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People with dementia and family carers are welcoming of a model of dementia palliative care, but sceptical of its implementation
Full text linkIntroduction: A palliative care approach can improve quality-of-life for people with dementia. It is the preference of many people with dementia to remain living at home until death, with the appropriate care. To develop a successful model for dementia palliative care in the community, it is essential to assimilate the perspectives and experiences of those affected. The guiding research question for this study was: What are people with dementia and family carers’ views on a model for dementia palliative care? Methods: Focus groups (n=3) were conducted with bereaved or current family carers (n=11), and people with dementia (n=2). Discussions centred around a proposed model of dementia palliative care. These were transcribed and analysed using thematic analysis. Results: Three main themes were identified: living and dying well with dementia; reducing carer burden to fulfil the wish for home care; and lack of faith in the healthcare system. One statement which summarised the analysis was: “Dementia palliative care is a dream, but not a reality.” This reflected participants’ repeated “wish” for this “ideal” model of care, but simultaneous scepticism regarding its implementation, based on their prior experiences of healthcare services. Conclusion: All participants were welcoming of the proposed model for dementia palliative care and were generally positive about palliative care as a concept relating to dementia. There was consensus that the model would allow people to live and die well with dementia, and reducing the carer burden would fulfil the wish to remain at home. However systemic changes in the healthcare system will be needed to facilitate a truly person-centred, holistic, individualised and flexible model of care. <br/
Disabled people’s experiences of English football fandom: Inclusion, exclusion and discrimination
Full text linkThis article employs a novel theoretical framework, rooted in the social relational model of disability alongside the concept of ableism, to critically analyse disabled football supporters lived experiences of inclusion and exclusion in English Football. In seeking to shed light on this hitherto neglected field, this study utilised a dual-phased qualitative approach comprised of two complementary netnographic methods, specifically online observations of fan message boards and online semi-structured interviews with 33 disabled football supporters of clubs in the English Football League and National League. We demonstrate that while some clubs provide inclusive spectator environments where disabled people experience moments of inclusion and belonging, they nonetheless face structural, social and psychological barriers before, during and after the matchday which create conditions that exclude, oppress and constrain full participation in football fandom. In doing so, this paper offers new insights into how the disabling nature of contemporary capitalist society continues to systematically exclude disabled people from areas of mainstream society – such as football fandom – to which they have a right
Alligation Alternate: Borrowing a Useful Concept from the Pharmacy Curriculum
Full text linkAlligation alternate is an arithmetic technique historically used to solve problems involving proportions and mixtures of the same substance in different concentrations. Demonstration of its use is widespread throughout pharmacy education, but this practice does not appear to extend to most chemistry curricula. As a result of interactions between pharmacy and chemistry students, we have trialed the introduction of alligation alternate as a problem solving technique in the first semester of a freshman chemistry course. We show that while other strategies can be used, students favored the newly introduced alligation alternate procedure due to its diagrammatic form and ease of use. The obvious benefits on cognitive load and use of the psychomotor domain make this a useful addition to precollege and early undergraduate chemistry curricula.</p
Experience of home monitoring of children with complex CHD during the COVID-19 pandemic: lessons learnt
Full text linkObjective: The COVID-19 pandemic presented unique challenges to global healthcare. Face-to-face outpatient care was dramatically reduced. This study implemented a remote consultation service via a mobile app (Pexip) to monitor patients with major CHD. Design: Study design was quasi-experimental and prospective. Setting: Remote consultations were carried out at a tertiary paediatric cardiology centre in Northern Ireland. Patients: Children with major CHD aged 0-16years in Northern Ireland. Intervention: The intervention was a Pexip-enabled remote consultation. Outcome measures: Primary outcome measures included the number of attendances to hospital both initiated and avoided via remote consultation. Remote consultations were conducted by doctor and/or cardiac specialist nurse or by