The Alzheimer’s Dementia Patients’ Observed Illness Course and Experience in Ghana and Care Lessons to Be Learnt: A Mental Health Professional’s Perspective

Alzheimer’s disease (AD) and associated dementia patient numbers continue to increase globally with associated economic costs to healthcare systems. Of note is the increase in numbers in lower and middle-income countries (LMICs) including Sub-Saharan African (SSA) countries, which already face challenges with their health budgets from communicable and non-communicable diseases. Ghana, an SSA country, faces the problem of healthcare budgetary difficulties and the additional impact of AD as a consequence of increasing population strata of old aged persons (OAPs) due to the demographic transition effect. This article uses examples of known patients’ illness courses to give a perspective on the lived experience of patients with dementia (PWD) in Ghana, living amongst a populace with a culture of stigmatization of PWD, and a relatively fragile public mental health system (PMHS) for those with mental illness, including AD. The lived experience of AD patients is characterised by stigmatisation, discrimination, non-inclusiveness, diminished dignity and human rights abuses in the face of their mental disability, and eventually death. This article is an advocacy article giving voice to the voiceless and all persons suffering from AD and other dementias in Ghana, whilst pleading for a call to action from healthcare professionals and responsible state agencies.

Adsorption behavior of CO_(2)/H_(2)S mixtures in calcite slit nanopores for CO_(2) storage:An insight from molecular perspective

It is acknowledged that injecting CO_(2) into oil reservoirs and saline aquifers for storage is a practical and affordable method for CO_(2) sequestration.Most CO_(2) produced from industrial exhaust contains impurity gases such as H_(2)S that might impact CO_(2) sequestration due to competitive adsorption.This study makes a commendable effort to explore the adsorption behavior of CO_(2)/H_(2)S mixtures in calcite slit nanopores.Grand Canonical Monte Carlo(GCMC)simulation is employed to reveal the adsorption of CO_(2),H_(2)S as well as their binary mixtures in calcite nanopores.Results show that the increase in pressure and temperature can promote and inhibit the adsorption capacity of CO_(2) and H_(2)S in calcite nanopores,respectively.CO_(2)exhibits stronger adsorption on calcite surface than H_(2)S.Electrostatic energy plays the dominating role in the adsorption behavior.Electrostatic energy accounts for 97.11%of the CO_(2)-calcite interaction energy and 56.33%of the H_(2)S-calcite interaction energy at 10 MPa and 323.15 K.The presence of H_(2)S inhibits the CO_(2) adsorption in calcite nanopores due to competitive adsorption,and a higher mole fraction of H_(2)S leads to less CO_(2) adsorption.The quantity of CO_(2) adsorbed is lessened by approximately 33%when the mole fraction of H_(2)S reaches 0.25.CO_(2) molecules preferentially occupy the regions near the po re wall and H_(2)S molecules tend to reside at the center of nanopore even when the molar ratio of CO_(2) is low,indicating that CO_(2) has an adsorption priority on the calcite surface over H_(2)S.In addition,moisture can weaken the adsorption of both CO_(2) and H_(2)S,while CO_(2) is more affected.More interestingly,we find that pure CO_(2) is more suitable to be sequestrated in the shallower formations,i.e.,500-1500 m,whereas CO_(2)with H_(2)S impurity should be settled in the deeper reservoirs.

Outcomes and patients' perspectives of transition from paediatric to adult care in inflammatory bowel disease

AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition process.RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices (of the options offered) was a shared clinic appointment with all key stakeholders.CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans.

Experience of the patient's success in facing post-stroke urinary incontinence: the patient's perspective

