bluuebunny/crossref_metadata_2025 huggingface dataset:
Womersley's solution for the measurement of volume flow rates in transient laminar flow tubes
Authors: Gilpin Matthew R. , Wei Heng , Pahlevan Niema M.
Published: October 2022

The characterization of transient flows within the Reynolds number range of Re = 10–100 and the Womersley number range α = 0.8–10 is required for the ongoing development of green monopropellant thrusters. However, at the ml/min scale flow rates of interest, these measurements are outside the capabilities of current commercial flow meters. It is proposed here that transient flows under the required dynamic conditions can be characterized via Womersley's solution for transient flow in a rigid tube. This solution method requires only the measured transient pressure gradient within a controlled laminar flow section and can be accomplished using existing commercial pressure measurement hardware. Experiments were performed where flow similarity was maintained with the ultimate thruster characterization application, but the radius of the flow passage was increased so that flows could be simultaneously characterized by both the proposed solution method and a commercial ultrasonic flow meter. It was shown that across the range of interest, applying Womersley's solution to a measured pressure gradient was an effective method of transient flow characterization. Additionally, it was shown that non-periodic flows can be characterized except for the initial flow startup transient with solution convergence times approximating the analytical solution to starting flow in a pipe. While these results were expected due to an experimental design matching the assumptions required for Womersley's analytic solution, this work demonstrates that this method is practically feasible as novel instrumentation enabling previously unobtainable measurements.
Relationship between physical parameters of supercritical fluids and normal shock characteristics
Authors: Li Yunzhu , Li Zhen , Yang Rui , Zhao Yuxin , Zhang Bo
Published: October 2022

Physical parameters of supercritical fluids change drastically near the critical region, which makes it difficult to predict and analyze the supercritical fluid flow parameters behind the normal shock wave. In this paper, in combination with supercritical fluid physical parameters database, we employed an iterative algorithm to solve the flow parameters behind normal shock by deriving shock equations. The change of normal shock parameters of six supercritical fluids with inflow state was studied by the controlled variable method and a correlation analysis. The results show that when the inflow Mach number is fixed, the normal shock parameters, such as density ratio and pressure ratio, change rapidly in the Widom zone as a result of the dramatic changes of the physical parameters. When the inflow state is the same, the normal shock pressure ratio of NH3 is the highest, whereas that of C8H24O2Si3 and C10H22 are pretty low. The normal shock intensity of supercritical fluid is better reflected by the pressure ratio rather than Mach number. According to the correlation analysis, the compressibility factor and the sound speed of inflow are the main physical factors that affect the normal shock density ratio and pressure ratio, respectively. Based on the main physical factors, empirical equations for predicting the change trend of normal shock pressure ratio and density ratio are obtained.
Enhanced photoluminescence and color tuning from Rhodamine 6G-doped sol–gel glass matrix via DNA templated CdS nanoparticles
Authors: Reena V. N. , Misha H. , Bhagyasree G. S. , Nithyaja B.
Published: October 2022

High-performance organic solid-state lasers can be fabricated using a variety of host and luminophore combinations. Rhodamine 6G is a promising candidate for tunable solid-state laser materials. It may, however, degrade faster when exposed to light. Sol–gel is a technique for fabricating glasses at low temperatures that prevent organic dyes from degrading. This work investigates the effect of deoxyribonucleic acid-capped cadmium sulfide nanoparticles on the photoluminescence of Rhodamine 6G-doped sol–gel glass. The samples were characterized by absorption spectroscopy, scanning electron microscopy, and powder x-ray diffraction. The chromaticity studies of the samples were carried out to evaluate the Commission International d’Eclairage coordinates, color correlation temperature, and color purity values. The photoluminescence studies of Rhodamine 6G-doped sol–gel glasses show enhancement in intensity and tuning of emission wavelength in the presence of cadmium sulfide nanoparticles. The annealing temperature effect on the photoluminescence was also investigated. The studies and observations have revealed the possibility of using CdS-incorporated Rhodamine 6G-doped sol–gel-derived glass as a tunable material for organic solid-state lasers.
Degradation and transformation of all-
Authors: Yeung Katie Wan Yee , Zhou Guang-Jie , Leung Kenneth Mei Yee
Published: October 2022

