183 DEVELOPING AND FACILITATING ONLINE INTERGENERATIONAL CAFÉS

Background

Many older people throughout their lives will require nursing care, consequentially most nurses will care for older people during their career. It is important that older people and student nurses are provided with shared learning opportunities so that professional caring partnerships can be nurtured and realised for mutual benefit. Intergenerational projects offer opportunities for intergenerational learning. However, few projects explore student nurse-older person dyads and how these can be integrated within undergraduate pre-registration programmes. This paper describes the development and facilitation of online older person-student nurse intergenerational cafés.

Methods

The project was managed by a design team comprising senior administration, lecturers in BSc Nursing programmes and a lecturer in Design for Health and Wellbeing. The ‘world café’ concept along with values of enablement and participation underpinned the design. The initiative was planned to align with a year three community care module. Regular online team meetings were held to agree the aims and outcomes for student nurse-older person cohorts, decide recruitment strategies, agree the process and format of facilitation. Older people were recruited through retirement, church, volunteer, social and sporting organisations, media and also using snowballing methods.

Results

Both student nurse and older person cohorts were offered support on how to access and participate in the café. Participants attended one of three online cafés hosted through Microsoft Teams. Each café followed the same format: 1) Group meeting convened with all participants; 2) Breakout small group ‘table’ discussions with student nurse-older people participants and design team facilitation; 3) The café was reconvened to whole group meeting where feedback was collated to elicit shared learning.

Conclusion

The initiative proved successful and there is merit in embedding intergenerational cafés into professionally accredited health care programmes. Through sharing life experiences and perspectives, intergenerational barriers can be reduced and new insights developed on person-centred gerontological care.

198 A UNIQUE COMMUNITY POST-DIAGNOSTIC DEMENTIA SUPPORT SERVICE DELIVERED BY THE ADVANCED NURSE PRACTITIONER

Background

In Ireland, approximately 67,744 people live with dementia and 63% reside in Irish communities with increasing care cost estimated at €58,550 per person, which is set to rise alongside increasing longevity (HSE, 2020; Department of Health, DOH 2014). Across the Republic of Ireland, care provision predominantly focuses on middle or later stages of the journey, leaving the newly diagnosed and their care partner as somewhat the invisible. Service provision for post diagnostic dementia services is disjointed, with resource allocation at a low level of provision relative to need, leading to inequity with subsequent disparity resulting in significant geographical variation in the provision of services.

Methods

Robust interdisciplinary community care pathways developed underpin this ANP Service. The multi-element pathway structure delivers community clinics for Dementia, NCSD and LivDem programmes alongside support networks for family care partners, amongst others. Support and care provision is demonstrated from point of diagnosis and throughout the dementia journey for the patient and family care partners, which is unique in Irish healthcare. ANP service provision through interdisciplinary collaboration has achieved increased QOL outcomes alongside illuminating KPI's and audit outcomes. Capturing dementia services early optimises outcomes for all involved including health service cost reductions, all in one setting.

Results

Patient satisfaction outcomes range from 71 - 100% with service intervention outcomes favourably indicating the direct impact of the service, which are unmeasurable to the older adult living with dementia, and include increases in: (i) Confidence - 90%; (ii) Mood - 50% and (iii) open to talking through difficulties encountered - 87%. This service contributes to innovations in practice in this complex care area and now achieves 60 attendances each month

Conclusion

Advanced practice drives collaboration and integration across services delivering on hospital avoidance, early supportive discharge and timely access to services. Facilitating early post diagnostic dementia services optimises interdisciplinary collaboration, crucial to achieve aging in place with timely access to services for all older adults.

