Familiar Environment Research Articles

Use of wearable inertial sensors for the assessment of spatiotemporal gait variables in children: A systematic review

Abstract Aim: The present study aimed to perform a literature review on the use of wearable inertial sensors for gait analysis of children in clinical practice. Methods: Searches were performed in the MEDLINE, EMBASE, Cochrane Library, and PEDro databases for studies involving children or adolescents submitted to gait analysis with the use of wearable inertial sensors. No restrictions were imposed regarding the date of publication or language. Results: Three hundred twenty articles were retrieved, 14 of which met the eligibility criteria and were selected for the present systematic review. Two independent reviewers assessed the risk of bias and study quality using the ROBINS-I and AXIS scale. The studies included in the present review reported multiple outcomes of kinematic gait assessments calculated from the signals provided by the wearable sensors, performed in a hospital setting, outpatient clinic, and a familiar environment, with several types of pediatric conditions. Conclusion: The findings suggest that wearable sensors are effective for the evaluation of quantitative gait variables in children with different pediatric conditions, enabling an objective analysis that should prove useful in the processes of clinical diagnosis and rehabilitation. However, given the relatively small number of studies published on this topic, it is difficult to make strong recommendations regarding the most appropriate equipment, sensor placement, and outcomes for assessing gait in children.

Electronic Orientation Aid for Visually Impaired using Graphics Processing Unit (GPU)

Vision is one of the very essential human senses and it plays a major role in human perception about surrounding environment. But for people with visual impairment their definition of vision is different. Visually impaired people are often unaware of dangers in front of them, even in familiar environment. This study proposes a real time guiding system for visually impaired people for solving their navigation problem and to travel without any difficulty. This system will help the visually impaired people by detecting the objects and giving necessary information about that object. This information may include what the object is, its location, its precision, distance from the visually impaired etc. All these information will be conveyed to the person through audio commands so that they can navigate freely anywhere anytime with no or minimal assistance. Object detection is done using You Only Look Once (YOLO) algorithm. As the process of capturing the video/images and sending it to the main module has to be carried at greater speed, Graphics Processing Unit (GPU) is used. This will help in enhancing the overall speed of the system and will help the visually Impaired to get the maximum necessary instructions as quickly as possible. The process starts from capturing the real time video, sending it for analysis and processing and get the calculated results. The results obtained from analysis are conveyed to user by means of hearing aid. As a result by this system the blind or the visually impaired people can visualize the surrounding environment and travel freely from source to destination on their own.

GESTIÓN INTEGRAL DE LA NUTRICIÓN ARTIFICIAL DOMICILIARIA: HUMANIZACIÓN E INNOVACIÓN AL SERVICIO DEL PACIENTE

Disease-related malnutrition is a common pathology in the developed world. It affects 30 million people in Europe and it has an associated cost of one hundred and seventy billion euros per year. In Spain, around 1.7 million adults, 4.4% of total population, are negatively affected. Malnutrition affects one out of four patients on hospital admissions. It is estimated that hospitalized patients who are malnourished throughout their stay range from 23.7% to 37%; sharpening these figures for multi-patients over 70 years old, and almost 10% are disensuaded during their hospital stay. All this implies an increase in hospital stays and associated costs; in particular, the direct costs of hospital malnutrition were estimated at 1.143 million annually in 2009, representing 1.8% of health expenses within the national health system. Advances in technology and infrastructure have facilitated the transfer of complex hospital-to-home services. Nowadays, the international trend points to the increasing development of the domicile as a care center. A meta-analysis of 61 randomized and controlled trials, published in 2012, showed that patients treated at home had a six-month mortality rate between 19% and 38% lower than those who were hospitalized. Home artificial nutrition (HAN) is the nutrients home-administration, among other therapeutic agents, administered through the digestive tract -home enteral nutrition (HEN)- or intravenously -home parenteral nutrition (NPD-), with the objective of improving or maintaining, at home, the patient’s nutritional status. That reports into a benefit for the patient as being able to continue the family, social and work commitments. The environment, in which 21st century health professionals work, is changing significantly. There are multiple innovations in process management, given by the growing potential offered by new technologies in remote care. It supports the patient’s home stay, either in the community or in a more familiar environment, that is, in a more humanized environment. Finally, HAN is shown to be an effective-cost alternative in relation to classical hospital care, resulting in the adoption of the efficiency criterion as an element of prioritization in healthcare.

