Relief Of Burden Research Articles

Medical insurance-related professionals’ identification of the benefits of the medical insurance system in Northeast China: a cross-sectional study

BackgroundThe identification of the benefits of the medical insurance system (IBMIS) serves as an important indicator of the effectiveness of medical insurance policy implementation and provides valuable feedback during the ongoing reform phase of the medical insurance system (MIS). This research aims to analyze the IBMIS from the perspective of medical insurance-related professionals and to identify potential associate factors with IBMIS.MethodsIn 2021, we conducted a cross-sectional questionnaire survey (n = 1829) in Heilongjiang Province, located in Northeast China, to collect data. Interviewees were selected using a multi-stage stratified cluster random sampling method. A binary logistic regression model was employed to identify the factors influencing the IBMIS.ResultsOverall, 66% (1,207) of professionals associated with medical insurance exhibited a high IBMIS. The logistic regression model indicated that a high IBMIS was positively correlated with the following dimensions: policy capacity (OR = 1.562, 95% CI: 1.375–1.775), financial burden (OR = 1.512, 95% CI: 1.347–1.699), and convenience (OR = 1.300, 95% CI: 1.171–1.442). Four significant factors (P < 0.05) contributing to a high IBMIS include: “Relief of financial burden for people with serious diseases” (OR = 2.288, 95% CI: 1.740–3.007), “Medical insurance’s ability to address major problems that people expect” (OR = 1.565, 95% CI: 1.175–2.085), “Governance capacity of the medical insurance administrative agencies and management institutions” (OR = 1.472, 95% CI: 1.111–1.951), and “Effectiveness of governance for off-site medical reimbursement issues” (OR = 1.445, 95% CI: 1.036–2.014).ConclusionThe policy capacity, financial burden, and convenience of the MIS have a positive impact on the IBMIS. Government departments can pay closer attention to these factors and formulate targeted intervention measures to improve the implementation effectiveness of medical insurance policies.

Experiences of Respite Care Among Carers or Relatives Who are Responsible for Caring for Individuals With a Mental Illness: An Integrative Literature Review.

An integrative review methodology was employed, following PRISMA guidelines and Whittemore and Knafi's method for integrative review. Thus, the review synthesised the findings of empirical literature published between 2005 and 2023 drawn from four databases: CINAHL, MEDLINE, PsycINFO and Scopus. From the seven studies that met the inclusion criteria, a number of themes emerged: (a) relief of carer burden; (b) benefits for individuals with Mental Illness (MI); (c) barriers to accessing respite care; and (d) inappropriate services model for respite care for individuals with MI. The review findings indicate that using respite care services can decrease a carer's burden and can positively impact both carers and individuals with MI. Conversely, respite care may cause an increase in carers' stress levels due to the lack of service availability, insufficient knowledge and understanding about respite care services for carers, respite accessibility challenges accessible for people with MI and the reluctance of people with MI to accept respite care.

Cascade NMPC-PID control strategy of active heave compensation system for ship-mounted offshore crane

In this paper, the problem associated with active heave motion compensation during heavy-lift operations performed by ship-mounted offshore cranes beneath rough marine environment is investigated. To effectively decouple the correlated motion of the suspended payload from the support vessel via the secondary regulated active heave compensation (SRAHC) system, a novel hierarchical control strategy is proposed by integrating a cascade control structure with an adaptive robust control scheme that incorporates a vertical motion forecast algorithm based on autoregressive integrated moving average (ARIMA) model, a conventional proportional-integral-derivative (PID) framework, and a nonlinear model predictive control (NMPC) method. The introduction of the cascade structure is motivated by its prompt error response against control lag and efficient system order reduction for computational burden alleviation, which forms a crucial foundation for the NMPC-based real-time regulation of PID gains, ensuring optimal evolution of the SRAHC system while improving its practical feasibility. Furthermore, the enhancements in heave compensation and trajectory tracking performance, noise resistance, constraint satisfaction, and engineering application potential of the proposal are demonstrated through a thorough comparative analysis conducted in a practical co-simulation research system.

