Culture change models are intended to improve the quality of life and care of nursing home residents. Using longitudinal qualitative methodology, this study evaluated the effectiveness of implementing culture change on the main stakeholders living and working in an Israeli nursing home. Eight focus groups with nursing home residents, family members and staff members (N = 57) were conducted at two-time points one year after and two years after implementing a culture change model. Using thematic content analysis and comparing the experiences of each group and across time, the results revealed that implementing culture change in a nursing home is a complex process, which requires am adaptation in the values, expectations, and perceptions of care of all those involved. Particular attention should be paid to the unique needs of each stakeholder group, while ensuring their engagement and cooperation in the change process.Although incontinence is common in hospital, the prevalence and predictors of continence aid use (continence wear and catheters) are poorly described. A one-day cross-sectional study was conducted in a large university hospital assessing consecutive inpatients (≥55) for their pre-admission and current use of continence aids. Barthel Index, Clinical Frailty Scale and Charlson Co-morbidity scores were recorded. Appropriateness was defined by local guidelines. 355 inpatients, median age 75±17 years, were included; 53% were male. Continence aid use was high; prevalence was 46% increasing to 58% for those ≥75. All-in-one pads were the most common, an overall prevalence of 31%. Older age, lower Barthel and higher frailty scores were associated with continence aid use in multivariate analysis. Inappropriate use of aids was high at 45% with older age being the only independent predictor. Continence aids are often used inappropriately during hospitalisation by older patients. Concerted efforts are required to address this issue.Our objective was to examine the quality of care perceived by nursing staff and its relationship with the staffing and organizational climate in nursing homes. The participants in this cross-sectional study included 358 nursing staff from 26 nursing homes in Hunan Province, China. This study found that the interaction effect between nursing staff to resident ratio and physician to resident ratio exerted a significant effect on quality of care (p less then 0.05). Higher scores on the relationships and communication scale (OR = 4.771, p = 0.002) and lower scores on the work stress scale (OR = 0.980, p = 0.050) were also associated with better quality of care. More work experience was related to lower quality of care (OR = 0.944, p = 0.048), and work experience was associated with relationships and communication (Beta = 0.172, p = 0.002) and work stress (Beta= = 0.259, p = 0.000). Staffing level, work experience, work stress, relationships and communication are key factors in providing higher quality of care in nursing homes.A fundamental question in affective neuroscience is whether there is a common hedonic system for valence processing independent of modality, or there are distinct neural systems for different modalities. To address this question, we used both region of interest and whole-brain representational similarity analyses on functional magnetic resonance imaging data to identify modality-general and modality-specific brain areas involved in valence processing across visual and auditory modalities. First, region of interest analyses showed that the superior temporal cortex was associated with both modality-general and auditory-specific models, while the primary visual cortex was associated with the visual-specific model. Second, the whole-brain searchlight analyses also identified both modality-general and modality-specific representations. The modality-general regions included the superior temporal, medial superior frontal, inferior frontal, precuneus, precentral, postcentral, supramarginal, paracentral lobule and middle cingulate cortices. The modality-specific regions included both perceptual cortices and higher-order brain areas. The valence representations derived from individualized behavioral valence ratings were consistent with these results. Together, these findings suggest both modality-general and modality-specific representations of valence.How does the human brain integrate spatial and temporal information into unified mnemonic representations? Building on classic theories of feature binding, we first define the oscillatory signatures of integrating 'where' and 'when' information in working memory (WM) and then investigate the role of prefrontal cortex (PFC) in spatiotemporal integration. Fourteen individuals with lateral PFC damage and 20 healthy controls completed a visuospatial WM task while electroencephalography (EEG) was recorded. On each trial, two shapes were presented sequentially in a top/bottom spatial orientation. We defined EEG signatures of spatiotemporal integration by comparing the maintenance of two possible where-when configurations the first shape presented on top and the reverse. Frontal delta-theta (δθ; 2-7 Hz) activity, frontal-posterior δθ functional connectivity, lateral posterior event-related potentials, and mesial posterior alpha phase-to-gamma amplitude coupling dissociated the two configurations in controls.  https://www.selleckchem.com/products/th1760.html  WM performance and frontal and mesial posterior signatures of spatiotemporal integration were diminished in PFC lesion patients, whereas lateral posterior signatures were intact. These findings reveal both PFC-dependent and independent substrates of spatiotemporal integration and link optimal performance to PFC.
  Like placebo analgesia, the antidepressant placebo effect appears to involve cortical and subcortical endogenous opioid signaling, yet the mechanism through which opioid release affects mood remains unclear. The orbitofrontal cortex (OFC)-which integrates various attributes of a stimulus to predict associated outcomes-has been implicated in placebo effects and is rich in μ opioid receptors. We hypothesized that naltrexone blockade of μ opioid receptors would blunt OFC-dependent antidepressant placebo effects.
 
  Twenty psychotropic-free patients with major depressive disorder completed a randomized, double-blind, placebo-controlled crossover study of 1 oral dose of 50 mg of naltrexone or matching placebo immediately before completing 2 sessions of the antidepressant placebo functional magnetic resonance imaging task. This task manipulates placebo-associated expectancies and their reinforcement while assessing expected and actual mood improvement.
 
  Behaviorally, manipulations of antidepressant placebo expectancies and their reinforcement had positive, interactive effects on participants' expectancy and mood ratings.