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96 Feasibility Trial of a Mobile Health Intervention for Dementia Caregivers
- Taylor R Maynard, Shehjar Sadhu, Dhaval Solanki, Kunal Mankodiya, Jennifer Davis, Lisa Uebelacker, Brian R Ott, Geoffrey Tremont
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 498-499
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Objective:
There are numerous adverse health outcomes associated with dementia caregiving, including increased stress and depression. Caregivers often face time-related, socioeconomic, geographic, and pandemic-related barriers to treatment. Thus, implementing mobile health (mHealth) interventions is one way of increasing caregivers’ access to supportive care. The objective of the current study was to collect data from a 3-month feasibility trial of a multicomponent mHealth intervention for dementia caregivers.
Participants and Methods:40 community-dwelling dementia caregivers were randomized to receive the CARE-Well (Caregiver Assessment, Resources, and Education) App or internet links connected to caregiver education, support, and resources. Caregivers were encouraged to use the App or links at least 4 times per week for 3 months. The App consisted of self-assessments, caregiver and stress reduction education, behavior problem management, calendar reminders, and online social support. Caregivers completed measures of burden, depression, and desire to institutionalize at baseline and post-intervention. Feasibility data included App usage, retention and adherence rates, and treatment satisfaction. Data were analyzed via descriptive statistics.
Results:Caregivers were mostly white (95%), female (68%), in their mid-60s, (M= 66.38, SD= 10.64), and well-educated (M= 15.52 years, SD= 2.26). Caregivers were mainly spouses (68%) or adult children (30%). Care recipients were diagnosed with mild (60%) or moderate (40%) dementia, with 80% diagnosed as having Alzheimer’s disease. Overall, the study had an 85% retention rate (80% for App group; 90% for links group). 58% of caregivers in the App group were considered high users, using the App >120 minutes over the course of 3 months (M= 362.42, SD= 432.68), and an average of 16.44 days (SD= 15.51). 15% of the sample was non-adherent due to time constraints, disinterest, and/or technology issues. Most participants (75%) using the App were mostly or very satisfied, about 87% would be likely or very likely to seek similar programs in the future, and 93% found the App mostly or very understandable. Groups did not significantly differ on clinical outcomes, although the study was not powered for an efficacy analysis. Within groups analysis revealed significant increases in depressive symptoms at post-treatment for caregivers in both groups.
Conclusions:This study demonstrated initial feasibility of the CARE-Well App for dementia caregivers. App use was lower than expected, however, high satisfaction, ease of use, and willingness to use similar programs in the future were endorsed. Some caregivers did not complete the intervention due to caregiving responsibilities, general disinterest, and/or technology issues. Although the study was not designed to assess clinical outcomes, we found that both groups reported higher depressive symptoms at post-treatment. This finding was unexpected and might reflect pandemic-related stress, which has been shown to particularly impact dementia caregivers. Future studies should address the efficacy of multicomponent mHealth interventions for dementia caregivers and the effects of increased dose on clinical outcomes. mHealth interventions should be refined to cater to varying levels of technology literacy among caregivers, and further research should aim to better integrate interventions into caregivers’ routines to enhance treatment engagement.