Онлайн-пространство в условиях пандемии: коммуникационный и антропологический подходы

Issues associated with changes in the familiar human physical environment, related to the 2020 pandemic are analyzed. It is proved that under the current conditions, a modern person is not ready for rather radical changes in the working, educational and communication environments. Studies to confirm the authorial analytical models are presented.

Birds in Medieval English Poetry: Metaphors, Realities, Transformations by Michael J. Warren

Reviewed by: Birds in Medieval English Poetry: Metaphors, Realities, Transformations by Michael J. Warren Jenny Smith Warren, Michael J., Birds in Medieval English Poetry: Metaphors, Realities, Transformations (Nature and Environment in the Middle Ages), Cambridge, D. S. Brewer, 2018; hardback; pp. 269; 6 b/w illustrations; R.R.P. £60.00; ISBN 9781843845089. Combining ornithological and literary history, this book is an important contribution to environmental history and ecocriticism, unpacking the complex relationships between human and other creatures and their shared environments. As Michael Warren points out, 'natural and cultural histories overlap': ornithological knowledge deepens our understanding of birds in medieval and modern culture (pp. 5–6). The five chapters analyse a range of texts chosen to show where 'metaphor and realities fuse and collide' (p. 10), allowing Warren to discuss natural and cultural history together. While 'a full exploration of how and why birds mattered' (p. 3) cannot be achieved in five case studies, other birds in other texts are mentioned throughout, and the choices and analyses bring out five distinct 'ways […] feathered physicality and transformation is embraced […] as part of poetic strategy' (p. 23) in England from the tenth to fifteenth centuries. In turn, each chapter illuminates a different aspect of metaphor. Birds have always been a powerful metaphor for human experience, being both like humans (voice, bipedality) and unlike (flight, feathers). As Warren [End Page 297] notes, medieval thinkers understood metaphor as an interrelation of likeness and unlikeness, making birds as a metaphor a rich study. The book focuses on particular ways birds both resemble and differ from humans, both physically and in social and ecological roles. Adaptability is another characteristic that could usefully have been discussed in a concluding chapter, had scope allowed. Chapter 1 discusses the flight of seabirds in The Seafarer as a metaphor for the pilgrimage of the soul. The argument's originality lies in its construction: Warren shows how the familiar littoral environment and the voices of the seabirds—which recall, but are not, the human voices of the hall—reframe the poem as homecoming, as well as exile (as in the more traditional reading). Chapter 2 explores how disguise and trickery among birds such as the cuckoo and jay illustrate and interrogate the boundaries of knowledge in the riddles of the Exeter Book. The focus on resemblance and illusion, on what we can and cannot know, drives a discussion of metaphor's uses in medieval pedagogy. Chapter 3 considers the (human) values attached to different species, embedded in metaphors like the owl's night-sight for spiritual blindness. In The Owl and the Nightingale, the problematic nature of such metaphors as both inaccurate and harmful to birds (owls are neither blind nor evil) is debated in the birds' own voices. Warren's analysis prompts us to think critically about medieval observation of animal kinds, and about what such observations can tell us about birds and about human–nonhuman relations. Throughout, Warren gives the Old English names of species, grounding the reader's understanding in the primary sources and allowing the non-specialist a richer experience. The cultural specificity of onomatopoeic bird names hints at another form of 'in-betweenness' between the metaphorical and the literal (p. 16). The cultural and linguistic moments embedded in such names could also inform studies of sound, accent, and rhyme, as well as of historical semantics, such as Warren's forthcoming work on birds in place-names. Chapter 4, on Chaucer's Parliament of Fowls, explores the limits of language and cross-species translation (translatio being the Latin for Greek metaphora). Like the poet's struggle to express birds' voices in English, mystical language, allegory, and metaphor attempt the impossible. Warren's book asks, and his choice and analysis of texts attempts to show, 'what […] we lose, overlook or misrepresent that […] cannot be transferred' (p. 222). In Chapter 5, literal transformations in Gower's Confessio Amantis enable a discussion of desire and identity across species, recentring the physical in the cultural. This last chapter is for me one of the most striking and successful, as it shows how the metaphor of transformation establishes a more nuanced understanding of the physical and human world. 'In all aspects...

