Irradiated Landscapes: Journey to Prospect Cottage

How does one map a memory of a place, a fragment of time, in a way that is as evocative and vivid as the initial experience? When we prospect a landscape, we witness it as it is now; light and shadow define it, complete with its current solar exposure, humidity and temperature. As we then move through the landscape our brains process this information, leading us to perceive something entirely new. Our memory of that perception is also rewritten each time we recall it. Intended as a process of design research – based at the late Derek Jarman’s Prospect Cottage on Dungeness beach in Kent, UK – this essay attempts to capture the fluidity of these perceived experiences and freeze them into sited mappings, unique to the temporal and climatic experience of the observer. Centered on the production of digitally-crafted ‘perceptual cartographies’, which are designed/generated from the site, it presents an exploration into ways of seeing architecture and landscape. In doing so, the essay calls for the recording of sites and designs in which emotional responses – induced by light – leave traces of the spaces in the individuals who visit them, creating a temporally sensitive and deeply perceptual experience of that place

Switch from sexual to parthenogenetic reproduction in a zebra shark

Parthenogenesis is a natural form of asexual reproduction in which embryos develop in the absence of fertilisation. Most commonly found in plants and invertebrate organisms, an increasing number of vertebrate species have recently been reported employing this reproductive strategy. Here we use DNA genotyping to report the first demonstration of an intra-individual switch from sexual to parthenogenetic reproduction in a shark species, the zebra shark Stegostoma fasciatum. A co-housed, sexually produced daughter zebra shark also commenced parthenogenetic reproduction at the onset of maturity without any prior mating. The demonstration of parthenogenesis in these two conspecific individuals with different sexual histories provides further support that elasmobranch fishes may flexibly adapt their reproductive strategy to environmental circumstances

Ghosts in the Smart Home

We are in the midst of a ‘post-anthropocentric’ turn in design, research and technology. The term refers to a renewed interest in a wide range of concepts, theoretical perspectives, and methodologies. Ghosts in the Smart Home is a post-anthropocentric experiment which manifests as a film whose cast of characters are all internet connected ‘smart’ devices. The motivation is to prototype and establish new ways to see, to be, and to know, which respond to the 21st century’s complex socio-technical system

Pharmaceutical care for elderly patients shared between community pharmacists and general practitioners: A randomised evaluation. RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) [ISRCTN16932128]

Background: This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly. Design: The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls. The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole.published_or_final_versio

Pain associated with pressure injury: A qualitative study of community-based, home-dwelling individuals

© 2017 John Wiley & Sons Ltd. Aims: The aim of this study was to provide deep insights into the pain associated with pressure injuries in home-dwelling individuals using narrative accounts. Background: Pressure injuries or pressure ulcers are burdensome and costly. Prevalence data, surveys and systematic reviews demonstrate that pain associated with pressure injury is widespread, but voices of home-dwelling patients have remained largely unheard. Design: Concurrent mixed methods case study of a UK community of approximately 50,000 adults. Methods: Qualitative interviews, conducted in 2016, of 12 home-dwelling adult participants with a current pressure injury (n = 10), or a recently healed pressure injury (n = 2). Findings: Pain had an adverse impact on activities of daily living, mobility and sleep. Participants described days that were clouded in pain; a pain they felt was poorly understood and often out of control. Thematic content analysis revealed two major themes; these are: Poorly controlled pain: “I just want the pain to go away”; and, Uncertainty for the future: “it almost seems insurmountable.”. Conclusion: Findings of our study support the need to develop an appropriate assessment tool for pressure injury patients in the community to enable healthcare professionals and patients to recognize and manage pressure injury-related pain effectively

The Effectiveness of Alcohol Screening and Brief Intervention in Emergency Departments: A Multicentre Pragmatic Cluster Randomized Controlled Trial