Epidemiological and Molecular Characterization of Clostridioides difficile Infection in Canadian Outpatient Settings, 2015–2019
- CNISP PHAC, Anada Silva, Nisha Thampi, Kelly Baekyung Choi, Linda Pelude, Charles Frenette, Blanda Chow, Control, Bonita Lee, s Hospital, Geoffrey Taylor, Susy Hota, Jennie Johnstone, Gerald Evans, Yves Longtin, Ian Davis, Joanne Langley, Jeannette Comeau, Michelle Science, Alice Wong, Dominik Mertz, Kathryn N. Suh, Pamela Kibsey, Jun Chen Collet, Jocelyn Srigley, Ghada Al-Rawahi, Paula Stagg, Jessica Minion, Appelle Health Region, Guanghong Han
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s472-s473
- Print publication:
- October 2020
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Background: Healthcare services are increasingly shifting from inpatient to outpatient settings. Outpatient settings such as emergency departments (EDs), oncology clinics, dialysis clinics, and day surgery often involve invasive procedures with the risk of acquiring healthcare-associated infections (HAIs). As a leading cause of HAI, Clostridioides difficile infection (CDI) in outpatient settings has not been sufficiently described in Canada. The Canadian Nosocomial Infection Surveillance Program (CNISP) aims to describe the epidemiology, molecular characterization, and antimicrobial susceptibility of outpatient CDI across Canada. Methods: Epidemiologic data were collected from patients diagnosed with CDI from a network of 47 adult and pediatric CNISP hospitals. Patients presenting to an outpatient setting such as the ED or outpatient clinics were considered as outpatient CDI. Cases were considered HAIs if the patient had had a healthcare intervention within the previous 4 weeks, and they were considered community-associated if there was no history of hospitalization within the previous 12 weeks. Clostridioides difficile isolates were submitted to the National Microbiology Laboratory for testing during an annual 2-month targeted surveillance period. National and regional rates of CDI were stratified by outpatient location. Results: Between January 1, 2015, and June 30, 2019, 2,691 cases of outpatient-CDI were reported, and 348 isolates were available for testing. Most cases (1,475 of 2,691, 54.8%) were identified in outpatient clinics, and 72.8% (1,960 of 2,691) were classified as community associated. CDI cases per 100,000 ED visits were highest in 2015, at 10.3, and decreased to 8.1 in 2018. Rates from outpatient clinics decreased from 3.5 in 2016 to 2.7 in 2018 (Fig. 1). Regionally, CDI rates in the ED declined in Central Canada and increased in the West after 2016. Rates in outpatient clinics were >2 times higher in the West compared to other regions. RT027 associated with NAP1 was most common among ED patients (26 of 195, 13.3%), whereas RT106 associated with NAP11 was predominant in outpatient clinics (22 of 189, 11.6%). Overall, 10.4% of isolates were resistant to moxifloxacin, 0.5% were resistant to rifampin, and 24.2% were resistant to clindamycin. No resistance was observed for metronidazole, vancomycin, or tigecycline. Compared to CNISP inpatient CDI data, outpatients with CDI were younger (51.8 ± 23.3 vs 64.2 ± 21.6; P < .001), included more females (56.4% vs 50.9%; P < .001), and were more often treated with metronidazole (63.0% vs 56.1%; P < .001). Conclusions: For the first time, CDI cases identified in outpatient settings were characterized in a Canadian context. Outpatient CDI rates are decreasing overall, but they vary by region. Predominant ribotypes vary based on outpatient location. Outpatients with CDI are younger and are more likely female than inpatients with CDI.
Funding: None
Disclosures: Susy Hota reports contract research for Finch Therapeutics.
A Growing Concern: The Emergence and Dissemination of Carbapenemase-producing Enterobacterales (CPE) in Canada
- Robyn Mitchell, Laura Mataseje, David Boyd, Ghada Al-Rawahi, Ian Davis, Chelsey Ellis, Joanne Embree, Susy Hota, Pamela Kibsey, pital Maisonneuve-Rosemont, Jerome Leis, Allison McGeer, Jessica Minion, Appelle Health Region, Michael Mulvey, Sonja Musto, Linda Pelude, Jocelyn Srigley, Stephanie Smith, Kathryn N. Suh, Geoffrey Taylor, Nisha Thampi, Titus Wong, Kevin Katz, CNISP PHAC
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, p. s454
- Print publication:
- October 2020
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Background: Carbapenemase-producing Enterobacterales (CPE) have rapidly become a global health concern and are associated with substantial morbidity and mortality due to limited treatment options. Travel to endemic areas, especially healthcare exposure in these areas, is an important risk factor for acquisition. We describe the evolving epidemiology, molecular features, and outcomes of CPE in Canada through surveillance by the Canadian Nosocomial Infection Surveillance Program (CNISP). Methods: CNISP has conducted surveillance for CPE among inpatients and outpatients of all ages since 2010. Participating acute-care facilities submit eligible specimens to the National Microbiology Laboratory for detection of carbapenemase production, and epidemiological data are collected. Incidence rates per 10,000 patient days are calculated based on inpatient data. Results: In total, 59 CNISP hospitals in 10 Canadian provinces representing 21,789 beds and 6,785,013 patient days participated in this surveillance. From 2010 to 2018, 118 (26%) CPE-infected and 547 (74%) CPE-colonized patients were identified. Few pediatric cases were identified (n = 18). Infection incidence rates remain low and stable (0.02 per 10,000 patient days in 2010 to 0.03 per 10,000 patient days in 2018), and colonization incidence rates have increased by 89% over the surveillance period. Overall, 92% of cases were acquired in a healthcare facility: 61% (n = 278) in a Canadian healthcare facility and 31% (n = 142) in a healthcare facility outside Canada. Of the 8% of cases not acquired in a healthcare facility, 50% (16 of 32) reported travel outside of Canada in the 12 months prior to positive culture. The distribution of carbapenemases varied by region; New Delhi metallo-B-lactamase (NDM) was dominant (59%) in western Canada and Klebsiella pneumoniae carbapenemase (KPC) (66%) in central Canada. NDM and class D carbapenemase OXA-48 were more commonly identified among those who traveled outside of Canada, whereas KPC was more commonly identified among patients without travel. In addition, 30-day all-cause mortality was 14% (25 of 181) among CPE infected patients and 32% (14 of 44) among those with bacteremia. Conclusions: CPE rates remain low in Canada; however, national surveillance data suggest that the increase in CPE in Canada is now being driven by local nosocomial transmission as well as travel and healthcare within endemic areas. Changes in screening practices may have contributed to the increase in colonizations; however, these data are currently lacking and will be collected moving forward. These data highlight the need to intensify surveillance and coordinate infection control measures to prevent further spread of CPE in Canadian acute-care hospitals.