Environmental context Excessive amounts of retinoic acids (RAs), the main derivatives of vitamin A, cause developmental abnormalities in animals, yet information on their fate in the marine environment is limited. This study investigated the degradation of all-trans-RA in seawater and found that over 90% was degraded and transformed in unfiltered natural seawater within 24 h. The results provide essential insights on the fate and risks of RAs in marine environments. Rationale Retinoic acids (RAs) are crucial to the development of various animals. However, exposure to excessive concentrations of RAs can lead to teratogenic effects in aquatic species during their developmental stages. Some urbanised coastal marine environments receive a large amount of partially treated wastewater effluent and occasionally suffer from algal bloom incidents, both of which are considered important sources of RAs in the marine environment. Yet information on degradation and transformation of RAs in seawater is currently unavailable for assessment of their environmental risk. This study, therefore, aimed to investigate the degradation and transformation of all-trans-RA (at-RA), which is the most abundant and widely distributed RA in the marine environment. Methodology A laboratory experiment was conducted to examine the degradation and transformation of at-RA in six different types of seawater (i.e. artificial seawater, unfiltered and filtered natural seawater, each with or without autoclave treatment). Degradation and transformation products of at-RA were analysed using high-performance liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Results The experiment showed that at-RA could be instantly degraded and transformed into other isomers such as 9-cis-RA and 13-cis-RA when entering seawater. Over 80% of at-RA was degraded in the first 48 h regardless of the type of seawater. Discussion The presence of microorganisms and suspended organic matters could jointly facilitate the degradation and removal of at-RA from the water column. Further investigation is encouraged to reveal the influence of other factors (e.g. temperature, solar radiation, aeration) on the transformation and degradation of at-RA in seawater.
Sulfur mass balance and speciation in the water cap during early-stage development in the first pilot pit lake in the Alberta Oil Sands
Authors: Yan Yunyun , Colenbrander Nelson Tara E. , Twible Lauren , Whaley-Martin Kelly , Jarolimek Chad V. , King Josh J. , Apte Simon C. , Arrey James , Warren Lesley A.
Published: October 2022

Environmental context Base Mine Lake (BML) is a demonstration pilot pit lake for long term oil sands tailings reclamation in Alberta, Canada. This study quantified BML water cap sulfur mass balance and speciation to help understand potential risks to oxygen levels during its early-stage development. Results provide important insights for the adaptive management of water-capped oil sands tailings reclamation. Rationale Sulfur cycling is crucial to the persistence of oxygen in the water cap of Base Mine Lake (BML), the first demonstration oil sands pit lake for water capped tailings technology (WCTT) in Alberta, Canada. Methodology Here, we report on the first investigation of sulfur mass balance and sulfur speciation (SO4 2−, SO3 2−, S2O3 2−, S0 and ƩH2S) over seasonal, annual and spatial scales in BML. Results and discussion High aqueous total sulfur concentration (1.7–2 mM), dominated by sulfate (>75%), decreased over the study period (2015–2021), due to the consolidation of fluid fine tailings (FFT) and operational pump-in and pump-out activities. Expanded BML water cap S biogeochemical cycling occurred after a 2016 alum amendment. Late summer hypolimnetic anoxia emerged post-alum (2017–2021), coincident with detectable total sulfide (ƩH2S) and elemental sulfur (S0) concentrations and expanded sulfur-reducing bacteria activity in anoxic bottom waters. Post spring turnover resuspended FFT and particle settling rates also likely increased post-alum, supported by the observed migration of epilimnetic highest sulfite concentration (pre-alum) to metalimnetic waters (post-alum). These sulfide containing particles are likely the primary reduced S substrate for spring–summer sulfur-oxidising bacteria activity, as winter aqueous reactive S species (ƩH2S, S0, S2O3 2 − and SO3 2−) were non-detectable across years. Concentrations of reactive S species reached up to 200 µM, posing risks to BML O2 levels (maximum 300–350 µM). Results of this study establish the interactive effects of physical and biogeochemical processes, as well as operational activities in emergent S risks to water cap oxygen levels, a key criterion for success of this reclamation tailings technology.
Population dynamics of Baltic herring since the Viking Age revealed by ancient DNA and genomics
Authors: Atmore Lane M. , Martínez-García Lourdes , Makowiecki Daniel , André Carl , Lõugas Lembi , Barrett James H. , Star Bastiaan
Published: October 2022

The world’s oceans are currently facing major stressors in the form of overexploitation and anthropogenic climate change. The Baltic Sea was home to the first “industrial” fishery ∼800 y ago targeting the Baltic herring, a species that is still economically and culturally important today. Yet, the early origins of marine industries and the long-term ecological consequences of historical and contemporary fisheries remain debated. Here, we study long-term population dynamics of Baltic herring to evaluate the past impacts of humans on the marine environment. We combine modern whole-genome data with ancient DNA (aDNA) to identify the earliest-known long-distance herring trade in the region, illustrating that extensive fish trade began during the Viking Age. We further resolve population structure within the Baltic and observe demographic independence for four local herring stocks over at least 200 generations. It has been suggested that overfishing at Øresund in the 16th century resulted in a demographic shift from autumn-spawning to spring-spawning herring dominance in the Baltic. We show that while the Øresund fishery had a negative impact on the western Baltic herring stock, the demographic shift to spring-spawning dominance did not occur until the 20th century. Instead, demographic reconstructions reveal population trajectories consistent with expected impacts of environmental change and historical reports on shifting fishing targets over time. This study illustrates the joint impact of climate change and human exploitation on marine species as well as the role historical ecology can play in conservation and management policies.
Phosphorylation of RXRα mediates the effect of JNK to suppress hepatic FGF21 expression and promote metabolic syndrome
Authors: Vernia Santiago , Lee Alexandra , Kennedy Norman J. , Han Myoung Sook , Isasa Marta , Cavanagh-Kyros Julie , Roy Armanda , Syed Aafreen , Chaudhry Shanzah , Edwards Yvonne J. K. , Gygi Steven P. , Gao Guangping , Davis Roger J.
Published: October 2022

