Health care support workers have patient-facing roles within care teams but little autonomy; work is allocated. This study reports work stress experiences of Health Care Assistants (HCAs; UK support workers) in a dementia unit in 2018 towards the end of national austerity, a period of significant staff reduction in the UK National Health Service. HCAs (15; 40% of total) were individually interviewed, and in a focus group (6). Analysis revealed high job demands but low job resources. HCAs were altruistic regarding stressful dementia care but tension from the work environment was high. Difficulties directly or indirectly related to staff shortage: workload, inadequate staffing, and reliance on inexperienced temporary staff who required supervision, poor team skill mix, and poor shift patterns. Serious relationship issues for HCAs were exposed so post-hoc interviews with nurses (n=10) from the same unit were undertaken for further insight. HCAs considered nurses unsupportive, poor leaders and disrespectful of their experience. Nurses considered HCAs obstructive, compounded by failure to recognise nurses’ professional responsibilities. Coping by HCAs was mainly through short, time-out breaks but these were constrained by lack of staff cover. Tensions had been left to fester. Better awareness of managers is required that staffing impacts extend beyond workload.

After exposing the black mulberry juice to ultraviolet light with the intensity of 5, 10 and 20 kJ/m2, their quality analysis have been performed for 4 days at +4 °C and +25 °C. Within the current study the antioxidant activity, Total Phenolic Content (TPC), microbial charges and pH values of the samples have also been investigated. In the UV light exposed samples there existed no meaningful difference in the % DPPH radical scavenging activity level, a small amount of decrease has been detected in the TPC creation process. While the storage time worsens the DPPH activity, it affects the TPC positively. Microbial studies showed reduction in total mesophile aerobic microorganisms, yeasts and mould counts about by 1-log cycle on UV treatments. This is the first report on the effects of UV radiation on black mulberry.

Objectives: The aim of our study is to compare the outcomes in unilateral and bilateral cochlear implants in pediatric age and also between simultaneous and sequential surgery.

Material and Methods: This retrospective study was carried out with 83 children aged which included 41 children with bilateral Cochlear implants and 42 with unilateral implants. Out of these 41 children 21 were simultaneous and 20 were sequential. All children were operated at civil hospital Gandhinagar, Gujarat, India. SIRS, CAP scores, speech perception in quiet and noise, sound localization and comprehension were assessed at regular intervals over the period of 4 years. Also, drug administration time, surgical time, operating room time were assessed for simultaneous and sequential surgery.

Results: Children with bilateral implants fared significantly better with sound localization, speech comprehension and speech production tests, expressive language subscales than unilateral implants with a significant difference (p=0006) of means t tests between the two groups. Children with simultaneous bilateral implants achieved significantly higher scores in vocabulary outcomes and expressive language subscales than those with sequential bilateral implants. Simultaneous Surgery is associated with reduced surgical time, operating room time, it shortens the total in patient stay. There is less of drug administration and both ears get stimulated simultaneously.

Conclusion: Bilateral Cochlear implants are associated with better expressive language and receptive language when compared with unilateral implants, these differences were not statistically significant when simultaneous and sequential implants were compared but simultaneous surgery is better and safe option for pediatric cochlear implantation.