Modeling and mobile home monitoring of behavioral and psychological symptoms of dementia (BPSD)

With the increasing global aging population, dementia care has rapidly become a major social problem. Current diagnosis of Behavior and Psychological Symptoms of Dementia (BPSD) relies on clinical interviews, and behavioral rating scales based on a period of behavior observation, but these methods are not suitable for identification of occurrence of BPSD in the daily living, which is necessary for providing appropriate interventions for dementia, though, has been studied by few research groups in the literature. To address these issues, in this study developed a BPSD monitoring system consisting of a Psycho-Cognitive (PsyCo) BPSD model, a Behavior-Physio-Environment (BePhyEn) BPSD model, and an implementation platform. The PsyCo BPSD model provides BPSD assessment support to caregivers and care providers, while the BePhyEn BPSD model provides instantaneous alerts for BPSD enabled by a 24-hour home monitoring platform for early intervention, and thereby alleviation of burden to patients and caregivers. Data for acquiring the models were generated through extensive literature review and regularity determined. A mobile robot was utilized as the implementation platform for improving sensitivity of sensors for home monitoring, and elderly individual following algorithms were investigated. Experiments in a virtual home environment showed that, a virtual BPSD elderly individual can be followed safely by the robot, and BPSD occurrence could be identified accurately, demonstrating the possibility of modeling and identification of BPSD in home environment.

Sustainability analysis of primary wastewater treatment by willow plantations in Québec

Wastewater treatment is a necessary step to avoid environmental impacts of water consumption and usage. Traditional approaches are expensive and are limited to developed countries. Phytofiltration using fast-growing trees and shrubs like willows potentially offer an alternative. This paper aims to determine if wastewater treatment using phytofiltration can provide complementary environmental and economic benefits for rural communities in a Nordic climate such as the province of Québec, Canada. It looks at different perspectives of the wastewater treatment solution in a local and rural context. Based on life cycle analysis (LCA) and life cycle cost analysis (LCC), we found that, for an exemplar Québec municipality, the conventional wastewater treatment scenario impacted more on climate change, ecosystem quality and human health than the two phytofiltration of wastewater scenarios studied, where impact is highly dependant on the biomass valorization. The net present cost of the phytofiltration scenarios were lower than typical conventional treatment in Québec. For a biomass producer, conventional biomass production had the highest environmental impact on ecosystem quality, while biomass production from phytofiltration had the highest environmental impact on climate change, human health, and resources. We demonstrate that the phytofiltration is a viable and multifunctional technology that could provide good incentives for a local biomass value chain. it allows to both alleviate wastewater treatment burden and provide affordable biomass for bioenergy development for rural communities. Mobilizing local stakeholders will be key to make phytofiltration an alternative solution for both environmental burden alleviation and rural economic development.

Embedding artificial intelligence in healthcare: An ethnographic exploration of an AI-based mHealth app through the lens of legitimacy.

Skin cancer, a significant global health problem, imposes financial and workload burdens on the Dutch healthcare system. Artificial intelligence (AI) for diagnostic augmentation has gained momentum in dermatology, but despite significant research on adoption, acceptance, and implementation, we lack a holistic understanding of why technologies (do not) become embedded in the healthcare system. This study utilizes the concept of legitimacy, omnipresent but underexplored in health technology studies, to examine assumptions guiding the integration of an AI mHealth app for skin lesion cancer risk assessment in the Dutch healthcare system. We conducted a 3-year ethnographic case study, using participant observation, interviews, focus groups, and document analysis to explore app integration within the Dutch healthcare system. Participants included doctors, policymakers, app users, developers, insurers, and researchers. Our analysis focused on moments of legitimacy breakdown, contrasting company narratives and healthcare-based assumptions with practices and affectively-charged experiences of professionals and app users. Three major kinds of legitimacy breakdowns impacted the embedding of this app: first, lack of institutional legitimacy led to informal workarounds by the company at the institutional level; second, quantification privilege impacted app influence in interactions with doctors; and third, interactive limits between users and the app contradicted expectations around ease of use and work burden alleviation. Our results demonstrate that legitimacy is a useful lens for understanding the embedding of health technology while taking into account institutional complexity. A legitimacy lens is helpful for decision-makers and researchers because it can clarify and anticipate pain points for the integration of AI into healthcare systems.

