And it’s only upward from here: Netflix co-CEO Ted Sarandos met with South Korea’s President Yoon Suk-yeol in Washington in April and announced that the company will invest $2.5 billion in the country for the next four years, including in the creation of new series, movies, and unscripted shows. It’s the streamer’s biggest line-up of Korean content to date, a testament to the unabated global popularity of South Korean entertainment. Whatever the reason, the 16-episode Korean drama The Glory became a crowd favorite this year, and now ranks as the fifth most popular non-English TV show ever on Netflix, joining the growing list of South Korea’s blockbuster offerings on the platform.Īfter releasing the first batch of episodes in December last year, The Glory’s final eight episodes were among the 34 Korean titles that Netflix said it will release this year. The drama follows the story of two lawyers who became business partners after the other builds a law cafe in the others building to sell coffee and give legal advice at the same time. In an effort to increase the number of Korean shows on Netflix, shows like A Korean Odyssey and Live were phenomenal additions to the library. Lee Seung Gi Lee Seung Gi recently starred in the legal rom-com drama 'The Law Cafe' with 'Korean Odyssey' co-star Lee Se Young. Two popular and beloved Netflix Original k-dramas will be leaving the service in March 2023, A Korean Odyssey and Live. Young entrepreneurs aspiring to launch virtual dreams into reality compete for success and love in the cutthroat world of Koreas high-tech industry. Maybe it’s the visceral, almost triggering, based-on-a-true-story depiction of school bullies searing a victim’s skin with a curling iron, or maybe it’s how the victim methodically plots her revenge against her assailants years later. Published on February 22nd, 2023, 7:10 am EST.
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8/7/2023 0 Comments Brave little abacus discomfortWe’ve been a band for a while, primarily focused on growing our live show and are currently wrapping up the recording of a project we’ve been working on for what feels like forever. Me in Capris is a Pop/Rock band that unlike Brave Little Abacus very much has live drums, haha. Could you tell us a little about it and what you've been up to recently? I think it really says something about the power of the Dreamcast that when I'm thinking of 1999 and its aesthetic identity I'm immediately brought to that little orange spiral. It's been amazing recently to see contemporary artists making music reminiscent of what I guess a lot of people now refer to as 'Y2K' culture. I find a ton of inspiration from that period in general. I open it up and just stare at the Jet Set Radio, Phantasy Star Online, and Crazy Taxi designs all of the time. A couple of years ago I picked up the book Sega Dreamcast: Collected Works from the awesome publisher Read-Only Memory. My relationship with the console now is primarily with its arcade ports but also just having a reverence for its ambition and style in general. I don’t think that this was necessarily the primary driving force though, it probably was more of a publicly-used excuse for dragging a CRT to shows, ha. I also remember believing that using a CD-based set-up to play our backing tracks would overall benefit our performance given the increased audio fidelity of a CD vs. I also have some recollection of us wanting to eventually perform in front of a wall of CRTs, which, like a lot of other Brave Little Abacus ideas, was certainly a bit over-the-top ambition-wise, ha. Pre-recorded/produced drum tracks along with in-between song vignettes and samples would be played on CD via a Dreamcast or PlayStation and eventually off of an iPod or Laptop.įrom the outset of the project, we were often sampling sound effects and passages from video games in our recorded music so I think from an aesthetic sense, relying on that technology live was a good fit. In the morning I’ll be fine.For the vast majority of Brave Little Abacus’ existence, we performed without a live drummer. Adam said it best with, “Ambitions always double the weight of the world.” Eclectic, fun, challenging, catchy, The Brave Little Abacus where everything an emo band should be, but they’re dead, dead and buried, gone forever, a blip on the radar, a cult project that likely will never generate money, but that’s OK. Perhaps Adam and company were too ambitious to succeed. Pound for pound TBLA is the best emo band that ever was. The Brave Little Abacus is important to me, they’re important to the genre, and to music in general: And that’s it, two full lengths, an EP, a split, and a demo. I take solace that the average TBLA fan is a devoted fanatic, but our numbers are still alarmingly thin. It’s disheartening knowing that a band with such potential broke up, that a band whose whole discography is strange and exciting has so few fans. It took a decade after fellow emo greats American Football broke up for them to catch on, so there is hope. I hope with all my heart that starts to change. There’s really nothing new to be found, but that’s OK because Okumay is icing on the discography-cake.