The role of built environments and use of communal spaces in helping facilitate social connections of older people living in housing with care schemes

Purpose: This paper examined the significance of the built environment for shaping inclusion and social connections in housing with care (HwC) schemes for older people (50+ years) in England and Wales. The purpose of this study was to develop a better understanding of how the availability, absence and use of communal spaces impacts social connections with other residents within HwC schemes. Design/methodology/approach: Longitudinal and cross-sectional qualitative interviews were conducted with 72 residents across three HwC providers in England and Wales. Data were analysed using a thematic framework approach to examine how residents experienced their living environments. Findings: Whilst the presence of communal shared spaces helps facilitate social connections and the development of friendships, full and equal access to these spaces remains challenging for residents with minority characteristics, and/or physical impairments. Building designers need to ensure they are complying with building regulations and the Equalities Act. The presence of on-site staff may also help to manage the impact of discriminatory attitudes. Research limitations/implications: A key strength of this study is its design, both in using longitudinal and cross-sectional interviews and in recruiting respondents with marginalised characteristics, whose voices have often been excluded in gerontological research. Another strength, albeit unexpected, is that this study was able to capture perspectives across the onset of the COVID-19 pandemic. The pandemic, however, may also have generated some limitations in this study. COVID-19 restrictions limited the ability to engage face-to-face within housing schemes whose residents were predominantly from different ethnic minoritised groups, and it therefore limits the inclusion of the voices and experiences of these groups. Responses in later interviews may also have been influenced by the changes in social engagement stimulated by lockdowns and may only be specific to the context of the pandemic. However, the findings reported here focus on the role and use of the built environment, and much of the interview content would feasibly apply regardless of the pandemic. Practical implications: This research offers some key insights and implications for housing providers and policy. Housing providers and architects must ensure that the design of HwC schemes affords all residents access to every area of the built environment to maintain independence, autonomy and to adopt the ethos of the ageing in place agenda. If communal areas are to function as “third” or social spaces – if they are to remain equally accessible to all members of the community – then building providers must ensure that all areas are accessible to all residents in line with building regulations and the Equality Act (2010). Social implications: Housing staff need to balance the natural development of friendship groups with the potential of the formation of exclusionary “cliques” within HwC schemes. Such cliques threaten the accomplishment of communal areas as “third” or social spaces and, as such, impact the quality of life for residents. Originality/value: This study offers insights into how built environments support the development of social connections and friendships in HwC schemes. It also identifies ways that housing managers can ensure that all residents feel equally valued and included

The multifunctional roles of vegetated strips around and within agricultural fields : A systematic map protocol.

Background: Agriculture and agricultural intensification can have significant negative impacts on the environment, including nutrient and pesticide leaching, spreading of pathogens, soil erosion and reduction of ecosystem services provided by terrestrial and aquatic biodiversity. The establishment and management of vegetated strips adjacent to farmed fields (including various field margins, buffer strips and hedgerows) are key mitigation measures for these negative environmental impacts and environmental managers and other stakeholders must often make decisions about how best to design and implement vegetated strips for a variety of different outcomes. However, it may be difficult to obtain relevant, accurate and summarised information on the effects of implementation and management of vegetated strips, even though a vast body of evidence exists on multipurpose vegetated strip interventions within and around fields. To improve the situation, we describe a method for assembling a database of relevant research relating to vegetated strips undertaken in boreo-temperate farming systems (arable, pasture, horticulture, orchards and viticulture). Methods: We will search 13 bibliographic databases, 1 search engine and 37 websites for stakeholder organisations using a predefined and tested search string that focuses on a comprehensive list of vegetated strip synonyms. Non-English language searches in Danish, Finnish, German, Spanish, and Swedish will also be undertaken using a web-based search engine. We will screen search results at title, abstract and full text levels, recording the number of studies deemed non-relevant (with reasons at full text). A systematic map database that displays the meta-data (i.e. descriptive summary information about settings and methods) of relevant studies will be produced following full text assessment. The systematic map database will be displayed as a web-based geographical information system (GIS). The nature and extent of the evidence base will be discussed

A "Candidate-Interactome" Aggregate Analysis of Genome-Wide Association Data in Multiple Sclerosis

