Impact of the Pandemic on Dementia Care and Caregivers: A Qualitative Study.

Physical distancing measures to limit contagion in the COVID-19 pandemic made it difficult to care for older persons with dementia. Non-essential home visits were prevented and family caregivers took over most of their care. The aim of our study was to describe the lived experience of peoples living with dementia caregivers during the pandemic regarding the care provided and the person cared for. A qualitative phenomenological design was used. Participants were recruited using purposeful sampling. Informants were selected from primary healthcare centers, day centers, and a community mental health unit. The study participants comprised 21 caregivers. Semi-structured in-depth interviews by telephone were used, and field notes were collected from the researchers. A thematic analysis was conducted. The criteria used to control trustworthiness were credibility, transferability, dependability, and confirmability. Three main themes and six related sub-themes were identified: (1) care for the person with dementia during the pandemic, including lockdown, associated with difficulties in coping with restrictions, deterioration in health, and the impact of the closure of health and social resources; (2) health and social care provided to people with dementia after the disruptions and the care received from primary care prior to hospital or residential admission; and (3) the caregiver's perspective on the effects of the psycho-emotional impact, and coping strategies adopted in caring. Interventions for people with dementia should be planned in order to prevent the worsening of their health and cognitive status, while also developing programs to prevent stress and alleviate caregiver burden in case of health crises.

The impact of sanctuary visits on children's knowledge and attitudes toward primate welfare and conservation.

Primate sanctuaries provide a solution for the increasing number of primates being taken from their home countries to support the demands of the illegal pet trade. To help end the primate trade and raise awareness about the risks this trade poses to delicate ecosystems, sanctuaries are increasingly developing conservation education programs. Education and raising awareness must be one of the primary roles of primate sanctuaries. However, there are few evaluations of the impacts of conservation education programs for school children published in scientific literature. To address this gap, we conducted an evaluation of educator-led visits of school children at Fundació Mona, a primate sanctuary located in Catalunya, Spain. Questionnaires for an experimental and control group were conducted with 3,205 school children, ages 8 to 18 from 83 different schools, to evaluate changes in their attitudes and knowledge of primate welfare and conservation. We found that Fundació Mona's program of environmental activities had a positive impact on children, both female and male students, in terms of attitudes and knowledge of primate welfare and conservation. Although female students gave better responses regarding welfare and conservation, all children showed gains in pro-conservation responses. This study demonstrates that environmental education activities focused on children can help shape a change in knowledge and attitudes toward primate welfare and conservation. Educator-led visits of school children to primate sanctuaries such as Fundació Mona can also serve to amplify biodiversity conservation messages among children and their families. We encourage primate sanctuaries to promote empirical studies of attitudes and knowledge of primate welfare and conservation and to conduct systematical evaluations to strengthen their educational activities.

Efficacy of nonpharmacologic interventions in preoperative anxiety: A systematic review of systematic reviews.

AIMS AND OBJECTIVES: Evidence suggests that preparing patients for surgery using nonpharmacological strategies reduces their anxiety. However, there is no consensus on what the best practices are. This study aims to answer the question: Are interventions using nonpharmacological therapies effective in reducing preoperative anxiety? BACKGROUND: Preoperative anxiety causes physiological and psychological adverse effects, with a negative effect on postoperative recovery. INTRODUCTION: According to the World Health Organization, between 266 and 360 million surgical procedures are performed annually worldwide, and it is estimated that more than 50% of patients will experience some degree of preoperative anxiety. DESIGN: Systematic review of systematic reviews with results of interventions aimed at mitigating preoperative anxiety. METHODS: A search was conducted for systematic reviews with meta-analyses published between 2012 and 2021 in Medline, Scopus, Web of Science and Cochrane Library. Quality was assessed using the AMSTAR-2 scale. The protocol was registered in PROSPERO. RESULTS: A total of 1016 studies were examined, of which 17 systematic reviews were selected, yielding 188 controlled trials with 16,884 participants. In adults, the most common intervention included music, followed by massage, in children virtual reality and clowns. Almost all controlled trials reported a reduction in preoperative anxiety after the intervention, of which almost half had statistically significant results. CONCLUSION: Interventions that include music, massage and virtual reality reduce preoperative anxiety and have shown that they are cost-effective, minimally invasive and with a low risk of adverse effects. Preoperative anxiety can be reduced through a short-term intervention involving nursing professionals as an alternative or complement to drugs. RELEVANCE TO CLINICAL PRACTICE: This review suggests that nursing professionals, in collaboration with other health professionals, should continue to conduct research on the reduction in preoperative anxiety. Further research in this area is needed, to reduce heterogeneity and consolidate the results. NO PATIENT OR PUBLIC CONTRIBUTION: Not applied to our study, as it is a systematic review of systematic reviews.

