scholarly journals Please Do Something: What Caregivers for Family Members with FTD Need

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 986-986
Author(s):  
Samantha Smith ◽  
Allison Lindauer ◽  
Leslie Tran

Abstract Frontotemporal dementia (FTD) often presents with pronounced behavioral symptoms that contribute to family Care Partner (CP) burden and psychological strain. FTD-specific interventions that support the unique challenges of FTD-CPs are lacking. The present focus group study (Phase 1), elicited feedback from twelve CPs of persons with FTD on the multi-component video-based STELLA intervention (Support via TEchnology: Living and Learning with Advancing ADRDs), to inform the revision and adaptation of STELLA for FTD-CPs (Phase 2). Using Thomas’s (2006) analytic approach to evaluation data, the investigators reviewed the raw text from two focus groups and used an inductive approach to create categories that informed future STELLA adaptation and revision. To address trustworthiness, each investigator independently analyzed the transcripts and CP-annotated STELLA booklets. Six commonalities emerged. Three address the caregiver experience: Burden and living with complex behaviors; Difficulties in getting a diagnosis; and Barriers to participation. The other three reflect specific intervention adaptations: Make a Roadmap, STELLA-FTD Structure, and Booklet edits. The focus group findings offer practical suggestions to create a revised STELLA intervention to address the needs of families living with FTD. The suggestions are nested in the intense caregiving experience of living with complex behavioral symptoms, feeling burdened, isolated, and “living in darkness.” Both the investigators and caregivers appreciate the difficulty in crafting an intervention that meets the needs of all families living with FTD, but the caregivers encouraged the team to develop “something”: “…You won't be able to solve every problem or meet every need… [but] please, please do something.”

2021 ◽  
Author(s):  
◽  
Loc Tan Nguyen

<p>Recent years have seen increasing research interest in the teaching of pronunciation in English as a second/foreign language classes (Thomson & Derwing, 2014), with particular strands of this research focused on understanding how pronunciation is represented in instructional materials and actual teaching practices in a range of settings and in teacher cognition (e.g., Couper, 2017; Derwing, Diepenbroek, & Foote, 2012; Foote, Trofimovich, Collins, & Urzúa, 2016). The study reported in this dissertation extends this research by investigating pronunciation teaching in a context where it has hitherto been under-researched, namely tertiary EFL in Vietnam.  The research involved two phases. Phase 1 was an introductory situation analysis which investigated pronunciation teaching practices of six Vietnamese tertiary EFL teachers teaching six intact classes at a Vietnamese university. First, the representation of pronunciation features in prescribed textbooks and supplementary materials of the EFL programme were analysed. Six ninety-minute lessons (one from each of the teachers) were then observed, and the teachers and 24 students across the six groups interviewed. The teacher interviews included both stimulated recall and general questions probing their beliefs about pronunciation teaching. Students were interviewed in focus groups (four each) regarding their teachers’ pronunciation teaching and their own pronunciation needs. The focus of Phase 1 was on how the teachers taught pronunciation, the factors shaping their pedagogical choices, and the students’ beliefs about their teachers’ pronunciation teaching and their instructional needs. The findings revealed that pronunciation was largely absent from course books and curriculum documents and that the teachers’ beliefs were in contrast with what they actually did in class. The teachers reported that they would follow deliberate steps if they taught pronunciation explicitly such as listening discrimination followed by explaining places of articulation and then practice. However, in the observed lessons, they only corrected their students’ pronunciation errors through recasts and/or prompts, with little if any explicit or pre-planned pronunciation teaching. In the interviews, the teachers confirmed that they never used any other techniques and that this was typically the only way they taught pronunciation in class.  The teachers’ pronunciation teaching was textbook-driven and was shaped by contextual factors including the curriculum and the learners. Decision making by all the teachers reflected a general commitment to strictly follow the mandated curriculum, with little evidence of pronunciation being taught explicitly. All the teachers reported a lack of initial training and professional learning in pronunciation pedagogy. In addition, there was a mismatch between the teachers’ and students’ preferences and beliefs about pronunciation teaching. Whereas the teachers believed error correction through recasts and/or prompts was effective, the students did not, and expressed a strong need for more explicit, communicative teaching of pronunciation. This pronunciation instructional need and the teachers’ lack of initial training and PL in pronunciation pedagogy motivated the Phase 2 study.  Phase 2 was an intervention study conducted with the same teachers teaching different classes. At the beginning of Phase 2, the teachers attended a teacher professional learning (TPL) workshop in which they were introduced to a pedagogic framework for teaching English pronunciation communicatively proposed by Celce-Murcia, Brinton, & Goodwin (2010). The teachers then planned communicative pronunciation teaching (CPT) lessons using this framework, and were subsequently observed implementing these lessons in their classes. Both the workshop and subsequent classes of this phase were audio-video recorded. A total of seven lesson plans and 24 classroom observations were made across the six teachers (four observations each). Right after the classroom observations, the teachers were interviewed to obtain their views of the TPL workshop and their implementation of the CPT lessons. Twenty-four students across the six groups were interviewed to reflect on their experience with the CPT lessons.  Observational data showed that the teachers understood and were able to translate what they learned about CPT from the workshop into actual classroom practice as reflected in their lesson planning and subsequent teaching. The lesson plans designed by the teachers closely followed the principles of the communicative framework. Interview data showed that the CPT model was favoured by both teacher and student participants. On the basis of the teachers’ implementation of the CPT lessons, both the teachers and students were confident that CPT has the advantages for promoting learners’ pronunciation knowledge, fostering their phonological ability, and developing their oral communication skills. They also reported that CPT can arouse learners’ interest and engagement in classroom learning.  Taken as a whole, this research highlights the need for pronunciation to be given a more explicit place in teaching and learning in tertiary EFL programmes in Vietnam, and for teachers to be better equipped for teaching pronunciation. Findings from interviews with teachers and learners in the study suggest that they would be receptive to such changes.</p>