ĭespite their limitless appeal, The Brave Little Abacus remains largely unknown. They have the songwriting chops to pull off the stripped down sound There are no samples (OK one, but it’s short), no weird stuff, no bullshit, just four fast and furious emo tracks. Upbeat keyboard riffs and Adam’s most polished vocal performance to date make Okumay an experiment in what The Brave Little Abacus would sound like if they were a “normal” band. Keyboard is often a secondary instrument for TBLA, hanging out in the background, providing atmosphere and counterpoint, but on Okumay, Zack’s ‘boards carry the music. It’s The Brave Little Abacus' least challenging, most pop oriented record. It doesn’t even attempt to live up to JGB, and that’s what makes it perfect. Okumay is not experimental in any way, it doesn’t advance the band’s sound. But once I freed myself from lofty expectations and comparisons, I started to realize I might be approaching it wrong, and it hit me that three of the four songs (all but the cover) are among TBLA’s best songs. It’s three new songs, one cover, and hardly groundbreaking, the songs are much simpler, bare, stripped back. Okumay was an anticlimactic way for a band like The Brave Little Abacus to go out. Part 5 - Big bulging eyes like frogs in the hands of boyhoodĪt first glance Okumay is a disappointing way for the band to go out - it’s short, simple, bare, and it’s not a “revelation” like Just Got Back From The Discomfort. The Most Underrated Band on The Planet: A Retrospective Subscriptions are also available worldwide. UK subscribers can save more than 30% off the price in the shops by signing up for an annual subscription by direct debit. Never miss an issue by taking out an annual subscription. The Essential Guide to Astronomy CommunityToursSubscribeCurrent IssueRenew LoginShop at Sky Sky & Telescope Magazine Take a peek inside the issues of Sky & Telescopemagazine and explore the digital extras that accompany our columns and feature articles. Subscribe today and save off the regular price iPad and iPhone users can download our app from the App Store. You can also purchase PDF versions of the magazine for reading on computers and many other devices. The world’s first astronomy magazine designed to be read on tablets and phonesĪstronomy Now can be read on tablets and phones. You can also order the magazine direct from our online store and, for UK addresses, receive the current issue by 1st class post at no extra charge. From Astronomy Magazine : Amateur astronomers discover enormous nebula. In the United States you can find copies in larger Barnes & Noble stores. Torrents of charged particles continuously lift off the suns atmosphere and. Sky and Telescope Digital Edition - posted in Astro Art, Books, Websites & Other Media: A few days ago I received an e-mail from Sky and Telescope. These maps will enlighten and inspire viewers for the events to come. Astronomy Retreat (MARS) Sky & Telescope ASTRONOMY MAGAZINE Blue Ridge Chair Free PDF Magazines for Ipad, Iphone. Copies are also distributed around the world. By: Alan MacRobert JPeople, Places, and Events Where to See the Two Great North American Eclipses The October 2023 and April 2024 solar eclipses will thrill millions of North Americans. You can pick up a copy of Astronomy Now from all good newsagents and larger supermarkets in the UK priced £5.99. Each month, the magazine contains features, reviews, news and practical guides on all aspects of astronomy, from the latest scientific discoveries to advice for those discovering the night sky for the first time. Since 1987 it has been essential reading for astronomers in the UK and around the world. Get more with the UK’s biggest astronomy magazineĪstronomy Now is the UK’s biggest astronomy magazine. Sky & Telescope is a monthly American magazine covering all aspects of amateur astronomy, including the following: current events in astronomy and space. 8/7/2023 0 Comments Simplemind pro pcThis is a full offline installer standalone setup for Windows Operating System.
