Antipsychotic Medications- Their Effects On Nursing Home Patients

The Journal of the American Geriatrics society published a systemic review about the medical records of about 84,000 patients of the nursing home in 45 states. The review focused on the fact whether the consumption of anti psychotic drugs increased the risk of other medical conditions, especially cardiac arrest, stroke, hip fracture and serious bacterial infections.

Through the review, it was found that well within 180 days of starting the consumption of antipsychotic medications, the nursing home patients were found to be at higher risk for cardiac arrest, hip fracture and bacterial infection; but, the risk of them having a stroke did not increase. This study also helped in identifying which medication lead to which specific health and which doses were found to be safer for the patients.

All in all, these kinds of information are the ones that that improves the quality of medical administration. The medical providers utilize the information to provide better medication for the patients who have complex medical conditions. The detail of data collected through this study which has covered thousands of patients across the country has provided a roadmap in keeping the public healthy.

Antipsychotic drugs help to treat psychological and behavioral symptoms like dementia. The medication is also used to treat mental health illness, for instance mania or schizophrenia caused due to bipolar disorder. Moreover it is used to treat depression and anxiety. It is also known as major tranquillizers. Antipsychotics are of two types, the atypical called the second generation antipsychotics like risperidone, aripiprazole, amisulpride, clozapine, quetiapine and olanzapine. The older antipsychotics are called first generation antipsychotics and include zuclopenthixol, chlorpromazine, haloperidol, flupentixol, pericyazine, levomepromazine, sulpiride and perphenazine.

The drugs are available as liquids, capsules, tablets and depot injections. The older antipsychotics are used since 1950s and are currently in use. The newer version is used from 1970s and it is believed it has fewer side effects when compared to the older version. The antipsychotics are prescribed for symptoms of mania, schizophrenia, anxiety and depression. These are no longer prescribed for elders as it increases the chance of stroke. Risperidone is prescribed for elderly people who suffer from dementia. This is also recommended only for shorter duration, a period of less than 6 weeks and only if the symptoms are severe.

The drug is usually prescribed by specialist in psychiatry. The drug should not be taken without the advice of specialist. Also seek their advice on when to start or stop the drug for conditions of biopolar disorder.

GO Applications And Dynatrace

Adapting to change is the part of contemporary software development. It is vital to understand the significance of Dynatrace in monitoring GO Applications. GO can be called Golang, native open source language developed by Ken Thompson created at Google. It is aimed at bringing about the best of other languages and helps overcome their shortcomings. It is a statically typed language combined with concurrent programming attributes and many more features. This feature is used by home automation companies in Chennai to power their smart gadgets. GO is targets platforms like smartphones. GO is used by Netflix, Uber, Dropbox, Google and SoundCloud, as of Docker it is completely written in GO.

Monitoring GO Executions

Monitoring GO Application is crucial because though the GO code is simple, the application is executed whenever a check in happens. There are many things that can go wrong, for instance triggering of wrong builds due to configuration mistakes, malfunctioning due to a bug and more. The solution would be to log things that go wrong, again this would be high volume task as the log output build up every minute. This is not just huge but also confusing and needs a professional log analytics to coordinate errors.

The advantage of using Dynatrace AppMon helps troubleshooting the problems easily without the need for logs. PurePath Technology captures parameters and returns errors. To identify the errors, the PurePaths can be filters using VCS revision number along with corrupted outputs in a Business Transaction.

Dynatrace and GO App

Download the free trial run of Dynatrace AppMon and monitor GO application. Once the 30 day Trial span is over you can still use it to analyze local apps for free for life.

Measuring GO Applications

Using the Native ADK create PurePath, capture parameter, exceptions, log entries, return values and more. Find majority of functions you need in the nativeAdkFunctions.c and nativeAdkFunctions.h. The constants file can be edited along with the API found in the header file. Moreover, the essential information on the functions is found in Native ADK documentation. You can use the ADK functions naturally instead of using the macros.

Troubleshooting process

In case of corrupted paths and timeouts it is crucial to check if the placeSensor() and exitSensor() are corresponding and in the right context. It is the same for uninitializeAgent() and initializeAgent(). Sometimes the tags are lost as GO switches threads on its own.

The GO is increasing especially Google is a well structured language giving the flexibility to write applications irrespective of complexity and is sure to replace C programs in the near future. Text editors and Multiple IDEs support GO making it easier for developers. 

Some Simple Tips For Uploading Media Using Google

It is easier to use Google Cloud Storage for performing storage management functions. The uses of Goggle Cloud Platform Console include a series of activities. The first include activating the Google Cloud Storage App for a particular project. Second, create new buckets and delete irrelevant buckets. Third, upload or download or delete objects and finally manage ACLs or access control lists for particular buckets and objects. The instructions below elaborate on how to upload media with the help of Google cloud storage.