2011 ◽  
Vol 39 (6) ◽  
pp. 1093-1097 ◽  
Author(s):  
A. Webb ◽  
H. Kolawole ◽  
S. Leong ◽  
T. E. Loughnan ◽  
T. Crofts ◽  
...  

The Bonfils and Levitan FPS™ scopes are rigid fibreoptic stylets that may assist routine or difficult intubation. This study compared the effectiveness of each in patients with predicted normal airways when used by specialist anaesthetists with no prior experience using optical stylets. Twelve anaesthetists and 324 elective surgical patients participated. Six anaesthetists were randomised to first intubate 20 patients with the Levitan scope (Phase 1) followed by a further seven patients with the Bonfils scope (Phase 2). The other six participating anaesthetists undertook their first 20 intubations with the Bonfils (Phase 1), followed by seven intubations with the Levitan (Phase 2). Outcomes recorded were success rate, total time to intubation, number of attempts, ease of intubation score and incidence of complications. Overall failure rates were similar for the two scopes with 5.6% of patients not intubated after three attempts. Median total times to intubation were similar for the Levitan (44 seconds) and Bonfils (36 seconds) (P=0.11). Participants using the Bonfils in Phase 1 had significantly higher chance of success on first attempt (73%) compared to Levitan users during Phase 1 (57%) (P=0.008). These differences were not significant in the second phase and ease of intubation scores were similar for both scopes (P=0.9). This study showed the two scopes were comparable but the high failure rate amongst novice users demonstrated the importance of familiarity and skill development prior to their introduction to a difficult airway cart.


2008 ◽  
Vol 48 (5) ◽  
pp. 608 ◽  
Author(s):  
R. G. Holroyd ◽  
V. J. Doogan ◽  
M. R. Jeffery ◽  
J. A. Lindsay ◽  
B. K. Venus ◽  
...  

This experiment tested the hypothesis that relocating cattle is detrimental to their growth. The study examined the effect of having relocated cattle mixed with, or segregated from, the local acclimatised cattle at the destination property. Bos indicus cross steers (120) were allocated to three groups and were relocated, in two separate cohorts, 980 km from northern Queensland to improved pastures in central Queensland. At the start of Phase 1, the control group (C) was moved 3 months before the other two groups. The remaining two groups grazed native pastures; one group was supplemented (SR) to increase growth rate similar to that expected from improved pasture in central Queensland and the other was not supplemented (R). At the end of Phase 1, C was significantly (P < 0.05) heavier than SR, which was significantly (P < 0.05) heavier than R. At the start of Phase 2, the SR and R groups were relocated and after transportation the R and SR groups lost 12 kg or 4.4% of liveweight and 18 kg or 5.7% of liveweight, respectively; this weight loss was recovered after 5 days. All steers were reallocated to segregated (SEG) or mixed (MIX) treatment groups forming six treatments (SEG.C, SEG.R and SEG.SR and MIX.C, MIX.R and MIX.SR). There were no significant differences in liveweights within the SEG treatments by 57 days or within the MIX treatments by 106 days after relocation. There were few if any significant differences in the plasma constituents and differential leucocyte counts of the steers and most results were within physiologically normal ranges. We conclude on the basis of these results and of other experiments that the anecdotal poor performance of cattle after relocation appears to be unfounded.


