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The objectivity and subjectivity of pain practices in older adults with dementia: A critical reflection
No full textProviding nursing care for people with dementia residing in long-term care facilities poses specific challenges regarding pain practices. With underlying communication barriers unique to dementia pathologies, this population is often unable to communicate verbal sentiments and descriptions of pain. In turn, nurses caring for older persons with dementia have difficulty assessing, managing and treating pain. Objectivity is an imperative factor in healthcare pain practices; however, it is difficult to objectively evaluate someone who cannot accurately communicate their experience of pain. Therefore, the authors believe that subjectivity is also an essential part of evaluating the person with dementia's experience of pain. In this critical reflection, the authors explore objectivity and subjectivity in relation to pain practices for dementia in long-term care. A historical summary of pain is provided outlining the evolution of objectivity and subjectivity related to pain practices. The authors discuss the complexities of assessing and managing pain and offer a new perspective about the role of objectivity (and co-existence of subjectivity) for nurses treating pain in the older adults with dementia
Statistical modeling of COVID-19 deaths with excess zero counts
No full textObjectives
Modeling and forecasting possible trajectories of COVID-19 infections and deaths using statistical methods is one of the most important topics in present time. However, statistical models use different assumptions and methods and thus yield different results. One issue in monitoring disease progression over time is how to handle excess zeros counts. In this research, we assess the statistical empirical performance of these models in terms of their fit and forecast accuracy of COVID-19 deaths.
Methods
Two types of models are suggested in the literature to study count time series data. The first type of models is based on Poisson and negative binomial conditional probability distributions to account for data over dispersion and using auto regression to account for dependence of the responses. The second type of models is based on zero-inflated mixed auto regression and also uses exponential family conditional distributions. We study the goodness of fit and forecast accuracy of these count time series models based on autoregressive conditional count distributions with and without zero inflation.
Results
We illustrate these methods using a recently published online COVID-19 data for Tunisia, which reports daily death counts from March 2020 to February 2021. We perform an empirical analysis and we compare the fit and the forecast performance of these models for death counts in presence of an intervention policy. Our statistical findings show that models that account for zero inflation produce better fit and have more accurate forecast of the pandemic deaths.
Conclusions
This paper shows that infectious disease data with excess zero counts are better modelled with zero-inflated models. These models yield more accurate predictions of deaths related to the pandemic than the generalized count data models. In addition, our statistical results find that the lift of travel restrictions has a significant impact on the surge of COVID-19 deaths. One plausible explanation of the outperformance of zero-inflated models is that the zero values are related to an intervention policy and therefore they are structural
A review of pre-appointment medications to reduce fear and anxiety in dogs and cats at veterinary visits.
No full textThis review focuses on pre-appointment medications used to decrease fear and anxiety in dogs and cats related to veterinary visits. A review of the literature revealed data on 4 medications from 4 medication classes that have been used to ameliorate acute situational fear and anxiety in dogs and cats: gabapentin, trazodone, oral transmucosal dexmedetomidine, and alprazolam. The available information on use, mechanism of action, and pharmacokinetics is reviewed.journal articlereview2021 09importe
Promotion effects of metallic iron on hydrothermal liquefaction of cornstalk in ethanol-water mixed solvents for the production of biocrude oil
No full textIn this article, effects of metallic Fe on biocrude oil production from cornstalk via hydrothermal liquefaction (HTL) in ethanol–water mixed solvents were investigated under various conditions. Experiments were conducted in single solvent of water or ethanol using Fe3O4 catalyst to explore the role of metallic Fe in the liquefaction process. The physiochemical properties of the liquefaction products were comprehensively characterized by elemental analysis, GC–MS, FT-IR and XRD. The results showed that the maximum biocrude oil yield (approx. 50 wt%) and higher heating value (HHV) of 30.86 MJ/kg were obtained in ethanol–water mixed solvents (50/50, v/v) at 300 °C for 30 min with 10 wt% Fe loading. It was found that the presence of Fe also promoted the hydrogenation and deoxygenation of liquid products, obtaining biocrude oils mainly consisted of phenolic, ester and hydrocarbon compounds. The positive role of metallic Fe in HTL of biomass in ethanol–water mixed solvents, simultaneously improving the yield and quality of biocrude oil, was believed to be due to in-situ hydrogen formed from the reaction of metallic Fe and water, while the generated Fe3O4 exhibited negligible catalytic effect in the process.National Natural Science Foundation of ChinaNatural Science and Engineering Research Council of Canada (NSERC)Agriculture and Agri-Food Canada’s AgriScience ProgramChina Scholarship Council (CSC
