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AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONHearing loss is highly prevalent in long-term care home (LTCH) residents with dementia (“residents”) and exacerbates confusion and communication difficulties. Residents rely on caregivers, including family, for hearing-related care. This study aims to understand the drivers of family caregivers’ provision of hearing support to LTCH residents using the Behaviour Change Wheel.This exploratory two-stage study was guided by the Capability, Opportunity, Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). A self-report survey (N = 87) and interviews (N = 6) explored drivers behind the provision of hearing support. Quantitative data were analysed using descriptive statistics and a within-participants ANOVA. Deductive coding of TDF domains alongside thematic analysis was used for qualitative data.Provision of hearing support was variable. Gaps in family caregivers’ psychological capability, reflective motivation and physical opportunity were identified. Barriers included lacking knowledge, unclear caregiver responsibilities, deprioritising hearing support, COVID-19 restrictions and fragmented collaborations with audiology services.Future behaviour-change interventions to facilitate family caregivers’ provision of hearing support to LTCH residents should include: Improving knowledge of how to provide effective hearing support, establishing caregiver responsibilities and increasing the resources for hearing support within LTCHs.Interventions to aid family caregivers in providing hearing support for their relative with dementia should be designed to address gaps in capabilities, opportunities and motivations, as barriers are present in all three constructs.Audiologists should signpost family caregivers to educational resources about traditional hearing aids and assistive listening devices to be used within the long-term care homes (LTCH) and understand the benefits of domiciliary audiology appointments for LTCH residents.Care staff and family to discuss roles and responsibilities for hearing support and document these in care plans when the resident first moves to the LTCH e.g., accompanying resident to external audiology appointments.Interventions to aid family caregivers in providing hearing support for their relative with dementia should be designed to address gaps in capabilities, opportunities and motivations, as barriers are present in all three constructs.Audiologists should signpost family caregivers to educational resources about traditional hearing aids and assistive listening devices to be used within the long-term care homes (LTCH) and understand the benefits of domiciliary audiology appointments for LTCH residents.Care staff and family to discuss roles and responsibilities for hearing support and document these in care plans when the resident first moves to the LTCH e.g., accompanying resident to external audiology appointments. [ABSTRACT FROM AUTHOR]

Hearing loss and dementia are common in long-term care home (LTCH) residents, causing communication difficulties and worsened behavioural symptoms. Hearing support provided to residents with dementia requires improvement. This study is the first to use the Behaviour Change Wheel (BCW) to identify barriers and propose interventions to improve the provision of hearing support by LTCH staff. Semi-structured interviews with 10 staff members were conducted. Transcripts were analysed according to the BCW's Theoretical Domains Framework alongside reflective thematic analysis. Relevant intervention functions and exemplar interventions were proposed. Staff believed hearing support to be beneficial to residents (Beliefs about Consequences) but lacked knowledge of hearing loss management (Knowledge). Poor collaborations between LTCHs and audiology (Environmental Context and Resources), led to despondency, and apprehension about traditional hearing aids for residents (Optimism). Despite feeling responsible for hearing support, staff lacked personal accountability (Social/Professional Role and Identity). Future interventions should include staff Training (on hearing support), Education (on the consequences of unsupported hearing loss), Enablement (dementia-friendly hearing devices), Incentivisation and Modelling (of Hearing Champions) and Environmental Restructuring (flexible audiology appointments to take place within the LTCH). Interventions should be multi-faceted to boost the capabilities, opportunities and motivations of LTCH staff. Hearing support for care home residents with dementia: Long-term care staff report inadequate knowledge and awareness of how to support residents' hearing needs and a lack of personal accountability for providing hearing support. They also report poor collaborations with audiologists and apprehension about traditional hearing aids. Barriers to hearing support stem from gaps in the capabilities, opportunities and motivations of staff, therefore, interventions should be designed to target all three constructs. Interventions to aid hearing support provision should target staffs' education, training, enablement, persuasion, modelling, incentivisation and environmental restructuring to boost staff capabilities, opportunities and motivations to provide hearing support. [ABSTRACT FROM AUTHOR]

Many long-term care home (LTCH) residents have dementia and hearing loss, causing communication difficulties and agitation. Residents rely on staff for hearing support, but provision is often inconsistent. This study used the Behaviour Change Wheel's Capability, Opportunity and Motivation model to understand why LTCH staff do or do not, provide hearing support to residents with dementia who they believe could benefit from it. An online survey exploring hearing support provision, capabilities, opportunities, motivations and demographics. Data were analysed using descriptive statistics, within-participants ANOVA and multiple linear regression. 165 LTCH staff. Staff provided hearing support to 50% of residents with dementia who they thought would benefit. Self-reported physical and psychological capabilities (skills/knowledge) were significantly higher than physical opportunity (having time/resources). The physical capability was significantly higher than social opportunity (collaborative working) and reflective motivation (feeling motivated). Lower levels of hearing support provision were predicted by LTCH funding (private vs. local authority), job role (care assistant vs. nurse) and fewer physical opportunities. Boosting capabilities through training alone may not be as effective as increasing opportunities via environmental restructuring. Opportunities may include strengthening working relationships with audiologists and ensuring hearing and communication aids are available within LTCHs. [ABSTRACT FROM AUTHOR]