1678 A Rare Example of a Simple Bone Cyst of The Ascending Ramus in A Paediatric Patient

A simple bone cyst is described as an intra-osseous pseudocyst, devoid of an epithelial lining and either empty of filled with serous or sanguineous fluid. This case presents a rare example of a simple bone cyst of the ascending ramus of the mandible in a paediatric patient. Studies have shown that less than 5% of simple bone cysts of the jaw bones are located within the mandibular ramus, with the most common site being the premolar-molar region (75%). The 14-year-old female was referred by her orthodontist to the local Oral and Maxillofacial department, for an incidental finding on her pre-orthodontic OPT of a radiolucency in the left ascending ramus. Her medical history was clear, she was asymptomatic and had no sensory deficit. A CT scan demonstrated a 22mm multilocular radiolucency centred on the left ascending ramus, extending superiorly up to the base of the coronoid process and condylar neck. Inferiorly, the radiolucency abutted but did not involve the unerupted third molar. The scan highlighted thinning of the buccal and lingual cortices putting the patient at risk of pathological fracture. The inferior alveolar nerve canal passed through the lingual aspect of the radiolucency. The patient underwent exploration of the left mandible which revealed an empty bony cavity, with no cystic lining or contents. The definitive diagnosis of a simple bone cyst was established. She experienced satisfactory healing by her review appointment 4 weeks post-surgery. Combined radiographic and clinical assessment is important in the diagnosis of simple bone cysts.

Effect of cold plasma on polyphenol oxidase inactivation in cloudy apple juice and on the quality parameters of the juice during storage

Direct cold plasma treatment has been investigated as an alternative non-thermal technology as a means of maintaining and improving quality of fresh cloudy apple juice. Process variables studied included type of plasma discharge, input voltage and treatment time on polyphenol oxidase (PPO) inactivation. Spark discharge plasma at 10.5 kV for 5 min was the best treatment, with near total inactivation of PPO achieved, although good PPO inactivation was also recorded using shorter treatment times. Residual activity (RA) of PPO was 16 and 27.6% after 5 and 4 min of treatment respectively. This PPO inactivation was maintained throughout the storage trials, but decreased with samples treated for a shorter time. Plasma treatment improved key quality parameters of Golden delicious cloudy apple juice, with retention of critical quality parameters during extended storage trials. Color was the most noticeable change, which was enhanced with retention of a greener color. An increase of 69 and 64% was obtained in the total phenolic content after 4 and 5 min of treatment, respectively. Therefore, cold plasma was demonstrated to be a good alternative to traditional heat treatments for enhanced quality retention of fresh cloudy apple juice and over its storage.

Colloid and Interfacial Chemistry at Stuttgart University

The research work carried out in our group can be referred to as “Colloid and Interfacial Chemistry”. We subdivide this rather broad research area into four main topics which are covered by the projects presented in this overview. The surfaces we study are surfactant-loaden water-air surfaces, the films are mainly free-standing thin foam films of less than 100 nm thickness, and the foams are 3D aqueous foams whose stability and drainage we investigate. As regards the topic “Complex Fluids” we study lyotropic liquid crystalline phases and microemulsions. In the past, we were able to establish two new tuning parameters for the formation and destruction of lyotropic liquid crystals, while current research focuses on the lyotropic mesomorphism of new surfactants and of surfactant mixtures. Apart from lyotropic liquid crystals microemulsions are a central theme in the group. Due to their unique properties and fascinating structure variety microemulsions offer a great potential as templates for the synthesis of new functional materials, which is a further research topic in our group. These studies involve the gelation of and the polymerisation in microemulsions preserving their nanostructure to create high surface area polymers. Currently, we also use microemulsions as tailor-made nano-compartmented reaction media. The studied reactions are either enzyme-catalysed conversions of substrates or the reduction of metal salts to synthesize mono- or bimetallic nanoparticles. In this context we focus on bicontinuous and water-in-oil droplet microemulsions. Last but not least we also synthesize new surfactant structures such as inositol-based surfactants and explore the properties.