8/7/2023 0 Comments Andy ruiz memeIt's been 9 months and 16 days since this fight. won the fight via 12 round unanimous decision. His most recent fight was a non-title bout against Cuban boxer Luis Ortiz on September 4, 2022. has had a total of two losses in his professional boxing career so far. Some of Ruiz Jr.'s best fights and notable victories include wins over Anthony Joshua, Devin Vargas, Alexander Dimitrenko, Ray Austin, Manuel Quezada, Tor Hamer, and Joe Hanks. Anthony Joshua vs Andy Ruiz Jr Funny Memes & Reactions COMPILATION Funniest Comments Anthony Joshua 4 KNOCKDOWNS in TKO LOSS vs Andy Ruiz funny hilarious comments and reactions Anthony. For all the details about Ruiz Jr.'s world title wins and defenses refer to " Andy Ruiz Jr. He is a one-time unified heavyweight world champion, and has won three world titles at heavyweight. He lost to Parker via 12 round majority decision. had his first world title fight at the age of 27 on Decemafter 29 professional fights, against Joseph Parker for the WBO (vacant) title. He went on to win 28 more consecutive fights after the debut, which included 18 wins via stoppage. made his professional boxing debut against Miguel Ramirez at the age of 19 on March 28, 2009, defeating Ramirez via 1st round KO. De Los Santos was only added to the card Wednesday when Jezreel Corrales couldn’t secure a travel visa from Panama.Andy Ruiz Jr. The pay-per-view card opened with an enormous upset: Edwin De Los Santos, a Dominican lightweight filling in as a late replacement opponent, battered previously unbeaten Mexican prospect Jose Valenzuela for a third-round stoppage victory. “But I felt good, and I thought I was landing the more powerful shots. “Obviously it had been over four years, so I was a little off with my timing, and a little sluggish,” Mares said. Mares tired in the second half, but won 96-94 on one judge’s card. He recovered from surgery on a detached retina shortly before the start of the coronavirus pandemic, and his ring absence stretched on while he landed a commentary job with Showtime.īut Mares eventually decided he had to return, and he looked quite sharp early against Flores (25-4-1) with a series of big right hands that rocked his opponent. Mares (31-3-2) hadn’t fought since his second loss to Leo Santa Cruz in June 2018. “The ability that I have for counterpunching instead of waiting for him to load up, that was a blessing.”Įarlier, Cruz (24-2-1, 17 KOs) made his case for a rematch with Gervonta “Tank” Davis with his two-round demolition of Ramirez, first knocking him down face-first with a left hook to the jaw before finishing him with a combination in the corner.ĭavis, who narrowly beat Cruz by decision last December, smiled as he watched the bout from ringside amid chants of: “We want Tank!” from Cruz’s fans. But Ruiz connected again late in the seventh, staggering Ortiz before sending him to the canvas with a right to the top of the head. Neither fighter threw much or risked much in the next four rounds, and the crowd that loudly backed Ruiz grumbled its displeasure. Ortiz wobbled to his feet and soon slipped back down while trying to clinch with Ruiz, but he made it to the bell. I want to be a champion again.”Īfter entering the ring in a blue-and-gold robe and trunks featuring the Super Bowl champion Los Angeles Rams’ colors and helmet horns, Ruiz abruptly floored Ortiz early in the second round with a short right hand. “I want to fight at least three or four times a year. “I do not want to be waiting,” Ruiz said. Ruiz had fought just once since, but he rededicated himself to training with hopes of getting another shot at the belts. Ruiz pulled off one of the bigger upsets in recent heavyweight history when he took Anthony Joshua’s three championship belts in 2019, only to lose them back to his British opponent six months later. The Associated Press also had Ruiz 114-111, with the knockdowns making the difference. “I thought I did a beautiful job handling his pressure and also coming forward.” “I worked so hard for this fight, because I knew he’s a warrior and he hits hard,” Ruiz said. The Southern California native knocked down the 43-year-old Ortiz twice in the second round and again in the seventh, but his Cuban opponent punched more accurately during long stretches of relative inactivity for both fighters. In the main event, Ruiz (35-2, 22 KOs) had all of the big moments while grinding out a decision over Ortiz (33-3), a two-time world title challenger. 