Clinical Geography: A Proposal to Embrace Space, Place and Wellbeing through Person-Centered Practice

This essay envisions how geography can operationalize nuanced understandings of space and place to enrich the lives of individuals across the lifespan. We propose a focused integration of geography into person-centered practice: a clinical geography dedicated to working directly with people to promote optimal physical and mental health outcomes and wellbeing. Our proposal integrates spatial modifications to facilitate access and utility, behavioral interventions to maximize effectiveness in using space, and therapeutic engagement to nurture a deeper sense of ‘being in place’ that enhances wellbeing and quality of life. This focus is timely given societal instability and precariousness resulting from incongruous person-environment situations. In addition to investigating, explaining, and critiquing hazardous and inappropriate conditions, geographers might also directly and more immediately intervene with people who find themselves in such situations

Sensory Processing Abnormalities in Community-Dwelling Older Adults with Cognitive Impairment: A Mixed Methods Study

Mild cognitive impairment (MCI) or dementia often leads to behavioral and psychiatric symptoms of dementia (BPSD). Sensory processing abnormalities may be associated with BPSD. The purpose of this study was to explore relationships among sensory processing, behavior, and environmental features within the homes of people with MCI or dementia. This project used mixed methods to assess participants’ sensory processing, care partner perspectives on behaviors, and in situ observations of the home environment. Nine participants with cognitive impairment (MCI n = 8, early dementia = 1) and their care partners were included. Seven participants with cognitive impairment were reported to have abnormal sensory processing. Findings suggest that unique environmental adaptations, tailored to personal and sensory preferences for each participant, were associated with a decreased level of behavioral disruption during the observation periods. Implementing sensory-based approaches to maximize environment adaptation may be beneficial in reducing disruptive behaviors for adults with cognitive impairment

A New (Old), Invasive Ant in the Hardwood Forests of Eastern North America and Its Potentially Widespread Impacts

Biological invasions represent a serious threat for the conservation of biodiversity in many ecosystems. While many social insect species and in particular ant species have been introduced outside their native ranges, few species have been successful at invading temperate forests. In this study, we document for the first time the relationship between the abundance of the introduced ant, Pachycondyla chinensis, in mature forests of North Carolina and the composition, abundance and diversity of native ant species using both a matched pair approach and generalized linear models. Where present, P. chinensis was more abundant than all native species combined. The diversity and abundance of native ants in general and many individual species were negatively associated with the presence and abundance of P. chinensis. These patterns held regardless of our statistical approach and across spatial scales. Interestingly, while the majority of ant species was strongly and negatively correlated with the abundance and presence of P. chinensis, a small subset of ant species larger than P. chinensis was either as abundant or even more abundant in invaded than in uninvaded sites. The large geographic range of this ant species combined with its apparent impact on native species make it likely to have cascading consequences on eastern forests in years to come, effects mediated by the specifics of its life history which is very different from those of other invasive ants. The apparent ecological impacts of P. chinensis are in addition to public health concerns associated with this species due to its sometimes, deadly sting

Use of Communication Plans by Certified Nursing Assistants: Little Things Mean a Lot

Background: Many residents in long-term care facilities in the United States have communication disorders that impede interactions with staff, particularly certified nursing assistants (CNAs) who provide direct care and are in a position to communicate with residents the most. Researchers in Canada have successfully used individualized communication plans to facilitate staff–resident communication in long-term care settings, but the viability of using communication plans to facilitate staff–resident communication in long-term care facilities in the United States has not been investigated. Aims: This study sought to determine the usefulness of communication plans by CNAs working in long-term care settings when providing personal care to residents with communication disorders and to explore the role support from the speech-language pathologist (SLP) might play in this process. Method & Procedures: The study used a grounded theory qualitative research design. Participants included 10 CNAs working in two long-term care facilities. Each CNA chose two residents with a communication disorder whom they felt might benefit from a communication plan. Communication plans were collaboratively developed by the SLP and the CNA for the selected residents. CNAs used the plans to facilitate communication during daily care of their residents for two weeks. Five CNAs from one facility received support from the SLP; five CNAs from a second facility did not. Following 2 weeks of communication plan use, all CNAs were interviewed. Interviews were transcribed verbatim and data were analyzed using open, axial, and selective coding per grounded theory methodology. Outcomes & Results: Findings indicated that communication plans were useful in facilitating CNA–resident communication. CNA’s negative views of certain aspects of their jobs were altered positively through use of communication plans. They gradually became more familiar with residents which made work less effortful and enriched relationships with residents. Findings also indicated that support for CNAs from a SLP may provide an incentive to use information in the communication plan to more effectively communicate with the resident while providing daily personal care and potentially improving the quality of that care. Conclusions: Communication plans are useful to CNAs in facilitating communication with residents in long-term care facilities and a minimal amount of support from the SLP enhances this process