To create a bucket, first create default App engine bucket, go to https://console.developers.google.com/appengine/settings. The App Engine bucket is something like YOUR_PROJECT_ID.appspot.com. Now change it to $ gsutil defacl ch -u AllUsers:R gs://YOUR_PROJECT_ID.appspot.com. By using this command, the new files found in the bucket turns by default publicly readable. The is suitable to use for WordPress Media Storage.

Activating the stream wrapper and installing the app engine PHP SDK 

Using the composer you can install the App Engine PHP SDK. It goes like $ composer require google/appengine-php-sdk.

Now add the required extension, it is php.ini:. 

extension=bcmath.so

Once this step is done it is time to add the lines given below to wordpress/wp-config.php:

They are as follows:

set_include_path(__DIR__ . '/../vendor/google/appengine-php-sdk');

require_once(__DIR__ . '/../vendor/autoload.php');

stream_wrapper_register(

    'gs',

    '\google\appengine\ext\cloud_storage_streams\CloudStorageStreamWrapper',

    0);

define('MY_BUCKET', 'YOUR_PROJECT_ID.appspot.com');

On the production environment use : gs:// stream wrapper. The disadvantage with the stream wrapper is that it does not work locally.

How to create simple plugin especially for tweaking upload? 

To create new file using `wordpress/wp-content/plugins/gcs-media.php` do the following:

<?php

/**

 * @package GCS media

 * @version 0.1

 */

/*

Plugin Name: GCS media

Plugin URI: https://wp.gaeflex.ninja/

Description: Use Google Cloud Storage for media upload.

Author: Takashi Matsuo

Version: 0.1

Author URI: https://wp.gaeflex.ninja/

License: Apache 2.0

*/

namespace GCS\Media;

defined( 'ABSPATH' ) or die('No direct access!');

add_filter('upload_dir', 'GCS\Media\filter_upload_dir');

function filter_upload_dir( $values ) {

    $basedir = 'gs://' . MY_BUCKET;

    $baseurl = 'https://storage.googleapis.com/' . MY_BUCKET;

    $values = array(

        'path' => $basedir . $values['subdir'],

        'subdir' => $values['subdir'],

        'error' => false,

    );

    $values['url'] = rtrim($baseurl . $values['subdir'], '/');

    $values['basedir'] = $basedir;

    $values['baseurl'] = $baseurl;

    return $values;

}

Once this is done position the app, then activate the plugin using the ‘activate’ GCS Media plug in. Upload the images if any and then you can see the images on the Google Cloud Storage bucket. But still the image editor does not work. This is not a major issue. Moreover, the stream wrapper does not work in any other environment except Managed VMs. The advantage of using App Engine PHP SDK is the usage of good features of App Engine with managed VMs.

How To Overcome Caregiver Turnover Challenges?

Senior Care is the greatest challenge the industry is encountering at present. A simple change in the daily routine can disturb our day to day activities and imagine the case of senior citizens who are unable to execute even simple household chores due to old age, injury or fragility. Old people are vulnerable to change and it can affect them drastically both physically and mentally. Even a simple change can cause huge repercussions in their life. Senior care services find it tough to sustain in the industry due to the large staff turnover, elaborate recruitment process including background check and training the staff for senior care. Statistics has it that it cost an agency around $3,500 to replace an employee who works on an hourly basis.

What is alarming, is the turnover rates. There is a steady increase in the turnover rates and it is estimated to be 39.4% in the year 2009 and 61.5% in the year 2014 as per the 2015 Home Care Pulse’s Private Duty Benchmarking Study. The annual turnover rates vary from one state to another and it stands between 60% and 100% according to the Institute for the Future of Aging Services. There is a shortage for caregivers especially in the long term care sector. The turnover is high and remedies to keep up the quality of care are primary.

The reason for caregiver turnover being high is attributed to low wages, irregular work timings, no overtime pay and poor benefits. The research by the Ball State University’s Center for Business and Economic reveals that there is a 23% hike in the caregivers’ employment since the year 2000 but the salaries remain at just $21,000. Moreover, The National Private Duty Association informs asking the employers to shell out overtime means the seniors need multiple caretakers as every senior needs around 40 hours of care in a week. This could be a financial burden on the family and the seniors will be deprived of any help.

Caregivers attribute better pay to better services. Some of the other factors to facilitate retention of caregivers are providing regular training to enhance their skills. The turnover happens during the first 60 days of joining work and it is attributed to lack of confidence. Offering recognition for their effort could go a long way in helping them develop a fondness for the job. Professional mentors not just boost the morale of the caregivers but also help retain high quality.