specialist nurse alone (52% vs. 48%). Results: In the study, 32 patients enrolled; three were non-responders and a further two excluded. There were 201 remote consultations delivered (mean = 7.4). There were 12 admissions to hospital resulting from the remote consultation; the commonest indication was abnormal oxygen saturations (42%). There were 38 hospital attendances avoided, predominantly related to infant feeding and medication advice (both 42%). Conclusions: A significant number of unnecessary hospital attendances were avoided (n = 38). Remote consultation technology proved a user-friendly and valuable adjunct to the provision of ongoing specialist patient care in challenging circumstances. There was a reduction in parental anxiety, and both parents and clinicians found this initiative beneficial to patient care. There was prompt identification of unwell children on remote consultations.</p
Children’s Social Work Safe Staffing Supply and Workforce Demands Analysis: A Case Study from Northern Ireland
Full text linkThe matter of ensuring adequate staffing levels in children’s social work services has become increasingly prominent due to challenges related to retention and staff wellbeing and exacerbated by limited governmental budgetary investment. Various operational tools and policy guidelines in the UK regulate staffing across different sectors of Health and Social Care. However, frameworks for safe staffing in social work are less developed. This study was based on qualitative and quantitative methodologies and specifically targeted Gateway and Family Intervention child protection teams in Northern Ireland, given the significant caseloads and staffing shortages within these specific team structures. The analysis unveiled systemic issues demanding systemic solutions. Frontline social workers and managers were often contending with overwhelming worker-to-caseload ratios, extensive waitlists, and vacancies within teams. This analysis also assisted in defining safe staffing in social work, including service-user safety, and staff wellbeing and retention. These findings serve as a foundation for evidence-based strategic planning, informing the development and enactment of safer and effective social work policies and legislation in the forthcoming years
Exploring person-centred practice
Full text linkPerson-centred practice offers an approach to healthcare provision that prioritises the personhood of individuals. This means that nurses' ethical and professional values underpin their approaches to care, where each person and their rights, relationships and dignity are respected. For nurses, the primary intention of person-centred practice is to contribute to a positive care experience for the people in their care. This article examines factors and models that influence person-centredness in nursing practice, notably the Person-centred Nursing Framework and the Person-centred Practice Framework. The authors also explore approaches nurses can take, such as values clarification, reflection on practice and engaging and working collaboratively with others, to engage in person-centred practice and create and sustain person-centred cultures.</p
Social connection and its prospective association with adolescent internalising and externalising symptoms: an exploratory cross-country study using retrospective harmonisation
Full text linkBackground: Social connection factors play a key role for young people's mental health. It is important to understand how their influence may vary across contexts. We investigated structural (e.g. household size), functional (e.g. social support) and quality (e.g. feeling close) social connection factors in relation to adolescent internalising and externalising symptoms, comparing two countries Brazil and the United Kingdom (UK). Methods: We pooled data from the UK Millennium Cohort Study (MCS) and the Brazilian High Risk Cohort Study (BHRCS). We included 12 social connection variables, identified through retrospective harmonisation and lived experience expert involvement. We tested measurement invariance and conducted multiple regressions to analyse associations between the social connection factors (age 14) and later internalising and externalising difficulties (age 17.5) in both cohorts. We investigated country-level interactions and used weights to account for attrition, survey design, population representativeness and sample size. Results: We found pooled main associations with later internalising symptoms for ‘living with half-siblings’ (p <.001), ‘moving address’ (p =.001), ‘mother marital status’ (p <.001–.003), ‘bullying’ (p =.001), ‘being bullied’ (p <.001) and ‘difficulties keeping friends’ (p <.001). For externalising, we found main associations with ‘household size’ (p =.041), ‘moving address’ (p =.041), ‘mother's marital status’ (p =.001–.013), ‘bullying others’ (p <.001) and ‘being bullied’ (p <.001). Country-level interactions suggested higher internalising symptoms were associated with ‘household size’ (p =.001) in Brazil and ‘being bullied’ (p <.001) in MCS. Additionally, ‘half-siblings in household’ (p =.003), ‘poor mother–child relationship’ (p =.018), ‘single mother’ (p =.035), ‘bullying’ (p <.001) and ‘being bullied’ (p <.001) were more strongly linked to externalising difficulties in MCS. Conclusions: Social connection factors, mostly structural, contributed to adolescent internalising and externalising difficulties in both countries. Factors relating to bullying and family composition seem to play a stronger role in each country. Cultural and socioeconomic factors might explain these differences. Future research should investigate cross-regional differences to meaningfully inform global mental health efforts.</p
