WestCare Foundation

A vast majority of advanced cancer care, including palliative and end-of-life care, is provided by the family members. Loss of loved ones leads to practical, emotional and psychological distress and thereby poor quality of life. The present study aims to explore the psycho social experiences of bereaved family members in the Indian context. In this prospective observational qualitative study, bereaved family members were (N=42) interviewed using a semi-structured in-depth interview schedule, after obtaining consent. Interviews were digitally recorded, transcribed and translated by the researcher. Manual thematic analysis was used for analysing the data collected. The thematic analysis of the transcripts revealed six key themes: Heightened distress, family expectations, emotional conflicts versus collusion, challenges during COVID pandemic, coping with self and others, and gratification from caregiving. Many family members maintained a positive outlook on the care they provided and shared effective coping strategies. However, most reported heightened distress due to the loss of their loved one and struggled with emotional expectations during the grieving process. Negative experiences with collusion and its consequences were also noted. The COVID-19 pandemic's impact, particularly in limiting access to support, was another significant challenge for many family members. caregiving during illness or loss presents significant challenges, including emotional strain, family issues, and external stressors like the COVID-19 pandemic. However, caregivers often find fulfilment and develop effective coping strategies to manage these difficulties. It is essential to address both the emotional and practical aspects of caregiving, particularly during crises, to support family members throughout their journey.

The process of child growth and development is a process that is important in the next life. The role of adults around children in paying attention to and stimulating growth and development can optimize children's growth and development, including caregivers and educators in daycare. This research aims to examine the need and feasibility of developing the Growth and Development of Child Information System (SI-GoChild) in daycares. The system development method was developed using the Waterfall method. Gradual testing was carried out starting from black box testing, white box testing and usability testing. Database development uses the Entity Relationship Diagram (ERD) method and the database is tested for feasibility using Normalization testing. The results of the study revealed that the most expected feature is growth monitoring and child development reports. As many as 85% of respondents stated that SI-GoChild can help improve the quality of services in childcare centers. Database testing shows that the table design is quite good and meets the Normal Form. Testing of the system on a computer laboratory scale showed that SI-GoChild was functioning properly and meeting the needs of users. The conclusion that SI-GoChild has great potential to be an effective tool in monitoring children's growth and development in Child Care.

People with HIV (PWH) who use cocaine are less likely to achieve virologic suppression (<200 copies/mL) because of poor engagement in care. We tested the efficacy of an integrated substance use treatment and outpatient HIV care intervention on improving viral suppression in nonsuppressed PWH who use cocaine. Project RETAIN recruited 360 cocaine-using PWH who were not virologically suppressed in Miami, FL, and Atlanta, GA. Patients were randomized to treatment as usual (TAU) or the intervention, which included patient navigation and substance use treatment with motivational enhancement therapy and cognitive-behavioral therapy. The primary outcome assessed viral suppression at 6- and 12-month follow-up. There was no difference in viral suppression by group (TAU = 17.1%, intervention = 15.6%, P = .897). The intervention group had significantly more participation in substance use treatment (87.0%) than TAU (7.2%, P < .001). There were significant decreases in stimulant use in both groups, but oxycodone use decreased more in the intervention group. Severe psychological distress (32% of the baseline sample) declined differentially at 6 months (TAU = 24.5%, intervention = 16.1%, P = .0492). Only a minority of PWH who used cocaine became virally suppressed over the 12-month study, with no effect of the integrated intervention. Patients in the intervention did have reduced psychological distress postintervention. Despite more substance use treatment in the intervention, both groups declined equally in substance use. Interventions that improve retention in care and viral suppression are needed for this vulnerable population, including those that address their other complex medical and psychosocial needs. NCT01614106.

