Search

BackgroundInternet-based dementia caregiver interventions have been shown to be effective for a range of caregiver outcomes; however, little is known about how to best implement them. We developed iGeriCare, an evidence-based, multimedia, web-based educational resource for family caregivers of people living with dementia. ObjectiveThis study aims to obtain feedback and opinions from experts and clinicians involved in dementia care and caregiver education about 1 iGeriCare and 2 barriers and facilitators to implementing a web-based caregiver program. MethodsWe carried out semistructured interviews with individuals who had a role in dementia care and/or caregiver education in several key stakeholder settings in Southern Ontario, Canada. We queried participants’ perceptions of iGeriCare, caregiver education, the implementation process, and their experience with facilitators and barriers. Transcripts were coded and analyzed using a grounded theory approach. The themes that emerged were organized using the Consolidated Framework for Implementation Research. ResultsA total of 12 participants from a range of disciplines described their perceptions of iGeriCare and identified barriers and facilitators to the implementation of the intervention. The intervention was generally perceived as a high-quality resource for caregiver education and support, with many stakeholders highlighting the relative advantage of a web-based format. The intervention was seen to meet dementia caregiver needs, partially because of its flexibility, accessibility, and compatibility within existing clinical workflows. In addition, the intervention helps to overcome time constraints for both caregivers and clinicians. ConclusionsStudy findings indicate a generally positive response to the use of internet-based interventions for dementia caregiver education. Results suggest that iGeriCare may be a useful clinical resource to complement traditional face-to-face and print material–based caregiver education. More comprehensive studies are required to identify the effectiveness and longevity of web-based caregiver education interventions and to better understand barriers and facilitators with regard to the implementation of technology-enhanced caregiver educational interventions in various health care settings.

Purpose: This paper investigates the levels of career resilience and self-efficacy of the principals of primary school units, identifies the relationship between them and determines the effect of the demographic elements of the sample on their career resilience and self-efficacy. Design/methodology/approach: The convenient sample of this study was 165 principals from public schools across the prefecture of Central Macedonia. A total of 422 questionnaires were mailed to all principals of kindergarten and elementary schools, accompanied by a personal letter to inform them about the procedure and the purpose of the survey. A pilot survey took place to check the adequacy of and get feedback on the questionnaire. The questionnaire used in the study consisted of three parts: The Career Resilience Scale (CRS) by Kodama (2015), the Principal Self-Efficacy Scale (PSES) by Tschannen-Moran and Gareis (2004) and demographic questions. Findings: The results of the survey showed that principals have high levels of career resilience and very high levels of self-efficacy. There are four factors that form the levels of career resilience: (a) problem-solving skills (b) social skills (c) interest in innovation and (d) optimism for the future. Demographic factors play a role in shaping career resilience as they affect two of the four factors. There are two factors that shape levels of self-efficacy: (a) self-efficiency in administration and (b) self-efficiency in moral leadership. Demographic factors play a role in shaping the factor of self-efficacy that refers to administration. Finally, there was a high positive correlation and a causal relationship between career resilience and self-efficacy. Research limitations/implications: The convenient sample used in the present study is a limiting factor, as it may not be representative of Greek primary school principals. Also, research is based on self-evaluation questionnaires, which may show a lack of objectivity, as the answers may reflect the personal worldviews of leaders and particular needs of educational institutions (Sarid, 2021). This fact may not allow us to generalize the results. Practical implications: The present study showed that resilience and self-efficacy have a causal relationship and that one enhances another, making their relation pivotal for a successful educational leadership. Regarding the professional development of school leaders, educational leadership training programs could be designed and offered by the Greek Ministry of Education (Dexter et al., 2020). Coaching programs and practices that help principals develop social skills, coping mechanisms, emotional capacities and confidence in one's knowledge should be widely introduced. Governments have to take the necessary initiative to ensure that, particularly in adverse contexts, education stimulate and nurture resilience and self-efficacy among citizens, by promoting appropriate lifelong learning programs and by ensuring the continuous training of employees (Renko et al., 2020). Social implications: Career resilience and self-efficacy ensures economic prosperity in times of crisis, globalization and rapid technology development and may be the best way to create strong and successful leaders. Coaching programs and practices that help principals develop social skills, coping mechanisms, emotional capacities and confidence in one's knowledge should be widely introduced. The results of the present research could prove helpful in developing strategic plans, building networks between organizations to improve communication and flow of information, through employee exchange programs. Originality/value: This research, which combined career resilience and self-efficacy, took place for the first time in Greece. The CRS by Kodama (2015) was also used for the first time in Greek population.

