The Resident VIEW in Nursing Homes

This article presents the Resident VIEW (Voicing Importance, Experience, and Well-Being), a measure designed to learn directly from long-term care residents the extent to which they experience support that matters most to them. The Resident VIEW contains 63 items across eight domains developed through cognitive interviews with residents in different types of residential settings (e.g., nursing homes, assisted living, and adult foster care). Residents rate items on both importance and their experience. In total, 258 nursing home residents living in 32 Oregon nursing homes were selected through a two-stage random sampling design and participated in the study. Results demonstrate that what matters most to residents varies, emphasizing the value of asking residents directly about their preferences. The relationship between importance and experience differed by item. Residents who experienced support rated very important within some domains, reported better quality of life and reported lower levels of depressive symptoms than those who did not experience these things. The interaction between importance and experience, however, did not reach statistical significance, suggesting that positive experiences may provide benefit even in some areas that are not perceived as important by residents. Results underscore the value of incorporating the resident perspective into measure development in long-term care

The Resident VIEW in Community- Based Care Residential Settings

The Resident VIEW is a measure of person-centered care (PCC) from residents’ perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents provided ratings for both the importance of and their experience with 66 items that tapped into PCC practices in eight domains. Results are provided for each item, many of which are significantly associated with greater quality of life, better resident satisfaction, and fewer depressive symptoms, especially in the domains of personalized care and being treated like a person. Incongruence between importance and experience ratings indicate many residents experience unmet needs across multiple domains. The Resident VIEW performed well in different types of settings, providing an important tool for researchers and providers who wish to learn about the PCC experience from residents’ points of view

Intergenerational responses to the death of a child

The death of a child is a traumatic family event. This qualitative study examined the experiences of parents and grandparents in 10 families who had lost a baby to SIDS, stillbirth, or birth defects. Key questions focused on support given and received, meanings attributed to the loss, continuing bonds, and adaptation. Significant family support was present in all families, but unskilled support was common. As expected, most support flowed from grandparents to parents. Relationships with maternal grandparents were particularly strong, especially those of mothers and adult daughters. Ambivalence was present in several intergenerational dyads. Meaning making was an important process, particularly for parents, and included making sense of what had happened and finding benefit from tragedy. Fewer grandparents than parents found benefit. Parents and many grandparents maintained continuing bonds with their babies through rituals or symbolic representations. These methods of connecting facilitated communication within some families. Participants were classified as adaptors, partial adaptors, in transition, or distressed. Parent adaptors were further in time since death than those in the transition and distressed groups, appeared more aware of support received, were tolerant of unskilled support, did not focus on the why of loss, experienced personal growth, and had integrated their deceased children into their sense of self No clear patterns emerged for grandparents, although they seemed to feel their adult children were coping well. Partial adaptor parents were similar to adaptors in time since loss, but experienced lingering distress. They were more likely to be asking why and to express feelings of vulnerability. Partial adaptor grandparents were concerned about their adult children's continuing suffering. Parents and grandparents in transition were close in time to loss and felt distress. At the same time, they were optimistic and were experiencing positive emotions as well as feelings of sadness. They were reappraising their experiences and finding benefit. Distressed group members had very high levels of distress and were isolated from those in their social network, either through their own actions or through unskilled support. They connected to their babies mostly through feelings of sadness, they ruminated on why, and they did not identify benefit