Acoustic Fingerprinting and Nanoslip Dynamics of Biofilms
Full text linkIt is reported that bacteria can generate nanomotion, but understanding the complex dynamics of bacterial colony gliding on solid interfaces has remained unresolved. Here, this work captures the real-time development and gliding of bacterial biofilms on vibrating solids made of piezoelectric quartz. The gliding, characterized by liquid slips, is measured in form of frequency and dissipation changes of the vibrating solid. These vibrations enable the generation of distinct acoustic fingerprints (sound/ music) of the three phases of biofilm development: viscoelastic strengthening, biofilm growth and biofilm stability. In adition, the effect of extracellular matrix secretion on the rigidity of the film and its nanoslip in each of the distinct biofilm developmental phases is quantified. This work provides a real-time, label-free method of quantifying bacteria biofilm dynamics and paves the way for developing libraries of acoustic signatures of bacteria and their metabolic products.</p
NLRP3 Inflammasome inhibition by the novel bispecific antibody InflamAb attenuates atherosclerosis in apolipoprotein E-deficient mice
Full text linkBackground: Cardiovascular disease remains the most common cause of mortality worldwide, which is attributable to the underlying chronic inflammatory condition atherosclerosis. The NLRP3 inflammasome contributes to this inflammatory process in atherosclerosis by producing IL-1β. Components of the intracellular NLRP3 inflammasome have been shown to be expressed by macrophages in the atherosclerotic plaque and are a potential target for intervention. Objectives: Here, we aimed to determine the efficacy of the novel bispecific antibody InflamAb, designed to target the interleukin-1 receptor type 1 and the NLRP3 inflammasome, in inhibiting atherosclerosis. Methods: We established the efficacy of InflamAb to inhibit IL-1β production upon NLRP3 inflammasome activation in bone marrow derived macrophages and in Western-type diet fed Apoe-/- mice. Subsequently, we treated Apoe-/- mice with developing collar-induced atherosclerosis and Apoe-/- mice with established atherosclerotic plaques with InflamAb.Results: InflamAb inhibited IL-1β secretion from bone marrow derived macrophages and circulating IL-1β levels in vivo, upon NLRP3 inflammasome activation. Furthermore, InflamAb treatment significantly inhibited atherosclerotic plaque development, which was accompanied by a reduction in relative macrophage and necrotic core content. Established atherosclerotic lesion size in the aortic root was not affected by InflamAb treatment, however, InflamAb significantly reduced relative macrophage and necrotic core content in these plaques.Conclusions: In conclusion, inhibition of the NLRP3 inflammasome by the bispecific antibody InflamAb shows promising efficacy in inhibiting atherosclerotic plaque development and destabilization in mice.<br/
Designing Lighting for Wellbeing: A Comparison of the Emotional versus Physiological Impact for People Living with Dementia from a Wellbeing Perspective
Full text linkInterior lighting environments are an integral part of everyday life, but often we pay little attention to the spectral composition of the lights as we monotonously switch them ‘on’ and ‘off’. However light has a huge impact on not only our vision but on our body clocks. The variation in intensity and wavelength of incident lighting at different times of the day helps to control our mood, rest-activity patterns and sleep-wake cycles. For people living with dementia, this regularity of the body clock is often absent. Therefore learning to incorporate this knowledge into lighting design while maintaining the user’s comfort is critical to help support their wellbeing. This research discusses the design of a study which aims to compare the emotional vs physiological impact of lighting as a means to inform lighting design for the ageing generation and people living with dementia. The authors propose an open and closed interview structure which weights the importance of different aspects of lighting from the perspective of people living with dementia. The responses are then compared to the ‘current guidelines’ which report on lighting to support the body clock. The final outcome then provides an analysis of how to integrate both evidence-based lighting forwellbeing while maintaining the comfort and sense of environment for the end users