Funding: None
Disclosures: Susy Hota reports contracted research for Finch Therapeutics. Allison McGeer reports funds to her institution for projects for which she is the principal investigator from Pfizer and Merck, as well as consulting fees from the following companies: Sanofi-Pasteur, Sunovion, GSK, Pfizer, and Cidara.
TEM Study of MoOx/Ni and MoOx/Al Contacts for Silicon Solar Cells
- Haider Ali, Geoffrey Gregory, Kristopher O. Davis
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- Journal:
- Microscopy and Microanalysis / Volume 25 / Issue S2 / August 2019
- Published online by Cambridge University Press:
- 05 August 2019, pp. 2116-2117
- Print publication:
- August 2019
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TEM studies of hole-selective molybdenum oxide contacts in silicon heterojunction solar cells
- Haider Ali, Geoffrey Gregory, Martin Bivour, Matthew Schneider, Martin Hermle, Kristopher O. Davis
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- Journal:
- Microscopy and Microanalysis / Volume 24 / Issue S1 / August 2018
- Published online by Cambridge University Press:
- 01 August 2018, pp. 1508-1509
- Print publication:
- August 2018
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Acceptance and valued living as critical appraisal and coping strengths for caregivers dealing with terminal illness and bereavement
- Esther L Davis, Frank P. Deane, Geoffrey C.B. Lyons
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- Journal:
- Palliative & Supportive Care / Volume 13 / Issue 2 / April 2015
- Published online by Cambridge University Press:
- 30 April 2014, pp. 359-368
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Objective:
Informal caregivers of palliative care patients play an essential role in the coordination of care for patients during their final phases of life. However, undertaking a caregiving role can have enduring psychological consequences for caregivers and interfere with functioning. Studies have investigated a variety of factors associated with individual differences in caregiver psychosocial outcomes, but little is known about their relative impact, and there is a need for guiding models to support research in this area.
Method:A review of the literature was conducted on factors influencing the psychological distress and grief of caregivers. Drawing from acceptance and commitment therapy (ACT) and Stroebe and colleagues' integrative risk factor framework, we developed a process model to describe individual differences in caregiver psychological distress and grief.
Results:The model presents caregiver psychological distress and grief as functions of death attitudes and communication about death and dying, mediated by acceptance and valued living from an ACT perspective. An outline of the empirical and theoretical underpinnings for each component in the model is provided.
Significant of results:The presented model is an inherently strengths-based model that is concordant with acceptance- and values- (ACT) based interventions to facilitate coping in caregivers.