Grief in children's story books. A systematic integrative review.

BACKGROUND: Grieving is an adaptive process in the face of the death of somebody close. Children grieve the loss of a family member or friend and need support from their caregivers and the professionals who care for them during this process. Failure to talk to children about the death of a family member or friend can lead to prolonged grief. Children's story books are one of the resources available for providing this type of support. OBJECTIVE: To provide the nursing professional with information on story books aimed at children from 7 to 11 years of age as a tool to help them understand and cope with grief. DESIGN: A systematic integrative review was conducted. METHODS: A search was performed in the ISBN database of the Ministry of Culture and the University Libraries Network. Data extraction was performed by two coders using a protocol registered in PROSPERO. RESULTS: Fifty-six books met the inclusion criteria. Twenty-five percent of the deceased characters were grandparents and 30.4% died due to illness. The most frequent emotion was sadness, (43.3%) and the most repeated coping strategy was remembering the deceased person, (28.7%). The grieving process was depicted in 32.1% of the selected stories. CONCLUSION: The children's books reviewed support understanding and coping with grief. However, some limitations were detected, and therefore it is advisable to accompany the child while reading these books to discuss aspects that have not been addressed.

Water-Energy-Food Nexus and Life Cycle Thinking: A New Approach to Environmental and Nutritional Assessment of Potato Chips.

The water-energy-food (WEF) nexus has become a key concept to promote the cross-sectoral coordination toward sustainable development. In particular, understanding the interdependences of these pillars, as well as addressing a life cycle perspective, is essential when evaluating food production systems. This study explores the environmental impacts and nutritional quality of potato chips, addressing life cycle thinking and a WEF nexus approach. For this purpose, the combined application of life cycle assessment (LCA) and the Nutrient-Rich Food 9.3 (NRF9.3) index was considered to identify the main environmental hotspots and advanced opportunities. The results indicated a major contribution of the cultivation stage on water use, whereas the processing accounted for most of the impacts in energy-related indicators and eutrophication potentials. Improvement opportunities reside in the joint application of drip irrigation, allowing to achieve important water savings, as well as the use of natural gas or pellets instead of diesel, which constitute cleaner energy sources. On the other hand, a poor nutritional density of potato chips became evident from the quantification of the NRF9.3, which can be significantly improved if potatoes undergo a roasted process instead of frying.

Behavioural Development of Three Former Pet Chimpanzees a Decade after Arrival at the MONA Sanctuary.

Chimpanzees used as pets and in the entertainment industry endure detrimental living conditions from early infancy onwards. The preferred option for ending their existence as pet or circus chimpanzees is their rescue and transfer to a primate sanctuary that will provide them with optimal living and social conditions, so that they can thrive. In this case study, we had the rare opportunity to compare the activity budgets of three chimpanzees from their time as pets in 2004 to their time living at the MONA sanctuary in 2020, after almost a decade in the centre. We found their behaviour patterns changed in accordance with the sanctuaries' rehabilitation objectives. Resting periods increased considerably while vigilance simultaneously declined sharply. Moreover, the chimpanzees' social competence increased as allogrooming became the predominant social behaviour, and agonistic interactions diminished even though they were living within a larger social group at the sanctuary. All three chimpanzees expanded their allogrooming and proximity networks at the sanctuary, which included new group members, but they maintained the closest relationships to those conspecifics who they were rescued with. In conclusion, these findings suggest that the sanctuary environment and social group setting made it possible for these three chimpanzees to improve their social competence and increase their well-being over time.