Dementia Caregiver Burden associated with COVID‐19 quarantine: A South American Cohort Study

AbstractBackgroundIn December 2019, a new virus, Coronavirus disease (COVID‐19/SARS‐CoV‐2), burst into the world. Social distancing reduces its transmission and delays the spread peak. However, because of the late arrival of vaccines to our region, Argentina had a rigorous mandatory preventive social isolation (MPSI) policy that extended beyond global record. As a result, MPSI had a disruptive impact on the actions associated with the well‐being of dementia patients, and caregivers. In addition, MPSI added to the well‐known caregiver burden already present in many dementia patients’ caregivers. This study aims to investigate the impact of MPSI on dementia patients’ caregivers’ mental health and to identify predictors of caregivers’ burden.MethodA sample of 112 caregivers (75.89% female; age 58.65 ± 14.30) of patients with dementia answered a survey with the following questionnaires: Zarit Burden Interview (ZBI), Weekly hourly load dedicated to dementia care, time spent on leisure activities (activity diary provided by Argentine National Institute of Statistics and Census), the Caregiver Activities Survey (CAS) and the Depression, Anxiety and Stress Scale (DASS‐21). These questionnaires evaluate caregiving characteristics and their impact on the caregiver. Additionally, history of COVID‐19 was recorded for patients, caregivers and people living with either of them.ResultMost caregivers were women (75.89%). This difference hindered direct comparison between men and women. A regularized L2 regression was performed and the number of caregiving hours (β = 0.090), depression (β = 0.085), anxiety (β = 0.099), stress (β = 0.164), and fear of COVID‐19 (β = 0.141), were identified as predictors of caregiver burden. Finally, a mediation analysis was also performed, and hours of care (CAS; r = 0.254), being the primary caregiver, and fear of COVID‐19 (r = 0.335) were identified as mediators of the effect between anxiety, depression, stress (DASS) and burden (ZBI).ConclusionCaregivers of dementia patients show sequelaes of anxiety, stress, depression, and caregivers’ burden in the context of COVID‐19 spread and during MPSI. Being a primary caregiver, dedicating more hours to caregiving, and fear of COVID‐19 are factors that contribute significantly to caregiver burden and mediate between this burden and mood variables. Relief of caregivers' burden could be aided by the design of public health policies that specifically address the mediators identified in this study.

Massively Parallel Modeling of Battery Energy Storage Systems for AC/DC Grid High-Performance Transient Simulation

Extensive integration of power electronics apparatuses complicates the modern power grid and consequently necessitates time-domain transients study for its planning and operation. In this work, a heterogeneous computing architecture utilizing the CPU and graphics processing unit (GPU) is proposed for the efficient study of interactions between a power grid network and massive utility-scale battery energy storage systems (BESSs). The device-level electromagnetic transient (EMT) simulation aiming at enhanced fidelity of the BESS is conducted simultaneously with electro-mechanical transient stability (TS) simulation which suffices system-level dynamic security assessment. Since the reservation of a large amount of energy storage units is computationally intensive for the CPU, the concurrent multi-streaming, multi-threading capability of GPU is exploited to achieve asynchronous sequential-parallel processing, so that the proposed EMT-TS co-simulation can flexibly harness all available computing resources. The multi-rate scheme is adopted for further computational burden alleviation in addition to achieving timely information exchange. It shows that the heterogeneous computation of an IEEE 118-bus system integrated with a substantial number of distributed batteries becomes feasible following the achievement of a remarkable speedup of over 200, and the device- as well as system-level accuracy are validated by MATLAB/Simulink^&#x00AE; and DSATools^TM/TSAT simulation, respectively.