Ultra-Deepwater Drilling Riser Lifecycle Management System

Subsea drilling operations are moving into harsher, deeper and less familiar offshore environments. To avoid disruptive events due to uncertainties associated with these environments, a Riser Lifecycle Management System (RLMS) has been developed for near real-time condition monitoring and fatigue estimation of drilling risers. Unlike conventional techniques such as strain gauges for direct strain/stress measurement, the RLMS measures the vibrations using accelerometers at select joints along the drilling riser. It transmits the vibration data via acoustic telemetry in near real-time to a topside data acquisition system on the drilling vessel where fatigue life estimates for all riser joints are made using machine learning techniques. A proof-of-concept of the RLMS system was successfully deployed in the Gulf of Mexico on a semi-submersible drilling rig for a 9-week test.

Digital Technologies in Teacher Training: New Experience

In the field of training higher educational institution teachers, an era of significant change is beginning. For long, this area has remained the most conservative and was not noticeably subject to changes in society. However, the situation has changed dramatically. First of all, this is due to the rapid development of other areas of human activity, and in particular digital technologies. It is already difficult to imagine a modern society without such technologies, and the main task of a higher education teacher is precisely to train highly qualified specialists with new competencies to solve the challenges facing humanity. Strengthening the explicit link between the needs of society and the objectives of higher education is one of the prerequisites for significant changes in the field of education. The concept of training a teacher of higher education for the future today is largely determined by the development trends of digital technologies. The absence of objective reasons to assume the cessation of the use and development of digital technologies allows us to make an assumption that virtual educational worlds will appear in the foreseeable future, which will become the same familiar environment for acquiring the necessary competencies as higher schools existing in the physical world. This largely determines the relevance of the chosen research topic and determines the need for a thorough analysis of the educational technologies used in the training of teachers. The purpose of this work is, using a combination of analysis, synthesis, idealization and analogy, to generalize at the national and international levels the existing ideas about effective approaches to teaching a higher education teacher, including continuous improvement of competence in his professional field, and modern practice of using digital technologies, and also highlight the most interesting new learning experiences. The necessity of applying the so-called “integrated approach to teaching a higher education teacher” by the authors is proved. The main advantages and disadvantages of using digital technologies are highlighted. Reasonable conclusions are made on the existence of an ideal recipe for combining accumulated educational practices in the framework of traditional education and digital technology.

Dynamics of the formation of the social capital of youth (based on the research materials in the Vologda Region in 2016-2019)

Over the past few years, neither the real incomes of the population, nor the economic situation of the country as a whole have been favourable by the Russian citizens. The presence of objective problems in the acquisition of material resources, together with the natural desire of a person to live in the most comfortable conditions, raise the question of finding other, intangible, resources to meet needs. An example of such a resource is social capital, which has recently attracted the attention of researchers in Russia and the world more recently. In view of the peculiarities of youth (18-30 y. o.), as a period of development of the human personality, it is precisely on this segment of life that the first significant attempts to independently form social capital fall. Not least of all, this is connected with admission to higher educational institutions, which is often associated with leaving the familiar environment and the need to act in completely new social networks and roles. Consequently, the responsibility for independent actions in this area is becoming higher. In this regard, based on studies conducted by the Vologda Scientific Center of the Russian Academy of Sciences, we decided to identify the main features of the formation of social capital in youth and to see how the situation with its accumulation changes in time. The main results of our study include the discovery that the accumulation of social capital at a young age is more effective due to the greater readiness of young people for joint action. Clarification of the fact that investments in social capital, even in youth, quickly begin to bring dividends. Based on the positive changes in social capital over time, it was concluded that the Vologda Region has the potential for its further development. As a result, it was concluded that the active use of the potential for the accumulation of social capital in youth is characterized by increased productivity, due to the fact that in the considered period of life, people are more prone to unification.