The cJun NH
2
-terminal kinase (JNK) signaling pathway in the liver promotes systemic changes in metabolism by regulating peroxisome proliferator-activated receptor α (PPARα)-dependent expression of the hepatokine fibroblast growth factor 21 (FGF21). Hepatocyte-specific gene ablation studies demonstrated that the
Mapk9
gene (encoding JNK2) plays a key mechanistic role. Mutually exclusive inclusion of exons 7a and 7b yields expression of the isoforms JNK2α and JNK2β. Here we demonstrate that
Fgf21
gene expression and metabolic regulation are primarily regulated by the JNK2α isoform. To identify relevant substrates of JNK2α, we performed a quantitative phosphoproteomic study of livers isolated from control mice, mice with JNK deficiency in hepatocytes, and mice that express only JNK2α or JNK2β in hepatocytes. We identified the JNK substrate retinoid X receptor α (RXRα) as a protein that exhibited JNK2α-promoted phosphorylation in vivo. RXRα functions as a heterodimeric partner of PPARα and may therefore mediate the effects of JNK2α signaling on
Fgf21
expression. To test this hypothesis, we established mice with hepatocyte-specific expression of wild-type or mutated RXRα proteins. We found that the RXRα phosphorylation site Ser
260
was required for suppression of
Fgf21
gene expression. Collectively, these data establish a JNK-mediated signaling pathway that regulates hepatic
Fgf21
expression.
The role of GTP hydrolysis by EF-G in ribosomal translocation
Authors: Rexroad Gillian , Donohue John Paul , Lancaster Laura , Noller Harry F.
Published: October 2022

Translocation of transfer RNA (tRNA) and messenger RNA (mRNA) through the ribosome is catalyzed by the GTPase elongation factor G (EF-G) in bacteria. Although guanosine-5'-triphosphate (GTP) hydrolysis accelerates translocation and is required for dissociation of EF-G, its fundamental role remains unclear. Here, we used ensemble Förster resonance energy transfer (FRET) to monitor how inhibition of GTP hydrolysis impacts the structural dynamics of the ribosome. We used FRET pairs S12-S19 and S11-S13, which unambiguously report on rotation of the 30S head domain, and the S6-L9 pair, which measures intersubunit rotation. Our results show that, in addition to slowing reverse intersubunit rotation, as shown previously, blocking GTP hydrolysis slows forward head rotation. Surprisingly, blocking GTP hydrolysis completely abolishes reverse head rotation. We find that the S13-L33 FRET pair, which has been used in previous studies to monitor head rotation, appears to report almost exclusively on intersubunit rotation. Furthermore, we find that the signal from quenching of 3′-terminal pyrene–labeled mRNA, which is used extensively to follow mRNA translocation, correlates most closely with reverse intersubunit rotation. To account for our finding that blocking GTP hydrolysis abolishes a rotational event that occurs after the movements of mRNA and tRNAs are essentially complete, we propose that the primary role of GTP hydrolysis is to create an irreversible step in a mechanism that prevents release of EF-G until both the tRNAs and mRNA have moved by one full codon, ensuring productive translocation and maintenance of the translational reading frame.
Implications of the non-observation of 6Li in halo stars for the primordial 7Li problem
Authors: Fields Brian D. , Olive Keith A.
Published: October 2022

The primordial Lithium Problem is intimately connected to the assumption that the 7Li
abundance observed in metal-poor halo stars is unchanged from its primordial value, which lies
significantly below the predictions of standard big-bang nucleosynthesis. Two key lines of
evidence have argued that these stars have not significantly depleted their initial (mostly
primordial) 7Li: i) the lack of dispersion in Li abundance measurements at low metallicity (and
high surface temperature); and ii) the detection of the more fragile 6Li isotope in at least two
halo stars. The purported 6Li detections were in good agreement with predictions from cosmic-ray
nucleosynthesis which is responsible for the origin of 6Li. This concordance left little room
for 6Li depletion, and the apparent 6Li survival implied that 7Li largely evaded destruction,
because stellar interiors destroy 6Li more vigorously then than 7Li. Recent (re)-observations
of halo stars challenge the evidence against 7Li depletion: i) lithium elemental abundances now
show significant dispersion, and ii) sensitive 6Li searches now reveal only upper limits to the 
6Li/7Li ratio. We discuss the consequences of these 6Li non-detections on the primordial 7Li
Problem, Galactic cosmic-ray nucleosynthesis, and the question of differential depletion of Li in
stars. The tight new 6Li upper limits generally fall far below the predictions of cosmic-ray
nucleosynthesis, implying that substantial 6Li depletion has occurred — by factors up to 50. We
show that in stars with 6Li limits and thus lower bounds on 6Li depletion, an equal amount of 
7Li depletion is more than sufficient to resolve the primordial 7Li Problem. This picture is
consistent with well-studied stellar models in which 7Li is less depleted than 6Li, and
strengthen the case that the Lithium Problem has an astrophysical solution. We conclude by
suggesting future observations that could test these ideas.
Primordial black hole from the running curvaton*
Authors: Liu 刘 Lei-Hua 磊华
Published: October 2022

