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One-on-one structured Montessori-based activities conducted with people with dementia can improve agitation and enhance engagement. These activities may however not always be implemented by nursing home staff. Family members may present an untapped resource for enabling these activities. This study aimed to evaluate the impact of the Montessori activities implemented by family members on visitation experiences with people who have dementia.
Cluster-randomized crossover design.
General and psychogeriatric nursing homes in the state of Victoria, Australia.
Forty participants (20 residents and 20 carers) were recruited.
During visits, family members interacted with their relative either through engaging in Montessori-based activities or reading a newspaper (the control condition) for four 30-minute sessions over 2 weeks.
Residents’ predominant affect and engagement were rated for each 30-second interval using the Philadelphia Geriatric Center Affect Rating Scale and the Menorah Park Engagement Scale. The Pearlin Mastery Scale was used to rate carers satisfaction with visits. The 15-item Mutuality Scale measured the carers quality of their relationship with the resident. Carers’ mood and overall quality of life were measured using the Center for Epidemiological Studies Depression Scale and Carer-QoL questionnaires, respectively.
Linear regressions within the generalized estimating equations approach assessed residents’ and carers’ outcomes. Relative to the control condition, the Montessori condition resulted in more positive engagement (b = 13.0, 95%CI 6.3–19.7, p < 0.001) and affect (b = 0.4, 95%CI 0.2–0.6, p < 0.001) for the residents and higher satisfaction with visits for carers (b = 1.7, 95%CI 0.45–3.00, p = 0.008). No correction was applied to p-values for multiple comparisons.
This study strengthens the evidence base for the use of the Montessori programs in increasing well-being in nursing home residents. The findings also provide evidence that family members are an additional valuable resource in implementing structured activities such as the Montessori program with residents.
Estimating population abundances and patterns of change over time are important in both ecology and conservation. Trend assessment typically entails fitting a regression to a time series of abundances to estimate population trajectory. However, changes in abundance estimates from year-to-year across time are due to both true variation in population size (process variation) and variation due to imperfect sampling and model fit. State-space models are a relatively new method that can be used to partition the error components and quantify trends based only on process variation. We compare a state-space modelling approach with a more traditional linear regression approach to assess trends in uncorrected raw counts and detection-corrected abundance estimates of forest birds at Hakalau Forest National Wildlife Refuge, Hawai‘i. Most species demonstrated similar trends using either method. In general, evidence for trends using state-space models was less strong than for linear regression, as measured by estimates of precision. However, while the state-space models may sacrifice precision, the expectation is that these estimates provide a better representation of the real world biological processes of interest because they are partitioning process variation (environmental and demographic variation) and observation variation (sampling and model variation). The state-space approach also provides annual estimates of abundance which can be used by managers to set conservation strategies, and can be linked to factors that vary by year, such as climate, to better understand processes that drive population trends.
Background: Increasingly more attention has been paid to non-pharmacological interventions as treatment of agitated behaviors that accompany dementia. The aim of the current study is to test if personalized one-to-one interaction activities based on Montessori principles will improve agitation, affect, and engagement more than a relevant control condition.
Methods: We conducted a randomized crossover trial in nine residential facilities in metropolitan Melbourne, Australia (n = 44). Personalized one-to-one activities that were delivered using Montessori principles were compared with a non-personalized activity to control for the non-specific benefits of one-to-one interaction. Participants were observed 30 minutes before, during, and after the sessions. The presence or absence of a selected physically non-aggressive behavior was noted in every minute, together with the predominant type of affect and engagement.
Results: Behavior counts fell considerably during both the Montessori and control sessions relative to beforehand. During Montessori activities, the amount of time spend actively engaged was double compared to during the control condition and participants displayed more positive affect and interest as well. Participants with no fluency in English (all from non-English speaking backgrounds) showed a significantly larger reduction in agitation during the Montessori than control sessions.
Conclusion: Our results show that even non-personalized social contact can assist in settling agitated residents. Tailoring activities to residents’ needs and capabilities elicit more positive interactions and are especially suitable for people who have lost fluency in the language spoken predominantly in their residential facility. Future studies could explore implementation by family members and volunteers to avoid demands on facilities’ resources.
Trial Registration: Australian New Zealand Clinical Trials Registry – ACTRN12609000564257.