Deadbeat Predictive Control Method for 4-leg Inverters

Until now, computational burden alleviation and stability issues for the three-phase four-leg converter has not yet been thoroughly investigated. However, compared to the conventional controllers, the implementation of predictive current control approach for 3-Ø, 4-L inverter suffers a large computational burden due to its additional fourth-leg. Motivated by this fact, this article provides an alternative predictive current control implementation for 3-Ø, 4-L inverter which offers reduced computational effort to achieve similar performance as the conventional FCS-MPC and ensures the global stability of the closed-loop system. To further understand the consequences of the developed control law, theoretical stability analysis has been carried out that links Lyapunov's direct method with the closed-loop system behavior. The outcome of the theoretical stability analysis demonstrates the global stability of the overall system which is later supported by the experimental results. With the proposed method, the number of possible voltage vectors required to obtain the optimal voltage vector in each sampling interval reduces from sixteen to five and thereby simplifies the prediction process. It is also derived that the Lyapunov function-based approach actually yields to the dead-beat control, which has not been previously highlighted in the previous papers. The current work also provides experimental results for different loading conditions (balanced and unbalanced) which further demonstrates the efficacy of the proposed method.

Utilization of Public Long-Term Care Services and Burden Alleviation of Service Recipients and Their Families: Home Care and Institutional Care for Older Adults in South Korea

South Korea launched national long-term care insurance in 2008, and about one in ten older adults currently receives public long-term care (LTC) services. However, little research using nationally representative data has examined the factors related to LTC services and burden alleviation. Using Andersen’s health service utilization model, this study aims to explore the factors associated with the utilization of LTC services (i.e., home care services and institutional care services) in South Korea. Further, the alleviation of the burden (i.e., emotional, financial, and physical) among the service recipients and their family members are studied. We performed logistic regressions using national data: the 2019 Long-Term Care Survey (N=3,601). The results showed that living in urban areas and having fewer mobility limitations were associated with higher emotional and physical burden alleviation of home care service users. Moreover, living in urban and having longer geographic distances from the families were associated with more elevated financial burden alleviation. In terms of institutional care services, when the service recipient had fewer children, more chronic diseases, and lived in urban areas, the financial burden alleviation was higher. Based on the findings, we discussed the policy implications of the factors related to service utilization which varied by service and burden types.

MO482: End-Stage Renal Disease in the Elderly: Dialysis or Conservative Management?

Abstract BACKGROUND AND AIMS Nowadays, end-stage renal disease (ESRD) is overrepresented in elderly patients. The presence of medical comorbidities, limited life expectancy, frailty and poor functional status in these patients poses substantial challenges in clinical decision-making and provision of optimal care. The decision to start dialysis or not should always be based on shared decision-making. The objective of our study was to compare clinical outcomes for patients who had chosen either maximum conservative management (MCM) or renal replacement therapy (RRT). METHOD This is an observational study of a single-center cohort in Tunisia that includes 152 elderly patients (&amp;gt;80 years), with chronic kidney disease (CKD) who consulted our center during the period from 1 January 2015 to 31 December 2016. Demographic and comorbidity data were collected on all patients. Then, we evaluated the management of patients who had reached the end stage of CKD during the study period (dialysis or conservative treatment), and we compared the survival of the two groups. RESULTS Of 152 patients, 54.6% were women. The mean age was 82 ± 2.6 years. High blood pressure, diabetes and dyslipidemia were the most common comorbidities. During follow-up, 65 patients have reached stage 5 of CKD. A total of 46.1% started dialysis and the rest received conservative treatment. Patients choosing dialysis were younger compared with those opting for conservative management and were less functionally impaired. Survival was better in those receiving conservative treatment: The mean survival was 24 months for RRT patients and 30 months for maximum conservative management (MCM) patients (P &amp;lt; .01). A total of 1- and 2-year survival rates were 76.3% and 22% in the dialysis group (n = 30) and 75.3% and 45% in the conservative group (n = 35), respectively. CONCLUSION When caring for older adults with advanced CKD who are contemplating dialysis therapy vs. conservative management, efforts must focus on promoting patient values and preferences, shared decision-making, and symptom burden alleviation.