In light of our previous study [Chin. Phys. C 44(8), 085103 (2020)], we investigate the possibility of the formation of a primordial black hole in the second inflationary process induced by the oscillation of the curvaton. By adopting the instability of the Mathieu equation, one can utilize the δ function to fully describe the power spectrum. Owing to the running of the curvaton mass, we can simulate the value of the abundance of primordial black holes covering almost all of the mass ranges. Three special cases are given. One case may account for dark matter because the abundance of a primordial black hole is approximately 75% . As late times, the relic of exponential potential may be approximated to a constant of the order of a cosmological constant, which is dubbed as the role of dark energy. Thus, our model could unify dark energy and dark matter from the perspective of phenomenology. Finally, it sheds new light on exploring Higgs physics.
Preprint Highlight: Mitotic clustering of pulverized chromosomes from micronuclei
Authors: Zhang Huaiying
Published: October 2022

Chromosomes in micronuclei are fragmented into small pieces, sometimes catastrophically. Such severely damaged chromosomes can lead to genomic rearrangements, but how the chromosome fragments segregate during mitosis is unknown. Using live-cell imaging to follow micronuclei during mitosis, this study shows that chromosome fragments in micronuclei cluster together during mitosis and segregate into one daughter cell. The authors found that the DNA damage response complex CIP2A-TOPBP1 is responsible for clustering chromosome fragments by binding to the damaged DNA after micronuclei membrane breakdown. This work suggests that biased segregation of chromosome fragments following micronucleation could explain the lack of DNA copy number errors in various cancers.
6 OLDER ADULTS’ DECISION-MAKING CAPACITY FOR INDEPENDENT LIVING: OCCUPATIONAL THERAPY CONTRIBUTIONS TO COLLABORATIVE MULTIDISCIPLINARY ASSESSMENT
Authors: Usher R , Stapleton T
Published: October 2022

Background

Increasing age and life expectancy, alongside the growing prevalence of dementia-related diseases, indicate more older adults are likely to experience challenges regarding their decision-making capacity (DMC). The Assisted Decision Making (Capacity) Act 2015 provides a statuary framework for adults who are experiencing difficulties with decision-making and has implications for all healthcare professionals. Occupational therapists frequently contribute to multidisciplinary assessments of older adults’ DMC for independent living (IL).

Methods

Focus groups were conducted among occupational therapists working with older adults in Ireland to explore assessment practices of DMC for IL.

Results

Fifty-two occupational therapists, from a range of hospital and community settings, participated in nine focus groups. Therapists reported using enablement strategies and occupation-based approaches when assessing DMC to address the person’s values and preferences, cognitive-functional abilities and environmental needs for IL. However, resource issues and lack of shared understanding of DMC among the multidisciplinary team constrain DMC assessment practices. Furthermore, older people are often excluded from care-planning, and IL options are determined by availability of services rather than will and preference. Multidisciplinary education on DMC is essential in shaping a cohesive approach to assessment and to enhance older adults’ participation in decision-making.

Conclusion

Multidisciplinary collaboration and commitment to person-centred approaches may lead to enhanced outcomes for maximising and supporting older adult’s DMC regarding IL. A potential leadership role for occupational therapy in assessing DMC for IL is also highlighted.
13 FIGHTING FRAILTY FROM FOUNDATION UP
Authors: McKeown W , Kelly R , Eakin R , Hunter N
Published: October 2022

Background

In 2021 the UK Foundation Programme introduced a new curriculum for UK Foundation Doctors (FDs). For the first time, frailty has been designated as a core learning topic. This means that all FDs are expected to undertake dedicated frailty training. Subsequently, a virtual frailty workshop was developed and delivered by Zoom to all F2 doctors in Northern Ireland. Entitled ‘Taking a Better Approach to the Frailer Adult’, the three hour workshop familiarises FDs with core frailty concepts including Comprehensive Geriatric Assessment (CGA), delirium, and deprescribing.

Methods

All attendees completed an online survey after workshops. They were asked to provide free text comments about what they felt were the most successful and useful aspects of the workshop. Attendees were also were asked to numerically rate the workshop relevance, handout quality and venue suitability.

Results

The frailty workshop was delivered to 222 F2 doctors over eight months. On average, attendees rated the relevance of the workshop as 4.8/5. Attendees rated the quality of the handouts and the venue suitability at 4.4/5 and 4.2/5 respectively. Thematic analysis of qualitative feedback on the most successful elements of the workshop showed that attendees found the session to be useful, relevant, and engaging, with particular preference for use of cases. For example, one attendee wrote that, ‘use of cases and breakout rooms to discuss CGA [allowed] us to get a feel of how this applies to patients in clinical settings”. Thematic analysis of qualitative feedback on what could be done to make the workshop better showed attendees had preferences for greater use of cases and smaller breakout rooms. This feedback was used to develop and improve the workshop.