BACKGROUND: Alcohol misuse is common in people attending emergency departments (EDs) and there is some evidence of efficacy of alcohol screening and brief interventions (SBI). This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in England: the SIPS ED trial. METHODS AND FINDINGS: Pragmatic multicentre cluster randomized controlled trial of SBI for hazardous and harmful drinkers presenting to ED. Nine EDs were randomized to three conditions: a patient information leaflet (PIL), 5 minutes of brief advice (BA), and referral to an alcohol health worker who provided 20 minutes of brief lifestyle counseling (BLC). The primary outcome measure was the Alcohol Use Disorders Identification Test (AUDIT) status at 6 months. Of 5899 patients aged 18 or more presenting to EDs, 3737 (63·3%) were eligible to participate and 1497 (40·1%) screened positive for hazardous or harmful drinking, of whom 1204 (80·4%) gave consent to participate in the trial. Follow up rates were 72% (n?=?863) at six, and 67% (n?=?810) at 12 months. There was no evidence of any differences between intervention conditions for AUDIT status or any other outcome measures at months 6 or 12 in an intention to treat analysis. At month 6, compared to the PIL group, the odds ratio of being AUDIT negative for brief advice was 1·103 (95% CI 0·328 to 3·715). The odds ratio comparing BLC to PIL was 1·247 (95% CI 0·315 to 4·939). A per protocol analysis confirmed these findings. CONCLUSIONS: SBI is difficult to implement in typical EDs. The results do not support widespread implementation of alcohol SBI in ED beyond screening followed by simple clinical feedback and alcohol information, which is likely to be easier and less expensive to implement than more complex interventions

Health service provision and the use of pressure-redistributing devices: mixed methods study of community dwelling individuals with pressure injuries

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Health care within the home setting is a vital and growing component of pressure injury (PI) prevention and management. Objectives: To describe the use of health services and pressure-redistributing devices in community dwelling patients with PI’s. Design: Mixed-methods collective case study of a defined, diverse geographic postcode area in the United Kingdom. Methods: Quantitative retrospective analysis of electronic and paper medical records of adult PI patients from 2015 district nursing reports. Qualitative semi-structured interviews of community dwelling adult patients receiving, or received, treatment for PI in 2016. Results: Mandatory reports (n = 103) revealed that 90 patients were supplied with a variety of pressure-redistributing devices but only one-third of patients used the equipment as recommended. Qualitative interviews (n = 12), reported to COREQ guidelines, revealed that patients felt reliant on community health services, and were concerned about the consistency of their care. Conclusions: Authentic patient involvement is required to provide care and interventions that are acceptable to PI patients and can be incorporated into self-care strategies and effectively monitored

What makes people stay in or leave shrinking cities? An empirical study from Portugal

The attractiveness of cities as places to live determines population movements into or out of them. Understanding the appealing features is fundamental to local governments, particularly for cities facing population decline. Pull and push attributes can include economic aspects, the availability of amenities and psychological constructs, initiating a discussion around which factors are more relevant for migration. However, such discussion has been underexplored in studies of shrinking cities. In the present study, we contribute to the discussion by identifying pull and push factors in Portuguese shrinking cities. Data were collected using a face-to-face questionnaire of 701 residents in four shrinking cities: Oporto, Barreiro, Peso da Regua and Moura. Factor analysis and automatic linear modelling were used to analyse the data. Our results show that the economic activity is the most relevant feature for retaining residents. However, characteristics specific to each city, related to heritage and natural beauty, are also shown to influence a city's attractiveness. The cause of population shrinkage was also found to influence residents' assessments of the pull and push attributes of each city. Furthermore, the results show the relevance of social ties and of place attachment to inhabitants' intention to continue living in their city of residence

Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14–17 years presenting to Emergency Departments (SIPS junior)

Background: Alcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effects of brief interventions on a range of alcohol consumption outcomes. A recent review of reviews also suggests that electronic brief interventions (eBIs) using internet and smartphone technologies may markedly reduce alcohol consumption compared with minimal or no intervention controls. Interventions that target non-drinking youth are known to delay the onset of drinking behaviours. Web based alcohol interventions for adolescents also demonstrate significantly greater reductions in consumption and harm among ‘high-risk’ drinkers; however changes in risk status at follow-up for non-drinkers or low-risk drinkers have not been assessed in controlled trials of brief alcohol interventions