Methodological issues in the observational studies conducted in older population: a narrative review

Introduction&#x0D; Well-conducted observational studies may represent valuable tools for getting insight to disease etiology, detecting the effect of age-related changes, and providing an important perspective on health risk factors and disabilities in an aging population. Nevertheless, this kind of research poses several challenges for researchers. The main aim of this narrative review was to address the potential methodological issues in performing the observational studies in the elderly, the factors that influence their participation, and the possible solutions for overcoming the barriers to research in this population.&#x0D; Methods&#x0D; Comprehensive search for the papers published in the period from January 1st 1980 until 31st July 2016 in English or Italian was conducted through MEDLINE, Scopus and Web of Science electronic databases. Findings from the included papers were finally summarized.&#x0D; Results&#x0D; In cohort studies, the following barriers were addressed: sample size calculation, ascertainment of the target population, frequency of data collection, exposure determination, multifactorial loss to follow-up (drop-outs), cognitive impairment, definition of confounders, and ethical aspects. Case-control studies were reported to be prone to the issues like ascertainment of cases and controls, willingness to participate, data accuracy, recall bias, issues related to patients’ multimorbidity, and cognitive impairment.&#x0D; Conclusions&#x0D; Important factors to consider in research in elderly people include: precise definition of the study population, well conducted recruitment process, engagement with family and home care staff, cognitive impairment assessment and the consequent relevant ethical and legal issues, relief of participant burden in order to minimize withdrawal, and engagement with the media.

Viewpoint on relief of COVID-19 burden in India by administration of system to break the chain of SARS-CoV-2 at the grass-roots level

During 2020, the first wave of COVID-19 pandemic hit badly the Indian subcontinent very surprisingly. Indian Government and every citizen of India have attempted many more strategies on damage control of pandemic in terms of human lives, population, health, and socio-economic impacts. Second wave have battered us significantly tanks to our hubris and callousness. In anticipation of the potential third wave, the system has developed a massive but at grassroots level pragmatic and strategic roadmap for sensitizing the policy maker and coordinators. The existing infrastructure and manpower utilization could be the best, eco-friendly and the most effective way to break the chain of SARS-CoV-2. The infrastructure includes government schools and manpower work as an administrative system which includes elected MLAs, medical doctors, village head (Sarpanch), village council’s elected members and local people. Managing this system at grass root level could be the best and effective way to break the chain of SARS-CoV-2 in all states of India.

The relationship between family and residential settings: Aging in place vs long term care facility in South Korea

Objective: This study aims to explore the factors influencing long-term-care beneficiaries’ decisions between home health care and institutional care in South Korea. This study further investigated the association between these two types of long-term care services and emotional, financial, and physical burden alleviation among the beneficiaries and their family members. Methods: We analyzed data from 2019 Long-Term Care Survey. Out of 5,606 respondents, 4,079 long-term care beneficiaries and family members were included in this study. Logistic regression models were conducted to understand factors associated with types of long-term care services, and the association between types of long-term care services and burden alleviation. Results: Having a spouse, having children, or a shorter geographic distance between the beneficiaries and their family members were factors associated with higher likelihood of receiving home health care rather than institutional care. Also, more sever mobility limitation, outpatient care, and fall experiences were associated with higher likelihood of receiving institutional care. Utilization of institutional care was significantly associated with higher alleviation of physical burden. No significant differences between home health care and institutional care were found on emotional and financial burden alleviation. Conclusions: The findings suggest that family resources may be beneficial for older adults to pursue aging in place in later life. However, the physical toll of their family members may exist. Our findings provide evidence to inform public policy decisions on long-term care services for older adults and their family members.