Conductivity Measurements as a Method for Studying Ionic Technical Grade Surfactants

The critical micellar concentrations (cmc) of cationic alkyltrimethylammonium bromides (C10TAB – C16TAB) and of anionic alkyl sulfates (SDS, technical grade Sulfopon 12G and Sulfopon 1214G) were determined using specific conductivity and surface tension measurements. While the cationic surfactants were purified, the anionic surfactants were used as received. In the former case, surface tension and conductivity measurements lead to the same cmc values. In the latter case, measuring the specific conductivities (bulk property) proved to be superior compared to measuring the surface tensions (surface property) because the presence of highly surface active impurities creates a pronounced minimum in the surface tension isotherm, which makes it impossible to determine an accurate value for the cmc. On the other hand, these impurities do not influence the conductivities, i. e. that the conductivities can be used to determine cmc values of impure and technical grade ionic surfactants, respectively. Moreover, an evaluation of the specific conductivities allows for the determination of the degree of micelle ionization (α) of the ionic surfactant solutions and thus provides additional useful information.

Disjoining pressure study of formamide foam films stabilized by surfactants

A thin film pressure balance was used to investigate the disjoining pressure Pi as a function of the film thickness h of surfactant-stabilized formamide foam films. Nonionic (alkylpoly(ethylene glycol)s) and cationic surfactant (alkyltrimethylammonium bromides (C(n)TAB) with n = 14 and 16) solutions were studied in the absence and presence of electrolyte. The resulting Pi-h curves were fitted with the DLVO theory from which we extracted surface charge densities q(0) and surface potentials Psi(0). Investigating formamide foam films is of interest for studying the electrostatic component of the stabilizing forces in foam films. We know that the aqueous foam films are stabilized via electrostatic forces. In this case the self-dissociation of water contributes to the charges in the foam film. As formamide has a dissociation constant which is about 2 orders of magnitude lower than that of water, the number of charges in the solution due to self-dissociation is much smaller, which, in turn, should lead to lower electrostatic forces. Indeed, we found that formamide solutions of nonionic surfactants did not form stable foam films at concentrations below the critical micelle concentration. Regarding the cationic surfactants, the main difference between the formamide and the aqueous foam films is the fact that the concentration of ionic surfactants to form stable foam films is about 2 orders of magnitude higher compared to water. Consequently, the screening length for the electrostatic interaction and thus the film thickness are much smaller compared to films formed by the respective aqueous solutions.

Differential expression of Rab3 isoforms in high- and low-secreting mast cell lines

The expression of several isoforms of the small-molecular-weight Rab3 GTP-binding proteins is a characteristic feature of all cell types undergoing regulated exocytosis, in which Rab3 proteins are considered to regulate the assembly/disassembly of a fusion complex between granule and plasma membrane in a positive and negative manner through interaction with effector proteins. The pattern of Rab3 protein expression may, therefore, provide a subtle means of regulating exocytosis. To investigate the relationship between Rab3 expression and secretory activity, we assessed the differential expression of individual Rab3 proteins in high- and low-secreting clones of the rat basophilic (RBL) cell line. mRNAs for Rab3 isoforms (a-d) were analyzed by constructing cDNA libraries of high- and low-secreting RBL clones. The relative abundance of mRNAs for Rab3 isoforms was initially determined from the clonal frequency of corresponding cDNA clones. RT-PCR using isoform-specific primers was successfully applied to the quantitation of Rab3a mRNA. The presence of individual Rab3 proteins was revealed by SDS-PAGE and immunoblotting, and also by in situ immunofluorescence confocal microscopy. We present evidence that Rab3a and Rab3c are expressed at high levels in the low-secreting variant, while Rab3d is predominant in the high secretor. Levels of the Rab3 effector proteins, Rabphilin and Noc2, are similar in both RBL cell lines. Subcellular fractionation of unstimulated high and low secretor RBL clones revealed that in both cell types Rab3a has a cytoplasmic location while Rab3d is present in a membrane/organelle fraction containing secretory vesicles. Differences in the pattern of expression of Rab3 isoforms in the two RBL cell lines and their localisation may influence the secretory potential. Furthermore, the presence of Rab3 and effector proteins indicates that the mechanism for regulated exocytosis in cells of mast cells/basophil lineage appears similar to that in pre-synaptic vesicles and pancreatic beta-cells.

