Mode Shifts in Conversations with People with Dementia can Cause Confusion_ Crimson Publishers

Mode Shifts in Conversations with People with Dementia can Cause Confusion by Margaret Maclagan* in Gerontology & Geriatrics Studies_ International Journal of Gerontology

 

Abstract
We illustrate how speakers with dementia may shift the whole mode of a conversation as well as its topic or their role in it. This can confuse their unimpaired conversation partner if that partner is less aware of features of dementia discourse. Examples are drawn from three women with moderate Alzheimer’s disease who were living in the south-eastern United States. These examples demonstrate the range.

Introduction
No one is surprised when conversation with a person with dementia becomes repetitive. They expect stories to be repeated, words to be forgotten or misused or for the direction of the conversation to change abruptly. What they do not usually expect is for the whole mode of the conversation to change with no warning. We use ‘mode’ to refer to the listener’s expectations about the conversation in this particular situation [1]. Listeners normally expect conversations to be ordered and coherent and for changes in direction to be signaled, often by a phrase lime ‘oh, by the way…’ or even directly by something like ‘to change the topic totally…’. We have found a continuum of discourse in dementia from coherent to very confused. Chinaei et al. [2] :376 found that “33% of conversations with people with middle-stage AD [Alzheimer’s disease] involve a breakdown in communication.” Brewer et al. [3] studied conversations with her mother-in-law. She thought they were like being on a carousel-up and down and around in circles.

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Clinico-radiological and Functional outcome of Unstable Intertrochanteric Fractures by Proximal Femoral Nail Antirotation-2 (PFN-A2)_ Crimson Publishers

 Clinico-radiological and Functional outcome of Unstable Intertrochanteric Fractures by Proximal Femoral Nail Antirotation-2 (PFN-A2) by Druva V* in Orthopedic Research Online Journal_ Orthopedic Research journal

 

Introduction
Background: Unstable intertrochanteric fractures were one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma and in young adults due to high velocity trauma. The incidence of these fractures was rising because of increasing number of senior citizens with osteoporosis. The problems associated with unstable intertrochanteric fractures were due to substantial morbidity and mortality, malunion, implant failure and associated medical conditions. Therefore, this has led to the development of intramedullary devices in the management of unstable intertrochanteric fractures.

Objective: To analyze clinico-radiological and functional outcome of unstable intertrochanteric fractures by proximal femoral nail antirotation A2 (PFN-A2).

Materials and methods: A prospective study with 73 adult patients with unstable intertrochanteric fractures according to Boyd & Griffin classification were treated with proximal femoral nail antirotation-2 (PFN-A2) in SSIMS, Davangere from October 2017 and September 2019. All the cases were followed at regular intervals as per our study protocol. The functional outcome were assessed with Harris Hip Score.

Results: In the present study, 73 unstable intertrochanteric fractures underwent surgical fixation with proximal femoral nail antirotation 2 (PFN-A2). The functional results assessed by Harris Hip score showed excellent in 41 cases (56.16%), good in 15 cases (20.54%), fair in 12 cases (16.43%) and poor in 5 cases (6.84%).

Conclusion: We conclude that the proximal femoral nail antirotation 2 (PFN-A2) was an ideal implant for unstable intertrochanteric fractures, leading to high rate of bone union restoring the lateral femoral wall, reducing the chances of implant failure and decreasing the post-operative morbidity by improving the functional quality of life.

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The Role of Major Hormones in Metabolic Adaptation of Farm Animals_ Crimson Publishers

The Role of Major Hormones in Metabolic Adaptation of Farm Animals by Tewodros Alemneh* in Approaches in Poultry, Dairy & Veterinary Sciences_ The Journal of Poultry Science

 

Introduction
Animals possess various inherent mechanisms to cope up with the changing environmental conditions. It has been observed that the ability of animals to adjust with these climatic extremes is related to their level of adaptation and this is inversely correlated with their production potential. Stress tolerance in livestock is determined through various mechanisms and metabolic neuroendocrine regulation is one of the crucial pathways by which the animal survives the stressful condition. The Hypothalamic-Pituitary- Adrenal (HPA) axis plays a significant role in the release of several neurotransmitters and hormones which regulates the thermoregulatory mechanisms in animals. The Thyrotropin-Releasing Hormone (TRH), Thyroid Stimulating Hormone (TSH) and Thyroid Hormones (T3 and T4) are the components of metabolic pathway in regulating body heat production. Thyroid hormones are recognized as the key regulators of metabolic activity in domestic animals. Further, leptin secreted from adipocytes also has a great influence in regulating whole body energy metabolism and may be attributed as a “metabolism modifier”. The release of cortisol stimulates physiological and metabolic responses necessary to optimize the animal capacity to overcome a stressful factor by increasing the energy availability by decrease of cortisol levels. Generally, thyroid hormones, cortisol and leptin are considered to be important biological markers of neuroendocrine pathways for the regulation of metabolic adaptation mechanisms during stress in livestock

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