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The vision for dementia-friendly communities is challenged by limited public awareness and stigma about dementia. The study aim was to elicit stakeholder priorities for the message content of an education program to improve dementia awareness among youth; specifically, what do children need to know about dementia?
A qualitative inquiry using interviews and focus groups was used. Purposive sampling achieved maximum variation in dementia experience and participant characteristics. Focus groups with Scouts in the community aged 9–12 years old (n = 22) used innovative techniques to explore children's attitudes towards people with dementia. Participants with personal experience of dementia were five people with early-stage dementia; 12 adult primary carers; four non-primary carers; and six grandchildren of a person with dementia. They were asked what is important for children to understand about dementia and what attitudes they may like an education program to confer. Content analysis was performed using NVivo10.
Strong themes to emerge were that children need to know the whole truth about dementia; that individuals with dementia are “still people,” that it is “not the fault” of the person with dementia; and that dementia is different and typically unpredictable for everyone. Discussions also indicated a need to educate children about ways to relate to a person with dementia, and to appreciate “positives” within a relationship.
Children are our future citizens. Developing an education program for children with this message content may be fundamental to de-stigmatizing dementia and laying the foundation to dementia-friendly communities.
Prescribed Disengagement® is the description of the post-diagnostic advice given to people after a diagnosis of dementia, which explicitly or implicitly suggests that the person should be slowing down or pulling back from activities. This results in isolation, loss of hope, self-esteem and self-identity, and threatens social health. This study aims to review whether Prescribed Disengagement® can be identified in the literature on subjective experiences of people living with early dementia.
A systematic search was performed. Inclusion criteria were original empirical qualitative studies published in English that addressed the subjective experiences of living with a diagnosis of objectively defined early dementia. Thematic synthesis was undertaken.
Thirty-five papers involving 373 participants were included. Following a diagnosis, people with dementia struggled with self-identity, independence, control and status, activities, stigma, and how to view the future. Reactions in these areas ranged from active and positive to negative and passive. Many studies reported participants’ dissatisfaction with the way the diagnosis was communicated. There was insufficient information provided about dementia and limited treatments and support offered. The diagnosis process and post-diagnostic support may have contributed to disempowerment of the person with dementia, made it more difficult to accept the diagnosis, and exacerbated negative views and self-stigma around dementia.
These results do not support the idea of Prescribed Disengagement®. However disengagement may have been implied during the diagnosis process and post-diagnostic support. Research is needed on how to improve the communication of dementia diagnosis and support people to live well post-diagnosis.
Existing literature suggests that mental health literacy is positively associated with mental health services utilization. Despite an aging population that faces significant mental health concerns in Korea, the role of mental health literacy on mental health services utilization is not known among older adults in Korea. This study aimed to (1) identify whether mental health literacy mediates the association between population characteristics and mental health services utilization and (2) identify an optimal path model for mental health services utilization among Korean older adults.
Using a cross-sectional survey with a quota sampling strategy, we collected and analyzed responses from 596 community-dwelling individuals ages 65 years and older. We used structural equation modeling (SEM) to estimate the effect of mental health literacy as a mediator.
When controlling for other relevant covariates in the optimal path model, mental health literacy mediated the relationships between three socio-demographic factors (education, general literacy, and health status) and mental health services utilization. The model fit index shows that the SEM fits very well (CFI = 0.92, NFI = 0.90, RMSEA = 0.07).
Efforts to improve mental health literacy through community-based education programs may need to particularly target Korean older adults with the relevant socio-demographic characteristics to enhance their utilization of appropriate mental health services.
Among domesticated traits, pre-harvest sprouting (PHS) caused by the early breakage of dormancy leads to severe economic losses. Therefore, regulating PHS is important for cereal crop improvement against changes in climate. In this study, we surveyed naturally occurring variations in seed germination in diverse rice germplasm for the available resources of this trait, and investigated the changes of abscisic acid (ABA) levels during grain development by the distinguished PHS-resistant groups. We discovered wide variations in germination among the 205 rice accessions examined and found that 90 accessions are resistant (germination <20%) to PHS. Tropical and subtropical accessions, which are subjected to long wet periods, are more resistant to PHS than the other accessions. We detected an increase in germination of detached seeds from the panicle compared with intact seeds in panicle at harvesting time. This might be attributed to a weakening of the mechanical barrier that prevents water imbibition and radical emergence. ABA levels were maximal at 10 d after flowering and decreased thereafter. Interestingly, PHS-susceptible accessions maintained higher or similar ABA levels compared with PHS-resistant accessions, suggesting that the key factors for seed dormancy and its breakage are ABA perception and signal transduction rather than total ABA content. The diversity of germination ability detected in this study could be sustainably used for crop improvement and to help unveil the genetic and physiological basis of this quantitative trait.