Two-dimensional electrophoresis reveals differential protein expression in high- and low-secreting variants of the rat basophilic leukaemia cell line

The aim of this investigation was the identification of cellular proteins that confer a high secretory phenotype on subclones of the rat basophilic leukaemia (RBL) cell line as a model of mast cell regulated degranulation. Following protein separation by two-dimensional (2-D) electrophoresis and silver staining, more than 2000 polypeptide "spots" were resolved reproducibly. Higher sample loads and Coomassie blue staining facilitated the identification by delayed extraction-matrix-assisted laser desorption/ionization (DE-MALDI) mass spectrometry of several polypeptides that were differentially expressed in the high- and low-secreting clones. Several proteins were identified whose expression could contribute to the difference in secretory phenotype. Furthermore, silver-stained 2-D gel patterns suggested differential expression of proteins in the 20-25 kDa and the pI 4.5-7.5 range, characteristic of small guanosine 5'-triphosphate (GTP)-binding proteins. By a combination of "GTP overlay" and immunoblotting, we were able to demonstrate differential expression of small GTP binding-proteins, including Rab3 proteins, in high-and low-secreting clones. The sensitivity of this complementary approach facilitated the detection of some GTP binding and Rab3 proteins, whose expression was not evident in silver-stained 2-D gels.

Peer reviewed: environmental sleuth at work

A combination of technical approaches and forensic tools can determine historic causes, timing, and impacts of site contamination.

Longitudinal development of sleep-related respiratory disturbance in adult humans

A number of cross-sectional studies have found that sleep-related respiratory disturbance ( SRRD ) is common in elderly adults. This preliminary study reports on samples of middle-aged and elderly humans in good health whose polysomnographically recorded sleep was followed over time. Participants were selected for low levels of SRRD on Time 1 recording. Results indicated an increase in SRRD over the study period. This increase ws not limited to rapid eye movement or nonrapid eye movement sleep; tobacco usage, medication status, and weight gain could not account for the change, although in several cases, modest weight gain was associated with increased respiratory disturbance. These data imply that future studies of incidence of SRRD may reveal changes within a 10-year period, although the pathological consequences of these age-related changes, if any at all, may take a longer period to develop.

Nightly variation in sleep-related respiratory disturbance in older adults

This study investigated variation in respiratory disturbance during sleep. Sixty-six healthy elderly subjects (mean age = 67.2) underwent two consecutive nights of polysomnography. Respiratory disturbance was assessed by Respiratory Disturbance Index (RDI), the number of events per hour of sleep. Results indicated an increase in RDI from Night 1 to Night 2. Fourteen subjects increased their RDI by over 2.5, and eight by over 5.0, events per hour on Night 2. The increase was not a function of increased REM on Night 2. Age was positively related to RDI on individual lab nights but unrelated to nightly variation in RDI. Subjects without complaints of insomnia were more likely to show increases in RDI, perhaps reflecting the sounder sleep of this group on the second laboratory night. This study suggests that a single night of polysomnography is likely to underestimate the absolute level of respiratory disturbance seen in a subsequent recording night. Studies placing prevalence of such disturbance in the elderly at approximately 30% are thus likely to be underestimates. Whether this "error" is important will depend ultimately upon the meaning of various absolute levels of respiratory disturbance in healthy older persons.

Human-to-human transmission of Pseudomonas pseudomallei

Melioidosis, the clinical manifestation of infection with Pseudomonas pseudomallei, has occurred infrequently in American citizens; almost all reported cases have been in Vietnam veterans, usually associated with respiratory disease. A Vietnam veteran from Mississippi developed chronic prostatitis, with no other clinical manifestations, during service in Vietnam, and P. pseudomallei was isolated from prostatic secretions 2 years after his return to the United States. The patient had had sexual contact with four women including his wife since his return from Vietnam. Vaginal and cervical cultures and serum samples were obtained from the four women, and serum samples and cultures of semen were obtained from the patient. Vaginal swabs and semen cultures were negative for P. pseudomallei. The patient and his wife had hemagglutination titers (greater than 640) diagnostic of P. pseudominallei infection. This occurrence of venereal transmission is the first report of person-to-person spread of P. pseudomallei infection.