Exploring the Possibility of Convergence Education for Developing Youth's Character Competencies of the Future Society: Focused on Literature Museum Experience

이 연구의 목적은 미래사회의 청소년 인성역량 개발을 위한 융·복합교육의 가능성을 탐색하고, ‘문학공간’ 연계 체험중심 인성교육을 위하여 지역문학관 활성화 방안을 이론적으로 탐색하는 것이다. 연구의 이론적 기초로서 미래사회의 핵심역량, 융·복합교육을 실천하기 위한 교육환경, 교사의 역할, 문학공간과 관련된 연구를 중점적으로 고찰하였다. 연구의 결과는 다음과 같다. 첫째, 문학공간과 연계한 체험중심 인성교육은 학생들에게 친숙한 학습 환경을 제공해줄 뿐만 아니라 학습에 필요한 자원들을 지역사회로부터 제공받음으로써 교육공간이 확장되는 효과를 종합할 수 있었다. 둘째, 문학공간의 문학 콘텐츠에 주목하고 활용 양상을 국내·외 사례를 통해 밝힘으로써 청소년의 인성역량 신장을 위한 교과 연계 융·복합교육의 실천 가능성을 확인하였다. 결론적으로 미래사회의 역량 개발을 위한 융·복합교육의 일환으로 ‘문학공간’을 활용한 체험중심의 인성교육은 청소년에게 다양한 인성 덕목을 체화할 수 있을 것으로 판단되며, 융·복합교육 측면에서 긍정적인 효과가 도출될 것으로 기대된다. 후속연구로는 테크놀로지를 활용한 가상 문학공간 조성과 활성화 방안, 그 효과를 검증하는 평가 연구를 제안하였다.The purpose of the study was to explore the possibility of convergence education for developing youth’s character competencies of the future society, and to theoretically seek ways to revitalize regional literature museums for experience-centered character education linked to ‘literature space.’ As a theoretical basis of the study, we reviewed a literature review on the core competencies of the future society, the educational environment for practicing convergence education, the role of teachers, and the literature space. The results of the study were as follows. Firstly, experience-based character education in connection with literature museum not only provided students with a familiar learning environment, but also explored the effect of expanding educational space by providing resources for learning from the community. Secondly, focused on the literary contents of the literature museum and clarifying the usage patterns through domestic and international cases, the possibility of practical convergence education for the development of the character of youth was confirmed. In conclusion, experience-based character education using the literature space as a part of convergence education for the future development of future society is expected to embody various virtues for adolescents, and was expected to have a positive effect on the aspect of convergence education. As a follow-up study, the researcher proposed a method of creating and activating a virtual literary space using technologies, and proposed an evaluation study to verify the effectiveness of technology utilization.

