Results From a Survey of American Geriatrics Society Members’ Views on Physician‐Assisted Suicide

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152741/1/jgs16245_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152741/2/jgs16245-sup-0001-Supinfo.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152741/3/jgs16245.pd

Comfort Feeding Only: A Proposal to Bring Clarity to Decision-Making Regarding Difficulty with Eating for Persons with Advanced Dementia

Feeding and eating difficulties leading to weight loss are common in the advanced stages of dementia. When such problems arise, family members are often faced with making a decision regarding the placement of a percutaneous endoscopic gastrostomy tube. The existing evidence based on observational studies suggests that feeding tubes do not improve survival or reduce the risk of aspiration, yet the use of feeding tubes is prevalent in patients with dementia, and the majority of nursing home residents do not have orders documenting their wishes about the use of artificial hydration and nutrition. One reason is that orders to forgo artificial hydration and nutrition get wrongly interpreted as “do not feed,” resulting in a reluctance of families to agree to them. Furthermore, nursing homes fear regulatory scrutiny of weight loss and wrongly believe that the use of feeding tubes signifies that everything possible is being done. These challenges might be overcome with the creation of clear language that stresses the patient's goals of care. A new order, “comfort feeding only,” that states what steps are to be taken to ensure the patient's comfort through an individualized feeding care plan, is proposed. Comfort feeding only through careful hand feeding, if possible, offers a clear goal-oriented alternative to tube feeding and eliminates the apparent care-no care dichotomy imposed by current orders to forgo artificial hydration and nutrition

Rationing Limited Healthcare Resources in the COVID‐19 Era and Beyond: Ethical Considerations Regarding Older Adults

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155955/1/jgs16539_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155955/2/jgs16539.pd

AGS Position Statement: Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155900/1/jgs16537.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155900/2/jgs16537_am.pd

Shape & Height Controls of Containerized Herbaceous Perennials

This research project was conducted from March 25 to September 5, 2001 at Western Kentucky University’s Agricultural Research and Education Complex in Bowling Green, Kentucky. The purpose was to evaluate effectiveness of plant growth regulators and pruning on shape and height of containerized herbaceous perennials. A completely random design was utilized with four treatments: Cycocel®, A-Rest®, pruned, and control. Six species of plants were utilized within each treatment, and 10 replications of each species within treatments. Plants used for this experiment were Anemone hupehensis, Baptisia australis, Heliopsis helianthoides ‘Summer Sun,’ Lysimachia clethroides, Phlox paniculate ‘Franz Schubert,’ and Rudbeckia fulgida ‘Goldsturm.’ Cycocel® and A-Rest® were applied on April 28 and May 26 of 2001 as foliar applications. Cycocel® was applied at 3000 ppm and A-Rest® was applied at 25 ppm as recommended by the manufacturers. Plants were pruned on June 2 following guidelines of Tracy DiSabato-Aust. Data were collected from each plant and recorded on September 5, 2001. Each plant was measured for the following: plant height, stem angle, number of stems, and flowering. Data were analyzed to determine the effects of treatment on plants as a whole as well as to determine effects on individual species. Pruning produced plants with the most upright habit as measured by stem angle. It was the only treatment that had any significant effect on overall stem angle. Pruning also produced the fullest plants overall as measured by number of stems. Overall flowering and plant height were not affected by pruning. Lysimachia responded best to pruning. Pruning increased number of stems and decreased height of Lysimachia without diminishing flowering. Cycocel® was the only treatment that decreased plant height. Cycocel® significantly decreased height of Heliopsis. Cycocel® also increased overall fullness of plants, but was not as effective as pruning. Over all Cycocel® diminished flowering. Only 50% of the Cycocel®-treated plants flowered. Anemone was the only species in which flowering was diminished by Cycocel®. Cycocel® had no overall effect on how upright plants stood. A-Rest® had no effect on plants in any of the overall measurements. Within species, A-Rest® actually increased the height of Anemone

Characteristics and impact of the most-cited palliative oncology studies from 1995 to 2016

Abstract Background Palliative care, as a relatively young field within medicine, has increasingly used original research to validate and standardize its practice. In particular, palliative care has been incorporated into oncology to better address end-of-life decisions and care. The goal of this study is to identify seminal studies in the field of palliative oncology while more broadly characterizing the trends across the literature. Methods The publication databases Scopus and Web of Science were queried using predefined search terms to identify palliative oncology studies published between 1995 and 2016. The 100 most-cited articles from the time periods 1995–2005 and 2006–2016 were selected and analysed for publication data and study content. Results Palliative oncology studies were found to primarily examine patients with multiple rather than single cancer types and rarely were randomized controlled trials. Early research topics of pain, symptoms, and survival studies have been replaced by the issues of access to care, healthcare utilization, and religion and spirituality. Conclusions By identifying and analyzing notable studies in palliative oncology, we found areas of research that are commonly investigated or overlooked and identified model studies that highlight the need for additional disease-specific randomized control trials to provide high quality clinical evidence in the field

From Caves to Culverts – Roost Selection and Roosting Ecology of the Large-footed Myotis (Myotis macropus)

The large-footed Myotis, Myotis macropus, is Australia’s only fishing bat. This species has adapted to living and breeding in urban areas and is found roosting in concrete culverts under roads. However, little is known about the selection and use of these unique roost sites. We investigated roost selection and roosting ecology of M. macropus roosting in concrete culverts in Brisbane. We used a stratified sampling design and generalized additive models to analyse drivers in roost selection at a landscape scale and surveyed roost sites and surrounding culverts to examine roost availability and roost selection at a roost site scale. We found a preference for culverts >1.2m in height, located on stream orders 3-5 and that culverts with microhabitat available for M. macropus to roost in were a limited resource. We deployed 18 VHF radio transmitters on non-reproductive adult females over two summers and two winters to study habitat use and roosting ecology. Key foraging areas, characteristics of roosts as well as frequency of roost switching were identified to get an understanding of movement patterns. Next Generation Sequencing (SNPs) of wing tissue was used to study gene flow and genetic diversity. Identifying the types of culverts that provide suitable M. macropus roost habitat and understanding how these roost sites and the landscapes around them are used will be used to inform conservation outcomes for this urban adapted bat

Roost Selection, Roost Availability and Gene Flow Among Culvert Roosts of a Trawling Bat in a Subtropical City

Many species of trawling bats roost in concrete culverts under roads. However, little is known about the selection of these artificial sites and how much gene flow occurs among culvert roosts. We investigated culvert roost selection by Myotis macropus at two spatial scales and studied gene flow between culvert roosts in a large subtropical city in eastern Australia. We surveyed 365 concrete culverts, identified 23 roosts and collected wing tissue samples from 72 bats. Using generalized additive models, we found the distribution of M. macropus roosts in concrete culverts can be predicted at a landscape scale and culvert roosts were a limited resource with only 5.5% of culverts identified as potential roosts. We examined roost selection at the roost scale by comparing roost culverts to available culverts. Roost culverts differed significantly from available culverts and the primary difference was the availability of microhabitat. Culverts containing microhabitat were a limited resource in this urban landscape. We used single nucleotide polymorphisms to study gene flow among culvert roosts located in peri-urban and urban areas. Gene flow was moderate between peri-urban roosts and restricted between urban roosts. We found higher relatedness coefficients between individuals roosting in urban roosts compared to peri-urban roosts, indicating reduced gene flow between urban culvert roosts. This study found that culvert roosts were limited at two spatial scales and that gene flow was restricted between urban culvert roosts. These findings suggest that disturbance to urban culvert roosts could be a significant impact to an urban population of M. macropus