Notes on contributors
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- By Bas Aarts, Alexander Bergs, Douglas Biber, Jill Bowie, Marcus Callies, Joanne Close, Mark Davies, Bethany Gray, Thomas Hoffmann, Stig Johansson, Gunther Kaltenböck, Manfred Krug, Geoffrey Leech, Magnus Levin, José Ramón Varela Pérez, Meike Pfaff, Ole Schützler, Nicholas Smith, Sali A. Tagliamonte, Sean Wallis, Christopher Williams
- Edited by Bas Aarts, University College London, Joanne Close, University of Chester, Geoffrey Leech, Lancaster University, Sean Wallis, University College London
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- The Verb Phrase in English
- Published online:
- 05 February 2013
- Print publication:
- 14 February 2013, pp xx-xxvi
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SANS/WANS Time-resolving Neutron Scattering Studiesof Polymer Phase Transitions Using NIMROD
- Geoffrey Robert Mitchell, Daniel Bowron, Artur Mateus, Paulo Bartolo, Thomas Gkourmpis, Khamphee Phomphrai, Daniel Lopez, Fred Davis
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1528 / 2013
- Published online by Cambridge University Press:
- 19 March 2013, mrsf12-1528-vv06-04
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- 2013
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We use new neutron scattering instrumentation to follow in a single quantitative time-resolving experiment, the three key scales of structural development which accompany the crystallisation of synthetic polymers. These length scales span 3 orders of magnitude of the scattering vector. The study of polymer crystallisation dates back to the pioneering experiments of Keller and others who discovered the chain-folded nature of the thin lamellae crystals which are normally found in synthetic polymers. The inherent connectivity of polymers makes their crystallisation a multiscale transformation. Much understanding has developed over the intervening fifty years but the process has remained something of a mystery. There are three key length scales. The chain folded lamellar thickness is ∼ 10nm, the crystal unit cell is ∼ 1nm and the detail of the chain conformation is ∼ 0.1nm. In previous work these length scales have been addressed using different instrumention or were coupled using compromised geometries. More recently researchers have attempted to exploit coupled time-resolved small-angle and wide-angle x-ray experiments. These turned out to be challenging experiments much related to the challenge of placing the scattering intensity on an absolute scale. However, they did stimulate the possibility of new phenomena in the very early stages of crystallisation. Although there is now considerable doubt on such experiments, they drew attention to the basic question as to the process of crystallisation in long chain molecules. We have used NIMROD on the second target station at ISIS to follow all three length scales in a time-resolving manner for poly(e-caprolactone). The technique can provide a single set of data from 0.01 to 100Å-1 on the same vertical scale. We present the results using a multiple scale model of the crystallisation process in polymers to analyse the results.
Performing South Africa's Truth Commission: Stages of Transition. By Catherine M. Cole. Bloomington and Indianapolis: Indiana University Press, 2010. Pp. xviii + 227 + 10 illus. $65 Hb; $24.95 Pb.
- Geoffrey V. Davis
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- Journal:
- Theatre Research International / Volume 37 / Issue 2 / July 2012
- Published online by Cambridge University Press:
- 03 May 2012, pp. 195-196
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- July 2012
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6 - The plate mode of convection
- Geoffrey F. Davies, Australian National University, Canberra
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- Mantle Convection for Geologists
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- 03 May 2011
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Summary
Mechanical properties change with temperature, from brittle plate to yielding mantle and back. This strongly affects their dynamical behaviour and their influence on convection. Plates organise the flow. Internal heating versus bottom heating also affects the form of convection. The plate cycle (formation, cooling, subduction, reabsorption) is convection. The plate mode of mantle convection transports a large fraction of Earth's heat budget. Seafloor topography and heat flow can be quantitatively explained with remarkable success.
The convection theory developed in the previous chapter applies to many forms of convection, and it seems to apply reasonably well to mantle convection, but with some important qualifications. Mantle convection takes distinctive forms that in some ways are quite unlike familiar examples of convection such as occur in familiar kinds of fluid. The main reason for the differences is that the mechanical behaviour of mantle rocks changes quite dramatically between the temperature at the Earth's surface and the temperature within the mantle.
The strong lithosphere
The temperature dependence of viscosity shown in Figure 4.4 tells us that reducing the temperature from 1300 °C to 1000 °C will increase the viscosity of mantle rocks by as much as three orders of magnitude – a factor of 1000. However, if the mantle rocks are much cooler than that, they cease to deform like a viscous fluid. Through an intermediate range of temperature they develop ductile shear zones, so that the deformation is concentrated in relatively narrow zones instead of occurring uniformly through the fluid.
Frontmatter
- Geoffrey F. Davies, Australian National University, Canberra
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2 - Context
- Geoffrey F. Davies, Australian National University, Canberra
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Summary
Basic concepts and primary observations. Defining the crust, mantle and core. Distinguishing crust from lithosphere, continents from ocean basins. The distribution of topography and heat flux over the sea floor.