Hearing loss is highly prevalent in dementia; however, people with dementia are less likely to use hearing aids consistently than people with intact cognition are. This qualitative study is the first of its kind to explore factors that influence hearing aid use from the perspective of community-living people with mild to moderate dementia and their care partners. Eleven UK-based dyads from the European SENSE-Cog Randomized Controlled Trial of a sensory intervention for people with dementia completed semi-structured interviews based on the Theoretical Domains Framework (TDF). Our findings suggest that the TDF domains environmental context and resources, behavioral regulation, reinforcement, and social influences are of greatest relevance to hearing aid use in dementia. Within these domains, we identified a range of factors that may influence the target behavior of hearing aid use. The findings suggest that adoption of multifaceted, flexible intervention approaches may support hearing aid use in dementia. [ABSTRACT FROM AUTHOR]

This study reports on 10 frontline healthcare workers, employed during the COVID-19 pandemic and experiencing symptoms of burnout and PTSD, treated with group ketamine-assisted psychotherapy (KAP) in a private outpatient clinic setting. Participants attended 6 sessions once weekly. These included 1 preparation session, 3 ketamine sessions (2 sublingual, 1 intramuscular), 2 integration sessions. Measures of PTSD (PCL-5), depression (PHQ-9), and anxiety (GAD-7) were administered at baseline and post-treatment. During ketamine sessions, the Emotional Breakthrough Inventory (EBI) and the 30-item Mystical Experience Questionnaire (MEQ-30) were recorded. Participant feedback was gathered 1-month post-treatment. We observed improvements in participants' average PCL-5 (59% reduction), PHQ-9 (58% reduction), and GAD-7 (36% reduction) scores from pre- to post-treatment. At post-treatment, 100% of participants screened negative for PTSD, 90% had minimal/mild depression or clinically significant improvement, and 60% had minimal/mild anxiety or clinically significant improvement. MEQ and EBI scores had large variations among participants at each ketamine session. Ketamine was well tolerated, and no significant adverse events were reported. Participant feedback corroborated findings of improvements observed in mental health symptoms. We found immediate improvements treating 10 frontline healthcare workers experiencing burnout, PTSD, depression, and anxiety using weekly group KAP and integration. [ABSTRACT FROM AUTHOR]

Ductal carcinoma in-situ (DCIS) accounts for 20–25% of all new breast cancer diagnoses. DCIS has an uncertain risk of progression to invasive breast cancer and a lack of predictive biomarkers may result in relatively high levels (~ 75%) of overtreatment. To identify unique prognostic biomarkers of invasive progression, crystallographic and chemical features of DCIS microcalcifications have been explored. Samples from patients with at least 5-years of follow up and no known recurrence (174 calcifications in 67 patients) or ipsilateral invasive breast cancer recurrence (179 microcalcifications in 57 patients) were studied. Significant differences were noted between the two groups including whitlockite relative mass, hydroxyapatite and whitlockite crystal maturity and, elementally, sodium to calcium ion ratio. A preliminary predictive model for DCIS to invasive cancer progression was developed from these parameters with an AUC of 0.797. These results provide insights into the differing DCIS tissue microenvironments, and how these impact microcalcification formation. [ABSTRACT FROM AUTHOR]

This debate piece argues for the importance of labour internationalism and anti-imperialism in the anti-racist defence of migrants. A focus on the Sahel region shows some of the ways that core European states militarily, economically and politically undermine countries' potential for self-determination. Border regimes, their modes of accumulation and selective labour policies expand militarism, social division and inequality between and within the regions. Challenges to these processes of global apartheid require attention to the national question and rejection of European imperialism, as indicated in recent pan-African calls for independence and popular sovereignty. This materialist analysis of migration in capitalism presents a basis for demanding equality of movement and the freedom and equality of societies facing capitalism-induced displacement. [ABSTRACT FROM AUTHOR]

The rates of dissociation of Tus from forked TerB oligonucleotides, which would be produced by the replicative DnaB helicase at both the fork-blocking and permissive ends of the Ter site, are measured to study the basis of polarity. The analysis has explained the mechanism of replication fork arrest at Tus bound Ter sites in the final stage of chromosomal DNA replication and has also revealed the stable interaction between a monomeric DNA binding protein and a forked DNA structure.