ROLA LITERATURY W ROZWOJU DZIECKA W WIEKU PRZEDSZKOLNYM

Literature plays a pivotal role in versatile development of a child. The contact with texts adjusted to a child’s age, interests and needs influences his emotional and social development. Reading also expands a child’s vocabulary, enriches his imagination, helps to understand the complicated world of moral rules and develops a young reader’s sensitivity and empathy towards another person. Undoubtedly, the texts, which have been appropriately selected, prepare a child to recognize and feel the right emotions which are connected not only with positive situations but also with those which evoke pain, sadness, disappointment or fear. The books create the treasury of values for preschool children, for instance: love, friendship, respect, justice, and honesty. One should also pay attention to the values which are not present in the stories or fairy tales, for example: a lie, betrayal, fraud or loneliness. A young reader learns to distinguish good from bad. Just like the protagonists of his favourite stories or fairy tales, he learns to tame with a new situation, making the right choices and decisions, learning to be independent, dutiful, and overcome difficulties. A child also observes the value of a written word and analysing and drawing conclusions. What is more, a young reader learns to follow particular moral norms and sensitive perception. He also learns to understand and respect the emotions expressed by other people.The subject of texts for preschool children is similar to the world of little reader. The described stories often take place in familiar environment: a family house or in the playground. A young reader often identifies with the protagonists of the books he reads. He gets to know the characters who, just like him, experience various emotions. The child learns to share happiness or sadness with the protagonists, he laughs and cries, and learns to name the emotions. A little child, while listening to the stories describing children similar to him, often identifies with the protagonists of the texts and notices the similarity of situations from his life to the situations which happen to the literary heroes. The stories described in the texts for children support the development of independence, they teach how to achieve the assumed goal and how to be happy when a barrier in life is overcome. They help to answer the questions bothering a child. They show to parents how meaningful the emotions of their children are, although they are sometimes difficult to understand. Situations which are complicated for a child or the questions which are difficult or painful are very often present in literary texts. Such a text can, therefore, become a great opportunity to start a conversation with a child. Home reading should become an everyday habit, awaited both by parents and children. The positive aspect of reading can also be the possibility to observe a child during this activity. The parents can see how a child reacts to the text, whether his mimics changes or not. The role of parents is therefore invaluable. By reading a book to children they help them to develop readership and love for books and selected texts. An interesting initiative has been originated in Poland. The action entitled “The whole Poland reads to children” popularizes reading for at least twenty minutes a day to children.Literature for children plays a huge role in versatile development of a child. A contact of a child with books expands his knowledge about the surrounding world. The plurality of topics, behaviours, and decisions which should be made by literary characters, places in which the action takes place and relations between the protagonists, who represent not only the real world but also fairy-tale world, influence the emotional, cognitive and social development of a child. If we choose the right texts suitable for perceptive skills of a child, the numerous problems described there can help to develop a child’s curiosity and the need to read new books.

Features of youtube video service use in the education process

Most of the younger generation watch different videos on YouTube (YT) daily, but these are usually not educational videos, although there are educational channels on YT. We believe that video services are a familiar medium for pupils, and, accordingly, the goal of the teacher is to adapt pupils to familiar environments with educational goals. To this end, the article explores the particularities of using the YT video service in the educational process. An explanation of the concept of "video service" as a service of the Internet, which provides the ability to see videos, comment, download, publish videos. The results of a foreign study on the use of YT in the educational process are presented. The video service Mix the Play is described. The types of educational video are outlined: professional training films, studio and natural video lectures, video scribing, video infographics, screencasts, demonstrations, interactive videos, 3D rendering, pseudo-video, video timeline, video zooming. YT educational service channels have been highlighted in various subjects (astronomy, biology, geography, informatics, history, mathematics, physics, chemistry, etc.). A list of YTC which is useful for teaching informatics in different classes is presented. The model of inverted class, the types of inverted classes are outlined: typical, discussion-oriented, demonstration-focused, group, virtual inverted classes, pseudo-inverted classroom, inverted teacher. The advantages and disadvantages of using the model of "Inverted class" for realization of the educational process are highlighted. The advantages and disadvantages of using the YT video service in the educational process are outlined. It is suggested how to use the YT at different stages of a computer science lesson. Examples of problems using video services for 8th grade informatics pupils have been developed. A list of topics in computer suense is offered, in the study of which it will be useful to use video services.

Individual Response to Stressors and Efficiency in Project Activities.