Polycyclic aromatic hydrocarbons (PAH) are common dietary exposures that cross the human placenta and are classified as a probable human carcinogen. The aim of the present study was to investigate the potential impact of exposure to PAH-containing meat consumed during pregnancy on birth outcomes.
Prospective birth cohort study. Only non-smoking women with singleton pregnancies, who were free from chronic disease such as diabetes and hypertension, were included in the study. Maternal consumption of PAH-rich meat was estimated through FFQ. Multiple linear regression was used to assess factors related to higher intake and the association between dietary PAH and birth outcomes.
Republic of Korea, 2006–2011.
Pregnant women (n 778) at 12–28 weeks of gestation enrolled in the Mothers and Children’s Environmental Health (MOCEH) study.
The multivariable regression model showed a significant reduction in birth weight associated with higher consumption level of foods rich in PAH, such as grilled or roasted meat, during pregnancy (β=−17·48 g, P<0·05 for every 1 point higher in meat score). Further adjusting for biomarkers of airborne PAH did not alter this association. There was no evidence that higher consumption level of PAH-rich meat shortens the duration of gestation (P=0·561). Regression models performed for birth length and head circumference produced negative effects that were not statistically significant.
Consumption of higher levels of barbecued, fried, roasted and smoked meats during pregnancy was associated with reduced birth weight. Dietary risk of PAH exposure in Korean women is of concern.
Depression is a common psychiatric disorder in older people. The study aimed to examine the screening accuracy of the Geriatric Depression Scale (GDS) and the Collateral Source version of the Geriatric Depression Scale (CS-GDS) in the nursing home setting.
Eighty-eight residents from 14 nursing homes were assessed for depression using the GDS and the CS-GDS, and validated against clinician diagnosed depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID) for residents without dementia and the Provisional Diagnostic Criteria for Depression in Alzheimer Disease (PDCdAD) for those with dementia. The screening performances of five versions of the GDS (30-, 15-, 10-, 8-, and 4-item) and two versions of the CS-GDS (30- and 15-item) were analyzed using receiver operating characteristic (ROC) curves.
Among residents without dementia, both the self-rated (AUC = 0.75–0.79) and proxy-rated (AUC = 0.67) GDS variations performed significantly better than chance in screening for depression. However, neither instrument adequately identified depression among residents with dementia (AUC between 0.57 and 0.70). Among the GDS variations, the 4- and 8-item scales had the highest AUC and the optimal cut-offs were >0 and >3, respectively.
The validity of the GDS in detecting depression requires a certain level of cognitive functioning. While the CS-GDS is designed to remedy this issue by using an informant, it did not have adequate validity in detecting depression among residents with dementia. Further research is needed on informant selection and other factors that can potentially influence the validity of proxy-based measures in the nursing home setting.
Pb is released from bone stores during pregnancy, which constitutes a period of increased bone resorption. A high Na intake has been found to be negatively associated with Ca and adversely associated with bone metabolism. It is possible that a high Na intake during pregnancy increases the blood Pb concentration; however, no previous study has reported on the relationship between Na intake and blood Pb concentration. We thus have investigated this relationship between Na intake and blood Pb concentrations, and examined whether this relationship differs with Ca intake in pregnant Korean women. Blood Pb concentrations were analysed in 1090 pregnant women at mid-pregnancy. Dietary intakes during mid-pregnancy were estimated by a 24 h recall method covering the use of dietary supplements. Blood Pb concentrations in whole-blood samples were analysed using graphite furnace atomic absorption spectrophotometry. Multiple regression analysis performed after adjustment for covariates revealed that maternal Na intake was positively associated with blood Pb concentration during pregnancy, but only when Ca intake was below the estimated average requirement for pregnant Korean women (P= 0·001). The findings of the present study suggest that blood Pb concentration during pregnancy could be minimised by dietary recommendations that include decreased Na and increased Ca intakes.