Conclusion

FDs value teaching on frailty and consider it highly relevant for clinical practice. Frailty education can be delivered successfully in a virtual setting. Junior doctors prefer interactive case based learning, with use of breakout rooms with small numbers of participants in each room.
25 EVALUATION OF PATIENTS PRESENTING WITH TIA IN THE AMAU AND TIA FAST ASSESSMENT CLINICS - ARE WE MEETING ESO GUIDELINES?
Authors: Hearne S , Costelloe R , Murphy S , Kelly P , McGorrian C , Marnane M
Published: October 2022

Background

The European Stroke Organisation published guidelines on the management of Transient Ischaemic Attack (TIA) in 2021. Specialist review of suspected TIA is recommended within 24-hours of symptom onset in a TIA clinic. They suggest using CT or MR angiogram for additional confirmation of large artery stenosis of >50%. They advise against the use of prediction tools alone e.g. ABCD2 score when identifying high-risk patients. Dual antiplatelet therapy is recommended short-term in high risk, non cardio-embolic TIA patients. This audit evaluates if these guidelines are being followed in our institution.

Methods

We evaluated all patients attending the TIA clinic and the Acute Medical Assessment Unit (AMAU) with suspected TIA over a three-week period in 2021 in a single tertiary referral centre. Retrospective data was collected based on chart review.

Results

Twenty patients underwent review in the TIA clinic and eight in the AMAU with suspected TIA in the chosen time period. One patient (3.5%) was seen within 24 hours from symptom onset, 2 were seen within 24-36 hours (7.1%), 4 patients (14.2%) were seen within 36-72 hours, 21 patients (75%) were seen >72 hours after symptom onset. In all patients who had a doppler US showing >50% carotid stenosis, a CT angiogram was performed. ABCD2 scores were recorded but used in combination with clinical judgment. All patients with high-risk, non-cardioembolic TIA received early, short-term dual antiplatelet therapy.

Conclusion

The diagnostic methods and treatment strategies in place for patients attending the TIA clinic or AMAU with TIA were in keeping with the recently published ESO guidelines. However, there was a time delay from symptom onset to time of review in many patients. Further studies are indicated to identify the potential mechanisms behind these delays. Interventions to ensure that we are meeting this ‘time-to-review’ target in patients could be implemented, ensuring high quality, evidence-based care.
30 THE DIAGNOSTIC AND PREDICTIVE ACCURACY OF THE EDMONTON FRAIL SCALE FOR SCREENING FRAILTY IN OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Hynes C , Galvin R
Published: October 2022

Background

Frailty is a dynamic, multidimensional syndrome that is highly prevalent in older adults (65 years or older), which increases one’s dependency and vulnerability to adverse health outcomes, including mortality. The Edmonton Frail Scale (EFS) is a commonly used screening tool for identifying frailty in older adults.

The purpose of this systematic review and meta-analysis is to determine the diagnostic test accuracy of the EFS to identify frailty in older adults, as well as the predictive accuracy of the EFS for adverse outcomes associated with frailty.

Methods

A literature search was performed across PubMed, EMBASE, CINAHL, MEDLINE and the Cochrane Library to identify all studies that validated the EFS across clinical settings. The methodological quality of the included studies was assessed using the QUADAS-2 tool. A bivariate random effects model generated pooled estimates of sensitivity and specificity.

Results

Eleven studies were included in the systematic review and six studies were included in meta-analysis. The diagnostic test accuracy of the EFS could not be proven from the included studies. The EFS was found to be more useful at ruling in rather than ruling out increased risk of mortality in individuals classified as frail, with a higher pooled specificity (0.75, 95% CI 0.64-0.84) than sensitivity (0.49, 95% CI 0.42-0.56).

Conclusion

The Edmonton Frail scale has limited ability as a frailty screening tool and should not be used in isolation to screen for frailty in older adults in clinical settings.
39 CAN BEHAVIOURAL CHANGE INTERVENTIONS IMPROVE SELF-EFFICACY AND EXERCISE ADHERENCE AMONG PEOPLE WITH PARKINSON’S? A SYSTEMATIC REVIEW
Authors: Ahern L , Timmons S , Lamb S , McCullagh R
Published: October 2022

Background

People with Parkinson’s (PwP) lead sedentary lifestyles compared to healthy peers. Personal influences including low self-efficacy and poor outcome expectation appear to predict exercise adherence more accurately than disease severity. The purpose of this review is to identify successful behavioural-change interventions that promote self-efficacy and exercise adherence among PwP.

Methods

Databases including EBSCO, Medline, CINAHL, Web of Science, PubMed, Embase, Scopus, Google Scholar and Cochrane Library were searched from inception to 2020. Interventional studies including a behavioural-change intervention were included. Title, abstract and full-text screening was conducted by two independent reviewers. The Cochrane Risk of Bias Tool and Robins-I were used to assess the Risk of Bias. Data was extracted by two independent reviewers. The outcomes of interest were self-efficacy, quality of life, physical function, and exercise adherence. A narrative synthesis was completed and mapped to the Theoretical Domains Framework, to produce practice-orientated outcomes.

Results

Seventeen studies (n=1319) were included. Risk of bias was generally moderate. A multicomponent behavioural-change intervention encompassing education, behavioural strategies and support groups appeared to improve quality of life, physical function, and exercise adherence in PwP. No intervention improved self-efficacy. Self-monitoring, goal setting, social supports, feedback, self-managements skills and action planning improved long-term adherence.

