The use of constant observation with people with dementia in hospitals: a mixed-methods systematic review.

OBJECTIVES: Constant observation is used in hospitals with people with dementia to manage their safety. However, opportunities for proactive care are not consistently recognised or utilised. A systematic review of constant observation was conducted to understand measures of effectiveness and facilitators for person-centred approaches. METHOD: Electronic databases were searched between 2010 and 2022. Four reviewers completed screening, quality assessments and data extraction with 20% checked for consistency. Findings were presented through narrative synthesis (PROSPERO registration CRD42020221078). FINDINGS: Twenty-four studies were included. Non-registered staff without specific training were the main providers of constant observation. Assessments and processes clarifying the level of observation encouraged reviews that linked initiation and discontinuation to a patient's changing needs. Examples of person-centred care, derived from studies of volunteers or staff employed to provide activities, demonstrated meaningful engagement could reassure a person and improve their mood. Proactive approaches that anticipated distress were thought to reduce behaviours that carried a risk of harm but supporting evidence was lacking. CONCLUSION: Non-registered staff are limited by organisational efforts to reduce risk, leading to a focus on containment. Trained staff who are supported during constant observation can connect with patients, provide comfort and potentially reduce behaviours that carry a risk of harm.

Efficacy of Potential Control Agents Against Rosellinia necatrix and Their Physiological Impact on Avocado.

Rosellinia necatrix is the causal agent of white root rot (WRR), a fatal disease affecting many woody plants, including avocado (Persea americana). As with other root diseases, an integrated approach is required to control WRR. No fully effective control methods are available, and no chemical or biological agents against R. necatrix have been registered for use on avocado in South Africa. Fluazinam has shown promising results in the greenhouse and field in other countries, including Spain. The current study aimed to investigate the potential of a fumigant, chloropicrin, and biological control agents (B-Rus, Beta-Bak, Mity-Gro, and Trichoderma) against R. necatrix both in vitro and in vivo as compared with fluazinam. In a greenhouse trial, results showed that Trichoderma and B-Rus were as effective as fluazinam at inhibiting R. necatrix in vitro and suppressed WRR symptoms when applied before inoculation with R. necatrix. In contrast, Mity-Gro and Beta-Bak failed to inhibit the pathogen in vitro and in the greenhouse trial, despite application of the products to plants before R. necatrix infection. Fluazinam suppressed WRR symptoms in plants when applied at the early stages of infection, whereas chloropicrin rendered the pathogen nonviable when used as a preplant treatment. Plants treated with Trichoderma, B-Rus, and fluazinam sustained dry mass production and net CO2 assimilation by maintaining the green leaf tissues despite being infected with the pathogen. This study has important implications for the integrated management of WRR.

Cell division versus cell elongation: the control of radicle elongation during thermoinhibition of Tagetes minuta achenes.

Endogenous embryo factors, which act mainly in the radicle, prevent germination in Tagetes minuta at high temperatures. These factors act to prevent cell elongation, which is critical for radicle protrusion under optimal conditions. Once the radicle has emerged both cell elongation and cell division are required for post-germination growth. Germination can be induced at high temperatures by fusicoccin, which rapidly stimulates cell elongation. In addition, priming seeds at 25 degrees C on polyethylene glycol (PEG) 6000 and mannitol could also induce germination on water at 36 degrees C, indicating that priming prevents radicle protrusion at a point subsequent to the point of control in thermoinhibited achenes. Flow cytometry studies revealed that DNA synthesis occurs during thermoinhibition and the inhibition of DNA synthesis during this process inhibits subsequent germination on water under optimal conditions, suggesting a protective role for DNA synthesis in thermoinhibited achenes of T. minuta.

Factors contributing to the regulation of thermoinhibition in Tagetes minuta L.

Thermoinhibition in Tagetes minuta achenes is tightly and rapidly regulated with regard to its imposition and release, with both processes occurring within 2-3h. Germination at high temperatures is almost exclusively regulated by the embryo, while the pericarp appears to play only a minor role. Thermoinhibition in T. minuta could not be alleviated by any single plant growth regulator application, but a combination of treatments that both reduced ABA levels and increased ethylene levels were able to restore germination at supraoptimal temperatures. This suggests a role for both ethylene and ABA in the imposition of thermoinhibition in this species.

Xanthine dehydrogenase and aldehyde oxidase impact plant hormone homeostasis and affect fruit size in 'Hass' avocado.

The contribution of xanthine dehydrogenase (XDH, EC 1.1.1.204) to fruit size was investigated using the normal and small-fruit variants of Persea americana Mill. cv. 'Hass'. Inhibition of XDH by treatment of normal fruit, in the linear phase of growth (phase II), with allopurinol (Allo) arrested fruit growth. Adenine (Ade), a less effective inhibitor of this enzyme, also arrested fruit growth when applied in phase II and slowed fruit growth when applied in phase III. A time-course study on the activity of XDH in mesocarp tissue from normal and small fruit showed that maximum activity occurred late in phase II and that the peak in activity was absent in mesocarp of the small fruit. Feeding Ade to growing fruit in phase III caused a transient decline in fruit growth (measured as change in fruit length). Thereafter, growth resumed although fruit size was irreversibly affected. Treatment of fruit with Ade and Ade-containing cytokinins altered activity of another molybdenum enzyme, aldehyde oxidase (EC 1.2.3.1). Cytokinin oxidase was induced by cytokinin and auxin. Purine catabolism via hypoxanthine/xanthine was operative in normal fruit and in mesocarp from the small-fruit variant and as expected, Allo treatment caused accumulation of xanthine and adenine. In the absence of an increase in XDH during growth of the small-fruit phenotype, low levels of Ade were interpreted as resulting from respiration-enhanced adenylate depletion. Stress and/or pathogen induction of the alternative oxidase pathway is proposed as a possible cause.