Hippocampal neurogenesis promotes preference for future rewards
No full textAdult hippocampal neurogenesis has been implicated in a number of disorders where reward processing is disrupted but whether new neurons regulate specific aspects of reward-related decision making remains unclear. Given the role of the hippocampus in future-oriented cognition, here we tested whether adult neurogenesis regulates preference for future, advantageous rewards in a delay discounting paradigm for rats. Indeed, blocking neurogenesis caused a profound aversion for delayed rewards, and biased choice behavior toward immediately available, but smaller, rewards. Consistent with a role for the ventral hippocampus in impulsive decision making and future-thinking, neurogenesis-deficient animals displayed reduced activity in the ventral hippocampus. In intact animals, delay-based decision making restructured dendrites and spines in adult-born neurons and specifically activated adult-born neurons in the ventral dentate gyrus, relative to dorsal activation in rats that chose between immediately-available rewards. Putative developmentally-born cells, located in the superficial granule cell layer, did not display task-specific activity. These findings identify a novel and specific role for neurogenesis in decisions about future rewards, thereby implicating newborn neurons in disorders where short-sighted gains are preferred at the expense of long-term health
Non-parametric estimation of the preferential attachment function from one network snapshot
No full textPreferential attachment is commonly invoked to explain the emergence of those heavy-tailed degree distributions characteristic of growing network representations of diverse real-world phenomena. Experimentally confirming this hypothesis in real-world growing networks is an important frontier in network science research. Conventional preferential attachment estimation methods require that a growing network be observed across at least two snapshots in time. Numerous publicly available growing network datasets are, however, only available as single snapshots, leaving the applied network scientist with no means of measuring preferential attachment in these cases. We propose a nonparametric method, called PAFit-oneshot, for estimating preferential attachment in a growing network from one snapshot. PAFit-oneshot corrects for a previously unnoticed bias that arises when estimating preferential attachment values only for degrees observed in the single snapshot. Our work provides a means of measuring preferential attachment in a large number of publicly available one-snapshot networks. As a demonstration, we estimated preferential attachment in three such networks, and found sublinear preferential attachment in all cases. PAFit-oneshot is implemented in the package .Japan Society for the Promotion of Scienc
Use of environmental scans in health services delivery research: a scoping review
No full textObjective: To examine the extent and nature of evidence on the use of the environmental scan (ES) in the health services delivery literature. Methods: This scoping review followed the five-stage scoping review methodology outlined by Khalil et al. A Peer Review of Electronic Search Strategies was completed. Seven electronic databases and the grey literature were searched. Pairs of researchers independently performed two levels of screening and data extraction. Data were analysed using qualitative content and thematic analysis. Results: Ninety-six studies were included in the scoping review. Researchers conducted ESs for many purposes, the most common being to examine the current state of programmes, services or policies. Recommendations were informed by ESs in 20% of studies. Most common data collection methods were literature review (71%), key informant or semistructured interviews (46%) and surveys (35%). Over half (53%) of the studies used a combination of passive (looking at information eg, literature, policies, guidelines) and active (looking for information eg, surveys, interviews) approaches to data collection. Person sources of data (eg, healthcare stakeholders, community representatives) and non-person sources of data (eg, documents, electronic databases, the web) were drawn on to a similar extent. The thematic analysis of the definitions/descriptions yielded several themes including instrument of discovery, knowledge synthesis, forward-looking and decision making. Research gaps identified included absence of a standard definition, inconsistencies in terminology and lack of guiding frameworks in the health services delivery context.