This article investigates the way a graded approach can be implemented in the organization of the project-based learning process in accordance with the personality characteristics of subjects. This study is based on the results analysis of the key features of project-based learning as one of the methods for developing human resources. The assessment of subjects’ individual response to stressors at different project stages is justified to be relevant in order to improve project efficiency in the framework of the learning process. The assessment of the individual response of subjects to stressors was carried out according to the activation dynamics of cerebral hemispheres. The research target was to determine features of the subjects’ individual responses to the project activity stressors and to identify specifics of the individual responding at each of its stages. The study involved 56 final-year students of different majors. Aktivatsiometr ATs-9K, a device for comprehensive psychophysiological diagnosis designed by Yu. A. Tsagarelli, was used to monitor hemispheric activation. This hardware and software complex consists of a device diagnosing the activation of cerebral hemispheres based on the galvanic skin response and PC software for automatic data processing. The individual typological indicators of activation (13 measurements in a familiar environment) and activity-situational indicators of activation (seven single measurements at different stages of the project activity) were calculated. The stress response was diagnosed if the activity-situational activation indicators of the cerebral hemispheres exceeded the individual typological activation indices by more than 1.5 times. The results of the empirical study show different types of individual responses to stressors at different stages of the project activity. The analysis of the profiles of individual responses to stressors made it possible to differentiate subjects, and also identify groups of students with the maximum resources for each stage of activity.

Repeated restraint stress potentiates methylphenidate and modafinil-induced behavioral sensitization in rats.

Stress increases the susceptibility of drug abuse and drugs of abuse impair behavioral tolerance. It has been shown that stress exposure enhances the sensitivity to the reinforcing properties of drugs, augments locomotor sensitization effects of drugs of abuse and impairs behavioral tolerance. Previously, it has been shown that long-term administration of psychostimulants (Methylphenidate and Modafinil) induced locomotor sensitization effect that was more pronounced after 13days of drug administration and was greater at high dose. The present study is designed to investigate the relationship between restraint stress and psychostimulants (Methylphenidate and Modafinil) that induced sensitization. Methylphenidate (10mg/kg/day twice a day), modafinil (75mg/kg/day once daily), and saline (0.9% NaCl; 1ml/kg/day) were administered orally to treated and control animals. Rats were exposed to immobilization stress for 30days (until locomotor sensitization produced) to monitor any change in drug-induced behavioral sensitization. The motor activity was compared daily by using familiar environment of home cage and weekly by novel environment of open field. The results show that the methylphenidate and modafinil-induced locomotor sensitization is enhanced and impaired behavioral tolerance in repeated restrained rats. It shows that the psychostimulants like methylphenidate and modafinil produce greater locomotor sensitization in stressful environment, suggesting addictive effects of stress and psychostimulants (methylphenidate/modafinil) on dopaminergic neurotransmission. These finding may be helpful to develop potential pharmacotherapies for the patients with co-occurring depression and substance abuse/dependence disorder.

Creating conditions for a sense of security during the evenings and nights among older persons receiving home health care in ordinary housing: a participatory appreciative action and reflection study

BackgroundToday many older persons in ordinary housing receive home health care. It is stipulated that the care is to provide security; however, deficiencies in home health care are reported in many countries. It may be difficult to implement a sense of security among older persons receiving home health care in ordinary housing, especially during the evenings and nights, due to a lack of knowledge.MethodsThis study is part of a larger project with a participatory appreciative action and reflection (PAAR) approach. We invited older persons, relatives, nurse assistants, registered nurses, and their managers to co-create knowledge with us on how conditions for a sense of security can be created during evenings and nights among older persons receiving home health care in ordinary housing. We performed thematic analysis of the data.ResultsFive subthemes were developed that gave structure to two main themes. The first main theme, To confirm the self-image, has the following subthemes: To see the home as a reflection of the person’s identity and To maintain self-determination. The second main theme, To create interaction in a sheltered place, has these subthemes: To undress the power, To create control and lifelines, and To create a good sleeping environment. The two themes interact and are each other’s conditions. The person’s self-image must be confirmed in order to create interaction in a sheltered place and through the interaction, the self-image is confirmed.ConclusionConditions necessary for older persons to have a sense of security are living in a familiar environment, having habits and routines maintained, and having self-determination. Other conditions are equality, the prevention of falls, and an individualized sleeping environment. Older people’s self-determination should be honored, and they should not being excluded from decision-making. We need to ask them if the conditions are sufficient and their sense of security is great enough to allow them to continue living in their ordinary housing.