We estimated the vaccine effectiveness (VE) of trivalent and monovalent influenza vaccines, respectively, against laboratory-confirmed influenza infections in patients with influenza-like illness who visited physicians participating in the Bayern Influenza Sentinel in Bavaria, Germany during 2010/2011. Swab specimens were analysed for influenza A(H1N1)pdm09, A(H3) and B by PCR. VE was estimated using the test-negative case-control study design and logistic regression. In total, 1866 patients (790 cases, 1076 controls) were included. The VE of trivalent vaccines administered in season 2010/2011 against laboratory-confirmed infection with any influenza virus, adjusted for age group, sex, chronic illness and week of arrival of the specimen, was 67·8% [95% confidence interval (CI) 39·2–82·9)]. The adjusted VE of monovalent influenza vaccines administered in season 2009/2010 against laboratory-confirmed influenza A(H1N1)pdm09 infection in 2010/2011 was 38·6% (95% CI −70·0 to 77·8). This is the first VE study conducted in Bavaria. We concluded that the trivalent influenza vaccines were effective in our study population.
Canteens are known to be promising settings for activities to promote intake of fruits and vegetables, but it remains unclear to what extent distributing free fruits and vegetables can influence dietary patterns of customers. The present study evaluated the effect of providing fruits and vegetables for free in a university canteen on the daily diet of university canteen customers. Canteen customers (n 209) were randomly allocated to a fruit and vegetable group (FVG) and a control group (CG). FVG participants were given two portions of fruits and one portion of vegetables for free at lunchtime. Food and beverage intake was measured using a dietary record for 3 d and dietary quality was appraised using a comprehensive scoring system. The FVG participants ate 80 g more fruits (P < 0·01) and 108 g more vegetables (P < 0·001) on a daily basis compared with the CG participants. No differences were found for energy density, total energy, Na and energy from fat between the groups per day. A higher intake of fruits and vegetables was observed at lunch and of vegetables during the dinner and evening snacks. The FVG participants were more likely to comply with dietary recommendations for fruits and vegetables and had a better dietary profile on the study days and for the lunch consumed on those days. The results of the present study demonstrate how modifications of a canteen lunch can be instrumental to enhance the nutritional quality of lunch as well as the overall quality of the diet of the customers.
To evaluate the nutritional profile of a lunch offered and consumed in a university canteen in Belgium.
The qualitative and quantitative content of 4365 meals theoretically available and 330 meals consumed was recorded during five weekdays spread over three weeks. Meal combinations were evaluated using a scoring system based on recommendations for Na content, energy from fat, and fruit and vegetable portions.
University canteen in Belgium.
Only a 5 % of the meal combinations available and consumed complied with the three basic dietary recommendations for a hot lunch. The nutritional profile of the meals consumed was in line with that of the meals available.
Our results show how the nutritional profile of what is eaten is largely determined by what is offered. To ensure overall compliance with dietary recommendations, considerable changes on the supply side, i.e. an increase in fruit and vegetable portions and a reduction in salt and fat of the lunch, are needed first in our setting. Our assessment provides baseline data to pilot a nutrient profiling intervention and shows how a nutrient profiling system can be used for meal evaluation purposes.
A community-based, randomized, placebo-controlled, double-blind trial was conducted from March 2001 to March 2002 in Kilosa, a rural district of Morogoro Region in Tanzania. One hundred and fifty-eight infants were selected randomly from lists of local Maternal and Child Health Care Centres and received either processed complementary food (PCF) or unprocessed complementary food (UPCF) from age 6 to 12 months. Processing increased Zn solubility and energy density of the porridge prepared from the complementary food (CF) as determined in vitro. Phytate:Zn molar ratio of the PCF and UPCF was 25·8 and 47·5, respectively. Under the study conditions, the processing of CF did not improve Zn status as measured by hair analysis. No significant correlations were found between hair Zn values and anthropometric measurements. Our findings suggest that processing alone of cereal-based CF may be insufficient to ensure an adequate supply of Zn to improve growth and Zn status of infants. Dietary modification to tackle Zn deficiencies in similar target groups may therefore only be successful when other Zn-rich foods such as meat and fish are included.
