Comparing proxy rated quality of life of people living with dementia in care homes

Background: Improving quality of life (QOL) for people with dementia is a priority. In care homes, we often rely on proxy ratings from staff and family but we do not know if, or how, they differ in care homes. Methods: We compared 1056 pairs of staff and family DEMQOL-Proxy ratings from 86 care homes across England. We explored factors associated with ratings quantitatively using multilevel modelling and, qualitatively, through thematic analysis of 12 staff and 12 relative interviews. Results: Staff and family ratings were weakly correlated (ρs = 0.35). Median staff scores were higher than family's (104 v. 101; p < 0.001). Family were more likely than staff to rate resident QOL as ‘Poor’ (χ2 = 55.91, p < 0.001). Staff and family rated QOL higher when residents had fewer neuropsychiatric symptoms and severe dementia. Staff rated QOL higher in homes with lower staff:resident ratios and when staff were native English speakers. Family rated QOL higher when the resident had spent longer living in the care home and was a native English. Spouses rated residents’ QOL higher than other relatives. Qualitative results suggest differences arise because staff felt good care provided high QOL but families compared the present to the past. Family judgements centre on loss and are complicated by decisions about care home placement and their understandings of dementia. Conclusion: Proxy reports differ systematically between staff and family. Reports are influenced by the rater:staff and family may conceptualise QOL differently

Toward a Game-Based Dialogical Pedagogy: Insights from Massively Multiplayer Online Role-Playing Games

Learning through dialogues enables individuals to engage different perspectives of other learners and foster wisdom. To date, researchers have dedicated themselves to utilizing games to facilitate learning engagement. From tabletop games to electronic games, the experience of gameplaying has encouraged dialogues and interactions between participants. The Massively Multiplayer Online Role-Playing Games (MMORPGs) introduced a new level of interacting experience in virtual worlds. They are designed to enhance cooperative experiences. Features like chat boxes, guilds, and easy grouping have afforded players opportunities for creative gameplay and facilitating teamwork. However, through the interviews with the players of Final Fantasy XIV (FFXIV), we found that the communication mechanisms embedded in the game are not always player-friendly. New players are often intimidated by the complexity of the game, and no effective channels have been in place to ask for help. Additionally, constraints associated with the private messaging system and limited communication across data centres further impede new players’ abilities to learn how to play. Alternately, players would stream the gameplay on Twitch, inviting other players to chat, which facilitates open discussion and results in a superior exchange of information compared to in-game communication. Over time, this improvisation of utilizing the streaming channel as an extended tool to facilitate dialogical learning of the gameplay has made the game itself more enjoyable. In this study, we explore how dialogical learning occurs in an MMORPG (i.e. FFXIV) and how it contributes to interactions and engagement within the game by using grounded theory approach. We conduct and analyse interviews of 10 U.S.-based FFXIV players to derive insights that will be beneficial to educators. Although video-based gamification and dialogical learning are not new concepts, they are still rarely implemented; monological structure continues its domination of school curriculums (from elementary to higher education). Through the present study, we want to call for change to this status quo

Transient flow-driven distortion of a nematic liquid crystal in channel flow with dissipative weak planar anchoring

Motivated by the one-drop-filling (ODF) method for the industrial manufacturing of liquid crystal displays, we analyze the pressure-driven flow of a nematic in a channel with dissipative weak planar anchoring at the boundaries of the channel. We obtain quasisteady asymptotic solutions for the director angle and the velocity in the limit of small Leslie angle, in which case the key parameters are the Ericksen number and the anchoring strength parameter. In the limit of large Ericksen number, the solution for the director angle has narrow reorientational boundary layers and a narrow reorientational internal layer separated by two outer regions in which the director is aligned at the positive Leslie angle in the lower half of the channel and the negative Leslie angle in the upper half of the channel. On the other hand, in the limit of small Ericksen number, the solution for the director angle is dominated by splay elastic effects with viscous effects appearing at first order. As the Ericksen number varies, there is a continuous transition between these asymptotic behaviors, and in fact the two asymptotic solutions capture the behavior rather well for all values of the Ericksen number. The steady-state value of the director angle at the boundaries and the timescale of the evolution toward this steady-state value in the asymptotic limits of large and small Ericksen number are determined. In particular, using estimated parameter values for the ODF method, it is found that the boundary director rotation timescale is substantially shorter than the timescale of the ODF method, suggesting that there is sufficient time for significant transient flow-driven distortion of the nematic molecules at the substrates from their required orientation to occur

Mass Segregation in the Globular Cluster Palomar 5 and its Tidal Tails

We present the stellar main sequence luminosity function (LF) of the disrupted, low-mass, low-concentration globular cluster Palomar 5 and its well-defined tidal tails, which emanate from the cluster as a result of its tidal interaction with the Milky Way. The results of our deep (B ~ 24.5) wide-field photometry unequivocally indicate that preferentially fainter stars were removed from the cluster so that the LF of the cluster's main body exhibits a significant degree of flattening compared to other globular clusters. There is clear evidence of mass segregation, which is reflected in a radial variation of the LFs. The LF of the tidal tails is distinctly enhanced with faint, low-mass stars. Pal 5 exhibits a binary main sequence, and we estimate a photometric binary frequency of roughly 10%. Also the binaries show evidence of mass segregation with more massive binary systems being more strongly concentrated toward the cluster center.Comment: 14 pages, 12 figures, accepted for publication in the Astronomical Journa