The Quest for the Ideal Darcy-Weisbach Friction Factor Equation from the Perspective of a Building Services Engineer

Abstract The calculation of the friction factor involved in the Darcy-Weisbach equation has a key role in the accurate assessment of distributed head losses. For the turbulent flow regime, this friction factor was mathematically expressed in the form of the Colebrook-White (C-W) equation, widely accepted by engineers and scientists. Nevertheless, the C-W equation is an implicit one and must be solved using numerical methods. This is a major disadvantage for the average engineer, who always prefers an explicit equation which could be easily integrated into his familiar spreadsheet environment. The present paper is investigating some of the most used explicit alternatives to the C-W equation, with respect to several case scenarios taken from typical Building Services hydraulic calculations.

Challenges Faced by Prehospital Emergency Physicians Providing Emergency Care to Patients with Advanced Incurable Diseases.

Introduction The aim of our study was to investigate challenges faced by emergency physicians (EPs) who provide prehospital emergency care to patients with advanced incurable diseases and family caregivers in their familiar home environment. Methods Qualitative study using semistructured interviews with open-ended questions to collect data from 24 EPs. Data were analyzed using qualitative content analysis. Results We identified nine categories of challenges: structural conditions of prehospital emergency care, medical documentation and orders, finding optimal patient-centered therapy, uncertainty about legal consequences, challenges at the individual (EP) level, challenges at the emergency team level, family caregiver's emotions, coping and understanding of patient's illness, patient's wishes, coping and understanding of patient's illness, and social, cultural, and religious background of patients and families. EPs strengthened that the integrations of specialized prehospital palliative care services improved emergency care by providing resources to patients and family caregivers, enhancing the quality and availability of medical documentation and accessibility of aftercare in emergencies. Areas of improvement that were identified were to promote emergency physicians' knowledge and skills in palliative care, communication, and family caregiver support by education and training. Furthermore, structures for better care on-site, thorough medical documentation, and specialized palliative care emergency facilities in hospital and prehospital care were requested. Conclusion Prehospital emergency care in patients with advanced incurable diseases in their familiar home environment may be improved by training EPs in palliative care, communication, and caregiver support competences. Results underline the importance of collaborative specialized palliative care and prehospital emergency care.

USE OF SERVICES BY PEOPLE LIVING ALONE WITH COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW

At least one third of older adults with dementia live alone in the United States. Living alone may represent an opportunity to maintain independence and autonomy, while remaining in a familiar home environment. However, living alone with cognitive impairment is also associated with health risks and unmet needs. No systematic reviews on this population have been published. We systematically reviewed research on use of healthcare and long-term services and supports (LTSS) by people living alone with cognitive impairment. Following PRISMA guidelines, we searched six electronic databases for studies reporting quantitative findings on use of services by people living alone with cognitive impairment; 33 studies met inclusion criteria. Nine countries were represented, all high-income economies. Race/ethnicity data was reported in just five studies, and only one included a majority of racial/ethnic minorities. Overall, people living alone with cognitive impairment appear to use health services at similar or lower rates compared to those living with others; however, LTSS use is higher among people living alone. Representation of non-white participants was poor, but the evidence available suggests that among racial/ethnic minorities with cognitive impairment, there is no difference in LTSS use between those living alone and living with others. Findings highlight inconsistencies in access to and use of essential services by older adults living alone with cognitive impairment. As the populations of the US and other high-income countries become both older and more diverse, with increasing numbers living alone, researchers and service providers must consider the specific needs and preferences of this population.