2021 ◽  
Author(s):  
◽  
Loc Tan Nguyen

<p>Recent years have seen increasing research interest in the teaching of pronunciation in English as a second/foreign language classes (Thomson & Derwing, 2014), with particular strands of this research focused on understanding how pronunciation is represented in instructional materials and actual teaching practices in a range of settings and in teacher cognition (e.g., Couper, 2017; Derwing, Diepenbroek, & Foote, 2012; Foote, Trofimovich, Collins, & Urzúa, 2016). The study reported in this dissertation extends this research by investigating pronunciation teaching in a context where it has hitherto been under-researched, namely tertiary EFL in Vietnam.  The research involved two phases. Phase 1 was an introductory situation analysis which investigated pronunciation teaching practices of six Vietnamese tertiary EFL teachers teaching six intact classes at a Vietnamese university. First, the representation of pronunciation features in prescribed textbooks and supplementary materials of the EFL programme were analysed. Six ninety-minute lessons (one from each of the teachers) were then observed, and the teachers and 24 students across the six groups interviewed. The teacher interviews included both stimulated recall and general questions probing their beliefs about pronunciation teaching. Students were interviewed in focus groups (four each) regarding their teachers’ pronunciation teaching and their own pronunciation needs. The focus of Phase 1 was on how the teachers taught pronunciation, the factors shaping their pedagogical choices, and the students’ beliefs about their teachers’ pronunciation teaching and their instructional needs. The findings revealed that pronunciation was largely absent from course books and curriculum documents and that the teachers’ beliefs were in contrast with what they actually did in class. The teachers reported that they would follow deliberate steps if they taught pronunciation explicitly such as listening discrimination followed by explaining places of articulation and then practice. However, in the observed lessons, they only corrected their students’ pronunciation errors through recasts and/or prompts, with little if any explicit or pre-planned pronunciation teaching. In the interviews, the teachers confirmed that they never used any other techniques and that this was typically the only way they taught pronunciation in class.  The teachers’ pronunciation teaching was textbook-driven and was shaped by contextual factors including the curriculum and the learners. Decision making by all the teachers reflected a general commitment to strictly follow the mandated curriculum, with little evidence of pronunciation being taught explicitly. All the teachers reported a lack of initial training and professional learning in pronunciation pedagogy. In addition, there was a mismatch between the teachers’ and students’ preferences and beliefs about pronunciation teaching. Whereas the teachers believed error correction through recasts and/or prompts was effective, the students did not, and expressed a strong need for more explicit, communicative teaching of pronunciation. This pronunciation instructional need and the teachers’ lack of initial training and PL in pronunciation pedagogy motivated the Phase 2 study.  Phase 2 was an intervention study conducted with the same teachers teaching different classes. At the beginning of Phase 2, the teachers attended a teacher professional learning (TPL) workshop in which they were introduced to a pedagogic framework for teaching English pronunciation communicatively proposed by Celce-Murcia, Brinton, & Goodwin (2010). The teachers then planned communicative pronunciation teaching (CPT) lessons using this framework, and were subsequently observed implementing these lessons in their classes. Both the workshop and subsequent classes of this phase were audio-video recorded. A total of seven lesson plans and 24 classroom observations were made across the six teachers (four observations each). Right after the classroom observations, the teachers were interviewed to obtain their views of the TPL workshop and their implementation of the CPT lessons. Twenty-four students across the six groups were interviewed to reflect on their experience with the CPT lessons.  Observational data showed that the teachers understood and were able to translate what they learned about CPT from the workshop into actual classroom practice as reflected in their lesson planning and subsequent teaching. The lesson plans designed by the teachers closely followed the principles of the communicative framework. Interview data showed that the CPT model was favoured by both teacher and student participants. On the basis of the teachers’ implementation of the CPT lessons, both the teachers and students were confident that CPT has the advantages for promoting learners’ pronunciation knowledge, fostering their phonological ability, and developing their oral communication skills. They also reported that CPT can arouse learners’ interest and engagement in classroom learning.  Taken as a whole, this research highlights the need for pronunciation to be given a more explicit place in teaching and learning in tertiary EFL programmes in Vietnam, and for teachers to be better equipped for teaching pronunciation. Findings from interviews with teachers and learners in the study suggest that they would be receptive to such changes.</p>


2016 ◽  
Vol 33 (3) ◽  
pp. 406-419 ◽  
Author(s):  
Virginie Debaere ◽  
Stijn Vanheule ◽  
Kaatje Van Roy ◽  
Reitske Meganck ◽  
Ruth Inslegers ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039763 ◽  
Author(s):  
Hardeep Singh ◽  
Arielle Shibi Rosen ◽  
Geoff Bostick ◽  
Anita Kaiser ◽  
Kristin E Musselman