The use of social network analysis in social support and care: a systematic scoping review protocol.

BACKGROUND: In recent decades, the literature on Social Network Analysis and health has experienced a significant increase. Disease transmission, health behavior, organizational networks, social capital, and social support are among the different health areas where Social Network Analysis has been applied. The current epidemiological trend is characterized by a progressive increase in the population's ageing and the incidence of long-term conditions. Thus, it seems relevant to highlight the importance of social support and care systems to guarantee the coverage of health and social needs within the context of acute illness, chronic disease, and disability for patients and their carers. Thus, the main aim is to identify, categorize, summarize, synthesize, and map existing knowledge, literature, and evidence about the use of Social Network Analysis to study social support and care in the context of illness and disability. METHODS: This scoping review will be conducted following Arksey and O'Malley's framework with adaptations from Levac et al. and Joanna Briggs Institute's methodological guidance for conducting scoping reviews. We will search the following databases (from January 2000 onwards): PubMed, MEDLINE, Web of Science Core Collection, SCOPUS, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, PROSPERO, and DARE. Complementary searches will be conducted in selected relevant journals. Only articles related to social support or care in patients or caregivers in the context of acute illnesses, disabilities or long-term conditions will be considered eligible for inclusion. Two reviewers will screen all the citations, full-text articles, and abstract the data independently. A narrative synthesis will be provided with information presented in the main text and tables. DISCUSSION: The knowledge about the scientific evidence available in the literature, the methodological characteristics of the studies identified based on Social Network Analysis, and its main contributions will highlight the importance of health-related research's social and relational dimensions. These results will shed light on the importance of the structure and composition of social networks to provide social support and care and their impact on other health outcomes. It is anticipated that results may guide future research on network-based interventions that might be considered drivers to provide further knowledge in social support and care from a relational approach at the individual and community levels. TRIAL REGISTRATION: Open Science Framework https://osf.io/dqkb5 .

Comparison between attention and experiences of chronic complex patients: A multicentric study.

The aim of this research is to explore and analyse the functional status and experiences of complex patients located at levels 3-4 of the risk pyramid of the chronic care model in primary care, within the hospital system of two regions in Spain. The design was a mixed design (COREQ). The participants were enrolled in programs for chronic complex patients and their caregivers. Sociodemographic variables were gathered, together with the following measures: the Barthel test, the Mini mental test, the Zarit questionnaire, the IEXPAC scale and the Braden scale. A semi-structured interview was conducted individually with patients in order to explore their experiences and narrative on the process of their illness and the support they had received. The sample comprised 206 chronic pluripathological patients, of whom 103 were from Cantabria and a further 103 were from Mallorca. The patient profile in both regions was very similar. There was an equal distribution across both gender and the patients were over 78 years old. They all had a basic (primary) education, an average income and required moderate physical dependence, receiving assistance primarily from their children. The qualitative analysis highlighted patients' awareness of the illness and their concern for the future, noting that, overall, patients were satisfied with the care provided by their caregivers and the health system. We can conclude that is the first multicentric study of these characteristics conducted in Spain, despite it being the country with the second largest ageing population in the world. It is important to test new organisational models with differentiating areas of advanced clinical practice in primary care, whereby both patients and their caregivers can be co-responsible within the care process.

Implementing a Care Pathway for Complex Chronic Patients from a Nursing Perspective: A Qualitative Study.

A care pathway constitutes a complex care strategy for decision-making and the organization of processes in the care of complex chronic patients, avoiding the fragmentation of care. Health professionals play a decisive role in the implementation, development, and evaluation of care pathways. This study sought to explore nurses' opinions on the care pathway for complex chronic patients three years after its implementation. The study participants were thirteen nurses with different roles who were involved in the care pathway. Thematic content analysis of the semi-structured interviews resulted in four major themes: (a) the strengths of the route; (b) the impact of the route on caregivers; (c) the weaknesses of the route; and (d) the future of the route. Overall, the pathway was positively valued for the benefits it provides to patients, the caregiver, and the administration of professional health care. Participants voiced their concerns regarding: communication and coordination difficulties among professionals across the different levels of care, the need for improved teamwork and consensus among professionals at the same center, and human and material resources. The ongoing evaluation and monitoring of facilitators and barriers is necessary throughout the implementation process, to ensure continuity and quality of care in the health system.