Mantle convection occurs, remarkably enough, in the Earth's mantle. It is affected by the crust, and part of the lithosphere plays a major role. There are peculiarities near the boundary of the mantle with the core that may significantly affect mantle convection, and that certainly tell us some important things about mantle convection. To discuss our subject sensibly, we had better be clear what all these terms refer to: mantle, crust, core, lithosphere and so on. That is one thing this chapter is about. There are also important constraints on mantle convection to be had from the form of the Earth's topography, and from the geographic variation of heat flow from the Earth's interior. These will also be summarised.
Crust, mantle, core
The major division of the Earth's interior is into crust, mantle and core. The boundaries between these regions were detected seismologically, in other words using the internal elastic waves generated by earthquakes, which are detected as they emerge at the Earth's surface. The variation of seismic velocities, and density, with depth in the Earth is shown in Figure 2.1. The boundary between the mantle and the core is at a depth of about 2900 km, where the seismic velocities drop, the shear velocity is zero and the density jumps.
References
- Geoffrey F. Davies, Australian National University, Canberra
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Appendix B - Thermal evolution details
- Geoffrey F. Davies, Australian National University, Canberra
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Mantle Convection for Geologists
- Geoffrey F. Davies
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Mantle convection is the fundamental agent driving many of the geological features observed at the Earth's surface, including plate tectonics and plume volcanism. Yet many Earth scientists have an incomplete understanding of the process. This book describes the physics and fluid dynamics of mantle convection, explaining what it is, how it works, and how to quantify it in simple terms. It assumes no specialist background: mechanisms are explained simply and the required basic physics is fully reviewed and explained with minimal mathematics. The distinctive forms that convection takes in the Earth's mantle are described within the context of tectonic plates and mantle plumes, and implications are explored for geochemistry and tectonic evolution. Common misconceptions and controversies are addressed - providing a straightforward but rigorous explanation of this key process for students and researchers across a variety of geoscience disciplines.
7 - The plume mode of convection
- Geoffrey F. Davies, Australian National University, Canberra
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Summary
How were plumes conceived? Is there evidence for plumes at the Earth's surface? Hotspot tracks. Inevitable plumes? Hotspot swells, heat and mass transport by the plume mode. Degree of melting. Favoured forms of upwelling and the role of temperature dependence of viscosity. Heads and tails – flood basalts, connecting tracks. Melt production from plume heads, and relation to flood basalts. Irregularities, misfits, puzzles and possibilities – the simple thermal model doesn't explain everything. Thermochemical plumes may account for much of the irregularity.
Scattered across the sea floor are many submarine ridges, seamounts and plateaus (Figure 2.4). These are not obviously related to plate tectonics, as are the mid-ocean ridges and deep ocean trenches. Some of these edifices reach above sea level to form islands. In Chapter 3 I recounted how Tuzo Wilson built on the observations of Darwin and Dana, who had discerned an apparent age progression along island chains in the Pacific, from volcanically active islands through eroded islands to atolls marking where an island had been eroded to sea level. The classic example is the Hawaiian island chain, shown in Figure 7.1. As well as the islands, there is a long chain of seamounts extending to the northwest. There is also a broad swell in the sea floor around the Hawaiian chain. These observations give us important information about processes in the mantle.
1 - Introduction
- Geoffrey F. Davies, Australian National University, Canberra
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Summary
Mantle convection is the fundamental agent driving most geology, yet many geologists still have only vague ideas about what mantle convection is, how it works and how it might inform their specialty. Because it is so fundamental, the better every geologist understands mantle convection, the better scientist he or she is likely to be. Of course, not everything is affected by mantle convection, but only by being well informed will a geologist recognise when it is relevant, and what that relevance is.
Misconceptions about mantle convection also seem still to be quite widespread. Some aspects of mantle convection are debated. Much of that debate concerns refinements, so the debate is quite legitimate, but some of the debate is based on misconceptions or incomplete understanding of current theories or observations. The latter debate is not productive. This is not to claim that alternative versions are inconceivable, but just to note that debaters need to be informed about the theories they wish to challenge if they are to make useful contributions.
For these reasons it seems worthwhile to offer an account of our current understanding of mantle convection in terms that are reasonably accessible to most geologists. That means the account should be fairly short, and there should be little mathematics beyond basic algebra and arithmetic. Nor should a strong grasp of physics be assumed, and such physics as is required (notably heat conduction and viscous fluid flow) should be explained in simple and reasonably familiar terms.
Contents
- Geoffrey F. Davies, Australian National University, Canberra
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- Mantle Convection for Geologists
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