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Gallin; an antimicrobial peptide member of a new avian defensin family, the ovodefensins, has been subject to recent gene duplication
Daoqing Gong, Peter W Wilson, Maureen M Bain, Karina McDade, Jiri Kalina, Virginie Hervé-Grépinet, Yves Nys, Ian C Dunn
BMC Immunology , 2010, DOI: 10.1186/1471-2172-11-12
Abstract: We have confirmed that there are at least 3 forms of the gallin gene in the chicken genome in 3 separate lines of chicken, all the forms are expressed in the tubular cells of the magnum region of the oviduct, consistent with its presence in egg white. mRNA expression levels are in the order 10,000 times greater in the magnum than the shell gland. The conservation between the multiple forms of gallin in the chicken genome compared with the conservation between gallin and other avian gallin like peptides, suggests that the gene duplication has occurred relatively recently in the chicken lineage. The gallin peptide family contains a six cysteine motif (C-X5-C-X3-C-X11-C-X3-C-C) found in all defensins, and is most closely related to avian beta-defensins, although the cysteine spacing differs. Further support for the classification comes from the presence of a glycine at position 10 in the 41 amino acid peptide. Recombinant gallin inhibited the growth of Escherischia coli (E. coli) at a concentration of 0.25 μM confirming it as part of the antimicrobial innate immune system in avian species.The relatively recent evolution of multiple forms of a member of a new defensin related group of peptides that we have termed ovodefensins, may be an adaptation to increase expression or the first steps in divergent evolution of the gene in chickens. The potent antimicrobial activity of the peptide against E. coli increases our understanding of the antimicrobial strategies of the avian innate immune system particularly those of the egg white and the evolution of the defensin family. The potential of this peptide and others in the family can now be investigated in a number of novel antimicrobial roles.Gallin was first noted using a proteomic approach to the analysis of chicken egg white [1]. It was named gallin because of its homology to meleagrin, a peptide previously discovered as a contaminant in a turkey (Meleagris gallopavo) ovomucin preparation [2] and to cygnin, discovered in th
Health self-perception by dementia family caregivers: sociodemographic and clinical factors
Valente, Letice Ericeira;Truzzi, Annibal;Souza, Wanderson F.;Alves, Gilberto Sousa;Alves, Carlos Eduardo de Oliveira;Sudo, Felipe Kenji;Lanna, Maria Elisa O.;Moreira, Denise Madeira;Engelhardt, Eliasz;Laks, Jerson;
Arquivos de Neuro-Psiquiatria , 2011, DOI: 10.1590/S0004-282X2011000600003
Abstract: caring for a demented family member has been associated with burden. studies concerning health self-perception of family caregivers are still scarce. objective: to investigate caregivers perceived health and to look into relationships with patients and caregivers' sociodemographic and clinical data. method: dyads of dementia outpatients and family caregivers (n=137) were assessed with mini mental state examination, functional activities questionnaire, neuropsychiatric inventory and clinical dementia rating. caregivers answered sociodemographic questionnaire, beck depression and anxiety inventories, zarit burden interview and maslach burnout inventory. results: caregivers poor perceived health was associated with emotional exhaustion, burden, depression and anxiety. logistic regression analyses revealed caregivers' age, anxiety and physical problem as the main predictors of health self-perception. conclusion: aged family caregivers with anxiety who also report physical problem characterize a group at risk for poor self-perceived health. evaluation of health self-perception may be useful for designing interventions to improve anxiety and physical health.
