Challenges faced and lessons learned: a multi-component prospective memory training program for Malaysian older adults / Desafios enfrentados e lições aprendidas: um programa de treinamento de memória prospectiva de vários componentes para adultos idosos da Malásia

Abstract The surrounding circumstances and environments of Malaysian older adults could make conducting interventions (mainly in terms of clinical or randomized controlled trials) a challenge. Working with older adults and facing cultural issues could be challenging. Objective: This paper illustrates a significant perspective of some of the challenges faced while conducting a randomized controlled trial exploring the impact of a multi-component intervention that included strategy- and process-based prospective memory (PM) training among Malaysian older adults. Methods: The current study was a randomized controlled trial (RCT) and therefore the challenges were presented in accordance with the CONSORT statement style. Results: A discussion on how these issues were addressed is provided. Conclusion: Some suggestions were presented to help researchers plan and create interventions for similar studies and to support a practical method of addressing all related challenges.

Resumo As circunstâncias e ambientes circundantes de adultos idosos da Malásia poderiam tornar a condução da intervenção (principalmente em termos de ensaios clínicos ou randomizados controlados) um desafio. Trabalhar com adultos mais velhos e enfrentar problemas culturais pode ser instigante. Objetivo: Este artigo ilustra uma perspectiva significativa de alguns dos desafios enfrentados durante a realização de um estudo controlado randomizado que explora o impacto de uma intervenção de múltiplos componentes, incluindo treinamento de memória prospectiva baseado em estratégia e processo (PM) entre idosos da Malásia. Métodos: Como o estudo atual foi um ensaio clínico randomizado (ECR), os desafios foram apresentados de acordo com o estilo de declaração CONSORT. Resultados: Uma discussão sobre como essas questões foram abordadas é fornecida. Conclusão: Algumas sugestões foram apresentadas para ajudar os pesquisadores a planejar e criar intervenções para estudos semelhantes e capacitar um método prático para abordar todos os desafios relacionados.

Exploration the supportive needs and coping behaviors of daughter and daughter in-law caregivers of stroke survivors, shiraz-lran: a qualitative content analysis

The period of hospital stay and the first month after discharge have been found to be the most problematic stages for family caregivers of stroke survivors. It is just at home that patients and caregivers actually understand the whole consequences of the stroke. The adult offspring often have more different needs and concerns than spousal caregivers. However, relatively little attention has been paid to the needs of this particular group of caregivers. Therefore, this qualitative content analysis study aimed to explore the supportive needs and coping behaviors of daughter and daughter in-law caregivers [DILs] of stroke survivors one month after the patient's discharge from the hospital in Shiraz, Southern of Iran. This is a qualitative content analysis study using semi-structured and in-depth interviews with a purposive sampling of seventeen daughter and daughter in-law caregivers. The data revealed seven major themes including information and training, financial support, home health care assistance need, self-care support need, adjusting with the cultural obligation in providing care for a parent in-law, and need for improving quality of hospital care. Also, data from the interview showed that daughter and daughter in-law caregivers mostly used emotional-oriented coping strategies, specially religiosity, to cope with their needs and problems in their care-giving role. The results of this qualitative study revealed that family caregivers have several unmet needs in their care-giving role. By providing individualized information and support, we can prepare these family caregivers to better cope with the home care needs of stroke survivors and regain control over aspects of life

A Rare Case of Acute Psychosis as an Isolated Manifestation of Extrapontine Myelinolysis.

Aims and Background: Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are recognized as osmotic demyelination syndrome (ODS). ODS is pathologically characterized by non-inflammatory demyelination of several brain structures with sparing of axons. This condition is usually associated with overzealous correction of hyponatraemia. Acute psychosis as the sole clinical manifestation is extremely rare. Presentation of Case: Hence, we report an interesting case of a middle-aged man who was diagnosed with EPM, following rapid correction of hyponatraemia and subsequently developed acute psychosis. He made a good recovery with supportive treatment alone. Discussion and Conclusion: The possibility of psychosis as a manifestation of ODS, particularly in patients with recent correction of hyponatraemia. The rate of correction of plasma sodium level is the key point for preventing ODS and its complications.