Though difficult, the study of gene-environment interactions in multifactorial diseases is crucial for interpreting the relevance of non-heritable factors and prevents from overlooking genetic associations with small but measurable effects. We propose a “candidate interactome” (i.e. a group of genes whose products are known to physically interact with environmental factors that may be relevant for disease pathogenesis) analysis of genome-wide association data in multiple sclerosis. We looked for statistical enrichment of associations among interactomes that, at the current state of knowledge, may be representative of gene-environment interactions of potential, uncertain or unlikely relevance for multiple sclerosis pathogenesis: Epstein-Barr virus, human immunodeficiency virus, hepatitis B virus, hepatitis C virus, cytomegalovirus, HHV8-Kaposi sarcoma, H1N1-influenza, JC virus, human innate immunity interactome for type I interferon, autoimmune regulator, vitamin D receptor, aryl hydrocarbon receptor and a panel of proteins targeted by 70 innate immune-modulating viral open reading frames from 30 viral species. Interactomes were either obtained from the literature or were manually curated. The P values of all single nucleotide polymorphism mapping to a given interactome were obtained from the last genome-wide association study of the International Multiple Sclerosis Genetics Consortium & the Wellcome Trust Case Control Consortium, 2. The interaction between genotype and Epstein Barr virus emerges as relevant for multiple sclerosis etiology. However, in line with recent data on the coexistence of common and unique strategies used by viruses to perturb the human molecular system, also other viruses have a similar potential, though probably less relevant in epidemiological terms

Use of a Cytosponge biomarker panel to prioritise endoscopic Barrett's oesophagus surveillance: a cross-sectional study followed by a real-world prospective pilot

Background Endoscopic surveillance is recommended for patients with Barrett's oesophagus because, although the progression risk is low, endoscopic intervention is highly effective for high-grade dysplasia and cancer. However, repeated endoscopy has associated harms and access has been limited during the COVID-19 pandemic. We aimed to evaluate the role of a non-endoscopic device (Cytosponge) coupled with laboratory biomarkers and clinical factors to prioritise endoscopy for Barrett's oesophagus. Methods We first conducted a retrospective, multicentre, cross-sectional study in patients older than 18 years who were having endoscopic surveillance for Barrett's oesophagus (with intestinal metaplasia confirmed by TFF3 and a minimum Barrett's segment length of 1 cm [circumferential or tongues by the Prague C and M criteria]). All patients had received the Cytosponge and confirmatory endoscopy during the BEST2 (ISRCTN12730505) and BEST3 (ISRCTN68382401) clinical trials, from July 7, 2011, to April 1, 2019 (UK Clinical Research Network Study Portfolio 9461). Participants were divided into training (n=557) and validation (n=334) cohorts to identify optimal risk groups. The biomarkers evaluated were overexpression of p53, cellular atypia, and 17 clinical demographic variables. Endoscopic biopsy diagnosis of high-grade dysplasia or cancer was the primary endpoint. Clinical feasibility of a decision tree for Cytosponge triage was evaluated in a real-world prospective cohort from Aug 27, 2020 (DELTA; ISRCTN91655550; n=223), in response to COVID-19 and the need to provide an alternative to endoscopic surveillance. Findings The prevalence of high-grade dysplasia or cancer determined by the current gold standard of endoscopic biopsy was 17% (92 of 557 patients) in the training cohort and 10% (35 of 344) in the validation cohort. From the new biomarker analysis, three risk groups were identified: high risk, defined as atypia or p53 overexpression or both on Cytosponge; moderate risk, defined by the presence of a clinical risk factor (age, sex, and segment length); and low risk, defined as Cytosponge-negative and no clinical risk factors. The risk of high-grade dysplasia or intramucosal cancer in the high-risk group was 52% (68 of 132 patients) in the training cohort and 41% (31 of 75) in the validation cohort, compared with 2% (five of 210) and 1% (two of 185) in the low-risk group, respectively. In the real-world setting, Cytosponge results prospectively identified 39 (17%) of 223 patients as high risk (atypia or p53 overexpression, or both) requiring endoscopy, among whom the positive predictive value was 31% (12 of 39 patients) for high-grade dysplasia or intramucosal cancer and 44% (17 of 39) for any grade of dysplasia. Interpretation Cytosponge atypia, p53 overexpression, and clinical risk factors (age, sex, and segment length) could be used to prioritise patients for endoscopy. Further investigation could validate their use in clinical practice and lead to a substantial reduction in endoscopy procedures compared with current surveillance pathways