8/7/2023 0 Comments Hashr punjabiI think they still got long way to go to match the standards of Bollywood. If our own people and our movies do not show sensibilities to this important cause & support Sikhs, then who else would do it. Then how come we don't get to see Sikhs (I mean turban Sikhs)in lead roles in Punjabi movies. In this regard, Indian Hindi films have started projecting Sikhs in a more appropriate manner & now we get to see lead roles as turban Sikhs. No Doubt, Punjabi films are getting better BUT somehow the scripts are taking their theams away from Sikh culture & its way of life. I like punjabi movies with good stories,but the actor has to be good who knows how to ack like harbhjan maan he doesn,t know how to act i don't know why they repeat him every movie. its better than most non realistic bollywood movies.babbu maan is a rockstar This film is very good ,supper ,hit outstading,histry ,mindbeloing,ever girls& boys like very good film now i wilk show that he is also a good actor. Hi dear i would like 2 say that this movie is very interested, lovable,and romantic.i like it very muchīabbu Maan is the sikest singer in da hole world no 1 betta i luv all his songs and films!!!!!!!!!!!!!!!!!!!!!!!!!!!!!īabbu maan is best singer,lyrics, music director. U are my jaan babbu mann i always listen your music. One more thing if you don't like Punjabi movies or bollywood movies then don't watch it keep your orthodox views to your self. Honestly fanatics like you cause chaos among people. It doesn't matter whether an actor wears a turban or not. Hashar was an excellent movie.This is a reply to Inderjeet Chowdhary first and foremost people like you are the ones who stir controversies. So far I am concerned, one can not be a sikh unless he wears a Turban. One needs to look into the rich values that Sikhis teaches. What does he or she may know about Sikhs & their punjabli culture. Very shortly, shall wear a turban myself.I must tell this person-Raj Hundal for his stupid remarks. I am Caucasian female from London who recently after thorougly searching many religions & converted myself to be a Sikh. Hello my dear babu i alwayslisten your songs your stylish is very good We are proud to be sikhs and of our punjabi culture This shows his low or low level of education. I along with a my team of over 30 girls and boys strongly condemn Raj Hundal's remarks which are uncalled for and nasty. I am a leader of a major punjabi cultural organization in Australia and my team has performed in all major cities of the world. I like ur ackting, singing very much.Bye ji. Sat Shri Akal ji.Babbu Mann is the best singer in the world. If he is a follower of Radhasoami, Nirankari, Namdhari, or other Deras then he cannot claim that he is Sikh. First of all it was a Punjabi movie not a Sikh religious film.Secondly I want to know if Inderjeet Chowdhary is a Sikh or a person following one of the anti sikh groups like Radhasoami, Nirankari, or other cult groups known as Deras. I think Raj Hundal was right in a way because people like Inderjeet Chowdhary are the ones who stir controversies because the movie Hashar had nothing to do with Sikhism to begin with. I loved the movie Hashar excellent movie.a must see. Hi i love u babba mann i love ur songs vry much i m ur great fan i love uuuuuuuuuuuu Yeah.n i love babbu maan lottttttttttttt. MAAN SAHIB AGLI FILM KAO A RAHI HAI G SANU BESUBRI NAL INZAR HAI GURDAS MAAN TON BAD TUSI HI LEGEND HO MAN SAHB RELY UR WAITING SIRIIIII LUCKY AND PARMINDER FROM ROPAR (SHAM PURA) The film is releasing in UK cinemas by EROS International this August 2008. Hashar - A Love Story is one of these new Punjabi films portraying family unity and Punjabi culture, with an underlying social message for their communities. This has resulted in an increased production of family orientated films from Punjabi filmmakers - catering for Sikh communities based in UK, especially the Midlands. The popularity of Punjabi films has slowly increased in UK cinemas during the last three years, with box office takings surpassing many Bollywood blockbusters. The film is said to be based on Maan's real life's experiences. The musical score of this Punjabi melodrama is composed by Babbu Maan who plays the lead role in Hashar. Various human feelings like love, passion and romance are also depicted in this film with a strong underlying message. So when the young couple face problems in their lives, they quickly surrender to situations instead of sorting them out. 8/7/2023 0 Comments Folx healthcareMuchomor // Getty Images What are some of the biggest things that people outside the LGBTQ community don't understand about what it's like to seek healthcare as an LGBTQ person? And