Conclusion: ESs were conducted to gather evidence and to help inform decision making on a range of policy and health services delivery issues across the continuum of care. Consistency in terminology, a consensus definition and more guidance on ES design may help provide structure for researchers and other stakeholders, and ultimately advance ES as a methodological approach. A working definition of ES in a health services delivery context is presented
“He Never Wants to Leave. I Would Leave in a Second.” Examining Perceptions of Rural Life and its Impact on Families who Migrate for Employment and Those who Stay Behind in Atlantic Canadian Communities
No full textIn Canada, interprovincial labor migration is a common form of mobile work that is significant for rural communities especially in Atlantic Canada. Unique to this form of labor migration is the gendered nature of the phenomenon resulting in men often leaving their wives, families and rural communities behind for employment opportunities in the oil and gas sectors thousands of kilometers away. As men leave their families and communities for employment, women who are left behind become primary caregivers to children in addition to also being the primary caretakers of the family home. The Tale of Two Islands project was a multi-year, cross regional mixed methods research study that examined labor mobility and its impact on families and communities. This paper examines how labor migration has impacted families and rural communities. Drawing upon focus group, conversational and key informant interviews with families impacted by mobile labor and practitioners who serve them, societal perceptions of gendered norms and perceptions of rural life became illuminated. This has contributed to multiple contradictions and role confusion as families adapt and adjust to periods of reunification and separation while striving to remain connected to their rural communities. Men yearn for opportunities to be an active member of their home communities but cannot a result of living away for extended periods of time. In contrast, women who stay behind in rural communities often chose to isolate from community activities as a result of perceived judgments that are attributed to traditional views of rural life and family roles.Social Sciences and Humanities Council of Canad
Music for your mental health?: The development and evaluation of a group mental health intervention in subacute rehabilitation
No full textObjectives: Short-stay residents of nursing homes experience high rates of mental health (MH) distress compared to community dwelling counterparts, yet MH interventions are difficult to implement and sustain. We modified a music therapy framework to Effective Music in Psychotherapy. Using the modified model, we integrated music listening into MH group intervention and evaluated MH outcomes. This pilot study reports the development and evaluation of the Mental Health and Music Group for short-stay nursing homes residents.Method: The group was developed and refined to be non-sequential and non-cumulative, specific to the needs of short-stay nursing home residents. Pre-/post-session ratings examined affect, quality of life, and pain. Leaders monitored engagement across and between sessions. Qualitative interviews were conducted with a selection of attendees.Results: Findings indicated decreases in irritation and worry, and increases in mood, energy, and self-as-a-whole from pre- to post-session. There were no changes in pain, perception of physical health or life-as-a-whole, energetic, sad, or happy affect, or differences in engagement. Qualitative interviews demonstrated benefits of group modality and music to group cohesion and highlighted the relevance of music for mental health outcomes.Conclusion: The Mental Health and Music group was designed around a framework of Effective Music in Psychotherapy, for short-stay nursing home settings, and demonstrated promising results. Future research can solidify the interventions generalizeability to medical and rehabilitation settings addressing the specific population needs and preferences
Initiatives to support older women who experience intimate partner violence
No full textTo contribute to our knowledge about initiatives to support older women who experience intimate partner violence (IPV), we conducted an internet search, online surveys, and telephone interviews with administrators of programs for women who have experienced IPV. We compiled information on initiatives providing individual in-person and telephone support, educational and/or therapeutic groups, and short- and long-term shelters and housing. The interviews provided insights about the history and rationale for these initiatives, strengths, positive outcomes, challenges, and future program development. Our study results can inform the creation of appropriate services to meet the needs of older women who experience IPV.Canada. Department of Justic