This note offers an answer to the problem of apparent disorder in Book 2 of Propertius by disclosing a principle of order that underlies it. The observations that follow tend to confirm the internal unity of some elegies, to indicate the divisions to be perceived at some points between one elegy and the next, and to suggest the probability or otherwise of some conjectured transpositions. They may also aid interpretation by suggesting what movement within an elegy was intended by the poet to be felt.
The area of observation has been restricted to Elegies 1–25 because it is possible to show that within that area an identifiable principle of composition has been applied consistently. It cannot be assumed without further consideration that a principle found to be applicable within the defined area is applicable outside it, even in this book, still less in the other books of the Elegies.
The writer purports to be conversing with the door of a house, now owned by a man named Caecilius, which is alleged to have harboured a scandal in the time of its previous occupants. For this the speaker reproaches the door, as having through negligence been partly responsible. The door replies (beginning at line 9) that it is wholly innocent in the matter; but people lay blame on it for everything that is done amiss. Line 12, in the door's speech, is obviously corrupt, and the greater part of it is obelized by editors accordingly.
Since the discovery of high critical temperature superconducting oxides, an important factor potentially limiting their technological application has been the typically low value of the critical current density that they can carry. Here are presented the results of a transmission electron microscopy study of sintered YBa2Cu3O7−x aimed primarily at the characterization of those elements of the microstructure responsible for the poor current-carrying capacity in the superconducting state. The observations are further discussed in relation both to the flux pinning characteristics required and to the prospect for controlling the microstructure in order to optimize the properties of this material for technological development.
Data which describe the unidirectional spreading of several pure oils and oilsurfactant mixtures on water in the surface-tension regime are reported. Leadingedge position and profiles of velocity, thickness and film tension are given as functions of time. The data are consistent with the numerical similarity solution of Foda & Cox (1980), although the measured dependence of the film tension on the film thickness often differs from the equilibrium relationship. The configuration of the oil film near the spreading origin may be either a coherent multimolecular layer or a multitude of thinning, outward-moving lenses surrounded by monolayer. The pure oils show an acceleration zone connecting the slow-moving inner region to a fast-moving outer region, while the oil-surfactant mixtures show a much more gradual increase in film velocity.
In the event that nuclear fuel from light water reactors (LWR) is reprocessed to reclaim the uranium or plutonium, several analytical techniques will be used for product accountability. Generally, the isotopic content of both the plutonium and uranium in the reprocessed product will have to be accurately determined. One plan for the reprocessing of LWR spent fuel incorporates the following scheme. After separation from both the fission products and transplutonium actinides (including neptunium and americium), part of the uranium and all of the plutonium in a nitrate solution will merge together to form a coprocessed stream. This solution will be concentrated by evaporation and sent to a hold tank for accountability. Input concentrations into the hold tank could be up to 350 g U/ℓ and nearly 50 g Pu/ℓ. The variation to be expected in these concentrations is not known. The remaining uranium fraction will be further purified and sent to a separate storage tank. Its expected stream concentration will be about 60 g U/ℓ. These two relatively high actinide stream concentrations can be monitored rapidly, quantitatively, and nondestructively using the technique of energy-dispersive x-ray fluorescence analysis(XRFA).
The concentration of cortisol (F) has been found to decrease only to a limited extent in intact brain tissue maintained at ambient temperature after death, and the decrease is mainly accounted for as 20-dihydrocortisols (DHF). The sum of F and DHF has therefore been estimated in samples of frontal cortex removed from human cadaver brains collected at necropsy, and taken as a measure of the concentration of cortisol at death. Corticosterone concentration was also estimated. The concentration of cortisol in the cerebral cortex of physically healthy individuals who had committed suicide was consistently as low or lower than in the cortex of control patients who had died suddenly without antecedent severe illness. It is concluded therefore that neither the presumed severe emotional stress preceding suicide nor depressive illness itself is associated with high levels of cortisol in the cerebral cortex. On the other hand, it was found that the cerebral cortical concentration of cortisol in patients who had died from stressful somatic diseases was raised and that the increase was roughly related to the likely degree and duration of the physical stress endured by the patients. There was some indication that the ratio of cortisol (F+DHF) to corticosterone may be lower in the cerebral cortex of suicides than in that of controls.