The effect of multimodal comprehensive care methodology training on oral health care professionals' empathy for patients with dementia.

BACKGROUND: The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. METHODS: This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants' empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). RESULTS: The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. CONCLUSIONS: The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals' empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. TRIAL REGISTRATION: UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687 . Registered 4 September 2020 - Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586.

Temporoorbital pulse rate can be obtained in ball pythons (Python regius) of any size and age and agrees with heart rate.

BACKGROUND: Currently, a standardised technique to obtain pulse rate in reptiles is lacking. We evaluated the feasibility of obtaining a temporoorbital pulse rate in ball pythons of various ages and sizes and whether it agreed with the heart rate. METHODS: Heart rate and pulse rate were recorded in 40 ball pythons (Python regius) weighing between 0.05 and 2.2 kg using a standard veterinary ultrasonic Doppler flow detector. The temporoorbital pulse rate was obtained on the dorsal aspect of the head at the level of the temporoorbital artery. Each measurement was performed in a randomised fashion by two operators, who were blinded to each other's results. RESULTS: Pulse rate and heart rate were successfully obtained for all snakes. The median heart rate was 60 beats per minute (bpm) (range 48‒88 bpm), and the median pulse rate was 60 bpm (range 48‒88 bpm). The mean difference between the pulse rate and heart rate was 1.2 beats (95% limits of agreement: ‒10.6 to 13.0). When pulse rate and heart rate were measured at the same time, they were synchronous. LIMITATIONS: Only healthy snakes were included. CONCLUSIONS: Temporoorbital pulse rates can be easily obtained in ball pythons of any size. This novel method to assess peripheral pulse allows for a more complete cardiovascular evaluation in this species.

Red-Colored Circularly Polarized Luminescence from a Benzo-Fused BODIPY-BINOL Complex.

Red emission with sharp bandwidth and high quantum yield is a desired characteristic for organic chromophores in optoelectronic, spintronic, and biomedical applications. Here, we observe circularly polarized luminescence (CPL) with these characteristics from a benzo-fused BODIPY-BINOL complex (1). Using time-resolved optical spectroscopy, electrochemistry, and density functional theory calculations, we showed that the emissive excited state of 1 does not have a charge-transfer (CT) character, unlike that of the regular BODIPY counterpart (2). The rigidity and the lack of CT character make this class of molecules an appealing platform for CPL-active molecules in the red spectral region, with ample room for improvement in the dissymmetry factor and brightness.

Nature Immersion in an Extreme Environment: Hiroshima Survivors' Personal Emergence Following Their Atomic Bomb Experience.

INTRODUCTION: Nature immersion is defined as multidimensional connecting with earthy materials to generate personal emergence. Personal emergence is an embodied healing force observable via synchronization of bodily rhythms. Research has revealed positive effects of green space for healing. However, little is known about healing of survivors in the space impacted with radioactive nuclear energies. PURPOSE: To use the theory of nature immersion to guide exploration of the concepts of connecting with earthy materials, personal emergence and space-time expansion in a sample of people who had experienced the catastrophic nature upheaval of the Hiroshima bombings on 6 August 1945. METHOD: A descriptive exploratory design with directed content analysis was used with existing qualitative data consisting of 29 Hiroshima atomic-bombing survivors' description of their experience. RESULTS: Self-healing empirically manifested through 23 survivors' connection with earthy materials. There was synchrony between recuperating natural space and healing of survivors. CONCLUSIONS: Synchrony, as a dimension of human connection with nature, transcended the disharmony of bombing upheaval. Although further exploration is necessary, these findings serve as evidence about the essence of healing as related to nature for those in extreme environments.

Chemical redox-induced chiroptical switching of supramolecular assemblies of viologens.

