Adults' perspectives of experiences and preferences for end-of-life care

Background: Decisions about end-of-life care often raise clinical and ethical challenges, especially when the person's capacity to contribute in the decision making at the end of life is limited. Aim: This study aimed to explore Taiwanese adults' preferences associated with communication, healthcare planning, life-sustaining treatments and palliative care and experiences of end-of-life care. Methods: Semi-structured interviews were conducted with 16 adults aged 20 years and above. The sampling approach was a convenience strategy in a community centre located in a metropolitan area in the Southern region of Taiwan. A qualitative content analysis approach was used to elicit key themes from the data. Results: Significant findings related to the two main themes of adults' experiences, including the observed distress of those who were dying and the distress experienced by the family. Other key findings pertain to personal preferences for end-of-life care, such as preferred end-of-life communication, preparing for the end-of-life and maintenance of quality of life. Conclusions: This exploratory study offers insight into 16 Taiwanese community-dwelling adults' views of preferences regarding end-of-life communication, preparation for the end of life and maintenance of quality of life, as well as their experiences of end-of-life care. A further exploration is suggested to elicit how personal end-of-life experiences shape individuals' health practices in advance care planning for end-of-life care

Influence of environmental factors on seed germination and seedling emergence of Amaranthus blitoides S. Watson and A. hybridus L.

Amaranthus blitoides S. Watson and A. hybridus L. are common herbaceous annual summer weeds in different regions of Iran, which produce a large number of small seeds per plant. The goal of these experiments was to determine seed germination cardinal temperature and investigate the effect of constant temperature, osmotic and salt stresses, stratification, flooding duration, after-ripening and seed planting depth on seed germination and seedling emergence. Two-piece segmented, dent-like and beta four-parameter models were used to investigate the relationship between germination rate and constant temperature. The dent-like model showed the best description of the effect of constant temperature on seed germination rate of both A. blitoides and A. hybridus. Optimal seed germination of A. blitoides occurred at 35°C, but in A. hybridus optimum germination was observed in a range of constant temperatures from 30 to 40°C. Osmotic and salt stresses and flooding adversely affected seed germination of both species. After ripening for 6 months increased germination percentage of both A. blitoides and A. hybridus. Maximum seedling emergence of A. blitoides (42.8%) and A. hybridus (44.9%) occurred at a planting depth of 3.3 cm, whereas further increased planting depth minimized seedling emergence of both weeds. Information obtained from this study will help us to develop effective techniques for management of A. blitoides and A. hybridus

Ccl2/Cx3cr1 Knockout Mice Have Inner Retinal Dysfunction but Are Not an Accelerated Model of AMD

PURPOSE. The chemokine, Ccl2, and the fractalkine receptor, Cx3cr1, have both been implicated in the pathogenesis of age related macular degeneration (AMD), with mice lacking both genes exhibiting features of AMD by 3 months of age. However, recent reports indicate that this ascribed phenotype is due to the presence of a retinal degeneration mutation (crb1rd8/rd8, rd8) on the background strain. Our aim was to characterize the retinal effects of lack of Ccl2 and Cx3cr1 (Ccl2−/−/Cx3cr1EGFP/EGFP, CDKO-mice), in mice without the rd8 mutation. METHODS.Nine-month-old, CDKO and wildtype C57blk6J mice were investigated for retinal fundus appearance and histology. The function of the rod and cone pathways was assessed using the ERG. RESULTS. The CDKO mice did not develop lesions in the retinal fundus, and the ultrastructure of Bruch’s membrane and the RPE were similar to that of C57blk6J mice. From the ERG, there was no change in the amplitude of the rod photoreceptor response, or in the rod or cone post-photoreceptor b-wave. However, the rod and cone ERG oscillatory potentials were significantly reduced in the CDKO animals, a phenotype apparent in Cx3cr1EGFP/EGFP- but not Ccl2−/−-founder lines. This correlated with aberrant amacrine cell morphology in the CDKO mice. In addition, Muller cells were gliotic and microglial ¨ morphology subtly altered, indicative of retinal stress. CONCLUSIONS. These results suggest that in the absence of the rd8 mutation, the CDKO-mouse has a mild inner retinal phenotype characterized by altered amacrine cell function, but that it is not an accelerated model of AMD

The Role of Social Networks in Supporting Survivors of Intimate Partner Violence Against Women

Intimate partner violence (IPV) is a global public health concern impacting millions of women each year. Despite the pervasive nature of IPV, survivors continue to face numerous barriers in disclosing abuse and accessing formal support services. Consequently, most survivors make their first disclosure of abuse to an informal supporter, such as a family member, friend, neighbour, or colleague. The assistance provided by informal supporters aids in promoting better mental health outcomes, reducing the level of risk, and providing a safe pathway to formal support services. Despite the crucial role that informal supporters play in safeguarding survivors; little research has been conducted on their experiences. This thesis aims to address this gap in the literature, through a series of studies focused on the role of informal supporters in IPV. In Study 1, a systematic review was completed, identifying the current understanding of factors that increased or decreased the likelihood of an informal supporter helping a urvivor of IPV, as well as the self-care strategies employed by informal supporters during periods of help-giving. The systematic review also considered the theoretical underpinnings of help-giving specific to the context of IPV and developed an integrated theory of IPV help-giving – the Model of Informal Supporter Readiness (MISR). Study 2 was an opinion piece hat considered the unintended consequences of mandated social restriction measures during he COVID-19 pandemic. This article highlighted both the increased risks experienced by urvivors during the pandemic and the barriers informal supporters faced providing help-giving. Study 3 operationalised the MISR, developed in Study 1, through the development nd validation of the Informal Supporter Readiness Inventory (ISRI). This study provided nitial support for the ISRI as a measure of the core components of an informal supporter’s readiness to help an IPV survivor. Study 4 further validated the ISRI for use within an Australian context. This validation supported its reliability and effectiveness in assessing the readiness and preparedness of informal supporters in IPV scenarios, supporting the ISRI’s robust psychometric properties and its potential as a valuable tool in enhancing IPV support strategies within a network-oriented framework. Study 5 explored the psychological and physical burden of help-giving and considered the need for greater screening and wellbeing supports for informal supporters. It highlighted the role of mindful self-care and social support as protective factors in mitigating psychological distress. Finally, Study 6 presented a perspective paper that integrated the findings of the above five studies and proposed an extended model of social network-oriented support, which incorporated a structured assessment of informal supporter readiness and greater consideration of their wellbeing to promote longevity in their support role. Overall, this thesis presents an exploration of the multifaceted dimensions of informal support in the context of IPV. Through various methodological approaches, it highlights the vital role of informal supporters, the complexities of their experiences, and the necessity of assessing and enhancing both readiness and wellbeing. The collective findings of this series of studies emphasises the importance of a focused understanding of informal support dynamics, the utility of effective support readiness tools, and the need for targeted interventions that prioritise the mental and physical health of these supporters. This body of work not only contributes valuable insights to the field of IPV research but also provides empirical advocacy for a network-oriented approach to strengthen the support network for IPV survivors