87 research outputs found
Mindfulness-Based Cognitive Therapy for Family Carers of Relatives Living with Dementia Adaptation and Feasibility studies for Online Delivery in Aotearoa New Zealand
No full textBackground:
The worldwide prevalence of dementia is expected to triple in the next three decades. In New Zealand, the prevalence will double over that time with massive economic implications. Services for family carers who support relatives living with dementia need to be evidence based, culturally safe and accessible to make a difference. Mindfulness-Based Cognitive Therapy (MBCT) is a potential intervention for this population due to its robust evidence base in depressive disorder and cost-effective group delivery mode which can be potentially scalable to meet the public health need.
Aims:
1. To systematically review the literature on MBCT-related stress reduction in the family carer population.
2. To adapt the MBCT protocol for delivery to family carers of relatives living with dementia including cultural adaptations for Māori and Pacific carers, and online delivery during the COVID-19 pandemic.
3. To examine the feasibility of the adapted MBCT protocol for stress reduction in the family carers population in New Zealand.
Methods:
1. A systematic review was conducted following PRISMA guidelines.
2. An adaptation phase involved four stages: consultation, co-creation, reconciliation and pivot.
3. An intervention study was delivered involving pre-post quantitative measures and assessment of feasibility,
4. A qualitative focus group and in-depth qualitative interviews were analysed using a reflexive thematic analysis.
Findings:
1. The systematic review showed that MBCT was a potentially effective intervention for this population but no consultation with carers as end-users had been undertaken in the design of the adapted protocols.
2. An adapted MBCT protocol was created incorporating Māori and Pacific values, as well as for online delivery.
3. The adapted online MBCT protocol resulted in significant improvements in all outcome measures (stress, anxiety, burden, wellbeing, self-compassion and trait mindfulness). It was feasible and acceptable to the population. The primary outcome measure, the Perceived Stress Score showed a significant reduction (T0 = 19.2, T1 = 13.9, p = 0.007).
4. Qualitative analysis suggested a journeying metaphor with three themes (“The perfect storm”, “The life raft of MBCT” and “Steadying the course”).
Conclusions:
The adapted online MBCT protocol was well-received and attended, with positive outcomes for carer stress, anxiety, burden and well-being
Robert Emmet Delaney
No full textPhotograph - A full length portrait of Dr. Delaney who practised in Athabasca, Alberta until ca. 1913Delaney, Robert Emme
Corresponding Author: Tolga DEMİRCAN
No full textGünümüzde içten yanmalı motorlar otomotiv, denizcilik, havacılık vb. birçok sektörde çok yaygın olarak kullanılmaktadır. Tek silindirli ve küçük boyutlarda yapılabileceği gibi, özellikle gemilerde kullanılmak üzere çok büyük boyutlarda da üretilebilmektedir. İçten yanmalı motorlar, birden çok parçanın birleşmesi ile oluşan kompleks yapılardır. Ayrıca silindir içerisinde gerçekleşen yanma olayı da oldukça hızlı ve karmaşık bir reaksiyondur. Dolayısıyla bir motorun güç performansı birden çok faktöre bağlıdır. Bu faktörlerden en önemlilerinden biri de yanmanın, ideal yanmaya yakın koşullarda sağlanabilmesidir. Bu ise, silindir içerisinde reaksiyona giren oksijen ve yakıtın uygun oranlarda karışması ile mümkün olabilmektedir. Bir motorun sürekli yüksek performansta çalışabilmesi için, yakıtın sürekli olarak, hava ile yeterli oranda beslenmesi gerekmektedir. Bu hava beslemesi emme manifoldu aracılığı ile gerçekleşir. Dolayısıyla iyi bir yanmanın sağlanabilmesi için emme manifold tasarımı önemli bir rol oynamaktadır. Bu amaçla, bu çalışmada; bir dizel motorda emme havasının ihtiyaç duyulan miktarda sağlanabilmesi için, emme manifoldunun giriş açılarının etkileri ele alınmıştır. Farklı giriş açıları için Ansys Fluent paket programı aracılığı ile simülasyonlar yapılmış ve akış karakteristiklerine olan etkileri irdelenmiştir. Simülasyonlardan elde edilen sonuçlar ışığında, manifold içerisindeki hız ve basınç dağılımları elde edilmiş ve çıkış debi değerleri aracılığıyla optimum şartlar belirlenmiştir.Today, internal combustion engines are widely used in many sectors such as automotive, marine, aviation, etc. They can be produced in single cylinders and small sizes for the automotive sector as well as in very large sizes for use on ships. Internal combustion engines are complex structures formed by joining multiple parts. In addition, the combustion inside the cylinder is a very quick and complicated reaction. Therefore, the power performance of the motor depends on multiple factors. One of the most important of these factors is approaching burning to ideal burning conditions. This is possible by mixing oxygen and fuel in the cylinder in a suitable ratio. For an engine to work at a high performance constantly, the fuel must be supplied continuously with sufficient air. The intake manifold is used for this air supply. Therefore, intake manifold design plays an important role for good combustion. For this purpose, in this study, the effects of the inlet angles of the intake manifold are discussed so that a sufficient amount of intake air can be supplied to a diesel engine. With the help of the Ansys Fluent package program, simulations were made for different manifold inlet angles and the effects of the inlet angles on flow characteristics were discussed. In the light of the results obtained from the simulations, velocity and pressure distributions in the manifold were obtained and optimum conditions were determined by outlet flow rate