History of Reading Struggles Linked to Enhanced Learning in Low Spatial Frequency Scenes

People with dyslexia, who face lifelong struggles with reading, exhibit numerous associated low-level sensory deficits including deficits in focal attention. Countering this, studies have shown that struggling readers outperform typical readers in some visual tasks that integrate distributed information across an expanse. Though such abilities would be expected to facilitate scene memory, prior investigations using the contextual cueing paradigm failed to find corresponding advantages in dyslexia. We suggest that these studies were confounded by task-dependent effects exaggerating known focal attention deficits in dyslexia, and that, if natural scenes were used as the context, advantages would emerge. Here, we investigate this hypothesis by comparing college students with histories of severe lifelong reading difficulties (SR) and typical readers (TR) in contexts that vary attention load. We find no differences in contextual-cueing when spatial contexts are letter-like objects, or when contexts are natural scenes. However, the SR group significantly outperforms the TR group when contexts are low-pass filtered natural scenes [F(3, 39) = 3.15, p<.05]. These findings suggest that perception or memory for low spatial frequency components in scenes is enhanced in dyslexia. These findings are important because they suggest strengths for spatial learning in a population otherwise impaired, carrying implications for the education and support of students who face challenges in school

Exploring differences in stakeholders' perceptions of illegal bird trapping in Cyprus

Abstract Background Cyprus is recognised as a hotspot for illegal bird trapping in the Mediterranean basin. A consumer demand for the Eurasian blackcap (Sylvia atricapilla) is driving the use of non-selective trapping methods, resulting in the indiscriminate killing of millions of migratory birds. Efforts to tackle the issue have so far been characterised mostly by a top-down approach, focusing on legislation and enforcement. However, trapping levels are not decreasing and conflict between stakeholder groups is intensifying. Methods To understand why efforts to stop illegal bird trapping have not been effective, we used semi-structured interviews to interview 18 local bird trappers and nine representatives from the pertinent environmental non-governmental organisations (NGOs) and the governmental agencies responsible for enforcing the legislation. Results We found distinct differences between the views of the local trapping community and the environmental NGOs, particularly on why trapping is occurring and its impact on the avifauna. This disparity has contributed to misrepresentations of both sides and a high degree of conflict, which is potentially proving counterproductive to conservation interventions. In addition, it appears that trappers are a heterogeneous group, likely driven by various motivations besides profit. Conclusion We argue that stakeholders interested in reducing illegal bird trapping need to develop anti-poaching strategies that aim at minimising the disparity in the views, and subsequently the conflict, acknowledging also that trappers are not a homogenous group, as often treated

A "candidate-interactome" aggregate analysis of genome-wide association data in multiple sclerosis

Though difficult, the study of gene-environment interactions in multifactorial diseases is crucial for interpreting the relevance of non-heritable factors and prevents from overlooking genetic associations with small but measurable effects. We propose a "candidate interactome" (i.e. a group of genes whose products are known to physically interact with environmental factors that may be relevant for disease pathogenesis) analysis of genome-wide association data in multiple sclerosis. We looked for statistical enrichment of associations among interactomes that, at the current state of knowledge, may be representative of gene-environment interactions of potential, uncertain or unlikely relevance for multiple sclerosis pathogenesis: Epstein-Barr virus, human immunodeficiency virus, hepatitis B virus, hepatitis C virus, cytomegalovirus, HHV8-Kaposi sarcoma, H1N1-influenza, JC virus, human innate immunity interactome for type I interferon, autoimmune regulator, vitamin D receptor, aryl hydrocarbon receptor and a panel of proteins targeted by 70 innate immune-modulating viral open reading frames from 30 viral species. Interactomes were either obtained from the literature or were manually curated. The P values of all single nucleotide polymorphism mapping to a given interactome were obtained from the last genome-wide association study of the International Multiple Sclerosis Genetics Consortium & the Wellcome Trust Case Control Consortium, 2. The interaction between genotype and Epstein Barr virus emerges as relevant for multiple sclerosis etiology. However, in line with recent data on the coexistence of common and unique strategies used by viruses to perturb the human molecular system, also other viruses have a similar potential, though probably less relevant in epidemiological terms