even if we get through that, our meds may still get changed at the pharmacy without our consent, and on top of that, we may end up paying most of the costs out of pocket because of high co-pays and deductibles. Much of the care we want isn’t even covered, and when it is, we often have to go through elaborate pre-approval processes and bureaucratic barriers. Add to that, the fact that many doctors won’t prescribe the medications we need, don’t understand our bodies, and if they do, they require many layers of unnecessary gatekeeping. This is made worse by an insurance system that often does not cover essential queer and trans services such as gender-affirming surgery or reciprocal IVF. The current system is confusing, expensive, and discriminatory. Today, most queer and trans folks experience a unique system of barriers that makes great care inaccessible. Can you talk about the current difficulties people face finding LGBTQ-competent providers and gender-affirming healthcare? All medication is delivered directly and discreetly to the patient’s home, democratizing the health journey for the LGBTQIA+ population. The current system includes care providers who don’t understand queer health needs, prescribed routines that treat people as problems to fix, endless government hoops, and millions of people left to defend their bodies, sexual choices, families, and goals.įOLX was founded as a digitally-native platform designed to reach the wider community, not hindering access based on location. Many members of the queer and trans community have dealt with a healthcare system that claims inclusive care but is far behind on delivering. In January, FOLX is also launching services such as PrEP and at-home STI testing in order to become an all-in-one queer healthcare service increasing access to care for all.Ĭlick here to meet more LGBTQ+ change-makers.’. FOLX offers medical plans for testosterone and estrogen hormone replacement therapy, as well as erectile dysfunction. It is pioneering a new standard of healthcare that serves this marginalized community in a way that has never been available before. How is FOLX changing healthcare for trans and nonbinary individuals?įOLX Health is the first queer and trans health platform that is created for and by the LGBTQIA+ community, removing barriers and stigmas that have previously existed. If you go to the average medical school, they will give you anywhere from zero to six hours of training over four years on queer and trans health. And then, with the queer and trans community, it’s difficult to find queer-competent healthcare.ĭoctors don’t know what it is to be on hormones or know what it is to even have gay sex. The last person who's asked about what they really want is the patient. All the while, I was frustrated with the medical system where everybody's view was being represented-because they had the money-except for the patient’s. I went to public health school and worked in startups around data. That set off the arc of an extremely Homeric journey through the healthcare system. I really got a firsthand look at how broken the system was in so many ways, but particularly the healthcare system for our community. I graduated from law school and started a little nonprofit for kids working on the streets of Boston in the sex trades in 1994, at the height of the AIDS crisis. Men's Health: Where did the idea for FOLX come from?ĪB: First, you’ll have to learn a bit of my trajectory. Breitenstein, founder and CEO of FOLX Health, to learn more about how the company is revolutionizing the medical landscape for the LGBTQ+ community. FOLX will soon provide prescriptions for Pre-Exposure Prophylaxis (PrEP) and at-home STI kits. At FOLX, everything is done virtually, including one-on-one telehealth visits with LGBTQ-competent providers, and prescriptions for hormone replacement therapy (HRT). Nearly 1 in 5 transgender individuals have been refused healthcare, notes the National LGBTQ Task Force. The current state of healthcare is abysmal for trans people, with 42% of trans women reporting mistreatment or abuse by healthcare providers, reports the National Center for Transgender Equality. Launched in January of this year, FOLX Health is one of the first healthcare companies dedicated to providing customized medical treatment and care specifically for queer and transgender communities. 