Conclusion

No intervention changed self-efficacy. However, it appears that a multicomponent intervention is essential to improve exercise adherence. Trials directly comparing different intervention types and adequate follow-up periods are limited, preventing a conclusive finding of the most effective behavioural-change intervention to promote exercise adherence among PwP.
43 EXPLORING STAFF PERCEPTIONS AND ATTITUDES TO CARE AND CAREBOTS: THE CASE OF AN ORIGINAL AIR-DISINFECTION ROBOT IN IRELAND
Authors: Kodate N , Kohli P , McGinn C , Scott R , Ross E , Treusch P , Maeda Y , Donnelly S , Leonard C , Cogan L , Mannan H , O’Shea D , Obayashi K , Masuyama S
Published: October 2022

Background

The pandemic heightened the sense of security and safety in care settings, with cleanliness and infection control becoming an even more important aspect of care delivery. Although the impact of new welfare technology on health and social care has been discussed in recent years, few studies have reported the implementation processes or human-robot interactions in care facilities in different cultural settings. The aims of this interdisciplinary research therefore were to understand needs and aspects that have to be considered for implementing an assistive robot, and to explore user perceptions, and the process by which the robots are adopted in Ireland and Japan.

Methods

An original air-disinfection robot (V-Air) was developed by Akara Robotics, as part of research project “Harmonisation towards the establishment of Person-centred, Robotics-aided Care System” (Toyota Foundation, D18-ST-0005). Prior to its instalment in a rehabilitation centre in Dublin, semi-structured interviews were conducted, and observations carried out with seven care professionals, as they interacted with V-Air. The robot was then trialled for eight weeks (March-May 2022) in selected areas of the facility. After four weeks, the users filled out the System Usability Score and were asked questions at the end of the trial. Their scores and answers to the questions revealed staff perceptions and attitudes to care robots.

Results

Overall, the users had positive perceptions of V-Air and its usability. Initial differences existed in staff’s confidence levels, depending on prior experiences with technologies. Collective sensemaking was observed, particularly, around care delivery processes and robot functionalities. The adoption process was facilitated by several factors such as the timing of introduction, user-centred design, concept of care and organisational support.

Conclusion

The findings suggest that the introduction of care robots in care settings can offer an additional layer of organisational safety, while highlighting the significance of the iterative process in adopting assistive technologies.
46 THE IMPACT OF THE INTRODUCTION OF STRUCTURED DOCUMENTATION ON A MULTI-DISCIPLINARY TEAM MEETING AS MEASURED BY CLINICAL AUDIT
Authors: Fitzgerald M
Published: October 2022

Background

The typical method for multidisciplinary teams (MDT) to coordinate care in a rehabilitation setting is by holding weekly meetings. These MDT meetings are not always effective, with poor communication and vague plans of treatment leading to a lack of progress with rehabilitation and even delayed patient discharge.

Methods

The MDT of the older person’s rehabilitation unit aimed to improve their MDT meeting. A series of meetings, open to all members, identified the key issues. These were; variation in the level of contribution from attending disciplines, a lack of clarity on patients’ current status, a lack of SMART goals being set and Predicted Dates of Discharge (PDD) not being set. This was confirmed by clinical audit examining contribution levels of attending disciplines across four questions. The proposed solution was a structured document called the Collaborative Rehabilitation Plan (CRP) booklet for use at MDT meetings, which was designed by a subcommittee with feedback from the full group. The audit was repeated after a one-month trial of the booklet.

Results

The average contribution was highest on the current status of the patient (59%), and this was not changed post-booklet (59%). This was lower regarding the setting of goals (18%), and this improved post booklet (40%). The average contribution was lowest for the goals meeting SMART criteria (4%). This improved post booklet (28%). Improvement was also seen in the setting of PDDs (from 27% to 52%). While the level of contributions from all disciplines improved after the introduction of the booklet (from 27% to 42%) there was still a wide degree of variation.

Conclusion

The development of the CRP booklet was of value in increasing the contributions of the team in a number of key areas. Contributions were still low in some areas and further work is needed to improve this.
63 FRAILTY AND COVID-19 IN HOSPITALISED OLDER ADULTS
Authors: Trueick R , Godson-Treacy M , Donnelly T
Published: October 2022

Background

Frailty is an important factor in clinical decision making for patients with COVID-19. In COVID-19, frailty can better predict outcomes than age or comorbidity. We aimed to establish the extent of frailty in a cohort of older adults admitted to an Irish hospital with COVID-19.

Methods

This is a retrospective observational study of frailty and outcomes in all patients over the age of 75 admitted to an Irish hospital between 01/03/20 - 31/10/20 who tested positive for SARS-CoV2 RNA on PCR during admission. This corresponded with the first wave of COVID-19. Frailty was assessed using the Rockwood Clinical Frailty Scale (CFS). Eligible patients’ charts were reviewed and a frailty score of 1 (very fit) to 9 (terminally ill) was assigned based on multidisciplinary assessment of pre-admission status. The outcomes assessed were length of stay, in-hospital mortality, and change in discharge destination i.e. patients admitted from home requiring discharge to long-term care.