ObjectivesThis study explored: (1) fall circumstances experienced by ambulators with spinal cord injury (SCI) over a 6-month period, (2) the impacts of falls-related injuries and fall risk and (3) their preferences/recommendations for fall prevention.DesignA sequential explanatory mixed-methods design with two phases.SettingA Canadian SCI rehabilitation hospital and community setting.ParticipantsThirty-three ambulators with SCI participated in phase 1 and eight participants that fell in phase 1 participated in phase 2.MethodsIn phase 1, fall circumstances were tracked using a survey that was completed each time a participant fell during the 6-month tracking period. Phase 2 involved photovoice; participants took photographs of factors that influenced their fall risk and how their fall risk impacted their work/recreational activities. Participants discussed the photographs and topics related to fall prevention in an individual interview and a focus group.ResultsOf the 33 participants, 21 fell in 6 months. Falls commonly occurred in the home while participants were changing positions or walking. Most falls occurred in the morning or afternoon. In phase 2, interviews and focus group discussion revealed three themes: (1) falls are caused by bodily impairments (eg, impaired reactive response during slips and trips and weakness and altered sensation in legs/feet), (2) impacts of fall-related injuries and fall risk (eg, psychosocial effects of fall-related injuries, limiting community participation due to the risk of falling and activity-dependent concern of falling) and (3) approaches to fall prevention (eg, fall prevention strategies used, components of fall prevention and utility of professional fall prevention strategies/interventions).ConclusionsFall prevention interventions/strategies should focus on minimising a person’s fall risk within their home as most falls occurred in the home environment. Ambulators with SCI would benefit from education and awareness about common fall circumstances that they may encounter in their daily lives.


2010 ◽  
Vol 108 (3) ◽  
pp. 596-603 ◽  
Author(s):  
E. A. Montcalm-Smith ◽  
R. M. McCarron ◽  
W. R. Porter ◽  
R. S. Lillo ◽  
J. T. Thomas ◽  
...  

Protection against decompression sickness (DCS) by acclimation to hyperbaric decompression has been hypothesized but never proven. We exposed rats to acclimation dives followed by a stressful “test” dive to determine whether acclimation occurred. Experiments were divided into two phases. Phase 1 rats were exposed to daily acclimation dives of hyperbaric air for 30 min followed by rapid decompression on one of the following regimens: 70 ft of seawater (fsw) for 9 days (L70), 70 fsw for 4 days (S70), 40 fsw for 9 days (L40), 40 fsw for 4 days (S40), or unpressurized sham exposure for 9 days (Control). On the day following the last exposure, all were subjected to a “test” dive (175 fsw, 60 min, rapid decompression). Both L70 and S70 rats had significantly lower incidences of DCS than Control rats (36% and 41% vs. 62%, respectively). DCS incidences for the other regimens were lower than in Control rats but without statistical significance. Phase 2 used the most protective regimen from phase 1 (L70); rats were exposed to L70 or a similar regimen with a less stressful staged decompression. Another group was exposed to a single acclimation dive (70 fsw/30 min) on the day before the test dive. We observed a nonsignificant trend for the rapidly decompressed L70 dives to be more protective than staged decompression dives (44% vs. 51% DCS incidence). The single acclimation dive regimen did not provide protection. We conclude that protection against DCS can be attained with acclimating exposures that do not themselves cause DCS. The deeper acclimation dive regimens (70 fsw) provided the most protection.


1973 ◽  
Vol 16 (1) ◽  
pp. 67-76 ◽  
Author(s):  
P. B. O'Donovan ◽  
M. B. Ghadaki ◽  
R. D. Behesti ◽  
B. A. Saleh ◽  
D. H. L. Rollinson

SUMMARYNinety-three Kellakui fat-tailed single lambs were assigned after birth to a 2×2×2 factorial experiment; 46 were uncastrated males and 47 were females. About half the lambs of each sex were docked before they were 1 week old. Half the lambs had unrestricted milk from the ewes until 115 days of age (phase 1) and the other half received all the ewes' milk for the first 30 days and then about one-third of the milk until weaning at 60 days. Creep feed was avail-able to all lambs from about 3 weeks of age, in addition to 200 g of alfalfa dry matter per lamb daily. From 115 days of age, all lambs were fed on a standard fattening ration until slaughtered at weights of 46 to 49 kg for males and 35 to 38 kg for females (phase 2).Lambs given unrestricted milk were 7·4 kg heavier than restricted lambs at the end of phase 1. Significantly better gains due to docking were observed only for females during phase 2. There was little indication that docking affected feed conversion efficiency. In docked lambs the fat normally deposited in the tail was partially (less than 50%) relocated as subcutaneous plus intermuscular and internal fat. Lean meat percentages of carcasses were similar for docked and control treatments. There is a need to standardize reporting of results from docking experiments to make valid comparisons.