Objective:Post-stroke urinary incontinence(UI)is one of the sequelae of stroke.This situation affects all aspects of the patient’s life–physically,psychologically,socially,and spiritually.This study aimed to investigate the experience of patients’success in facing a post-stroke UI.Methods:A qualitative study using the Rapid Assessment Procedure(RAP)approach was used in this study.Informants were selected using purposive sampling.In-depth interviews with as many as 8 patients who had recovered from post-stroke UI and living in the greater area of Southeast Sulawesi(Indonesia)were conducted.In-depth interviews were also conducted with 8 caregivers and 2 nurses.Data were analyzed using a thematic analysis approach and interpretation of data was based on Humanbecoming theory and Self-care deficit theory of nursing.Results:Five successful things the patients experienced during post-stroke UI were identified.The five successes were as follows:they provided information to get to know and understand post-stroke UI,followed the procedures to overcome post-stroke UI,conducted self-control exercises and stayed motivated,performed daily activities independently according to ability,and made use of family suppor t and peers’attention.Conclusions:These findings indicated that persistence,belief,independence,and social support(family and peer)made patients to successfully face their post-stroke UI and improved their quality of life.These findings also became the basis for developing a poststroke UI management model based on Humanbecoming theory and Self-care deficit theory of nursing.

Intensive care environment: Perspective of relatives of critically ill patient sustained by health technology

The intensive care unit(ICU)is a complex setting by nature,and some have described it as bizarre due to its numerous sirens that sound when anything is dangerous,constant activity,equipment,bright lights,and high fatality rate.The demands placed on nurses to care for critically ill patients in this environment frequently prevent nurses and other health‑care professionals from acknowledging the feelings of patient’s relatives or family caregivers,resulting in a hostile environment from the patient’s relative’s perspective.When a patient’s family enters the ICU,they feel that hospital administrators do little to nothing to alleviate their discomfort and fear.Despite research demonstrating the importance of providing a homely environment for patients’families,In Nigeria ICU is still far behind how a conventional ICU environment should be structured to accommodate patient’s relations in the unit.The goal of this study was to look at the patient’s relative’s perspective on providing care for a critically ill patient in an ICU,with a focus on the unit’s complexity and overall experience.Based on the findings of this study,we recommend that hospital administrators ensure that the environment of the upcoming ICU is designed to meet the needs of patient’s relatives by addressing identified environmental concerns,like caring neglect,by providing a friendly and stress‑free environment.

Hello,can you hear me?Orthopaedic clinic telephone consultations in the COVID-19 era-a patient and clinician perspective

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare delivery.As a result of this,hospital footfall required to be reduced due to increased risk of transmission of infection.To ensure patients can safely access healthcare,we introduced orthopaedic clinic telephone consultations in our busy district general hospital.AIM To investigate patients’and clinicians’perspective of telephone consultations during COVID-19,and whether this method of consultation could be a viable option in the post-pandemic future.METHODS This is a single centre,prospective study conducted in a busy National Health Service district general hospital.In May 2020,100 non-consecutive adult patients were contacted by independent investigators within 48 h of their orthopaedic clinic telephone consultation to complete a telephone satisfaction questionnaire.The questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long term.Satisfaction and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey tool.RESULTS 93%of patients were overall satisfied with telephone consultations and 79%were willing to continue this method of consultation post-pandemic.Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment.72%of clinicians reported overall satisfaction with this service and 80%agreed that telephone consultations should be used in the future.The majority found it less laborious in time and administration in comparison to face to face consultations.Patients and clinicians expressed their desire for video consultations as a method of further improving their experience with remote consultations.CONCLUSION Our study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic,achieving the aim of reducing hospital footfall.This method of consultation has resulted in immense clinician and patient satisfaction.Our findings suggest that this tool has benefits in post pandemic healthcare delivery.It has also highlighted that telephone consultations can act as a steppingstone to the introduction of the more complex platform of video consulting.

The Impact of Nursing Staff’s Work Attitude on the Fear of Patients Recovering from Benign Tumors:Family Support as a Mediating Variable