The unprecedented heatwave that hit the Pacific northwest of North America in late June-early July 2021 impacted ecosystems and communities, yet evidence and analysis of this impact are still missing. Here we bring a unique dataset quantifying the impact on conifer trees, which are keystone species of many northwest ecosystems. Moreover, we take advantage of this exceptional event as a broad, extreme, &amp;#8220;field experiment&amp;#8221; to test a fundamental theory in plant physiology, and prepare our forests to a harsher future. Overall, the data collected confirm the role of hydraulic vulnerability in drought-induced injury to trees. Among the recorded species, we obtained P50 data for 27 species, represented by 64 cultivars. Plotting needle browning extent by P50 revealed important thresholds of drought sensitivity: (1) species with P50 &lt;-6 MPa were unaffected by drought. (2) species with -6 MPa&lt; P50 &lt;-5 MPa had mild extent of needle browning, up to 25% of the canopy. (3) species with P50 &gt; -5 MPa had browning of up to 95%. The sharp divergence among resistant and vulnerable conifer species according to their xylem vulnerability, all of which simultaneously exposed trees to the same extreme event at the same site, is evidence to the key role of P50, in agreement with previous assessments of drought effects on angiosperms. Among local, NW conifer species, some cultivars proved hardier than others. The aftermath of the 2021 NW heatwave should take advantage of this broad, extreme, &amp;#8220;field experiment&amp;#8221; to prepare our forests to a harsher future.

Abstract Introduction The health benefits of physical activity for older people are well recognised and include reduction in falls, improvement in frailty status and physical function. Nonetheless, physical inactivity remains a significant problem among older adults. This study aimed to determine the feasibility and acceptability of implementing online volunteer-led group exercise for community-dwelling older adults. Methods This pre-post mixed methods study was conducted among older adults attending community social clubs. Eligible participants were aged ≥ 65 years, able to walk independently, and able to provide written consent. The intervention consisted of a once weekly volunteer-led online group chair-based exercise. The primary outcomes were the feasibility and acceptability of the intervention. Secondary outcomes included physical activity levels measured using the Community Health Model Activities Program for Seniors (CHAMPS) questionnaire, functional status (Barthel Index), and health-related quality of life (EQ-5D-5L). Outcomes were measured at baseline and at 6 months. Trials registration: NCT04672200. Results Nineteen volunteers were recruited, 15 completed training and 9 were retained (mean age 68 years, 7 female). Thirty participants (mean age 77 years, 27 female) received the intervention and attended 54% (IQR 37-67) of exercise sessions. One minor adverse event was reported. Participants had no significant changes in secondary outcome measures, with a trend towards improvement in physical activity levels. The intervention was acceptable to volunteers, participants, and staff. The seated exercises were perceived as safe, manageable and enjoyable. Volunteers were relatable role models providing positive vicarious experiences that improved participants confidence to exercise within a friendly, non-judgmental environment. Technological issues, or reluctance to learn how to use technology were barriers to the intervention. The social interactions and sense of belonging motivated participation. Conclusions Trained volunteers can safely deliver online group exercise for community-dwelling older adults and the intervention was feasible and acceptable to older adults, volunteers and club staff.

Introduction.The Physical Therapy and Society Summit, convened by the American Physical Therapy Association (APTA) in 2009, reframed the physical therapy care paradigm from a traditional 1:1 physical therapist (PT) to patient relationship, to one in which PTs are effective and thrive as part of a co

Organizational change literature has traditionally concentrated on how organizations realign internal resources in an effort to predict and match the needs of the external environment. This paper examines how managing the change process can influence organizational performance measures such as voluntary turnover. The underlying causes of resistance to change and person-organization fit are discussed as the National Health Service (NHS) in the United Kingdom continues to experience upheaval as it shifts from a nationalized institution to a fragmented network of trusts charged with visibly increasing efficiencies. This paper argues that middle managers may be better placed to communicate the vision of the future to nursing professionals as they simultaneously receive leadership communications and engage in sensemaking activities to interpret, manage, and respond to events. Ultimately, they play the critical role in mitigating a loss of experienced professionals and knowledge capital.