2020 ◽  
Author(s):  
Leigh-Ann McCrum ◽  
Sinead Watson ◽  
Laura McGowan ◽  
Bernadette Mcguinness ◽  
Chris Cardwell ◽  
...  

Abstract Background: Older adults suffering partial tooth loss may need additional intervention strategies other than natural tooth replacement alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with natural tooth replacement, amongst partially dentate older adults. Methods: The design and development of the dietary intervention (Phase 1) consisted of analysis of the target population’s dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). The dietary intervention consisted of forming three healthy dietary habits around fruits and vegetables, wholegrains and healthy proteins. Feasibility of the intervention was then tested among older adults receiving natural tooth replacement in a small non-randomised single arm study (Phase 2). The principal feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Supporting outcomes consisted of feasibility of screening procedures; recruitment strategies; and retention/ attrition rates as well as the participant’s compliance to the intervention assessed through self-monitoring tracking sheets. Results: Twenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (Phase 1). Twelve themes related to barriers (e.g oral health, appetite) and facilitators (e.g nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (Phase 2) where eight themes were identified from feedback interview discussions. The principal outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a supporting outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention. Conclusion: Phase 1 and Phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention’s effectiveness. Trial registration: ISRCTN66118345


2021 ◽  
Vol 2 (4) ◽  
Author(s):  
J De Juan Baguda ◽  
M Pachon Iglesias ◽  
J J Gavira Gomez ◽  
V Martinez Mateo ◽  
M F Arcocha Torres ◽  
...  

Abstract Background The HeartLogic algorithm measures data from multiple implantable cardioverter-defibrillator-based (ICD) sensors and combines them into a single index. The associated alert has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation. Objective To analyze the association between HeartLogic alerts and clinical events and to describe the implementation in clinical practice of the algorithm for remote management of HF patients. Methods The association between HeartLogic alerts and clinical events has been analyzed in the blinded study Phase 1 (from ICD implantation to HeartLogic alert activation) and in the following unblinded Phase 2 and 3 (after HeartLogic activation). During Phase 1, patients were managed according to the standard clinical practice and physicians were blinded to the alert status. During Phase 2 physicians reacted to alerts according to their clinical practice, while during Phase 3 they followed a standardized protocol in response to alerts. Results We enrolled 288 patients who received HeartLogic-enabled ICD or CRT-D at 15 centers. 101 patients contributed to Phase 1. During a median observation period of 10 [95% CI: 5 – 19] months, the HeartLogic index crossed the alert-threshold value 73 times (0.72 alerts/patient-year) in 39 patients. 8 HF hospitalizations and 2 emergency room admissions occurred in 9 patients (0.10 events/patient-year) during HeartLogic IN alert state. Other 10 minor events (HF in-office visits and non-HF hospitalization) were associated with HeartLogic alerts. During the active phases 267 patients were observed for a median follow-up of 16 [95% CI: 15 – 22] months. 277 HeartLogic alerts (0.89 alerts/patient-year) occurred in 136 patients. Thirty-three HeartLogic alerts were associated with hospitalizations for HF or with HF death (n=6), and 46 alerts were associated with unplanned in-office visits for HF. In 78 cases, HeartLogic alerts were associated with other clinically relevant events. The rate of unexplained alerts was low (0.39 alerts/patient-year). During the active phases, one HF hospitalization and one unplanned in-office visit for HF occurred when patients were in OUT of alert state. Patient phone contacts or in-person assessments were performed more frequently in Phase 3 (85%) than in Phase 2 (73%; p=0.047), while alert-triggered actions were similar in the two phases. Most alerts in both Phases (82% in 2 and 81% in 3; p=0.861) were managed remotely. The total number of patient phone contacts performed during Phase 2 was 35 (0.65 contacts/patient-year) and during Phase 3 was 287 (1.12 contacts/patient-year; p=0.002). Conclusions HeartLogic index was frequently associated with HF-related clinical events, with a low rate of unexplained events. The HeartLogic alert and a standardize protocol of actions allowed to remotely detect impending decompensation events and to implement clinical actions with a low workload for the centers. Funding Acknowledgement Type of funding sources: None.


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