The perception of nursing staff’s attitude influences patient fear.Understanding this dynamic is crucial for fostering a supportive environment conducive to patient well-being and effective healthcare practices.The purpose of this research is to investigate how the attitudes and behaviours of nursing staff influence the fear and anxiety levels of patients recovering from benign tumors,aiming to improve patient care and recovery outcomes.Data was collected from a sample of 100 participants,comprising 20 nursing staff and 80 patients recovering from benign tumors.Surveys were administered to gather quantitative data on attitudes and fear levels.Participants were selected randomly from hospital records and outpatient clinics.Our analysis encompassed nursing staff attitude,patient fear levels,the influence of family support,progression of tumor recovery,patient-reported satisfaction,and the quality of healthcare services provided.The quantitative aspect utilized PLS-SEM software to perform regression analysis,evaluating both direct and indirect effects.Statistical analysis assessed the relationships between nursing staff attitudes,patient fear during benign tumor recovery,and the mediating role of family support.The findings of the study demonstrate that better nurse attitudes(Hypothesis 1,β=0.45,p<0.001)and stronger family support(Hypothesis 2,β=0.32;p<0.001) are linked to lower levels of patient fear.Partially mediating the relationship between nurse attitudes and patient fear,according to Hypothesis 3(β=0.28,p<0.002),is family support.Patients’perceptions of family support are highly influenced by nursing behaviour,as demonstrated by Hypothesis 4(β=0.38;p<0.001).Our research showed a strong relationship between the attitudes of nursing personnel and patient fear levels.Family support demonstrated a strong mediating effect on patient fear.Patient-reported satisfaction is positively correlated with family support.However,no significant relationship was found between healthcare service quality and patient fear.

Second-order problem solving:Nurses'perspectives on learning from.near misses

Objectives:Near misses happen more frequently than actual errors,and highlight system vulnerabilities without causing any harm,thus provide a safe space for organizational learning.Second-order problem solving behavior offers a new perspective to better understand how nurses promote learning from near misses to improve organizational outcomes.This study aimed to explore frontline nurses’perspectives on using second-order problem solving behavior in learning from near misses to improve patient safety.Methods:A qualitative exploratory study design was employed.This study was conducted in three tertiary hospitals in east China from June to November 2015.Purposive sampling was used to recruit 19 frontline nurses.Semi-structured interviews and a qualitative directed content analysis was undertaken using Crossan’s 4I Framework of Organizational Learning as a coding framework.Results:Second-order problem solving behavior,based on the 4I Framework of Organizational Learning,was referred to as being a leader in exposing near misses,pushing forward the cause analysis within limited capacity,balancing the active and passive role during improvement project,and promoting the continuous improvement with passion while feeling low-powered.Conclusions:4I Framework of Organizational Learning can be an underlying guide to enrich frontline nurses’role in promoting organizations to learn from near misses.In this study,nurses displayed their pivotal role in organizational learning from near misses by using second-order problem solving.However,additional knowledge,skills,and support are needed to maximize the application of second-order problem solving behavior when near misses are recognized.

Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery at the National Institute of Neurology and Neurosurgery

Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

Africa's Perspectives on China-Africa Relations and Forum on China-Africa Cooperation(FOCAC)

China is in Africa in a vigorous way,and doing business in several countries like Sudan,Congo DRC,Angola,South Africa,and Nigeria.In the short term,the relationship may appear to be mutually beneficial.This paper seeks to address the issue of Africa's perspectives on China-Africa Relations and the FOCAC and examine the concept of strategic partnerships,determine the state of China-Africa relations,examines FOCAC and draw conclusion as well as recommendation on possible ways and issues for future engageme...

Glyco-sphingo biology: a novel perspective for potential new treatments in Huntington's disease

Huntington＇s disease （HD） is the most common dominantly inherited neurodegenerative disorder, mainly characterized by the progressive striatal and cortical neurodegeneration and as- sociated motor, cognitive and behavioural disturbances （Zuccato et al., 2010）. The disease-causing mutation is an expansion of a GAG trinucleotide repeat （〉 36 repeats） encoding a polygluta- mine stretch in the N-terminal region ofhuntingtin （Htt） （Zuc- cato et al., 2010）, a ubiquitous protein whose function is still unclear （Zuccato et al., 2010）. Expansion of the polyQ stretch endows mutant Htt （mHtt） with toxic properties, and results in the development of a broad array of undesirable effects in both neuronal and non-neuronal cells （Zuccato et al., 2010）. Among all cellular dysfunctions and biochemical imbalances classically associated with HD, perturbed metabolism of （glyco） sphingolipids appears to play a crucial role in the pathogenesis of the disease. Over the last years, we and other have extensively contributed to these findings （Desplats et al., 2007;

Perspective of World Economy and China's External Economic Environment

Owing to a series of impacts of the "9·11 terrorist attack," the accounting scandals of big companies, Iraq War and the SARS crisis in the past two years, the world economy that might have rebounded forcefully has been on a wavering process of slow recovery.