Linking Wolf Diet to Changes in Marine and Terrestrial Prey Abundance

Since most wolf (Canis lupus) diet studies have been conducted in inland ecosystems, comparatively few data are available on diets of wolves in coastal systems. We investigated the diet of wolves in Glacier Bay, Alaska, from 12 May to 28 June in both 2010 and 2011. Although we identified 12 different prey species, including birds and small to medium-sized mammals, in wolf scats, moose (Alces alces) was the most frequent food item, observed in 80% of all scats. In contrast, a study conducted in 1993 in an area 37 km away found harbor seal (Phoca vitulina richardii) in 41% of wolf scats. Although we cannot account for differences in sampling design between the two studies, wolf diets may have changed between the two time periods.Puisque la plupart des études sur le régime alimentaire des loups (Canis lupus) ont été réalisées dans des écosystèmes situés à l’intérieur des terres, relativement peu de données existent sur le régime alimentaire des loups évoluant dans les environnements côtiers. Nous avons étudié l’alimentation des loups de Glacier Bay, en Alaska, du 12 mai au 28 juin 2010 et 2011. Bien que nous ayons retrouvé 12 proies différentes, y compris des espèces aviaires et des mammifères de taille petite ou de taille moyenne dans les déjections de loups, l’aliment le plus fréquemment rencontré, dans une mesure de 80 %, a été l’original, aussi appelé élan (Alces alces). Par contraste, une étude effectuée en 1993 dans une zone située à 37 kilomètres de distance a permis de découvrir du phoque commun (Phoca vitulina richardii) dans 41 % des déjections de loups. Bien que nous ne soyons pas en mesure de prendre en compte les différences d´échantillonnage entre les deux études, il est possible que le régime alimentaire des loups ait changé entre ces deux périodes.Большинство исследований рациона волка (Canis lupus) проводилось на внутриматериковых территориях, в то время как имеется сравнительно небольшое количество данных по рациону волка в прибрежных экосистемах. Ежегодно с 12 мая по 28 июня 2010-2011 гг. нашей группой проводились исследования рациона волков в бухте Глейшер-Бей, Аляска. Несмотря на то, что нами было определено 12 различных видов, используемых волками в качестве добычи, включая птиц, а также мелких и средних млекопитающих, останки лося (Alces alces) встречались в 80% экскрементов волков, указывая на то, что данный вид является наиболее частым пищевым объектом волка.В отличие от данных результатов, эксперимент, проведенный в 1993 г. на участке, удаленном от нашего на 37 км, обнаружил наличие останков тюленя (Phoca vitulina richardii) в 41% экскрементов волков. Несмотря на то, что мы не можем объяснить различия в выборке по каждому из исследований, их результаты указывают на то, что в период между двумя исследованиями в рационе волков могли произойти изменения

A systematic review of patient reported outcome measures (PROMs) used in child and adolescent burn research

Crown Copyright © 2014 Published by Elsevier Ltd and ISBI. All rights reserved. Introduction: Patient reported outcome measures (PROMs) can identify important information about patient needs and therapeutic progress. The aim of this review was to identify the PROMs that are being used in child and adolescent burn care and to determine the quality of such scales. Methods: Computerised and manual bibliographic searches of Medline, Social Sciences Index, Cinahl, Psychinfo, Psycharticles, AMED, and HAPI, were used to identify Englishlanguage articles using English-language PROMs from January 2001 to March 2013. The psychometric quality of the PROMs was assessed. Results: 23 studies met the entry criteria and identified 32 different PROMs (31 generic, 1 burns-specific). Overall, the psychometric quality of the PROMs was low; only two generic scales (the Perceived Stigmatisation Questionnaire and the Social Comfort Scale) and only one burns-specific scale (the Children Burn Outcomes Questionnaire for children aged 5-18) had psychometric evidence relevant to this population. Conclusions: The majority of PROMs did not have psychometric evidence for their use with child or adolescent burn patients. To appropriately identify the needs and treatment progress of child and adolescent burn patients, new burns-specific PROMs need to be developed and validated to reflect issues that are of importance to this population

The effect of a lifestyle intervention in obese pregnant women on gestational metabolic profiles: findings from the UK Pregnancies Better Eating and Activity Trial (UPBEAT) randomised controlled trial