8/7/2023 0 Comments Cosmopolitan drink wiki“I think this is the most common example of how this cocktail has been misconceived. “Reaching its height of popularity in the 1990s, the Cosmopolitan has been featured time and time again on the TV show Sex and the City as a transparent purple cocktail in a V-shaped martini glass,” he says. He says the Cosmo is a product of its environment, born of a desire to create a new classic cocktail with vodka as its base. There is about ten drops.Zachery West is the bar lead at White Limozeen, the stylish rooftop bar that’s part of the Graduate Hotel in Nashville. This is clear liquid with just a hint of vanilla amidst the stench of alcohol. Raw and burning, this stuff burns its way down to your stomach. This is a clear liquid that smells like vodka. Often used instead of blood in clicks, this thick red drink also has another similariy with blood - it's a hell to get out of clothes. Where is the salt, lemon and lime? There is about ten drops. This clear liquid smells strongly of agave and alcohol. This is a thick, sweet, clear liquid with an aniseed aroma.Ī blood-red liquid with a rich, fruity scent. This dark brown thin liquid has a sharp, vinegary tang. This is about ten drops of a suspiciously bright green liqueur that is made from the finest Honeydew melons grown in the fields that surround Djelibeybi. It makes peoples toes curl the instant a drop touches their lip. This slightly milky liquid is one-hundred-percent pure. This chocolatey, pale brown cream is smooth and delicioius, and is one of Casanunda's favourite seduction weapons. This is a slightly sour, yet very refreshening drink. This is about ten drops of a clear, strongly alcoholic liquid with a scent of juniper. This sweet liquid smells strongly and mouth-wateringly of chocolate, mixed with the unmistakable ting of the highly alcoholic.Ī clearish liquid, looking and tasting somewhat like urine. You could pour it on something, or perhaps just drink it straight. The cream is white and slightly thicker than milk, it looks wonderful and appetising. This sweet alcoholic drink tastes faintly of Klatchian coffee, but without the risk of knurdness.Īn orange flavoured liqueur, sweet and syrupy, and strongly alcoholic. You wouldn't want to use more than a drop at a time.Ī sweetly smelling fortified wine, about ten drops.
8/7/2023 0 Comments Mifflin st jeor equationAll other predictions significantly underestimated RMR for both sexes. Jeor equation in women could be used with caution in the absence of indirect calorimetry in ultra-endurance athletes. SETTINGS AND DESIGN:Cross-sectional study. Patients were categorized according to sex and diagnosis. Jeor and Cunningham equations for men and the Mifflin-St. AIM:This study tests the degree of agreement between measured resting energy expenditure by indirect calorimetry and predicted resting energy expenditure by Harris Benedict and Mifflin-St Jeor equations. The Cunningham equation could be used in estimating RMR in male athletes (RMSPE, 310.77 kcal/day, the bias between measured vs. Jeor equation was found to be the best predictive equation with lowest RMSPE (275.85 kcal/day for men and 388.34 kcal/day for women) and mean difference (3.04☒85.51 kcal/day for men and 185.57☓53.10 for women) in ultra-endurance athletes. Linear regression analysis was used to determine the accuracy of each predictive equation by computing the standard error of estimate and root-mean-squared prediction error (RMSPE). The Bland-Altman plot was performed to determine mean bias and limits of agreement between measured and predicted RMRs. Methods: Male (n=15) and female (n=15) ultra-endurance athletes age 23 to 55 years from Ankyra Sports Club were included. Jeor, Cunningham, WHO/FAO/UNU (calculated by using body mass and height and body mass alone), Wang, and Sabounchi (Structure 4, 5, and 11) equations) comparing with measured RMR in ultra-endurance athletes. A comparative study of four predictive equations found that the Mifflin-St Jeor equation is more likely than the other equations to predict RMR to within 10 of that measured. The aim of this study was to assess the accuracy of commonly used RMR predictive equations (Harris-Benedict, Mifflin-St. Background/aims: Only a few studies determined some equations to predict resting metabolic rate (RMR) in endurance athletes, however the validity in ultra-endurance athletes, such as triathletes and ultra-marathoners, had not been examined previously. 8/6/2023 0 Comments Speeko app reviewSpeeko is more than just a public speaking app - it's a complete communication coach. Benefit from our cutting-edge technology that adapts to your specific needs and intelligently recommends tailored lessons and exercises. Transform your speaking skills with real-time feedback on your pace, tone, and fillers. Process-based costing will be used to determine costs for app use in NHs and other long-term service and support settings.