Customer Retention: Behaviour Perspective Model of Ghanaian Telecommunication Industry Using Multinomial Regression Analysis

To stay competitive, the mobile telecommunication companies spend millions of Ghana cedi each year on building long-term relationships with their customers. Marketing managers are constantly challenged with the problem of where to channel the limited resources in order to retain existing customers. This study approaches the customer retention problem in the mobile phone sector from a behavioural perspective, applying the Behavioural Perspective Model as the main analytical framework and further exploits some other factors that influence customer retention. The model includes a set of pre-behaviour and post-behaviour factors to study consumer choice, and explains its relevant drivers in a viable and comprehensive way, grounded in radical behaviourism. Data for the analysis were collected from tertiary students from Accra and Takoradi. Data collected were analysed using the multinomial regression technique. Analysis of the data revealed that the Behaviour setting factor is the only significant element in Behaviour Perspective Model. Further exploitation of behaviour situation revealed that the number of networks a customer uses, previous experience of a customer and customer’s intention are significant factors in determining customer retention in Ghana’s mobile telecommunication industry.

＂Going Global＂ Strategies of Chinese Culture from the Audience＇ s Perspective

This paper revealed American students'interest in Chinese culture potentially due to China's recent development.Moreover,participants reported that understanding Chinese culture would broaden their perspective to include customs which were perceived as quite different from their own.Unsurprisingly,all of the participants were interested in superficial experiences with Chinese culture,like eating Chinese food.More than half of the participants indicated a desire to visit historical sites,such as the Great Wall and the Forbidden City.Half of the participants would like to travel in big cities such as Beijing and Shanghai,if they were to visit China.Not a few of Chinese descendants were eager to go to China for tracing roots.According to the results of the research,some"going global"strategies of Chinese culture were provided.The results may impact on Chinese culture's"going global"trend and offer support to the spread of Chinese culture.

Improving PetroChina's Company Value: a Corporate Governance Perspective

In China, the concept of corporate governance does not have a long history, and the implementation of corporate governance has been growing up with the process of China's enterprise reform especially the SOEs (state-owned enterprises) reform and economic growth. In the last two decades, China's enterprise reform has been the focus of economic reform and system reform, and the importance of corporate governance became clearly recognized among the join stock corporations which had undergone or are ongoing the corporatization progress.

Current Situation of China's Thermal Power Generation Equipment & Its Development Perspective

1. The present manufacturing situation of China’s thermal power generation equipment By the year 1995. development of China’s electric power industry has experienced a course of a hundred years. Over a period of the initial 50 years. China’s development of electric power was slow. At the time of 1949, the total installed capacity in China was 1,850 MW and the electricity generated was only 4.3 billion kWh. During the past 46 years after 1949, her

The Dilemma and Way Out of China’s Participation in the Development of Marine Genetic Resources in ABNJ from the Perspective of BBNJ

The fifth intergovernmental negotiations on marine BBNJ(Biodiversity beyond Areas of National Jurisdiction)concluded in August 2022,in which there are still major differences regarding access to marine genetic resources,management,and technology transfer.China’s participation in the development of marine genetic resources in ABNJ(areas beyond national jurisdiction)has many dilemmas,which are linked to the difficulties faced in advancing the BBNJ negotiations.The following countermeasures are proposed at the institutional and practical levels respectively:clarifying the legal attributes and applicability of the principles of marine genetic resources;establishing mechanisms for access,management,environmental impact assessment and benefit sharing of marine genetic resources;and using the“Blue Partnership”to build a governance mechanism for marine genetic resources to achieve mutual benefits.

A Study on Teacher-Child Interaction from the Perspective of Children

Children’s perspective is based on their own cognitive level in understanding objective things.The study of children’s perspective is a bottom-up research process under the premise of having a full respect for a child’s view.With the change of views about children in recent years,“children’s perspective”has become a new research direction.At the same time,teacher-child interaction,as an important means of evaluating the quality of kindergarten education,requires a bottom-up perspective from children.This study hopes to understand children’s emotional experience in the process of teacher-child interaction as well as their understanding and evaluation of their own experience by exploring their perspectives on the interaction,so as to better improve the quality of teacher-child interaction in kindergarten.