Zn is an essential element for human growth. The nutritional adequacy of dietary Zn depends not only on the total Zn intake, but also on the type of food source (i.e. of plant or animal origin). We investigated the association between maternal dietary Zn intake from animal and plant food sources and fetal growth. A total of 918 pregnant women at 12–28 weeks of gestation were selected from the Mothers and Children's Environmental Health study in Korea. Dietary intakes in mid-pregnancy were estimated by a 24 h recall method, and subsequent birth weight and height were obtained from medical records. Multiple regression analysis showed that maternal Zn intake from animal food sources and their proportions relative to total Zn intake were positively associated with birth weight (P = 0·034 and 0·045, respectively) and height (P = 0·020 and 0·032, respectively). Conversely, the percentage of Zn intake from plant food sources relative to total Zn intake was negatively associated with birth height (P = 0·026) after adjustment for covariates that may affect fetal growth. The molar ratio of phytate:Zn was negatively associated with birth weight (P = 0·037). In conclusion, we found that the absolute amounts of Zn from different food sources (e.g. animal or plant) and their proportions relative to total Zn intake were significantly associated with birth weight and height. A sufficient amount of Zn intake from animal food sources of a relatively higher Zn bioavailability is thus encouraged for women during pregnancy.
Determining valid zygosity is a basic and important requirement in a twin study, because misdiagnosing zygosity leads to biased results. The Healthy Twin Study has collected data from adult like-sex twins and their families since 2005. In the study, a questionnaire to determine zygosity was developed comprising four questions; one concerning the degree of resemblance, and three concerning the degree of confusion by the resemblance. Among 2,761 individuals (624 twin pairs) of twin and their families, 406 pairs of twins (mean age 38.3, 63.5% women) with both questionnaire and genotype information were selected to examine the validity of the zygosity questionnaire using 16 short tandem repeat markers. We first determined individual zygosity including undetermined category, and then decided the zygosity of a twin pair using a decision tree. Sensitivity of questionnaire diagnosis was 98.8% for monozygotic (MZ) and 88.9% for dizygotic (DZ) twins, and positive predictive value was 97.2% for MZ and 95.0% for DZ. When we compared correctly and wrongly diagnosed twin pairs, misdiagnosed DZ twins (nine pairs) showed striking similarity in stature or obesity even exceeding that of true MZ twins. Our finding suggests that a parsimonious questionnaire method of diagnosing the zygosity will be useful, and adding physical or physiological measurements to a questionnaire of zygosity diagnosis will either confound the correct diagnosis or reduce the efficiency of the study compared with using questionnaire alone or with introducing genotyping.
Cellulose electro-active paper (EAPap) has attracted much attention as a new smart electronic material to be utilized as mechanical sensors, bio compatible applications and wireless communications. The thin EAPap film has many advantages such as lightweight, flexible, dryness, biodegradable, easy to chemically modify, cheap and abundance. Also EAPap film has a good reversibility for mechanical performance, such as bending movement, under electric field. The main actuation mechanism governed by piezoelectric property can be modulated by material direction and stretching ratio during process. In this paper we present the overview as well as fabrication process of cellulose EAPap as a novel smart material. Also we propose the method to enhance the piezoelectricity, its mechanical and electromechanical properties. In addition, the fabrication of high quality metal patterns with Schottky diode on the cellulose surface is an initiating stage for the integration of the EAPap actuator and electronic components. The integration of flexible actuator and electronic elements has huge potential application including flying magic carpets, microwave driven flying insets and micro-robots and smart wall papers.
Multiaxial deformation of Zr55Al10Ni5Cu30 metallic glass was investigated by instrumented indentation tests with a spherical indenter. Contrary to the elastic–rigid-plastic behavior of bulk metallic glasses (BMGs), indentation pressure showed a significant increase with increasing indentation strain, and it was ascribed to a rapid transition of the plastic constraint factor (PCF). However, it was impossible to measure the PCF values from the indentation pressures in the Zr-based BMG because information on uniaxial flow stress was insufficient due to the limited flow strain of 2.2%. Here we developed a PCF assessment method using a relative residual depth hf/hmax, which was experimentally confirmed by adopting it to spherical indentations of a steel sample having well-known flow properties. Flow properties of the BMG were calculated using the new PCF assessment method, and the effects of the materials pileup and low strain indentations on PCF and flow properties were discussed.