A chiral supramolecular assembly exhibiting redox-induced changes in its chiroptical properties was prepared using viologen-modified glutamide (G-V2+) derivatives. Achiral viologen moieties in the G-V2+ assembly were chirally orientated by glutamide groups, affording a unique orange-colored solution, with a visible absorption band at around 470 nm, having electronic circular dichroism (CD) signals (molar ellipticity [θ] = 0.58 × 105 deg cm2 dmol-1: absorption dissymmetry factors (g) = 5.2 × 10-3 at 512 nm). The G-V2+ could be reduced to its cation radical (G-V+˙) but retains its chiral assembly. After chemical reduction, the color change from orange to blueish violet, indicating an absorption band at approximately 560 nm, and the sign change of the CD signal from positive to negative ([θ] = -0.36 × 105 deg cm2 dmol-1; g = -2.9 × 10-3 at 580 nm) were observed in water. Subsequent oxidation re-introduces the G-V2+ chiroptical behavior before reduction.

Development and Evaluation of the Behavioral and Psychological Symptoms of Dementia Questionnaire 13-Item Version (BPSD13Q).

INTRODUCTION: Most behavioral and psychological symptoms of dementia (BPSD) scales have copyright issues and are difficult for care staff to use in daily care settings because they were primarily designed for physicians. Therefore, an easier tool for care staff is required. This study aimed to develop and validate the BPSD questionnaire 13-item version (BPSD13Q). METHODS: We obtained data from 444 people with dementia living in group homes in Japan using the BPSD plus questionnaire (BPSD + Q; 27-item version) and Neuropsychiatric Inventory Nursing Home version (NPI-NH). We selected appropriate items to make a short-form version of the BPSD + Q and examined the construct validity, internal consistency, and criterion-related validity of the questionnaire. RESULTS: By the pilot review, research on correlations with similar items from comparable scales, and factor analysis, we reduced 27 items to 13 items (BPSD13Q). The BPSD13Q and BPSD13Q-distress (BPSD13Q-D) showed good internal consistency (Cronbach's α = 0.76 and 0.80, respectively). Moreover, the BPSD13Q was positively correlated with the NPI-NH (r = 0.72, p < 0.001) and BPSD + Q (r = 0.95, p < 0.001). The BPSD13Q-D was positively correlated with the NPI-NH-caregiver distress (r = 0.74, p < 0.001) and BPSD + Q-distress (r = 0.96, p < 0.001). CONCLUSION: We developed and validated the BPSD13Q, which is a short-form version of the BPSD + Q and is downloadable. The BPSD13Q may make BPSD evaluations easier for the care staff.

The Power of Documentary Theatre to Promote Cross-National Understanding: Personal Impact of Performing With Their Voices Raised by Japanese and American Youth Actors.

PURPOSE: The purpose of this article is to share descriptions of the personal impact for cross-national youth actors (Japanese, American) who performed With Their Voices Raised (Voices), a documentary theater script that shares the stories of Pearl Harbor and Hiroshima survivors who lived through the bombings of December 7, 1941, and August 6, 1945, respectively. DESIGN/METHODS: This was a descriptive exploratory focus group study conducted immediately after student-actors from Funairi High School in Hiroshima (n = 15) and Farrington High School in Oahu, Hawaii (n = 8), performed Voices. Data were content analyzed by a cross-national research team to address the question "What was the personal impact of performing Voices for Japanese and American youth actors?" FINDINGS: There were three themes that crossed national boundaries: sense of power of the message from real-life people, new cross-national awareness, and moving beyond familiar history to engage and learn. The fourth theme distinguished the youth groups: for Japanese youth, performing Voices inspired an awareness of their local focus; for American youth, it enlivened youth-to-youth engagement as a learning approach. CONCLUSIONS: Documentary theater script is a creative, holistic approach with the potential to bridge divisiveness and promote cross-national understanding.

Reduction of Behavioral Psychological Symptoms of Dementia by Multimodal Comprehensive Care for Vulnerable Geriatric Patients in an Acute Care Hospital: A Case Series.