The molecular connections between homeostatic systems that maintain both genome integrity and proteostasis are poorly understood. Here we identify the selective activation of the unfolded protein response transducer IRE1α under genotoxic stress to modulate repair programs and sustain cell survival. DNA damage engages IRE1α signaling in the absence of an endoplasmic reticulum (ER) stress signature, leading to the exclusive activation of regulated IRE1α-dependent decay (RIDD) without activating its canonical output mediated by the transcription factor XBP1. IRE1α endoribonuclease activity controls the stability of mRNAs involved in the DNA damage response, impacting DNA repair, cell cycle arrest and apoptosis. The activation of the c-Abl kinase by DNA damage triggers the oligomerization of IRE1α to catalyze RIDD. The protective role of IRE1α under genotoxic stress is conserved in fly and mouse. Altogether, our results uncover an important intersection between the molecular pathways that sustain genome stability and proteostasis.

To understand experiences and perceptions on non-pharmacological treatment of vertebral fractures and virtual-care from the perspective of care professionals' (HCPs) We conducted semi-structured interviews with 13 HCPs within Canada (7 F, 6 M, aged 46 ± 12 years) and performed a thematic and content analysis from a post-positivism perspective. Two themes were identified: acuity matters when selecting appropriate interventions; and roadblocks to receiving non-pharmacological interventions. We found that treatment options were dependent on the acuity/stability of fracture and were individualized accordingly. Pain medication was perceived as important, but non-pharmacological strategies were also considered helpful in supporting recovery. Participants discussed barriers related to the timely identification of fracture, referral to physiotherapy, and lack of knowledge among HCPs on how to manage osteoporosis and vertebral fractures. HCPs reported positive use of virtual-care, but had concerns related to patient access, cost, and comprehensive assessments. HCPs used and perceived non-pharmacological interventions as helpful and selected specific treatments based on the recency of fracture and patient symptoms. HCPs' also believed that virtual-care that included an educational component, an assessment by a physiotherapist, and an exercise group was a feasible alternative, but concerns exist and may require further evaluation. Non-pharmacological strategies in combination with pain medication may be a more effective strategy to support recovery than pain medication alone but should be informed by fracture acuity and patient symptoms. To improve access to physiotherapy and other non-pharmacological treatment options during the acute or chronic management of vertebral fractures, it may be worthwhile to explore the effectiveness and feasibility of virtual-care. [ABSTRACT FROM AUTHOR]

GERAS DANcing for Cognition and Exercise is a therapeutic dance program for older adults with cognitive or mobility impairments. Using a pre-/posttest study design, we investigated the effect of 12 weeks of dance on the short performance physical battery (SPPB). In 107 participants aged 61–93 (mean 76.1, SD = 7.0; 20% men), over 90% had multifrailty and/or cognitive impairment. The mean attendance rate was 18/24 classes (75%). A substantial minimal clinically important difference (>0.4) occurred for SPPB total (+0.53, SD = 2.04, p =.002) and chair stands (+0.45, SD = 0.92, p <.001). Individuals with baseline SPPB ≤8 points (n = 38)—indicative of sarcopenia and physical frailty—had the most marked improvement (SPPB total: +1.45, SD = 1.97, p <.001; balance: +0.65, SD = 1.27, p =.006; chair stands: +0.68, SD = 0.97, p <.001). GERAS DANcing for Cognition and Exercise may be a promising rehabilitation intervention to improve daily physical function. [ABSTRACT FROM AUTHOR]

Older adults who are frail are likely to be sedentary. Prior interventions to reduce sedentary time in older adults have not been effective as there is little research about the context of sedentary behaviour (posture, location, purpose, social environment). Moreover, there is limited evidence on feasible measures to assess context of sedentary behaviour in older adults. The aim of our study was to determine the feasibility of measuring context of sedentary behaviour in older adults with pre-frailty or frailty using a combination of objective and self-report measures. We defined "feasibility process" using recruitment (20 participants within two-months), retention (85%), and refusal (20%) rates and "feasibility resource" if the measures capture context and can be linked (e.g., sitting-kitchen-eating-alone) and are all participants willing to use the measures. Context was assessed using a wearable sensor to assess posture, a smart home monitoring system for location, and an electronic or hard-copy diary for purpose and social context over three days in winter and spring. We approached 80 potential individuals, and 58 expressed interest; of the 58 individuals, 37 did not enroll due to lack of interest or medical mistrust (64% refusal). We recruited 21 older adults (72±7.3 years, 13 females, 13 frail) within two months and experienced two dropouts due to medical mistrust or worsening health (90% retention). The wearable sensor, indoor positioning system, and electronic diary accurately captured one domain of context, but the hard copy was often not completed with enough detail, so it was challenging to link it to the other devices. Although not all participants were willing to use the wearable sensor, indoor positioning system, or electronic diary, we were able to triage the measures of those who did. The use of wearable sensors and electronic diaries may be a feasible method to assess context of sedentary behaviour, but more research is needed with device-based measures in diverse groups. [ABSTRACT FROM AUTHOR]