Painting the ideal home: using art to express visions of technologically supported independent living for older people in North East England

This paper describes the investigation of the development of future technological products to support older people in everyday living through the agency of a community art group. Recent research has identified a number of challenges facing designers seeking to use traditional participatory design approaches to gather technology requirements data from older people. Here, a project is described that sought to get a group of older people to think creatively about their needs and desires for technological support through the medium of paint. The artistic expression technique described in this article allowed the identification of issues that had also been found by previous research that used a range of different techniques. This indicates that the approach shows promise, as it allows information to be gathered in an environment that is comfortable and familiar using methods already known by the participants and which they find enjoyable. It provides a complement (or possible alternative) to standard protocols and has the potential benefit of extracting even richer information as the primary task for participants is enjoyable in its own right and is not associated with an interrogative process. Furthermore, it is argued that some of the key risks of traditional approaches are lessened or removed by the naturalistic setting of this approach

Experiences of a Novice Researcher Conducting Focus Group Interviews

The purpose of this paper is to report what I learned about how to conduct focus group interviews that produce insightful, revealing and informative data.  I will discuss my experiences facilitating focus group interviews as a novice researcher and compare these experiences with the literature.  I planned the focus groups in collaboration with a research team, recruited participants from various units at the local tertiary care hospital and set up the meeting rooms for the groups.  I then facilitated the focus groups with the support of an assistant.  Following the focus groups, I documented my field notes, as well as my personal reflective memos.  I downloaded the audio recordings, de-identified the written transcripts, and reviewed them for accuracy prior to analysis.  A number of concepts emerged that merit particular attention: challenges with recruitment, the use of field notes and reflective memos, the benefits and limitations of using a flip chart, importance of professional support, using homogenous groups, and attending to the set-up of the environment.  As the focus group interview becomes an increasingly popular data collection method in qualitative research, my experiences could inform the preparation of other novice researchers as they undertake their own focus groups

Effect of moisture on leaf litter decomposition and its contribution to soil respiration in a temperate forest

The degree to which increased soil respiration rates following wetting is caused by plant (autotrophic) versus microbial (heterotrophic) processes, is still largely uninvestigated. Incubation studies suggest microbial processes play a role but it remains unclear whether there is a stimulation of the microbial population as a whole or an increase in the importance of specific substrates that become available with wetting of the soil. We took advantage of an ongoing manipulation of leaf litter <sup>14</sup>C contents at the Oak Ridge Reservation, Oak Ridge, Tennessee, to (1) determine the degree to which an increase in soil respiration rates that accompanied wetting of litter and soil, following a short period of drought, could be explained by heterotrophic contributions; and (2) investigate the potential causes of increased heterotrophic respiration in incubated litter and 0–5 cm mineral soil. The contribution of leaf litter decomposition increased from 6 ± 3 mg C m<sup>−2</sup> hr<sup>−1</sup> during a transient drought, to 63 ± 18 mg C m<sup>−2</sup> hr<sup>−1</sup> immediately after water addition, corresponding to an increase in the contribution to soil respiration from 5 ± 2% to 37 ± 8%. The increased relative contribution was sufficient to explain all of the observed increase in soil respiration for this one wetting event in the late growing season. Temperature (13°C versus 25°C) and moisture (dry versus field capacity) conditions did not change the relative contributions of different decomposition substrates in incubations, suggesting that more slowly cycling C has at least the same sensitivity to decomposition as faster cycling organic C at the temperature and moisture conditions studied

Level of Care Preferences Among Nursing Home Residents With Advanced Dementia

Delivering goal-directed care is a hallmark of high-quality palliative care, but requires an understanding of preferences

