The design and implementation of a novel music-based curriculum for dementia care professionals: The experience of SOUND in Italy, Portugal and Romania.

BACKGROUND: The positive effects of active and passive music activities on older people with dementia are well and largely documented by the literature. Nevertheless, the use of music as a non-pharmacological intervention is not so common both in private and public older people care facilities because in-home staff have no competencies for delivering such activities. Conversely, the realization and implementation of a co-designed music-based curriculum for dementia care professionals may help the diffusion of music in the older people care facilities. This study was aimed at evaluating the learning outcomes of the SOUND training, based on an original co-designed music-based curriculum for dementia care professionals and implemented in Italy, Portugal and Romania. METHODS: The SOUND training study was developed through three phases: a) the co-design of the music-based curriculum for dementia care professionals, involving 55 people in the three participating countries; b) the teaching of the training curriculum to 63 dementia care professionals (29 in Italy, 17 in Portugal and 17 in Romania), delivered both in person and via a Moodle platform named Virtual Music Circle; c) the learning outcomes assessment, carried out by means of 13 self-evaluation tests, and a practical test, and the trainees' course evaluation by a questionnaire. RESULTS: Most of the trainees reached the highest score in the evaluation of the theoretical competencies in the three study countries. Conversely, some practical competencies in the facilitation of music activities need to be fine-tuned. The SOUND training course was evaluated very positively in the overall structure, theoretical contents, and practical workshops by the trainees. Nevertheless, they preferred the face-to-face compared to the distance learning methodology in the three countries. CONCLUSIONS: The SOUND training curriculum was effective in teaching music techniques and neurocognitive knowledge to dementia care professionals. Nevertheless, future courses should be differentiated for dementia care professionals with or without previous music knowledge and competencies. Moreover, the course is fully sustainable, because it does not require additional costs given that the curriculum is fully accessible online and it is also replicable because it trains professionals who can continue to apply the method in their working routine.

Anemia in Dogs with Acute Kidney Injury.

Anemia is a well-known complication in CKD dogs, but its frequency in AKI dogs has been poorly investigated. The aim of the present study was to retrospectively evaluate frequency, degree of severity, and regeneration rate of anemia in relation to IRIS grade, etiology, therapy, and outcome. Medical records of dogs (2017-2023) with historical, laboratory, and ultrasound findings consistent with AKI were retrospectively reviewed. According to etiology, AKI was classified as ischemic/inflammatory (IS), infectious (INF), nephrotoxic (NEP), obstructive (OBS), and unknown (UK). AKI dogs were also classified according to therapeutical management (medical vs. hemodialysis), survival to discharge (survivors vs. non-survivors). Anemia was defined as HCT < 37% and classified as mild (HCT 30-37%), moderate (HCT 20-29%), severe (13-19%), or very severe (<13%). Anemia was classified as microcytic (MCV < 61 fL), normocytic (61 and 73 fL), and macrocytic (>73 fL). Anemia was considered hypochromic (MCHC< 32 g/dL), normochromic (32 and 38 g/dL), and hyperchromic (>38 g/dL). Regeneration rate was considered absent (RET ≤ 60,000/µL), mild 61,000-150,000/µL), and moderate (>150,000/µL). A total of 120 AKI dogs were included in the study, and anemia was found in 86/120 dogs (72%). The severity of anemia was mild in 32/86 dogs (37%), moderate in 40/86 dogs (47%), severe in 11/86 dogs (13%), and very severe in 3/86 (3%). Anemia was normochromic in 71/86 dogs (83%), hyperchromic in 12/86 dogs (14%), and hypochromic in 3/86 dogs (3%). Normocytic anemia was present in 56/86 dogs (65%), microcytic anemia in 27/86 dogs (31%), and macrocytic anemia in 3/86 dogs (4%). Non-regenerative anemia was found in 76/86 dogs (88%). The frequency of anemia increased significantly (p < 0.0001) with the progression of IRIS grade, although no significant difference in the severity of anemia was found among the IRIS grades. The frequency of non-regenerative forms of anemia was significantly higher than regenerative forms (p < 0.0001) in all IRIS grades. In our population of AKI dogs, anemia was a very frequent finding, in agreement with current findings in human nephrology.

Adolescent Young Carers Who Provide Care to Siblings.

A child's disability, long-term illness, or mental ill-health is known to affect siblings' health, social life, school engagement, and quality of life. This article addresses a research gap by its focus on young sibling carers and the impact of providing care to a sibling. A cross-national survey study was conducted in 2018-2019 (Italy, the Netherlands, Slovenia, Sweden, Switzerland, the UK) to examine the incidence of adolescent sibling carers, the extent of care they provide, and their self-reported health, well-being, and school situation. The survey was completed by 7146 adolescents, aged 15-17, and 1444 of them provided care to family members with health-related conditions. Out of these, 286 were identified as Sibling Carers and 668 as Parent Carers, while 181 had both sibling(s) and parent(s) with health-related conditions, and thus were identified as Sibling-Parent Carers. Sibling Carers and Sibling-Parent Carers carried out higher levels of caring activities compared to Parent Carers. They reported both positive aspects of caring, such as increased maturity, and negative aspects, such as mental ill-health, impact on schooling and a lack of support. To reduce the negative aspects of a sibling carer role, it is important to recognise them and to implement early preventive measures and formal support.

Predictors of Deterioration in Mental Well-Being and Quality of Life among Family Caregivers and Older People with Long-Term Care Needs during the COVID-19 Pandemic.

BACKGROUND: During the COVID-19 pandemic, reduced access to care services and fear of infection prompted families to increase home care for their older relatives with long-term care needs. This had negative effects on both members of the caring dyad, impacting their quality of life (QoL) and mental well-being. This study investigated the factors that influenced the mental well-being and QoL of 239 dyads, before and after the first pandemic wave in Italy. METHODS: Data were collected through a survey on the use of health and social care services and interventions by older care recipients living in the community and their family caregivers. Factors associated with deterioration of mental well-being and QoL in older care recipients (mean age 86.1 years old) and their family caregivers after the pandemic were studied. RESULTS: The importance attached by family caregivers to the skills and training of healthcare professionals was a protective factor against the deterioration in the well-being of older care recipients. Similarly, the importance associated by family caregivers to the help received from healthcare professionals was a protective factor for QoL. Financial hardship of older care recipients was a risk factor for deterioration in caregivers' mental well-being, while support from other family members was a protective factor for QoL. CONCLUSIONS: The presence of attentive healthcare professionals, a supportive family environment, and economic support can reduce the burden on both the caregiver and the older care recipient. These aspects need to be considered in any future emergency situation and when planning care services for community-dwelling older people.