Play Behavior in Two Captive Bottlenose Dolphin Calves (Tursiops Truncatus): Ethogram, Ontogeny, and Individual Differences.

This research focused on different aspects of play behavior including ethogram, ontogeny, and individual differences, in one male and one female captive bottlenose dolphin calves (Tursiops truncatus) from November 2003 to June 2004. We presented the first peer-reviewed description of a play ethogram in bottlenose dolphin calves whose behaviors were grouped into three hierarchical levels: two categories: solitary and social play; four subcategories: locomotor, object, bubble play, and in the presence of humans, and 35 entries. It was conducted in two phases: the descriptive phase - from 3 to 5 months old - with 29 entries and the quantitative phase - from 6 to 10 months old -with six entries. All social and solitary locomotor behaviors appeared when animals were 3 months old meanwhile more complex behaviors concerning playing with objects, bubbles, and in the presence of humans were observed for 6 months old. There were no statistically significant intra-individual and inter-individual differences in the play behavioral diversity, in the time invested in play and in the Shannon's evenness index. However, we observed statistically significant inter-individual but not intra-individual differences for the Shannon's diversity index.

Inter-individual Distance in Different Captive Packs of Iberian Wolf (Canis lupus signatus): Management Applications.

There is a tendency for the wolves of a pack to stay together assuming that there is a social bond between the pack members. A rough estimate of the strength of this bond can be obtained by measuring the distances between pack members. The aim of this study was to determine the inter-individual distance by calculating the Euclidian distance to determine the Iberian wolf cohesion in different pack compositions. The study subjects were seven captive Iberian wolves (Canis lupus signatus) housed at the Barcelona Zoo. Multifocal sampling methods were used for data collection, and instantaneous scans were made at 15-min during different sessions. Proximity relationships among these wolves in different pack composition were visualized using two-dimensional scaling analysis. The pair leader without offspring and the breeding pair with their offspring were significantly closer than the rest of the dyads which combinations were equidistant. During the pregnancy period, the breeding pair was significantly further than during the juvenile period. More studies in field and captivity by using Euclidian distance are necessary to improve social husbandry techniques, animal welfare and conservation programs.

Using High-Fidelity Simulation to Introduce Communication Skills about End-of-Life to Novice Nursing Students.

Background: High-fidelity simulation is being considered as a suitable environment for imparting the skills needed to deal with end-of-life (EOL) situations. The objective was to evaluate an EOL simulation project that introduced communication skills to nursing students who had not yet begun their training in real healthcare environments. Methods: A sequential approach was used. The "questionnaire for the evaluation of the end-of-life project" was employed. Results: A total of 130 students participated. Increasing the time spent in high-fidelity simulation significantly favored the exploration of feelings and fears regarding EOL (t = -2.37, p = 0.019), encouraged dialogue (t = -2.23, p = 0.028) and increased the acquisition of communication skills (t = -2.32, p = 0.022). Conclusions: High-fidelity simulation promotes communication skills related to EOL in novice nursing students.

Characteristics of nursing interventions that improve the quality of life of people with chronic diseases. A systematic review with meta-analysis.

PURPOSE: The objective of this systematic review was to determine the characteristics of the interventions conducted by nurses that attempt to improve the health related quality of life (HRQoL) of people over 18 years of age with chronic diseases. METHODS: This systematic review with meta-analysis summarizes 24 studies, conducted in 10 countries, that evaluated HRQoL through the Short-Form Health Survey (SF). Five databases were accessed to find the available studies from December 31st, 2000 to May 22sd, 2017. Selected studies were coded according to the characteristics of the sample and the intervention. A model of random effects was adopted for the overall estimation and to explain the heterogeneity. RESULTS: Twenty-four studies were included in the systematic review and meta-analysis providing a sample of 4324 chronic patients aged 63.4 years. Among the 8 subscales and two summary measures that comprise the SF-36, only an overall significant effect size (ES) index was found in the Mental Health Component summary score (ES = 0.14; 95% CI:0.03 - 0.26; I2 = 44.6, p = 0.042) and the Mental Health subscale. This improvement on HRQoL was associated to interventions on "Case Management" and "Treatments and Procedures", which were based on a theory, were of shorter duration, and had a follow-up period. CONCLUSIONS: Interventions targeting people with chronic diseases resulted in a slight increase in the HRQoL that was not always significant, which suggests that there is a need for their continuous improvement.

