the NIHR ARC Yorkshire and Humber in the form of funding to R
Children of the Abyss: Investigating the association between isotopic physiological stress and skeletal pathology in London during the Industrial Revolution
Get PDFYesObjective: This project sought to investigate whether an association may be observed between isotopic stress indicators and skeletal evidence of pathological conditions.
Materials: Deciduous and permanent teeth of 15 non-adults from two contemporaneous mid-19th century London burial grounds (City Bunhill, Lukin Street).
Methods: δ13C and δ15N was measured in the incrementally sectioned dentine collagen. Isotopic profiles for each individual included death during tooth development.
Results: Individuals with skeletal evidence of chronic pathological conditions (e.g., rickets, tuberculosis) exhibited raised δ15N values of 0.5-1.7‰ in the months prior to death. Isotopic change consistent with chronic physiological stress prior to death was also recorded in two individuals with no skeletal evidence of disease. An offset was observed between co-forming bone and dentine δ15N values in both populations, indicating that bone and dentine are not recording the same isotopic changes.
Conclusions: Isotopic change consistent with chronic physiological stress was observed in both those with and without skeletal evidence of disease, suggesting that adaptation to chronic stress in childhood was not uncommon within these 19th century London populations.
Significance: Chronic physiological stress prior to death may be seen in the incrementally sampled dentine of non-adults who die during tooth formation.
Limitations: The temporal resolution of current dentine micro-sampling methods may mask or minimise visibility of shorter-term periods of stress or dietary change.
Suggestions for further research: Future research should further explore the relationship between specific skeletal pathologies and isotopic evidence for stress
Enhancement and underlying mechanisms of stainless steel wires to fatigue properties of concrete under flexure
Get PDFYesIn this study, the enhancement of stainless steel wires (SSWs) to the flexural fatigue performance of reactive powder concrete (RPC) including fatigue life and fatigue stress-strain hysteresis relationship as well as fatigue damage were investigated, and the underlying mechanisms were explored through microstructure observation and characteristic analyses of hydration products. The average flexural fatigue life of RPC is increased by 636.6%, 558.3% and 1010.7% at the maximum stress levels of 0.7, 0.8 and 0.9 when 1.5 vol.% SSWs are incorporated. The method of moments and method of maximum likelihood are employed to calculate the scale and shape parameters for fatigue life subscribed to Weibull distribution. The calculated ratio of flexural fatigue endurance limit to static flexural strength for SSWs reinforced RPC reaches up to 0.64. The incorporation of SSWs decreases the flexural failure damage of RPC by 41.5% and converts the long and link-up micro cracks into emission cracks centered on SSWs. Benefited from the large specific surface area of SSWs, abound of silica fume with pozzolanic activity absorbs on the surface of SSWs and continues to hydrate, reducing the surrounding water-binder ratio to form a microstructure enhancement zone with SSWs as the core and improve the homogeneity of RPC. This can be confirmed by the decrease of porosity, Ca(OH)2 crystal orientation index and molar ratio of CaO to SiO2 for calcium silicate hydrate gels. SSWs can also enhance the fatigue performance of RPC by transmitting hydration heat, inhibiting the initiation and propagation of micro cracks especially at the initial stage of fatigue load, bridging cracks and being pulled-off. The excellent flexural fatigue properties and homogeneous microstructures of SSWs reinforced RPC make it particularly suitable for large-span and ultra-thin elements in extreme service environments
Message from the A-MOST 2021 Workshop Chairs
Get PDFYesWe are pleased to welcome you to the 17th edition of the Advances in Model-Based Testing Workshop (A-MOST 2021), collocated with the IEEE International Conference on Software Testing, Verification and Validation (ICST 2021)
Driver Behaviour Clustering Using Discrete PDFs and Modified Markov Algorithm
No full textNoThis paper presents a novel approach for probabilistic clustering, motivated
by a real-world problem of modelling driving behaviour. The main aim is
to establish clusters of drivers with similar journey behaviour, based on a large
sample of historic journeys data. The proposed approach is to establish similarity
between driving behaviours by using the Kullback-Leibler and Jensen-Shannon
divergence metrics based on empirical multi-dimensional probability density functions.
A graph-clustering algorithm is proposed based on modifications of the
Markov Cluster algorithm. The paper provides a complete mathematical formulation,
details of the algorithms and their implementation in Python, and case study
validation based on real-world data
Teachers' Perspectives on the Acceptability and Feasibility of Wearable Technology to Inform School-Based Physical Activity Practices
Get PDFYesMany children are not engaging in sufficient physical activity and there are substantial between-children physical activity inequalities. In addition to their primary role as educators, teachers are often regarded as being well-placed to make vital contributions to inclusive visions of physical activity promotion. With the dramatic increase in popularity of wearable technologies for physical activity promotion in recent years, there is a need to better understand teachers' perspectives about using such devices, and the data they produce, to support physical activity promotion in schools. Method: Semi-structured interviews were conducted with 26 UK-based primary school teachers, exploring their responses to children's physical activity data and their views about using wearable technologies during the school day. Interview discussions were facilitated by an elicitation technique whereby participants were presented with graphs illustrating children's in-school physical activity obtained from secondary wearable technology data. Interview transcripts were thematically analyzed. Results: Most teachers spoke positively about the use of wearable technologies specifically designed for school use, highlighting potential benefits and considerations. Many teachers were able to understand and critically interpret data showing unequal physical activity patterns both within-and between-schools. Being presented with the data prompted teachers to provide explanations about observable patterns, emotional reactions-particularly about inequalities-and express motivations to change the current situations in schools. Conclusion: These findings suggest that primary school teachers in the UK are open to integrating wearable technology for measuring children's physical activity into their practices and can interpret the data produced by such devices. Visual representations of physical activity elicited strong responses and thus could be used when working with teachers as an effective trigger to inform school practices and policies seeking to address in-school physical inactivity and inequalities
Methods and approaches for enhancing communication with people with moderate-to-severe dementia that can facilitate their inclusion in research and service evaluation findings from the IDEAL programme
Get PDFYesObjectives
Dementia can affect language processing and production, making communication more difficult. This creates challenges for including the person’s perspective in research and service evaluation. This study aims to identify methods, tools and approaches that could facilitate meaningful communication with people with moderate-to-severe dementia and support the inclusion of their perspectives.
Methods
This qualitative study was conducted as part of the IDEAL programme and involved in-depth, semi-structured interviews with 17 dementia research and/or care professionals with expertise in communication. Transcripts were analysed using framework analysis.
Findings
Three main themes each with sub-themes were identified: (1) Awareness, knowledge and experience; (2) Communication approach and (3) Personalization. A person-centred orientation based on getting to know the participant and developing a bi-directional exchange formed the fundamental context for effective communication. Building on this foundation, an approach using pictures, photographs or objects that are meaningful to the person and appropriate for that person’s preferences and ability could help to facilitate conversations. The findings were integrated into a diagram illustrating how the topics covered by the themes interrelate to facilitate communication.
Conclusions
Useful skills and approaches were identified to help researchers engage and work with people with moderate-to-severe dementia and ensure their perspective is included. These covered getting to know the participant, using a variety of tangible tools and interactional techniques and considering the environment and context of the conversation.ESRC, NIHR (ES/L001853/2); Alzheimer's Society (348, AS-PR2-16-001