Metabolic side effects of atypical antipsychotics in older adults
No full textABSTRACTBackground:The atypical antipsychotics (AAPs) are associated with a recognized class effect of glucose and lipid dysregulation. The use of these medications is rapidly increasing in elderly patients with, and without, dementia. However, the metabolic risks specific to elderly remain poorly studied.Methods:Design: A case-control study.Setting: Psychogeriatric service in Auckland, New Zealand.Participants: Elderly patients either receiving AAP treatment (cases) or not (controls) between 1 Jan 2008 and 1 Jan 2014.Main outcome measures: metabolic data of glucose, HbA1c, lipids, and cardiovascular events and death. The data were analyzed usingt-tests and linear regression models for each metabolic outcome.Results:There were 330 eligible cases and 301 controls from a total study population of 5,307. There was a statistically significant change in the HbA1c over time, within the cases group of −1.14 mmol/mol (p = 0.018, 95% CI −0.19 to −2.09). Also statistically significant was the reduction in total cholesterol of −0.13 mmol/L (p = 0.036, 95% CI −0.008 to −0.245). The only significant difference found between cases and controls was in the change in cholesterol ratio of 0.16 mmol/L between groups (95%CI 0.01–0.31, p = 0.036).Conclusions:AAP use was not associated with any clinically significant change in metabolic outcomes in this study population.</jats:sec
Using eye-movement modelling examples to improve critical reading of multiple webpages on a conflicting topic
No full textInterventions to promote students' source evaluations have used various methods designed for the classroom context. In the present study, we tested an approach that is easily adaptable to online courses, based on eye movement modelling examples (EMME), that is, short videos displaying an expert student's eye gaze while s/he reads multiple pages on the Internet to learn about a conflicting topic. Using an eye-tracking methodology in a pre–post design, we analysed how an intervention using EMME changed students' attention to source information, and how this processing affected their learning. EMME increased participants' attention to the search engine results page, author information and decreased attention of texts from untrustworthy pages. In addition, EMME increased the number of participants who cited at least one document source at post-test. We discuss the potential benefits and limitations of EMME in teaching complex literacy strategies, and the importance of measuring processing data in educational research studies
Influenza vaccine for patients with chronic obstructive pulmonary disease
No full textBackground Influenza vaccinations are currently recommended in the care of people with COPD, but these recommendations are based largely on evidence from observational studies with very few randomised controlled trials (RCTs) reported. Influenza infection causes excess morbidity and mortality in COPD patients but there is also the potential for influenza vaccination to cause adverse effects or not to be cost effective. Objectives To evaluate the evidence from RCTs for a treatment effect of influenza vaccination in COPD subjects. Outcomes of interest were exacerbation rates, hospitalisations, mortality, lung function and adverse effects. Search methods We searched the Cochrane Airways Group Specialised Register of trials, and reference lists of articles. References were also provided by a number of drug companies we contacted. The latest search was carried out in May 2010. Selection criteria RCTs that compared live or inactivated virus vaccines with placebo, either alone or with another vaccine in persons with COPD. Studies of people with asthma were excluded. Data collection and analysis Two reviewers extracted data. All entries were double checked. Study authors and drug companies were contacted for missing information. Main results Eleven trials were included but only six of these were specifically performed in COPD patients. The others were conducted on elderly and high-risk individuals, some of whom had chronic lung disease. Inactivated vaccine in COPD patients resulted in a significant reduction in the total number of exacerbations per vaccinated subject compared with those who received placebo (weighted mean difference (WMD) -0.37, 95% confidence interval -0.64 to -0.11, P = 0.006). This was