Compassion Fatigue: An Application of the Concept to Informal Caregivers of Family Members with Dementia  [PDF]
Jennifer R. Day,Ruth A. Anderson
Nursing Research and Practice , 2011, DOI: 10.1155/2011/408024
Abstract: Introduction. Compassion fatigue is a concept used with increasing frequency in the nursing literature. The objective of this paper is to identify common themes across the literature and to apply these themes, and an existing model of compassion fatigue, to informal caregivers for family members with dementia. Findings. Caregivers for family members with dementia may be at risk for developing compassion fatigue. The model of compassion fatigue provides an informative framework for understanding compassion fatigue in the informal caregiver population. Limitations of the model when applied to this population were identified as traumatic memories and the emotional relationship between parent and child, suggesting areas for future research. Conclusions. Research is needed to better understand the impact of compassion fatigue on informal caregivers through qualitative interviews, to identify informal caregivers at risk for compassion fatigue, and to provide an empirical basis for developing nursing interventions for caregivers experiencing compassion fatigue. 1. Introduction Compassion fatigue was introduced to the health care community as a unique form of burnout experienced by those in caring professions, particularly palliative care and oncology nurses [1]. Later, other health care professions such as social work, medicine, and psychology adopted the concept [2–5]. Many definitions of compassion fatigue have been offered by researchers and authors, the most common being that compassion fatigue is an adverse consequence of caring for individuals in need and the caregiver may experience the symptoms of anger, depression, and apathy [1, 6, 7]. Family caregivers, particularly those caring for older adults with dementia, display many of the characteristics of compassion fatigue. Caregivers for family members with dementia experience depression, anxiety, and stress [8–15] and also feelings of resentment, helplessness, and hopelessness, in addition to feeling that they have little free time [16]. Caregivers who have these feelings and experiences on top of the emotionally laden filial caregiving relationship may be suffering from compassion fatigue, yet compassion fatigue has not been explored for informal caregivers of family members with dementia. Informal caregivers for family members with dementia who develop compassion fatigue may terminate the caregiving relationship though premature nursing home admission or relinquishing care to another family member, and there may also be increased risk for abuse or neglect [13, 14]. Supporting these caregivers may
Peer support for family carers of people with dementia, alone or in combination with group reminiscence in a factorial design: study protocol for a randomised controlled trial
Georgina Charlesworth, Karen Burnell, Jennifer Beecham, Zo? Hoare, Juanita Hoe, Jennifer Wenborn, Martin Knapp, Ian Russell, Bob Woods, Martin Orrell
Trials , 2011, DOI: 10.1186/1745-6215-12-205
Abstract: A 2 × 2 factorial multi-site randomised controlled trial of individual peer support and group reminiscence interventions for family carers and people with dementia in community settings in England, addressing both effectiveness and cost-effectiveness.The methods described in this protocol have implications for research into psychosocial interventions, particularly complex interventions seeking to test both individual and group approaches.ISRCTN37956201People with dementia who are cared for by a family member are less likely to be hospitalised or move into residential care [1], and have a better quality of life than those in care homes [2]. However, family carers of people with dementia experience greater strain and distress than carers of other older people [3]. Family carers may experience social isolation [4] through lack of personal time and opportunities to socialise, and stigma resulting in family and friends distancing themselves [5]. Without support, family carers can feel emotionally and physically burdened and may experience interrelational conflicts, which may reduce perceived level of emotional support and increase feelings of loneliness [6]. As interventions delivered by health staff can 'medicalise' the experience of caring and raise stigma [7], interventions in the voluntary and community sector can provide a more informal setting for the support of carers. The World Health Organisation noted the importance of enhancing social relationships for carers [8], and peer support for carers is included in the recommendations of the National Dementia Strategy for England [9]. It has been suggested that peer support can directly improve wellbeing by decreasing feelings of isolation and/or encouraging more appropriate coping strategies, and enabling a change in behaviour, emotion or cognitions [10]. Hence a body of work is developing to evaluate befriending and peer support interventions.A recent systematic review of befriending interventions in healthcare estab
Staff’s and family members’ spiritual well-being in relation to help for residents with dementia  [cached]
John Fisher
Journal of Nursing Education and Practice , 2012, DOI: 10.5430/jnep.v2n4p77
Abstract: Background: Spiritual well-being of providers and patients is paramount for holistic care in nursing. Spiritual well-being is reflected in relationships in four areas, namely with self, others, environment and/or Transcendent Other. Method: Fisher’s 20-item Spiritual Health and Life-Orientation Measure (SHALOM) was used to assess these four key components of spiritual health. A survey was completed by staff and family members of residents in a dementia care unit, to record three responses on SHALOM, namely their ideals for spiritual health, their lived experiences, and what they thought residents need for spiritual nurture in these four areas. Demographic variables were investigated, with respect to any impact on respondents’ spiritual well-being. Results: Variations were found in the staff’s and family members’ spiritual well-being based on age, religious group membership and activities, and whether or not the respondent was facing a spiritual challenge. However, regression analyses showed that these variables had no significant influence on the help that staff thought residents need to nurture their spiritual well-being. Regression analyses did show that staff’s ideals contributed greatest explanation of variance in terms of help staff believe is needed for spiritual nurture of residents. On the other hand, it was the lived experiences of family members that showed greatest influence on what help they thought residents needed. This was especially true for family members who had difficulty living up to their own ideals. Even though they based their judgements on different rationale, staff and family members agreed on the priorities to be set in nurturing residents’ spiritual well-being in a dementia care unit. Conclusion: Congruence was found between staff’s and family members’ perceptions of help needed to nurture residents’ spiritual well-being. This study, using the spiritual well-being questionnaire called SHALOM, revealed that staff acted professionally basing their judgment on ideals, whereas family members reflected their own lived experience, when determining what they thought was needed to help nurture residents’ spiritual well-being.