Semi-natural grasslands in boreal Europe: a rise of a socioecological research agenda

Peer reviewe

Optimizing ExoMars rover remote sensing multispectral science : cross-rover comparison using laboratory and orbital data

PMG, RBS, CRC, and EJA thank the UK Space Agency for support (grant ST/T001747/1). SM acknowledges a UK Science and Technology Facilities Council (STFC) PhD studentship (grant ST/R504961/1).Multispectral imaging instruments have been core payload components of Mars lander and rover missions for several decades. In order to place into context the future performance of the ExoMars Rosalind Franklin rover, we have carried out a detailed analysis of the spectral performance of three visible and near-infrared (VNIR) multispectral instruments. We have determined the root mean square error (RMSE) between the expected multispectral sampling of the instruments and high-resolution spectral reflectance data, using both laboratory spectral libraries and Mars orbital hyperspectral data. ExoMars Panoramic Camera (PanCam) and Mars2020 Perseverance Mastcam-Z instruments have similar values of RMSE, and are consistently lower than for Mars Science Laboratory Mastcam, across both laboratory and orbital remote sensing data sets. The performance across mineral groups is similar across all instruments, with the lowest RMSE values for hematite, basalt, and basaltic soil. Minerals with broader, or absent, absorption features in these visible wavelengths, such as olivine, saponite, and vermiculite have overall larger RMSE values. Instrument RMSE as a function of filter wavelength and bandwidth suggests that spectral parameters that use shorter wavelengths are likely to perform better. Our simulations of the spectral performance of the PanCam instrument will allow the future use of targeted filter selection during ExoMars 2022 Rosalind Franklin operations on Mars.Publisher PDFPeer reviewe

Gambling Harm as a Global Public Health Concern: A Mixed Method Investigation of Trends in Wales

Background: Recent research evidence has suggested that gambling is a public health concern. A number of studies report the association between gambling activity and increased instances of various other harms, including substance misuse and psychological disorders. In parallel to alcohol misuse, it is also becoming clear that gambling related harm is more of a continuum of harm, as opposed to traditionally accepted categorisations of gambling behavior: safe and responsible or “problem” and harmful. Previous effective treatment models for alcohol misuse have considered a public health approach to develop interventions. As such, the current research seeks to use a public health approach to both investigate the extent of gambling harm across Wales, and to identify upstream predictors of harm to inform future interventions. / Method: A triangulation of data collection methods was utilized across Wales, UK. Two hundred and forty-eight participants completed a quantitative survey relating to gambling behavior and related harm, which included the Problem Severity Gambling Index, the Gambling Commission measure of frequency, The Gambling Motives Questionnaire and the Fast Alcohol Screening tool. Ninety-eight of these participants completed a qualitative subsection. Structured interviews were conducted with 20 individuals from 11 service providers. Semi-structured interviews were conducted for the five case studies of individuals who had previously sought help for gambling. The geographical density and distribution of Licensed Gambling Outlets was also mapped in local areas. / Results: The findings provide further evidence of a continuum of gambling related harm. Twenty seven percent of survey participants demonstrate some indicators of risk of gambling harm. Social, cultural and environmental contexts play a role in initiation and maintenance of gambling behavior and the subsequent related harm. Accounts from individuals corroborated the quantitative findings. / Conclusions: Findings from this Welsh sample are in line with and add support to the growing international research evidence that gambling harms are a universal issue that cross cultures. It is clear that action is needed by legislators at a policy level and that broadening the focus of intervention to a public health level is necessary to develop effective strategies for harm reduction

A straw drift chamber spectrometer for studies of rare kaon decays

We describe the design, construction, readout, tests, and performance of planar drift chambers, based on 5 mm diameter copperized Mylar and Kapton straws, used in an experimental search for rare kaon decays. The experiment took place in the high-intensity neutral beam at the Alternating Gradient Synchrotron of Brookhaven National Laboratory, using a neutral beam stop, two analyzing dipoles, and redundant particle identification to remove backgrounds

How do pilot and feasibility studies inform randomised placebo-controlled trials in surgery? : A systematic review

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.Peer reviewedPublisher PD

Optimizing the design of invasive placebo interventions in randomized controlled trials

The authors thank A. Skilton for preparing Fig. 1. This study was supported by the NIHR Biomedical Research Centre at University Hospitals Bristol National Health Service (NHS) Foundation Trust and the University of Bristol, MRC ConDuCT‐II (Collaboration and innovation for Difficult and Complex randomised controlled Trials In Invasive procedures) Hub for Trials Methodology Research (MR/K025643/1) (http://www.bristol.ac.uk/population‐health‐sciences/centres/conduct2), a NIHR senior investigator award (NF‐SI‐0514‐10114) and the Bristol Royal College of Surgeons Trials Centre. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funders played no role in any aspect of the study design, analysis or publication decisions.Peer reviewedPublisher PD