Results

The 45 study participants had a median age of 83 years. 19 (42%) patients were female. The mean CFS on admission was 6, indicating moderate frailty. 12 (27%) patients were residents in long-term care. The average length of stay was 27 days. 14 (31%) patients died. Of these, the median age was 82 and the median clinical frailty score was 6.5. Death occurred in 5 (42%) patients admitted from long-term care and in 9 (27%) patients admitted from home. There was a change in discharge destination in 7 (29%) of the 24 patients who were admitted from home and survived the hospitalisation. Of these, the median clinical frailty score was 5.

Conclusion

Frailty was highly prevalent in this cohort of hospital in-patients with COVID-19. Frailty likely contributed to the high mortality and lengths of stay. Furthermore, this study highlights the harmful impact of COVID-19 by its association with high rates of discharge to long-term care in those who were admitted from home.
65 POLYPHARMACY BURDEN IN THE RAPID-ACCESS FRAILTY ASSESSMENT UNIT (RAFAU)
Authors: Kemple O , Bozic D , O'Keane C , Donnelly T , Doherty J , McGlynn J
Published: October 2022

Background

The adverse outcomes associated with polypharmacy (regular use of five or more medications) are well described. One in three over 65 report polypharmacy in Ireland (The Irish Longitudinal Study on Ageing, 2012). A review of the burden of polypharmacy was carried out in a Rapid Access Frailty Assessment Unit (RAFAU) in a regional Irish hospital.

Methods

Data was collected on each patient presenting to the RAFAU from May 2021 to March 2022. Each patient was categorised based on number of medications taken. It was recorded whether each patient had a change made to their medications during their review. The inclusion criterion was any patient over 65 presenting to the RAFAU with clear documentation of their medications. Excluded were those without medication lists available.

Results

Polypharmacy data was collected in 496 of the total 587 patients attending RAFAU since May 2021. A higher proportion of 59% (n=496) were female. The mean clinical frailty score was four. 100% of the group were reviewed by a doctor.

78.6% of patients were prescribed over five medications. 49.3% of patients were prescribed between 5-10 medications. 22.9% were prescribed 10-15 medications and 6.4% prescribed over 15 medications. 60.8% had a change made to their medication. The incidence of medication changes initiated rose with the increasing number of prescribed medications. 71% of those with more than 15 medications had changes made.

Conclusion

The incidence of polypharmacy in those attending RAFAU is extremely high. The frailty unit is an ideal location to review and reduce medication burden as patients have access to a specialist clinician and multidisciplinary team. Although 60% of our patients had medication changes made, we do not use a standard tool in RAFAU to guide medication reduction in frail patients with polypharmacy. It is planned to introduce routine assessment of polypharmacy utilising the STOPP/START tool and re-audit one year after implementation.
67 TECHNOLOGY TO SUPPORT INDEPENDENT LIVING AT HOME: ONLINE SURVEY OF USER NEEDS AND REQUIREMENTS
Authors: Murphy C , Timon C , Heffernan E , Hopper L , Gallagher P , Hussey P
Published: October 2022

Background

Technology can play a key role in supporting older adults to live independently at home. A User Needs and Requirements study including co-design workshops and an online survey was conducted to inform the development of a technological solution aimed at supporting older adults to remain living independently at home. The online survey component is reported here.

Methods

Eligibility criteria included that respondents were older adults living at home or caregiving stakeholders providing care to older adults at home e.g. family caregivers or health/social care professionals. Recruitment took place throughout Ireland through civil society organisations and age friendly networks in local councils. Quantitative and qualitative data were gathered from June to July 2020. Descriptive statistics were applied to quantitative data and inductive thematic analysis was performed on free text responses.

Results

In total, 380 respondents completed the survey (n= 235 older adults, n=77 family caregivers, n=47 healthcare professionals and n=21 home support workers). Older adults identified key issues where technology might support them to live independently, these included, home security (33% n=77), falls (30% n=69), reduced mobility (23% n=55) and loneliness (23% n=54). Thematic analysis highlighted key areas where technology could assist stakeholders in providing care for older adults living independently, these included, remote monitoring of family members (family caregivers), communication with clients (healthcare professionals) and falls (home support workers). Older adults reported that data privacy and the cost of technology were key concerns. All groups reported a high level of willingness to use technology such as ambient sensors, wearable devices and voice activated assistants to support independent living.

Conclusion

Results of this survey provide insights into user needs and requirements in combination with results from co-design workshops to inform the design, development and trial of a technology system to support independent living at home.
76 HOW BLOGS SUPPORT THE TRANSFER OF KNOWLEDGE INTO PRACTICE IN THE FIELD OF DEMENTIA PALLIATIVE CARE: FACILITATORS AND BARRIERS
Authors: Rukundo A , Fox S , Guerin S , Kernohan G , Drennan J , O'Connor N , Timmons S
Published: October 2022

Background

Blogging can help to maximise the impact of one’s work in academia and beyond by making research findings accessible for multiple knowledge users. As part of the knowledge exchange and dissemination activities of the Model for Dementia Palliative Care Project, this study explored stakeholders’ views of blogs as a means to translate research findings in the field of Dementia Palliative care.