Management of Behavioral and Psychological Symptoms of Dementia (BPSD) is a key challenge in geriatric dementia care. A multimodal comprehensive care methodology, Humanitude, with eye contact, verbal communication, and touch as its elements, was provided to three geriatric dementia patients for whom conventional nursing care failed in an acute care hospital. Each episode was evaluated by video analysis. All patients had advanced dementia with BPSD. Failure of care was identified by patient's shouting, screaming, or abrupt movements of limbs. In this case series, conventional care failed for all three patients. Each element of care communication was much shorter than in Humanitude care, which was accepted by the patients. The average of the elements performed during the care was eye contact 0.6%, verbal communication 15.7%, and touch 0.1% in conventional care and 12.5%, 54.8%, and 44.5% in Humanitude care, respectively. The duration of aggressive behavior of each patient during care was 25.0%, 25.4%, and 66.3% in conventional care and 0%, 0%, and 0.3% in Humanitude, respectively. In our case series, conventional care was provided by less eye contact, verbal communication, and touch. The multimodal comprehensive care approach, Humanitude, decreased BPSD and showed success by patients' acceptance of care.

Creating a duet: The Couples Life Story Approach in the United States and Japan.

There is a global need for interventions that help couples who are dealing with dementia. This paper describes the way in which interventionists from the United States and Japan participated in the development of an intervention for dyads in which one person is experiencing memory loss. The 5-week intervention, the Couples Life Story Approach, helps dyads to reminisce about their life together as a couple, to work on their patterns of communication, and to develop a Life Story Book. Based on an analysis of cases conducted in the United States (n = 20 couples) and Japan (n = 9 couples), this paper highlights the cross-fertilization process that has occurred as interventionists from the two countries have shared their experiences with one another. Using case illustrations, the discussion focuses on the clinical themes that have emerged for couples in the United States and Japan.

A lifelong journey of moving beyond wartime trauma for survivors from Hiroshima and Pearl Harbor.

This study examines 51 stories of health, shared by people who survived the wartime trauma of Hiroshima and Pearl Harbor, seeking to identify turning points that moved participants along over their lifetime. The central turning point for Hiroshima survivors was "becoming Hibabusha (A-bomb survivor)" and for Pearl Harbor survivors was "honoring the memory and setting it aside." Wartime trauma was permanently integrated into survivors' histories, surfacing steadily over decades for Hiroshima survivors and intermittently over decades for Pearl Harbor survivors. Regardless of experience or nationality, participants moved through wartime trauma by connecting with others, pursuing personal and global peace.

Heeding the behavioral message of elders with dementia in day care.

Embodied language is unity of bodily, linguistic, and behavioral descriptors, expressed as health. Disagreement behavior, client unwillingness to respond as requested when uncomfortable in a situation, occurs in elders with dementia. Case study analysis suggests that agitation/aggression may be avoided if disagreement behavior is recognized as a message of discomfort.

Sequence analysis of three plasmids harboured in Rhodococcus erythropolis strain PR4.

Rhodococcus erythropolis strain PR4 has been isolated as an alkane-degrading bacterium. The strain harbours one linear plasmid, pREL1 (271 577 bp) and two circular plasmids, pREC1 (104 014 bp) and pREC2 (3637 bp), all with some sequence similarities to other Rhodococcus plasmids. For pREL1, pREC1 and pREC2, 298, 102 and 3 open reading frames, respectively, were predicted. Linear plasmid pREL1 has several regions homologous to plasmid pBD2 found in R. erythropolis BD2. Sequence analysis of pREL1 and pBD2 identified common metal-resistance genes on both, but pREL1 also encodes alkane-degradation genes not found on pBD2, with enzyme constituents some of which are quite different from those of other organisms. The alkane hydroxylase consisted of a cytochrome P450 monooxygenase, a 2Fe-2S ferredoxin, and a ferredoxin reductase. The ferredoxin reductase amino acid sequence resembles the AlkT (rubredoxin reductase) sequence. A zinc-containing alcohol dehydrogenase further oxydizes alkanols, alkane oxidation products catalysed by alkane hydroxylase. Of the circular plasmids, the pREC1 sequence is partially similar to the sequence of pREAT701, the virulence plasmid found in Rhodococcus equi. pREC1 has no pREAT701 virulence genes and encodes genes for beta-oxidation of fatty acids. Thus, joint actions of enzymes encoded by pREL1 and pREC1 may enable efficient mineralization of alkanes.