due to the reduction in “late” exacerbations occurring after three or four weeks (WMD -0.39, 95% CI -0.61 to -0.18, P = 0.0004). In Howells 1961, the number of patients experiencing late exacerbations was also significantly less (odds ratio 0.13, 95% CI 0.04 to 0.45, P = 0.002). Both Howells 1961 and Wongsurakiat 2004 found that inactivated influenza vaccination reduced influenza -related respiratory infections (WMD 0.19, 95% CI 0.07 to 0.48, P = 0.0005). In both COPD patient and in elderly patients (only a minority of whom had COPD), there was a significant increase in the occurrence of local adverse reactions in vaccinees, but the effects were generally mild and transient. There was no evidence of an effect of intranasal live attenuated virus when this was added to inactivated intramuscular vaccination. The studies are too small to have detected any effect on mortality. An updated search conducted in September 2001did not yield any further studies. A search in 2003 yielded two further reports of the same eligible study Gorse 2003. A search in 2004 yielded two reports of the another eligible study Wongsurakiat 2004. The author informed us of another report of the same study Wongsurakiat 2004/2. An update search in May 2010 did not identify any new studies for consideration
Reactions to driving cessation: a qualitative study of people with dementia and their families
No full textOBJECTIVES: A proportion of older people with mild dementia are safe to drive. However, driving cessation is recommended at some point as the disease progresses. Driving cessation can have significant psychological and social consequences on people with dementia and their carers. This paper aims to explore the psychosocial and adjustment issues following driving cessation for people with dementia and their supporters. METHOD: Participants and their supporters were interviewed within 1 month of driving-cessation advice, and again 6 months later. Issues associated with driving cessation were explored in semi-structured interviews. RESULTS: Seven participants and their supporters were recruited. This has generated a total of 22 transcripts for qualitative analysis including follow-up interviews. For those who could remember the details of driving cessation, most were unhappy with the decision. Carers who were supportive of driving cessation questioned the legality of it. Most participants minimised the impact of their driving cessation on their supporters. Most supporters were negatively affected by the decision. CONCLUSIONS: The preliminary findings highlight the need for a more comprehensive process for driving cessation in those with dementia, with closer links to regulatory bodies, and increased support for their families/carers
Zur Rekonstruktion der kaiserzeitlichen Halle am Nordmarkt in Milet
No full textIn dem Beitrag wird die von A. von Gerkan entwickelte und in der Forschung bis heute gültige Rekonstruktion der kaiserzeitlichen Halle am Nordmarkt von Milet kritisch analysiert und eine alternative Rekonstruktion vorgestellt. Das Hauptergebnis dieser Revision besteht in der Feststellung, dass die Ostseite des Baus nicht wie von von Gerkan angenommen mit einer geschlossenen Wand sowie einer Blendordnung aus Halbsäulen sondern stattdessen mit einer offenen Säulenstellung zu rekonstruieren ist. Abschließend wird kurz auf die sich hieraus ergebenden Konsequenzen für das kaiserzeitliche Stadtbild an dem neuralgischen Punkt zwischen Hafentor und Südmarkt eingegangen.Since its publication in 1922 the reconstruction of the so called North Market by A. von Gerkan has remained unchallenged. There is, however, reason to doubt von Gerkan’s reconstruction of the imperial phase of the building. The author argues that the front of the eastern section of the complex that was erected in the 2nd cent. A.D. is to be restored with full columns rather than with a screen wall with half-columns attached to it. Finally, further consequences for the urban landscape of Miletus in imperial times are discussed.Makalede, A. von Gerkan tarafından geliştirilen ve araştırmada şimdiye kadar geçerli olan, Milet kuzey pazar yerinde bulunan İmparatorluk Dönemi galerisinin rekontrüksiyonu eleştirel olarak analiz edilmiş ve alternatif bir rekonstrüksiyon öne sürülmüştür. Bu revizyonun ana sonucu, yapının doğu tarafının Gerkan tarafından tahmin edildiği gibi yarım sütunlardan oluşan bir düzenleme ve bir duvara sahip olmayıp bunun yerine açık bir sütun yerleştirmesi şeklinde canlandırılabileceğinin saptanmasından ibarettir. Son olarak kentin İmparatorluk Döneminde güney pazarı ve liman kapısı arasında bulunan kritik nokta için bundan çıkarılan sonuçlara kısaca değinilmektedir
Analiza miselnega sloga protagonista v romanu Room avtorice Emme Donoghue
