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This paper concludes with a proposal to establish an international collaboration among academics and HTA agencies in the region the REAL World Data In ASia for HEalth Technology Assessment in Reimbursement (REALISE) working group, which seeks to develop a non-binding guidance document on the use of RWD/RWE to inform HTA for decision making in Asia.Research has supported a link between insecure attachment and disordered eating in adolescents; however, how this influence is exerted remains unclear. This study explored whether depressive symptoms constitute a pathway through which insecure attachment to parents predicts subsequent development of disordered eating in the transition from childhood to adolescence. The study also examines whether there are differential effects regarding the attachment figure, child's gender, or reciprocity between variables. A community-based sample of Spanish youth (n = 904; 49.4% girls) was followed biennially from age 10 to 16 years. Attachment, depressive symptoms, and disordered eating were measured using the Inventory of Parental and Peer Attachment, Children's Depression Inventory, and Children's Eating Attitudes Test, respectively. Prospective data were analyzed using a dynamic panel model, which accounts for unmeasured time-invariant factors. Whereas insecure attachment to the father did not predict later depression or disordered eating, higher insecure attachment to the mother at ages 10 and 12 years predicted more disordered eating at ages 14 and 16 years via increased depressive symptoms at ages 12 and 14 years. No child's gender-specific or reverse mediational effects were found. This study suggests that an increase in depressive symptoms might be one mechanism by which insecure attachment exerts its influence on the development of eating disorders symptomatology in adolescence. Intervention efforts aimed at strengthening particularly the mother-child attachment relationship may reduce the vulnerability to develop depressive symptoms and disordered eating.

Personal protective equipment (PPE) are essential for medical personnel responding to hazardous materials (HAZMAT) incidents. However, their impermeable design causes increased physiological strain and reduced thermoregulation, limiting work times and causing heat-related illnesses (HRI). Use of wearable cooling devices slow heat accumulation and have been shown to reduce thermal and cardiovascular strain in such situations.

This was a prospective clinical evaluation to determine the tolerability and effectiveness of the CarbonCool cooling system - a half-body cooling vest - in participants undergoing a HAZMAT decontamination recertification. Physiological measurements (heart rate [HR], weight, temperature, and blood pressure) and participant feedback were obtained. The main outcome of interest was participants' tolerability of the cooling vest.

A total of 23 healthy participants were recruited, with 10 randomized to the intervention group and 13 in the control group. Mean age in the control and intervention group was 35.5 years old (SD = 7.8) and 30.0 years old (SD = 6.2), respectively. ARN-509 datasheet Qualitative feedback obtained from participants regarding safety, mobility, and cooling efficacy was largely positive. Difference of before-after temperature and HR was 0.3°C (SD = 0.8) and 11.5bpm (SD = 13.6) in the control group compared to 0.0°C (SD = 0.5) and 0.0bpm (SD = 6.4) for the intervention group.

This clinical evaluation showed that the CarbonCool cooling vest is safe and tolerable in participants wearing PPE. Further trials with sample size powered to detect physiological outcomes are needed to assess the effect of the cooling vest on a subject's endurance to heat stress.

This clinical evaluation showed that the CarbonCool cooling vest is safe and tolerable in participants wearing PPE. Further trials with sample size powered to detect physiological outcomes are needed to assess the effect of the cooling vest on a subject's endurance to heat stress.

To develop a staff training intervention for agitation in people with severe dementia, reaching end-of-life, residing in nursing homes (NHs), test feasibility, acceptability, and whether a trial is warranted.

Feasibility study with pre- and post-intervention data collection, qualitative interviews, and focus groups.

Three NHs in South East England with dementia units, diverse in terms of size, ownership status, and location.

Residents with a dementia diagnosis or scoring ≥2 on the Noticeable Problems Checklist, rated as "severe" on Clinical Dementia Rating Scale, family carers, and staff (healthcare assistants and nurses).

Manualized training, delivered by nonclinical psychology graduates focusing on agitation in severe dementia, underpinned by a palliative care framework.

Main outcomes were feasibility of recruitment, data collection, follow-up, and intervention acceptability. We collected resident, family carer, and staff demographics. Staff provided data on resident's agitation, pain, quality of life, and service receipt. Staff reported their sense of competence in dementia care. Family carers reported on satisfaction with end-of-life care. In qualitative interviews, we explored staff and family carers' views on the intervention.

The target three NHs participated 28 (49%) residents, 53 (74%) staff, and 11 (85%) family carers who were eligible to participate consented. Eight-four percent of staff attended ≥3 sessions, and we achieved 93% follow-up. We were able to complete quantitative interviews. Staff and family carers reported the intervention and delivery were acceptable and helpful.

The intervention was feasible and acceptable indicating a larger trial for effectiveness may be warranted.

The intervention was feasible and acceptable indicating a larger trial for effectiveness may be warranted.

Patients with terminal illness are at high risk of developing delirium, in particular, those with multiple predisposing and precipitating risk factors. Delirium in palliative care is largely under-researched, and few studies have systematically assessed key aspects of delirium in elderly, palliative-care patients.

In this prospective, observational cohort study at a tertiary care center, 229 delirious palliative-care patients stratified by age <65 (N = 105) and ≥65 years (N = 124), were analyzed with logistic regression models to identify associations with respect to predisposing and precipitating factors.

In 88% of the patients, the underlying diagnosis was cancer. Mortality rate and median time to death did not differ significantly between the two age groups. No inter-group differences were detected with respect to gender, care requirements, length of hospital stay, or medical costs. In patients ≥65 years, exclusively predisposing factors were relevant for delirium, including hearing impairment [odds ratio (OR) 3.