Since in instrumented indentation the contact area is indirectly measured from the contact depth, the natural and unavoidable roughness of real surfaces can induce some errors in determining the contact area and thus in calculating hardness and Young's modulus. To alleviate these possible errors and evaluate mechanical properties more precisely, here a simple contact model that takes into account the surface roughness is proposed. A series of instrumented indentations were made on W and Ni samples whose surface roughness is intentionally controlled, and the results are discussed in terms of the proposed model.
Conventional nanoindentation testing generally uses a peak penetration depth of less than 10 % of thin-film thickness in order to measure film-only mechanical properties, without considering the critical depth for a given thin film-substrate system. The uncertainties in this testing condition make hardness measurement more difficult. We propose a new way to determine the critical relative depth for general thin-film/substrate systems; an impression volume analyzed from the remnant indent image is used here as a new parameter. Nanoindents made on soft Cu and Au thin films with various indentation loads were observed by atomic force microscope. The impression volume calculated from 3D remnant image was normalized by the indenter penetration volume. This indent volume ratio varied only slightly in the shallow regime but decreased significantly when the indenter penetration depth exceeded the targeted critical relative depth. Thus, we determined the critical relative depth by empirically fitting the trend of the indent volume ratio and determining the inflection point. The critical relative depths for Cu and Au films were determined as 0.170 and 0.173, respectively, values smaller than 0.249 and 0.183 determined from the hardness variation of the two thin films. Hence the proposed indent volume ratio is highly sensitive to the substrate constraint, and stricter control of the penetration depth is needed to measure film-only mechanical properties.
The nanoindentation technique has great promise in evaluating mechanical properties such as nanohardness and elastic modulus at micrometer or nanometer scales, since sample preparation and testing procedures are very easy. However, the nanohardness and elastic modulus cannot be directly related to basic material flow properties. Here a novel and simple experimental/computational method is proposed to extract stress-strain curves based on finite-element modeling (FEM) of nanoindentation. This method was verified for bulk Al by comparing the stress-strain curves extracted with those obtained from tensile testing, and was applied to Al thin films (0.5 μm and 1 μm) deposited on a Si substrate.
Residual stress in a thin film was analyzed by the nanoindentation technique. Two dominant effects of residual stress to indentation were summarized as the slope change in loading curve and the invariant value of intrinsic hardness. A stress-sensitive reversibly deformed zone around contact was modeled to explain the indentation behaviors under a residually stressed state. Finally, the residual stress was evaluated from the changes in contact shape and applied load during stress relaxation under the condition of constant indentation depth. The residual stresses in diamond-like carbon and Au films analyzed from this model agreed well with the average values measured by the curvature method.
Aluminum films have wide applications in micromechanical devices such as micro sensors and actuators. Therefore, their mechanical properties are very important for reliability evaluation. However, there is no standardized method to evaluate the mechanical properties of the materials used in MEMS(microelectromechanical system) devices since the measured mechanical properties are influenced by many factors such as the surface condition of materials, intrinsic limit of the measurement device, etc. Hence, it was intended to evaluate the mechanical properties of thin film, which is important in its mechanical operation. Because MEMS devices are usually operated in the elastic range, Young's modulus and yield strength were evaluated by using a microcantilever beam technique. First, A1 cantilever beams were fabricated using the silicon bulk micromachining technology to have various film thicknesses. The load-displacement curves during beam bending by nanoindentation method were then obtained. The linear relationship of the curve in elastic range was utilized in deriving Young's modulus of the A1 film, which gave reproducible results regardless of film thickness. In the high load range, the deviation from the linear relation was detected, so that yield strength of A1 film could be evaluated. It was found that the yield strength increases with decreasing film thickness. By applying the misfit dislocation theory and the Hall-Petch relationship, the theoretical estimation could predict the trend of yield strength.
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