Developing differences: early-life effects and evolutionary medicine

Variation in early-life conditions can trigger developmental switches that lead to predictable individual differences in adult behaviour and physiology. Despite evidence for such early-life effects being widespread both in humans and throughout the animal kingdom, the evolutionary causes and consequences of this developmental plasticity remain unclear. The current issue aims to bring together studies of early-life effects from the fields of both evolutionary ecology and biomedicine to synthesise and advance current knowledge of how information is used during development, the mechanisms involved, and how early-life effects evolved. We hope this will stimulate further research into early-life effects, improving our understanding of why individuals differ and how this might influence their susceptibility to disease. This article is part of the theme issue ‘Developing differences: early-life effects and evolutionary medicine’.</p

Choices:Future trade-offs and plausible pathways

Policy development and management of deltas in the Anthropocene involves the consideration of trade-offs and the balancing of positive and negative consequences for delta functions and the societies that rely on them. This assessment outlines policy-driven and spatial trade-offs that dominate the landscape of choice. It highlights examples of such trade-offs using plausible delta futures and the governance choices associated with them. The analysis is based on modelling broad-scale processes and individual adaptive actions. It highlights how policy choices to maximise economic growth can, for example, have unforeseen consequences such as diminished well-being for some populations. Hence the chapter concludes that trade-offs are a crucial governance challenge for future sustainability of deltas

Characterization of MSB Synapses in Dissociated Hippocampal Culture with Simultaneous Pre- and Postsynaptic Live Microscopy

Multisynaptic boutons (MSBs) are presynaptic boutons in contact with multiple postsynaptic partners. Although MSB synapses have been studied with static imaging techniques such as electron microscopy (EM), the dynamics of individual MSB synapses have not been directly evaluated. It is known that the number of MSB synapses increases with synaptogenesis and plasticity but the formation, behavior, and fate of individual MSB synapses remains largely unknown. To address this, we developed a means of live imaging MSB synapses to observe them directly over time. With time lapse confocal microscopy of GFP-filled dendrites in contact with VAMP2-DsRed-labeled boutons, we recorded both MSBs and their contacting spines hourly over 15 or more hours. Our live microscopy showed that, compared to spines contacting single synaptic boutons (SSBs), MSB-contacting spines exhibit elevated dynamic behavior. These results are consistent with the idea that MSBs serve as intermediates in synaptic development and plasticity

Length vs. Structural Complexity in Sentence Comprehension in Aphasia

TB

Triggered Palliative Care for Late-stage Dementia: a Pilot Randomized Trial

Context Persons with late-stage dementia have limited access to palliative care. Objective To test dementia-specific specialty palliative care triggered by hospitalization. Methods This pilot randomized controlled trial enrolled 62 dyads of persons with late-stage dementia and family decision-makers on admission to hospital. Intervention dyads received dementia-specific specialty palliative care consultation plus post-acute transitional care. Control dyads received usual care and educational information. The primary outcome was 60-day hospital or emergency department visits. Secondary patient and family-centered outcomes were patient comfort, family distress, palliative care domains addressed in the treatment plan, and access to hospice or community-based palliative care. Secondary decision-making outcomes were discussion of prognosis, goals of care, completion of Medical Orders for Scope of Treatment (MOST), and treatment decisions. Results Of 137 eligible dyads, 62 (45%) enrolled. The intervention proved feasible, with protocol completion ranging from 77% (family 2-week call) to 93% (initial consultation). Hospital and emergency department visits did not differ (intervention vs control, 0.68 vs 0.53 transfers per 60 days, p=0.415). Intervention patients had more palliative care domains addressed, and were more likely to receive hospice (25% vs 3%, p<0.019). Intervention families were more likely to discuss prognosis (90% vs 3%, p<0.001) and goals of care (90% vs 25%, p<0.001), and to have a MOST at 60-day follow-up (79% vs 30%, p<0.001). More intervention families made decisions to avoid re-hospitalization (13% vs 0%, p=0.033). Conclusion Specialty palliative care consultation for hospitalized patients with for late-stage dementia is feasible and promising to improve decision-making and some treatment outcomes