Why are family carers of people with dementia dissatisfied with general hospital care? a qualitative study  [cached]
Jurgens Fiona J,Clissett Philip,Gladman John RF,Harwood Rowan H
BMC Geriatrics , 2012, DOI: 10.1186/1471-2318-12-57
Abstract: Background Families and other carers report widespread dissatisfaction with general hospital care for confused older people. Methods We undertook a qualitative interviews study of 35 family carers of 34 confused older patients to ascertain their experiences of care on geriatric and general medical, and orthopaedic wards of a large English hospital. Transcripts were analysed using a grounded theory approach. Themes identified in interviews were categorised, and used to build a model explaining dissatisfaction with care. Results The experience of hospital care was often negative. Key themes were events (illness leading to admission, experiences in the hospital, adverse occurrences including deterioration in health, or perceived poor care); expectations (which were sometimes unrealistic, usually unexplored by staff, and largely unmet from the carers’ perspective); and relationships with staff (poor communication and conflict over care). Expectations were influenced by prior experience. A cycle of discontent is proposed. Events (or ‘crises’) are associated with expectations. When these are unmet, carers become uncertain or suspicious, which leads to a period of ‘hyper vigilant monitoring’ during which carers seek out evidence of poor care, culminating in challenge, conflict with staff, or withdrawal, itself a crisis. The cycle could be completed early during the admission pathway, and multiple cycles within a single admission were seen. Conclusion People with dementia who have family carers should be considered together as a unit. Family carers are often stressed and tired, and need engaging and reassuring. They need to give and receive information about the care of the person with dementia, and offered the opportunity to participate in care whilst in hospital. Understanding the perspective of the family carer, and recognising elements of the ‘cycle of discontent’, could help ward staff anticipate carer needs, enable relationship building, to pre-empt or avoid dissatisfaction or conflict.
The Active Role of Material Things: An Environment-Based Conceptual Framework to Understand the Well-Being of People with Dementia  [PDF]
Hui Ren, Megan Strickfaden
Open Journal of Social Sciences (JSS) , 2018, DOI: 10.4236/jss.2018.66002
Abstract:
This study discusses the relationships of material things to people with dementia and proposes the development of material environments to enhance their well-being. Integrating research on well-being from existential, ecological, and place-based perspectives, this study develops a new understanding of the well-being of people with dementia when considering the active role of material things in the process of developing well-being. “Well-being of people with dementia” refers to the awareness of self-existence in a real-world environment established by the interactions of people and material things. Based on this understanding, this study integrates four types of environmental embodiments, including obliviousness, watching, noticing, and heightened contact, providing specific guides to understand people’s associations with their material environments. An environment-based conceptual framework, based on the new understanding of the meanings of well-being and its association with material things, allows designers and professional/family caregivers to understand the lived experiences of people with dementia, in order to enhance the well-being of their clients and their families by using material things to create a more holistic environment.