Ĭosts will be compared in relation to each group's outcomes.Instant feedback on your speaking style. Hypothesis: Staff who use the app will find it acceptable and beneficial for their practice. Hypothesis: Staff who receive immediate app feedback (N= 30 in three NHs) will have greater elderspeak reduction after completing CHATO training compared to delayed feedback controls (N= 30 in three NHs). Test preliminary effects of an innovative self-monitoring feedback app on staff elderspeak use and compare accuracy to psycholinguistic analyses of audio-recorded staff communication. Hypothesis: The app will be readily used and acceptable to CNAs.ĭiminutive counts determined by the app will be correlated with psycholinguistic analysis, validating accuracy. Demonstrate feasibility, acceptability, and validity of the SPEEKO for Elderspeak feedback app use by staff in the NH.įive certified nursing assistants (CNAs) will use the app during NH care and provide feedback about any needed modifications. Next, a clinical trial (N= 6NHs) will be conducted to test preliminary efficacy of the app for amplifying reductions in diminutives use for NH staff completing the CHATO training. The PI and colleagues developed the SPEEKO for Elderspeak app using archived NH recordings from previous research to identify the most commonly used diminutives and then to develop algorithms to detect them in speech.īuilding on proof of concept established in the laboratory, the app will demonstrate feasibility at the point-of-care. This study will test feasibility and preliminary effects of an automated and performance-based feedback app that detects and reports the use of diminutives (terms of endearment such as honey, dearie, and sweetie) which are prevalent elderspeak terms linked to BPSD. However, feasibility and costs for individualized expert feedback in NH settings are usually prohibitive and thus not widely used in practice. Performance-based reinforcement of skills is effective in achieving greater immediate implementation and long-term maintenance of new skills use in practice. Recognizing the delay and incomplete adoption and application of evidence-based skills in practice, the PI and colleagues believe additional strategies to optimize CHATO skills implementation are indicated. To facilitate dissemination, interactive online CHAT modules have been developed (CHATO) which provides the same CHAT classroom content with the advantage of flexible access via the internet for busy NH staff, including those in rural areas and small, independent NHs. The subsequent CHAT R01 trial verified that staff reduced their use of elderspeak after attending the three-session Changing Talk (CHAT) communication training program, and that this reduced RTC. The R03 study established that residents with dementia are more than twice as likely to exhibit BPSD (measured by coding RTC behavior in videos) when staff use elderspeak instead of normal adult communication. The PI and other researchers have empirically verified that RTC occurs when NH staff use elderspeak (speech similar to baby talk) that features inappropriately intimate terms of endearment (diminutives such as "honey"), belittling pronoun substitutions that imply dependence ("the investigators" need a bath), and harsh task-oriented commands ("sit down").Įlderspeak conveys a message of disrespect and incompetence to residents who react with withdrawal or BPSD. A new person is diagnosed with Alzheimer's disease or other dementia every 66 seconds, and most persons with dementia (PWD) spend the late stages of dementia in nursing homes (NHs) where lack of dementia care skills and staff shortages limit quality of care.Ĭare of PWD in NHs is complicated by behavioral and psychological symptoms of dementia (BPSD) such as aggression, vocal outbursts, wandering, and withdrawal that occur as PWD lose cognitive and communication abilities and cannot express their unmet physical and psychosocial needs.īPSD present to NH staff as resistiveness to care (RTC) that increases staff stress and costly time to complete care, often leading to staff turnover, injury, and inappropriate use of psychotropic medications to control BPSD.Īlthough Center for Medicare and Medicaid Services (CMS) mandates and penalties have reduced antipsychotic medication use slightly, contraindicated use in NH residents remains a pervasive problem, causing harmful side effects and reducing the quality of life for PWD. |
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