No full textEmma Donoghue’s main character and narrator in Room is a literary construct with a severely deviant mind style that portrays a unique outlook on the world. The protagonist is a five-year-old boy who has been living in extreme social isolation his whole life. His mother was kidnapped, locked in a room and repeatedly raped and gave birth to a son named Jack. The dissertation analyses and outlines the deviant features of his mind style. The analysis later focuses on the underlying reason that inspired or even provoked the author to construct such a deviant mind style. Two possible phenomena are introduced as the basis for the analysis. The first theory that is researched and then compared to the constructed mind style, is the theory of feral people, individuals living in extreme social isolation. Certain cases were supposedly raised by animals, others contained in small spaces without human contact. The second possible theory explaining Donoghue’s unique mind style construction, is an autistic disorder. Characteristics of feral and autistic individuals are often similar and sometimes even overlap, which is why this phenomenon was chosen as an alternative option for the basis of the construction of Jack’s mind style. The dissertation finally tries to determine, whether a feral or autistic nature can be ascribed to the protagonist, and to what extent he pertains to either theory.Tema magistrske naloge je analiza miselnega sloga protagonista literarnega dela, ki je izšlo v letu 2010. Glavna oseba in pripovedovalec literarnega dela Room (slovenski prevod: Soba), avtorice Emme Donoghue, je literarni konstrukt, katerega miselni slog odstopa od norme in predstavlja edinstven pogled na svet. Po tej knjižni uspešnici je bil posnet tudi film, ki si je prislužil kar nekaj nagrad, vendar pa v magistrski nalogi ni analiziran, saj predstavlja drugačno perspektivo zgodbe. Literarno delo je zanimivo predvsem, ker nam omogoči vpogled v misli otroka. Celotna zgodba je predstavljena izključno iz njegove perspektive, kar pa je v filmih težko poustvariti. Protagonist je petletni deček, ki je bil celo svoje življenje podvržen ekstremnim družbenim okoliščinam. Njegova mama je bila ugrabljena, zaklenjena v sobo in večkrat posiljena, kar je povzročilo rojstvo edinega sina z imenom Jack. Naloga magistrske naloge je bila, da opiše in analizira najbolj izstopajoče in deviantne značilnosti protagonistovega miselnega sloga. Slednje sem poskušala določiti s pomočjo stilistične analize, ki je tudi glavna raziskovalna metoda magistrske naloge. Miselni slog sestavljajo jezikovni vzorci, ki prikazujejo določen pogled na svet. Kadar pa ti vzorci odstopajo od pričakovanega, so še posebej zanimivi za bralce, ker prikazujejo pogled na svet, ki ga bralci niso navajeni. Branje takšnega besedila bralcu omogoči poistovetenje z literarnimi osebami, ki bi jih v realnem življenju celo zavračali. Bralec lahko na zgodbo gleda iz perspektive kriminalca, morilca, posameznika z duševnimi motnjami ali, v tem primeru, otroka, ki je bil podvržen ekstremnim družbenim okoliščinam. S tem je bralcem omogočen edinstven pogled na svet, ki jih prisili k globljemu razmišljanju o obravnavanih problematikah.
Prva hipoteza magistrske naloge se nanaša na izpostavljene značilnosti protagonistovega miselnega sloga, ki se pojavljajo skozi celotno besedilo in pripomorejo k vtisu, da ima pripovedovalec, ki je v tem primeru tudi glavna oseba literarnega dela, edinstven pogled na svet. Ta v bralcih vzbuja pozornost in začudenje. Izpostavljene značilnosti protagonistovega miselnega sloga se pojavljajo na več ravninah jezika: na besedoslovni, skladenjski in oblikoslovni ravnini. Ena izmed pogosto prisotnih izpostavljenih značilnosti analiziranega miselnega sloga je neupoštevanje konverzacijskih implikatur. Pogosta je tudi izstopajoča ali celo nepravilna raba oz. nepoznavanje določenih pesniških figur, kot so npr. metafora, poosebitev, prispodoba, pretiravanje in onomatopoija. Tudi jezik protagonista vsebuje veliko slovničnih napak in nepravilne rabe stavčnih členov ter preteklika. Njegova raba jezika je enostavna, kar je tudi tipično za otroka njegovih let. Protagonist pa odstopa od norme predvsem na ravni pragmatike, kajti manjka mu še veliko znanja o pravilni komunikaciji, ki ga zaradi ekstremnih družbenih pogojev še ni bil deležen.
V nadaljnji razpravi sem poskušala določiti osnovni razlog, ki je služil kot inspiracija oz. je izzval avtorico, da ustvari literarni lik s takšnim odstopajočim miselnim slogom. Magistrska naloga navede dva možna fenomena, ki bi lahko služila kot osnova analize. Prva teorija, ki sem jo raziskala in nato primerjala z ustvarjenim miselnim slogom, je teorija divjih otrok. To so posamezniki, ki so bili izolirani od družbe oz. so živeli v ekstremnih družbenih razmerah. V nekaterih primerih naj bi jih vzgajale živali, v drugih pa so bili posamezniki zaklenjeni v majhne prostore, kjer so bili prepuščeni sami sebi in niso imeli stika z ljudmi. Eden najbolj znanih primerov današnjega časa je primer Fritzl, ki je avtorici služil kot inspiracija za nastanek tega literarnega dela. Zgodba je zelo podobna, saj je Josef Fritzl v svoji kleti prav tako imel ujetnico. Ta ujetnica je bila celo njegova hčerka, ki je v kleti preživela dvajset let. Oče jo je večkrat posilil in rodila je kar nekaj otrok. Nekaterim je bilo dovoljeno zapustiti kletno sobo, dru
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