A Medical Student Postpartum Telehealth Initiative During the COVID-19 Pandemic.

PurposeThe coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on our health systems and delivery of care and on the disruption of medical education. It has forced hospitals to move to a telehealth model for prenatal and postpartum visits and expedite discharges for postpartum patients in order to reduce exposure. We describe our medical school and hospital system initiative to employ medical student volunteers for postpartum telehealth calls during the peak of the COVID-19 pandemic in New York City.DescriptionTen medical students conducted phone interviews with postpartum patients within 72 h of discharge at three hospitals in a large NYC health system, with faculty preceptors at each site who provided daily call assignments and oversight. Students called patients to screen for risk factors for postpartum complications, including preeclampsia and postpartum depression; provide additional contraception counseling; and address newborn care and health. One week and 2 week post-discharge calls were also made for COVID-19 positive patients for ongoing symptom monitoring and counseling.AssessmentWe found numerous opportunities for intervention in postpartum health via telehealth, including addressing pharmacy-related needs, patient counseling, improving pain management, and identifying patients in need of emergent re-evaluation.ConclusionAs this pandemic continues to evolve, our model demonstrates the feasibility of telehealth and medical student involvement in postpartum care and its benefits to patients, medical student learning, and alleviation of burden on obstetric staff.

Model-Free Predictive Current Control for Three-Level Inverter-Fed IPMSM With an Improved Current Difference Updating Technique

Parameter mismatches in conventional model predictive current control (MPCC) would worsen torque and THD performance. To eliminate the parameter dependence of MPCC, this letter proposes a model-free predictive current control (MFPCC) for a three-level inverter-fed interior permanent magnet synchronous motor (IPMSM). Firstly, to increase the current difference updating frequency in the diode neutral-point-clamped (NPC) three-level inverter, a synchronous updating method is proposed in a manner where the number of updated current differences during one sampling period is increased up to 6. Secondly, for the sake of computational burden alleviation, a candidate vector selection algorithm is introduced in such a way that the number of candidate vectors is reduced to only 7–9. Then, the problem of neutral-point voltage fluctuation which is inherent to the three-level NPC inverter is investigated, and a reasonable replacement method incorporating the redundancy characteristic of small vectors is developed. Finally, experimental results verify that the system robustness against mismatched parameters can be greatly enhanced by use of the proposed control scheme; meanwhile, steady-state performance and dynamic-state response of the system can be improved to some extent as well.

Information and Communications Technology-Based Telehealth Approach for Occupational Therapy Interventions for Cancer Survivors: A Systematic Review.

(1) Background: Occupational therapy (OT) practice has a unique perspective that addresses the complex needs of cancer survivors. Despite the expanded research and application of OT services using telehealth (TH) to promote clients’ health and well-being, studies on OT services using TH for cancer survivors are rare. This study aimed to review the TH approaches in the scope of OT and the outcome of factors affecting occupational engagement in adult cancer survivors. (2) Materials and Methods: This systematic review performed a literature search of five databases (Medline Complete, PubMed, CINAHL, PsycINFO, Web of Science) using a combination of keywords and cross-referencing. Studies were included if they described a TH intervention within the scope of OT practice to improve occupational engagement. (3) Results: Fifteen studies (12 randomized controlled trials, three quasiexperimental studies) were reviewed. Physical activity had a positive effect on physical and cognitive function. Symptom self-management showed positive effects on the relief of symptom burden. Psychosocial interventions, which included cognitive behavioral therapy, problem-solving, cognitive behavioral therapy for insomnia, mind–body training, reduced sleep disturbance, and improved physical activity. Lifestyle behavior change interventions improved participation in moderate-intensity physical activity and diet quality. In addition, these interventions reduced cancer-related symptoms such as pain, depression, fatigue, distress, and improved quality of life. There were no direct outcomes of occupational engagement, excluding sleep, that could be confirmed through this review. (4) Conclusion: This review explored and confirmed the usefulness of TH approaches in the scope of OT practice in adult cancer survivors. It also supports the notion that OT-specific research using TH interventions for cancer survivors will be needed in the future.