Psychosocial Factors That Shape Patient and Carer Experiences of Dementia Diagnosis and Treatment: A Systematic Review of Qualitative Studies  [PDF]
Frances Bunn ,Claire Goodman,Katie Sworn,Greta Rait,Carol Brayne,Louise Robinson,Elaine McNeilly,Steve Iliffe
PLOS Medicine , 2012, DOI: 10.1371/journal.pmed.1001331
Abstract: Background Early diagnosis and intervention for people with dementia is increasingly considered a priority, but practitioners are concerned with the effects of earlier diagnosis and interventions on patients and caregivers. This systematic review evaluates the qualitative evidence about how people accommodate and adapt to the diagnosis of dementia and its immediate consequences, to guide practice. Methods and Findings We systematically reviewed qualitative studies exploring experiences of community-dwelling individuals with dementia, and their carers, around diagnosis and the transition to becoming a person with dementia. We searched PubMed, PsychINFO, Embase, CINAHL, and the British Nursing Index (all searched in May 2010 with no date restrictions; PubMed search updated in February 2012), checked reference lists, and undertook citation searches in PubMed and Google Scholar (ongoing to September 2011). We used thematic synthesis to identify key themes, commonalities, barriers to earlier diagnosis, and support identified as helpful. We identified 126 papers reporting 102 studies including a total of 3,095 participants. Three overarching themes emerged from our analysis: (1) pathways through diagnosis, including its impact on identity, roles, and relationships; (2) resolving conflicts to accommodate a diagnosis, including the acceptability of support, focusing on the present or the future, and the use or avoidance of knowledge; and (3) strategies and support to minimise the impact of dementia. Consistent barriers to diagnosis include stigma, normalisation of symptoms, and lack of knowledge. Studies report a lack of specialist support particularly post-diagnosis. Conclusions There is an extensive body of qualitative literature on the experiences of community-dwelling individuals with dementia on receiving and adapting to a diagnosis of dementia. We present a thematic analysis that could be useful to professionals working with people with dementia. We suggest that research emphasis should shift towards the development and evaluation of interventions, particularly those providing support after diagnosis. Please see later in the article for the Editors' Summary.
Identifying Dementia And Depression In The Elderly: The Role Of The Family
R Uwakwe, M Prince
Nigerian Journal of Clinical Practice , 2004,
Abstract: Objective: To measure the ability of family members to detect dementia/depression in their elderly relatives. Method: Subjects diagnosed with dementia/depression were assessed with 10/66 dementia package. The Geriatric Depression Scale (GDS), Family Questionnaire (FQ) and the Functional Activities Questionnaire (FAQ) were used to interview the family members of the patients. These were then compared with cognitively normal individuals with high and low education. Results: Seventy-six patients aged 60 – 69 participated in the study. Nearly 24% of all the subjects scored above the cut off score of the GDS. The FAQ, FQ and CSI – D (informant section) correlated significantly with the GMS organicity. Conclusion: the FQ and FAQ may be used to indirectly screen elderly subjects who have cognitive deficits and dementia through their family co-residents. This will likely yield an increase in the detection of dementia/depression in elderly subjects who have limited access to direct contact with health care services. Key Words: Dementia, Depression, elderly, family members. Nigerian Journal of Clinical Practice Vol.7(2) 2004: 82-87
Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities
Christopher Beer, Barbara Horner, Osvaldo P Almeida, Samuel Scherer, Nicola T Lautenschlager, Nick Bretland, Penelope Flett, Frank Schaper, Leon Flicker
BMC Geriatrics , 2009, DOI: 10.1186/1471-2318-9-36
Abstract: A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey) and 202 GPs (19% of metropolitan GPs). Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically.Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern, communication, knowledge regarding dementia, aspects of person centred care, system factors and the multidisciplinary team were consistently and frequently cited. Small group education which is flexible, individualized, practical and case based was sought.The effectiveness and sustainability of an educational intervention based on these findings needs to be tested. In addition, future interventions should focus on supporting cultural change to facilitate sustainable improvements in care.Dementia is estimated to affect 0.9% of Australians and is now the leading cause of non-fatal disease burden among older Australians. [1,2] Prevalence is strongly age-related, with estimated prevalence rates of 6.5% in people aged 65 years a
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