Background: Pregnancy is associated with widespread change in metabolism, which may be more marked in obese women. Whether lifestyle interventions in obese pregnant women improve pregnancy metabolic profiles remains unknown. Our objectives were to determine the magnitude of change in metabolic measures during obese pregnancy, to indirectly compare these to similar profiles in a general pregnant population, and to determine the impact of a lifestyle intervention on change in metabolic measures in obese pregnant women. Methods: Data from a randomised controlled trial of 1158 obese (BMI ≥ 30 kg/m2) pregnant women recruited from six UK inner-city obstetric departments were used. Women were randomised to either the UPBEAT intervention, a tailored complex lifestyle intervention focused on improving diet and physical activity, or standard antenatal care (control group). UPBEAT has been shown to improve diet and physical activity during pregnancy and up to 6-months postnatally in obese women and to reduce offspring adiposity at 6-months; it did not affect risk of gestational diabetes (the primary outcome). Change in the concentrations of 158 metabolic measures (129 lipids, 9 glycerides and phospholipids, and 20 low-molecular weight metabolites), quantified three times during pregnancy, were compared using multilevel models. The role of chance was assessed with a false discovery rate of 5% adjusted p values. Results: All very low-density lipoprotein (VLDL) particles increased by 1.5–3 standard deviation units (SD) whereas intermediate density lipoprotein and specific (large, medium and small) LDL particles increased by 1–2 SD, between 16 and 36 weeks’ gestation. Triglycerides increased by 2–3 SD, with more modest changes in other metabolites. Indirect comparisons suggest that the magnitudes of change across pregnancy in these obese women were 2- to 3-fold larger than in unselected women (n = 4260 in cross-sectional and 583 in longitudinal analyses) from an independent, previously published, study. The intervention reduced the rate of increase in extremely large, very large, large and medium VLDL particles, particularly those containing triglycerides. Conclusion: There are marked changes in lipids and lipoproteins and more modest changes in other metabolites across pregnancy in obese women, with some evidence that this is more marked than in unselected pregnant women. The UPBEAT lifestyle intervention may contribute to a healthier metabolic profile in obese pregnant women, but our results require replication. Trial Registration: UPBEAT was registered with Current Controlled Trials, ISRCTN89971375, on July 23, 2008 (prior to recruitment)

Linking Wolf Diet to Changes in Marine and Terrestrial Prey Abundance

Since most wolf (Canis lupus) diet studies have been conducted in inland ecosystems, comparatively few data are available on diets of wolves in coastal systems. We investigated the diet of wolves in Glacier Bay, Alaska, from 12 May to 28 June in both 2010 and 2011. Although we identified 12 different prey species, including birds and small to medium-sized mammals, in wolf scats, moose (Alces alces) was the most frequent food item, observed in 80% of all scats. In contrast, a study conducted in 1993 in an area 37 km away found harbor seal (Phoca vitulina richardii) in 41% of wolf scats. Although we cannot account for differences in sampling design between the two studies, wolf diets may have changed between the two time periods.Keywords: Alaska, Glacier Bay, Diet, Canis lupus, WolvesKeywords: Alaska, Glacier Bay, Diet, Canis lupus, Wolve

Steering Operational Synergies in Terrestrial Observation Networks: Opportunity for Advancing Earth System Dynamics Modelling

Advancing our understanding of Earth system dynamics (ESD) depends on the development of models and other analytical tools that apply physical, biological, and chemical data. This ambition to increase understanding and develop models of ESD based on site observations was the stimulus for creating the networks of Long-Term Ecological Research (LTER), Critical Zone Observatories (CZOs), and others. We organized a survey, the results of which identified pressing gaps in data availability from these networks, in particular for the future development and evaluation of models that represent ESD processes, and provide insights for improvement in both data collection and model integration. From this survey overview of data applications in the context of LTER and CZO research, we identified three challenges: (1) widen application of terrestrial observation network data in Earth system modelling, (2) develop integrated Earth system models that incorporate process representation and data of multiple disciplines, and (3) identify complementarity in measured variables and spatial extent, and promoting synergies in the existing observational networks. These challenges lead to perspectives and recommendations for an improved dialogue between the observation networks and the ESD modelling community, including co-location of sites in the existing networks and further formalizing these recommendations among these communities. Developing these synergies will enable cross-site and cross-network comparison and synthesis studies, which will help produce insights around organizing principles, classifications, and general rules of coupling processes with environmental conditions