Methods

A web-based survey was developed, piloted, and revised. It was distributed electronically via key dementia and palliative care organisations. Complete responses (N=128) were received from healthcare researchers (n=53), healthcare providers (n=46) and others with an interest in healthcare research (n=29). Data were analysed using descriptive statistics and content analysis

Results

The preferred methods of reviewing research findings were scientific papers, websites and news articles. Respondents read healthcare blogs “sometimes” (39.1%), with <19% reading them “often” or “very often”. Receiving an email notification might increase the likelihood of reading a new blog post for 83% of respondents. Barriers to engaging with blogs included lack of time, preference for other media, lack of awareness regarding available blogs, and concerns about the credibility and source of information. An appropriate length and the author of the blog were key features that encouraged engagement with a blog. Most respondents (37.7 % ‘Yes’ and 23.0% ‘Maybe’) would read Dementia Palliative care blogs by the research team.

Conclusion

Despite respondents choosing a scientific paper as their preferred method to consume research findings, many indicated an openness to reading blogs on their area of interest. Creating concise, relevant, and credible blogs, and suitably promoting them, could increase the impact and reach of healthcare research, such as in the emerging field of dementia palliative care, and thus promote translation of research findings into practice.
78 THE ISIMPATHY APPROACH TO POLYPHARMACY AND ADHERENCE: EXPLORING PHARMACIST AND GENERAL PRACTITIONER EXPERIENCE
Authors: Coyle EJ
Published: October 2022

Background

iSIMPATHY is an EU INTERREG VA funded project, delivering quality clinical care in primary care (Republic of Ireland (ROI) and Scotland) and in secondary care (Northern Ireland). The approach is interdisciplinary, collaborative and centred around pharmacist-led medicines reviews. iSIMPATHY recognises patients as key partners in their own health. iSIMPATHY addresses the challenges posed by polypharmacy and adherence, identified by the WHO as a priority area to focus on to reduce severe, avoidable medication related harm.

Methods

In July 2021, a survey was conducted to obtain structured feedback about GPs and Pharmacists’ experiences of the iSIMPATHY project in participating GP practices in Ireland. The survey identified issues to be addressed and informed the evaluation of the project. Survey topics included barriers and facilitators to success of the project, overall impression and visions for the future for pharmacist roles in primary care in ROI.

Results

33% GPs and 100% Project Pharmacists responded to the survey. They agreed that iSIMPATHY is: Having a positive effect on patient safety, patient quality of life, satisfaction, knowledge and understanding, adherence and quality of patient careImpacting positively on GP job satisfaction, knowledge and understandingPharmacist knowledge and skills, capacity to carry out and follow up on reviews (time available) and pharmacist communication with the patient are facilitating project successProject funding and support, including training of the pharmacists, was felt by most to be a facilitator of project successAll are not only in favour of the continuation of pharmacy presence in their practice beyond the life of this project but they would encourage integration of more clinical pharmacy roles within the primary care setting in the future.

Conclusion

GPs and pharmacists find the iSIMPATHY approach overwhelmingly positive. The project is perceived to benefit patients and GPs and there is unanimity in support for the clinical pharmacist role in project practices and more broadly in Ireland.
84 A PROSPECTIVE AUDIT OF THE MANAGEMENT OF POSTOPERATIVE ANAEMIA IN PATIENTS AFTER OPERATIVE MANAGEMENT OF NECK OF FEMUR FRACTURES
Authors: Awad H , Jeyaseelan A , O'Connor S , Donnelly R , O'Donnell N , O'Regan N
Published: October 2022

Background

There is limited evidence available to guide the diagnosis and management of anaemia and iron deficiency in post operative patients. Numerous guidelines from professional associations exist for the management of pre-operative anaemia. We identified an international consensus statement that provided guidance on patient care with respect to postoperative anaemia and iron deficiency. Our aim was to determine if our practice was consistent with the best practice recommendations of this document.

Methods

We conducted a prospective audit on a convenience sample of patients over the age of 60 with neck of femur fractures who underwent operative management between January and April 2022. We collected data on pre and post operative haematological indices including haemoglobin, serum iron, ferritin and transferrin saturation as well as data on patients who received IV iron and red cell transfusions.

Results

We included 50 patients with neck of femur fractures who underwent hip replacement. All patients had post-op haemoglobin levels performed. Fifteen (30%) patients fulfilled the criteria for diagnosis of postoperative iron deficiency. Only 4/15 of these patients received IV iron postoperatively. Four patients who did not fulfil criteria for post-op iron deficiency received IV iron. Two patients had a post-op haemoglobin between 7-8g/dL and appropriately received red cell transfusions. Four patients received red cell transfusions despite having post-op haemoglobin levels >8g/dL.

Conclusion

Our findings indicated approximately 1/3 of patients fulfilled criteria for post operative iron deficiency while only a small proportion were treated for this. More data is required to establish the impact of post-op anaemia management strategies on functional recovery and quality of life as well as laboratory and interventional endpoints. A local protocol for the management of post operative iron deficiency with and without anaemia will be developed.