BARRIERS TO TRANSIT MOBILITY AND WELL-BEING AMONG LATE-LIFE ASIAN INDIAN IMMIGRANTS

Using qualitative interpretative phenomenological analysis and semi-structured interviews, we explored transit mobility needs and its impact on well-being and quality of life among late-life Asian Indian immigrants. Using inductive and deductive methods, we analyzed qualitative data collected from 18 participants. Four themes emerged specific to the influence of contextual factors on transportation mobility barriers among participants. Findings suggest that cultural and individual attitudes combined with the ‘built environment’ hinder participation at the temple and other cultural and religious activities and increase dependence on adult children. The reciprocal fit between transit mobility needs, access to culturally familiar environments and the built environment is critical to freedom, independence, and healthy aging for diverse older adults. Research at the intersection of global aging and transportation mobility requires equal grounding in a range of justice principles (environmental, social, and economic) in the pursuit of sustainable transportation options for diverse older adult populations.

Using AIDET® Education Simulations to Improve Patient Experience Scores

The acronym AIDET stands for Acknowledge, Introduce, Duration, Explanation, and Thank You. Created by the Studer Group as a communication framework for health care professionals, AIDET is aimed at enhancing communication with patients, thereby decreasing patient anxiety, increasing compliance, and improving clinical outcomes. Its use has also been shown to improve patients' satisfaction and perceptions of care. Staff at a large urban academic medical center were trained on the use of AIDET. However, patient engagement scores on the Heart and Vascular Center unit remained low in certain domains. Simulation-based re-education is an effective strategy regarding retention of skills. Thus, we developed and implemented a series of in situ AIDET simulations, hypothesizing that staff training of AIDET could positively impact patient engagement scores. The in situ simulations provided an effective learning opportunity for Heart and Vascular Center staff to practice their AIDET communication skills in a familiar environment and receive real-time feedback. There was a slight increase for all questions of interest in the Consumer Assessment of Healthcare Providers and Systems program survey.

Desensitization of 5-HT-1A Somatodentritic Receptors in Tryptophan Treated and Co-treated Rats Induced by Methylphenidate.

Psychostimulants can induce behavioral sensitization by their chronic use. The main target for the action of these drugs is dopamine, neither epinephrine nor serotonin transporters. Serotonin is synthesized by the precursor L-tryptophan. Tryptophan and methylphenidate being 5-HT agonists, both increase the level of serotonin thereby causing desensitization of 5-HT1a receptors. The present study investigated whether behavioral sensitization induced by Methylphenidate is decreased in tryptophan administrated animals. The Experiment was divided into 2 phases (1). Behavioral effects of repeated administration of TRP 100 mg/kg and MPD for 14 days in three groups; (i) water (ii) MPD 1.0 mg/kg (iii) TRP. To explore the locomotor effects of treatment, the activity was monitored in a familiar and novel environment. (2) Behavioral consequences of repeatedly administrated MPD (1.0 mg/kg) on pretreated TRP (100 mg/kg) and MPD (1.0 mg/kg) animals following Co-MPD and TRP for 14 days, rats were divided in three groups (i) water, (ii) MPD and (iii) TRP as mentioned in Experiment no 1. After two weeks six subgroups were assigned i.e. (i) water-saline, (ii) water- MPD, (iii) TRP-saline (iv) TRP-MPD (v) MPD-saline and (vi) MPD-MPD+TRP and treated for further 14 days. Locomotor behavior was monitored in familiar environment on the next day and in novel environment on alternate days of each administration. The Results from phase 1 showed increased activity in both (TRP and MPD) treatments. However, the results of phase 2 showed significant decrease in methylphenidate-induced behavioral sensitization by both pretreatment and co-administration with TRP. The present study suggests the potential of tryptophan to decrease the risk of behavioral sensitization induced by methylphenidate.