Perspectives of stakeholders on technology use in the care of community-living older adults with dementia

Although technology has the potential to promote aging in place among community-living older adults with dementia, the use remains scarce. In this literature study we provide an overview of perspectives (i.e., needs, wishes, attitudes, possibilities, and difficulties) of different stakeholders on technology use in the care for community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Shared perspectives were, among other things, ease of use, stability and flexibility of technology, importance of privacy, and confidentiality. Among older adults, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers' peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in perspectives of stakeholders are essential to enhance the use of technology in the care for community-living older adults with dementia.

Food-effect study of nilotinib in chronic myeloid leukaemia (NiFo study): Enabling dose reduction and relief of treatment burden.

ObjectivesTaking advantage of its food‐dependent bioavailability, the present study investigated the effect of a reduced dose taken with real‐life meals on the pharmacokinetics (PK) of nilotinib in chronic myeloid leukaemia (CML) patients.MethodsNilotinib was taken fasted (300 mg BID, days 1‐4) or with real‐life meals (200 mg BID, days 5‐11). Rich sampling (days 1, 3, 8, 11) allowed for non‐compartmental PK analysis. Nilotinib exposure (AUC0–12 h ‐C min ‐C max) and its intra‐ and interpatient variability were compared between the two regimens. Adverse events were recorded by means of a patient diary and ECG monitoring.ResultsFifteen patients aged 40‐74 years participated. Nilotinib PK following 200 mg BID taken with a meal strongly resembled that of 300 mg BID taken fasted (C min percentile (P)10‐P90: 665‐1404 ng/mL and 557‐1743 ng/mL, respectively). Meals delayed nilotinib absorption. Intra‐ and interpatient variability were not increased by intake with meals. Nilotinib with food was well tolerated.ConclusionWith support of therapeutic drug monitoring, the use of a reduced 200 mg nilotinib dose with real‐life meals seems feasible and safe. Future (confirmatory) studies should further explore the usefulness of nilotinib dosing together with food, including the relationship with treatment efficacy as well as long‐term effects on quality of life.Clinical Trial Registration: NTR5000 (Netherlands Trial Register, www.trialregister.nl).

The experiences of people with Alzheimer’s dementia and their caregivers in acquiring and using a mobility aid: a qualitative study

Purpose Cognitive deficits and gait and balance problems are progressive in people with Alzheimer’s dementia. Yet, mobility aids are associated with an increased falls risk in people with dementia. Our objectives were to identify the perceptions of people living with mild-to-moderate Alzheimer’s dementia, and their caregivers, on the use of mobility aids. Methods A qualitative study using semi-structured, face-to-face interviews was conducted. Community-dwelling older adults with dementia attending a day hospital program were recruited. Thematic analysis was conducted and the text was coded into broad themes aligned with the research questions. The coded text was examined for patterns and similarities, and grouped to form inductive themes. Results Twenty-four people (12 living with dementia and their 12 caregivers) participated. Five themes were identified: (1) acknowledgement of need; (2) protecting a sense of self; (3) caregiver oversight and relief of burden; (4) healthcare professional involvement; (5) environment and design of aids. Conclusions The findings suggest that people with Alzheimer’s dementia and their caregivers regard mobility aid use as increasing independence. There is a role for healthcare professionals to be involved in the prescription, provision and training for use of mobility aids among people living with dementia to ensure uptake and safety. IMPLICATIONS FOR REHABILITATION Mobility aid use is regarded as increasing independence by people with Alzheimer’s disease and their caregivers. Falls risk associated with mobility aid use was not well known and caregivers perceived mobility aids as a means to reduce falls. Most people do not see a healthcare professional when they acquire a mobility aid and there is a role for healthcare professionals to be involved in the prescription, provision and training of people living with dementia in the use of mobility aids in order to increase the uptake of aids and their safe use.