Improving the Welfare of a Zoo-Housed Male Drill (Mandrillus leucophaeus poensis) Aggressive Toward Visitors.

Improving the welfare of nonhuman animals in captivity and maintaining behavioral competence for future conservation purposes is of the highest priority for zoos. The behavior of an aggressive male drill (Mandrillus leucophaeus poensis) was assessed in Barcelona Zoo. The 2-year study presented in this article examined the effects of introducing changes in the exhibit of the drill to improve his welfare by analyzing scan behaviors. First, a partial visual barrier was applied and proved to be insufficient to decrease the long-term stress indicators assessed. Next, a feeding enrichment program was implemented. The results supported the hypothesis that feeding and explorative activities would increase, whereas apathetic and stereotypic behaviors would decrease. However, visitor-directed aggression did not vary, indicating that more profound structural modifications were needed to reduce the negative impact of the agonistic interactions between the drill and the public. The study emphasized the usefulness of environmental enrichment evaluations in assessing captive animal welfare.

Long-Term Macroevaluation of Environmental Enrichment in Three Brown Bears (Ursus arctos) at Barcelona Zoo.

The evaluation of enrichment programs is important to determine their effect on nonhuman animal welfare. The daily activity pattern and use of space of 3 brown bears (Ursus arctos) were used for long-term macroevaluation of enrichment to compare the baseline and enrichment phases. Focal sampling methods were used for data collection, and instantaneous scans were made at 2-min intervals during 15 sessions of 1 hr for each animal during the 2 study periods. The enrichment devices were categorized as feeding, occupational, and sensorial. The long-term macroevaluation in 3 bears showed statistically significant differences in some types of activity but not in others. There were also statistically significant differences for the use of space in 4 of the 8 zones in which the enclosures were divided. A more homogenous pattern in the use of space was only observed during the enrichment phase in the old female. The 3 brown bears followed different patterns concerning the enrichment program.

[Data sharing: Towards a more sustainable research]. / Compartir datos: hacia una investigación más sostenible.

In psychology, there is little tradition of sharing raw data from one's research. This lack of tradition, along with other circumstances, reflects some weaknesses of psychology as a science. The reasons for which this scarce willingness to share data and the counter-arguments in favour of the benefits that a change in attitude would involve are discussed in this article. Such a change would not only strengthen the scientific nature of psychology, but also result in a more sustainable development of the research, allowing practices such as recycling and secondary analyses of raw data. Some ways of action to facilitate this change are also suggested.

Compartir datos: hacia una investigación más sostenible / Data sharing: towards a more sustainable research

En Psicología hay poca tradición de compartir los datos directos de nuestras investigaciones. Esta falta de tradición, más otras circunstancias, reflejan algunas debilidades de la psicología como ciencia. Se exponen las razones por las que hay poca disposición a compartir los datos y se presentan contra-argumentos para defender los beneficios que tendría un cambio en esta actitud. Aparte de fortalecer el carácter científico de la psicología, este cambio redundaría en un desarrollo más sostenible de la investigación, permitiendo prácticas como el análisis secundario y el reciclado de datos. Se proponen vías de actuación para facilitar este cambio (AU)

In psychology, there is little tradition of sharing raw data from one’s research. This lack of tradition, along with other circumstances, reflects some weaknesses of psychology as a science. The reasons for which this scarce willingness to share data and the counter-arguments in favour of the benefits that a change in attitude would involve are discussed in this article. Such a change would not only strengthen the scientific nature of psychology, but also result in a more sustainable development of the research, allowing practices such as recycling and secondary analyses of raw data. Some ways of action to facilitate this change are also suggested (AU)